Numerical Assessment Tool to Measure Realism in Clinical Simulation

Abstract

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.

Clinical competency development with handmade simulator in highly realistic paediatric dentistry scenarios

“…compared the perception of realism of teachers and students, finding that the former were much more critical. Similarly, in our work, we obtained a higher perception of realism (6.79) than the measure of realism calculated by the expert teachers who validated the use of the mannequin with the ProRealSim v.1.0 (5.1 realism for the mannequin) 39 producing an increase in motivation and commitment to student practice, as described by Van Soeren et al 12 . and by Kyaw Tun et al 25 …”

“…The clinical skills perception scales were validated with a previous pilot study with a different sample. The Cronbach alpha for all Likert scales was >0.969 29 …”

“…The simulator was previously tested in a simulated scene. After this test, its design and case were corrected, and its level of realism was measured by two expert teachers with the ProRealSim v.1.0 tool, obtaining a realism index of 5.1 (medium) for the mannequin and considering it suitable for educational use 29,30 …”

“…The Cronbach alpha for all Likert scales was >0.969. 29 The perception of clinical skills before and after the scenario was measured with a 10-point Likert scale that asked the student how capable he/she was to solve a case with the characteristics described in the real clinical practice. Perceived realism (by the student) was measured with a 10-point Likert scale that assessed the perceived realism of the mannequin, the cabinet, the simulated participant (actress in the role of the mother) and the overall realism.…”

“…After this test, its design and case were corrected, and its level of realism was measured by two expert teachers with the ProRealSim v.1.0 tool, obtaining a realism index of 5.1 (medium) for the mannequin and considering it suitable for educational use. 29,30 A video was created showing the simulator and the simulated environment where a dental visit was shown in which the simulator showed a lack of collaboration. To facilitate prior knowledge of the new mannequin, the video was posted on the Blackboard Learn virtual campus tool.…”