The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. How effective is FB SBT and which instructional features contribute to training effectiveness? We searched Embase, PubMed, Scopus, and Web of Science for articles on FB SBT for novice trainees, considering all available literature until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument, evaluated risk of bias with relevant tools depending on study design, assessed instructional features, and intended to correlate instructional features to outcome measures. We identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on most of their outcome measures. However, risk of bias was moderate or high in eight studies, and only six studies were of high quality (modified Medical Education Research Study Quality Instrument score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies, and only four studies evaluated intervention effects on behavioral outcome measures in the patient setting. All of the simulation training programs in studies with the highest methodological quality and most relevant outcome measures included curriculum integration and a range in task difficulty. Although most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made because of heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting. PROSPERO; No.: CRD42021262853; URL: https://www.crd.york.ac.uk/prospero/.

Introduction Communication training with simulated patients (SPs) is widely accepted as a valuable and effective means of teaching communication skills. However, it is unclear which elements within SP-student encounters make these learning experiences meaningful. This study focuses on the SP’s role during meaningful learning of the student by giving an in-depth understanding of the contribution of the SP from a student perspective. Methods Fifteen bachelor Technical Medicine students were interviewed. Technical medicine students become technical physicians who optimize individual patient care through the use of personalized technology. Their perceptions of meaningful learning experiences during SP-student encounters were explored through in-depth, semi-structured interviews, and analyzed using thematic analysis. Results Three main themes were identified that described what students considered to be important for meaningful learning experiences. First, SPs provide implicit feedback-in-action. Through this, students received an impression of their communication during the encounter. Implicit feedback-in-action was perceived as an authentic reaction of the SPs. Second, implicit feedback-in-action could lead to a process of reflection-in-action, meaning that students reflect on their own actions during the consultation. Third, interactions with SPs contributed to students’ identity development, enabling them to know themselves on a professional and personal level. Discussion During SP encounters, students learn more than just communication skills; the interaction with SPs contributes to their professional and personal identity development. Primarily, the authentic response of an SP during the interaction provides students an understanding of how well they communicate. This raises issues whether standardizing SPs might limit opportunities for meaningful learning.

Introduction: Simulated patients (SPs) play an instrumental role in teaching communication skills and enhancing learning outcomes. Prior research mostly focused on the SP’s contribution to students’ learning outcomes by providing feedback afterwards. A detailed understanding of the contribution of the SP during SP-student encounters is currently lacking although the majority of the interaction between SPs and students occurs during the SP-student encounter. Therefore, this study focuses on how SPs see their contribution to meaningful student learning experiences during SP-student encounters. Methods: We interviewed fifteen simulated patients from one institution. We explored their perspectives on meaningful learning experiences during SP-student encounters through in-depth, semi-structured interviews and analyzed using thematic analysis. Results: SPs view their contribution to meaningful student learning during SP-student encounters from two perspectives. A collective perspective as a member of the community of SPs and an individual perspective. From the collective perspective, SPs believe that the fact that students deal with multiple varied SP-student encounters over time is of value for meaningful learning. From the individual perspective, we noticed that SPs think, act, and react from three different positions. First, as the patient in the role description, second, as a teaching aid and third, as an individual with personal experiences, beliefs, and values. SPs mentioned that the ratio between these different positions can vary within and between encounters. Conclusions: According to SPs, we should value the variation between SPs, thereby creating meaningful variation in authentic interactions in SP-student encounters. SPs should be allowed to act and react from different positions during SP-student encounters, including their role description, as teaching aid, and based on their own experiences. In this way, SP-student encounters are optimized to contribute to meaningful student learning through authenticity.

Complex medical technology is rapidly being introduced in health care, aimed at improving diagnosis and treatment. However, mistakes in the use of medical