Online and in-presence simulated patient: implications in terms of learning, self-efficacy perception and psychological safety in the healthcare context

Journal title PSICOLOGIA DELLA SALUTE
Author/s Alessandra Bigoni, Simona Caputo, Annalisa Paterna, Anna Viganò, Francesca Brivio, Silvia Cozzolino, Anna Maria Cebrelli, Michela Bernardini, Andrea Greco
Publishing Year 2025 Issue 2025/1
Language Italian Pages 21 P. 126-146 File size 159 KB
DOI 10.3280/PDS2025-001010
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Background. Simulation in healthcare is a training technique that enables students and health professionals to experience, in a protected context, clinical situations typical of their work. Such training can be delivered through different modalities, which involve the deliberate practice of skills theoretically acquired. Currently, to the best of our experience and knowledge, a small number of studies have explored the differences between online and in-presence simulation. Therefore, this paper aims to compare these two types of simulation. Methods. Studies compared in this study involved twenty-eight students enrolled in the Nursing Bachelor’s Degree Course at the University of Eastern Piedmont, who individually participated in simulation with a Simulated Patient either in presence or online. Subsequently, a total of 6 focus groups were conducted with students, 4 tutors, 3 debriefers and 3 simulated patients. Results. Analysis reveals similarities in learning, with positive results on the perception of psychological safety in the working context and on self-efficacy; in addition, the presence of the Simulated Patient seems to guarantee the realism of the scenario. A central element of distinction between the two activities, however, is the non-verbal dimension of communication with the patient. Conclusion. Potential for professional growth related to the implementation of simulation methods (in-presence and online) in university courses emerges. The need for the application and integration of the two modalities in different teaching contexts is also noted, expanding the possibility to develop projects for the learning of relational skills, alongside the technical ones, which are important for patient care and the well-being of operators.

Keywords: online simulated patient, in-presence simulated patient, simulation, students, nurse

  1. Babbar M. and Gupta T. (2022). Response of educational institutions to COVID-19 pandemic: An inter-country comparison. Policy Futures in Education, 20(4): 469-491. DOI: 10.1177/1478210321102193
  2. Bandura A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2): 191-215. DOI: 10.1037/0033-295X.84.2.19
  3. Barisone M., Bagnasco A., Aleo G., Catania G., Bona M., Gabriele Scaglia S., Zanini M., Timmins F. and Sasso L. (2019). The effectiveness of web-based learning in supporting the development of nursing students’ practical skills during clinical placements: A qualitative study. Nurse Education in Practice, 37: 56-61. DOI. 10.1016/j.nepr.2019.02.009
  4. Birnbach D.J. and Salas E. (2008). Can Medical Simulation and Team Training Reduce Errors in Labor and Delivery? Anesthesiology Clinics, 26(1): 159-168.
  5. Cruz-Panesso I., Perron R., Chabot V., Gauthier F., Demers M.-M., Trottier R., Soulières F., Juste L., Gharavi S., MacDonald N., Richard A., Boivin A., Deligne B., Bouillon K., & Drolet P. (2022). A practical guide for translating in-person simulation curriculum to telesimulation. Advances in Simulation, 7(1): 14.
  6. Diaz M.C.G. and Walsh B.M. (2021). Telesimulation-based education during COVID-19. The Clinical Teacher, 18(2): 121-125.
  7. Edmondson A. (1999). Psychological Safety and Learning Behavior in Work Teams. Administrative Science Quarterly, 44(2): 350–383. DOI: 10.2307/266699
  8. Gaba D.M. (2004). The future vision of simulation in health care. BMJ Quality & Safety, 13(suppl 1): i2-i10.
  9. Issenberg S.B., Chung H.S. and Devine L.A. (2011). Patient Safety Training Simulations Based on Competency Criteria of the Accreditation Council for Graduate Medical Education. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 78(6): 842-853.
  10. Kuehster C.R. and Hall C.D. (2010). Simulation: Learning From Mistakes While Building Communication and Teamwork. Journal for Nurses in Staff Development (JNSD), 26(3): 123-127.
  11. Lamé G. and Dixon-Woods M. (2020). Using clinical simulation to study how to improve quality and safety in healthcare. BMJ Simulation and Technology Enhanced Learning, 6(2): 87-94.
  12. Lancia F. (2012). The Logic of the T-LAB Tools Explained. -- http://www.tlab.it/en/toolsexplained.php.
  13. Lin E., You A.X. and Wardi G. (2021). Comparison of In-Person and Telesimulation for Critical Care Training during the COVID-19 Pandemic. ATS Scholar, 2(4): 581-594.
  14. Lioce L., Conelius, J., Brown, K., Schneidereith, T., Nye, C., Weston, C., & Bigley, M. (2020). Simulation Guidelines and Best Practices for Nurse Practitioner Programs. National Organization of Nurse Practitioner Faculties [Guidelines].
  15. McGaghie W.C., Issenberg S.B., Cohen E.R., Barsuk J.H. and Wayne D.B. (2011). Does Simulation-Based Medical Education with Deliberate Practice Yield Better Results Than Traditional Clinical Education? A Meta-Analytic Comparative Review of the Evidence. Academic Medicine, 86(6): 706-711.
  16. Montgomery E.E., Thomas A., Abulebda K., Sanseau E., Pearson K., Chipman M., Chapman J.H., Kou M. and Auerbach M.A. (2021). Development and Implementation of a Pediatric Telesimulation Intervention for Nurses in Community Emergency Departments. Journal of Emergency Nursing, 47(5): 818-823.e1.
  17. Motola I., Devine L.A., Chung H.S., Sullivan J.E. and Issenberg S.B. (2013). Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82. Medical Teacher, 35(10): e1511–e1530. DOI: 10.3109/0142159X.2013.81863
  18. Newman A., Donohue R. and Eva N. (2017). Psychological safety: A systematic review of the literature. Human Resource Management Review, 27(3): 521-535.
  19. Pedersen I., Lee Solevåg A. and Solberg M.T. (2019). Simulation-Based Training Promotes Higher Levels of Cognitive Control in Acute and Unforeseen Situations. Clinical Simulation in Nursing, 34: 6-15.
  20. Ray J.M., Wong A.H., Yang T.J., Buck S., Joseph M., Bonz J.W., Auerbach M.A., Couturier K., Tomassoni A.J., Schwartz M.L. and Evans L.V. (2021). Virtual Telesimulation for Medical Students During the COVID-19 Pandemic. Academic Medicine, 96(10): 1431-1435. DOI: 10.1097/ACM.000000000000412
  21. Roussin C.J., Larraz E., Jamieson K. and Maestre J.M. (2018). Psychological Safety, Self-Efficacy, and Speaking Up in Interprofessional Health Care Simulation. Clinical Simulation in Nursing, 17: 38–46.
  22. Salas E., DiazGranados D., Weaver S.J. and King H. (2008). Does Team Training Work? Principles for Health Care. Academic Emergency Medicine, 15(11): 1002–1009.
  23. Stephen L.-A., Kostovich C. and O’Rourke J. (2020). Psychological Safety in Simulation: Prelicensure Nursing Students’ Perceptions. Clinical Simulation in Nursing, 47: 25-31.
  24. Watters C., Reedy G., Ross A., Morgan N.J., Handslip R. and Jaye P. (2015). Does interprofessional simulation increase self-efficacy: A comparative study. BMJ Open, 5(1): e005472–e005472.

Alessandra Bigoni, Simona Caputo, Annalisa Paterna, Anna Viganò, Francesca Brivio, Silvia Cozzolino, Anna Maria Cebrelli, Michela Bernardini, Andrea Greco, Paziente simulato online e in presenza: implicazioni in termini di apprendimento, percezione di autoefficacia e sicurezza psicologica nel contesto sanitario in "PSICOLOGIA DELLA SALUTE" 1/2025, pp 126-146, DOI: 10.3280/PDS2025-001010