Interprofessional Paediatric High-Fidelity Simulation Training: A Mixed Methods Study of Experiences and Readiness among Nursing and Medical Students

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

I read your manuscript and the description of the research conducted with great interest.

Medical simulation, as numerous scientific reports show, is one of the most effective teaching methods. It also provides many opportunities to conduct scientific research aimed at improving students' teaching and better preparing them for their profession.

The idea for the study was very good, but I have a few comments and doubts.

1 – There are a lot of typos in the manuscript

2 - Fig. 3 I consider unnecessary

3 - I don't understand the participation of 76 students (41 from medicine,35 from healthcare and nursing) what was their contribution to the research? Were these the same students who participated in the simulation?

4 - Mix of methods or triangulation?

5 - How was the online research conducted? please provide more details

6 - in limitations, I think it should also be written that the selected roles in the simulations were played by the teacher. This may have caused students' uncertainty. It is best to hire outsiders for such roles, people the students do not know

Author Response

Attached the Covering letter with the point by point aspects

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The article "Interprofessional Pediatric High Fidelity Simulation Training: Experiences and Readiness among Nursing and Medical Students” was considered for review. A Mixed Methods Study. The authors aimed "to evaluate the impact of interprofessional simulation on enhancing teamwork and communication skills”. The article is relevant as it analyzes the use of clinical simulation in training nursing and medical students in pediatric emergencies. However, some specific modifications will be necessary to improve the paper's dissertation, which is described below:

Title: I suggest revision. As described, the object of the study needs to be clarified. I recommend: High-fidelity pediatric simulation in interprofessional training in pediatric emergencies: an analysis of myth methods.

Summary: indicate the study period; present how the analysis was carried out to configure a mixed method study (explanatory sequential?); explain how the analysis was carried out.

Introduction: presents the theoretical framework and the reasons for the research. I suggest reviewing the objective. The impact of interprofessional simulation on improving participating students' teamwork and communication skills was not evaluated, as an analysis of a new simulation was not carried out. I suggest adaptation according to the objectives of the pre-post simulation instruments, which are more focused on interprofessional attitudes. It is also essential to include in the objective or another secondary quantitative analysis of secondary data from the 18 debriefing videos that involved the enumeration of human factors (team time out, communication, speaking up) and their occurrences.

Method: presents weaknesses that need clarification, namely, presenting the theoretical framework that supported the simulation protocol. Further clarification regarding the scenario construction, learning objectives, and procedures verification checklist is required. I suggest indicating which emergencies were addressed with their respective number in the Results section. In addition, it is necessary to show the eligibility criteria for the study. The makeup of the sample could be more precise. Were there 65 or 76 participants? I recommend specifying how the sample size was determined and the method used to generate the group allocation sequence.

Results: I suggest summarizing the text more objectively and clearly.

Discussion: The main characteristic of mixed methods studies is the complementarity of using different strategies to observe a phenomenon. I suggest a summary and review to present an interpretation of the entire analysis on using high-fidelity simulation in interprofessional training in pediatric emergencies.

References are adequate in number but need to be updated, as approximately 75% were published more than five years ago.

Author Response

Attached the covering letter with the point by point comments 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

General comments:

Thank you for an opportunity to review this manuscript, which presents an interesting topic to pharmacy educators. This is a comprehensive mixed methods study to evaluate students’ experiences and attitudes towards an interprofessional learning experience, and the research team conducted a well-designed study to examine the effectiveness of this teaching method. Results were clearly presented in tables, figures and in text, which is a key strength of this paper.

Title:

It is unusual to have 2 sentences in the article title. Consider changing the title to: Experiences and Readiness among Nursing and Medical Students in an Interprofessional Simulated Pediatric Emergency Care Training: A Mixed Methods Study

Abstract:

‘Pediatric’ is included in the title and as a keyword but was not described in the abstract. Some details on pediatric training should be included to provide context to the readers and justify the inclusion of this keyword.

Introduction:

Paragraph 3 – Suggest to introduce Crisis Resource Management (CRM) by providing details in this paragraph, to highlight its importance and relevance of CRM to this study.

Paragraph 4 - Please elaborate on the training of human factors that were provided.

Methods:

Figure 1 – Please provide full name of GTM in the figure caption.

Figures 1 and 2 - What does ‘own presentation’ mean?

Page 4 – ‘Among these76 students (41 from medicine,35 from healthcare and nursing) completed the questionnaire so that it was possible to clearly assign their pre- and post-survey data.’ This sentence is unclear. Did 76 out of 108 students completed both pre- and post- surveys? If yes suggest to revise the sentence to improve clarity.

Results:

Analyses of data were appropriate.

Note that Table 3 Number of communication strategies in the three quality groups should be Table 4.

The strategies encompassed three communication aspects – there were 4 aspects listed?

Discussion:

The discussion is fairly brief. The authors referred to the findings from other studies frequently however there isn’t sufficient synthesis of the findings from this study, and the relevance of findings from the literature to this study is often not explained clearly.

I am interested in seeing a comparison of pre- and post-survey results from this study to other interprofessional training on pediatric emergency scenarios.

The use of high fidelity simulation training in this study and its impact on students’ learning experiences should be discussed in more depth.

Paragraph 3 on human factors should be included in the introduction instead as there was no detail provided on human factors and CRM in the introduction.

Figure 6 - What does ‘own presentation’ mean?

In the results section it was mentioned that different levels of experience of students contributed to differences in how students were approaching the cases. This should be discussed further in the discussion.

Mechanics:

There are several minor grammatical, punctuation and spacing errors throughout the manuscript. For example

missing full stop in the abstract: online questionnaires To measure the

missing space in the abstract: and medical students.Medical students AND assessments.Overall,

Missing space between words in the introduction: settingsintegratinghigh-fidelity

Figure 1 – Should be video not vidoe

Page 5 – Each videos were screened – should be video

Figure 3 – in die? Software – should be the not die

Page 7 – The scale is poled?

Page 7 – Medical students also showed significant improvement, a is missing

Page 8 – emloyed, should be employed

Page 11 - with in the medical staff, should be with the medical staff

Page 13 – were blocked in communication, suggest to revise this sentence

Page 13 – contributed to overwhelm, suggest to change this to feeling overwhelmed

Page 15 – respective responsibilities. Consequence – perhaps change to (consequence) to make it easier to read the text

Page 17 – IP simulation, suggest to change this to interprofessional simulation to be consistent.

This is not an exhaustive list and the authors are strongly encouraged to proofread the article to improve readability.

Comments on the Quality of English Language

Extensive proofreading and editing will be required to improve readability of this article.

Author Response

Attached the covering letter with all point by point comments

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for the explanations and taking into account the reviewers' suggestions.

Now the manuscript reads much better. I have no doubts about the described course of the study and the results.

Good job! 

Reviewer 2 Report

Comments and Suggestions for Authors

I have carried out the 2nd revision of the article entitled: " Interprofessional Paediatric High Fidelity Simulation Training: Experiences and Readiness among Nursing and Medical Students. A Mixed Methods Study ". The authors aimed to evaluate the impact of interprofessional simulation on enhancing teamwork and communication skills. Most of the requests indicated were met or justified, considerably increasing the quality of the manuscript.