IntroductionTranslational research has been identified as a research priority for the National Institutes of Health (NIH) and the Society for Simulation in Healthcare (SSH). Despite a larger focus on translational research in recent years, the overall amount of simulation-based translational research remains low. Greater understanding of how to approach translational simulation is required to inform novice simulation and translational researchers. This study sought to answer the following research questions: How do simulation experts describe the barriers and facilitators to implementing translational simulation programs? How do simulation experts describe their various approaches to implementing translational simulation programs? What recommendations do simulation experts describe for overcoming barriers to implementing translational simulation programs?MethodsA qualitative instrumental case study was used to elicit multiple instances of translational simulation research to gather an in-depth description from study participants. Three data sources were used: documents, semistructured interviews, and a focus group.ResultsData analyses revealed 5 major themes: clarifying goals and definitions, special considerations, social networking, research, and factors external to the simulation program.ConclusionsKey findings include a lack of a standardized definitions for translational simulation and simulation-based translational research, the challenge of demonstrating the value of translational simulation, and the need for translational simulation programs to be integrated into departmental quality, patient safety, and risk management work. The findings and advice from the experts in this research can assist new researchers or those encountering challenges in implementing translational simulations.

BACKGROUND: The widespread use of social media has led to exploration of its use as an educational tool to engage learners and enhance interactive learning with its use in the healthcare literature dating back to 2008. If an intervention can impact clerkship Shelf Exam scores as a measurable short-term goal, it may have a downstream impact on USMLE or COMLEX-USA examination scores. The purpose of the investigation was to evaluate if Twitter could be used in undergraduate allopathic and osteopathic medical students to enhance learning outcomes defined as scores and passage on NBME Shelf examinations taken directly after the intervention period. METHODS: This investigation used a quasi-experimental study design. Ninety questions covering 30 different Family Medicine topics were developed through a psychometrically sound process. Following sample size calculations 32 3rd-year allopathic and osteopathic participants were recruited from a Family Medicine clerkship at a community-based hospital in the Northeast. Participants were sent tweets during two weeks of their Family Medicine clerkships. Upon completion of their clerkship, surveys were emailed to participants containing questions from ane an engagement survey. A historical comparison group of individuals completing their rotations immediately prior to the intervention was used to assess a difference in Shelf examination scores. A two-group Wilcoxon-Mann-Whitney test was used to examine differences. RESULTS: There was no statistical evidence of a difference between percentile scores (_P_-value=.157). The CLES for COMAT/NCME Shelf Exam percentile was 62% - a meaningful effect size. DISCUSSION: This study adds support for the use of Twitter to improve learning outcomes during medical student clerkships. Our study built upon this finding by adding the bidirectional aspect of Twitter communication. The change in scores change may have been due to student engagement. Twitter demonstrated a social media approach to providing students with anytime-anyplace and just-in-time experience consistent with Bauman’s Layered-Learning Model. The chief limitation of this study was medical student in-person clerkships were paused during the COVID pandemic and therefore our study enrollment was also paused and posed many more logistical challenges. The results of this investigation further the potential for Twitter to be used as an inexpensive educational intervention to modestly improve standardized exam scores with the potential to be used in a broader fashion (e.g., COMLEX and USMLE Step Scores). Future research can build upon this study by applying this intervention to other locations with larger samples. This study should be replicated for each core clerkship rotation for COMLEX and USMLE Step preparation.

Misconceptions regarding quality improvement (QI) projects and their role within the human subjects research paradigm exist. Projects resulting in information applicable to local institutions with an emphasis on dissemination of the process implemented represent QI projects. Studies resulting in generalizable knowledge represent human subjects research. The chief misconception is that projects using experimental and quasi-experimental designs are not QI. Defining QI based on methodology is incorrect. Determination of whether a study is or is not QI lies in the study’s purpose. Nineteen study designs applicable to QI are presented. To assist faculty in determining whether a proposed study is considered human subjects research or QI, several tools are presented, and the IRB process in the context of QI is discussed. To ensure the rigor of QI, the SQUIRE guidelines are reviewed to provide guidance to faculty project directors. Finally, best practices for QI ethical considerations and human subjects research are emphasized.