Realism is indispensable in clinical simulation learning, and the objective of this work is to present to the scientific community the methodology behind a novel numerical and digital tool to objectively measure realism in clinical simulation. Indicators measuring accuracy and naturality constitute ProRealSim v.1.0 (Universidad Europea, Madrid, Spain) which allows the assessing of attained realism for three dimensions: simulated participant, scenography, and simulator. Twelve experts in simulation-based learning (SBL) analyzed the conceptual relevance of 73 initial qualitative indicators that were then reduced to 53 final indicators after a screening study evaluating eight medical clinical simulation scenarios. Inter- and intra-observer concordance, correlation, and internal consistency were calculated, and an exploratory factorial analysis was conducted. Realism units were weighted based on variability and its mathematical contribution to global and dimensional realism. A statistical significance of p < 0.05 was applied and internal consistency was significant in all cases (raw_alpha ≥ 0.9698094). ProRealSim v.1.0 is integrated into a bilingual, free, and open access digital platform, and the intention is to foster a culture of interpretation of realism for its better study and didactic use.
Task trainer simulators are often used in medical programs for bachelor’s degree students when teaching procedural skills. They provide the opportunity to practice dangerous maneuvers that students are not ready to perform on real patients yet. The rise of technology has vastly expanded the availability of these devices for use in teaching. To develop a protocol that would account for the complexities of psychomotor learning, based on student progress, and improve training quality, we designed a protocol for the bachelor’s degree program in dentistry. We justify the key elements of the proposal and explain the full working protocol.
Simulation, depending on the modality and fidelity of the scenarios, is an important resource for clinical teaching and achievement of learning outcomes in dentistry. The objectives of this study were to compare the degree of realism perceived by students and teachers in a simulated scenario, and to assess the level of competence acquired by the students. Method: In the Pediatric Dentistry course, eight clinical scenarios were carried out, each one using a modified Erler Zimmer child simulator (handmade), a professional actress and two students (dentist and assistant) on the same pediatric dentistry case consisting of a pulp abscess in tooth 8.5. A total of 114 students in the 4th year of dentistry studies participated in the pediatric dentistry course. Questionnaires with Likert-type answers were elaborated to evaluate the educational intervention, applying them before and after the simulation. Results: The realism best valued by the students was that of the simulated participant and the worst that of the manikin, the latter being strongly related to the realism of the office. It was observed that students' perception of clinical competence increased as the overall realism of the scenario increased (p-value = 0.00576). Conclusion: This research suggests that the creation of scenarios using handmade mannequins and simulated participants achieves a high level of realism, increasing the level of clinical competence perceived by dental students.
Dental training faces the growing shortage of extracted teeth and the ethical precepts of Bionot learning on patients and reducing the environmental damage that preclinical trainings generate. Haptic and 3D simulators reproduce pathologies and provide a greater magnification of the processes, reducing water expenditure and pollution, but their curricular integration is complex. Two resources of complementary use (informative written manual and video tutorial) were designed to facilitate the theoretical and technical domain (know how the simulator works and make it work), as well as the advanced management of the simulator (operate the simulator autonomously, without setbacks). After 5 years of using these resources, an evaluative study was conducted with 175 students and 32 teachers. The aim was to assess the student’s perception of knowledge/learning, its statistical relationship with the didactic resources used and compare these results with the teachers’ perception of their students’ knowledge/learning. Spearman’s Rho coefficient and Kolmogorov-Smirnov test were performed. Both students and teachers considered that the technical domain (make the simulator work) was the domain that prevailed the most. There was a tendency for students not to value much the necessity of a specific preparation prior to using the simulator. This tendency resulted in a low level of study of both the written manual and the video tutorial. In conclusion, both students and teachers considered that the best strategy of knowledge/learning was the direct exchange with the simulator.
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