Using Strategic Options Development and Analysis (SODA) to Understand the Simulation Accessibility Problem

Simulation modelling is applied to a wide range of problems, including defense and healthcare. However, there is a concern within the simulation community that there is a limited use and implementation of simulation studies in practice. This suggests that despite its benefits, simulation may not be reaching its potential in making a real-world impact. The main reason for this could be that simulation tools are not widely accessible in industry. In this paper, we investigate the issues that affect simulation modelling accessibility through a workshop with simulation practitioners. We use Strategic Options Development and Analysis (SODA), a problem-structuring approach that allows for the stakeholder views to be expressed and linked in a systematic way. The causal map derived represents the emerging concepts and their effects, with the view to identifying their impact on the accessibility problem. We present our analysis of the issues and options identified. Based on our findings, we discuss the implications and recommendations for the future uptake of simulation

The context, influences and challenges for undergraduate nurse clinical education: Continuing the dialogue

Introduction – Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu Objective – To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions. Method: A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature. Discussion - Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) Legacies from the past and the inherent features of nurse education and (2) Challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models. Conclusion(s) – Ongoing challenges in providing accessible, effective and quality clinical learning experiences are apparent

Methodology for profiling literature in healthcare simulation

The publications that relate to the application of simulation to healthcare have steadily increased over the years. These publications are scattered amongst various journals that belong to several subject categories, including Operational Research, Health Economics and Pharmacokinetics. The simulation techniques that are applied to the study of healthcare problems are also varied. The aim of this study is to present a methodology for profiling literature in healthcare simulation. In our methodology, we have considered papers on healthcare that have been published between 1970 and 2007 in journals with impact factors that belonging to various subject categories reporting on the application of four simulation techniques, namely, Monte Carlo Simulation, Discrete-Event Simulation, System Dynamics and Agent-Based Simulation. The methodology has the following objectives: (a) to categorise the papers under the different simulation techniques and identify the healthcare problems that each technique is employed to investigate; (b) to profile, within our dataset, variables such as authors, article citations, etc.; (c) to identify turning point (strategically important) papers and authors through co-citation analysis of references cited by the papers in our dataset. The focus of the paper is on the literature profiling methodology, and not the results that have been derived through the application of this methodology. The authors hope that the methodology presented here will be used to conduct similar work in not only healthcare but also other research domains

A perspective on the Healthgrid initiative

This paper presents a perspective on the Healthgrid initiative which involves European projects deploying pioneering applications of grid technology in the health sector. In the last couple of years, several grid projects have been funded on health related issues at national and European levels. A crucial issue is to maximize their cross fertilization in the context of an environment where data of medical interest can be stored and made easily available to the different actors in healthcare, physicians, healthcare centres and administrations, and of course the citizens. The Healthgrid initiative, represented by the Healthgrid association (http://www.healthgrid.org), was initiated to bring the necessary long term continuity, to reinforce and promote awareness of the possibilities and advantages linked to the deployment of GRID technologies in health. Technologies to address the specific requirements for medical applications are under development. Results from the DataGrid and other projects are given as examples of early applications.Comment: 6 pages, 1 figure. Accepted by the Second International Workshop on Biomedical Computations on the Grid, at the 4th IEEE/ACM International Symposium on Cluster Computing and the Grid (CCGrid 2004). Chicago USA, April 200

A survey of simulation techniques in commerce and defence

Despite the developments in Modelling and Simulation (M&S) tools and techniques over the past years, there has been a gap in the M&S research and practice in healthcare on developing a toolkit to assist the modellers and simulation practitioners with selecting an appropriate set of techniques. This study is a preliminary step towards this goal. This paper presents some results from a systematic literature survey on applications of M&S in the commerce and defence domains that could inspire some improvements in the healthcare. Interim results show that in the commercial sector Discrete-Event Simulation (DES) has been the most widely used technique with System Dynamics (SD) in second place. However in the defence sector, SD has gained relatively more attention. SD has been found quite useful for qualitative and soft factors analysis. From both the surveys it becomes clear that there is a growing trend towards using hybrid M&S approaches

A multi-faceted approach to optimising a complex unplanned healthcare system

Unscheduled and urgent health care represents the largest area of activity and cost for the UK’s National Health Service (NHS). Like typical complex systems unplanned care has the features of interdependence and having structures at different scales which requires modelling at different levels. The aim of this paper is to discuss the development of a multifaceted approach to study and optimise this complex system. We aim to integrate four different methodologies to gain better understanding of the nature of the system and to develop ways to enhance its performance. These methodologies are: (a) Lean/ Flow theory to look at the process and patients and other flows; (b) Simulation/ System Dynamics to undertake analytical analysis and multi-level modelling; (c) stakeholder consultation and use of system thinking to analyse the system and identify options, barriers and good practice; and (d) visual analytic modelling to facilitate effective decision making in this complex environment. Of particular concern are the boundary issues i.e. how changes in unplanned care will impact on the adjacent facilities and ultimately on the whole Healthcare system

Potential applications of simulation modelling techniques in healthcare: lessons learned from aerospace and military

The Aerospace and Military areas are to do with complex missions and situations. Modelling and Simulation (M&S) has been applied in many areas of defence ranging from space sciences, satellite engineering to multi-warfare (air warfare, undersea warfare), air & missile defence, acquisition, tactical military trainings & exercises, national security analysis and strategic decision making & planning, etc. The application of simulation modelling techniques in healthcare would improve the provision of healthcare services; however, their application has been much relatively feeble in the healthcare sector as compared to the defence sector. This paper presents results from a systematic literature survey on applications of modelling simulation techniques in the Aerospace & Military. The knowledge gained or lessons learned from the survey were finally used to analyze the potential applications of the simulation modelling techniques to the healthcare sector. Results show that in the defence sector, Distributed Simulation has now become a widely adopted technique. However, System Dynamics (SD) and Discrete Event Simulation (DSE) have also gained relative attention. From this survey it becomes clear that various simulation modelling techniques are useful for specific purposes and have potential applications in the healthcare sector

Use of functional near-infrared spectroscopy to evaluate cognitive change when using healthcare simulation tools

This is an accepted manuscript of an article published by BMJ on 01/11/2020, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936993/ The accepted version of the publication may differ from the final published version.Background The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional nearinfrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events. Methods This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-toface and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12. Results In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load. Conclusion Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required