INTRODUCTION:

In-service training, synonymous with professional development, plays a vital role in enhancing nurses’ professional knowledge and skills. It offers access to the latest information, research, and best practises in healthcare, ensuring that nurses remain updated with industry developments^1–3.

Through hands-on workshops and simulations, nurses acquire practical skills that directly benefit patient care. In addition, in-service training promotes critical thinking and problem-solving and fosters a culture of continuous learning^4–8. This boosts confidence and job satisfaction while contributing to career growth. Moreover, it encourages collaboration and networking among nurses, enriching their learning experience. Ultimately, in-service training equips nurses to meet the dynamic challenges of healthcare by enhancing their professional competence and fostering a culture of continuous improvement.^1,3,4,9,10

As nurses become more proficient in handling diverse patient needs and challenging situations, they can provide higher quality patient care¹. In addition, in-service training contributes to the professional development and career advancement of nurses. Through participation in relevant educational programmes nurses can expand their skill sets, qualify for specific roles, and access leadership positions, reflecting their dedication to professional growth and unlocking new opportunities within the nursing field.^1,11,12

Simulation training in health care is an effective approach that occurs in virtual environments to mimic real-world scenarios. It has been widely used in health care to enhance clinical practise reduce the risk of errors and improve decision-making skills. This method is particularly effective for increasing practical experience in clinical settings¹³. The health care simulation research literature has experienced corresponding growth, indicating the increasing recognition of simulation as an effective training method.^{7,8,10,13–20}

Kern’s six-step curriculum development approach, created by Dr. David Kern, has gained prominence in various educational programmes including medical schools. It is a systematic framework for planning, implementing, and evaluating educational programmes. This approach is not limited to medical education and serves as a valuable guide for curriculum development in diverse fields.^6,21–27 In nursing education, Kern’s approach is instrumental in clinical teaching, quality enhancement, specialty training, professional development, and continuing education⁸. It aligns educational content with current nursing practises and research, thereby ensuring a higher standard of education for nurses. Kern’s approach is particularly valuable for defining clear learning objectives in simulation training ²⁸. It aids in the selection of training materials and learning strategies, making it a valuable tool in curriculum development.

Simulation training, guided busing Kern’s six-step curriculum development approach, is an effective approach in health care education. It enhances clinical practise reduces the risk of errors and improves decision-making skills. It aligns educational content with current practises and research and aids in defining clear learning objectives. Simulation-based training has been widely recognised and used in various health care settings, and it continues to evolve and improve as a training method.^{1,3,4,10,29–32}

Developing a Simulation-Based Orientation Program for New Nurses:

We have created an orientation training programme for new nurses using Kern’s six-stage programme design model^6,21–23. Kern’s curriculum development process involved the following steps:

1. Problem Identification and General Needs Assessment:

In this initial step, we defined the learning objectives for the simulation-based orientation and clarified its purpose. At Acıbadem Health Group, which employs approximately 22,500 professionals in 24 hospitals and 16 medical centres we identified the fundamental skills required for new nurses. Recognizing Acıbadem’s popularity among both new graduates and experienced health care professionals, our goal was to standardise training and enhance nurses’ professional development.

We regularly conduct training needs analyses using questionnaires and exams to assess the needs of our nursing staff. Historically, nursing orientation training comprised 81-hours over 9 days in a classroom with basic models. In 2010, it was enhanced by integrating clinical experiences and adding one day of clinical practise The collaboration between AHG and Acıbadem Mehmet Ali Aydinlar University in 2007 led to the incorporation of simulation-based education in nursing programmes since 2014. The Nursing Orientation programme was subsequently updated to include 64-hours of theoretical classroom training and 27-hours of simulation centre training.

2. Determination of the Target Audience and Goals:

To identify the target audience and establish clear goals, the institution developed an educational needs assessment form. This tool was used to assess the current skill levels of nurses and identify their learning needs. Clinical training nurses were involved in this step to identify skills gaps and strengths among the nursing staff.

The Nursing Orientation Training programme is designed for new nurses who begin to work outside the operating room and central sterilisation unit. The primary objectives for these new employees are as follows:

Understanding the mission, vision, and organisational structure of AHG nursing services.

Familiarizing themselves with the orientation process.

Learning essential procedures and instructions.

Recognizing the significance of nursing records.

Gaining foundational nursing knowledge and skills.

Acquiring knowledge about concepts related to hospital infections.

Learning and practising basic life support techniques.

The goal of this training is to equip new nurses with the competence required for their roles.

3. Development of Instructional Strategies and Materials:

In this phase, instructional strategies and learning materials for clinical skills training were thoughtfully designed. A collaborative working group composed of training nurses and educators from the Clinical Simulation Training Center played a crucial role in this process.

The working group accomplished the following tasks:

Identified training topics tailored for the simulation laboratory.

Defined the competencies, proficiencies, and sub competencies to be acquired.

Established clear learning objectives.

Developed realistic scenarios for practical applications.

Created skill assessment forms to evaluate performance.

These decisions were informed by existing training programmes research findings related to simulation, established clinical skills assessment forms, and the collective expertise of the team. The content and structure of the training were harmonized with the educational and training methodologies of the Society for Simulation in Health care (SSIH)³³. Furthermore, the training adhered to the format of Continuing Medical Education and aligned with the criteria outlined by the Accreditation Council for Graduate Medical Education (ACGME). These criteria encompassed patient care, medical knowledge, practice-based learning, interprofessional communication, and professionalism. Meticulous planning was undertaken to determine the training content, duration, and selection of simulators. During the 27-hour nursing orientation simulation training, one day was dedicated to "Adult and Child Basic and Advanced Life Support" demonstrations and scenario applications. On the remaining training days, basic nursing practises were conducted in the task trainer’s laboratory using simple models. These sessions were followed by scenario applications focussed on preoperative patient preparation and postoperative patient follow-up.

4. Application:

In this phase, our primary focus was the development and implementation of educational materials and tools to teach orientation skills to nurses. We organised a 2-day Medical Simulation Instructor Training (Training of the Trainer) programme to ensure the readiness of instructors delivering training in the simulation laboratory. This programme was conducted by internationally certified trainers from the Acıbadem University Clinical Medical Simulation Center (CASE). Acıbadem University - CASE (Center of Advanced Simulation and Education) consists of Clinical Simulation and Advanced Endoscopic/Robotic Surgery Training departments. With its variety of medical simulation modalities and technological infrastructure, CASE creates a difference in both undergraduate and postgraduate training. In addition to its medical simulation labs, CASE has a wet lab with nine stations for laparoscopic surgery, a robotic surgery training centre, and a dissection lab for cadaver-based surgical training. (https://case.acibadem.edu.tr/case/home).

The course content was meticulously aligned with the European Simulation Instructor Course (EUSIM) certification programme and the Certified Healthcare Simulation Educator (CHSE) criteria. It received approval from both the European Network of Accredited Clinical Skills Centers (NASCE)³⁴ and the Society for Simulation in Healthcare (SSIH)³³. The training covered various critical topics, including scenario preparation, instructional methodologies, simulation techniques, and the planning of simulation-based training. After the trainer training, a one-year fellowship programme was established for the instructors, which was overseen by the core staff, which included field-specific doctors and nurses from the centre This programme offered essential guidance and feedback on scenario preparation, scenario execution, and the analysis conducted by the trainers.

After completing the in-class theoretical training, the participants were seamlessly integrated into the training programme. Each training group comprised 24 individuals, divided into three subgroups, each led by at least three instructors. We employed effective instructional techniques, including simultaneous demonstration and demonstration, to deliver comprehensive explanations. During the program’s scenarios, every participant actively engaged in a minimum of two scenarios, both by participating in the scenario and observing their peers’ scenarios.

5. Evaluation:

In this phase, the focus was on assessing and enhancing the skills of the participants.

To gauge the effectiveness of the programme cognitive tests were administered to all participants both before and after the training. Scenario checklists and OSCE (Objective Structured Clinical Examination) assessments were employed during the simulation centre scenarios. Peer evaluation and feedback were collected from participants who observed and engaged in the scenarios. At the conclusion of the programme all participants were provided with a "Training programme Evaluation Survey," through which feedback on the training programme and the instructors was gathered and assessed.

6. Curriculum Revision and Publication:

The training programme initially encompassing basic nursing practises and basic and advanced life support training from 2014 to 2016, underwent significant updates and improvements after 2017. These revisions were driven by evolving needs, valuable feedback, and participant input. The curriculum was continuously adapted to stay current and responsive to the changing landscape, ensuring that it remained effective and met the expectations and requirements of the participants.

OBJECTIVE:

The objective of this study was to share the long-term results and valuable experience acquired using Kern’s six-step approach for updating the curriculum of a nursing orientation training programme within a private health institution. This endeavour seeks to provide insights and outcomes that can be beneficial for both the health care industry and educational institutions, shedding light on the long-term effectiveness of curriculum development methodologies in nursing education.

MATERIALS AND METHODS:

Research Type:

This study is a descriptive retrospective file review.

Place and Time of the Research:

The research was carried out within Acıbadem’s Health Group.

Population and Sample of the Research:

The population and sample of this research comprised 285 orientation training sessions given to new nurses in AHG between 2017 and 2022. Because the entire universe was covered, the sample selection method was not used.

Data Collection Tools:

Data collection relied on various tools, including the computation of training pretest and post test score averages, determination of training participants’ simulation score averages, and utilization of an institution-developed training evaluation form. This form comprised 10 items, with 5 items dedicated to the training programme and 5 items aimed at evaluating the trainers. Participants provided their ratings for these items on a 5-point Likert scale (1: Strongly disagree, 2: disagree, 3: Partially agree, 4: Agree, 5: Completely agree).

Participants provided their ratings for these items on a 5-point Likert scale (1: Strongly disagree, 2: Disagree, 3: Partially agree, 4: Agree, 5: Completely agree). Each item was assigned a numerical value based on the participant's chosen response, with 1 indicating the lowest level of agreement and 5 indicating the highest. The scores for the 5 items dedicated to the training program and the 5 items evaluating the trainers were then averaged separately to compute overall scores for both aspects. Therefore, the maximum and minimum points that could be obtained from each participant's evaluation of the training program and trainers ranged from 1 to 5, reflecting the Likert scale values assigned to each response category.

Data Collection Method:

This retrospective data collection for the study used a multi-faceted approach, combining quantitative measures derived from pre- and post-test scores, simulation performance assessments, and participant feedback via a structured training evaluation form. The specific data collection steps are as follows

Pretest and Posttest Score Averages:Prior to the training program, participants underwent a pretest assessment to gauge their baseline knowledge and skills. Following the training, a post test was administered to measure the effectiveness of the program. The scores obtained were then averaged separately for the pretest and post test to determine the degree of improvement.

Simulation Score Averages: Participants engaged in simulation exercises as part of the training. Their performance in these simulations was quantified, and the average scores were calculated. This provided insights into the practical application of the acquired knowledge and skills.

Training Evaluation Form: An institution-developed training evaluation form was distributed to participants, comprising 10 items. These items were designed to assess both the training program (5 items) and the trainers (5 items). Participants were asked to rate their agreement with each statement on a 5-point Likert scale (1: Strongly disagree to 5: Completely agree).

Numerical Value Assignment: Each Likert scale response provided by the participants was assigned a numerical value for analysis purposes. 'Strongly disagree' was assigned a score of 1, 'Disagree' a score of 2, 'Partially agree' a score of 3, 'Agree' a score of 4, and 'Completely agree' a score of 5.

Calculation of Overall Scores: The scores for the 5 items related to the training program and the 5 items assessing the trainers were averaged separately for each participant. This process yielded overall scores reflecting participant perceptions of the training program and the effectiveness of the trainers.

This combination of pre- and post-test scores, simulation performance assessments and participant feedback via the Likert scale-based evaluation form provided a comprehensive dataset for evaluating the training programme and trainers.

Analysis of Data:

Data extracted from the training sessions were methodically coded and analysed. Statistical analyses were performed using SPSS software (ver. 23.0; SPSS, Inc, Chicago, IL), and a p value below 0.05 was considered statistically significant. Descriptive data analysis involved techniques such as calculating numbers and percentages, computing mean values, performing chi-square tests, and conducting correlation analyses.

Ethics:

This study deliberately refrained from disclosing the sociodemographic characteristics of the participants. The study, which primarily focussed on programme development and experience sharing, adhered to rigorous ethical standards. This study obtained institutional approval for publication. The study underwent a thorough ethical review process, and all procedures were conducted in accordance with the principles outlined in relevant ethical guidelines and standards. The researchers have made every effort to safeguard the rights and well-being of the participants involved.

RESULTS:

Table 1: Distribution of the Number of Trainings and Participants by Years

Years	Training Sessions		Participants
	Number	Percentage	Number	Percentage
2014	29	10.2	623	9.80
2015	32	11.2	652	10.26
2016	28	9.8	626	9.85
2017	31	10.9	867	13.64
2018	37	13.0	1015	15.97
2019	20	7.0	445	7.00
2020	27	9.5	656	10.32
2021	42	14.7	911	14.33
2022	39	13.7	561	8.83
Total	285	100.0	6356	100.0

When considering the number of training sessions conducted each year, it is evident that the highest number occurred in 2021, followed by 2022 as the second highest, and 2018 as the third highest. When we examine the number of participants in the training sessions by year, most participants were in 2018, followed by 2021 as the second highest, and 2017 as the third highest (Table 1).

The average number of education sessions per years was calculated to be 16.98±10.18. The average number of education sessions per year was calculated to be quite consistent across the years. There was no statistically significant difference when comparing the number of education sessions conducted annually (X² = 76.146, df = 328, p = 1.000).

The pretest score had an average of 61.76 with a standard deviation of 14.56, while the post-test score averaged 81.10 with a standard deviation of 7.98 points. In addition, the mean score for the Adult Cardiopulmonary Resituating (CPR) Script was 89.52 with a standard deviation of 7.33 points, and the mean score for the Paediatric CPR Scenario was 87.28 with a standard deviation of 8.35 points.

Table 2: Distribution of Nurses’ Thoughts on Training and Educators

	Mean	Ss
Thoughts on Education
1. The training programme achieved its purpose, and its content met my expectations.	4.79	0.14
2. I can apply what I learned in the training programme in my workplace.	4.80	0.14
3. The examples and exercises given were sufficient.	4.78	0.15
4. The training programme provided the personal contribution I expected.	4.79	0.14
5. The duration of the training programme was sufficient.	4.68	0.23
Total Average	4.76	0.14
Thoughts on the Educator
6. The instructor was well versed in the subject.	4.83	0.14
7. The presentation technique was effective.	4.85	0.16
8. The presentation content was up-to-date and visually rich.	4.83	0.15
9. He explained the subject clearly and comprehensibly.	4.83	0.14
10. Encouraged participation.	4.85	0.14
Total Average	4.84	0.14

The overall satisfaction level for the entire training was determined to be 4.81 points with a standard deviation of 0.13. Additionally, it was noted that 56.8% (n=41) of the training participants provided feedback and suggestions for enhancing the training programme.

Table 3: Correlation of Education Satisfaction Over the Years

		Years	Education Satisfaction Mean
Years	Pearson Correlation	1	0.151^*
	Sig. (2-tailed)		0.011
	N	285	285
Education Satisfaction Mean	Pearson Correlation	0.151^*	1
	Sig. (2-tailed)	0.011
	N	285	285

*. Correlation is significant at the 0.05 level (2-tailed).

A positive correlation was found that nurses who had been trained by years had higher levels of satisfaction. This connection was statistically significant with a p-value of 0.011. (Table 3).

Table 4: Correlation of General Evaluation Over the Years

		Years	General evaluation mean
Years	Pearson Correlation	1	0.115
	Sig. (2-tailed)		0.053
	N	285	285
General evaluation mean	Pearson Correlation	0.115	1
	Sig. (2-tailed)	0.053
	N	285	285

Table 4 displays the correlations between general evaluation and the number of years.

A modest positive correlation (Pearson Correlation) of 0.115 was observed between education satisfaction and the number of years of study. This correlation, although indicative of a positive relationship, approached statistical significance (p = 0.053) based on the dataset involving 285 training sessions. Conversely, a positive correlation of 0.115 was also identified for the number of years and the general evaluation mean, approaching statistical significance (p = 0.053). It is worth noting that while these correlations suggest that the variables tend to move in tandem, the significance level is 0.053, which is near the threshold of statistical significance (p = 0.05).

Table 5: Correlation of Pre-Test and Post-Test Scores

		Pretest	Post test
Pretest	Pearson Correlation	1	0.654^**
	Sig. (2-tailed)		0.000
	N	285	285
Post test	Pearson Correlation	0.654^**	1
	Sig. (2-tailed)	0.000
	N	285	285

**. Correlation is significant at the 0.01 level (2-tailed).

Test scores and their connection, a robust positive correlation (0.654**), was found between pretest and post-test scores, signifying a significant relationship. The p-value for this correlation was 0.000. (Table 5)

The significance level was set at 0.01 (2-tailed), highlighting the strength and significance of these relationships within our dataset.

DISCUSSION:

Research in various fields of education consistently reflects similar positive results. Kern’s six-step approach to curriculum development has become a widely recognised and extensively studied framework in the field of education. The literature contains numerous articles, dissertations, and book chapters that examine the intricacies of Kern’s approach to curriculum development. Although it is difficult to determine the exact number of these studies due to their ever-increasing volume, this approach has garnered considerable interest and is gaining continued attention.^{11,12,14,21–24,35–38}

Kern's six-step approach is increasingly recognised as a powerful and versatile tool that enhances the effectiveness of educational programmes in different disciplines^6,21–24. Kern’s six-step approach has had a significant impact on educational programmes in various health fields, especially in Turkey, such as nursing, medicine, dentistry, and pharmacy. Turkish academia has produced numerous articles, dissertations, and book chapters on this topic, reflecting the growing interest and importance of Kern’s approach. The results of such studies have consistently shown that students significantly improve their clinical skills and exhibit improvement in their job performance after graduation.^39–45

Simulation training, in which incorporates adult learning theory, real-time clinical scenarios, and video debriefing, is becoming increasingly prominent in health care. This transformative approach empowers health care teams to practise and assess their skills effectively.^{4–7,13,19,20,46,47} In response to current challenges, simulation-based training has proven invaluable. It has helped identify safety protocol gaps and enhance preparedness for managing infectious diseases like COVID-19¹⁵ has been instrumental in educating health care providers on the correct use of personal protective equipment.³²

Our study has shed light on several key aspects of our training programme. We found variations in the number of training sessions and participants across different years, but the average number of education sessions remained consistent without any statistically significant differences. Both pretest and post test scores indicated improvements in learning outcomes, affirming the effectiveness of our training programme. Furthermore, the scores for the Adult CPR Script and Paediatric CPR Scenario demonstrated variations, reflecting the diverse skill levels among our participants. These outcomes collectively contributed to our understanding of the training program’s dynamics and effectiveness.

Notably, participants expressed a high degree of overall satisfaction with the programme which was substantiated by statistical evidence. The correlation between education levels and test scores showed that individuals with years of education tended to achieve better results in our training programme These results underscore the significance of education in influencing both test scores and overall satisfaction. It emphasises the need for continuous improvement and tailoring our programmes to meet the diverse educational backgrounds of our participants.

Similarly, curriculum renewal studies using Kern’s approach in nursing education have yielded positive results. Students in these programmes have been shown to improve their clinical skills, achieve higher levels of job performance after graduation, and contribute to the overall improvement of health care quality. ^{3,10,11,29–32}

The findings of this study provide insight into the intricate interactions between these variables, underscoring the impact of education on both test scores and overall satisfaction within the context of the training programme. Research in various fields of education consistently reflects similar positive results. As a result, Kern's six-step approach is increasingly recognised as a powerful and versatile tool that enhances the effectiveness of educational programmes in different disciplines.^6,21–24

Kern’s systematic approach to curriculum development provides a structured and effective way to define programme objectives, design content and learning activities, assess student performance, and continually enhance educational programmes. This approach is a valuable tool for standardising updating and evaluating training programmes particularly in dynamic and intricate fields such as nursing, healthcare, and various educational domains. By using Kern’s methodology, students and professionals can acquire and maintain current, essential skills and knowledge, ultimately elevating the quality of education and supporting ongoing professional development.

CONCLUSION:

In summary, our study highlights several key findings on our training programme:

The number of training sessions and participants varied across different years, but the average number of education sessions remained consistent without significant differences.

Participants test scores, including pretest and post-test, showed improvements, indicating the program’s effectiveness.

Scores for the Adult CPR Script and Paediatric CPR Scenario varied, reflecting diverse participant skill levels. The participants reported a high level of overall satisfaction, supported by statistical evidence (p= 0.011).

It was associated with the increasing development of satisfaction with education according to the years of education.

In essence, our study demonstrates the impact of education on both test scores and overall satisfaction within our training programme emphasising the importance of tailored and continuously improved programmes to accommodate participants’ diverse educational backgrounds.

ACKNOWLEDGEMENTS:

The authors would like to express their heartfelt gratitude to the dedicated teams at Nursing management team and education department for their invaluable contributions to this project. This project's success is a testament to the hard work and dedication of each team, and it wouldn't have been possible without their dedication and expertise.

CONFLICT OF INTEREST:

The authors declare that there are no conflicts of interest related to this research.

PLAGIARISM REPORT:

To maintain the integrity of this research, a plagiarism check was conducted using the iThenticate program. The results indicate a similarity score of 9%.

REFERENCES:

1. Coventry TH, Maslin‐Prothero SE, Smith G. Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review. J Adv Nurs. 2015; 71(12): 2715-2727. doi:10.1111/jan.12724

2. Tian F, Xi Z, Ai L, et al. Investigation on Nurses’ Willingness to “Internet + Nursing Service” and Analysis of Influencing Factors. J Multidiscip Health. 2023; 16: 251-260. doi:10.2147/JMDH.S396826

3. Hvidberg LB, Paine MA, Sorensen JL, Thellesen L, Wildgaard K. Developing Core Competency-Based Learning Objectives for Postgraduate Curricula for Postanesthesia Nurses—A Delphi Study. Journal of Perianesthesia Nursing. 2021; 36(4). doi:10.1016/j.jopan.2020.09.009

4. Kim J, Park JH, Shin S. Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis. BMC Med Educ. 2016; 16(1): 152. doi:10.1186/s12909-016-0672-7

5. Yan S, Huang Q, Huang J, et al. Clinical research capability enhanced for medical undergraduates: an innovative simulation-based clinical research curriculum development. BMC Med Educ. 2022; 22(1). doi:10.1186/s12909-022-03574-6

6. Khamis NN, Satava RM, Alnassar SA, Kern DE. A stepwise model for simulation-based curriculum development for clinical skills, a modification of the six-step approach. Surg Endosc. 2016; 30(1). doi:10.1007/s00464-015-4206-x

7. Aicken C, Hodgson L, de Vries K, Wilkinson I, Aldridge Z, Galvin K. This Adds Another Perspective: Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes. Int J Environ Res Public Health. 2021; 18(8): 3995. doi:10.3390/ijerph18083995

8. Aggarwal R, Mytton OT, Derbrew M, et al. Training and simulation for patient safety. Qual Saf Health Care. 2010;19(Suppl 2):i34-i43. doi:10.1136/qshc.2009.038562

9. Kessler C, Shakeel F, Gene Hern H, et al. An algorithm for transition of care in the emergency department. Academic Emergency Medicine. 2013; 20(6). doi:10.1111/acem.12153

10. Guerrero JG, Hafiz AH, Eltohamy NAE, Gomma N, Jarrah I Al. Repeated Exposure to High-fidelity Simulation and Nursing Interns’ Clinical Performance: Impact on Practice Readiness. Clin Simul Nurs. 2021; 60: 18-24. doi:10.1016/j.ecns.2021.06.011

11. Montgomery EE, Thomas A, Abulebda K, et al. Development and Implementation of a Pediatric Telesimulation Intervention for Nurses in Community Emergency Departments. J Emerg Nurs. 2021; 47(5): 818-823.e1. doi:10.1016/j.jen.2021.01.013

12. Geng J, Liu M, Zhang H, et al. Application of the Six-Step Standard Communication Process in the Communication Training for Newly Recruited Nurses in Cancer Specialist Hospitals. Front Surg. 2022; 9. doi:10.3389/fsurg.2022.842716

13. Walsh C, Lydon S, Byrne D, Madden C, Fox S, O’Connor P. The 100 Most Cited Articles on Healthcare Simulation. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2018; 13(3): 211-220. doi:10.1097/SIH.0000000000000293

14. Walsh DP, Neves SE, Wong VT, Mitchell JD. Formation of an Intraoperative Educational Curriculum for Anesthesiology Residents Using a Systematic Approach. A A Pract. 2020; 14(12). doi:10.1213/XAA.0000000000001330

15. Aldekhyl S, Arabi Y. Simulation role in preparing for COVID-19. Ann Thorac Med. 2020; 15(3): 134. doi:10.4103/atm.ATM_114_20

16. Piller Y, Hoggatt-Krumwiede K, Ambardekar A, Hernandez J. Simulation 101: A blended approach to faculty development. In: INTED 2020 Proceedings. Vol 1; 2020. doi:10.21125/inted.2020.0421

17. Scalese RJ, Obeso VT, Issenberg SB. Simulation Technology for Skills Training and Competency Assessment in Medical Education. J Gen Intern Med. 2008; 23(S1): 46-49. doi:10.1007/s11606-007-0283-4

18. Lee-Jayaram JJ, Kunimune M, Hara KM, Barnes LC, Berg BW. Pediatric Simulation Training for Emergency Pre-Hospital Providers in Hawai’i: An Inter-Professional Curriculum Collaboration and Update. Hawaii J Health Soc Welf. 2020; 79(5).

19. Altuntug K, Anik Y, Aygor H, Ege E. Use of Simulation in Women’s Health Nursing Education: A Case of Turkey. International Journal of Nursing Education and Research. 2019; 7(3): 299. doi:10.5958/2454-2660.2019.00069.3

20. Forouzi MA, Heidarzadeh A, Kazemi M, Jahani Y, Afeshari M. Comparison of the Combined based with the mannequin based simulation models in self efficacy, performance and satisfaction of nursing students on Cardiopulmonary Resuscitation. Asian Journal of Nursing Education and Research. 2016; 6(1): 69. doi:10.5958/2349-2996.2016.00014.8

21. Robertson AC, Fowler LC, Niconchuk J, et al. Application of Kern’s 6-Step Approach in the Development of a Novel Anesthesiology Curriculum for Perioperative Code Status and Goals of Care Discussions. J Educ Perioper Med. 2019; 21(1): E634.

22. Bourque JM, Wooster E, Bacha B, et al. Implementation of a New Stereotactic Radiation Program in Middle Income Countries: A Pilot Project using KERN’s 6 Step Framework. International Journal of Radiation Oncology Biology Physics. 2020; 108(3). doi:10.1016/j.ijrobp.2020.07.2513

23. Singh MK, Gullett HL, Thomas PA. Using Kern’s 6-Step Approach to Integrate Health Systems Science Curricula into Medical Education. Academic Medicine. 2021; 96(9). doi:10.1097/ACM.0000000000004141

24. Chalupa RL, Kocher BK, Douglas MS. Using Kern’s Model to Redesign a Postgraduate Curriculum for Orthopaedic Physician Assistants. Journal of Physician Assistant Education. 2023; 34(1). doi:10.1097/JPA.0000000000000478

25. Al-Ghamdi HS. A novel approach to teaching dermatology and plastic surgery in a combined module for undergraduate medical students. Adv Med Educ Pract. 2019; 10. doi:10.2147/AMEP.S191931

26. Fayyaz J. 215 Neonatal emergency readiness project (NERP): development of asynchronous virtual simulation curriculum to improve emergency department neonatal resuscitation care among inter-professional teams. In: 2022. doi:10.1136/archdischild-2022-rcpch.4

27. Mathioudakis N, Bashura H, Boyér L, et al. Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum. J Med Educ Curric Dev. 2019; 6. doi:10.1177/2382120519861342

28. Halalau A, Holmes B, Rogers-Snyr A, et al. Evidence-based medicine curricula and barriers for physicians in training: a scoping review. Int J Med Educ. 2021; 12. doi:10.5116/ijme.6097.ccc0

29. Johnson M, Cowin LS, Wilson I, Young H. Professional identity and nursing: contemporary theoretical developments and future research challenges. Int Nurs Rev. 2012; 59(4): 562-569. doi:10.1111/j.1466-7657.2012.01013.x

30. Westmoreland GR, Counsell SR, Mueller M, et al. Development of a new geriatrics interprofessional curriculum for medical, advanced practice nursing, and master of social work students. J Am Geriatr Soc. 2017; 65.

31. Pivač S, Skela-Savič B, Jović D, Avdić M, Kalender-Smajlović S. Implementation of active learning methods by nurse educators in undergraduate nursing students’ programs – a group interview. BMC Nurs. 2021; 20(1): 173. doi:10.1186/s12912-021-00688-y

32. Hung PP, Choi KS, Chiang VCI. Using Interactive Computer Simulation for Teaching the Proper Use of Personal Protective Equipment. CIN: Computers, Informatics, Nursing. 2015; 33(2): 49-57. doi:10.1097/CIN.0000000000000125

33. Society for Simulation in Healthcare Certification Council. SSH Certification. https://www.ssih.org/Credentialing/Certification.

34. NASCE. NASCE (Network of Accredited Skills Centers in Europe). https://nascenet.org/.

35. Langhan ML, Woolf S, Tiyyagura G. A Community Emergency Department Rotation for Pediatric Emergency Medicine Fellows. Pediatr Emerg Care. 2021; 37(12): e1521-e1523. doi:10.1097/PEC.0000000000002103

36. Balasundaram K, Logiudice R, Dillon E, Abookire S, Gordan P. Using A Six-Step Approach To Implement A Hospital-wide Culture-Changing System. In: 2010. doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a4307

37. Mai DH, Newton H, Farrell PR, Mullan P, Kapoor R. Implementation of a Clinical Leadership Curriculum for Pediatric Residents. J Med Educ Curric Dev. 2022; 9. doi:10.1177/23821205221096354

38. Marsh MC, Reed SM, Mahan JD, et al. Advanced Multimodal Communication Curriculum for Pediatric Residents. J Med Educ Curric Dev. 2021; 8. doi:10.1177/23821205211035239

39. Çakmakkaya ÖS. Formal evidence-based medicine instruction in Turkish undergraduate medical education: an initial evaluation. BMC Med Educ. 2021; 21(1): 437. doi:10.1186/s12909-021-02876-5

40. Yilmaz Y, Sarikaya O, Senol Y, et al. RE-AIMing COVID-19 online learning for medical students: a massive open online course evaluation. BMC Med Educ. 2021;21(1):303. doi:10.1186/s12909-021-02751-3

41. Karabilgin ÖS, Şahin H, Çalışkan SA, et al. Ege Üniversitesi Tıp Fakültesi İkinci Sınıf Eğitim Programındaki İletişim Becerileri Eğitiminin Öğrenci Bakış Açısıyla Değerlendirilmesi Students’ Opinions on Communication Skills Training in Second. 2007.

42. Daloğlu M, Alimoğlu MK. What do otolaryngologists want to learn? An educational targeted needs assessment study. Braz J Otorhinolaryngol. 2020; 86(3): 287-293. doi:10.1016/j.bjorl.2018.12.001

43. Yolcu MB, Emre S, Celayir S. Use of Augmented Reality in Medicine and Pediatric Surgery. Turkish Association of Pediatric Surgeons. Published online 2018. doi:10.5222/JTAPS.2018.089

44. Özdemir O, Erbaş D, Yücesoy Özkan Ş. Özel Eğitimde Sanal Gerçeklik Uygulamaları. Ankara Üniversitesi Eğitim Bilimleri Fakültesi Özel Eğitim Dergisi. 2019; 20(2): 395-420. doi:10.21565/ozelegitimdergisi.448322

45. Demir O. Uzaktan Eğitim Sürecinde Öğretmenlerin Çevrim İçi Eğitimlere İlişkin Hizmet İçi Eğitim Deneyimlerinin Belirlenmesi. Dokuz Eylül Üniversitesi Buca Eğitim Fakültesi Dergisi. 2022; 54: 721-735. doi:10.53444/deubefd.984594

46. Sawaya RD, Mrad S, Rajha E, Saleh R, Rice J. Simulation-based curriculum development: lessons learnt in Global Health education. BMC Med Educ. 2021; 21(1). doi:10.1186/s12909-020-02430-9

47. Zimmermann K, Holzinger IB, Ganassi L, et al. Inter-professional in-situ simulated team and resuscitation training for patient safety: Description and impact of a programmatic approach. BMC Med Educ. 2015; 15(1): 189. doi:10.1186/s12909-015-0472-5

Received on 03.11.2023 Modified on 15.12.2023

Asian J. Nursing Education and Research. 2024; 14(1):17-24.

DOI: 10.52711/2349-2996.2024.00004