Videos by Marian Luctkar-Flude
This trailer features four virtual simulation games (VSGs)from the Sexual Orientation and Gender ... more This trailer features four virtual simulation games (VSGs)from the Sexual Orientation and Gender Identity (SOGI) Nursing Education Website. The website is a toolkit for nurses, nurse educators, nursing students and other healthcare providers to learn about cultural humility and providing culturally safe care to members of the LGBTQI2S community. The toolkit includes resources, academic literature and an embedded course. The course includes voice-over-PowerPoint mini-lectures, suggested readings and a series of VSGs that include learning outcomes, self-assessment rubrics and remediation resources. The course can be completed independently or incorporated into any professional development, undergraduate, or graduate health professions program. The open-access website, hosted by the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) is www.soginursing.ca 20 views
Papers by Marian Luctkar-Flude
Summary: This presentation describes a multi-site randomized controlled study that aims to evalua... more Summary: This presentation describes a multi-site randomized controlled study that aims to evaluate the feasibility and impact of using virtual simulation games to prepare nursing students to participate in live clinical simulations. Content Outline: BACKGROUND • Pre-simulation preparation: o traditional preparatory activities are not always effective o alternate innovative activities improve learning outcomes more than traditional ones • Virtual simulation games o may be more engaging to nursing students o may result in better preparation for simulation o may result in improved performance during simulation
Inquiry@Queen's Undergraduate Research Conference Proceedings
Background: Misinformation and disinformation perpetuate negative stereotypes, reinforce prejudic... more Background: Misinformation and disinformation perpetuate negative stereotypes, reinforce prejudice and lead to racially motivated discrimination. As displayed in post-secondary institutions worldwide, white-centric perspectives are primarily embedded in school cultures and systems. Such racial aggressions produce ‘racial battle fatigue,’ creating physiological, physiological, and behavioural stress for the recipient. Virtual simulation is proposed as an educational strategy for learners to identify racism in an academic setting and develop allyship for equity-seeking groups. This poster aims to advocate the use of virtual simulation to improve the overall educational experience by highlighting the voices of diverse students and educators. Methods: Our team developed a pre-learning simulation consisting of five short scenes depicting racially discriminatory acts. It highlights the urgency to discontinue the term 'microaggression'. A longer simulation was developed in which a ...
Wolfgang’s Story: A Virtual Simulation Supporting Effective and Supportive Communication With an Older Gay Adult
Creative Nursing, May 1, 2022
Lesbian, gay, bisexual, transgender, queer, intersex, and Two-Spirit (LGBTQI2S) older adults face... more Lesbian, gay, bisexual, transgender, queer, intersex, and Two-Spirit (LGBTQI2S) older adults face barriers to quality health care, often because practitioners misunderstand the unique health needs of this population. Education is essential to support nurses in maintaining culturally safe practice. Wolfigang's Story, a virtual simulation developed as an educational resource to address this need, focuses on an interaction between an older gay adult and a nurse during a health-care encounter, exploring the use of appropriate terminology, personal assumptions, biases, and key concepts related to heterosexism and to grief. The aim of the article is to report on the development, implementation, and evaluation of this project.
Optimizing Sosido to suit your needs: A brief guide for CANO/ACIO members
PubMed, 2019
Established in 2011, Sosido was developed as an online knowledge-sharing network for healthcare p... more Established in 2011, Sosido was developed as an online knowledge-sharing network for healthcare professionals. The goals of the Sosido platform are to 1) speed knowledge translation through community building; 2) stimulate collaboration; and 3) raise the profile of researchers and broadcast contributions of specialities to the broader healthcare community (source: http://www.screencast.com/t/T1P0PHsukwg).
Usability, Engagement, Learning Outcomes, Benefits and Challenges of Using a Mobile Classroom Response System During Clinical Simulations for Undergraduate Nursing Students
Clinical Simulation in Nursing, Sep 1, 2022
Health professional students’ experiences with virtual simulation: a scoping review protocol
International Journal of Healthcare Simulation
Virtual simulation can have a positive impact on student outcomes; still, guidance from an educat... more Virtual simulation can have a positive impact on student outcomes; still, guidance from an educator and a reliable connection to the internet are cited as important factors for a positive learning experience. However, when students are asked to complete the simulation outside of class time, it remains unknown how their experience is impacted. The objective of this scoping review is to answer the question: What are health professional student experiences with We will include published peer-reviewed evidence about any health professional student completing virtual simulation outside of a course context. To be included, the virtual simulation activity needs to be required as part of a course. We will use the scoping review methodology from the Joanna Briggs Institute (JBI). Published literature will be located through Medline and Embase (via Ovid), CINAHL, Education Source Complete and ERIC (via Ebsco) and the Web of Science Core Collection. We will search for qualitative, quantitative...
Background: Breast cancer survivors may experience persistent cognitive impairment and fatigue af... more Background: Breast cancer survivors may experience persistent cognitive impairment and fatigue after completion of cancer treatment, which negatively impacts their quality of life. Neurofeedback is a novel, non-invasive form of brain training reported to help with symptoms such as pain, fatigue, depression, anxiety, sleep problems, and cognitive decline; however, there is a lack of research exploring its use with cancer survivors. Objective: The objective of this study was to describe experiences of neurofeedback and its impact on the lives of post-treatment breast cancer survivors. Methods: This article describes the qualitative phase of a prospective pilot feasibility trial of a nonlinear dynamical neurofeedback intervention. Study participants had the option to participate in a semi-structured interview at follow-up. A sample of 12 breast cancer survivor clients participated in interviews 5-10 weeks after the completion of 20 sessions of nonlinear dynamic neurofeedback. This qualitative descriptive study employed thematic analysis of interview transcripts. Results: Qualitative analysis revealed two overarching themes of impact and experience and six subthemes: symptom impact, dramatic effect, symptom improvement, enjoyable experience, lack of side effects, and recommend for cancer survivors. Conclusion: Results of this qualitative descriptive study suggest that nonlinear dynamical neurofeedback had a dramatic and meaningful positive effect on persistent symptoms experienced by breast cancer survivors, without any negative side effects. Participants in our sample found the neurofeedback sessions to be enjoyable and recommend that they be offered to all cancer patients. Clinical trials with larger sample sizes are needed to corroborate our findings. Establishing clinical effectiveness could encourage adoption of neurofeedback into routine cancer care and health insurance coverage.
The use of simulation-based education in cancer care: a scoping review
International Journal of Healthcare Simulation, May 20, 2023
Continuing education for cancer care providers is essential for promoting high-quality patient ca... more Continuing education for cancer care providers is essential for promoting high-quality patient care. Simulation-based education can be an effective strategy to educate healthcare professionals; however, there is a lack of synthesized evidence available to inform the delivery of simulation-based education for nurses and physicians across the cancer care continuum. This scoping review aimed to collate and synthesize the literature regarding how simulation has been reported to educate nurses and physicians about cancer care. Scoping review following the JBI methodology. Medline, CINAHL, EMBASE and PsycINFO were searched until July 2021. Unpublished literature was searched using ResearchGate, OpenGrey and open access theses and dissertation databases. Articles were eligible if they discussed how simulation has been utilized to educate nurses and physicians about any aspect of cancer care. Two independent reviewers screened the references, extracted and analysed the data. In total, 19 studies were included. When compared to previous reviews, our findings showed an increase in the use of virtual simulation; however, most interventions reported in-person simulation approaches and focused on improving skills (e.g. practical, communication), knowledge, confidence or decision-making for physicians and nurses caring for patients with a wide variety of cancers. Overall, simulation demonstrated positive results in educating nurses and physicians across the cancer care continuum through improved knowledge, skills and satisfaction. However, simulation interventions can be time-consuming and require significant resources for effective implementation. Although simulation-based education demonstrated promise to educate nurses and physicians across the cancer continuum, it requires a significant allocation of resources to develop and implement these educational strategies. Educators and researchers should be aware of these challenges when planning and implementing simulation-based educational strategies.
Canadian Journal of Nursing Research Archive, Jun 10, 2020
Background: Building research capacity in nursing academic units continues to be a challenge. The... more Background: Building research capacity in nursing academic units continues to be a challenge. There are a number of external contextual factors and internal factors that influence individual faculty as well as the collective to engage successfully in research. Purpose: The overall aim of this opinion article is to provide an overview of the current external and internal, processes and structures, relevant to capacity of nursing faculty to engage in research. Methods: To inform the external context, we reviewed national research funding trends for nursing. To inform the internal context, we provided an exemplar of the internal processes and structures designed to support research capacity building within our academic unit. Results: Canadian Institutes of Health Research funding trends for research grants led by nurse principal applicants increased between 2010 and 2013, followed by a steady decline. In 2017 to 2018, there were only 24 research grants led by nurse principal applicants. These external challenges coupled with the traditional internal barriers, such as the imbalance between teaching and research time, threaten research capacity for nursing academics. Conclusion: Organizational strategies to promote research capacity within academic nursing units are a necessary requirement to move forward.
Virtual Simulations to Replace Clinical Hours in a Family Assessment Course: Development Using H5P, Gamification, and Student Co-Creation
Clinical Simulation in Nursing, Aug 1, 2021
Abstract Quality clinical placements have become increasingly challenging to locate, supervise, a... more Abstract Quality clinical placements have become increasingly challenging to locate, supervise, and learn from. The purpose of this article is twofold: (1) to describe the process used to develop virtual simulations for a family assessment course using H5P technology; and (2) to describe how gamification was used to leverage student creativity as scenario creators and actors. Anecdotally, the use of H5P technology and students as simulation co-creators has improved the learning experience in a first-year family assessment course.
Research Square (Research Square), May 16, 2023
To evaluate the impact of a virtual simulation game (VSG) to improve primary care sexual health s... more To evaluate the impact of a virtual simulation game (VSG) to improve primary care sexual health services for breast cancer survivors. Methods We developed a VSG to help primary care providers (PCPs) address sexual health disturbances among breast cancer survivors. We used a pretest-posttest design with a series of validated tools to assess the feasibility and perceived impact of the game, including an open-ended question about participants' perceptions. Quantitative data was analyzed using descriptive and inferential statistics, and qualitative data through an inductive content analysis approach. Results Of the 60 participants, the majority were nurse practitioner students (n = 26; 43.3%); female (n = 48; 80%); and worked full-time (n = 35; 58.3%). Participants perceived the game as feasible and potentially effective. The intervention elicited an improvement in PCPs' perception of knowledge between pretest and posttest surveys (z =-1.998, p = .046). Professional background and previous exposure to sexual health training were predictors of knowledge perception. Participants described the intervention as an engaging educational strategy where they felt safe to make mistakes and learn from that. Conclusions VSGs can be a potentially effective educational approach for PCPs. Our ndings indicate that despite being an engaging interactive strategy, VSG interventions should be tailored for each professional group. Implications for cancer survivors This intervention has the potential to improve the knowledge and practice of PCPs related to breast cancer follow-up care to support comprehensive care for survivors, resulting in a better quality of life and patient outcomes.
Background Many breast cancer survivors continue to have a broad range of physical and psychosoci... more Background Many breast cancer survivors continue to have a broad range of physical and psychosocial problems after breast cancer treatment. As cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up it is important that comprehensive evidence-based breast cancer survivorship care is implemented to effectively address these needs. Research suggests primary care providers are willing to provide breast cancer survivorship care but many lack the knowledge and confidence to provide evidence-based care. Purpose The overall purpose of this thesis was to determine the challenges, strengths and opportunities related to implementing comprehensive evidence-based breast cancer survivorship guidelines by primary care physicians and nurse practitioners in southeastern Ontario. Methods This mixed-methods research was conducted in three phases: (1) synthesis and appraisal of clinical practice guidelines relevant to provision of breast cancer survivorship care within the primary care practice setting; (2) a brief quantitative survey of primary care providers to determine actual practices related to provision of evidence-based breast cancer survivorship care; Co-Authorship
Clinical Simulation in Nursing, 2021
Paratuberculosis-infected cattle initially develop an effective cell-mediated immune response tha... more Paratuberculosis-infected cattle initially develop an effective cell-mediated immune response that declines as the disease progresses. Blood is one of best sources for characterizing the inflammatory status of infected cows and for studying mediators related to chronic diseases. The aim of this study was to evaluate the cowlevel association between blood cytokine concentration, the influence of serum on immune cell proliferation, and dairy cows naturally infected with Mycobacterium avium ssp. paratuberculosis (MAP). Positive animals (n = 41) from 19 herds were selected on the basis of 2 positive fecal culture results and divided into 2 groups: single-positive, or serum ELISA-negative cows (n = 32), and double-positive, or cows that gave positive results for both mycobacterial culture and serum ELISA (n = 9). Negative animals (n = 39) were selected from paratuberculosis-negative herds in which at least 80% of the animals had been diagnosed as negative by fecal culture and ELISA and that did not produce positive results during the 2-yr study. Analysis of plasma levels of the cytokines IL-4, IL-10, IL-17, IFN-γ, and osteopontin was performed, revealing distinct patterns. The ELISApositive cows with MAP shedding had similar plasma concentrations of IL-4 and IL-10 but elevated levels of IFN-γ, IL-17, and osteopontin, which is indicative of inflammatory disease in these subclinical positive cows. In vitro MAP infection of bovine macrophages showed increased gene expression of tumor necrosis factor-α, IL-1β, IL-6, IL-23, and transforming growth factor-β as early as 6 h postinfection for all of the cytokines involved in the establishment of a T-helper type-17 immune response. To determine the systemic influence of serum on immune cell functions, lymphoproliferation assays were also performed in presence of JD serum. The serum from shedding cows showed 15% less proliferation. These results indicate that infected cows have a lower systemic capacity to maintain a protective immune response and that, as the disease progresses, an emerging T-helper type-17 immune response is established.
The Integration of Virtual Simulation Gaming Into Undergraduate Nursing Resuscitation Education: A Pilot Randomised Controlled Trial
Clinical Simulation in Nursing, May 1, 2021
Abstract Background Researchers at Queen's University developed a virtual simulation game to ... more Abstract Background Researchers at Queen's University developed a virtual simulation game to serve as a presimulation preparation tool for students learning to perform cardiac resuscitation. Methods A pilot randomised controlled trial compared nursing students who received traditional presimulation preparation to those who received a virtual simulation game in addition to traditional presimulation preparation during a resuscitation-oriented clinical simulation. Student performance was evaluated using a 12-item performance checklist. Results Students provided with the virtual simulation game outperformed those provided with only the traditional presimulation preparation. Conclusion Virtual simulation gaming could serve as an effective presimulation preparation tool and should be explored further.
Effectiveness of Debriefing Methods for Virtual Simulation: A Systematic Review
Clinical Simulation in Nursing, Aug 1, 2021
Abstract Background Debriefing has been widely explored; however, there has been little focus on ... more Abstract Background Debriefing has been widely explored; however, there has been little focus on debriefing virtual simulations. Objective This systematic review examined efficacy of debriefing methods for virtual simulation related to healthcare learner outcomes including satisfaction, knowledge, attitudes, and skills. Methods Seven papers were reviewed using Joanna Briggs Institute (JBI) methodology. Results Options to debrief virtual simulations included face-to-face, synchronous virtual debrief, asynchronous debrief, computer debrief or self-debrief. Conclusions All debriefing methods demonstrated some benefits, and debriefer experience was found to be important. Additional research is needed to determine methods that are most effective in supporting different levels of learners.
Shaping Social Justice Values Through Inclusive Assessment and Debriefing of eLearning Modules
Journal of Nursing Education, Jul 31, 2023
Background: Nurses need to recognize how intersectionality shapes the experiences of individuals ... more Background: Nurses need to recognize how intersectionality shapes the experiences of individuals and families navigating complex health systems. Guided reflection on complex social justice issues serves as an approach to move beyond simply understanding social determinants of health toward shaping core professional values of developing nurses to promote lasting change. Method: Third-year Canadian undergraduate prelicensure nursing students co-created assignment expectations, completed online modules, and submitted initial reflections before class in a mandatory social justice course. In-class debriefing was based on students' reflections and cofacilitated by subject matter experts. Students completed a final reflection that focused on advocating for social change. Results: Student feedback, reflections, and grades as well as faculty observations support the success of this interactive student-centered approach. Conclusion: A flexible approach to debriefing modular content informed by universal design for learning and simulation theory enables nurse educators to promote in-depth, meaningful, and lasting student learning. [ J Nurs Educ . 2023;62(X):XXX–XXX.]
Perspectives of simulation facilitators, course professors and students on factors and outcomes of simulation effectiveness
International Journal of Healthcare Simulation, Mar 20, 2023
Journal of Nursing Education and Practice, Apr 28, 2019
Background: Few studies have examined effective methods to prepare learners to participate in sim... more Background: Few studies have examined effective methods to prepare learners to participate in simulation-based learning experiences. Similarly, there is limited literature on valid, reliable assessment methods to determine whether clinical simulation learning outcomes have been met. We developed a learning outcomes assessment rubric to support self-regulated learning and assessment during presimulation preparation and debriefing. Methods: Fourth-year undergraduate nursing students enrolled in a critical care nursing course participated in two deteriorating patient simulations, one delivered in a traditional format, and the other using a new format incorporating a learning outcomes assessment rubric into presimulation preparation and debriefing. A descriptive survey evaluated learner perceived competence with deteriorating patients and satisfaction with the two simulations formats. Learner self-assessment data using the rubric was collected pre and post simulation. Results: Learner satisfaction with the deteriorating patient scenario and accompanying assessment rubric was very high. Learners were significantly more satisfied with the simulation scenario delivered using the new format which included the assessment rubric than with the standard format without the assessment rubric (p < .001). Learners valued the opportunity to identify their own learning needs, and reported increased competence in management of a deteriorating patient following the simulation (p < .001). Conclusions: Senior nursing students perceived that integration of learning outcomes assessment rubrics into simulation design enhanced their self-regulated learning and presimulation preparation. Further research is needed to explore presimulation preparation strategies and to validate rubrics used for summative assessment.
The Rise of Virtual Simulation: Pandemic Response or Enduring Pedagogy?
Clinical Simulation in Nursing, Aug 1, 2021
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Videos by Marian Luctkar-Flude
Papers by Marian Luctkar-Flude