{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:32Z","timestamp":1787228912760,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The WHO Surgical Safety Checklist is a cornerstone of perioperative safety, yet its effective implementation hinges on nontechnical skills like communication. High-fidelity simulation (HFS) is a promising tool for training these competencies. This study evaluated the impact of HFS on anesthesiology students\u2019 perceptions of patient safety, specifically examining the mediating role of improved communication through the checklist. A convergent parallel mixed-methods study was conducted with 137 fourth-year medical students specializing in anesthesiology. Participants completed a SimMan3G-based operating room simulation centered on the WHO Checklist. Quantitative data from a postsimulation survey (Likert-scale items on realism, communication, and safety) were analyzed using descriptive statistics, Pearson correlation, and causal mediation analysis via Ordinary Least Squares regression. Qualitative feedback was analyzed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      An overwhelming majority of students perceived the checklist as effective for improving communication (86.1%, Mean =4.3 \/ 5) and enhancing patient safety (85.4%, Mean =4.3 \/ 5). A strong correlation was found between communication and safety perceptions (r = 0.89,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Mediation analysis revealed a significant total effect of simulation realism on safety perception (\u03b2 =0.52,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). This effect was fully mediated by perceived improvement in communication (indirect effect: \u03b2 =0.42, 95% Boot CI [0.31, 0.54]; direct effect: \u03b2 =0.10,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.118). Qualitative analysis reinforced this, identifying \u2018Communication is Safety\u2019 as a central theme.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>HFS using SimMan3G is highly effective in fostering a strong perceived culture of patient safety among anesthesiology students. This effect is primarily driven by the simulation\u2019s ability to demonstrate that the WHO Checklist improves team communication, which students then link to enhanced safety. Educational efforts should maximize realism and explicitly articulate the communication-safety nexus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_946_25","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:34Z","timestamp":1782968434000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the impact of operating room simulations on communication skills and patient safety (EIORS-CPS)"],"prefix":"10.4103","volume":"20","author":[{"given":"Walid M. R.","family":"Badwi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed B.","family":"Delvi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumana","family":"Baaj","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Chehab","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail A.","family":"Elzogari","sequence":"additional","affiliation":[{"name":"College of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Walid","sequence":"additional","affiliation":[{"name":"College of Medicine, El-Minya University, Second Al Minya, Minya Governorate, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Walid","sequence":"additional","affiliation":[{"name":"College of Clinical Pharmacy, El-Minya University, Second Al Minya, Minya Governorate, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alshibuikey","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"R1-20260820","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Organ Behav Hum Decis Process"},{"key":"R2-20260820","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1056\/NEJM199102073240604","article-title":"Incidence of adverse events and negligence in hospitalized patients. 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A systematic review","volume":"258","author":"Russ","year":"2013","journal-title":"Ann Surg"},{"key":"R14-20260820","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/bmjqs-2012-001797","article-title":"Surgical checklists: A systematic review of impacts and implementation","volume":"23","author":"Treadwell","year":"2014","journal-title":"BMJ Qual Saf"},{"key":"R15-20260820","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/ACM.0000000000000130","article-title":"Reconsidering fidelity in simulation-based training","volume":"89","author":"Hamstra","year":"2014","journal-title":"Acad Med"},{"key":"R16-20260820","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/SIH.0000000000000072","article-title":"Promoting excellence and reflective learning in simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing","volume":"10","author":"Eppich","year":"2015","journal-title":"Simul Healthc"},{"key":"R19-20260820","doi-asserted-by":"crossref","first-page":"52","DOI":"10.4997\/jrcpe.2019.112","article-title":"Simulation in medical education","volume":"49","author":"So","year":"2019","journal-title":"J R Coll Physicians Edinb"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_946_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:01:25Z","timestamp":1787227285000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_946_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_946_25","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-11-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}