WEBVTT 00:00:05.461 --> 00:00:09.460 position:50% align:middle - [Brenda] Well, thank you for being here this afternoon and I'd like to also thank NCSBN 00:00:09.460 --> 00:00:11.110 position:50% align:middle for funding this research. 00:00:11.110 --> 00:00:20.860 position:50% align:middle So, the Middle East, depending upon who you ask, is made up of 20 questions or 21 countries. 00:00:20.860 --> 00:00:28.120 position:50% align:middle The research I did was using the countries that are most commonly considered the Middle East when we 00:00:28.120 --> 00:00:28.790 position:50% align:middle think of it. 00:00:28.790 --> 00:00:36.705 position:50% align:middle So, places like Jordan, Palestine, Israel, Iraq, Iran, Syria, Lebanon, the ones that you tend to think of when 00:00:36.705 --> 00:00:38.815 position:50% align:middle you think of the Middle East countries. 00:00:38.815 --> 00:00:45.105 position:50% align:middle I tried to extend the research out to include the Sudan and Morocco, but it was quite difficult. 00:00:45.105 --> 00:00:53.435 position:50% align:middle There were very few nursing programs to find in Morocco and when I contacted programs in Sudan, 00:00:53.435 --> 00:00:56.265 position:50% align:middle I had no response whatsoever. 00:00:56.265 --> 00:01:02.933 position:50% align:middle So I consolidated it to the areas that are most likely to get a response. 00:01:02.933 --> 00:01:03.693 position:50% align:middle So, this is my team. 00:01:03.693 --> 00:01:11.413 position:50% align:middle You can see, Fadwa Alhalaiqa from Jordan, Ahlam Al-Zahrani from the Kingdom of Saudi Arabia and 00:01:11.413 --> 00:01:14.223 position:50% align:middle Hoda Sayed from Egypt. 00:01:14.223 --> 00:01:20.323 position:50% align:middle All of us are nursing educators and these individuals were, I met them individually, 00:01:20.323 --> 00:01:22.493 position:50% align:middle both on Zoom and in person. 00:01:22.493 --> 00:01:25.363 position:50% align:middle And they were all very committed to collecting this data. 00:01:25.363 --> 00:01:31.053 position:50% align:middle And without this network and without this collaboration, I don't think the data would have been 00:01:31.053 --> 00:01:34.703 position:50% align:middle collected at the level that it was. 00:01:34.703 --> 00:01:40.733 position:50% align:middle So, as you know, simulation is a nursing education strategy that mimics hospital environments. 00:01:40.733 --> 00:01:46.443 position:50% align:middle It allows the students to have a safe environment, both for themselves and for their patients. 00:01:46.443 --> 00:01:51.983 position:50% align:middle And of course, it allows us to use simulation in place of clinical experience. 00:01:51.983 --> 00:01:58.553 position:50% align:middle And this is very important in the Middle East because female nurses care for female patients. 00:01:58.553 --> 00:02:01.579 position:50% align:middle And male nurses care for male patients. 00:02:01.579 --> 00:02:08.809 position:50% align:middle On a hospital unit, you would have a one side of the unit would be all female rooms and the other side would 00:02:08.809 --> 00:02:10.499 position:50% align:middle be all male rooms. 00:02:10.499 --> 00:02:15.119 position:50% align:middle And so, female nurses then take care of the female patients and you may ask, "Well, 00:02:15.119 --> 00:02:19.019 position:50% align:middle certainly there aren't enough male nurses to care for those male patients." 00:02:19.019 --> 00:02:25.089 position:50% align:middle What happens is that you have family members in these rooms all the time. 00:02:25.089 --> 00:02:30.328 position:50% align:middle So, all the care that happens, happens with the family members present, 00:02:30.328 --> 00:02:31.768 position:50% align:middle both for male and female nurses. 00:02:31.768 --> 00:02:37.698 position:50% align:middle Now, it does not make a difference the gender of the doctor, only the nurse. 00:02:37.698 --> 00:02:44.408 position:50% align:middle And obviously, one of the other benefits of simulation, not only for opposite gender care but for contagious 00:02:44.408 --> 00:02:49.848 position:50% align:middle situations that our students wouldn't be allowed to participate in, things like active tuberculosis 00:02:49.848 --> 00:02:56.568 position:50% align:middle or COVID, even leprosy, which is not common here but it is in other places. 00:02:56.568 --> 00:03:01.955 position:50% align:middle So, my experience with simulation and the Middle East comes from a couple of times. 00:03:01.955 --> 00:03:06.365 position:50% align:middle I was a Filbert scholar in Jordan and I was there for six months. 00:03:06.365 --> 00:03:11.825 position:50% align:middle I lectured and I conducted research and I was also part of their stimulation. 00:03:11.825 --> 00:03:17.715 position:50% align:middle The first time they asked me to come to the simulation suite and show me their simulation, 00:03:17.715 --> 00:03:26.925 position:50% align:middle it was all demonstration and return demonstration and it was on a 4G simulator with a computer attached. 00:03:26.925 --> 00:03:28.405 position:50% align:middle And that's what they did. 00:03:28.405 --> 00:03:32.395 position:50% align:middle And as soon as it was over, that clinical faculty pulled me to the side and said, 00:03:32.395 --> 00:03:33.505 position:50% align:middle "How did I do? 00:03:33.505 --> 00:03:36.045 position:50% align:middle What can I do better?" 00:03:36.045 --> 00:03:42.055 position:50% align:middle And I didn't know what to say because they didn't do any simulation, right? 00:03:42.055 --> 00:03:44.925 position:50% align:middle It was all demonstration and return demonstration. 00:03:44.925 --> 00:03:48.005 position:50% align:middle And so, I said, you know, "Let's talk about how the students can get a little 00:03:48.005 --> 00:03:50.795 position:50% align:middle more involved and they can do more." 00:03:50.795 --> 00:03:56.195 position:50% align:middle And then, I had a meeting with the dean of the College of Nursing and I said, "We need to do something." 00:03:56.195 --> 00:04:03.104 position:50% align:middle So, I ran a couple of workshops before I left Jordan and that's also what then I went on to do in Egypt was 00:04:03.104 --> 00:04:07.454 position:50% align:middle run simulation workshops, helping the faculty understand the difference 00:04:07.454 --> 00:04:12.644 position:50% align:middle between demonstration, return demonstration and actually simulation. 00:04:12.644 --> 00:04:21.494 position:50% align:middle In Egypt, my focus was on low resource simulation, because they don't have the 3 and 4G manikins. 00:04:21.494 --> 00:04:28.294 position:50% align:middle One thing I found in Jordan that was a little bit disappointing was that vendors come in and they are 00:04:28.294 --> 00:04:34.856 position:50% align:middle funded to place 3 and 4G simulators with the computers in the nursing simulation labs. 00:04:34.856 --> 00:04:37.716 position:50% align:middle After about three days of training, they leave. 00:04:37.716 --> 00:04:44.376 position:50% align:middle And in about two months, nobody remembers how to use these high-end manikins. 00:04:44.376 --> 00:04:46.506 position:50% align:middle They don't remember how to use the computers. 00:04:46.506 --> 00:04:51.376 position:50% align:middle When they showed me, we had to make an appointment with the IT helpdesk so 00:04:51.376 --> 00:04:54.966 position:50% align:middle they could come in and run the computers. 00:04:54.966 --> 00:04:56.776 position:50% align:middle So, it's really disappointing. 00:04:56.776 --> 00:05:07.566 position:50% align:middle This whole idea of high-end simulation is difficult for these programs to support it long term. 00:05:07.566 --> 00:05:10.516 position:50% align:middle So, why is simulation happening in the Middle East? 00:05:10.516 --> 00:05:12.976 position:50% align:middle It's very similar to our own issues. 00:05:12.976 --> 00:05:19.686 position:50% align:middle Modernization, faculty shortages, of course, accreditation expectations and they have 00:05:19.686 --> 00:05:23.436 position:50% align:middle limited clinical spaces. 00:05:23.436 --> 00:05:31.327 position:50% align:middle Publications in the Middle East about simulation comes from mostly three locations: Saudi Arabia, 00:05:31.327 --> 00:05:33.547 position:50% align:middle Oman and Jordan. 00:05:33.547 --> 00:05:39.037 position:50% align:middle In the Kingdom of Saudi Arabia, they are expanding their medical education. 00:05:39.037 --> 00:05:45.177 position:50% align:middle One problem they have that is significant is clinical space. 00:05:45.177 --> 00:05:51.207 position:50% align:middle I was just in Saudi Arabia about three months ago helping to build a medical school and a hospital. 00:05:51.207 --> 00:05:59.327 position:50% align:middle And they have hospitals, I was in Dammam, Saudi Arabia, which is southeast, and they have huge hospitals that 00:05:59.327 --> 00:06:01.157 position:50% align:middle can accommodate 500 patients. 00:06:01.157 --> 00:06:04.187 position:50% align:middle And they have 150 patients. 00:06:04.187 --> 00:06:11.857 position:50% align:middle So, not only is the clinical space a problem, but the actual patient population is a problem. 00:06:11.857 --> 00:06:17.657 position:50% align:middle Getting their medical students and nursing students into this environment is very tricky because the 00:06:17.657 --> 00:06:19.587 position:50% align:middle patients aren't there. 00:06:19.587 --> 00:06:23.527 position:50% align:middle The patients, instead, are in clinics and they go home. 00:06:23.527 --> 00:06:25.517 position:50% align:middle They don't stay as inpatients. 00:06:25.517 --> 00:06:27.527 position:50% align:middle Or they're treated at home. 00:06:27.527 --> 00:06:31.433 position:50% align:middle So, that's one thing, that's one reason that Saudi Arabia 00:06:31.433 --> 00:06:33.513 position:50% align:middle is using simulation. 00:06:33.513 --> 00:06:39.573 position:50% align:middle Oman has now moved from an on-the-fly simulation to the NLN designs. 00:06:39.573 --> 00:06:44.643 position:50% align:middle So, that's how they're using simulation and they're incorporating it into more areas. 00:06:44.643 --> 00:06:51.083 position:50% align:middle And in Jordan, it's widely being used, both for the doctors and for the nurses to help them 00:06:51.083 --> 00:06:56.233 position:50% align:middle with skill acquisition and comfort in the clinical area. 00:06:56.233 --> 00:06:57.603 position:50% align:middle So, the survey. 00:06:57.603 --> 00:07:04.884 position:50% align:middle We started with the survey in 2019 and as you all know what happened in 2020, COVID, the pandemic, 00:07:04.884 --> 00:07:07.524 position:50% align:middle really limited our responses. 00:07:07.524 --> 00:07:14.354 position:50% align:middle Faculty, this survey was sent electronically to faculty administrators They had gone home and they didn't 00:07:14.354 --> 00:07:17.624 position:50% align:middle necessarily work from home online. 00:07:17.624 --> 00:07:19.844 position:50% align:middle They were simply working at home. 00:07:19.844 --> 00:07:23.334 position:50% align:middle They didn't necessarily have computers that went home with them. 00:07:23.334 --> 00:07:29.264 position:50% align:middle So, there was a big disconnect between this survey arriving to these individuals and then having 00:07:29.264 --> 00:07:30.956 position:50% align:middle an opportunity to fill it out. 00:07:30.956 --> 00:07:32.796 position:50% align:middle So I did a couple of different things. 00:07:32.796 --> 00:07:34.156 position:50% align:middle I used snail mail. 00:07:34.156 --> 00:07:43.086 position:50% align:middle I got one of those back and that was handed to me when I went to Egypt well after the data had been collected. 00:07:43.086 --> 00:07:48.126 position:50% align:middle And I sent a bunch via snail mail to the Sudan and I heard nothing back. 00:07:48.126 --> 00:07:53.746 position:50% align:middle What did help was that team, the team of researchers. 00:07:53.746 --> 00:07:56.936 position:50% align:middle I contacted them, Some I already knew. 00:07:56.936 --> 00:08:01.377 position:50% align:middle Because I was, you know, in the Middle East, I did have some contacts and networks 00:08:01.377 --> 00:08:02.937 position:50% align:middle and found collaborators. 00:08:02.937 --> 00:08:05.667 position:50% align:middle I reached out to people and they made recommendations. 00:08:05.667 --> 00:08:06.957 position:50% align:middle I met via Zoom. 00:08:06.957 --> 00:08:15.677 position:50% align:middle And these teammembers literally took that survey and told me, "I'm going to have tea with that dean tomorrow 00:08:15.677 --> 00:08:19.077 position:50% align:middle and they're going to fill it out while I sit there with them." 00:08:19.077 --> 00:08:20.367 position:50% align:middle And they did. 00:08:20.367 --> 00:08:24.597 position:50% align:middle They hand-delivered these surveys to people and they filled them out. 00:08:24.597 --> 00:08:32.357 position:50% align:middle And then, there's this wide mistrust of online surveys in the Middle East and perhaps other places. 00:08:32.357 --> 00:08:39.947 position:50% align:middle There's the belief that the results from this survey will not only go to the person that sent it, 00:08:39.947 --> 00:08:46.437 position:50% align:middle but instead, to their boss, to administrators, to the government, to other people. 00:08:46.437 --> 00:08:48.347 position:50% align:middle So, it's not safe. 00:08:48.347 --> 00:08:52.847 position:50% align:middle This online survey, like, monkey surveys, are not safe. 00:08:52.847 --> 00:08:59.357 position:50% align:middle So, then I sent them a Word document and/or a PDF of the survey. 00:08:59.357 --> 00:09:03.151 position:50% align:middle I asked them to fill it out, scan it and email it back to me. 00:09:03.151 --> 00:09:04.191 position:50% align:middle So, that worked. 00:09:04.191 --> 00:09:06.381 position:50% align:middle That worked. 00:09:06.381 --> 00:09:09.141 position:50% align:middle So, those were the three ways we collected data. 00:09:09.141 --> 00:09:11.201 position:50% align:middle So, these are the countries that replied. 00:09:11.201 --> 00:09:16.011 position:50% align:middle So, I sent surveys to 93 programs. 00:09:16.011 --> 00:09:21.611 position:50% align:middle Thirty-nine programs participated and these programs were in 10 different countries. 00:09:21.611 --> 00:09:28.791 position:50% align:middle And I have to say that other faculty in the Middle East said not to bother with Syria because there was civil 00:09:28.791 --> 00:09:31.310 position:50% align:middle unrest and disagreement between these countries. 00:09:31.310 --> 00:09:35.150 position:50% align:middle So, as with many of us researchers, the minute someone tells you, "Oh, 00:09:35.150 --> 00:09:38.740 position:50% align:middle don't do that," we do it. 00:09:38.740 --> 00:09:46.280 position:50% align:middle And so, I was really moved because I sent the survey to a nursing program in Syria and I heard 00:09:46.280 --> 00:09:48.390 position:50% align:middle back within days. 00:09:48.390 --> 00:09:55.320 position:50% align:middle And that dean also sent me pictures of the equipment in their simulation lab. 00:09:55.320 --> 00:10:03.554 position:50% align:middle They have places to learn to suture, stop bleeding, put in emergency trachs and they had no simulators, 00:10:03.554 --> 00:10:08.224 position:50% align:middle no 3G, 4G, because of the civil unrest in Syria. 00:10:08.224 --> 00:10:13.614 position:50% align:middle Although their simulation is focused on war-related trauma. 00:10:13.614 --> 00:10:16.254 position:50% align:middle And they had time to answer my survey, right? 00:10:16.254 --> 00:10:23.174 position:50% align:middle You know, it really touched me that they took time to do it and send me pictures. 00:10:23.174 --> 00:10:25.214 position:50% align:middle So, what do we find? 00:10:25.214 --> 00:10:27.294 position:50% align:middle So, first clinical hours. 00:10:27.294 --> 00:10:33.483 position:50% align:middle For programs it ranged from 160 program clinical hours to over 1,000. 00:10:33.483 --> 00:10:35.873 position:50% align:middle Med-surg was the most common. 00:10:35.873 --> 00:10:40.773 position:50% align:middle Of course, we find that as well, as well as advanced med-surg being ICU. 00:10:40.773 --> 00:10:44.803 position:50% align:middle And then, capstone, you know, that final program. 00:10:44.803 --> 00:10:49.443 position:50% align:middle That was also highly significant. 00:10:49.443 --> 00:10:55.903 position:50% align:middle So, some respondents was 100% substitution for their simulation. 00:10:55.903 --> 00:11:01.959 position:50% align:middle Most common courses, yeah, was med-surg, women's health and then PD. 00:11:01.959 --> 00:11:06.819 position:50% align:middle So obviously, women's health is part of that cross-gender care. 00:11:06.819 --> 00:11:10.409 position:50% align:middle This is where male students are going to learn about labor and delivery. 00:11:10.409 --> 00:11:16.409 position:50% align:middle They are not going to be part of the labor and delivery process in the hospital. 00:11:16.409 --> 00:11:17.349 position:50% align:middle They're not going to be there. 00:11:17.349 --> 00:11:19.829 position:50% align:middle So this is where they learn it. 00:11:19.829 --> 00:11:24.969 position:50% align:middle Some program simulation, you know, like I said, was all clinical hours. 00:11:24.969 --> 00:11:33.865 position:50% align:middle And the vast majority of the simulation space was open to students to come in and practice at any time. 00:11:33.865 --> 00:11:39.235 position:50% align:middle So, we also asked what their thoughts and opinions were, like, their ideas. 00:11:39.235 --> 00:11:44.725 position:50% align:middle So, 45% of the faculty felt that we had enough simulation. 00:11:44.725 --> 00:11:51.705 position:50% align:middle Another 45% thought we needed more and 6% thought we had too much simulation. 00:11:51.705 --> 00:11:57.435 position:50% align:middle The reason, so their ideas about what doesn't belong in simulation. 00:11:57.435 --> 00:12:01.296 position:50% align:middle So, only in clinical, they felt that is where 00:12:01.296 --> 00:12:03.546 position:50% align:middle therapeutic communication belonged. 00:12:03.546 --> 00:12:12.006 position:50% align:middle That is where patient education belonged as well as empathy, caring and compassion and interestingly, 00:12:12.006 --> 00:12:14.716 position:50% align:middle problem-solving and critical thinking. 00:12:14.716 --> 00:12:20.776 position:50% align:middle Now, I think in my own experience, critical thinking is a big part of simulation, 00:12:20.776 --> 00:12:28.536 position:50% align:middle but they felt that belonged in the clinical setting and not in simulation. 00:12:28.536 --> 00:12:34.773 position:50% align:middle So, what is needed to increase simulation and these themes are interesting. 00:12:34.773 --> 00:12:40.733 position:50% align:middle Training to facilitate simulation, writing scenarios, conducting debriefings, 00:12:40.733 --> 00:12:46.623 position:50% align:middle staff to run simulation centers, and oversee students and time to write scenarios. 00:12:46.623 --> 00:12:47.903 position:50% align:middle Very common, right? 00:12:47.903 --> 00:12:49.863 position:50% align:middle We have the same complaints. 00:12:49.863 --> 00:12:57.503 position:50% align:middle Except in the Middle East, the faculty that do clinical are the MSN faculty. 00:12:57.503 --> 00:13:01.507 position:50% align:middle They're the ones that need to do all of this. 00:13:01.507 --> 00:13:05.498 position:50% align:middle Write the scenarios, make time, equipment. 00:13:05.498 --> 00:13:11.888 position:50% align:middle The PhD or didactic faculty are not involved with the clinical world. 00:13:11.888 --> 00:13:13.338 position:50% align:middle They do not go to the hospital. 00:13:13.338 --> 00:13:20.358 position:50% align:middle So, their idea of simulation is all these MSN faculty making this work. 00:13:20.358 --> 00:13:26.088 position:50% align:middle We're going to send your students and in the lab, you're going to do simulation with them. 00:13:26.088 --> 00:13:28.488 position:50% align:middle You are going to train them on these skills. 00:13:28.488 --> 00:13:30.529 position:50% align:middle You're going to do this with them. 00:13:30.529 --> 00:13:34.169 position:50% align:middle The PhD and didactic faculty are not involved. 00:13:34.169 --> 00:13:37.919 position:50% align:middle So, there's really, like, a layering of faculty here. 00:13:37.919 --> 00:13:39.779 position:50% align:middle There's them and us. 00:13:39.779 --> 00:13:43.879 position:50% align:middle And the expectation from these administrators is them. 00:13:43.879 --> 00:13:45.699 position:50% align:middle They need to fix this. 00:13:45.699 --> 00:13:51.439 position:50% align:middle So, it's a really different view of how this works in that environment. 00:13:51.439 --> 00:13:53.299 position:50% align:middle So, regulation and training. 00:13:53.299 --> 00:14:00.817 position:50% align:middle Thirty-nine percent have updated in the last few years and these were related to the NCSBN guidelines. 00:14:00.817 --> 00:14:11.807 position:50% align:middle Training, 68% have received running simulation training, 45% conducting debriefings and 33% 00:14:11.807 --> 00:14:13.837 position:50% align:middle programming the manikins. 00:14:13.837 --> 00:14:19.437 position:50% align:middle And 21% of the respondents have had no training. 00:14:19.437 --> 00:14:21.887 position:50% align:middle So, our discussion around this. 00:14:21.887 --> 00:14:30.331 position:50% align:middle So, definitely simulation is being used in the MENA region and that's because of the same problems we have, 00:14:30.331 --> 00:14:37.071 position:50% align:middle limited clinical space, faculty availability, training in complex care situations and 00:14:37.071 --> 00:14:39.191 position:50% align:middle opposite gender care. 00:14:39.191 --> 00:14:47.711 position:50% align:middle It is used for all clinical courses and can substitute 50% to 100% in those responding programs. 00:14:47.711 --> 00:14:52.141 position:50% align:middle The challenges, space, cost, trained faculty. 00:14:52.141 --> 00:14:58.621 position:50% align:middle And we have similar challenges in the U.S., being limited clinical space, time, 00:14:58.621 --> 00:15:03.166 position:50% align:middle faculty availability and then complex care situations. 00:15:03.166 --> 00:15:07.456 position:50% align:middle So, there was some limitations to our data collection. 00:15:07.456 --> 00:15:10.006 position:50% align:middle There was civil unrest in many of the countries. 00:15:10.006 --> 00:15:14.696 position:50% align:middle That kind of waxed and waned depending upon where you had information from. 00:15:14.696 --> 00:15:17.576 position:50% align:middle I was surprised at the limited responses from Israel. 00:15:17.576 --> 00:15:24.676 position:50% align:middle At that time, there was not any civil unrest in Israel, yet I got very little information back from them. 00:15:24.676 --> 00:15:29.616 position:50% align:middle I was surprised at the responses from Palestine. 00:15:29.616 --> 00:15:35.323 position:50% align:middle Programs in Palestine are very eager to make improvements and I heard back from a significant 00:15:35.323 --> 00:15:36.513 position:50% align:middle number of those. 00:15:36.513 --> 00:15:42.213 position:50% align:middle And as you may know now, Palestine and Israel are very close together. 00:15:42.213 --> 00:15:44.933 position:50% align:middle There was anxiety about sharing data, of course. 00:15:44.933 --> 00:15:49.663 position:50% align:middle They don't know me but they knew my collaborators. 00:15:49.663 --> 00:15:52.853 position:50% align:middle But they don't know me so there's some anxiety about that. 00:15:52.853 --> 00:15:54.323 position:50% align:middle Lack of time and incentive. 00:15:54.323 --> 00:16:00.673 position:50% align:middle There was a lot of problems during the pandemic, lots of anxiety, so that was a limiting factor. 00:16:00.673 --> 00:16:01.993 position:50% align:middle COVID, right? 00:16:01.993 --> 00:16:03.823 position:50% align:middle We separated from campus. 00:16:03.823 --> 00:16:10.213 position:50% align:middle People weren't even thinking about simulation when they went home to return six months or a year later. 00:16:10.213 --> 00:16:14.953 position:50% align:middle And again, lack of that personal relationship. 00:16:14.953 --> 00:16:22.373 position:50% align:middle So, in conclusion, nursing simulation is actively being used as a teaching strategy and it's very welcome. 00:16:22.373 --> 00:16:27.893 position:50% align:middle They need support just like we do in training and regulation. 00:16:27.893 --> 00:16:35.759 position:50% align:middle So, hopefully going forward, I'll do more research in this area and in addition 00:16:35.759 --> 00:16:40.009 position:50% align:middle to collaborating with the individuals. 00:16:40.009 --> 00:16:41.359 position:50% align:middle Questions? 00:16:44.017 --> 00:16:45.344 position:50% align:middle Yes? 00:16:48.202 --> 00:16:55.749 position:50% align:middle - [Woman 1] These faculty of deans that you interviewed or got information from, are they using sims, 00:16:55.749 --> 00:16:57.469 position:50% align:middle both of pre-licensure and master's? 00:16:57.469 --> 00:17:02.072 position:50% align:middle - So, the question is are they using simulation in both pre-licensure and the master's programs? 00:17:02.072 --> 00:17:02.622 position:50% align:middle Yes. 00:17:02.622 --> 00:17:04.632 position:50% align:middle So, they are using simulation in both. 00:17:04.632 --> 00:17:10.692 position:50% align:middle However, the pre-licensure undergraduate programs is where there's more simulation 00:17:10.692 --> 00:17:12.542 position:50% align:middle than in the graduate programs. 00:17:12.542 --> 00:17:19.852 position:50% align:middle Most of the programs, especially in Jordan, are not focused on the healthcare provider programs, 00:17:19.852 --> 00:17:25.352 position:50% align:middle like nurse practitioners, because they have an abundance of medical doctors. 00:17:25.352 --> 00:17:25.622 position:50% align:middle Yeah. 00:17:25.622 --> 00:17:32.094 position:50% align:middle They put out lots of medical doctors very year and there are many medical doctors. 00:17:32.094 --> 00:17:34.614 position:50% align:middle There's not that lack of the healthcare provider role. 00:17:34.614 --> 00:17:37.324 position:50% align:middle So, it's mostly in undergraduate. 00:17:37.324 --> 00:17:39.784 position:50% align:middle That's a good question. 00:17:39.784 --> 00:17:42.224 position:50% align:middle Other questions? 00:17:42.224 --> 00:17:43.683 position:50% align:middle Yes? 00:17:43.683 --> 00:17:45.434 position:50% align:middle - [Woman 2] Thank you for your presentation. 00:17:45.434 --> 00:17:51.224 position:50% align:middle One question I had was around the percentage of clinical with their replacing simulation. 00:17:51.224 --> 00:17:54.504 position:50% align:middle Whenever I think about a percentage, I think about what is the total that 00:17:54.504 --> 00:17:56.144 position:50% align:middle they're starting with. 00:17:56.144 --> 00:18:02.343 position:50% align:middle Was there a range in the number of required clinical hours across the countries? 00:18:02.343 --> 00:18:08.663 position:50% align:middle - It isn't really across the country but program-specific, like one program had 1,000 clinical 00:18:08.663 --> 00:18:10.353 position:50% align:middle hours in their program. 00:18:10.353 --> 00:18:13.753 position:50% align:middle Another program had about 200 in the entire program. 00:18:13.753 --> 00:18:13.903 position:50% align:middle Yeah. 00:18:13.903 --> 00:18:18.113 position:50% align:middle So, not really a country-wide result. 00:18:18.113 --> 00:18:22.793 position:50% align:middle And I intentionally did not compare one country to the next. 00:18:22.793 --> 00:18:27.493 position:50% align:middle You know, one reason is there wasn't equal data between one country and the next. 00:18:27.493 --> 00:18:35.459 position:50% align:middle And there's nothing to be gained from comparing one Middle Eastern country to another. 00:18:35.459 --> 00:18:35.779 position:50% align:middle Yeah. 00:18:35.779 --> 00:18:40.051 position:50% align:middle You're not going to get anywhere with that, so definitely did not do that. 00:18:40.051 --> 00:18:42.935 position:50% align:middle Yeah. Yes? 00:18:42.935 --> 00:18:46.713 position:50% align:middle - [Woman 3] [inaudible 00:18:43.650] educator. 00:18:46.713 --> 00:18:50.767 position:50% align:middle While I don't do sims yet, I'm very interested in those and this may be too broad of a question. 00:18:50.767 --> 00:18:55.181 position:50% align:middle But my question is what am I looking for, as an educator, what am I looking for in a 00:18:55.181 --> 00:18:56.498 position:50% align:middle good simulation program? 00:18:56.498 --> 00:18:57.929 position:50% align:middle - Good. That's a good question. 00:18:57.929 --> 00:19:01.201 position:50% align:middle So, what are we looking for in a good simulation program? 00:19:01.201 --> 00:19:02.871 position:50% align:middle Faculty that are trained. 00:19:02.871 --> 00:19:09.881 position:50% align:middle Faculty that have the INACSL, the abbreviation behind our name. 00:19:09.881 --> 00:19:12.851 position:50% align:middle There's a healthcare simulation educator. 00:19:12.851 --> 00:19:25.331 position:50% align:middle HCSE is the abbreviation behind people's names that are certified in healthcare simulation education. 00:19:25.331 --> 00:19:26.361 position:50% align:middle And that's through INACSL. 00:19:26.361 --> 00:19:30.246 position:50% align:middle I-N-A...somebody help me. - C-S-L. 00:19:30.246 --> 00:19:32.909 position:50% align:middle - There we go. Yeah. 00:19:32.909 --> 00:19:34.244 position:50% align:middle - I-N-A-C-S-L. 00:19:34.244 --> 00:19:37.919 position:50% align:middle - And once you get on their mailing list, they will never stop. 00:19:37.919 --> 00:19:43.339 position:50% align:middle And you will always have all the information you could possibly want. 00:19:43.339 --> 00:19:43.649 position:50% align:middle Yes? 00:19:43.649 --> 00:19:43.999 position:50% align:middle Go ahead. 00:19:43.999 --> 00:19:45.455 position:50% align:middle I'm sorry. 00:19:45.455 --> 00:19:51.981 position:50% align:middle I was just curious, were these English-speaking universities or were they in the native language? 00:19:51.981 --> 00:19:53.019 position:50% align:middle - That's a great question. 00:19:53.019 --> 00:19:58.899 position:50% align:middle So, when I went to Jordan and I went to my first med-surg course that I was going to observe and then 00:19:58.899 --> 00:20:02.322 position:50% align:middle later teach, they had our book, Elsevier Med-Surg. 00:20:02.322 --> 00:20:06.132 position:50% align:middle And that was widespread. 00:20:06.132 --> 00:20:08.122 position:50% align:middle So, always in English. 00:20:08.122 --> 00:20:13.992 position:50% align:middle The master's and doctoral programs were exclusively taught and then, like, 00:20:13.992 --> 00:20:16.962 position:50% align:middle papers came back in English only. 00:20:16.962 --> 00:20:21.522 position:50% align:middle In the undergraduate program, what I saw was that it would be presented in English 00:20:21.522 --> 00:20:26.792 position:50% align:middle and then the professor, who was Arabic-speaking, would add in when there was clearly confusion, 00:20:26.792 --> 00:20:28.632 position:50% align:middle but in Arabic. 00:20:28.632 --> 00:20:34.410 position:50% align:middle So yeah, so a combination but all of the surveys were English exclusively. 00:20:34.410 --> 00:20:35.860 position:50% align:middle Other questions? 00:20:39.600 --> 00:20:40.912 position:50% align:middle Well, good. Thank you very much. 00:20:40.912 --> 00:20:43.821 position:50% align:middle If you have any other questions, I'll see you at break.