Suzie Kardong-Edgren

MGH Institute for Health Professions

Cultural competence is one component of effective communication between patients, families and healthcare professionals. Tools to assess physicians’ clinical cultural competencies need validity evidence. This paper describes Lawshe’s method for determining the Content Validity Index (CVI) for the Clinical Cultural Competence Questionnaire (CCCQ) fo...

Accepted for publication.

Background Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities. Methods This mixed‐methods analysis of an educational interv...

(1) Background: Integrated standardized patient examinations (ISPEs) allow students to demonstrate competence with curricular learning and communication. Digital recordings of these experiences provide an objective permanent record, allowing students to review and improve their performance. Although recordings have been utilized as a tool in physic...

Background: Workplace incivility poses a threat to patient safety. This intervention pilot study used simulation and biomarker data with newly graduated nurses to explore the impact of incivility on patient care and tested whether cognitive rehearsal could mitigate the effects of workplace incivility. Method: A clinical scenario and script were...

In 2016, the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) launched a Continued Professional Certification (CPC) Program to promote lifelong learning and to facilitate ongoing professional competency checks for practicing certified registered nurse anesthesiologists (CRNA). The use of simulation-based assessmen...

Background In the simulation community, colleagues who are no longer clinically practicing were often proximal to the COVID-19 response, not working in the frontlines of patient care. At the same time, their work as simulationists changed dramatically or was halted. This research explored the experiences of those simulationists who have clinical ba...

Abstract Background The coronavirus pandemic continues to shake the embedded structures of traditional in-person education across all learning levels and across the globe. In healthcare simulation, the pandemic tested the innovative and technological capabilities of simulation programs, educators, operations staff, and administration. This study ai...

Background The use of pictures or art-cards during debriefing may help deepen self-reflection and add a new unexplored dimension to simulation. Purpose This study evaluated the use of art-cards (various interesting pictures attached to 6 × 8 file cards) to help nursing students with their reflections on their “clinical take home” learning. Researc...

Objectives Bibliometrics is an emerging science in nursing. Quantitative methods were used to conduct a bibliometric analysis of highly cited virtual simulation nursing education articles to describe rank order, breadth of topics and authorship patterns. Design and data sources A desktop analysis of publication performance was conducted using the...

The COVID-19 pandemic has sparked radical shifts in the ways that both health care and health professions education are delivered. Prior to the pandemic, some degree programs were offered fully online or in a hybrid format, but in-person learning was considered essential to the education and training of health professionals. Similarly, even as the...

Background: Educators agree that clinical experiences are vital to the development of a graduate nurse; however, there is little research on student learning outcomes related to these experiences. Purpose: The purpose of this systematic review was to examine qualitative studies of student learning in traditional clinical models. Methods: A sys...

Background: Nurse educators expanded replacement of traditional clinical practice and face-to-face simulation experiences with screen-based simulation (SBS) during the COVID-19 (coronavirus disease 2019) pandemic. Purpose: The purpose of this research was to understand the student experience when learning in 3 types of clinical education environ...

Clinical learning environments provide a cultural milieu in which the work of nursing occurs. Each clinical site presents a unique place for learners to practice (Irby, 2018). Learning environments have established patterns of interacting with learners and educators in a “social and cultural climate as well as the organizational structures and phys...

The COVID-19 pandemic demanded rapid change in health care education, moving many students to online learning. It is important to examine how this shift affected both student perceptions of learning and achievement of learning outcomes. Snowball sampling strategy was used to reach and recruit nursing students, who had shifted to online learning dur...

Background Many learners are observers and do not directly participate in the care for a simulated patient. Immersive telepresence technology makes it possible to don virtual reality goggles, giving learners their own vantage point, making them feel present in the room. Methods A multisite quasi-experimental design was used to explore differences...

The physical requirements mandated by the COVID-19 pandemic have presented a challenge and an opportunity for simulation educators. Although there were already examples of simulation being delivered at a distance, the pandemic forced this technique into the mainstream. With any new discipline, it is important for the community to agree on vocabular...

Introduction: The study examined how the spacing of training during initial acquisition of cardiopulmonary resuscitation (CPR) skill affects longer-term retention and sustainment of these skills. Methods: This was a multiphased, longitudinal study. Nursing students were randomly assigned to 2 initial acquisition conditions in which they complete...

Background: Effectiveness of traditional apprenticeship models used in undergraduate nursing education has been questioned in the literature for over 50 years. This systematic review aimed to examine best evidence available upon which to base decisions regarding use of traditional clinical experience with prelicensure nursing students. Method: A...

Faculty and nursing professionals participated in a usability study of a second-generation Virtual Reality Sterile Urinary Catheter Insertion Game (VR SUCIG). Background: Faculty are key decision makers in acquiring technologies that lead to learning and retention of psychomotor skills in nursing. Methods: Fourty-six nursing faculty and professiona...

A usability study of a Virtual Reality Sterile Urinary Catheter Insertion Game (VR SUCIG) was conducted to understand user needs in regards to this game. Background Learning and retention of psychomotor skills in health care is essential to safe clinical practice. Bauman suggests games are most useful when they are part of a layered-learning appro...

Academic leaders in nursing have invested vast resources such as dedicated space, technology, and facilitator education to support their simulation centers. In order to maximize return on investment, one school of nursing and health sciences conducted external leadership training for corporate business mid-level managers utilizing the expertise of...

This article reports the results of baseline cardiopulmonary resuscitation (CPR) skills performance measurements from 467 nursing students. All participants had completed a CPR course. Baseline measurements were compared to performance after one 10-minute refresher training session on the Resuscitation Quality Improvement system. Significant improv...

Aim Although evidence supports brief, frequent CPR training, optimal training intervals have not been established. The purpose of this study was to compare nursing students’ CPR skills (compressions and ventilations) with 4 different spaced training intervals: daily, weekly, monthly, and quarterly, each for 4 times in a row. Methods Participants w...

Simulation as an evidence-based pedagogy began emerging at a time when many constraints were being imposed on clinical experiences for nursing students. As research illuminated the advantages of simulation and standards were developed, educators began to recognize the limitations of the clinical setting, such as the inability to provide experiences...

Fifteen simulation specialists met at Columbia University School of Nursing on October 12, 2018, for an interprofessional summit on innovations in simulation. Three successive panels focused on the future of simulation-based education, latest trends in simulation research, and linking simulation to improved patient safety outcomes. Discussions foll...

A 2‐year long, multisite research study that evaluated cardiopulmonary resuscitation skill decay among nursing students was conducted at 10 schools of nursing across the United States. The study was conducted in two phases and required carefully timed sessions for skill performance. Multisite studies in nursing education need to be carefully planne...

This article describes the evolution of a hospice simulation over time. Based on student evaluations and faculty observations, a manikin-based simulation was converted to a standardized patient simulation, and videos of faculty performing the scenarios and modeling caring behaviors were developed. As their “ticket into class,” students wrote a brie...

: Once considered solely as an educational tool in undergraduate education, simulation-based education (SBE) now has many uses. SBE is now embedded in both graduate and undergraduate nursing education programs and has become increasingly accepted practice in hospital orientation and transition-to-practice programs. Newer applications include ongoin...

This chapter provides guidance to healthcare simulation technology specialists (HSTS) regarding professional development and career advancement. The traditional academic degrees required for a career in simulation technology as well as avenues for advancement via certification programs are reviewed. Organizational memberships, website resources, ma...

Background New nursing graduates rarely achieve practice-ready competency in reporting critical information to other health care professionals. Methods This experimental group comparison study used an online asynchronized simulation intervention based on deliberate practice incorporated with mastery learning to explore the impacts on students’ cri...

Background: Clinical experience is an important component of nursing education that is largely managed by clinical educators. While highly competent clinicians, clinical educators may not have training or expertise in education and be ill-prepared to frame constructive feedback or manage performance issues. Of concern is the increase in the frequen...

Background: Recognition is increasing that many psychomotor skills essential for safe nursing practice are not being retained. New theories and methods are emerging that, when applied in an organized pedagogical model, could influence initial learning and the retention of critical psychomotor skills. Method: This article explains and applies eme...

Virtual reality (VR) will be widely adopted by nursing within the next five years as a simulation method. The confusion generated by the various emerging definitions of VR led to the authors to review various definitions and to make a recommendation for the use of the concepts immersion and presence as a way to define VR.

Background: There is limited evidence comparing the clinical and simulation environments. Methods: This multicenter observational study compared traditional clinical to simulation on the type, number, and level of educational activities as determined by Miller's Pyramid. Results: Forty-two students’ experience revealed that skills, physical assessm...

Communicating with healthcare providers is a core tenant in the Quality and Safety Education for Nurses and Institute of Medicine teamwork and collaboration competency but remains a major concern for pre-licensure nursing students and novice nurses. Pre-licensure nursing students rarely have opportunities to practice interprofessional communication...

Background: Virtual reality (VR) allows risk- and anxiety-free practice, mediated by consistent objective feedback. Purpose: This study evaluated the usability of a VR game system for sterile catheterization practice. Participant enjoyment, engagement, likelihood to practice, and comfort using VR are reported. Methods: Thirty-one students and...

The 2016 INACSL Professional Integrity Standard presented a major change in sharing of performance information. This article presents arguments for and against the sharing of clinical performance information along with audience perspectives from presentations at both the INACSL and SSH conferences.

Background Faculty workload calculations are not designed to capture nursing simulation faculty workload. The purposes of this literature review were to gather available determinants of simulation faculty workload in the existing literature and to propose a nascent simulation faculty workload model. Method Scholarly databases were searched and syn...

Background Nurse educators are challenged to find innovative methods to help nursing students develop and remember fundamental skills while ensuring patient safety. Virtual reality (VR) headgear and custom haptic technology combined with game-based learning principles may provide an innovative approach to promoting mastery learning and retention....

One-size-fits-all fixed calendar date approaches to training have proven to be inadequate across an array of domains and contexts, and in the medical field specifically, many studies document that skills deteriorate as early as two months after training (e.g., Madden, 2006; Woollard et al., 2006). Given the individual differences learners inherentl...

Background Simulation practice evaluation has evolved from self-reports of indirect measures such as learner satisfaction and confidence to more direct measures of learning and performance improvement. There is a need for psychometrically tested instruments to document direct learner outcomes. Methods This article describes the history, development...

Aim: This article reports one method to develop a standardized training method to establish the inter- and intrarater reliability of a group of raters for high-stakes testing. Background: Simulation is used increasingly for high-stakes testing, but without research into the development of inter- and intrarater reliability for raters. Method: E...

The teaching of psychomotor skills in schools of nursing and medicine has remained basically unchanged for the past 50 years despite known problems with inconsistent teaching, testing, and retention of critical foundational skills. Add to this, prolonged periods of non-use of certain skills known as retention intervals, and there is bound to be los...

Background This article describes one simulation center's logistical planning experience as it consolidated three small simulation and skills areas in tree buildings into one brand new building and space. Method Six months of planning and packing are described with enough detail that the ideas can be duplicated by others. Results The contents of th...

The aim of this study was to explore the feasibility of developing scenarios for high-stakes evaluation of students' clinical performance. We used video recordings of graduating nursing students performing in these scenarios. This article shares the findings of the study and challenges we encountered with using simulation for high-stakes evaluation...

Simulation has offered a practical means to train and rehearse clinical skills for many years. Simulated environments, patients, and related technologies have been used to develop, validate, and maintain a wide range of clinical skills across numerous clinical specialties. In the past 30 years, the field has truly thrived, as evidenced in rapidly e...

Simulation has offered a practical means to train and rehearse clinical skills for many years. Simulated environments, patients and related technologies have been used to develop, validate and maintain a wide range of clinical skills, across numerous clinical specialties. In the past 30 years, the field has truly thrived—as evidenced in rapidly evo...

Background: Summative simulated-based assessments are intended to determine students' competence in practice. These assessments need to be carefully designed and implemented especially when the results are used to make high-stakes decisions. Method: Critical steps need to be followed to design simulations for summative assessment, ensure the val...

Background: The National Council State Boards of Nursing (NCSBN) Simulation Study has generated increased conversation about the use of simulation in nursing education. Method: At the 14th Annual International Nursing Association for Clinical Simulation and Learning (INACSL) conference in Atlanta Georgia, a panel discussed the results and significa...

The National Council of State Boards of Nursing (NCSBN) published the results of the largest, most comprehensive study to date concerning the use of simulation as a substitute for traditional clinical experience. Results of the study, which were published in 2014, demonstrated that high-quality simulation experiences could be substituted for up to...

The Angoff method is a commonly used and legally defensible method for setting passing or cut scores for high-stakes examinations. It also can be used for setting passing scores on clinical skill checklists. Two variations of the Angoff method were compared with a traditional and arbitrary 75% passing score, using a Foley catheter insertion checkli...

Aim: This project was designed to explore the feasibility of using simulation for high-stakes assessment in pre-licensure RN programs. Method: A think tank of experts recommended simulation scenarios suitable for assessing students at the end of their program. Two teams were formed: one to design the simulations, the other to develop the evaluat...

It is unclear whether traditional lecture followed by simulation leads to the best learning and knowledge and skill retention over time. A 3×4 mixed design study used three modes of education-traditional lecture with self-guided learning, expert modeling/dual viewing with brief questioning, and expert plus self-modeling-at four time points to compa...

Nursing programs are seeking guidance from boards of nursing about how much simulation can be substituted for traditional clinical practice. To address this question and to assess educational outcomes when simulation is substituted for clinical time, the National Council of State Boards of Nursing (NCSBN) conducted a study using 10 nursing schools...

This article compares the International Nursing Association of Clinical Simulation and Learning (INACSL) memberships' thoughts and discussions about the use of simulation for high- stakes evaluation in nursing education to a similar town hall discussion, five years ago. Data on the topic of high-stakes testing were collected through a survey before...

Standards are created by experts within a discipline and reflect best practice. The International Association for Clinical Simulation and Learning (INACSL) developed the first set of published Standards for Best Practice: Simulation in 2011, and added guidelines in 2013. The INACSL Standards serve as a framework for providing simulation-based educa...

Drawing from seminal articles on the topic, this chapter provides researchers with a comprehensive overview of suggestions related to the use of simulation in health care. Ideas for research studies, theoretical models to help guide and strengthen research questions and concepts, building a research team, designing a study, recruiting subjects, int...

The theory of deliberate practice for mastery learning is well known and widely used in music and sports. Medical faculty are embracing this theory but it remains nascent in nursing education. DP is built around the concepts of well-defined goals, immediate feedback, reflection on practice, and frequent continued opportunities for practice. We will...

Aim: The Creighton Competency Evaluation Instrument (CCEI) was modified from an existing instrument, the Creighton Simulation Evaluation Instrument, for use in the National Council of States Boards of Nursing National Simulation Study (NCSBN NSS). Background: The CCEI was developed for the NCSBN NSS for use as the evaluation instrument for both...

How long should a simulated scenario last? Little literature exists, and what does exist, offers unsubstantiated opinions on the optimal timeframe. The authors of this article discuss the merits of both short scenarios, scenarios-defined as <30 minutes; and long scenarios-defined as >l30 minutes. Advantages and disadvantages of both types of scenar...