Sok Ying Liaw

• PhD in Health Professional Education
• National University of Singapore

Background Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients. Objective The objective of this study was to describe the development of the virtual patient sim...

Background: Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. Aim: The aim of the study is to describe the development, implementat...

A simulation program was implemented in a pre-registration nursing curriculum for developing nursing students' performances in assessing, managing and reporting in relation to patients with physiological deterioration. To explore nursing students' experiences of how a simulation programme has prepared them to transfer their performance to clinical...

This article is a report of a study which developed and tested the validity and reliability of the RAPIDS-Tool to measure student nurses' simulation performance in assessing, managing and reporting of clinical deterioration. The importance for nurses to recognize and respond to deteriorating patients has led educators to advocate for increasing use...

To describe the development, implementation and evaluation of an undergraduate nursing simulation program for developing nursing students' competency in assessing, managing and reporting of patients with physiological deterioration. A full-scale simulation program was developed and implemented in a pre-registered nursing curriculum. A randomized co...

Background Live-in migrant caregivers have been employed in various developed countries to meet the growing demands of long-term care needs for older adults. Increasingly, nurses in these countries are involved in providing caregiving training to these live-in migrant caregivers. A comprehensive understanding of the caring experiences of these live...

Background: Final year nursing students may experience higher levels of stress owing to the increasing complexity and expectations from their clinical practicums. Enhancing psychological readiness may be a potential strategy to enhance nursing students' transition to the clinical area. Objective: To evaluate the effects of a psychological readiness...

Background: Virtual reality-reminiscence therapy (VR-RT) has increasingly been applied to older adults to improve psychological well-being and cognition. Objective: This review aims to identify (1) the design characteristics of conducting a VR-RT and (2) the effects of VR-RT on the user experience, cognitive outcomes and psychological well-being. D...

Background Given nurses’ increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncov...

Aim The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home‐based care (HBC) nurses' competencies. Design A hybrid systematic narrative review was performed. Review Methods The eligible studies were reviewed to identify the competencies measured by the instruments...

Background: Non-cognitive skills are crucial for nursing students to achieve their academic performance successfully and perform clinical practice effectively. Although different non-cognitive assessment tools have been established in various disciplines, few are focused on nursing students. Objective: The study aims to develop and psychometrically...

Objectives: This study explores interprofessional collaboration amongst healthcare professionals in patient education. Methods: A systematic review was conducted. A search in seven databases was conducted from 2011 to 2022 and screened against the inclusion criteria. Quality appraisal was done independently by two reviewers. Studies were extract...

Background: Widespread and sustained adoption of telemedicine in long-term residential care is emerging. Nursing home (NH) nurses play a key role in collaborating with remote physicians to manage residents' medical conditions through videoconferencing. Therefore, understanding of interprofessional collaboration and effective communication between...

Background The maintenance of nursing professional competency is essential to ensure patients’ health outcomes. With the current shortage of nursing workforce, a novel approach is necessary to refresh clinical skills and update practice. Objective This study aims to examine the effectiveness of using head-mounted display virtual reality to refresh...

Aim: To understand the issues surrounding collaborative practice and collaboration experiences among general ward staff in the escalation of care for clinically deteriorating patients. Design: A systematic synthesis without meta-analysis. Review methods: Seven electronic databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, Scopus and ProQues...

Aim: To explore general ward nurses' attitudes and perceptions towards recognising and responding to clinical deterioration in a hospital with automated rapid response system activation. Background: There is growing interest in deploying automated clinical deterioration notification systems to reduce delayed or failed recognition and response to...

BACKGROUND Interprofessional communication is needed to enhance the early recognition and management of patients with sepsis. Preparing medical and nursing students using virtual reality simulation has been shown to be an effective learning approach for sepsis team training. However, its scalability is constrained by unequal cohort sizes between me...

Background Interprofessional communication is needed to enhance the early recognition and management of patients with sepsis. Preparing medical and nursing students using virtual reality simulation has been shown to be an effective learning approach for sepsis team training. However, its scalability is constrained by unequal cohort sizes between me...

Background: Virtual reality simulations are shown to be an effective approach for interprofessional nurse-physician communication training. However, its scalability is constrained by unequal medical-nursing cohort size, rendering a great challenge for all nursing students to form an interprofessional team with medical students. With the evolution...

Objectives: To provide a comprehensive overview on the utilization and effectiveness of telesimulation in healthcare education. Design: A scoping review. Data sources: A search of five databases including PubMed, Web of Science, Cochrane, EMBASE and ProQuest was conducted between 2000 and 2022. Review methods: Arksey and O' Malley's scoping...

BACKGROUND The capacity of healthcare professionals to perform clinical procedures safely and competently is crucial as it will directly impact patients’ outcomes. Given the ability of the head-mounted virtual reality to simulate the authentic clinical environment, this platform would be suitable for nurses to refine their clinical skills for knowl...

Background: There has been an increase of mid-career professionals joining nursing. These adult students possess significant expertise in other areas and may benefit substantially in deliberate practice to acquire skills competency using immersive virtual reality (IVR) for clinical procedures before they practise in actual clinical settings. Obje...

Background Nurses play a major role in facilitating teleconsultations in nursing homes with remote physicians. Currently, evidence explicating their role in teleconsultations is lacking. As telemedicine usage grows, understanding the factors that enable or impede nurses’ role in teleconsultations allows for more support in the provision of patient...

Background Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthc...

Background: Collaboration between academic institutions and clinical practice plays an important role in supporting students' learning in clinical practice. A virtual telesimulation was incorporated to provide academic-practice collaboration between academic educators and nurse preceptors to support students' clinical education. Purpose: The pur...

Background: Noncognitive skills have a considerable role in influencing nursing students’ performance in clinical and educational settings. Understanding how nursing students and educators perceive noncognitive skills is important given the broad classifications of noncognitive competencies. Objective: This study sought to examine nursing students’...

Background The COVID-19 pandemic has given rise to more virtual simulation training. This study aimed to review the effectiveness of virtual simulations and their design features in developing clinical reasoning skills among nurses and nursing students. Method A systematic search in CINAHL, PubMed, Cochrane Library, Embase, ProQuest, PsycINFO, and...

Background: Simulation-based mastery learning (SBML) was developed and implemented to facilitate nursing students' transition to clinical practice. Purpose: To evaluate nursing students' perspectives on the impact of SBML on their transition to clinical practice. Method: A descriptive qualitative study using focus group discussions was conduct...

Rapidly ageing populations are putting a strain on healthcare due to their increasing chronic conditions and complex comorbidities. Community care is an important part of the healthcare system and community healthcare workers are under pressure to care for the growing ageing population. It is crucial to recruit healthcare workers in community care...

Aim To explore home-based care nurses’ practice experiences in order to understand their competency and needs. Background The demand for home-based care is increasing in many countries. Nurses performs a broader range of competencies with a significant degree of independence in home-based care. However, little is known about nurses' day-to-day exp...

Aims and objectives: To develop and evaluate the psychometric properties of an instrument that measures nurses' Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND). Background: General ward nurses play an important role in recognising patient deterioration. However, their attitudes towards early recognition of clinical dete...

Aim To evaluate the effectiveness of an online program on nurse preceptors’ knowledge and self-efficacy in their roles to support students’ clinical education, and to examine their online experience. Background Professional development of nurse preceptors is paramount to fostering work readiness of future graduate nurses on entering the workforce....

Background Improving interprofessional communication and collaboration is necessary to facilitate the early identification and treatment of patients with sepsis. Preparing undergraduate medical and nursing students for the knowledge and skills required to assess, escalate, and manage patients with sepsis is crucial for their entry into clinical pra...

Objective This review aimed to synthesise evidence from experimental studies of the application of digital serious games in developing nursing clinical competence. Design Systematic review and meta-analysis. Data sources Eight databases were searched for randomized controlled trials and quasi-experimental studies published in English from 2000 to...

Background The Objective Structured Clinical Examination (OSCE) is widely used in nursing education, but its implementation is costly and resource intensive, potentially limiting its feasibility. A five-station OSCE was designed to replace a previously validated 12-station OSCE but was not evaluated for its psychometric properties. Purpose This st...

Background Sepsis is an important global healthcare problem that is a key challenge faced by healthcare professionals face worldwide. One key effort aimed at reducing the global burden of sepsis is educating healthcare professionals about early identification and management of sepsis. Aim To provide a comprehensive evaluation of sepsis education a...

Background The development of interprofessional competencies through an evidence-based program is paramount to nurture a collaborative practice-ready workforce for patient-centered care and safety. Aims To describe an implementation science approach for translation of an evidence-based virtual reality simulation-based interprofessional education (...

Abstract Aims and objectives: To identify and consolidate the available evidence about nursingrelated competencies for home-based care. Background: Over recent years, the demand for home-based nursing care has increased because of the need to meet the increasing need for chronic disease care to be delivered in patients' homes. However, knowledge is...

Objectives The incidence of stroke is on the rise among younger adults. Stroke educational campaigns are often used to raise public knowledge of stroke warning signs and response actions, but their effectiveness in non-elderly adults is unclear. This study investigated the effectiveness of stroke campaigns in improving stroke symptom recognition an...

BACKGROUND Improving interprofessional communication and collaboration is necessary to facilitate the early identification and treatment of patients with sepsis. Preparing undergraduate medical and nursing students for the knowledge and skills required to assess, escalate, and manage patients with sepsis is crucial for their entry into clinical pra...

Background Nursing home nurses are pivotal in recognising resident deterioration and initiating the decision-making process on resident transfer to emergency departments. However, their decisions have not been adequately explored in the Asian context which places a strong emphasis on family connection and has a longstanding history of considering e...

COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer during the COVID-19 pandemic, the role o...

Background In an age disrupted by COVID-19 pandemic, three-dimensional virtual world (3DVW) offers an opportunity for healthcare students from different higher education institutions to participate in interprofessional education. Despite its growing evidence, there is a need to unravel the complex learning process in order to ensure high quality of...

Background: Nurses' role in vital signs monitoring places them in an ideal position to recognise and respond to clinical deterioration in general wards. However, enrolled nurses (ENs) and registered nurses (RNs) do not always work collaboratively, and this can lead to delays in recognition and escalation of clinical deterioration in general wards....

Background Physical assessment skills are taught in pre-registration nursing programs to equip nurses with the competencies to provide holistic nursing care. However, only a fraction of the skills they acquired during training are routinely performed in clinical practice thus highlighting a disconnect between learning and practicing. Objective To...

Academic‐practice collaborations between academic educators and preceptors are important to ensure the success of clinical education. This study explored the perceptions of academic educators and preceptors on their collaborations in a transition‐to‐practice program for nursing students. A qualitative exploratory study was undertaken with a purposi...

Background Validated measures of ward nurses' safety cultures in relation to escalations of care in deteriorating patients are lacking. Objectives This study aimed to develop and evaluate the psychometric properties of the Clinicians' Attitudes towards Responding and Escalating care of Deteriorating patients (CARED) scale for use among ward nurses...

Aim This study aimed to examine the perceived level of nursing teamwork and factors influencing teamwork among enrolled nurses (ENs) and registered nurses (RNs) in general ward settings. Background The nursing care delivery model includes RNs, ENs and others who work as a team to deliver patient care. The potential impact of teamwork on nursing ca...

Background Interprofessional rounds are increasingly applied in providing patient-centered team care delivery. Students from six health care courses in medicine, nursing, pharmacy, physiotherapy, occupational therapy, and social work formed interprofessional teams to undertake an interprofessional education (IPE) on virtual reality simulation–based...

Aim: To explore the different levels of nurses' perspectives in the delivery of patient education in postoperative care. Background: Patient education is a frequently reported missed nursing care and can lead to postoperative complications and hospital readmissions. Method: Descriptive exploratory qualitative study involving eight focus groups...

This capsule commentary, Capsule Commentary on Liaw et al., "Getting everyone on the same page": interprofessional team training to develop shared mental models on interprofessional rounds," was to have accompanied the article, DOI: https://doi.org/10.1007/s11606-019-05320-z, which appeared in the December 2019 issue.

BACKGROUND Interprofessional team training is needed to improve nurse-physician communication skills that are lacking in clinical practice. Simulation has been proved to be an effective learning approach for team training. Yet, it has logistical constraints that called for the exploration of virtual environments in delivering team training. OBJECT...

Background: Interprofessional team training is needed to improve nurse-physician communication skills that are lacking in clinical practice. Using simulations has proven to be an effective learning approach for team training. Yet, it has logistical constraints that call for the exploration of virtual environments in delivering team training. Obje...

Background: With Singapore facing an ageing population, there is an increase demand in healthcare. Nurses would have to shoulder a heavier workload, inflating the risk of error-making or omitting nursing care. Effective nursing teamwork brings about potential to offset these shortcomings. Despite the benefits, little is known regarding nursing team...

Aim: To explore the perceptions of Registered Nurses (RN) and Non-Registered Nurses (Non-RN) on factors affecting nursing teamwork in the general ward setting. Background: Missed nursing care is a prevalent problem among patient care all over the world. Previous studies identified nursing teamwork as a massive contributor to the occurrence of mis...

Aim This study aimed to evaluate the effect of a team training program to support shared mental model (SMM) development in interprofessional rounds. Design and Participants A three-arm randomized controlled trial study was conducted for interprofessional teams of 207 health profession learners who were randomized into three groups. Program Descri...

Preparing healthcare students for community care has been emphasised due to the global ageing population. An instrument to measure students’ community care competency is lacking. This study aimed to develop and evaluate the psychometric properties of a new scale known as Community Care Competency Scale (CCCS) for measuring nursing students’ communi...

Background: Collaborative learning in interprofessional team care delivery across different healthcare courses and institutions is constrained by geographical locations and tedious scheduling. Three dimensional virtual environments (3D-VE) are a viable and innovative tool to bring diverse healthcare students to learn together. Aim: The aim of th...

Background: Singapore's nursing services and education need to keep pace with the ever-changing healthcare landscape and international trends in nursing capability development. Aims: To examine the development of Singapore's nursing education and to propose recommendations for its future development. Sources of evidence: This discussion paper...

Introduction: The Rapid Response System for recognising and responding to clinically deteriorating patients has been progressively implemented in acute care hospitals across the globe. This study sought to review the implementation of this system in acute public hospitals in Singapore. Methods: A cross-sectional study using a face-to-face survey...

Background: The ageing population and the changing disease profile have been driving the demand for community nurses. However, few nursing students in Singapore aspire to have a career in community nursing following graduation. Objectives: To explore undergraduate nursing students' perceptions of a career in community nursing and to identify str...

Background: With the availability and capabilities of varied technologically enhanced learning activities, the blended learning approach has become increasingly popular in interprofessional education. The combined use of different technologically enhanced learning activities has not been fully examined, particularly to determine the effects of ins...

Background: The implementation of early warning scoring systems and medical emergency teams that aim to reduce failure to rescue in general wards is only effective if frontline nurses can recognize and act on clinical deterioration in a timely manner. While much of the research to date has primarily focused on registered nurses as recognizers of c...

Background: Despite the widespread implementation of medical emergency teams (METs) in hospitals to provide immediate interventions to deteriorating ward patients, little is known about how junior doctors and nurses escalate care for deteriorating ward patients in hospitals with established MET services. Objectives: The objective of this researc...

Interprofessional bedside rounds by nurses and physicians provide valuable space and time for the discussion of patient care, which is essential for providing quality care. However, nurse-physician collaboration and barriers to attending these rounds are not well-examined. This study aimed to examine the collaboration of nurses and physicians and t...

OBJECTIVE: To describe the development and evaluation of a nurse-patient interactive serious game in improving nurses' self-efficacy and performances in teaching the correct inhaler technique. MATERIALS AND METHODS: The technology, pedagogy, and content knowledge (TPACK) framework was applied to guide the development of the serious game. The learn...

BACKGROUND With the availability and capabilities of varied technologically-enhanced learning activities, the blended learning approach has become increasingly popular in interprofessional education. The combined use of different technologically-enhanced learning activities has not been fully examined, particularly on the effects of instructional s...

Background The use of multiuser virtual worlds (MUVWs) for collaborative learning has generated interest among healthcare educators. Published evidence to support its use is growing, but none has synthesized the evidence to guide future work. Objective This study sought to provide a comprehensive and systematic evaluation of MUVWs in healthcare ed...

Background: Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career c...

Background: The effectiveness of educational interventions for osteoarthritic patients undergoing total joint arthroplasty remains inconclusive. It is essential to understand the educational needs of these patients from their perspectives. Aim: The aim of this study was to systematically summarize and synthesize osteoarthritic patients' expectation...

Purpose: To synthesize factors influencing the activation of the rapid response system (RRS) and reasons for suboptimal RRS activation by ward nurses and junior physicians. Data sources: Nine electronic databases were searched for articles published between January 1995 and January 2016 in addition to a hand-search of reference lists and relevan...

Introduction: Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CP...

Aims and objectives: To evaluate the effectiveness of a Web-based educational program to enhance enrolled nurses' knowledge and skills in the recognition and management of deteriorating patients. Background: Ward nurses of different skill levels play a pivotal role in detecting and responding to deteriorating patients. A skill mix of registered...

Background A mental rehearsal (MR) strategy using standardized patients was implemented for third-year nursing students in a simulation training on clinical deterioration. The study aimed to evaluate its efficacy, by comparing with a conventional approach using a mnemonic strategy with mannequin simulation, for improving the nursing students' perfo...

Background With the availability of more healthcare courses and an increased intake of nursing students, education institutions are facing challenges to attract school leavers to enter nursing courses. The comparison of career choice influences and perception of nursing among healthcare students can provide information for recruitment strategies. A...

Background: Due to the ageing population and competition from other healthcare courses, a greater demand in the healthcare workforce has made it challenging for educational institutions to attract school leavers to enter nursing courses. Understanding the considerations of students who have chosen non-nursing healthcare courses and their perceptio...

Introduction There is an international interest for optimising nursing performance in detecting and responding to deteriorating patients. Aim To explore nurses’ perspective of a web-based educational program on their clinical practice in recognising and responding to deteriorating ward patients. Methods This study used an exploratory descriptive...

Background: Internationally, and particularly in Singapore, health education institutions are facing challenges in attracting school leavers to enter nursing courses. Objectives: To identify the factors influencing the career choice of Singaporean healthcare students and determine the deterrents in choosing nursing as a career choice. Design:...

Introduction Simulation training has been used to teach clinical skills to health profession trainees. Stress and/or anxiety occur in high-acuity scenarios in the clinical environment, and affect clinician performance and patient outcomes. To date, strategies that have been used in conjunction with simulation training for healthcare professionals t...

Background: Nurses play an important role in detecting patients with clinical deterioration. However, the problem of nurses failing to trigger deteriorating ward patients still persists despite the implementation of a patient safety initiative, the Rapid Response System. A Web-based simulation was developed to enhance nurses' role in recognizing a...

Background Compression-only cardiopulmonary resuscitation (CPR) has been advocated as a preferable approach for bystanders in an out-of-hospital cardiac arrest (OHCA) event as it has been associated with an increased chance of survival. The elimination of mouth-to-mouth ventilation also addresses some of the barriers to performing CPR. The aim of t...

Aim: To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). Background: Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessme...

Background: In recent years, increasing emphasis has been placed on the importance of collaboration within multi-disciplinary healthcare teams, so as to facilitate holistic patient care and thus allow improved treatment outcomes. There is hence an urgent need to educate healthcare undergraduates early in their professional careers on the importanc...

Background: A global shortage of healthcare professionals calls for effective recruitment and retention strategies. The nursing profession faces greater staffing shortages compared with other healthcare professions. Identifying these factors for choosing a career in health care is an important step in structuring future nursing recruitment strateg...

Background: Mental rehearsal is a form of mental training that has been used by physicians and nurses to improve performance of clinical skills, and as a vital component of stress management training. To help novice nurses deal with often stressful clinical events that require the processing of information essential to patient management, a mental...

Commentary on : Osborne S, Douglas C, Reid C, et al. RBWH Patient Assessment Research Council. The primacy of vital signs—acute care nurses’ and midwives’ use of physical assessment skills: a cross sectional study. Int J Nurs Stud 2015;52:951–62.[OpenUrl][1][CrossRef][2][PubMed][3] Existing track and trigger models that improve early recognition a...