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Participants randomized to the mental simulation intervention, will be presented with written instructions in the form of a standardized script for the mental simulation exercise (Additional file 1).
Calculation of 95% CI obtained after the simulation intervention (post-MCQ, post-SAQ, stress measurements, IMI) was based on generalised estimating equations (GEE) 56 since observations from individuals on the same team were potentially correlated.
Research has suggested that imagery-based and mental simulation intervention techniques in health behavior exert their effects through changes in motivation [ 30, 57], intentions and attitudes [ 33, 58] and planning [ 31], although there are few studies that have conducted formal mediator analyses.
57 The mean outcomes obtained after the simulation intervention (postmeasurements) in the two intervention groups were compared by a linear model including intervention and baseline (premeasurements) as explanatory variables (analysis of covariance (ANCOVA)), and inferences were based on GEE to account for the potential correlation within teams.
We predict statistically-significant, medium-sized multiple mediation of the effects of the mental simulation intervention on follow-up alcohol consumption by the theory of planned behavior and motivational change scores and significant mediation of the effect of self-control training on alcohol consumption by state self-control change scores.
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Researchers have studied simulation interventions, student perceptions and feelings, and learning outcomes of simulation; however, gaps still exist in what is known about the outcomes of simulation.
These three factors are closely interrelated, and to understand them and how to design high-quality simulation interventions from a learning perspective, it is important to look not only to the simulation literature but also to the pedagogical literature.
In 17 studies comparing alternative simulation interventions, training in non-technical skills (e.g. communication) and medical management compared with training in medical management alone was associated with negligible effects for knowledge and skills (four studies, ES range 0.14 0.15).
The effect sizes of mental simulation interventions is generally small-to-medium, with a medium effect size reported for the research on alcohol consumption of employees, the context that is most closely aligned to that of the current study [ 34].
Intervention outcome is measured in terms of impact, defined as the percentage reduction in infection or disease caused by an intervention in a trial group (simulated intervention) compared to a control group (simulation without any intervention).
In a treatment simulation, an intervention is represented through higher probabilities of preventing this binding taking place.
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