Caregiver Psychopathology, Resilience, and Their Associations with Social-Emotional Challenges of Young Children Affected by Armed Conflict in Colombia.

The closure of simulation centers during the COVID-19 (novel coronavirus SARS-CoV-2) pandemic resulted in medical education innovations. The 2020 paper by Wagner and Gross et al. studied simulation during pandemics and other disasters. They concluded, “in the future, new technology such as tele simulation or virtual reality might offer a method to continue education and training while maintaining social distance.” Centers instituted “distance learning” by streaming mannequin simulation via platforms such as Zoom Video Communications Inc. (San Jose, California). A study entitled “The state of distance healthcare simulation during the COVID-19 pandemic: results of an international survey” evaluated responses from 32 countries with 618 respondents: 70% of respondents reported that their simulation center was conducting distance simulation and 82% indicated long-term plans for maintaining a hybrid format relative to going back to in-person simulation (11%, < 0.001). Although this may not have been optimal for team training and certainly affected the ability of learners to practice hands-on tasks such as cardiopulmonary resuscitation (CPR), many felt that telesimulation fit under the category of the old English proverb “something is better than nothing.” Learners directed teams of masked simulation staff to execute the steps of the scenario remotely while assisted by others watching the same live stream. Drawbacks included difficulties in closed-loop communication via video and the need for creative ways to debrief with those not onsite. Quality of a single camera view was another challenge. Staff had to prepare remote simulation adjuncts such as radiographs, laboratory results, and debriefing charts. Finally, telesimulation was limited by less than lifelike plastic mannequins and the inability to change the surroundings to simulate different hospital areas. A 2021 paper by Diaz and Walsh during the pandemic echoed these drawbacks. “Educators and facilitators must understand the nuances between tele simulation and traditional simulation-based education prior to delivering a tele simulation-based program. In addition, this modality requires practice. Educators need to be facile with and effectively troubleshoot technology so that the participants are able to focus on learning rather than technical mishaps.” Virtual reality (VR) technology in the healthcare setting is growing. Chang et al. described at least four current uses for VR. Two are patient facing and based in relaxation, therapeutic escape, and desensitization. They are used primarily in patients undergoing repetitive stressful interventions such as intravenous catheter access or chemotherapy/radiation. Provider facing VR examples include three-dimensional (3D) visualization for complex operative modeling and team training/simulation. More recently, VR expanded into including patient education for complex diseases like diabetes, as an adjunct to physical and occupational therapies via game play, and in remote telepsychiatry and counseling.