***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 Although simulated clinical experience is being used increasingly in nursing education , vital evidence related to knowledge acquisition associated with simulated clinical experience does not exist . This intervention study used a 2 × 2 crossover design and equivalence testing to explore the effects of simulated clinical experiences on undergraduate students ' ( n = 74 ) knowledge acquisition in a fundamentals of nursing course . Following r and om assignment , students participated in laboratory-based simulated clinical experiences with high-fidelity human patient simulators and traditional clinical experiences and completed knowledge pretests and posttests . Analysis identified significant knowledge gain associated with both simulated and traditional clinical experiences , with the groups ' knowledge scores being statistically significantly equivalent . A priori equivalence bounds around the difference between the groups were set at ± 5 points . Simulated clinical experience was found to be as effective as traditional clinical experience in promoting students ' knowledge acquisition This experimental study examined whether the use of clinical simulation in nursing education could help reduce medication errors .  Fifty-four student volunteers were r and omly assigned to an  experimental ( treatment ) group ( 24 students ) or a clinical control group ( 30 students ) . The treatment replaced some early-term clinical placement hours with a simulated clinical experience . The control group had all normally scheduled clinical hours . Treatment occurred prior to opportunities for medication administration & NA ; The use of clinical simulation in nursing education provides many opportunities for students to learn and apply theoretical principles of nursing care in a safe environment . The purpose of this study was to evaluate simulated clinical experiences as a teaching/learning method to increase the self‐efficacy of nursing students during their initial clinical course in a prelicensure program . An integrated , quasiexperimental , repeated measures design was used . A sample of 112 students completed surveys , indicating their confidence in various skills necessary for postpartum and newborn nursing , both before and after the simulation experience . Results indicated that students experienced a significant increase in overall self‐efficacy ( p < .01 ) . Students also experienced an increase in confidence in assessing vital signs ( p < .01 ) , breasts ( p < .01 ) , the fundus ( p < .001 ) , and lochia ( p < .001 ) , and in providing patient education ( p < .001 ) . Three themes that emerged in the qualitative results were communication , confidence , and clinical judgment 
    Output:
    
The available literature on simulation and nursing education provides evidence that that simulation is useful in creating a learning environment which contributes to knowledge , skills , safety , and confidence .