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131-627: The Gemelli University Hospital ( Italian : Fondazione Policlinico Universitario Agostino Gemelli ) is a large general hospital in Rome, Italy . With 1575 beds, it is the second-largest hospital in Italy, the largest hospital in Rome and one of the largest private hospitals in Europe. It serves as the teaching hospital for the medical school of the Università Cattolica del Sacro Cuore , and owes its name to

262-615: A local language of Italy , most frequently the language spoken at home in their place of origin. Italian is a major language in Europe, being one of the official languages of the Organization for Security and Co-operation in Europe and one of the working languages of the Council of Europe . It is the third-most-widely spoken native language in the European Union (13% of the EU population) and it

393-517: A "facilitator". It is this facilitator who guides the debriefing which occurs after a simulation scenario has been completed. When these elements are present, the simulation is often referred to as "Instructional simulation", "Educational simulation," or "Simulation-based learning". Favorable and statistically significant effects for nearly all knowledge and process skill outcomes when comparing simulation AND debriefing versus simulation with no intervention (in healthcare) has been shown. When applied in

524-445: A capacity to further professional development, simulation and debriefing may be referred to as "Simulation-based training". Experiential learning , which draws from prominent scholars such as John Dewey , Jean Piaget , and Carl Rogers , among others, underpins simulation-based learning. Often referred to as "learning by doing", or more broadly, a "theory of experience", Experiential Learning Theory states that experience plays

655-448: A central role in human learning and development. The six principles of Experiential Learning Theory align with educational simulation. The six principles are: Simulation also aligns with Guided Discovery learning . Developed by Jerome Bruner in the 1960s, discovery learning also stems from the work of Jean Piaget and can be described as a learning environment where there is little to no instructor-guidance. Guided discovery learning, on

786-448: A clinical setting. The key elements in the design of a simulation center are building form, room usage, and technology. For learners to suspend disbelief during simulation scenarios, it is important to create a realistic environment. It may include incorporating aspects of the environment not essential in simulation activities, but that play a big role in patient safety. For instance, many reports show that patient falls and injuries occur in

917-561: A discussion of that experience. Debriefing in simulation is a critical component of learning in simulation and is necessary to facilitate change "on an individual and systematic level". It draws from the above-mentioned forms of debriefing, but the emphasis here is on education. Debriefing in education can be described as a "facilitator-led participant discussion of events, reflection, and assimilation of activities into [participants'] cognitions [which] produce long-lasting learning". More specific descriptions of debriefing can be found, such as

1048-522: A facilitator during this phase include: Participant performance is a key component during the analysis phase. However, performance can often be a difficult topic to broach with participants, as criticism or constructive feedback often incur negative feelings. There exists a framework for questioning named "Advocacy-Inquiry," or the "debriefing with good judgment" approach, which aims to reduce negative experiences in medical simulation debriefing. Advocacy Inquiry. The use of advocacy-inquiry (AI) questioning

1179-405: A few weeks before his death in 2005. Other famous ex-patients include politicians Giulio Andreotti , Walter Veltroni and Francesco Cossiga , Nobel Peace Prize laureate Mother Teresa , theoretical physicist Stephen Hawking , priest Georg Ratzinger (elder brother of Pope Benedict XVI ), footballers Francesco Totti and Daniele De Rossi and Canadian filmmaker Damian Pettigrew to name

1310-477: A few. In June 2009 a statue of Pope John Paul II was unveiled in front of the hospital building. On July 4, 2021, the hospital treated Pope Francis , administering a scheduled colon surgery for Francis' diverticular disease . Pope Francis was admitted again on March 29. 2023 for treatment for a respiratory infection. Pope Francis was discharged April 1, 2023, after treatment for bronchitis, quipping to journalists before being driven away: "I'm still alive." Francis

1441-550: A huge number of civil servants and soldiers recruited from all over the country introduced many more words and idioms from their home languages— ciao is derived from the Venetian word s-cia[v]o ("slave", that is "your servant"), panettone comes from the Lombard word panetton , etc. Only 2.5% of Italy's population could speak the Italian standardized language properly when

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1572-464: A little over one million people in the United States speak Italian at home. Nevertheless, an Italian language media market does exist in the country. In Canada, Italian is the second most spoken non-official language when varieties of Chinese are not grouped together, with 375,645 claiming Italian as their mother tongue in 2016. Italian immigrants to South America have also brought a presence of

1703-399: A mission or war game exercise, participants were asked to gather as a group and recount what had happened. These gatherings had the primary intention of developing new strategies to use in future encounters; these gatherings also provided a learning opportunity for other members of the team who were not present at the events being debriefed. In the field of psychology , debriefing is used in

1834-624: A paucity of quantitative data regarding the effectiveness of debriefing in medical simulation, despite Lederman's 1992 seminal Model for the Systematic Assessment of Debriefing. Nearly every article reviewed had a cry for objective studies regarding the effectiveness of debriefing, whether it be comparing: the myriad options of conversational structures, debriefing models, or the comprehensive 5 W's of Who – debriefer, What – content and methods, When – timing, Where – environment, and Why – theory. Currently, there are critical limitations in

1965-572: A physician's understanding and use of best practices, management of patient complications, appropriate use of instruments and tools, and overall competence in performing procedures." The main purpose of medical simulation is to properly educate students in various fields through the use of high technology simulators. According to the Institute of Medicine, 44,000 to 98,000 deaths annually are recorded due primarily to medical mistakes during treatment. Other statistics include: If 44,000 to 98,000 deaths are

2096-645: A poetic and literary origin in the works of Tuscan writers of the 12th century, and, although the grammar and core lexicon are basically unchanged from those used in Florence in the 13th century, the modern standard of the language was largely shaped by relatively recent events. However, Romance vernacular as language spoken in the Italian Peninsula has a longer history. In fact, the earliest surviving texts that can definitely be called vernacular (as distinct from its predecessor Vulgar Latin) are legal formulae known as

2227-417: A renewed interest in linguistics in the 16th century, sparked a debate that raged throughout Italy concerning the criteria that should govern the establishment of a modern Italian literary and spoken language. This discussion, known as questione della lingua (i.e., the problem of the language ), ran through the Italian culture until the end of the 19th century, often linked to the political debate on achieving

2358-509: A result. Starting in late medieval times in much of Europe and the Mediterranean, Latin was replaced as the primary commercial language by languages of Italy, especially Tuscan and Venetian. These varieties were consolidated during the Renaissance with the strength of Italy and the rise of humanism and the arts . Italy came to enjoy increasing artistic prestige within Europe. A mark of

2489-464: A seven-vowel system, consisting of /a, ɛ, e, i, ɔ, o, u/ , as well as 23 consonants. Compared with most other Romance languages, Italian phonology is conservative, preserving many words nearly unchanged from Vulgar Latin . Some examples: Medical simulation Medical simulation, or more broadly, healthcare simulation, is a branch of simulation related to education and training in medical fields of various industries. Simulations can be held in

2620-474: A single language is that they have evolved so that they are no longer mutually intelligible ; this diagnostic is effective if mutual intelligibility is minimal or absent (e.g. in Romance, Romanian and Portuguese), but it fails in cases such as Spanish-Portuguese or Spanish-Italian, as educated native speakers of either pairing can understand each other well if they choose to do so; however, the level of intelligibility

2751-551: A study conducted by Bjorn Hoffman, to find the level of efficiency of simulation based medical training in a hi-tech health care setting, "simulation's ability to address skillful device handling as well as purposive aspects of technology provides a potential for effective and efficient learning." More positive information is found in the article entitled, "The role of medical simulation: an overview," by Kevin Kunkler. Kunkler states that, "medical simulators can be useful tools in determining

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2882-412: A unique set of experiences which frame their interpretation of information. While many models for debriefing exist, they all follow, at a minimum, a three-phase format. Debriefing models can be divided into two categories: the "Three-Phase Debriefing Structure," and the "Multiphase Debriefing Structure". A benchmark in all forms of facilitator-guided, post-event debriefing conversational structures,

3013-504: A united Italian state. Renaissance scholars divided into three main factions: A fourth faction claimed that the best Italian was the one that the papal court adopted, which was a mixture of the Tuscan and Roman dialects. Eventually, Bembo's ideas prevailed, and the foundation of the Accademia della Crusca in Florence (1582–1583), the official legislative body of the Italian language, led to

3144-642: A variety of other clinical subjects takes place at the main building. Four further buildings are open to the public: the "Biological Institutes", the "Protected Health Residence", the combined "Institute of Infectious Diseases" and "Centre for the Medicine of Aging". In the early 2000s, a new building was added to the main body, which hosts the Accident and Emergency department , most of the operating theatres and several laboratories. The buildings are surrounded by parks and meadows. The original manorial villa, built long before

3275-427: Is 89% with French, 87% with Catalan , 85% with Sardinian , 82% with Spanish, 80% with Portuguese , 78% with Ladin , 77% with Romanian . Estimates may differ according to sources. One study, analyzing the degree of differentiation of Romance languages in comparison to Latin (comparing phonology , inflection , discourse , syntax , vocabulary , and intonation ), estimated that distance between Italian and Latin

3406-729: Is also spoken by a minority in Monaco and France, especially in the southeastern part of the country. Italian was the official language in Savoy and in Nice until 1860, when they were both annexed by France under the Treaty of Turin , a development that triggered the " Niçard exodus ", or the emigration of a quarter of the Niçard Italians to Italy, and the Niçard Vespers . Giuseppe Garibaldi complained about

3537-528: Is higher than that between Sardinian and Latin. In particular, its vowels are the second-closest to Latin after Sardinian . As in most Romance languages, stress is distinctive. Italian is the official language of Italy and San Marino and is spoken fluently by the majority of the countries' populations. Italian is the third most spoken language in Switzerland (after German and French; see Swiss Italian ), although its use there has moderately declined since

3668-414: Is highly encouraged by nearly all authors of debriefing models. Advocacy-inquiry consists of pairing "an assertion, observation, or statement" (advocacy), together with a question (inquiry), in order to elicit the mental frameworks – or schema – of both the facilitator and the participants. In phrasing questions this way, participants are made aware of the facilitator's own point of view in relation to

3799-455: Is markedly lower between Italian-Spanish, and considerably higher between the Iberian sister languages of Portuguese-Spanish. Speakers of this latter pair can communicate with one another with remarkable ease, each speaking to the other in his own native language without slang/jargon. Nevertheless, on the basis of accumulated differences in morphology, syntax, phonology, and to some extent lexicon, it

3930-410: Is not difficult to identify that for the Romance varieties of Italy, the first extant written evidence of languages that can no longer be considered Latin comes from the ninth and tenth centuries C.E. These written sources demonstrate certain vernacular characteristics and sometimes explicitly mention the use of the vernacular in Italy. Full literary manifestations of the vernacular began to surface around

4061-417: Is often defined as, "a technique (not a technology) to replace and amplify real life experiences with guided ones, often "immersive" in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion". This definition deliberately defines simulation as a technique and not a technology, implying that simulation is greater than the technology or tools which it adopts. Also note

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4192-417: Is one of Italy’s top centres for colorectal tumours , as well as tumours of the stomach, liver, biliary system and pancreas, and also for transplants. The Endocrinology-Metabolic Diseases Area has clinical-surgical units specialised in managing the main endocrine and metabolic illnesses. The hospital boasts one of Italy’s leading case statistics in terms of management and medical-surgical therapy for diseases of

4323-446: Is recommended that these types of debriefings occur in a separate room from where the simulation scenario took place. This allows for a release of tension as participants move from one place to another and encounter new surroundings. Note, however, that it is important to remind participants not to begin debriefing during the walk to the new room. The momentum of the simulation leads participants to begin debriefing with one another as soon

4454-410: Is recommended that, during the debriefing, the facilitator(s) or participants be seated in a circle. This is done so that everyone can see each other and increase group cohesion. Furthermore, the use of a circle implies equality among the group, and decreases any sense of hierarchy which may be present. Establishing psychological safety and a safe learning environment is of utmost importance within both

4585-575: Is spoken as a second language by 13.4 million EU citizens (3%). Including Italian speakers in non-EU European countries (such as Switzerland, Albania and the United Kingdom ) and on other continents, the total number of speakers is approximately 85 million. Italian is the main working language of the Holy See , serving as the lingua franca (common language) in the Roman Catholic hierarchy as well as

4716-411: Is the phase in which the bulk of the time of debriefing is spent, with a focus on participant performance, rationales, and frames. It is meant to be a time of reflective practice on what actually occurred during the scenario, and the reasons why events unfolded as they did. The analysis phase uncovers the decision-making process behind observed actions. Common questions posed, or statements made, by

4847-538: Is used, and the town of Chipilo near Puebla, Mexico; each continues to use a derived form of Venetian dating back to the 19th century. Other examples are Cocoliche , an Italian–Spanish pidgin once spoken in Argentina and especially in Buenos Aires , and Lunfardo . The Rioplatense Spanish dialect of Argentina and Uruguay today has thus been heavily influenced by both standard Italian and Italian regional languages as

4978-501: The Il Globo (Australia) and the La gazzetta del Sud Africa (South Africa). Italian is widely taught in many schools around the world, but rarely as the first foreign language. In the 21st century, technology also allows for the continual spread of the Italian language, as people have new ways to learn how to speak, read, and write languages at their own pace and at any given time. For example,

5109-936: The La Voce del Popolo ( Croatia ), the Corriere d'Italia (Germany), the L'italoeuropeo (United Kingdom), the Passaparola ( Luxembourg ), the America Oggi (United States), the Corriere Canadese and the Corriere Italiano (Canada), the Il punto d'incontro (Mexico), the L'Italia del Popolo ( Argentina ), the Fanfulla (Brazil), the Gente d'Italia ( Uruguay ), the La Voce d'Italia ( Venezuela ),

5240-672: The Gallo-Italic linguistic panorama of Northern Italy , the Italo-Dalmatian , Neapolitan and its related dialects were largely unaffected by the Franco- Occitan influences introduced to Italy mainly by bards from France during the Middle Ages, but after the Norman conquest of southern Italy , Sicily became the first Italian land to adopt Occitan lyric moods (and words) in poetry. Even in

5371-649: The Kingdom of Italy in the Dodecanese ). Italian is widely spoken in Malta , where nearly two-thirds of the population can speak it fluently (see Maltese Italian ). Italian served as Malta's official language until 1934, when it was abolished by the British colonial administration amid strong local opposition. Italian language in Slovenia is an officially recognized minority language in

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5502-763: The Kingdom of Lombardy–Venetia ), although the masses kept speaking primarily their local vernaculars. Italian was also one of the many recognised languages in the Austro-Hungarian Empire . Italy has always had a distinctive dialect for each city because the cities, until recently, were thought of as city-states . Those dialects now have considerable variety . As Tuscan-derived Italian came to be used throughout Italy, features of local speech were naturally adopted, producing various versions of Regional Italian . The most characteristic differences, for instance, between Roman Italian and Milanese Italian are syntactic gemination of initial consonants in some contexts and

5633-1019: The Middle Ages , the established written language in Europe was Latin, although the great majority of people were illiterate, and only few were well versed in the language. In the Italian Peninsula , as in most of Europe, most would instead speak a local vernacular. These dialects, as they are commonly referred to, evolved from Vulgar Latin over the course of centuries, unaffected by formal standards and teachings. They are not in any sense "dialects" of standard Italian, which itself started off as one of these local tongues, but sister languages of Italian. Mutual intelligibility with Italian varies widely, as it does with Romance languages in general. The Romance languages of Italy can differ greatly from Italian at all levels ( phonology , morphology , syntax , lexicon , pragmatics ) and are classified typologically as distinct languages. The standard Italian language has

5764-539: The Placiti Cassinesi from the province of Benevento that date from 960 to 963, although the Veronese Riddle , probably from the 8th or early 9th century, contains a late form of Vulgar Latin that can be seen as a very early sample of a vernacular dialect of Italy. The Commodilla catacomb inscription is also a similar case. The Italian language has progressed through a long and slow process, which started after

5895-671: The Roman Empire . Italian is the least divergent language from Latin , together with Sardinian (meaning that Italian and Sardinian are the most conservative Romance languages). Spoken by about 85 million people, including 67 million native speakers (2024), Italian is an official language in Italy , San Marino , Switzerland ( Ticino and the Grisons ), Corsica , and Vatican City . It has official minority status in Croatia , Slovenian Istria , and

6026-691: The Society for Simulation in Healthcare (SSH) was formed to assist in collaboration between associations interested in medical simulation in healthcare. The need for a "uniform mechanism to educate, evaluate, and certify simulation instructors for the health care profession" was recognized by McGaghie et al. in their critical review of simulation-based medical education research. In 2012 the SSH piloted two new certifications to provide recognition to educators to meet this need. The American Board of Emergency Medicine employs

6157-514: The Western Roman Empire's fall in the 5th century. The language that came to be thought of as Italian developed in central Tuscany and was first formalized in the early 14th century through the works of Tuscan writer Dante Alighieri , written in his native Florentine . Dante's epic poems, known collectively as the Commedia , to which another Tuscan poet Giovanni Boccaccio later affixed

6288-519: The 111 Italian lecturer sections belonging to foreign schools where Italian is taught as a language of culture. As of 2022, Australia had the highest number of students learning Italian in the world. This occurred because of support by the Italian community in Australia and the Italian Government and also because of successful educational reform efforts led by local governments in Australia. From

6419-506: The 13th century in the form of various religious texts and poetry. Although these are the first written records of Italian varieties separate from Latin, the spoken language had probably diverged long before the first written records appeared since those who were literate generally wrote in Latin even if they spoke other Romance varieties in person. Throughout the 19th and 20th centuries, the use of Standard Italian became increasingly widespread and

6550-594: The 1930s due to the invention of the Trainer Building Link Trainer for flight and military applications, many field experts attempted to adapt simulation to their own needs. Medical simulation was not immediately accepted as a useful training technique, both because of technological limitations and because of the limited availability of medical expertise at the time. However, extensive military use demonstrated that medical simulation could be cost-effective. Additionally, valuable simulation hardware and software

6681-549: The 1970s. It is official both on the national level and on regional level in two cantons : Ticino and Grisons . In the latter canton, however, it is only spoken by a small minority, in the Italian Grisons . Ticino, which includes Lugano , the largest Italian-speaking city outside Italy, is the only canton where Italian is predominant. Italian is also used in administration and official documents in Vatican City . Italian

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6812-561: The Emergency Department, 10,000 blood dialysis sessions and more than 6 million radiological procedures were conducted. The hospital staff includes more than 5,000 employees, of whom there are almost 1,000 physicians and more than 2,000 nurses . Every day, the hospital premises and the whole campus host an estimated number of 30,000 people. Each year the hospital consumes around 50 million kWh and 16 million cubic metres of natural gas. Its co-generation system provides around 60% of

6943-417: The Italian dialects has declined in the modern era , as Italy unified under Standard Italian and continues to do so aided by mass media from newspapers to radio to television, diglossia is still frequently encountered in Italy and triglossia is not uncommon in emigrant communities among older speakers. Both situations normally involve some degree of code-switching and code-mixing . Notes: Italian has

7074-485: The Italian language into a lingua franca used not only among clerks, nobility, and functionaries in the Italian courts but also by the bourgeoisie . Italian literature's first modern novel, I promessi sposi ( The Betrothed ) by Alessandro Manzoni , further defined the standard by "rinsing" his Milanese "in the waters of the Arno " ( Florence 's river), as he states in the preface to his 1840 edition. After unification,

7205-550: The Mediterranean. The increasing political and cultural relevance of Florence during the periods of the rise of the Medici Bank , humanism , and the Renaissance made its dialect, or rather a refined version of it, a standard in the arts. The Renaissance era, known as il Rinascimento in Italian, was seen as a time of rebirth, which is the literal meaning of both renaissance (from French) and rinascimento (Italian). During this time, long-existing beliefs stemming from

7336-475: The NEMO (NEuroMuscular Omnicentre) Clinical Center, highly specialized in taking care of people affected with neuromuscular diseases including Amyotrophic lateral sclerosis (ALS) , Spinal Muscular Atrophy (SMA) and Muscular Dystrophies . More recently, a 1,200 sqm center dedicated to medical, surgical and diagnostic simulation (IPSE Center, Interactive Patient Simulation Experience) has been inaugurated. The Gemelli

7467-531: The University are focused on research: in 2015 alone, 1500 scientific papers were published, with 323 scientific experiments underway and 17 patents developed by internal researchers thanks to €16,000,000 in research fundings, provided by Italian, European and international agencies. Since 2015, the hospital hosts one of the largest and newest hybrid operating theatres in Europe, a highly specialised Oncological Radiotherapy Center (Gemelli ART) unique in Italy and

7598-492: The best way to approach medical training through simulation, which remains un-standardized despite having been embraced generally by the medical community. That said, successful strides are being made in terms of medical education and training, although a number of studies have shown that students engaged in medical simulation training have overall higher scores and retention rates than those trained through traditional means. The Council of Residency Directors (CORD) has established

7729-674: The burden of feeling that they will be shamed, humiliated, or belittled". It is recommended that establishing safety begin in the pre-brief phase by alerting participants to the "basic assumption." The basic assumption, derived from the Centre for Medical Simulation at Harvard University (n.d.), is an agreed upon, predetermined mental model whereby everyone involved in the simulation & debrief believe that all participants are intelligent, well-trained, want to do their best, and are participating to learn and promote development. Additionally, Rudolph et al. (2014) have identified four principles to guide

7860-444: The case of Northern Italian languages, however, scholars are careful not to overstate the effects of outsiders on the natural indigenous developments of the languages. The economic might and relatively advanced development of Tuscany at the time ( Late Middle Ages ) gave its language weight, although Venetian remained widespread in medieval Italian commercial life, and Ligurian (or Genoese) remained in use in maritime trade alongside

7991-419: The classroom, in situational environments, or in spaces built specifically for simulation practice. It can involve simulated human patients (whether artificial, human or a combination of the two), educational documents with detailed simulated animations, casualty assessment in homeland security and military situations, emergency response , and support for virtual health functions with holographic simulation. In

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8122-630: The colonial period. In the early 19th century, Eritrea was the country with the highest number of Italians abroad, and the Italian Eritreans grew from 4,000 during World War I to nearly 100,000 at the beginning of World War II. In Asmara there are two Italian schools, the Italian School of Asmara (Italian primary school with a Montessori department) and the Liceo Sperimentale "G. Marconi" (Italian international senior high school). Italian

8253-563: The country (some 0.42% of the total population). Their numbers dropped dramatically after World War II following the Istrian–Dalmatian exodus , which caused the emigration of between 230,000 and 350,000 Istrian Italians and Dalmatian Italians. Italian was the official language of the Republic of Ragusa from 1492 to 1807. It formerly had official status in Albania due to the annexation of

8384-508: The country to the Kingdom of Italy (1939–1943). Albania has a large population of non-native speakers, with over half of the population having some knowledge of the Italian language. The Albanian government has pushed to make Italian a compulsory second language in schools. The Italian language is well-known and studied in Albania, due to its historical ties and geographical proximity to Italy and to

8515-446: The country. A few hundred Italian settlers returned to Libya in the 2000s. Italian was the official language of Eritrea during Italian colonisation . Italian is today used in commerce, and it is still spoken especially among elders; besides that, Italian words are incorporated as loan words in the main language spoken in the country (Tigrinya). The capital city of Eritrea, Asmara , still has several Italian schools, established during

8646-515: The country. The official census, carried out in 2002, reported 2,258 ethnic Italians ( Istrian Italians ) in Slovenia (0.11% of the total population). Italian language in Croatia is an official minority language in the country, with many schools and public announcements published in both languages. The 2001 census in Croatia reported 19,636 ethnic Italians (Istrian Italians and Dalmatian Italians ) in

8777-464: The design and fashion industries, in some sports such as football and especially in culinary terms. In Italy, almost all the other languages spoken as the vernacular —other than standard Italian and some languages spoken among immigrant communities—are often called " Italian dialects ", a label that can be very misleading if it is understood to mean "dialects of Italian". The Romance dialects of Italy are local evolutions of spoken Latin that pre-date

8908-427: The development of a simulation scenario, or they may be emergent as the scenario unfolds. It can be challenging for the novice facilitator to adapt to emergent learning objectives, as the subsequent discussion may be purely exploratory in nature with no defined outcome. Conversely, the discussion may lead to a specific area of expertise which neither the facilitator nor participants are familiar with. In such situations,

9039-572: The diffusion of Italian television in the country. Due to heavy Italian influence during the Italian colonial period , Italian is still understood by some in former colonies such as Libya. Although it was the primary language in Libya since colonial rule , Italian greatly declined under the rule of Muammar Gaddafi , who expelled the Italian Libyan population and made Arabic the sole official language of

9170-496: The direct result of medical mistakes, and the CDC reported in 1999 that roughly 2.4 million people died in the United States, the medical mistakes estimate represents 1.8% to 4.0% of all deaths, respectively. A near 5% representation of deaths primarily related to medical mistakes is simply unacceptable in the world of medicine. Anything that can assist in bringing this number down is highly recommended and medical simulation has proven to be

9301-472: The educated gentlemen was to make the Grand Tour , visiting Italy to see its great historical monuments and works of art. It was expected that the visitor would learn at least some Italian, understood as language based on Florentine. In England, while the classical languages Latin and Greek were the first to be learned, Italian became the second most common modern language after French, a position it held until

9432-522: The energy that is needed for electricity, heating and cooling, making it one of the largest infrastructures of this kind in the civil and hospital sectors in Italy. Compliance with existing regulations have resulted in the Hospital obtaining ISO 50001 certification from the Bureau Veritas agency. Gemelli Hospital was the first teaching hospital in Italy ever to receive this certification. The Hospital and

9563-458: The establishment of Italian, and as such are sister languages to the Tuscan that was the historical source of Italian. They can be quite different from Italian and from each other, with some belonging to different linguistic branches of Romance. The only exceptions to this are twelve groups considered " historical language minorities ", which are officially recognized as distinct minority languages by

9694-407: The experience. It is the opening phase of systematic reflection, enabled by a facilitator who poses key questions such as: A facilitator is to keep asking these questions of the learners until they feel confident that all participants have voiced their understanding of the situation. The point of the description phase is to identify the impact of the experience, gain insights into what mattered to

9825-531: The facilitator and participants must be flexible and move on to the next objective, and follow-up with the debriefing of the emergent outcome at a later time. The debriefing environment consists of two main features: the physical setting, as well as the psychological environment. When choosing a space in which to debrief, one must consider whether the scenario which unfolded was a complex case. Complex cases usually involve heightened emotions, interdependent processes, and require more time spent debriefing. As such, it

9956-433: The fact that it was linguistically an intermediate between the northern and the southern Italian dialects. Thus the dialect of Florence became the basis for what would become the official language of Italy. Italian was progressively made an official language of most of the Italian states predating unification, slowly replacing Latin, even when ruled by foreign powers (such as Spain in the Kingdom of Naples , or Austria in

10087-488: The following in relation to debriefing in healthcare simulations, described by Cheng et al. (2014): "...a discussion between two or more individuals in which aspects of a performance are explored and analysed with the aim of gaining insights that impact the quality of future clinical practice". Or another regarding debriefing in gaming, by Steinwachs (1992), "...a time to reflect on and discover together what happened during game play and what it all means." Medical simulation

10218-655: The following recommendations for simulation: The Association of Surgeons in Training has produced recommendations for the introduction, availability, and role of simulation in surgical training. The two main types of medical institutions that train people through medical simulations are medical schools and teaching hospitals. According to survey results from the Association of American Medical Colleges (AAMC), simulation content taught at American medical schools spans all four years of study, while hospitals utilize simulations during

10349-431: The formulation of a psychologically safe environment: Included in these principles is the notion of confidentiality . Explicitly reminding participants that their individual performance and debriefing reflections are not meant to be shared outside of the simulation event can help foster participation. Confidentiality builds trust by increasing transparency and allowing participants to practice without fear. There exists

10480-468: The free website and application Duolingo has 4.94 million English speakers learning the Italian language. According to the Italian Ministry of Foreign Affairs , every year there are more than 200,000 foreign students who study the Italian language; they are distributed among the 90 Institutes of Italian Culture that are located around the world, in the 179 Italian schools located abroad, or in

10611-560: The greatest impact of learning. The summary may be done by either the facilitator or the participants – debriefing models differ in their suggestions. In the latter, the participants summarize what was of most value for them. A summary by the facilitator consists of re-stating key learning points which occurred throughout the debrief. While all debriefing models include the phases of the three-part debriefing structure, there are several with additional phases. These additions either explicitly call out specific features which may be included in

10742-461: The hospital bathroom, so the simulation rooms were designed with bathroom spaces. A successful simulation center must be within walking distance of the medical professionals who will be using it. Often, clinical and medical faculty are responsible for the day-to-day operations of simulation centers, typically in addition to other responsibilities. However, the technology that has emerged within medical simulation has become complex and can benefit from

10873-483: The island of Corsica (but not in the neighbouring Sardinia , which on the contrary underwent Italianization well into the late 18th century, under Savoyard sway: the island's linguistic composition, roofed by the prestige of Spanish among the Sardinians , would therein make for a rather slow process of assimilation to the Italian cultural sphere ). The rediscovery of Dante's De vulgari eloquentia , as well as

11004-631: The language to that continent. According to some sources, Italian is the second most spoken language in Argentina after the official language of Spanish, although its number of speakers, mainly of the older generation, is decreasing. Italian bilingual speakers can be found scattered across the Southeast of Brazil as well as in the South. In Venezuela , Italian is the most spoken language after Spanish and Portuguese, with around 200,000 speakers. In Uruguay , people who speak Italian as their home language are 1.1% of

11135-491: The late 18th century when it tended to be replaced by German. John Milton , for instance, wrote some of his early poetry in Italian. Within the Catholic Church , Italian is known by a large part of the ecclesiastical hierarchy and is used in substitution for Latin in some official documents. Italian loanwords continue to be used in most languages in matters of art and music (especially classical music including opera), in

11266-525: The late 19th to the mid-20th century, millions of Italians settled in Argentina, Uruguay, Southern Brazil and Venezuela, as well as in Canada and the United States, where they formed a physical and cultural presence. In some cases, colonies were established where variants of regional languages of Italy were used, and some continue to use this regional language. Examples are Rio Grande do Sul , Brazil, where Talian

11397-563: The law. On the other hand, Corsican (a language spoken on the French island of Corsica ) is closely related to medieval Tuscan , from which Standard Italian derives and evolved. The differences in the evolution of Latin in the different regions of Italy can be attributed to the natural changes that all languages in regular use are subject to, and to some extent to the presence of three other types of languages: substrata, superstrata, and adstrata . The most prevalent were substrata (the language of

11528-421: The medical training institutions own their own facilities. Often, medical school CSSC locations include rooms for debriefs, training exercises, standardized exam and patient rooms, procedure rooms, offices, observation area, control rooms, classrooms, and storage rooms. On average, a medical school dedicates 27 rooms of its CSSC to training with simulations. A medical simulation centre is an educational centre in

11659-597: The most known are the use of mannequins (referred to by the simulation company METI as Human Patient Simulators, or HPS for short) and standardized patients. As seen in the chart titled "Types of Simulation Used in Medical Education" retrieved from the AAMC article, medical schools are leading the way when it comes to the use of standardized patients, but teaching hospitals and medical schools are close when it comes to full-scale mannequins and partial task trainers. According to

11790-794: The municipalities of Santa Tereza and Encantado in Brazil . Italian is also spoken by large immigrant and expatriate communities in the Americas and Australia . Italian is included under the languages covered by the European Charter for Regional or Minority Languages in Bosnia and Herzegovina and in Romania , although Italian is neither a co-official nor a protected language in these countries. Some speakers of Italian are native bilinguals of both Italian (either in its standard form or regional varieties ) and

11921-412: The nation was unified in 1861. Italian is a Romance language , a descendant of Vulgar Latin (colloquial spoken Latin). Standard Italian is based on Tuscan , especially its Florentine dialect , and is, therefore, an Italo-Dalmatian language , a classification that includes most other central and southern Italian languages and the extinct Dalmatian . According to Ethnologue , lexical similarity

12052-408: The number of printing presses in Italy grew rapidly and by the year 1500 reached a total of 56, the biggest number of printing presses in all of Europe. This enabled the production of more pieces of literature at a lower cost and Italian, as the dominant language, spread. Italian became the language used in the courts of every state in the Italian Peninsula , as well as the prestige variety used on

12183-580: The official language of the Sovereign Military Order of Malta . Italian has a significant use in musical terminology and opera with numerous Italian words referring to music that have become international terms taken into various languages worldwide. Almost all native Italian words end with vowels , and the language has a 7-vowel sound system ('e' and 'o' have mid-low and mid-high sounds). Italian has contrast between short and long consonants and gemination (doubling) of consonants. During

12314-630: The openness of vowels, the length of the consonants, and influence of the local language (for example, in informal situations andà , annà and nare replace the standard Italian andare in the area of Tuscany, Rome and Venice respectively for the infinitive "to go"). There is no definitive date when the various Italian variants of Latin—including varieties that contributed to modern Standard Italian—began to be distinct enough from Latin to be considered separate languages. One criterion for determining that two language variants are to be considered separate languages rather than variants of

12445-584: The original inhabitants), as the Italian dialects were most probably simply Latin as spoken by native cultural groups. Superstrata and adstrata were both less important. Foreign conquerors of Italy that dominated different regions at different times left behind little to no influence on the dialects. Foreign cultures with which Italy engaged in peaceful relations with, such as trade, had no significant influence either. Throughout Italy, regional varieties of Standard Italian, called Regional Italian , are spoken. Regional differences can be recognized by various factors:

12576-453: The other hand, almost everyone still speaks the Corsican idiom , which, due to its linguistic proximity to the Italian standard language, appears both linguistically as an Italian dialect and therefore as a carrier of Italian culture, despite the French government's decades-long efforts to cut Corsica off from the Italian motherland. Italian was the official language in Monaco until 1860, when it

12707-448: The other hand, continues to place learners in a discovery environment, but where an instructor is available to help guide learning via coaching, feedback, hints, or modeling. Both Experiential and Discovery Learning are based on constructivist philosophy. Broadly, Constructivism is based on the belief that learning is an active process whereby learners make sense of new knowledge by building upon their prior experiences; each person has

12838-403: The participants throughout the simulation, and to establish a shared mental model of the events which occurred. A debate in the healthcare simulation community exists regarding the exploration of feelings in the descriptive phase. One camp believes that the descriptive phase should allow an opportunity for participants to "blow off steam," and release any tension which may have accumulated during

12969-453: The past, its main purpose was to train medical professionals to reduce errors during surgery , prescription, crisis interventions, and general practice. Combined with methods in debriefing, it is now also used to train students in anatomy , physiology , and communication during their schooling. Modern-day simulation for training was first utilized by anesthesia physicians to reduce accidents. When simulation skyrocketed in popularity during

13100-406: The population of Italy could speak Standard Italian. He reports that in 1951 that percentage had risen to 87%. The ability to speak Italian did not necessarily mean it was in everyday use, and most people (63.5%) still usually spoke their native dialects. In addition, other factors such as mass emigration, industrialization, and urbanization, and internal migrations after World War II , contributed to

13231-791: The presentation of existing studies, a sparsity of research related to debriefing topics of importance, and debriefing characteristics are incompletely reported. Recommendations for future debriefing studies include: or: Current research has found that simulation training with debriefing, when compared with no intervention, had favorable, statistically significant effects for nearly all outcomes: knowledge, process skill, time skills, product skills, behavior process, behavior time, and patient effects. When compared with other forms of instruction, simulation and debriefing showed small favorable effects for knowledge, time and process outcomes, and moderate effects for satisfaction. There many different types of simulations that are used for training purposes. Some of

13362-508: The processing of traumatic events. Here, the emphasis is on the narrative; in a facilitator-led environment, participants reconstruct what happened and review facts, share reactions, and develop a shared meaning of the events. The aim is to reduce stress, accelerate normal recovery, and assist in both the cognitive and emotional processing of the experience. In all instances, debriefing is the process by which people who have gone through an experience are intentionally and thoughtfully led through

13493-469: The proliferation of Standard Italian. The Italians who emigrated during the Italian diaspora beginning in 1861 were often of the uneducated lower class, and thus the emigration had the effect of increasing the percentage of literates, who often knew and understood the importance of Standard Italian, back home in Italy. A large percentage of those who had emigrated also eventually returned to Italy, often more educated than when they had left. Although use of

13624-528: The pronunciation of stressed "e", and of "s" between vowels in many words: e.g. va bene "all right" is pronounced [vabˈbɛːne] by a Roman (and by any standard Italian speaker), [vaˈbeːne] by a Milanese (and by any speaker whose native dialect lies to the north of the La Spezia–Rimini Line ); a casa "at home" is [akˈkaːsa] for Roman, [akˈkaːsa] or [akˈkaːza] for standard, [aˈkaːza] for Milanese and generally northern. In contrast to

13755-415: The publication of Agnolo Monosini 's Latin tome Floris italicae linguae libri novem in 1604 followed by the first Italian dictionary in 1612. An important event that helped the diffusion of Italian was the conquest and occupation of Italy by Napoleon in the early 19th century (who was himself of Italian-Corsican descent). This conquest propelled the unification of Italy some decades after and pushed

13886-512: The question being posed. Note that the use of AI is most encouraged when a facilitator has a judgment about something which was observed during the simulation scenario. Using AI eliminates the tone of judgment as well as the "guess what I'm thinking" which can occur when asking questions. The third and final phase of three-phase debriefing structures is most commonly referred to as "application," or "summary". Participants are asked to move any newly acquired insights or knowledge gained throughout

14017-479: The referendum that allowed France to annex Savoy and Nice, and a group of his followers (among the Italian Savoyards ) took refuge in Italy in the following years. Corsica passed from the Republic of Genoa to France in 1769 after the Treaty of Versailles . Italian was the official language of Corsica until 1859. Giuseppe Garibaldi called for the inclusion of the " Corsican Italians " within Italy when Rome

14148-438: The residency and subspecialty period. Internal medicine, emergency medicine, obstetrics/gynecology, pediatrics, surgery, and anesthesiology are the most common areas taught in medical schools and hospitals. The AAMC reported that the majority of medical schools and teaching hospitals centralize their simulation activities at a single physical location, while some use decentralized facilities or mobile simulation resources. Most of

14279-473: The scenario has finished. However, in order to establish a shared mental model with all participants, debriefing must occur in a fashion whereby all participants can hear one another and have a chance to respond. This is difficult to accomplish while walking down a hallway, or in any disorganized fashion. The location of the debriefing is ideally somewhere comfortable and conducive to conversation and reflection, where chairs can be maneuvered and manipulated. It

14410-719: The signing of an agreement for the management of the Mater Olbia Hospital in Olbia , Sardinia. The hospital, acquired by QFE through the European investment platform in May 2015, underwent major structural and technological interventions that led to its opening in 2019. The Gemelli became the focus of international attention during the pontificate of Pope John Paul II who, in 1981, received emergency surgery after Mehmet Ali Ağca 's failed assassination attempt . He returned at various times, up to

14541-422: The simulation and the debriefing period. As simulation participants often find the experience stressful and intimidating, worried about judgment from their peers and facilitator(s), establishing safety must be done from the outset of the simulation event. Note that psychological safety does not necessarily equate to comfort, but rather that participants "feel safe enough to embrace being uncomfortable...without

14672-438: The simulation experience forward to their daily activities or thought processes. This includes learning which may have occurred during the previous phases in the debriefing process. Common questions posed, or statements made, by a facilitator during this phase include: Note that the summary here is not always in terms of re-stating the major points which were visited throughout the simulation and debrief, but more so emphasize

14803-423: The simulation scenario in order for learners to continue the debrief and subsequent reflection without pent-up emotion. Others believe that the "venting" phase is not necessary and may explicitly make this statement in their debriefing models, or simply omit any reference to emotions or feelings at all. The second phase of debriefing is often referred to as "analysis," "description," or "discovering". This

14934-630: The site was chosen to build the hospital and previously used as a convent , now serves as the Institute of Bioethics, as well as the main university Church. Since 2015, the Hospital is organized into 21 areas grouped in 8 departments, whose aim is to coordinate healthcare, training, education and research roles assigned to the areas they cover. The Hospital uses "Critical Pathways" to map, integrate and assess every phase involved in providing care for key health problems. In 2015 alone, almost 95,000 patients were hospitalised and more than 45,000 surgical operations were conducted. 80,000 patients were treated in

15065-691: The subsequent debriefs are aimless, disorganized, and often dysfunctional. Most debriefing models explicitly make mention of stating learning objectives. The exploration of learning objectives ought to answer at least two questions: What competencies – knowledge, skills, or attitudes – are to be learned, and what specifically should be learned about them? The method of debriefing chosen should align with learning objectives through evaluation of three points: performance domain – cognitive, technical, or behavioral; evidence for rationale – yes/no; and estimated length of time to address – short, moderate, or long. Learning objectives may be predetermined and included in

15196-464: The teachings of the Roman Catholic Church began to be understood from new perspectives as humanists —individuals who placed emphasis on the human body and its full potential—began to shift focus from the church to human beings themselves. The continual advancements in technology play a crucial role in the diffusion of languages. After the invention of the printing press in the 15th century,

15327-521: The three conventional phases of debriefing are: description, analysis, and application. Frameworks which make use of the three-phase debriefing format include Debriefing with Good Judgment, the 3D Model, the GAS model, and Diamond Debrief. Also labelled as "reaction," "defusing," "gather," and "identify what happened," the description phase of debriefing sees simulation participants describing and exploring their reactions, emotions, and overall impact of

15458-711: The three-part debriefing model, such as reviewing learning objectives, or provide additional process recommendations, such as immediately re-practicing any skills involved in the original simulation scenario. Examples of multi-phase debriefing structures include the Promoting Excellence and Reflective Learning in Simulation (PEARLS) framework, TeamGAINS, and Healthcare Simulation After-Action Review (AAR). As with any other educational initiative, learning objectives are of paramount importance in simulation and debriefing. Without learning objectives, simulations themselves and

15589-615: The thyroid, adrenal gland and pituitary gland. The mortality rate for cardiac surgery is among the lowest in Italy. In 2015, in collaboration with the MediCinema Italy Onlus, the Hospital completed and inaugurated the 130 seats MediCinema theatre which can accommodate patients in wheelchairs and beds. It is the first hospital in Italy to have premises set aside for “cinematherapy” and relief therapy for patients and their family members. In July 2017, Qatar Foundation Endowment (QFE) and Agostino Gemelli University Policlinic announced

15720-463: The title Divina , were read throughout the peninsula and his written dialect became the "canonical standard" that all educated Italians could understand. Dante is still credited with standardizing the Italian language. In addition to the widespread exposure gained through literature, the Florentine dialect also gained prestige due to the political and cultural significance of Florence at the time and

15851-529: The total population of the country. In Australia, Italian is the second most spoken foreign language after Chinese, with 1.4% of the population speaking it as their home language. The main Italian-language newspapers published outside Italy are the L'Osservatore Romano ( Vatican City ), the L'Informazione di San Marino ( San Marino ), the Corriere del Ticino and the laRegione Ticino ( Switzerland ),

15982-787: The university founder, the Franciscan friar , physician and psychologist Agostino Gemelli . The hospital provides free medical assistance as part of the Italian national health system as well as paid-for private assistance in dedicated hotel-style wards. Construction began in 1959 under the direction of Giuseppe Cigni on the hill of Monte Mario in Rome, and the hospital opened its doors in July 1964. The hospital hosts facilities for both basic and clinical research, on-site housing for medical students, canteens, cafeterias, one restaurant, one bookshop and two medical libraries. Undergraduate and postgraduate Medical studies , Nursing sciences, Physiotherapy and

16113-425: The use of medical simulation technology in order to accurately judge students by using "patient scenarios" during oral board examinations. However, these forms of simulation are a far cry from high- fidelity models that have surfaced since the 1990s. Due to the fact that computer simulation technology is still relatively new with regard to flight and military simulators, there is still much research to be done about

16244-415: The use of the word guided in the definition, further implying that the interactions which occur in a simulated environment are not left solely to those persons immersed in the simulation, but that a "guide" also be present. This guide may be virtual in nature, such as prompts from a computer program, or may be physically present, in the form of an instructor or teacher. The human guide is often referred to as

16375-514: The utilization of specialists. In 2014, Society for Simulation in Healthcare introduced the Certified Healthcare Simulation Operations Specialist (CHSOS) certification. The CHSOS certification endeavors to standardize and authenticate the minimum competencies to be demonstrated by simulation center operations specialists. The origins of debriefing can be traced back to the military, whereby upon return from

16506-524: Was admitted to Gemelli on 7 June 2023, and later underwent a three-hour operation on his intestine . He left hospital on 16 June. Italian language Italian ( italiano , pronounced [itaˈljaːno] , or lingua italiana , pronounced [ˈliŋɡwa itaˈljaːna] ) is a Romance language of the Indo-European language family that evolved from the Vulgar Latin of

16637-548: Was also introduced to Somalia through colonialism and was the sole official language of administration and education during the colonial period but fell out of use after government, educational and economic infrastructure were destroyed in the Somali Civil War . Italian is also spoken by large immigrant and expatriate communities in the Americas and Australia. Although over 17 million Americans are of Italian descent , only

16768-516: Was annexed to the Kingdom of Italy , but King Victor Emmanuel II did not agree to it. Italian is generally understood in Corsica by the population resident therein who speak Corsican , which is an Italo-Romance idiom similar to Tuscan. Francization occurred in Nice case, and caused a near-disappearance of the Italian language as many of the Italian speakers in these areas migrated to Italy. In Corsica, on

16899-519: Was developed, and medical standards were established. Gradually, medical simulation became affordable, although it remained un-standardized. By the 1980s software simulations became available. With the help of a UCSD School of Medicine student, Computer Gaming World reported that a Surgeon (1986) for the Apple Macintosh very accurately simulated operating on an aortic aneurysm . Others followed, such as Life & Death (1988). In 2004,

17030-443: Was mirrored by a decline in the use of the dialects. An increase in literacy was one of the main driving factors (one can assume that only literates were capable of learning Standard Italian, whereas those who were illiterate had access only to their native dialect). The percentage of literates rose from 25% in 1861 to 60% in 1911, and then on to 78.1% in 1951. Tullio De Mauro , an Italian linguist, has asserted that in 1861 only 2.5% of

17161-630: Was replaced by the French. This was due to the annexation of the surrounding County of Nice to France following the Treaty of Turin (1860) . It formerly had official status in Montenegro (because of the Venetian Albania ), parts of Slovenia and Croatia (because of the Venetian Istria and Venetian Dalmatia ), parts of Greece (because of the Venetian rule in the Ionian Islands and by

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