Simulation is an essential component of healthcare education as it enables educators to replicate clinical scenarios in a controlled learning environment. Simulation has traditionally been conducted in-person through the use of manikins, however, the COVID-19 pandemic has challenged the practice of manikin simulation. Social distance constraints were enforced during the pandemic to reduce the potential spread of the virus and as a result, many educators and students were denied physical access to their universities' simulation facilities. Healthcare educators sought remote alternatives to manikin simulation and many resorted to instructional videos to educate their learners. While the use of videos increases safety, passively watching videos lacks interactivity which is an important component of simulation learning. In response to these challenges, we developed an interactive video simulation software that uses educators' existing video content to conduct a simulation remotely, thereby promoting safety during the pandemic while also meeting the interactivity standards of best practice for healthcare simulation. In this paper, we compare the interactive video simulation to the current practice of watching non-interactive video of a simulation using the same content. We found that interactivity promotes higher order learning, increases teamwork and enhances the perception of authenticity. Additionally, the majority of participants demonstrated positive reception of the interactive simulation. The simulation software provides the safety desired of a remote simulation during the pandemic while also engaging students in interactive learning experiences.

Reliable and accurate measurement methods are necessary for clinical assessment of wounds. Repeated measure of a wound indicates whether its healing is progressing or deteriorating, and if alternate treatment must be initiated. Many wound measurement techniques lack accuracy and reliability. Technology: We developed a software prototype that calculates 3-dimensional (3D) wound measurements from 3D scans. We conducted a study to compare the software prototype to physical and 2-dimensional (2D) image measurement techniques commonly used by clinicians. We compared inter-rater reliability between the techniques and measurements (i.e., length, width, depth, perimeter, surface area). Results: Inter-rater reliability was good or excellent for the physical, image, and software measurement techniques, however, there were significant differences in measurements between the techniques. For complex measurements (i.e., perimeter, surface area), the reliability of the software exceeded that of the physical and image techniques. Conclusions: Although inter-rater reliability was high for all measurement techniques, there was significant variability between the techniques. The software was overall most reliable, especially for calculation of complex measurements. Clinical Impact: Reducing the variability of wound measurements may improve patient outcomes, reduce the injury's prevalence, and mitigate the associated morbidity, mortality, and costs of these occurrences.

Background Remote and virtual simulations have gained prevalence during the COVID-19 pandemic as institutions maintain social distancing measures. Because of the challenges of cost, flexibility, and feasibility in traditional mannequin simulation, many health care educators have used videos as a remote simulation modality; however, videos provide minimal interactivity. Objective In this study, we aimed to evaluate the role of interactivity in students’ simulation experiences. We analyzed students’ perceptions of technology acceptance and authenticity in interactive and noninteractive simulations. Methods Undergraduate nursing students participated in interactive and noninteractive simulations. The interactive simulation was conducted using interactive video simulation software that we developed, and the noninteractive simulation consisted of passively playing a video of the simulation. After each simulation, the students completed a 10-item technology acceptance questionnaire and 6-item authenticity questionnaire. The data were analyzed using the Wilcoxon signed-rank test. In addition, we performed an exploratory analysis to compare technology acceptance and authenticity in interactive local and remote simulations using the Mann-Whitney U test. Results Data from 29 students were included in this study. Statistically significant differences were found between interactive and noninteractive simulations for overall technology acceptance (P<.001) and authenticity (P<.001). Analysis of the individual questionnaire items showed statistical significance for 3 out of the 10 technology acceptance items (P=.002, P=.002, and P=.004) and 5 out of the 6 authenticity items (P<.001, P<.001, P=.001, P=.003, and P=.005). The interactive simulation scored higher than the noninteractive simulation in all the statistically significant comparisons. Our exploratory analysis revealed that local simulation may promote greater perceptions of technology acceptance (P=.007) and authenticity (P=.027) than remote simulation. Conclusions Students’ perceptions of technology acceptance and authenticity were greater in interactive simulation than in noninteractive simulation. These results support the importance of interactivity in students’ simulation experiences, especially in remote or virtual simulations in which students’ involvement may be less active.