Aim:To review the literature on the use of simulation in the development of non-technical skills in nursingBackground:The potential risks to patients associated with learning 'at the bedside' are becoming increasingly unacceptable, and the search for innovative education and training methods that do not expose the patient to preventable errors continues. All the evidence shows that a significant proportion of adverse events in health care is caused by problems relating to the application of the 'non-technical' skills of communication, teamwork, leadership and decision-making.Results:Simulation is positively associated with significantly improved interpersonal communication skills at patient handover, and it has also been clearly shown to improve team behaviours in a wide variety of clinical contexts and clinical personnel, associated with improved team performance in the management of crisis situations. It also enables the effective development of transferable, transformational leadership skills, and has also been demonstrated to improve students' critical thinking and clinical reasoning in complex care situations, and to aid in the development of students' self-efficacy and confidence in their own clinical abilities.Conclusion:High fidelity simulation is able to provide participants with a learning environment in which to develop non-technical skills, that is safe and controlled so that the participants are able to make mistakes, correct those mistakes in real time and learn from them, without fear of compromising patient safety. Participants in simulation are also able to rehearse the clinical management of rare, complex or crisis situations in a valid representation of clinical practice, before practising on patients.

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1 Central effects of the P-adrenoceptor antagonists, propranolol (40, 80 and 160 mg) and atenolol (50 and 100 mg) were studied in 12 healthy male subjects. Two placebo ingestions and an active control (oxazepam 15 mg) were included. Single doses were administered double-blind at 11.00 h, and assessments of performance and subjective feelings were made before, 2 h and 4 h after ingestion. 2 Performance was measured using letter cancellation, digit symbol substitution, continuous attention, choice reaction time, finger tapping, short term and immediate memory, critical flicker fusion and two flash fusion. Subjective feelings were assessed using twelve visual-analogue scales.3 Oxazepam impaired performance at letter cancellation (P < 0.001), digit symbol substitution (P < 0.05), continuous attention (P < 0.001), immediate recall (P < 0.05) and finger tapping (P < 0.05), but neither of the 3-adrenoceptor antagonists affected these measures. Propranolol (40 and 160 mg) also impaired short term memory (P < 0.05), though it was not possible to establish this effect with atenolol.4 Subjective alertness was reduced by oxazepam (P < 0.01) and atenolol (P < 0.05), while propranolol (40 mg) reduced anxiety (P < 0.01) and propranolol (80 mg) impaired ability to concentrate (P < 0.05). 5 The results suggest that both lipophilic and hydrophilic antagonists modify the central nervous system, though impairment may be difficult to establish with conventional tests.The observations on memory and alertness suggest that the central effect of P-adrenoceptor antagonists may be subtle. Keywords ,B-adrenoceptor antagonists propranolol atenolol performance IntroductionThere is uncertainty concerning the nature of the Fleming, 1978). However, presently available possible central effects of 1-adrenoceptor an-information is difficult to evaluate. Impaired tagonists, but, though it is likely that these drugs performance has been reported after single doses have such effects, their severity may be minimal (Bryan et al., 1974;Glaister et al., 1973; Landauer compared with the benzodiazepines. Indeed, et al., 1979;Salem & McDevitt, 1983), while light-headedness, visual and auditory halluci-other studies have failed to show such effects nations, sleep disturbances, vivid dreams and (Ogle etal., 1976;Turner & Hedges, 1973 In this paper we report the observations on various aspects of performance as well as subjective assessments of well being and mood, and in the following paper we deal with the findings on the electroencephalogram and body sway. Methods Experimental designTwelve healthy male volunteers, aged between 19 and 29 years, participated in the study which was approved by the Hospital Ethics Committee. None was taking any concurrent medication and each was required to abstain from alcohol for 24 h before each study period. No caffeinecontaining beverages were permitted during the study days.Performance was tested in individual, soundproofed cubicles. The intensity of lighting could be adjusted to permit dark adaptation before measurem...

BackgroundThe recent UK Government paper ‘Five year forward view’ describes the need to move much patient management from secondary to primary care, and this will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no clear recruitment strategy to address this. There have however been a number of proposed solutions to address the impending GPN recruitment crisis and to increase the numbers of new GPNs in post. General Practitioners (GPs) working in the Advanced Training Practice Scheme (ATPS) have been commissioned by Health Education England to provide placements for student nurses. This paper reports upon the findings of a study evaluating the South Yorkshire ATPS network in relation to nursing students’ perceptions of general practice as a placement and a potential career option post-graduation.MethodsData were collected using semi-structured interviews with 18 nursing students. Qualitative data analysis used a framework approach and themes were cross-checked within the team. The research had ethical approval and anonymity and confidentiality were maintained throughout.ResultsUsing the Communities of Practice (CoP) framework as a theoretical lens, two main themes emerged from the data: ‘Myths and misunderstandings’ outlined some of the misconceptions that abounded in the absence of an established CoP in general practice. These included perceptions of what constitutes a ‘good’ placement, an apparent lack of relevant content in the curriculum, and the widespread use of social media by students as a means of information gathering. ‘Changing hearts and minds’ referred to the need to positively influence the culture within general practice by addressing some of the longstanding myths. Through the fledgling CoP, the students’ perceptions of the GPN role in particular were positively revised, as was the prospect of a career in general practice upon graduation.ConclusionsThe CoP that is emerging through the ATPS placements appear to be gradually changing the socio-cultural landscape within general practice by enabling student nurses to experience the reality of life in general practice nursing, and to view the GPN role as a viable career option upon graduation.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1182-6) contains supplementary material, which is available to authorized users.

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