***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM The aim of this paper is to present the results of a study design ed to determine the effect of scenario-based simulation training on nursing students ' clinical skills and competence . BACKGROUND Using full-scale , realistic , medical simulation for training healthcare professionals is becoming more and more common . Access to this technology is easier than ever before with the opening of several simulation centres throughout the world and the availability on the market of more sophisticated and affordable patient simulators . However , there is little scientific evidence proving that such technology is better than more traditional techniques in the education of , for example , undergraduate nursing students . METHODS A pretest/post-test design was employed with volunteer undergraduate students ( n = 99 ) from second year Diploma of Higher Education in Nursing programme in United Kingdom using a 15-station Objective Structured Clinical Examination . Students were r and omly allocated to either a control or an experimental group . The experimental group , as well as following their normal curriculum , were exposed to simulation training . Subsequently , all students were re-tested and completed a question naire . The data were collected between 2001 and 2003 . RESULTS The control and experimental groups improved their performance on the second Objective Structured Clinical Examination . Mean test scores , respectively , increased by 7.18 and 14.18 percentage points . The difference between the means was statistically significant ( P < 0.001 ) . However , students ' perceptions of stress and confidence , measured on a 5-point Likert scale , was very similar between groups at 2.9 ( 1 , not stressful ; 5 , very stressful ) and 3.5 ( 1 , very confident ; 5 , not confident ) for the control group , and 3.0 and 3.4 for the experimental group . CONCLUSIONS Intermediate-fidelity simulation is a useful training technique . It enables small groups of students to practise in a safe and controlled environment how to react adequately in a critical patient care situation . This type of training is very valuable to equip students with a minimum of technical and non-technical skills before they use them in practice setting OBJECTIVE To determine the most effective method of delivering training to staff on the management of an obstetric emergency . SUBJECTS The research was conducted in a District General Hospital in the UK , delivering approximately 3500 women per year . Thirty-six staff , comprising of junior and senior medical and midwifery staff were included as research subjects . Each of the staff members were put into one of six multi-professional teams . Effectively , this gave six teams , each comprising of six members . METHOD Three teaching methods were employed . Lecture based teaching ( LBT ) , simulation based teaching ( SBT ) or a combination of these two ( LAS ) . Each team of staff were r and omly allocated to undertake a full day of training in the management of Post Partum Haemorrhage utilising one of these three teaching methods . Team knowledge and performance were assessed pre-training , post training and at three months later . In addition to this assessment of knowledge and performance , qualitative semi-structured interviews were carried out with 50 % of the original cohort one year after the training , to explore anxiety , confidence , communication , knowledge retention , enjoyment and transferable skills . RESULTS All teams improved in their performance and knowledge . The teams taught using simulation only ( SBT ) were the only group to demonstrate sustained improvement in clinical management of the case , confidence , communication skills and knowledge . However , the study did not have enough power to reach statistical significance . The SBT group reported transferable skills and less anxiety in subsequent emergencies . SBT and LAS reported improved multidisciplinary communication . Although tiring , the SBT was enjoyed the most . CONCLUSION Obstetrics is a high risk speciality , in which emergencies are to some extent , inevitable . Training staff to manage these emergencies is a fundamental principal of risk management . Traditional risk management strategies based on incident reporting and event analysis are reactive and not always effective . Simulation based training is an appropriate proactive approach to reducing errors and risk in obstetrics , improving teamwork and communication , whilst giving the student a multiplicity of transferable skills to improve their performance Purpose : Although simulation technology in nursing education is becoming increasingly commonplace , a review of the literature reveals a paucity of rigorous , high-level research comparing the effectiveness of simulation with other traditional education methods in the acquisition of clinical knowledge and skills . This research aim ed to investigate the impact of three learning interventions on graduate nurse health  assessment knowledge and skills . It was hypothesized that the patient assessment skills of graduate nurses who completed a simulation learning activity would be superior to those who completed traditional education activities . Methods : Graduate nurses ( n = 74 ) were r and omly allocated to three groups ( 1 : self-directed learning package [ SDLP ] only ; 2 : SDLP plus two scenario-based PowerPoint workshops ; and 3 : SDLP plus two simulation education sessions using a manikin with low-fidelity capabilities . Following the education activities , graduates completed an individual test involving a systematic patient assessment upon a manikin . They were scored using a checklist of relevant responses . Results : Analysis of variance results suggest that the mean test score for nurses in the simulation group ( mean = 135.52 , SD = 26.63 ) was significantly higher ( P < 0.001 ) than those in the learning package group ( mean = 107.42 , SD = 29.82 ) and the PowerPoint group ( mean = 102.77 , SD = 31.68 ) . Conclusions : Simulation appears to be an effective educational tool for teaching patient assessment knowledge and skills to graduate nurses . Incorporation of such technology into graduate nurse education may decrease the time required to become clinical ly proficient , result ing in more confident and work-ready practitioners Cost-benefit management trends in Taiwan healthcare setting s have led nurses to perform more invasive skills , such as Port-A cath administration of medications . Accordingly , nurses must be well-prepared prior to teaching by the mentor and supervision method . The purpose of the current study was to develop a computer-assisted protocol using virtual reality ( VR ) in performing Port-A cath as a training program for novice nurses . A pre-tested and post-tested control group experimental design was used in this study . Seventy-seven novice nurses were invited from one large medical center hospital in North Taiwan . Thirty-seven and forty nurses were r and omly assigned to experimental and control groups . First , we design ed a 40 minute port-A cath injection VR simulation . Then , the experimental group practice d this simulation two times over 3 weeks . The control group attended the traditional class . The post-test 1 was right after completion of the simulation practice . The post-test 2 was after the second simulation practice in 3 weeks . The results showed that most novice nurses lacked Port-A cath experience both in the classroom and during the period of their practice training . The knowledge score regarding the Port-A cath technique was significantly higher in the nurses that participated in the simulation training than in the control group . The novice nurses were most satisfied with the reduction in their fear of performing the Port-A cath technique and their enhanced clinical skills .  VR simulation significantly reduced error rates and increased correct equipment selection , showing that nurses who participated in the simulation may be better prepared for inserting Port-A cath The study was design ed to compare the efficacy of controlled simulation mannequin ( SM ) assisted learning and case study presentation on knowledge and confidence of nurse practitioner ( NP ) students in managing a cardiac event . Twenty-three volunteer students were r and omly assigned to the experimental ( simulation ) or control ( case study presentation ) group . All participants were instructed on atrial arrhythmias , were pre- and post-tested on knowledge and confidence , and completed an evaluation of the experience . There were no statistically significant differences in knowledge test scores , although the control group scored significantly higher on post- test confidence ( p=.040 ) . Both groups rated their experience as valuable . The simulation and case study presentation had similar outcomes . Additional research is needed to determine the effectiveness of this teaching modality 
    Output:
    
Medium and /or high fidelity simulation using manikins is an effective teaching and learning method when best practice guidelines are adhered to .
Simulation may have some advantage over other teaching methods , depending on the context , topic and method .