Purpose: The use of simulation has become a routine part of education and training for health professionals in many health education facilities. The increased awareness of patient safety and recent advances in technology are the main incentives to use simulation to teach and evaluate clinical competencies. The primary purpose of this study was to review the best available evidence (level and quality) for the use of simulation training to improve clinical skills, knowledge, and self-confidence among healthcare students. Method: A systematic review of qualitative and quantitative literature published between 2000 and 2016 was undertaken using databases including PubMed, CINAHL®, and PsycINFO® databases as well as three journal collections within ProQuest. In addition to the database search, the literature search for this study included two additional activities: search results were compared against the bibliographies of the reviewed studies, and Google Scholar was used to search the Internet for relevant publications. Data from studies meeting inclusion criteria was extracted and summarized. The level and strength of evidence was rated for each study. Results: Of 1412 studies identified via the search strategy, 30 met the inclusion criteria for this systematic review. A wide variety of study designs, interventions, measurements, and simulation types were represented. Data for study location, health profession, sample size, purpose, simulation type, intervention, and outcome measure are presented via evidence tables by authors. Statistically and/or clinically significant improvements in knowledge, skills, and/or self-confidence following simulation training were reported. Primary and secondary outcomes were identified and summarized. Conclusions: Evidence demonstrates that the use of simulation in student education significantly improves knowledge, skills, and self-confidence. A quality improvement framework of five best practice components for application in simulation research is proposed, generated from the findings of this review. Future research employing high quality research designs focusing on debriefing practices, interprofessional education applications, validation of outcome measures, student satisfaction, and long-term information retention will contribute to the growing body of literature supporting best practices for simulation training in healthcare.

Purpose This study aimed to find out more about the effect of the use of the 1-3-6 early hearing detection and intervention (EHDI) timeline and interprofessional simulation training on audiology and speech-language pathology graduate students' confidence level of knowledge and skills. Method A 1-group pretest–posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills. The mean age for 50 graduate students participating in this study was 25.32 years ( SD = ±3.77, range: 22–37 years). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Three case scenarios represented by standardized parents were developed, and 8 students volunteered to participate in implementing the 1-3-6 EHDI timeline, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each scenario. Participants were asked to rate their readiness for interprofessional education/practice and their satisfaction of the educational experience after the last case scenario. Results Overall, the pre- and postsimulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels in knowledge and skills. The mean difference between pre- and postevent scores was 0.78 ( p < .01). The mean interprofessional learning was 2.13 (range: 1.16–2.57, SD = ±0.24) based on a Likert scale, where 1 = strongly agree and 5 = strongly disagree . The mean satisfaction level was 4.37 (range: 3.94–4.72, SD = ±0.24) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied . Conclusions The results demonstrated the value of using interprofessional simulation training among audiology and speech-language pathology students to improve their confidence in knowledge and skills. The curriculum developed in this study for the 1-3-6 EHDI timeline provides resources for educators in both professions and other related professions.

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Congenital hearing loss has been commonly reported as a significant health problem. Lost to system (LTS) is a major challenge facing newborn hearing screening (NHS) programs. This retrospective cross-sectional descriptive study aimed to determine the referral and LTS rates after the two-stage NHS based on transient evoked otoacoustic emissions (TEOAEs) in two main hospitals in Riyadh, Saudi Arabia (SA). NHS was performed on newborns before hospital discharge. Newborns were only rescreened if NHS initially revealed a fail/refer outcome in one or both ears. Those who failed the first and second screenings or had risk factors were referred for auditory brainstem response (ABR) testing to confirm or exclude hearing loss. In total, 20,171 newborns (40,342 ears; 52% males; 48% females) were screened, of whom 19,498 (96.66%) passed the initial screening, while 673 (3.34%) failed. Of the 673 newborns, 235 (34.92%) were LTS, and 438 (65.08%) were rescreened, of whom 269 (61.42%) failed and were referred for a comprehensive audiological assessment to confirm the existence of hearing loss. The referral rate after the initial two-stage screening was equal to 1.33%. The lack of awareness of the importance of NHS among parents seems to be the major cause behind the LTS rate. The stakeholders have to work efficiently to reduce the LTS rate.

The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.