Objective:To gain insight into the potential factors that may cause perceived stress and anxiety in simulation education.Methods:A secondary qualitative analysis study using qualitative thematic synthesis.A local high...Objective:To gain insight into the potential factors that may cause perceived stress and anxiety in simulation education.Methods:A secondary qualitative analysis study using qualitative thematic synthesis.A local higher education institution that conducted pre-registration nursing programs.A total of 189 undergraduate nursing students that were never attained any clinical placement prior to the parent study.Focus group interviews were conducted to collect data that were then transcribed and analyzed through the qualitative thematic synthesis approach to develop themes.Results:Three themes were emerged from the participants’simulation experiences in terms of peoples(the observers vs the observed),actions(the prepared vs the unprepared),and settings(the realism vs the simulation).Conclusions:By considering and reviewing the current design and development of the simulation practice,the findings of this study contribute to the body of knowledge with valuable insights on stress and anxiety that may affect students’learning in simulation.展开更多
Objective:To explore the application effect of high-fidelity simulation teaching in the training of emergency management for difficult airways among anesthesia nursing students,providing practical references for enhan...Objective:To explore the application effect of high-fidelity simulation teaching in the training of emergency management for difficult airways among anesthesia nursing students,providing practical references for enhancing their clinical emergency response capabilities.Methods:Eighty-four anesthesia nursing students who interned in the Department of Anesthesiology of our hospital from September 2023 to March 2024 were selected as the research subjects.They were randomly divided into a control group(n=42)and an observation group(n=42)using the random number table method.The control group adopted the traditional teaching mode(theoretical lectures+video demonstrations),while the observation group adopted the high-fidelity simulation teaching mode.After the training,the theoretical assessment scores,operational assessment scores,emergency response capability scores,and teaching satisfaction of the two groups of students were compared.Results:The observation group scored significantly higher than the control group in both theoretical assessment(90.35±4.82)points and practical assessment(92.17±3.96)points,with scores of(79.26±5.78)points and(81.34±5.21)points,respectively,in the control group.The differences were statistically significant(p<0.05).The observation group also scored higher than the control group in all dimensions of emergency response capabilities and total scores,including airway assessment(18.92±2.05)points vs.(14.56±2.37)points,equipment selection(19.15±1.83)points vs.(13.89±2.24)points,operation execution(19.36±1.78)points vs.(14.23±2.41)points,teamwork(18.73±2.11)points vs.(13.98±2.53)points,and total score(76.16±6.84)points vs.(56.66±7.92)points.All differences were statistically significant(p<0.05).The teaching satisfaction rate in the observation group was 97.62%(41/42),significantly higher than that in the control group at 78.57%(33/42),with a statistically significant difference(p<0.05).Conclusion:High-fidelity simulation teaching can effectively enhance the theoretical knowledge,practical skills,and emergency response capabilities of anesthesia nursing students in managing difficult airways,as well as improve teaching satisfaction.It is an efficient clinical teaching model for anesthesia nursing and is worthy of promotion and application.展开更多
Objective： Clinical reasoning is an essential feature of health care practice; it is also a crucial ability for providing patient care of high quality. It has been identified that graduate nurses may lack the clinica...Objective： Clinical reasoning is an essential feature of health care practice; it is also a crucial ability for providing patient care of high quality. It has been identified that graduate nurses may lack the clinical reasoning skills to deliver safe and effective patient cam. It is therefore of paramount importance to enhance nursing students＇ clinical reasoning ability. High-fidelity simulation （HFS） is proved to be an effective teaching and learning method, which may also have some advantages over other teaching methods. Methods： The authors retrospectively reviewed the related literature, illustrated the application of high-fidelity simulation teaching method in nursing education, putting the focus on the use of it in teaching with clinical reasoning. Results： The application of high-fidelity simulation to nursing education can simulate the clinical situation, thus to create a safe, continuous and efficient learning environment for students, and it can effectively improve students＇ clinical reasoning ability. Conclusions： high-fidelity simulation is effective for clinical reasoning teaching in nursing education. The extension of its application in China should be of great value. The relevant further study is suggested focusing on how to overcome its own limitations and have it better applied in nursing education in China.展开更多
Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze...Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.展开更多
Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its ef...Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.展开更多
Objective The purpose of this study was to explore student perspectives of high-fidelity simulation.Methods A descriptive study with semi-structured focus group interviews was conducted in Macao.Twenty-one focus group...Objective The purpose of this study was to explore student perspectives of high-fidelity simulation.Methods A descriptive study with semi-structured focus group interviews was conducted in Macao.Twenty-one focus group interviews were held with 113 baccalaureate nursing students who had experienced 36-hour of simulation.Results Students perceived that simulation created a nonrisk learning environment,and was helpful in knowledge and skill enhancement and nurse role understanding.However,lack of realistic interactions in psychosocial responses made it difficult for students to relate simulation experience to real-working situations,and poor group contributions affected their learning.ConclusionInteracting with a human patient simulator does not replicate the experience of working with a live patient.Tutors need to come up with ideas about how to make scenarios more real and give more forthright responses to improve the realism of psychosocial responses during simulation.Students experienced uncertainty with clinical decision making and commented on the minimal contributions of some group members.Tutors should be prepared to provide students with substantial supports in developing their understanding of simulation and engaging in the learning process.展开更多
Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing expe...Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。展开更多
Wire arc additive manufacturing(WAAM)has emerged as a promising approach for fabricating large-scale components.However,conventional WAAM still faces challenges in optimizing microstructural evolution,minimizing addit...Wire arc additive manufacturing(WAAM)has emerged as a promising approach for fabricating large-scale components.However,conventional WAAM still faces challenges in optimizing microstructural evolution,minimizing additive-induced defects,and alleviating residual stress and deformation,all of which are critical for enhancing the mechanical performance of the manufactured parts.Integrating interlayer friction stir processing(FSP)into WAAM significantly enhances the quality of deposited materials.However,numerical simulation research focusing on elucidating the associated thermomechanical coupling mechanisms remains insufficient.A comprehensive numerical model was developed to simulate the thermomechanical coupling behavior in friction stir-assisted WAAM.The influence of post-deposition FSP on the coupled thermomechanical response of the WAAM process was analyzed quantitatively.Moreover,the residual stress distribution and deformation behavior under both single-layer and multilayer deposition conditions were investigated.Thermal analysis of different deposition layers in WAAM and friction stir-assisted WAAM was conducted.Results show that subsequent layer deposition induces partial remelting of the previously solidified layer,whereas FSP does not cause such remelting.Furthermore,thermal stress and deformation analysis confirm that interlayer FSP effectively mitigates residual stresses and distortion in WAAM components,thereby improving their structural integrity and mechanical properties.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
This study introduces a new ocean surface friction velocity scheme and a modified Thompson cloud microphysics parameterization scheme into the CMA-TYM model.The impact of these two parameterization schemes on the pred...This study introduces a new ocean surface friction velocity scheme and a modified Thompson cloud microphysics parameterization scheme into the CMA-TYM model.The impact of these two parameterization schemes on the prediction of the movement track and intensity of Typhoon Kompasu in 2021 is examined.Additionally,the possible reasons for their effects on tropical cyclone(TC)intensity prediction are analyzed.Statistical results show that both parameterization schemes improve the predictions of Typhoon Kompasu’s track and intensity.The influence on track prediction becomes evident after 60 h of model integration,while the significant positive impact on intensity prediction is observed after 66 h.Further analysis reveals that these two schemes affect the timing and magnitude of extreme TC intensity values by influencing the evolution of the TC’s warm-core structure.展开更多
Marine thin plates are susceptible to welding deformation owing to their low structural stiffness.Therefore,the efficient and accurate prediction of welding deformation is essential for improving welding quality.The t...Marine thin plates are susceptible to welding deformation owing to their low structural stiffness.Therefore,the efficient and accurate prediction of welding deformation is essential for improving welding quality.The traditional thermal elastic-plastic finite element method(TEP-FEM)can accurately predict welding deformation.However,its efficiency is low because of the complex nonlinear transient computation,making it difficult to meet the needs of rapid engineering evaluation.To address this challenge,this study proposes an efficient prediction method for welding deformation in marine thin plate butt welds.This method is based on the coupled temperature gradient-thermal strain method(TG-TSM)that integrates inherent strain theory with a shell element finite element model.The proposed method first extracts the distribution pattern and characteristic value of welding-induced inherent strain through TEP-FEM analysis.This strain is then converted into the equivalent thermal load applied to the shell element model for rapid computation.The proposed method-particularly,the gradual temperature gradient-thermal strain method(GTG-TSM)-achieved improved computational efficiency and consistent precision.Furthermore,the proposed method required much less computation time than the traditional TEP-FEM.Thus,this study lays the foundation for future prediction of welding deformation in more complex marine thin plates.展开更多
Analysis of the environmental and economic performance of fishing vessels has received limited attention compared with other ship types despite their notable contribution to global greenhouse gas(GHG)emissions.This st...Analysis of the environmental and economic performance of fishing vessels has received limited attention compared with other ship types despite their notable contribution to global greenhouse gas(GHG)emissions.This study evaluates the carbon footprint(CF)and economic viability of a liquefied natural gas(LNG)-fueled fishing vessel,using real engine operation simulations to provide precise and dynamic evaluation of fuel consumption and GHG emissions.Operational profiles are obtained through the utilization of onboard monitoring systems,whereas engine performance is simulated using the 1D/0D AVL Boost^(TM)model.Life cycle assessment(LCA)is conducted to quantify the environmental impact,whereas life cycle cost assessment(LCCA)is performed to analyze the profitability of LNG as an alternative fuel.The potential impact of the future fuel price uncertainties is addressed using Monte Carlo simulations.The LCA findings indicate that LNG has the potential to reduce the CF of the vessel by 14%to 16%,in comparison to a diesel power system configuration that serves as the baseline scenario.The LCCA results further indicate that the total cost of an LNG-powered ship is lower by 9.5%-13.8%,depending on the share of LNG and pilot fuels.This finding highlights the potential of LNG to produce considerable environmental benefits while addressing economic challenges under diverse operational and fuel price conditions.展开更多
Engineering design is undergoing a paradigm shift from design for performance to design for affordability, operability, and durability, seeking multi-objective optimization. To facilitate this transformation, signific...Engineering design is undergoing a paradigm shift from design for performance to design for affordability, operability, and durability, seeking multi-objective optimization. To facilitate this transformation, significantly extended design freedom and knowledge must be available in the early design stages. This paper presents a high-fidelity framework for design and optimization of the liquid swirl injectors that are widely used in aerospace propulsion and power-generation systems. The framework assembles a set of techniques, including Design Of Experiment(DOE), high-fidelity Large Eddy Simulations(LES), machine learning, Proper Orthogonal Decomposition(POD)-based Kriging surrogate modeling(emulation), inverse problem optimization, and uncertainty quantification. LES-based simulations can reveal detailed spatiotemporal evolution of flow structures and flame dynamics in a high-fidelity manner, and identify important injector design parameters according to their effects on propellant mixing, flame stabilization, and thermal protection.For a given a space of design parameters, DOE determines the number of design points to perform LES-based simulations. POD-based emulations, trained by the LES database, can effectively explore the design space and deduce an optimal group of design parameters in a turn-around time that is reduced by three orders of magnitude. The accuracy of the emulated results is validated, and the uncertainty of prediction is quantified. The proposed design methodology is expected to profoundly extend the knowledge base and reduce the cost for initial design stages.展开更多
High-fidelity cargo airdrop simulation requires the contact dynamics between an aircraft and a cargo to be modeled accurately. This paper presents a general and efficient contact-friction model for simulation of aircr...High-fidelity cargo airdrop simulation requires the contact dynamics between an aircraft and a cargo to be modeled accurately. This paper presents a general and efficient contact-friction model for simulation of aircraft-cargo coupling dynamics during airdrops. The proposed approach has the same essence as that of the finite element node-to-segment contact formulation, which leads to a flexible, straight forward, and efficient code implementation. The formulation is developed under an arbitrary moving frame with both the aircraft and the cargo being treated as general six-degree-of-freedom rigid bodies, and thus it eliminates the restrictions of lateral symmetric assumptions in most existing methods. Moreover, the aircraft-cargo coupling algorithm is discussed in detail, and some practical implementation details are presented. The accuracy and capability of the present method are demonstrated through three numerical examples with increasing complexity and fidelity.展开更多
Objective： To investigate the effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors. Methods： A high-fide...Objective： To investigate the effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors. Methods： A high-fidelity teaching simulation on clinical nursing practices using intelligent human analogues was conducted with 200 students, and The Simulation Design Scale, and the Student Satisfaction and Self-Confidence in Learning Scale developed by the National League for Nursing were used to evaluate the training effectiveness and its influencing factors. Results： For the high-fidelity teaching simulation, students gave scores of 4.36± 0.54 points for satisfaction and 4.33 ± 0.46 points for Self-Confidence. The students highly rated the five dimensions of teaching design, i.e., teaching objectives/information, assistance/support for students, problem solving, guided feedback, and fidelity. The teaching design was closely correlated with the satisfaction of the high-fidelity teaching simulation and self-efficacy, and the dimensions of teaching objectives/informa- tion and assistance/support for students were particularly strong predictors of teaching effectiveness. Conclusions： A high-fidelity teaching simulation based on Jeffries＇ theoretical framework improved student satisfaction with the simulation and their Self-Confidence. In planning simulations, teachers should take into account five characteristics, i.e., teaching objectives/information on simulation education, assistance/support for students, problem solving, guided reflection, and fidelity, to achieve better teaching effectiveness.展开更多
基金supported by School Research Grant of Tung Wah College(SRG210401).
文摘Objective:To gain insight into the potential factors that may cause perceived stress and anxiety in simulation education.Methods:A secondary qualitative analysis study using qualitative thematic synthesis.A local higher education institution that conducted pre-registration nursing programs.A total of 189 undergraduate nursing students that were never attained any clinical placement prior to the parent study.Focus group interviews were conducted to collect data that were then transcribed and analyzed through the qualitative thematic synthesis approach to develop themes.Results:Three themes were emerged from the participants’simulation experiences in terms of peoples(the observers vs the observed),actions(the prepared vs the unprepared),and settings(the realism vs the simulation).Conclusions:By considering and reviewing the current design and development of the simulation practice,the findings of this study contribute to the body of knowledge with valuable insights on stress and anxiety that may affect students’learning in simulation.
基金Mechanism of HSP90 Regulating DRP1 Acetylation-Induced Mitochondrial Dynamics Imbalance in Endothelial Cells Promoting Atherosclerosis Progression,Shaanxi Provincial People’s Hospital(Project No.:2025JCYBBQN-1163)。
文摘Objective:To explore the application effect of high-fidelity simulation teaching in the training of emergency management for difficult airways among anesthesia nursing students,providing practical references for enhancing their clinical emergency response capabilities.Methods:Eighty-four anesthesia nursing students who interned in the Department of Anesthesiology of our hospital from September 2023 to March 2024 were selected as the research subjects.They were randomly divided into a control group(n=42)and an observation group(n=42)using the random number table method.The control group adopted the traditional teaching mode(theoretical lectures+video demonstrations),while the observation group adopted the high-fidelity simulation teaching mode.After the training,the theoretical assessment scores,operational assessment scores,emergency response capability scores,and teaching satisfaction of the two groups of students were compared.Results:The observation group scored significantly higher than the control group in both theoretical assessment(90.35±4.82)points and practical assessment(92.17±3.96)points,with scores of(79.26±5.78)points and(81.34±5.21)points,respectively,in the control group.The differences were statistically significant(p<0.05).The observation group also scored higher than the control group in all dimensions of emergency response capabilities and total scores,including airway assessment(18.92±2.05)points vs.(14.56±2.37)points,equipment selection(19.15±1.83)points vs.(13.89±2.24)points,operation execution(19.36±1.78)points vs.(14.23±2.41)points,teamwork(18.73±2.11)points vs.(13.98±2.53)points,and total score(76.16±6.84)points vs.(56.66±7.92)points.All differences were statistically significant(p<0.05).The teaching satisfaction rate in the observation group was 97.62%(41/42),significantly higher than that in the control group at 78.57%(33/42),with a statistically significant difference(p<0.05).Conclusion:High-fidelity simulation teaching can effectively enhance the theoretical knowledge,practical skills,and emergency response capabilities of anesthesia nursing students in managing difficult airways,as well as improve teaching satisfaction.It is an efficient clinical teaching model for anesthesia nursing and is worthy of promotion and application.
文摘Objective： Clinical reasoning is an essential feature of health care practice; it is also a crucial ability for providing patient care of high quality. It has been identified that graduate nurses may lack the clinical reasoning skills to deliver safe and effective patient cam. It is therefore of paramount importance to enhance nursing students＇ clinical reasoning ability. High-fidelity simulation （HFS） is proved to be an effective teaching and learning method, which may also have some advantages over other teaching methods. Methods： The authors retrospectively reviewed the related literature, illustrated the application of high-fidelity simulation teaching method in nursing education, putting the focus on the use of it in teaching with clinical reasoning. Results： The application of high-fidelity simulation to nursing education can simulate the clinical situation, thus to create a safe, continuous and efficient learning environment for students, and it can effectively improve students＇ clinical reasoning ability. Conclusions： high-fidelity simulation is effective for clinical reasoning teaching in nursing education. The extension of its application in China should be of great value. The relevant further study is suggested focusing on how to overcome its own limitations and have it better applied in nursing education in China.
基金This project was supported by research funding from the Macao Polytechnic Institute(No.RP/ESS-06/2017).
文摘Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.
基金supported by Fudan Good Practice Program of Teaching and Learning(2019C003).
文摘Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.
基金the Macao Polytechnic Institute(code RP/ESS-01/2012)for providing funding for this research
文摘Objective The purpose of this study was to explore student perspectives of high-fidelity simulation.Methods A descriptive study with semi-structured focus group interviews was conducted in Macao.Twenty-one focus group interviews were held with 113 baccalaureate nursing students who had experienced 36-hour of simulation.Results Students perceived that simulation created a nonrisk learning environment,and was helpful in knowledge and skill enhancement and nurse role understanding.However,lack of realistic interactions in psychosocial responses made it difficult for students to relate simulation experience to real-working situations,and poor group contributions affected their learning.ConclusionInteracting with a human patient simulator does not replicate the experience of working with a live patient.Tutors need to come up with ideas about how to make scenarios more real and give more forthright responses to improve the realism of psychosocial responses during simulation.Students experienced uncertainty with clinical decision making and commented on the minimal contributions of some group members.Tutors should be prepared to provide students with substantial supports in developing their understanding of simulation and engaging in the learning process.
基金supported by research funding from the Macao Polytechnic Institute(No.RP/ESS-06/2017)。
文摘Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。
基金National Key Research and Development Program of China(2022YFB4600902)Shandong Provincial Science Foundation for Outstanding Young Scholars(ZR2024YQ020)。
文摘Wire arc additive manufacturing(WAAM)has emerged as a promising approach for fabricating large-scale components.However,conventional WAAM still faces challenges in optimizing microstructural evolution,minimizing additive-induced defects,and alleviating residual stress and deformation,all of which are critical for enhancing the mechanical performance of the manufactured parts.Integrating interlayer friction stir processing(FSP)into WAAM significantly enhances the quality of deposited materials.However,numerical simulation research focusing on elucidating the associated thermomechanical coupling mechanisms remains insufficient.A comprehensive numerical model was developed to simulate the thermomechanical coupling behavior in friction stir-assisted WAAM.The influence of post-deposition FSP on the coupled thermomechanical response of the WAAM process was analyzed quantitatively.Moreover,the residual stress distribution and deformation behavior under both single-layer and multilayer deposition conditions were investigated.Thermal analysis of different deposition layers in WAAM and friction stir-assisted WAAM was conducted.Results show that subsequent layer deposition induces partial remelting of the previously solidified layer,whereas FSP does not cause such remelting.Furthermore,thermal stress and deformation analysis confirm that interlayer FSP effectively mitigates residual stresses and distortion in WAAM components,thereby improving their structural integrity and mechanical properties.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金supported by the National Key R&D Program of China[grant number 2023YFC3008004]。
文摘This study introduces a new ocean surface friction velocity scheme and a modified Thompson cloud microphysics parameterization scheme into the CMA-TYM model.The impact of these two parameterization schemes on the prediction of the movement track and intensity of Typhoon Kompasu in 2021 is examined.Additionally,the possible reasons for their effects on tropical cyclone(TC)intensity prediction are analyzed.Statistical results show that both parameterization schemes improve the predictions of Typhoon Kompasu’s track and intensity.The influence on track prediction becomes evident after 60 h of model integration,while the significant positive impact on intensity prediction is observed after 66 h.Further analysis reveals that these two schemes affect the timing and magnitude of extreme TC intensity values by influencing the evolution of the TC’s warm-core structure.
基金Supported by the National Natural Science Foundation of China under Grant No.51975138the High-Tech Ship Scientific Research Project from the Ministry of Industry and Information Technology under Grant No.CJ05N20the National Defense Basic Research Project under Grant No.JCKY2023604C006.
文摘Marine thin plates are susceptible to welding deformation owing to their low structural stiffness.Therefore,the efficient and accurate prediction of welding deformation is essential for improving welding quality.The traditional thermal elastic-plastic finite element method(TEP-FEM)can accurately predict welding deformation.However,its efficiency is low because of the complex nonlinear transient computation,making it difficult to meet the needs of rapid engineering evaluation.To address this challenge,this study proposes an efficient prediction method for welding deformation in marine thin plate butt welds.This method is based on the coupled temperature gradient-thermal strain method(TG-TSM)that integrates inherent strain theory with a shell element finite element model.The proposed method first extracts the distribution pattern and characteristic value of welding-induced inherent strain through TEP-FEM analysis.This strain is then converted into the equivalent thermal load applied to the shell element model for rapid computation.The proposed method-particularly,the gradual temperature gradient-thermal strain method(GTG-TSM)-achieved improved computational efficiency and consistent precision.Furthermore,the proposed method required much less computation time than the traditional TEP-FEM.Thus,this study lays the foundation for future prediction of welding deformation in more complex marine thin plates.
文摘Analysis of the environmental and economic performance of fishing vessels has received limited attention compared with other ship types despite their notable contribution to global greenhouse gas(GHG)emissions.This study evaluates the carbon footprint(CF)and economic viability of a liquefied natural gas(LNG)-fueled fishing vessel,using real engine operation simulations to provide precise and dynamic evaluation of fuel consumption and GHG emissions.Operational profiles are obtained through the utilization of onboard monitoring systems,whereas engine performance is simulated using the 1D/0D AVL Boost^(TM)model.Life cycle assessment(LCA)is conducted to quantify the environmental impact,whereas life cycle cost assessment(LCCA)is performed to analyze the profitability of LNG as an alternative fuel.The potential impact of the future fuel price uncertainties is addressed using Monte Carlo simulations.The LCA findings indicate that LNG has the potential to reduce the CF of the vessel by 14%to 16%,in comparison to a diesel power system configuration that serves as the baseline scenario.The LCCA results further indicate that the total cost of an LNG-powered ship is lower by 9.5%-13.8%,depending on the share of LNG and pilot fuels.This finding highlights the potential of LNG to produce considerable environmental benefits while addressing economic challenges under diverse operational and fuel price conditions.
基金sponsored by the William RT Oakes Endowment of the Georgia Institute of Technology
文摘Engineering design is undergoing a paradigm shift from design for performance to design for affordability, operability, and durability, seeking multi-objective optimization. To facilitate this transformation, significantly extended design freedom and knowledge must be available in the early design stages. This paper presents a high-fidelity framework for design and optimization of the liquid swirl injectors that are widely used in aerospace propulsion and power-generation systems. The framework assembles a set of techniques, including Design Of Experiment(DOE), high-fidelity Large Eddy Simulations(LES), machine learning, Proper Orthogonal Decomposition(POD)-based Kriging surrogate modeling(emulation), inverse problem optimization, and uncertainty quantification. LES-based simulations can reveal detailed spatiotemporal evolution of flow structures and flame dynamics in a high-fidelity manner, and identify important injector design parameters according to their effects on propellant mixing, flame stabilization, and thermal protection.For a given a space of design parameters, DOE determines the number of design points to perform LES-based simulations. POD-based emulations, trained by the LES database, can effectively explore the design space and deduce an optimal group of design parameters in a turn-around time that is reduced by three orders of magnitude. The accuracy of the emulated results is validated, and the uncertainty of prediction is quantified. The proposed design methodology is expected to profoundly extend the knowledge base and reduce the cost for initial design stages.
文摘High-fidelity cargo airdrop simulation requires the contact dynamics between an aircraft and a cargo to be modeled accurately. This paper presents a general and efficient contact-friction model for simulation of aircraft-cargo coupling dynamics during airdrops. The proposed approach has the same essence as that of the finite element node-to-segment contact formulation, which leads to a flexible, straight forward, and efficient code implementation. The formulation is developed under an arbitrary moving frame with both the aircraft and the cargo being treated as general six-degree-of-freedom rigid bodies, and thus it eliminates the restrictions of lateral symmetric assumptions in most existing methods. Moreover, the aircraft-cargo coupling algorithm is discussed in detail, and some practical implementation details are presented. The accuracy and capability of the present method are demonstrated through three numerical examples with increasing complexity and fidelity.
基金supported by Jiangsu Province Health Vocational and Technical Education Research Grants Program(No.201402)Jiangsu Province College“Qing Lan Project”[Su Teacher No.2014(23)]The Science and Technology Innovation Team Project of Suzhou Health College(No.szwzytd 201304)
文摘Objective： To investigate the effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors. Methods： A high-fidelity teaching simulation on clinical nursing practices using intelligent human analogues was conducted with 200 students, and The Simulation Design Scale, and the Student Satisfaction and Self-Confidence in Learning Scale developed by the National League for Nursing were used to evaluate the training effectiveness and its influencing factors. Results： For the high-fidelity teaching simulation, students gave scores of 4.36± 0.54 points for satisfaction and 4.33 ± 0.46 points for Self-Confidence. The students highly rated the five dimensions of teaching design, i.e., teaching objectives/information, assistance/support for students, problem solving, guided feedback, and fidelity. The teaching design was closely correlated with the satisfaction of the high-fidelity teaching simulation and self-efficacy, and the dimensions of teaching objectives/informa- tion and assistance/support for students were particularly strong predictors of teaching effectiveness. Conclusions： A high-fidelity teaching simulation based on Jeffries＇ theoretical framework improved student satisfaction with the simulation and their Self-Confidence. In planning simulations, teachers should take into account five characteristics, i.e., teaching objectives/information on simulation education, assistance/support for students, problem solving, guided reflection, and fidelity, to achieve better teaching effectiveness.
