WorldWideScience

Sample records for fidelity medical simulation

  1. High-fidelity simulation in the nonmedical domain: practices and potential transferable competencies for the medical field

    Directory of Open Access Journals (Sweden)

    Carron PN

    2011-05-01

    Full Text Available Pierre-Nicolas Carron, Lionel Trueb, Bertrand YersinEmergency Service, University Hospital Center, Lausanne, SwitzerlandAbstract: Simulation is a promising pedagogical tool in the area of medical education. High-fidelity simulators can reproduce realistic environments or clinical situations. This allows for the practice of teamwork and communication skills, thereby enhancing reflective reasoning and experiential learning. Use of high-fidelity simulators is not limited to the medical and aeronautical fields, but has developed in a large number of nonmedical organizations as well. The techniques and pedagogical tools which have evolved through the use of nonmedical simulations serve not only as teaching examples but also as avenues which can help further the evolution of the concept of high-fidelity simulation in the field of medicine. This paper presents examples of high-fidelity simulations in the military, maritime, and aeronautical fields. We compare the implementation of high-fidelity simulation in the medical and nonmedical domains, and discuss the possibilities and limitations of simulators in medicine, based on recent nonmedical applications.Keywords: high-fidelity simulation, crew resource management, experiential learning

  2. Fidelity in clinical simulation

    DEFF Research Database (Denmark)

    Jensen, Sanne; Nøhr, Christian; Rasmussen, Stine Loft

    2013-01-01

    Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype...... without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known...... functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation....

  3. Task Specific Simulations for Medical Training: Fidelity Requirements Compared with Levels of Care

    Science.gov (United States)

    2009-01-01

    the pharmacological responses are simulated. The analysis will also include a discussion on simulating versus replicating human physiology . An initial...systems, such as bleeding, heart rate, blood pressure, etc. An attempt will be made to define a strategy for selecting the correct fidelity of human physiology models as well as ways to reuse existing models.

  4. High fidelity medical simulation in the difficult environment of a helicopter: feasibility, self-efficacy and cost

    Directory of Open Access Journals (Sweden)

    Holland Carolyn

    2006-10-01

    Full Text Available Abstract Background This study assessed the feasibility, self-efficacy and cost of providing a high fidelity medical simulation experience in the difficult environment of an air ambulance helicopter. Methods Seven of 12 EM residents in their first postgraduate year participated in an EMS flight simulation as the flight physician. The simulation used the Laerdal SimMan™ to present a cardiac and a trauma case in an EMS helicopter while running at flight idle. Before and after the simulation, subjects completed visual analog scales and a semi-structured interview to measure their self-efficacy, i.e. comfort with their ability to treat patients in the helicopter, and recognition of obstacles to care in the helicopter environment. After all 12 residents had completed their first non-simulated flight as the flight physician; they were surveyed about self-assessed comfort and perceived value of the simulation. Continuous data were compared between pre- and post-simulation using a paired samples t-test, and between residents participating in the simulation and those who did not using an independent samples t-test. Categorical data were compared using Fisher's exact test. Cost data for the simulation experience were estimated by the investigators. Results The simulations functioned correctly 5 out of 7 times; suggesting some refinement is necessary. Cost data indicated a monetary cost of $440 and a time cost of 22 hours of skilled instructor time. The simulation and non-simulation groups were similar in their demographics and pre-hospital experiences. The simulation did not improve residents' self-assessed comfort prior to their first flight (p > 0.234, but did improve understanding of the obstacles to patient care in the helicopter (p = 0.029. Every resident undertaking the simulation agreed it was educational and it should be included in their training. Qualitative data suggested residents would benefit from high fidelity simulation in other

  5. Using multimedia tools and high-fidelity simulations to improve medical students' resuscitation performance: an observational study

    Science.gov (United States)

    Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

    2016-01-01

    Objectives The goal of our study was to shed light on educational methods to strengthen medical students' cardiopulmonary resuscitation (CPR) leadership and team skills in order to optimise CPR understanding and success using didactic videos and high-fidelity simulations. Design An observational study. Setting A tertiary medical centre in Northern Taiwan. Participants A total of 104 5–7th year medical students, including 72 men and 32 women. Interventions We provided the medical students with a 2-hour training session on advanced CPR. During each class, we divided the students into 1–2 groups; each group consisted of 4–6 team members. Medical student teams were trained by using either method A or B. Method A started with an instructional CPR video followed by a first CPR simulation. Method B started with a first CPR simulation followed by an instructional CPR video. All students then participated in a second CPR simulation. Outcome measures Student teams were assessed with checklist rating scores in leadership, teamwork and team member skills, global rating scores by an attending physician and video-recording evaluation by 2 independent individuals. Results The 104 medical students were divided into 22 teams. We trained 11 teams using method A and 11 using method B. Total second CPR simulation scores were significantly higher than first CPR simulation scores in leadership (p<0.001), teamwork (p<0.001) and team member skills (p<0.001). For methods A and B students' first CPR simulation scores were similar, but method A students' second CPR simulation scores were significantly higher than those of method B in leadership skills (p=0.034), specifically in the support subcategory (p=0.049). Conclusions Although both teaching strategies improved leadership, teamwork and team member performance, video exposure followed by CPR simulation further increased students' leadership skills compared with CPR simulation followed by video exposure. PMID:27678539

  6. [Team dynamics and clinical performance of medical students in web-based and high-fidelity simulations].

    Science.gov (United States)

    Bang, Jae Beum; Yoon, Yoo Sang; Lee, Young Hwan; Lee, Sam Beom

    2014-12-01

    The importance of team dynamics with regard to clinical performance is being emphasized to improve patient safety and the quality of health care. The aim of this study was to examine the correlation and differences in team dynamics and team clinical performance in a web-based simulation (WS) and high-fidelity simulation (HS) in the medical students. The simulations were held for 15 teams of fourth year medical students (n=52). They were given two clinical cases, dyspnea (case 1) and chest pain (case 2) by WS and then HS. The scores on the team dynamics and the team's clinical performance were analyzed by paired t-test and multiple regression using SPSS version 21.0 (IBM Corp.). The teamwork scores on case 2 (22.67 ± 6.58) were higher than for case 1 in the HS (20.47 ± 7.22). Team clinical performance scores were the same the WS and HS. Team clinical performances were significantly associated with team dynamics in both cases by HS. Teamwork scores of team dynamics were each explanation on case 1 (74.9%), case 2 (63.4%) in the HS. The team dynamics and clinical performance can improve if undergraduate medical students have more opportunities. They should be trained in these endeavors to become future doctors for which scenario-based simulations could be valuable.

  7. High Fidelity BWR Fuel Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Su Jong [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-08-01

    This report describes the Consortium for Advanced Simulation of Light Water Reactors (CASL) work conducted for completion of the Thermal Hydraulics Methods (THM) Level 3 milestone THM.CFD.P13.03: High Fidelity BWR Fuel Simulation. High fidelity computational fluid dynamics (CFD) simulation for Boiling Water Reactor (BWR) was conducted to investigate the applicability and robustness performance of BWR closures. As a preliminary study, a CFD model with simplified Ferrule spacer grid geometry of NUPEC BWR Full-size Fine-mesh Bundle Test (BFBT) benchmark has been implemented. Performance of multiphase segregated solver with baseline boiling closures has been evaluated. Although the mean values of void fraction and exit quality of CFD result for BFBT case 4101-61 agreed with experimental data, the local void distribution was not predicted accurately. The mesh quality was one of the critical factors to obtain converged result. The stability and robustness of the simulation was mainly affected by the mesh quality, combination of BWR closure models. In addition, the CFD modeling of fully-detailed spacer grid geometry with mixing vane is necessary for improving the accuracy of CFD simulation.

  8. Effect of High-Fidelity Simulation on Medical Students' Knowledge about Advanced Life Support: A Randomized Study.

    Directory of Open Access Journals (Sweden)

    Andrea Cortegiani

    Full Text Available High-fidelity simulation (HFS is a learning method which has proven effective in medical education for technical and non-technical skills. However, its effectiveness for knowledge acquisition is less validated. We performed a randomized study with the primary aim of investigating whether HFS, in association with frontal lessons, would improve knowledge about advanced life support (ALS, in comparison to frontal lessons only among medical students. The secondary aims were to evaluate the effect of HFS on knowledge acquisition of different sections of ALS and personal knowledge perception. Participants answered a pre-test questionnaire consisting of a subjective (evaluating personal perception of knowledge and an objective section (measuring level of knowledge containing 100 questions about algorithms, technical skills, team working/early warning scores/communication strategies according to ALS guidelines. All students participated in 3 frontal lessons before being randomized in group S, undergoing a HFS session, and group C, receiving no further interventions. After 10 days from the end of each intervention, both groups answered a questionnaire (post-test with the same subjective section but a different objective one. The overall number of correct answers of the post-test was significantly higher in group S (mean 74.1, SD 11.2 than in group C (mean 65.5, SD 14.3, p = 0.0017, 95% C.I. 3.34 - 13.9. A significantly higher number of correct answers was reported in group S than in group C for questions investigating knowledge of algorithms (p = 0.0001; 95% C.I 2.22-5.99 and team working/early warning scores/communication strategies (p = 0.0060; 95% C.I 1.13-6.53. Students in group S showed a significantly higher score in the post-test subjective section (p = 0.0074. A lower proportion of students in group S confirmed their perception of knowledge compared to group C (p = 0.0079. HFS showed a beneficial effect on knowledge of ALS among medical students

  9. Reconsidering fidelity in simulation-based training.

    Science.gov (United States)

    Hamstra, Stanley J; Brydges, Ryan; Hatala, Rose; Zendejas, Benjamin; Cook, David A

    2014-03-01

    In simulation-based health professions education, the concept of simulator fidelity is usually understood as the degree to which a simulator looks, feels, and acts like a human patient. Although this can be a useful guide in designing simulators, this definition emphasizes technological advances and physical resemblance over principles of educational effectiveness. In fact, several empirical studies have shown that the degree of fidelity appears to be independent of educational effectiveness. The authors confronted these issues while conducting a recent systematic review of simulation-based health professions education, and in this Perspective they use their experience in conducting that review to examine key concepts and assumptions surrounding the topic of fidelity in simulation.Several concepts typically associated with fidelity are more useful in explaining educational effectiveness, such as transfer of learning, learner engagement, and suspension of disbelief. Given that these concepts more directly influence properties of the learning experience, the authors make the following recommendations: (1) abandon the term fidelity in simulation-based health professions education and replace it with terms reflecting the underlying primary concepts of physical resemblance and functional task alignment; (2) make a shift away from the current emphasis on physical resemblance to a focus on functional correspondence between the simulator and the applied context; and (3) focus on methods to enhance educational effectiveness using principles of transfer of learning, learner engagement, and suspension of disbelief. These recommendations clarify underlying concepts for researchers in simulation-based health professions education and will help advance this burgeoning field.

  10. [The development and current status of high-fidelity patient simulation teaching].

    Science.gov (United States)

    Chen, Shiah-Lian; Lee, Mei-Li; Liao, I-Chen; Liang, Tienli

    2013-04-01

    High-fidelity patient simulation teaching represents one of the most important innovations in healthcare education in the past two decades. In Taiwan, many medical centers and medical colleges now have clinical skill centers equipped with a high-fidelity patient simulator. Practicing clinical scenarios in this simulated environment can help strengthen students' professional essentials and competencies outside of classroom and clinical teaching settings. High-fidelity simulation teaching is an integrated teaching strategy that is continuing to receive greater attention. This article describes the historical development of high-fidelity patient simulation teaching, its current status, and applications in nursing education as a reference for nursing educators.

  11. Simulation Learning PC Screen-Based vs. High Fidelity

    Science.gov (United States)

    2011-08-01

    conceptualization to evaluation. New York; National league for Nursing. 31 Smith, S. and Roehrs, C. (2009). High fidelity simulation: factors...PMH: healthy male, history of fracture right humerus playing rugby in high-school. No known allergies. Last medical clinic VS: 120/78, HR

  12. High-fidelity simulation enhances ACLS training.

    Science.gov (United States)

    Langdorf, Mark I; Strom, Suzanne L; Yang, Luanna; Canales, Cecilia; Anderson, Craig L; Amin, Alpesh; Lotfipour, Shahram

    2014-01-01

    Medical student training and experience in cardiac arrest situations is limited. Traditional Advanced Cardiac Life Support (ACLS) teaching methods are largely unrealistic with rare personal experience as team leader. Yet Postgraduate Year 1 residents may perform this role shortly after graduation. We expanded our ACLS teaching to a "Resuscitation Boot Camp" where we taught 2010 ACLS to 19 pregraduation students in didactic (12 hours) and experiential (8 hours) format. Immediately before the course, we recorded students performing an acute coronary syndrome/ventricular fibrillation (VF) scenario. As a final test, we recorded the same scenario for each student. Primary outcomes were time to cardiopulmonary resuscitation (CPR) and defibrillation (DF). Secondary measures were total scenario score, dangerous actions, proportion of students voicing "ventricular fibrillation," 12-lead ST-elevation myocardial infarction (STEMI) interpretation, and care necessary for return of spontaneous circulation (ROSC). Two expert ACLS instructors scored both performances on a 121-point scale, with each student serving as their own control. We used t tests and McNemar tests for paired data with statistical significance at pmask ventilation before DF. After instruction, students scored 97±4/121 points (ptraining, only 4 of 19 (21%) students performed both CPR and DF within 2 minutes, and 3 of these had ROSC. After training, 14 of 19 (74%) achieved CPR+DF≤2 minutes (p=.002), and all had ROSC. Before training, 5 of 19 (26%) students said "VF" and 4 of 19 obtained an ECG, but none identified STEMI. After training, corresponding performance was 13 of 19 "VF" (68%, p=021) and 100% ECG and STEMI identification (ptraining. ACLS training including high-fidelity simulation decreases time to CPR and DF and improves performance during resuscitation.

  13. Patterns of communication in high-fidelity simulation.

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    Anderson, Judy K; Nelson, Kimberly

    2015-01-01

    High-fidelity simulation is commonplace in nursing education. However, critical thinking, decision making, and psychomotor skills scenarios are emphasized. Scenarios involving communication occur in interprofessional or intraprofessional settings. The importance of effective nurse-patient communication is reflected in statements from the American Nurses Association and Quality and Safety Education for Nurses, and in the graduate outcomes of most nursing programs. This qualitative study examined the patterns of communication observed in video recordings of a medical-surgical scenario with 71 senior students in a baccalaureate program. Thematic analysis revealed patterns of (a) focusing on tasks, (b) communicating-in-action, and (c) being therapeutic. Additional categories under the patterns included missing opportunities, viewing the "small picture," relying on informing, speaking in "medical tongues," offering choices…okay?, feeling uncomfortable, and using therapeutic techniques. The findings suggest the importance of using high-fidelity simulation to develop expertise in communication. In addition, the findings reinforce the recommendation to prioritize communication aspects of scenarios and debriefing for all simulations.

  14. Quantum simulation using fidelity-profile optimization

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    Manu, V. S.; Kumar, Anil

    2014-05-01

    Experimental quantum simulation of a Hamiltonian H requires unitary operator decomposition (UOD) of its evolution unitary U =exp(-iHt) in terms of native unitary operators of the experimental system. Here, using a genetic algorithm, we numerically evaluate the most generic UOD (valid over a continuous range of Hamiltonian parameters) of the unitary operator U , termed fidelity-profile optimization. The optimization is obtained by systematically evaluating the functional dependence of experimental unitary operators (such as single-qubit rotations and time-evolution unitaries of the system interactions) to the Hamiltonian (H) parameters. Using this technique, we have solved the experimental unitary decomposition of a controlled-phase gate (for any phase value), the evolution unitary of the Heisenberg XY interaction, and simulation of the Dzyaloshinskii-Moriya (DM) interaction in the presence of the Heisenberg XY interaction. Using these decompositions, we studied the entanglement dynamics of a Bell state in the DM interaction and experimentally verified the entanglement preservation procedure of Hou et al. [Ann. Phys. (N.Y.) 327, 292 (2012), 10.1016/j.aop.2011.08.004] in a nuclear magnetic resonance quantum information processor.

  15. Importance of debriefing in high-fidelity simulations

    Directory of Open Access Journals (Sweden)

    Igor Karnjuš

    2014-04-01

    Full Text Available Debriefing has been identified as one of the most important parts of a high-fidelity simulation learning process. During debriefing, the mentor invites learners to critically assess the knowledge and skills used during the execution of a scenario. Regardless of the abundance of studies that have examined simulation-based education, debriefing is still poorly defined.The present article examines the essential features of debriefing, its phases, techniques and methods with a systematic review of recent publications. It emphasizes the mentor’s role, since the effectiveness of debriefing largely depends on the mentor’s skills to conduct it. The guidelines that allow the mentor to evaluate his performance in conducting debriefing are also presented. We underline the importance of debriefing in clinical settings as part of continuous learning process. Debriefing allows the medical teams to assess their performance and develop new strategies to achieve higher competencies.Although the debriefing is the cornerstone of high-fidelity simulation learning process, it also represents an important learning strategy in the clinical setting. Many important aspects of debriefing are still poorly explored and understood, therefore this part of the learning process should be given greater attention in the future.

  16. Incorporating medium fidelity simulation in a practical nurse education program.

    Science.gov (United States)

    Cunningham, Donna D

    2010-01-01

    We frequently hear the word simulation in nursing educatioh. Research has been done on the use of high fidelity simulation in registered nursing programs. High fidelity simulators are expensive and require more than one faculty to facilitate. The question remains: Does every nursing program require a high fidelity simulation laboratory? This article will define the three levels of fidelity and describe the incorporation of a medium fidelity simulation into a practical nursing program and will describe the benefits of simulation use. The article will assist the faculty and students new to simulation, and allow them to choose the equipment and scenarios that will be most advantageous for their individual programs. The choice of equipment, scenarios, and fidelity often depends upon the space, time, funds, and faculty available. Simulation adds an important component to nursing education. Using simulation wisely helps students practice in a controlled environment without danger to living patients. The lessons learned will someday play into a "life or death" scenario, and the patient will not be a simulation mannequin.

  17. A methodology for the assessment of manned flight simulator fidelity

    Science.gov (United States)

    Hess, Ronald A.; Malsbury, Terry N.

    1989-01-01

    A relatively simple analytical methodology for assessing the fidelity of manned flight simulators for specific vehicles and tasks is offered. The methodology is based upon an application of a structural model of the human pilot, including motion cue effects. In particular, predicted pilot/vehicle dynamic characteristics are obtained with and without simulator limitations. A procedure for selecting model parameters can be implemented, given a probable pilot control strategy. In analyzing a pair of piloting tasks for which flight and simulation data are available, the methodology correctly predicted the existence of simulator fidelity problems. The methodology permitted the analytical evaluation of a change in simulator characteristics and indicated that a major source of the fidelity problems was a visual time delay in the simulation.

  18. Recommendations on Model Fidelity for Wind Turbine Gearbox Simulations: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Y.; Keller, J.; La Cava, W.; Austin, J.; Nejad, A. R.; Halse, C.; Bastard, L.; Helsen, J.

    2015-01-01

    This work investigates the minimum level of fidelity required to accurately simulate wind turbine gearboxes using state-of-the-art design tools. Excessive model fidelity including drivetrain complexity, gearbox complexity, excitation sources, and imperfections, significantly increases computational time, but may not provide a commensurate increase in the value of the results. Essential design parameters are evaluated, including the planetary load-sharing factor, gear tooth load distribution, and sun orbit motion. Based on the sensitivity study results, recommendations for the minimum model fidelities are provided.

  19. Objective Fidelity Evaluation in Multisensory Virtual Environments: Auditory Cue Fidelity in Flight Simulation

    Science.gov (United States)

    Meyer, Georg F.; Wong, Li Ting; Timson, Emma; Perfect, Philip; White, Mark D.

    2012-01-01

    We argue that objective fidelity evaluation of virtual environments, such as flight simulation, should be human-performance-centred and task-specific rather than measure the match between simulation and physical reality. We show how principled experimental paradigms and behavioural models to quantify human performance in simulated environments that have emerged from research in multisensory perception provide a framework for the objective evaluation of the contribution of individual cues to human performance measures of fidelity. We present three examples in a flight simulation environment as a case study: Experiment 1: Detection and categorisation of auditory and kinematic motion cues; Experiment 2: Performance evaluation in a target-tracking task; Experiment 3: Transferrable learning of auditory motion cues. We show how the contribution of individual cues to human performance can be robustly evaluated for each task and that the contribution is highly task dependent. The same auditory cues that can be discriminated and are optimally integrated in experiment 1, do not contribute to target-tracking performance in an in-flight refuelling simulation without training, experiment 2. In experiment 3, however, we demonstrate that the auditory cue leads to significant, transferrable, performance improvements with training. We conclude that objective fidelity evaluation requires a task-specific analysis of the contribution of individual cues. PMID:22957068

  20. Motion fidelity during a simulated takeoff

    NARCIS (Netherlands)

    Groen, E.L.; Hosman, R.J.A.W.; Dominicus, J.W.

    2003-01-01

    In this psychophysical study, seven airline pilots reported on their perceived self-motion in response to variations of motion filter gains during a simulated takeoff. Each pilot participated both as pilot flying and pilot non-flying. In order to vary the gains of the simulated linear acceleration

  1. Teaching elliptical excision skills to novice medical students: A randomized controlled study comparing low- and high-fidelity bench models

    Directory of Open Access Journals (Sweden)

    Rafael Denadai

    2014-01-01

    Full Text Available Background: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. Aims : To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Materials and Methods: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills′ training (n = 8: didactic materials (control; organic bench model (low-fidelity; ethylene-vinyl acetate bench model (low-fidelity; chicken legs′ skin bench model (high-fidelity; or pig foot skin bench model (high-fidelity. Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. Results : The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P 0.05 between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills′ training was considered large (>0.80 in all measurements. Conclusion : The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.

  2. Psychological Fidelity in Simulated Work Environments

    Science.gov (United States)

    1978-12-01

    Advanced Simulator for Pilot Training ( ASPT ) have had little or no impact on certain performance variables studied. The same conclusion was...reached by Martin and Waaq (I’J/fl) in their work with the ASPT . Kurthermon», Kddowes found that in oni1 case, the ^!ystem with a...approach could overwhelm the trainee, leadinq to results such as those described by Fddowes (1978) and Martin and Waaq (1978) for the ASPT

  3. Fidelity of Simulation for Pilot Training

    Science.gov (United States)

    1980-12-01

    virtualI measurement hous* FI4A Flight Simulator 1-Sigma V 35K Asmly Csae ig’ 4 "lCoonn""’ Calligraphi 46~i I-wiodow folded,. iie efrac S F95 (4 units...Film (photographic) d) Shadowgraph Presentation to the pilot for a) and b) is normally by CRT, with the information written calligraphi - cally or

  4. Manufacturing High-Fidelity Lunar Agglutinate Simulants

    Science.gov (United States)

    Gutafson, R. J.; Edmunson, J. E.; Rickman, D. L.

    2010-01-01

    The lunar regolith is very different from many naturally occurring material on Earth because it forms in the unique, impact-dominated environment of the lunar surface. Lunar regolith is composed of five basic particle types: mineral fragments, pristine crystalline rock fragments, breccia fragments, glasses of various kinds, and agglutinates (glass-bonded aggregates). Agglutinates are abundant in the lunar regolith, especially in mature regoliths where they can be the dominant component.This presentation will discuss the technical feasibility of manufacturing-simulated agglutinate particles that match many of the unique properties of lunar agglutinates.

  5. The theatre of high-fidelity simulation education.

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    Roberts, Debbie; Greene, Leah

    2011-10-01

    High-fidelity simulation is a useful mechanism to aid progression, development and skill acquisition in nurse education. However, nurse lecturers are daunted by sophisticated simulation technology. This paper presents a new method of introducing human patient simulation to students and educators, whilst seeking to demystify the roles, responsibilities and underpinning pedagogy. The analogy of simulation as theatre outlines the concepts of the theatre and stage (simulation laboratory); the play itself (Simulated Clinical Experience, SCE); the actors (nursing students); audience (peer review panel); director (session facilitator); and the production team (technical coordinators). Performing in front of people in a safe environment, repeated practice and taking on a new role teaches students to act, think and be like a nurse. This in turn supports student learning and enhances self confidence.

  6. High Fidelity Simulation of Primary Atomization in Diesel Engine Sprays

    Science.gov (United States)

    Ivey, Christopher; Bravo, Luis; Kim, Dokyun

    2014-11-01

    A high-fidelity numerical simulation of jet breakup and spray formation from a complex diesel fuel injector at ambient conditions has been performed. A full understanding of the primary atomization process in fuel injection of diesel has not been achieved for several reasons including the difficulties accessing the optically dense region. Due to the recent advances in numerical methods and computing resources, high fidelity simulations of atomizing flows are becoming available to provide new insights of the process. In the present study, an unstructured un-split Volume-of-Fluid (VoF) method coupled to a stochastic Lagrangian spray model is employed to simulate the atomization process. A common rail fuel injector is simulated by using a nozzle geometry available through the Engine Combustion Network. The working conditions correspond to a single orifice (90 μm) JP-8 fueled injector operating at an injection pressure of 90 bar, ambient condition at 29 bar, 300 K filled with 100% nitrogen with Rel = 16,071, Wel = 75,334 setting the spray in the full atomization mode. The experimental dataset from Army Research Lab is used for validation in terms of spray global parameters and local droplet distributions. The quantitative comparison will be presented and discussed. Supported by Oak Ridge Associated Universities and the Army Research Laboratory.

  7. Towards developing high-fidelity simulated learning environment training modules in audiology.

    Science.gov (United States)

    Dzulkarnain, A A; Rahmat, S; Mohd Puzi, N A F; Badzis, M

    2017-02-01

    This discussion paper reviews and synthesises the literature on simulated learning environment (SLE) from allied health sciences, medical and nursing in general and audiology specifically. The focus of the paper is on discussing the use of high-fidelity (HF) SLE and describing the challenges for developing a HF SLE for clinical audiology training. Through the review of the literature, this paper discusses seven questions, (i) What is SLE? (ii) What are the types of SLEs? (iii) How is SLE classified? (iv) What is HF SLE? (v) What types of SLEs are available in audiology and their level of fidelity? (vi) What are the components needed for developing HF SLE? (vii) What are the possible types of HF SLEs that are suitable for audiology training? Publications were identified by structured searches from three major databases PubMed, Web of Knowledge and PsychInfo and from the reference lists of relevant articles. The authors discussed and mapped the levels of fidelity of SLE audiology training modules from the literature and the learning domains involved in the clinical audiology courses. The discussion paper has highlighted that most of the existing SLE audiology training modules consist of either low- or medium-fidelity types of simulators. Those components needed to achieve a HF SLE for audiology training are also highlighted. Overall, this review recommends that the combined approach of different levels and types of SLE could be used to obtain a HF SLE training module in audiology training.

  8. Beyond Fidelity: Deconstructing the Seductive Simplicity of Fidelity in Simulator-Based Education in the Health Care Professions.

    Science.gov (United States)

    Schoenherr, Jordan Richard; Hamstra, Stanley J

    2017-04-01

    Fidelity has become a ubiquitous feature of discourse in simulation studies. Recent studies have highlighted the often ambiguous and contradictory manner in which fidelity has been defined, with each definition emphasizing different physical and functional features of simulation. We suggest that regarding fidelity as an objective property of a simulation obscures the interactive nature of the educator-learner relationship and should be abandoned. Rather than conceiving training as tasks performed by an individual in isolation, we suggest that it is more accurately understood as the social learning of affordances. Affordances represent the functional features of a simulator, which are taken as relevant in a specific learning context by means of analogy. Training is successful to the extent that educators and learners share an understanding of those affordances. Even when explicitly formulated, the concept of fidelity has greater difficulty accounting for the complex, interactional features of the training situation in comparison with accounts based on social learning. We conclude that continued attempts to redefine and use fidelity in the context of training will likely yield little benefit to the field compared with an interactive social learning framework.

  9. Computer-Based versus High-Fidelity Mannequin Simulation in Developing Clinical Judgment in Nursing Education

    Science.gov (United States)

    Howard, Beverly J.

    2013-01-01

    The purpose of this study was to determine if students learn clinical judgment as effectively using computer-based simulations as when using high-fidelity mannequin simulations. There was a single research questions for this study: What is the difference in clinical judgment between participants completing high-fidelity human simulator mannequin…

  10. Fidelity considerations for simulation-based usability assessments of mobile ICT for hospitals

    DEFF Research Database (Denmark)

    Dahl, Yngve; Alsos, Ole A; Svanæs, Dag

    2010-01-01

    training simulation fidelity theories. Based on a review of the training simulation literature, a set of fidelity dimensions through which training simulations are often adjusted to meet specific goals are identified. It is argued that the same mechanisms can be used in usability assessments of mobile ICT...

  11. High-fidelity simulation as an experiential model for teaching root cause analysis.

    Science.gov (United States)

    Quraishi, Sadeq A; Kimatian, Stephen J; Murray, W Bosseau; Sinz, Elizabeth H

    2011-12-01

    The purpose of this study was to assess the effectiveness of high-fidelity simulation for teaching root cause analysis (RCA) in graduate medical education. Thirty clinical anesthesiology-1 through clinical anesthesiology-3 residents were randomly assigned to 2 groups: group A participants received a 10-minute lecture on RCA and participated in a simulation exercise where a medical error occurs, and group B participants received the 10-minute lecture on RCA only. Participants completed baseline, postintervention, and 6-month follow-up assessments, and they were evaluated on their attitude toward as well as understanding of RCA and "systems-based" care. All 30 residents completed the surveys. Baseline attitudes and knowledge scores were similar between groups. Postintervention knowledge scores were also similar between groups; however, group B was significantly more skeptical (P strategies. Six months later, group A demonstrated retained knowledge scores and unchanged attitude, whereas group B demonstrated significantly worse knowledge scores (P  =  .001) as well as continued skepticism toward a systems-based approach (P didactics is an effective strategy for teaching RCA and systems theory in graduate medical education. Our findings also suggest that there is greater retention of knowledge and increased positive attitude toward systems improvement when focused didactics are coupled with a high-fidelity simulation exercise.

  12. High-fidelity simulation in anesthesiology training: a survey of Canadian anesthesiology residents' simulator experience.

    Science.gov (United States)

    Price, James W; Price, John R; Pratt, Dan D; Collins, John B; McDonald, Julie

    2010-02-01

    The objective of this survey was to explore Canadian anesthesiology residents' educational experience with high-fidelity simulation and to improve understanding of the factors perceived to have either a positive or a negative effect on residents' learning. In 2008, all Canadian anesthesiology residents (n = 599) were invited to complete a ten-minute anonymous online survey. Survey questions were derived from two sources, a literature search of MEDLINE (1966 to present), EMBASE (1980 to present), and the Cochrane and Campbell collaboration libraries and the experience of 25 pilot residents and the lead author. The survey response rate was 27.9% (n = 167). Junior residents (PGY1-3) responded that it would be helpful to have an introductory simulation course dealing with common intraoperative emergencies. The introduction of multidisciplinary scenarios (where nurses and colleagues from different specialties were involved in scenarios) was strongly supported. With respect to gender, male anesthesia residents indicated their comfort in making mistakes and asking for help in the simulator more frequently than female residents. In accordance with the ten Best Evidence Medical Education (BEME) principles of successful simulator education, Canadian centres could improve residents' opportunities for repetitive practice (with feedback), individualization of scenarios, and defined learning outcomes for scenarios. Anesthesiology residents indicate that simulation-based education is an anxiety provoking experience, but value its role in promoting safe practice and enhancing one's ability to deal with emergency situations. Suggestions to improve simulation training include increasing residents' access, adopting a more student-centred approach to learning, and creating a safer learning environment.

  13. Prospective randomized comparison of standard didactic lecture versus high-fidelity simulation for radiology resident contrast reaction management training.

    Science.gov (United States)

    Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H

    2011-06-01

    The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.

  14. Using high-fidelity simulation as a learning strategy in an undergraduate intensive care course.

    Science.gov (United States)

    Badir, Aysel; Zeybekoğlu, Zuhal; Karacay, Pelin; Göktepe, Nilgün; Topcu, Serpil; Yalcin, Begüm; Kebapci, Ayda; Oban, Gül

    2015-01-01

    Using high-fidelity simulations to facilitate student learning is an uncommon practice in Turkish nursing programs. The aim of the present study was to understand students' perceptions of the use of simulation in nursing courses. Subjects included 36 senior nursing students taking an intensive care course. This study revealed that high-fidelity simulation is an ideal method of promoting learning by helping students transfer theory into practice, build confidence and teamwork, and raise professional awareness.

  15. High-Fidelity Simulation for Neonatal Nursing Education: An Integrative Review of the Literature.

    Science.gov (United States)

    Cooper, Allyson

    2015-01-01

    The lack of safe avenues to develop neonatal nursing competencies using human subjects leads to the notion that simulation education for neonatal nurses might be an ideal form of education. This integrative literature review compares traditional, teacher-centered education with high-fidelity simulation education for neonatal nurses. It examines the theoretical frameworks used in neonatal nursing education and outlines the advantages of this type of training, including improving communication and teamwork; providing an innovative pedagogical approach; and aiding in skill acquisition, confidence, and participant satisfaction. The importance of debriefing is also examined. High-fidelity simulation is not without disadvantages, including its significant cost, the time associated with training, the need for very complex technical equipment, and increased faculty resource requirements. Innovative uses of high-fidelity simulation in neonatal nursing education are suggested. High-fidelity simulation has great potential but requires additional research to fully prove its efficacy.

  16. High Fidelity Imaging Algorithm for the Undique Imaging Monte Carlo Simulator

    Directory of Open Access Journals (Sweden)

    Tremblay Grégoire

    2016-01-01

    Full Text Available The Undique imaging Monte Carlo simulator (Undique hereafter was developed to reproduce the behavior of 3D imaging devices. This paper describes its high fidelity imaging algorithm.

  17. Effects of High-Fidelity Simulation on Physical Therapy and Nursing Students' Attitudes Toward Interprofessional Learning and Collaboration.

    Science.gov (United States)

    Wellmon, Robert; Lefebvre, Kristin M; Ferry, Dawn

    2017-08-01

    The study purpose was to examine changes in physical therapy (PT) and nursing (RN) student attitudes toward interprofessional learning (IPL) and interprofessional collaboration (IPC) following a high-fidelity code simulation. PT (n = 42) and RN (n = 35) students, while working together to transfer a simulated patient, had to respond to a sudden and unexpected medical emergency. Pre- and postsurveys included the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS), and Attitudes Toward Health Care Teams Scale (ATHCTS). A control group (PT, n = 41; RN, n = 33) of students were also surveyed. Statistically significant between- (p IEPS (competency and autonomy, perceived need for and perceptions of actual cooperation), the RIPLS (teamwork and collaboration, professional identity), and the ATHCTS (team value and efficiency). The IPL experience using high-fidelity simulation fostered the development of attitudes necessary for effective IPL and IPC. [J Nurs Educ. 2017;56(8):456-465.]. Copyright 2017, SLACK Incorporated.

  18. How we developed an emergency psychiatry training course for new residents using principles of high-fidelity simulation.

    Science.gov (United States)

    Thomson, Alex B; Cross, Sean; Key, Suzie; Jaye, Peter; Iversen, Amy C

    2013-10-01

    New psychiatry residents must rapidly acquire new clinical skills and learn to work effectively with new colleagues. In medical and surgical specialties, high-fidelity simulation with structured debriefing is widely used, but so far this has not been applied to psychiatry. We have developed a one-day simulation-based training course for emergency psychiatry which incorporates clinical and team-working skills training. Five scenarios covering key psychiatric emergencies are delivered in a purpose-built simulation facility. Patients are played by an actor or a high-fidelity manikin. Each scenario is followed by a 45-minute group debrief. Evaluation of a pilot group found that the course was well received and improved participants' workplace confidence. We are now planning to expand the course, provide it to all new residents and conduct further evaluation.

  19. SIMULATION IN MEDICAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Jorge L. Palés Argullós

    2010-07-01

    Full Text Available In last twenty years, we are seeing increasingly widespread use of simulations in the training of doctors and other professionals of health sciences at the different stages of their educational continuum (undergraduate, postgraduate and continuing medical education. So much so that the concept of simulations-based medical education has emerged and it is now recognized as a vital tool to ensure the learning of medical students and doctors, and to improve patient safety. This article will describe the reasons for the introduction and development of this new methodology, its advantages and the different models and currently available resources. We will describe also the characteristics of so-called simulation centres or clinical skills laboratories that have been developed worldwide, where the simulation-based medical education take place. Moreover, we will refer briefly to the situation in our country and finally to the principles of a good development of the simulation-based medical education.

  20. Simulator fidelity and training effectiveness: a comprehensive bibliography with selected annotations

    Energy Technology Data Exchange (ETDEWEB)

    Rankin, W.L.; Bolton, P.A.; Shikiar, R.; Saari, L.M.

    1984-05-01

    This document contains a comprehensive bibliography on the topic of simulator fidelity and training effectiveness, prepared during the preliminary phases of work on an NRC-sponsored project on the Role of Nuclear Power Plant Simulators in Operator Licensing and Training. Section A of the document is an annotated bibliography consisting of articles and reports with relevance to the psychological aspects of simulator fidelity and the effectiveness of training simulators in a variety of settings, including military. The annotated items are drawn from a more comprehensive bibliography, presented in Section B, listing documents treating the role of simulators in operator training both in the nuclear industry and elsewhere.

  1. Inspiring careers in STEM and healthcare fields through medical simulation embedded in high school science education

    National Research Council Canada - National Science Library

    Berk, Louis J; Muret-Wagstaff, Sharon L; Goyal, Riya; Joyal, Julie A; Gordon, James A; Faux, Russell; Oriol, Nancy E

    2014-01-01

    .... To address this gap, we reviewed the literature and designed and implemented a high-fidelity, medical simulation-based Harvard Medical School MEDscience course, which was integrated into high school...

  2. High-fidelity simulator technology may not be superior to traditional low-fidelity equipment for neonatal resuscitation training.

    Science.gov (United States)

    Finan, E; Bismilla, Z; Whyte, H E; Leblanc, V; McNamara, P J

    2012-04-01

    Despite completing accredited resuscitation training, neonatal trainees often feel unprepared to deal with real-life clinical emergencies. High-fidelity simulator (HFS) technology offers the potential of recreating a realistic stressful clinical environment to aid training and evaluation. To date, there are limited data examining the physiological impact of this training modality in comparison to less costly alternatives. The objective of this study was to compare the effects of low-fidelity simulator (LFS) versus HFS technology on performance levels, objective and subjective measures of stress in neonatal trainees. Sixteen neonatal fellows were invited to participate in a prospective randomized study. Subjects were divided into pairs and randomized to LFS or HFS for completion of scenario I. After an interval of 1 month, fellow teams crossed over to complete scenario II using the alternative simulator technology. Technical and non-technical skills were assessed using validated resuscitation scoring tools. Participants recorded subjective stress at sequential time points before and after each simulation. Buccal cortisol was measured at each corresponding time point and comparison between HFS and LFS groups was made. The mean overall resuscitation performance score was 75.8%±10, but there was no difference in performance between HFS and LFS groups. There was also no significant difference in non-technical skills performance between groups. Salivary cortisol increased over the duration of the simulated experience, but there were no differences between the two groups (P=0.001, two-way repeated measures analysis of variance). We also identified changes in subjective measures of stress (P<0.001, analysis of variance) over time, but again there were no differences between groups. Simulated neonatal resuscitations induce a significant stress response in neonatal trainees; however, we were unable to identify any difference in stress measures between HFS and LFS. These

  3. A critical examination of high-fidelity human patient simulation within the context of nursing pedagogy.

    Science.gov (United States)

    Parker, Brian C; Myrick, Florence

    2009-04-01

    The use of high-fidelity human patient simulators (HPS) have been embraced by nursing education programs in the development of immersive clinical simulations despite the lack of research into a pedagogy or educational philosophy appropriate to guide this technology-based learning tool. In this article, we explore this approach to clinical teaching through a critical examination of the application of behaviorist and constructivist pedagogy to high-fidelity scenario-based simulation sessions. Practical guidelines for developing simulation-based learning sessions that reflect both philosophical paradigms are provided. Consideration is also given to societal trends such as the digital revolution and the incoming millennial generation who represent the aptitude of the modern nursing student to utilize high-fidelity realistic and immersive simulation. Depending on the desired goal of simulator utilization, the nurse educator may want to draw on constructivism or behaviorism or a blend of both educational philosophies to best meet the needs of the adult learner.

  4. Recommendations on Model Fidelity for Wind Turbine Gearbox Simulations; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Keller, J.; Lacava, W.; Austin, J.; Nejad, A.; Halse, C.; Bastard, L.; Helsen, J.

    2015-02-01

    This work investigates the minimum level of fidelity required to accurately simulate wind turbine gearboxes using state-of-the-art design tools. Excessive model fidelity including drivetrain complexity, gearbox complexity, excitation sources, and imperfections, significantly increases computational time, but may not provide a commensurate increase in the value of the results. Essential designparameters are evaluated, including the planetary load-sharing factor, gear tooth load distribution, and sun orbit motion. Based on the sensitivity study results, recommendations for the minimum model fidelities are provided.

  5. Development of the orpheus perfusion simulator for use in high-fidelity extracorporeal membrane oxygenation simulation.

    Science.gov (United States)

    Lansdowne, William; Machin, David; Grant, David J

    2012-12-01

    Despite its life-sustaining potential, extracorporeal membrane oxygenation (ECMO) remains a complex treatment modality for which close teamwork is imperative with a high risk of adverse events leading to significant morbidity and mortality. The provision of adequate training and continuing education is key in mitigating these risks. Traditional training for ECMO has relied predominantly on didactic education and hands-on water drills. These methods may overemphasize cognitive skills while underemphasizing technical skills and completely ignoring team and human factor skills. These water drills are often static, lacking the time pressure, typical alarms, and a sense of urgency inherent to actual critical ECMO scenarios. Simulation-based training provides an opportunity for staff to develop and maintain technical proficiency in high-risk, infrequent events without fear of harming patients. In addition, it provides opportunities for interdisciplinary training and improved communication and teamwork among team members (1). Although simulation has become widely accepted for training of practitioners from many disciplines, there are currently, to our knowledge, no commercially available dedicated high-fidelity ECMO simulators. Our article describes the modification of the Orpheus Perfusion Simulator and its incorporation into a fully immersive, high-fidelity, point-of-care ECMO simulation model.

  6. Implementing a high-fidelity simulation program in a community college setting.

    Science.gov (United States)

    Tuoriniemi, Pamela; Schott-Baer, Darlene

    2008-01-01

    Despite their relatively high cost, there is heightened interest by faculty in undergraduate nursing programs to implement high-fidelity simulation (HFS) programs. High-fidelity simulators are appealing because they allow students to experience high-risk, low-volume patient problems in a realistic setting. The decision to purchase a simulator is the first step in the process of implementing and maintaining an HFS lab. Knowledge, technical skill, commitment, and considerable time are needed to develop a successful program. The process, as experienced by one community college nursing program, is described.

  7. Progress in the Utilization of High-Fidelity Simulation in Basic Science Education

    Science.gov (United States)

    Helyer, Richard; Dickens, Peter

    2016-01-01

    High-fidelity patient simulators are mainly used to teach clinical skills and remain underutilized in teaching basic sciences. This article summarizes our current views on the use of simulation in basic science education and identifies pitfalls and opportunities for progress.

  8. Zero-Fidelity Simulation: Engaging Team Coordination without Physical, Functional, or Psychological Re-Creation

    Science.gov (United States)

    Toups, Zachary O.; Hamilton, William A.; Kerne, Andruid

    2012-01-01

    Team coordination is essential across domains, enabling efficiency and safety. As technology improves, our temptation is to simulate with ever-higher fidelity, by making simulators re-create reality through their physical interfaces, functionality, and by making participants believe they are undertaking the simulated task. However, high-fidelity simulations often miss salient human-human work practices. We introduce the concept of zero-fidelity simulation (ZFS), a move away from literal high-fidelity mimesis of the concrete environment. ZFS alternatively models cooperation and communication as the basis of simulation. The ZFS Team Coordination Game (TeC) is developed from observation of fire emergency response work practice. We identify ways in which team members are mutually dependent on one another for information, and use these as the basis for the ZFS game design. The design creates a need for cooperation by restricting individual activity and requiring communication. The present research analyzes the design of interdependence in the validated ZFS TeC game. We successfully simulate interdependence between roles in emergency response without simulating the concrete environment.

  9. High-fidelity simulation among bachelor students in simulation groups and use of different roles.

    Science.gov (United States)

    Thidemann, Inger-Johanne; Söderhamn, Olle

    2013-12-01

    Cost limitations might challenge the use of high-fidelity simulation as a teaching-learning method. This article presents the results of a Norwegian project including two simulation studies in which simulation teaching and learning were studied among students in the second year of a three-year bachelor nursing programme. The students were organised into small simulation groups with different roles; nurse, physician, family member and observer. Based on experiences in different roles, the students evaluated the simulation design characteristics and educational practices used in the simulation. In addition, three simulation outcomes were measured; knowledge (learning), Student Satisfaction and Self-confidence in Learning. The simulation was evaluated to be a valuable teaching-learning method to develop professional understanding and insight independent of roles. Overall, the students rated the Student Satisfaction and Self-confidence in Learning as high. Knowledge about the specific patient focus increased after the simulation activity. Students can develop practical, communication and collaboration skills, through experiencing the nurse's role. Assuming the observer role, students have the potential for vicarious learning, which could increase the learning value. Both methods of learning (practical experience or vicarious learning) may bridge the gap between theory and practice and contribute to the development of skills in reflective and critical thinking.

  10. A new paradigm for variable-fidelity stochastic simulation and information fusion in fluid mechanics

    Science.gov (United States)

    Venturi, Daniele; Parussini, Lucia; Perdikaris, Paris; Karniadakis, George

    2015-11-01

    Predicting the statistical properties of fluid systems based on stochastic simulations and experimental data is a problem of major interest across many disciplines. Even with recent theoretical and computational advancements, no broadly applicable techniques exist that could deal effectively with uncertainty propagation and model inadequacy in high-dimensions. To address these problems, we propose a new paradigm for variable-fidelity stochastic modeling, simulation and information fusion in fluid mechanics. The key idea relies in employing recursive Bayesian networks and multi-fidelity information sources (e.g., stochastic simulations at different resolution) to construct optimal predictors for quantities of interest, e.g., the random temperature field in stochastic Rayleigh-Bénard convection. The object of inference is the quantity of interest at the highest possible level of fidelity, for which we can usually afford only few simulations. To compute the optimal predictors, we developed a multivariate recursive co-kriging approach that simultaneously takes into account variable fidelity in the space of models (e.g., DNS vs. potential flow solvers), as well as variable-fidelity in probability space. Numerical applications are presented and discussed. This research was supported by AFOSR and DARPA.

  11. Simulation to develop tomorrow's medical registrar.

    Science.gov (United States)

    Shah, Anand; Carter, Thomas; Kuwani, Thungo; Sharpe, Roger

    2013-02-01

     Critical incident analysis reveals that poor performance in 'human-factor' or non-technical skills, such as decision making, leadership, teamwork and situational awareness, are frequently identified as key underlying features leading to adverse events. Simulation technology is a rapidly emerging modality used to develop technical and non-technical skills within specialist training as increasing shift-pattern work reduces work-based exposure and learning opportunities. To date, however, there is little literature regarding its use within core medical training to develop crisis resource management skills and medical registrar competency. We present results from a pilot in situ high-fidelity, multidisciplinary, simulation training course in which core medical trainees practised the role of a medical registrar within challenging crisis scenarios. Twenty-one trainees completed the simulation course. All trainees agreed that the course improved their clinical skills and knowledge, concentrated on key non-technical skills that are important in crisis management and, importantly, would change their clinical practice and improve patient safety. Trainee overall performance strongly correlated with assessment of non-technical skills during the simulation scenario. Trainees invited to return for a repeat session after previous concerns and specific feedback showed a visible improvement in performance, with an objective improvement in self-assessed performance. This pilot programme shows the benefits of a high-fidelity, in situ, multidisciplinary simulation training course for core medical trainees in developing the key crisis resource management skills necessary at medical registrar level. As a historical apprenticeship model of training becomes increasingly variable and absent, we present a novel complimentary training strategy for tomorrow's medical registrars. © Blackwell Publishing Ltd 2013.

  12. Technical Basis for Physical Fidelity of NRC Control Room Training Simulators for Advanced Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Minsk, Brian S.; Branch, Kristi M.; Bates, Edward K.; Mitchell, Mark R.; Gore, Bryan F.; Faris, Drury K.

    2009-10-09

    The objective of this study is to determine how simulator physical fidelity influences the effectiveness of training the regulatory personnel responsible for examination and oversight of operating personnel and inspection of technical systems at nuclear power reactors. It seeks to contribute to the U.S. Nuclear Regulatory Commission’s (NRC’s) understanding of the physical fidelity requirements of training simulators. The goal of the study is to provide an analytic framework, data, and analyses that inform NRC decisions about the physical fidelity requirements of the simulators it will need to train its staff for assignment at advanced reactors. These staff are expected to come from increasingly diverse educational and experiential backgrounds.

  13. Integrating the Electronic Health Record into high-fidelity interprofessional intensive care unit simulations.

    Science.gov (United States)

    Gold, Jeffrey A; Tutsch, Alycia S R; Gorsuch, Adriel; Mohan, Vishnu

    2015-01-01

    With the rapid adoption of electronic health records (EHR), there is a growing appreciation for the central role they play in clinical decision making and team communication, with many studies documenting new safety issues with integration of the EHR into the clinical enterprise. To study these issues, we created a high-fidelity simulation instance of our clinical EHR. In this paper, we describe the impact of integrating the EHR into high-fidelity, interprofessional intensive care unit (ICU) simulations, and the errors induced. We found a number of safety issues directly related to the EHR including alert fatigue, negative impacts on interprofessional communication, and problems with selective data gathering, and these issues were present for all members of the interprofessional team. Through successful integration of the EHR into high-fidelity team-based simulations, we now have an infrastructure to focus educational initiative and deploy informatics solutions to mitigate these safety issues.

  14. Advancing interprofessional education through the use of high fidelity human patient simulators

    Directory of Open Access Journals (Sweden)

    Kane-Gill SL

    2013-06-01

    Full Text Available Background: Modern medical care increasingly requires coordinated teamwork and communication between healthcare professionals of different disciplines. Unfortunately, healthcare professional students are rarely afforded the opportunity to learn effective methods of interprofessional (IP communication and teamwork strategies during their education. The question of how to best incorporate IP interactions in the curricula of the schools of health professions remains unanswered.Objective: We aim to solve the lack of IP education in the pharmacy curricula through the use of high fidelity simulation (HFS to allow teams of medical, pharmacy, nursing, physician assistant, and social work students to work together in a controlled environment to solve cases of complex medical and social issues.Methods: Once weekly for a 4-week time period, students worked together to complete complex simulation scenarios in small IP teams consisting of pharmacy, medical, nursing, social work, and physician assistant students. Student perception of the use of HFS was evaluated by a survey given at the conclusion of the HFS sessions. Team communication was evaluated through the use of Communication and Teamwork Skills (CATS Assessment by 2 independent evaluators external to the project.Results: The CATS scores improved from the HFS sessions 1 to 2 (p = 0.01, 2 to 3 (p = 0.035, and overall from 1 to 4 (p = 0.001. The inter-rater reliability between evaluators was high (0.85, 95% CI 0.71, 0.99. Students perceived the HFS improved: their ability to communicate with other professionals (median =4; confidence in patient care in an IP team (median=4. It also stimulated student interest in IP work (median=4.5, and was an efficient use of student time (median=4.5Conclusion: The use of HFS improved student teamwork and communication and was an accepted teaching modality. This method of exposing students of the health sciences to IP care should be incorporated throughout the

  15. Implementing high-fidelity simulations with large groups of nursing students.

    Science.gov (United States)

    Hooper, Barbara; Shaw, Luanne; Zamzam, Rebekah

    2015-01-01

    Nurse educators are increasing the use of simulation as a teaching strategy. Simulations are conducted typically with a small group of students. This article describes the process for implementing 6 high-fidelity simulations with a large group of undergraduate nursing students. The goal was to evaluate if student knowledge increased on postsimulation quiz scores when only a few individuals actively participated in the simulation while the other students observed.

  16. The use of high-fidelity simulation in the admissions process: one nurse anesthesia program's experience.

    Science.gov (United States)

    Penprase, Barbara; Mileto, Lisa; Bittinger, Andrea; Hranchook, Anne Marie; Atchley, Jana A; Bergakker, Sarah A; Eimers, Treavor J; Franson, Holly E

    2012-02-01

    Nurse anesthesia programs across the country are frequently in search of better selection criteria and more efficient evaluation systems. The goal is to select qualified applicants who will successfully complete the program and represent the profession of nurse anesthesia. The primary method of assessing the quality of candidates' noncognitive attributes at the Oakland University Beaumont Program of Nurse Anesthesia (Royal Oak, Michigan) was by face-to-face interviews. The admissions committee believed that high-fidelity simulation may be a valuable tool to improve the overall admission process. For the 2008 application interview process, high-fidelity simulation was used as a method of simultaneously evaluating candidates' cognitive and noncognitive attributes, in addition to the traditional face-to-face interview. On completion of the admission interview process, a retrospective research design was used to identify a possible correlation between high-fidelity simulation performance scores and other candidate characteristics. The findings of this pilot study revealed a positive correlation between simulation and face-to-face interview scores, suggesting that candidates who exhibited desirable noncognitive attributes in the face-to-face interview also performed well in the simulation environment. The use of high-fidelity simulation as an interview tool may provide an innovative adjunct for admission committees in assessment of candidates.

  17. The Validity and Incremental Validity of Knowledge Tests, Low-Fidelity Simulations, and High-Fidelity Simulations for Predicting Job Performance in Advanced-Level High-Stakes Selection

    Science.gov (United States)

    Lievens, Filip; Patterson, Fiona

    2011-01-01

    In high-stakes selection among candidates with considerable domain-specific knowledge and experience, investigations of whether high-fidelity simulations (assessment centers; ACs) have incremental validity over low-fidelity simulations (situational judgment tests; SJTs) are lacking. Therefore, this article integrates research on the validity of…

  18. The Validity and Incremental Validity of Knowledge Tests, Low-Fidelity Simulations, and High-Fidelity Simulations for Predicting Job Performance in Advanced-Level High-Stakes Selection

    Science.gov (United States)

    Lievens, Filip; Patterson, Fiona

    2011-01-01

    In high-stakes selection among candidates with considerable domain-specific knowledge and experience, investigations of whether high-fidelity simulations (assessment centers; ACs) have incremental validity over low-fidelity simulations (situational judgment tests; SJTs) are lacking. Therefore, this article integrates research on the validity of…

  19. A Randomized Controlled Study of Manikin Simulator Fidelity on Neonatal Resuscitation Program Learning Outcomes

    Science.gov (United States)

    Curran, Vernon; Fleet, Lisa; White, Susan; Bessell, Clare; Deshpandey, Akhil; Drover, Anne; Hayward, Mark; Valcour, James

    2015-01-01

    The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin…

  20. Debriefing after High-Fidelity Simulation and Knowledge Retention: A Quasi-Experimental Study

    Science.gov (United States)

    Olson, Susan L.

    2013-01-01

    High-fidelity simulation (HFS) use in nursing education has been a frequent research topic in recent years. Previous research included studies on the use of HFS with nursing students, focusing on their feelings of self-confidence and anxiety. However, research focused specifically on the debriefing portion of HFS was limited. This quantitative,…

  1. Pharmacy students' learning and satisfaction with high-fidelity simulation to teach drug-induced dyspepsia.

    Science.gov (United States)

    Branch, Cleopatra

    2013-03-12

    To assess second-year pharmacy students' acquisition of pharmacotherapy knowledge and clinical competence from participation in a high-fidelity simulation, and to determine the impact on the simulation experience of implementing feedback from previous students. A high-fidelity simulation was used to present a patient case scenario of drug-induced dyspepsia with gastrointestinal bleeding. The simulation was revised based on feedback from a previous class of students to include a smaller group size, provision of session material to students in advance, and an improved learning environment. Student performance on pre- and post-simulation knowledge and clinical competence tests documented significant improvements in students' knowledge of dyspepsia and associated symptoms, with the greatest improvement on questions relating to the hemodynamic effects of gastrointestinal bleeding. Students were more satisfied with the simulation experience compared to students in the earlier study. Participation in a high-fidelity simulation allowed pharmacy students to apply knowledge and skills learned in the classroom. Improved student satisfaction with the simulation suggests that implementing feedback obtained through student course evaluations can be an effective means of improving the curriculum.

  2. A survey of modelling methods for high-fidelity wind farm simulations using large eddy simulation.

    Science.gov (United States)

    Breton, S-P; Sumner, J; Sørensen, J N; Hansen, K S; Sarmast, S; Ivanell, S

    2017-04-13

    Large eddy simulations (LES) of wind farms have the capability to provide valuable and detailed information about the dynamics of wind turbine wakes. For this reason, their use within the wind energy research community is on the rise, spurring the development of new models and methods. This review surveys the most common schemes available to model the rotor, atmospheric conditions and terrain effects within current state-of-the-art LES codes, of which an overview is provided. A summary of the experimental research data available for validation of LES codes within the context of single and multiple wake situations is also supplied. Some typical results for wind turbine and wind farm flows are presented to illustrate best practices for carrying out high-fidelity LES of wind farms under various atmospheric and terrain conditions.This article is part of the themed issue 'Wind energy in complex terrains'.

  3. Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

    Science.gov (United States)

    El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

    2013-11-01

    Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

  4. High Fidelity Simulations of Large-Scale Wireless Networks

    Energy Technology Data Exchange (ETDEWEB)

    Onunkwo, Uzoma [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Benz, Zachary [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-11-01

    The worldwide proliferation of wireless connected devices continues to accelerate. There are 10s of billions of wireless links across the planet with an additional explosion of new wireless usage anticipated as the Internet of Things develops. Wireless technologies do not only provide convenience for mobile applications, but are also extremely cost-effective to deploy. Thus, this trend towards wireless connectivity will only continue and Sandia must develop the necessary simulation technology to proactively analyze the associated emerging vulnerabilities. Wireless networks are marked by mobility and proximity-based connectivity. The de facto standard for exploratory studies of wireless networks is discrete event simulations (DES). However, the simulation of large-scale wireless networks is extremely difficult due to prohibitively large turnaround time. A path forward is to expedite simulations with parallel discrete event simulation (PDES) techniques. The mobility and distance-based connectivity associated with wireless simulations, however, typically doom PDES and fail to scale (e.g., OPNET and ns-3 simulators). We propose a PDES-based tool aimed at reducing the communication overhead between processors. The proposed solution will use light-weight processes to dynamically distribute computation workload while mitigating communication overhead associated with synchronizations. This work is vital to the analytics and validation capabilities of simulation and emulation at Sandia. We have years of experience in Sandia’s simulation and emulation projects (e.g., MINIMEGA and FIREWHEEL). Sandia’s current highly-regarded capabilities in large-scale emulations have focused on wired networks, where two assumptions prevent scalable wireless studies: (a) the connections between objects are mostly static and (b) the nodes have fixed locations.

  5. High Fidelity Regolith Simulation Tool for ISRU Applications Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA has serious unmet needs for simulation tools capable of predicting the behavior of lunar regolith in proposed excavation, transport and handling systems....

  6. Using High-Fidelity Simulation Scenarios in the Classroom to Engage Learners.

    Science.gov (United States)

    Turner, Stephanie; Cole, Leslie G

    2017-02-01

    It is well known that active teaching strategies improve student learning outcomes. By using simulation scenarios as a tool to teach systematic decision making in the classroom, faculty allow a large group of students to develop abstract thinking and gain experience in a setting that has traditionally delivered information in a linear format. This article will describe the process of using a high-fidelity simulation scenario as an unfolding case study to teach students how to manage and care for a patient.

  7. Final Report: Quantifying Prediction Fidelity in Multiscale Multiphysics Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Long, Kevin [Texas Tech University

    2014-09-30

    We have developed algorithms and software in support of uncertainty quantification in nonlinear multiphysics simulations. This work includes high-level, high-performance software for large-scale, matrix-free linear algebra and a new algorithm for fast computation of transcendental functions of stochastic variables.

  8. Construct validity in a high-fidelity prostate exam simulator.

    Science.gov (United States)

    Kowalik, C G; Gerling, G J; Lee, A J; Carson, W C; Harper, J; Moskaluk, C A; Krupski, T L

    2012-03-01

    All health care practitioners should be facile in the digital rectal exam (DRE) as it provides prostate, rectal and neurological information. The purpose of this study was first to justify our hypothesis that tissue elasticity is indicative of carcinomatous changes. Second, we employed urological surgeons to evaluate our prostate simulator in three ways: (1) authenticate that the elasticity of the simulated prostates accurately represents the range of normal prostate stiffness, (2) determine the range of nodule size reasonably palpable by DRE and (3) discern what degree of elasticity difference within the same prostate suggests malignancy. Institutional Review Board-approved materials characterization, human-subjects experiments, histopathology and chart abstraction of clinical history were performed. Material characterization of 21 ex-vivo prostatectomy specimens was evaluated using a custom-built, portable spherical indentation device while a novel prostate simulator was employed to measure human-subject perception of prostatic state. From the materials characterization, the measurements of the 21 gross prostates and 40 cross-sections yielded 306 data points. Within the same prostate, cancer was always stiffer. Of the seven cases with an abnormal DRE, the DRE accurately identified adenocarcinoma in 85%. From the human-subjects experiments, the simulated prostates evaluated by urologists ranged in stiffness from 8.9 to 91 kPa, mimicking the range found on ex vivo analysis of 4.6-236.7 kPa. The urological surgeons determined the upper limit of stiffness palpated as realistic for a healthy prostate was 59.63 kPa while the lower limit of stiffness was 27.1 kPa. Nodule size less than 7.5 mm was felt to be too small to reasonably palpate. We found it is not the absolute elasticity of the nodule, but rather the relationship of the nodule with the background prostate elasticity that constitutes the critical tactile feedback. Prostate simulator training may lead to

  9. High Fidelity Simulations of Electromagnetic Propagation and RF Communication Systems

    Science.gov (United States)

    2017-05-01

    planning or platform performance assessment within a virtual scene. This report presents the results of two test cases—within a virtual rendering of...of remotely controlled robotics in virtual environments, par- ticularly urban scenes. Dr. Goodin’s simulation platform is the Virtual Au- tonomous...for mission planning or platform performance assessment within a virtual scene. This report presents the results of two test cases—within a virtual

  10. The Effects of Various Fidelity Factors on Simulated Helicopter Hover

    Science.gov (United States)

    1981-01-01

    for Pilot Training ( ASPT ) and the Simulator for Air-to-Air Combat were fitted with them (Kron, 1975). An extra seat was sent to the NASA Ames...early seats. Irish, Grunzke, Gray, and Waters (1977) showed that the g-seat of the ASPT aided 9 NAVTRAEQUIPCEN IH-321 piloting control during take offs...demanding segments of initial confidence maneuvers (loops, rolls, etc.). The particular tasks chosen for the studies that used the ASPT may not have been

  11. High Fidelity Simulation of Atomization in Diesel Engine Sprays

    Science.gov (United States)

    2015-09-01

    sprays, volume of fluids, CFD, diesel 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 16 19a. NAME OF...Reynolds number, Re = 3000. In a related study, Desjardins con- ducted detailed numerical simulations ( DNS ) of primary atomization for several values...model development. Note that, as with most other DNS studies, no quantitative comparison to experimental data is typically provided. The need to

  12. A high-fidelity approach towards simulation of pool boiling

    Energy Technology Data Exchange (ETDEWEB)

    Yazdani, Miad; Radcliff, Thomas; Soteriou, Marios; Alahyari, Abbas A. [United Technologies Research Center, East Hartford, Connecticut 06108 (United States)

    2016-01-15

    A novel numerical approach is developed to simulate the multiscale problem of pool-boiling phase change. The particular focus is to develop a simulation technique that is capable of predicting the heat transfer and hydrodynamic characteristics of nucleate boiling and the transition to critical heat flux on surfaces of arbitrary shape and roughness distribution addressing a critical need to design enhanced boiling heat transfer surfaces. The macro-scale of the phase change and bubble dynamics is addressed through employing off-the-shelf Computational Fluid Dynamics (CFD) methods for interface tracking and interphase mass and energy transfer. The micro-scale of the microlayer, which forms at early stage of bubble nucleation near the wall, is resolved through asymptotic approximation of the thin-film theory which provides a closed-form solution for the distribution of the micro-layer and its influence on the evaporation process. In addition, the sub-grid surface roughness is represented stochastically through probabilistic density functions and its role in bubble nucleation and growth is then represented based on the thermodynamics of nucleation process. This combination of deterministic CFD, local approximation, and stochastic representation allows the simulation of pool boiling on any surface with known roughness and enhancement characteristics. The numerical model is validated for dynamics and hydrothermal characteristics of a single nucleated bubble on a flat surface against available literature data. In addition, the prediction of pool-boiling heat transfer coefficient is verified against experimental measurements as well as reputable correlations for various roughness distributions and different surface orientations. Finally, the model is employed to demonstrate pool-boiling phenomenon on enhanced structures with reentrance cavities and to explore the effect of enhancement feature design on thermal and hydrodynamic characteristics of these surfaces.

  13. A high-fidelity approach towards simulation of pool boiling

    Science.gov (United States)

    Yazdani, Miad; Radcliff, Thomas; Soteriou, Marios; Alahyari, Abbas A.

    2016-01-01

    A novel numerical approach is developed to simulate the multiscale problem of pool-boiling phase change. The particular focus is to develop a simulation technique that is capable of predicting the heat transfer and hydrodynamic characteristics of nucleate boiling and the transition to critical heat flux on surfaces of arbitrary shape and roughness distribution addressing a critical need to design enhanced boiling heat transfer surfaces. The macro-scale of the phase change and bubble dynamics is addressed through employing off-the-shelf Computational Fluid Dynamics (CFD) methods for interface tracking and interphase mass and energy transfer. The micro-scale of the microlayer, which forms at early stage of bubble nucleation near the wall, is resolved through asymptotic approximation of the thin-film theory which provides a closed-form solution for the distribution of the micro-layer and its influence on the evaporation process. In addition, the sub-grid surface roughness is represented stochastically through probabilistic density functions and its role in bubble nucleation and growth is then represented based on the thermodynamics of nucleation process. This combination of deterministic CFD, local approximation, and stochastic representation allows the simulation of pool boiling on any surface with known roughness and enhancement characteristics. The numerical model is validated for dynamics and hydrothermal characteristics of a single nucleated bubble on a flat surface against available literature data. In addition, the prediction of pool-boiling heat transfer coefficient is verified against experimental measurements as well as reputable correlations for various roughness distributions and different surface orientations. Finally, the model is employed to demonstrate pool-boiling phenomenon on enhanced structures with reentrance cavities and to explore the effect of enhancement feature design on thermal and hydrodynamic characteristics of these surfaces.

  14. Bioelectric Control of a 757 Class High Fidelity Aircraft Simulation

    Science.gov (United States)

    Jorgensen, Charles; Wheeler, Kevin; Stepniewski, Slawomir; Norvig, Peter (Technical Monitor)

    2000-01-01

    This paper presents results of a recent experiment in fine grain Electromyographic (EMG) signal recognition, We demonstrate bioelectric flight control of 757 class simulation aircraft landing at San Francisco International Airport. The physical instrumentality of a pilot control stick is not used. A pilot closes a fist in empty air and performs control movements which are captured by a dry electrode array on the arm, analyzed and routed through a flight director permitting full pilot outer loop control of the simulation. A Vision Dome immersive display is used to create a VR world for the aircraft body mechanics and flight changes to pilot movements. Inner loop surfaces and differential aircraft thrust is controlled using a hybrid neural network architecture that combines a damage adaptive controller (Jorgensen 1998, Totah 1998) with a propulsion only based control system (Bull & Kaneshige 1997). Thus the 757 aircraft is not only being flown bioelectrically at the pilot level but also demonstrates damage adaptive neural network control permitting adaptation to severe changes in the physical flight characteristics of the aircraft at the inner loop level. To compensate for accident scenarios, the aircraft uses remaining control surface authority and differential thrust from the engines. To the best of our knowledge this is the first time real time bioelectric fine-grained control, differential thrust based control, and neural network damage adaptive control have been integrated into a single flight demonstration. The paper describes the EMG pattern recognition system and the bioelectric pattern recognition methodology.

  15. Using high-fidelity simulation to develop nurse-physician teams.

    Science.gov (United States)

    Klipfel, Janee M; Gettman, Matthew T; Johnson, Kristine M; Olson, Marianne E; Derscheid, Della J; Maxson, Pamela M; Arnold, Jacqueline J; Moehnke, Darcie E; Nelson, Elise A S; Vierstraete, Helen T

    2011-08-01

    This study was undertaken to determine whether interdisciplinary high-fidelity simulation training improves group cohesion in nurse-physician teams. In addition, perceptions of collaboration and satisfaction with patient care decisions were measured in nurse-physician participants. Clinical scenarios relevant to the general surgical urology inpatient unit were conducted in an interdisciplinary high-fidelity simulation center. Participants included physicians and staff nurses. Participants reported a positive shift in group cohesion over time. In addition, the results suggested a positive shift in perceptions of collaboration and satisfaction with patient care decisions over time. The youngest participants (Millennial Generation, born in the 1980s and 1990s) showed the most significant growth in response to the training. This study provides evidence of benefits of high-fidelity simulation that extend beyond the training. Simulation training may be a strategy to build and strengthen relationships across nurse-physician teams. In addition, this type of training may positively affect collaboration and satisfaction with patient care decisions. When data were analyzed by generational grouping, the most significant growth occurred in the Millennial Generation participants. These influences need to be explored further. Copyright 2011, SLACK Incorporated.

  16. Physicians' and pharmacies' overview of patients' medication. An analysis of fidelity coefficients

    DEFF Research Database (Denmark)

    Pottegård, Anton; Hallas, J.

    2011-01-01

    It is essential that pharmacies and prescribers have an overview of each patient's medication in order to prevent drug interactions, unintentional co-prescribing, unnecessary polypharmacy and underprescribing. We have assessed this overview by measuring the 'fidelity coefficient', a measure.......0439-0.0453). Among the factors associated with a high FC(presc) and high FC(pharm) were older age, male gender and a high volume of prescriptions. The major drug classes that were most often prescribed by a non-main prescriber were beta-lactams, antidepressants and opioids. Similarly, the major drug classes...... associated with use of non-main pharmacy were beta-lactams, antidepressants and inhaled beta-agonists. Based on this analysis, both prescribers and pharmacies generally have an equal potential for maintaining an excellent overview of their patients' medication, but the pharmacies account for a slightly...

  17. High Fidelity Simulations of Large-Scale Wireless Networks (Plus-Up)

    Energy Technology Data Exchange (ETDEWEB)

    Onunkwo, Uzoma [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-11-01

    Sandia has built a strong reputation in scalable network simulation and emulation for cyber security studies to protect our nation’s critical information infrastructures. Georgia Tech has preeminent reputation in academia for excellence in scalable discrete event simulations, with strong emphasis on simulating cyber networks. Many of the experts in this field, such as Dr. Richard Fujimoto, Dr. George Riley, and Dr. Chris Carothers, have strong affiliations with Georgia Tech. The collaborative relationship that we intend to immediately pursue is in high fidelity simulations of practical large-scale wireless networks using ns-3 simulator via Dr. George Riley. This project will have mutual benefits in bolstering both institutions’ expertise and reputation in the field of scalable simulation for cyber-security studies. This project promises to address high fidelity simulations of large-scale wireless networks. This proposed collaboration is directly in line with Georgia Tech’s goals for developing and expanding the Communications Systems Center, the Georgia Tech Broadband Institute, and Georgia Tech Information Security Center along with its yearly Emerging Cyber Threats Report. At Sandia, this work benefits the defense systems and assessment area with promise for large-scale assessment of cyber security needs and vulnerabilities of our nation’s critical cyber infrastructures exposed to wireless communications.

  18. Fidelity to the healing relationship: a medical student's challenge to contemporary bioethics and prescription for medical practice.

    Science.gov (United States)

    Corcoran, Blake C; Brandt, Lea; Fleming, David A; Gu, Chris N

    2016-04-01

    As a medical  student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clarify the moral event within the clinical encounter and offers a sufficiently useful and justified approach to patient care.

  19. The effectiveness of a high-fidelity teaching simulation based on an NLN/Jeffries simulation in the nursing education theoretical framework and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    Fen-Fen Zhu; Li-Rong Wu

    2016-01-01

    Objective: To investigate the effectiveness of a high-fidelity teaching simulation based on an NLN/Jef-fries simulation in the nursing education theoretical framework and its influencing factors. Methods: A high-fidelity teaching simulation on clinical nursing practices using intelligent human an-alogues was conducted with 200 students, and The Simulation Design Scale, and the Student Satisfaction and Self-Confidence in Learning Scale developed by the National League for Nursing were used to evaluate the training effectiveness and its influencing factors. Results: For the high-fidelity teaching simulation, students gave scores of 4.36 ± 0.54 points for satis-faction and 4.33 ± 0.46 points for Self-Confidence. The students highly rated the five dimensions of teaching design, i.e., teaching objectives/information, assistance/support for students, problem solving, guided feedback, and fidelity. The teaching design was closely correlated with the satisfaction of the high-fidelity teaching simulation and self-efficacy, and the dimensions of teaching objectives/informa-tion and assistance/support for students were particularly strong predictors of teaching effectiveness. Conclusions: A high-fidelity teaching simulation based on Jeffries' theoretical framework improved student satisfaction with the simulation and their Self-Confidence. In planning simulations, teachers should take into account five characteristics, i.e., teaching objectives/information on simulation educa-tion, assistance/support for students, problem solving, guided reflection, and fidelity, to achieve better teaching effectiveness.

  20. Physicians' and pharmacies' overview of patients' medication. An analysis of fidelity coefficients

    DEFF Research Database (Denmark)

    Pottegård, Anton; Hallas, J.

    2011-01-01

    It is essential that pharmacies and prescribers have an overview of each patient's medication in order to prevent drug interactions, unintentional co-prescribing, unnecessary polypharmacy and underprescribing. We have assessed this overview by measuring the 'fidelity coefficient', a measure...... of the extent to which a drug user has a preference for one prescriber or one pharmacy. Data for all prescriptions issued for the population in Southern Denmark (population 1.2 million) in 2009 was extracted from the Odense University Pharmacoepidemiological Database (OPED). Analysis of the extracted data......(presc)). The individual user's most frequented pharmacy was also identified and the FC(pharm) calculated in a similar fashion. The average FC(Presc) and average FC(Pharm) were 0.883 (standard deviation 0.158) and 0.927 (0.139), respectively. The estimated difference was 0.0446 (95% confidence interval 0...

  1. Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-Fidelity Mannequins?

    Directory of Open Access Journals (Sweden)

    Steven J Warrington

    2013-05-01

    Full Text Available Introduction: Emergency medicine residents use simulation training for many reasons, such as gaining experience with critically ill patients and becoming familiar with disease processes. Residents frequently criticize simulation training using current high-fidelity mannequins due to the poor quality of physical exam findings present, such as auscultatory findings, as it may lead them down an alternate diagnostic or therapeutic pathway. Recently wireless remote programmed stethoscopes (simulation stethoscopes have been developed that allow wireless transmission of any sound to a stethoscope receiver, which improves the fidelity of a physical examination and the simulation case. Methods: Following institutional review committee approval, 14 PGY1-3 emergency medicine residents were assessed during 2 simulation-based cases using pre-defined scoring anchors on multiple actions, such as communication skills and treatment decisions (Appendix 1. Each case involved a patient presenting with dyspnea requiring management based off physical examination findings. One case was a patient with exacerbation of heart failure, while the other was a patient with a tension pneumothorax. Each resident was randomized into a case associated with the simulation stethoscope. Following the cases residents were asked to fill out an evaluation questionnaire. Results: Residents perceived the most realistic physical exam findings on those associated with the case using the simulation stethoscope (13/14, 93%. Residents also preferred the simulation stethoscope as an adjunct to the case (13/14, 93%, and they rated the simulation stethoscope case to have significantly more realistic auscultatory findings (4.4/5 vs. 3.0/5 difference of means 1.4, P = 0.0007. Average scores of residents were significantly better in the simulation stethoscope-associated case (2.5/3 vs. 2.3/3 difference of means 0.2, P = 0.04. There was no considerable difference in the total time taken per case

  2. Comparative effectiveness of low- and high-fidelity bronchoscopy simulation for training in conventional transbronchial needle aspiration and user preferences.

    Science.gov (United States)

    Davoudi, Mohsen; Wahidi, Momen M; Zamanian Rohani, Nazanin; Colt, Henri G

    2010-01-01

    Conventional transbronchial needle aspiration (TBNA) can be learned using high-fidelity virtual-reality platforms and low-fidelity models comprised of molded silicone or excised animal airways. The purpose of this study was to determine perceptions and preferences of learners and instructors regarding the comparative effectiveness of low-fidelity and high-fidelity bronchoscopy simulation for training in TBNA. During the 2008 annual CHEST conference, a prospective randomized crossover design was used to train study participants in three methods of conventional TBNA using low- and high-fidelity models. Likert style questions were administered to learners and instructors in order to elicit preferences and opinions regarding educational effectiveness of the models. Results were tabulated and depicted in graphic format, with medians calculated. Learners felt that the models were equally enjoyable (13-13) and enthusiasm generating (low 17-high 15). There was preference for low-fidelity in terms of realism (23-17), ease of learning (20-6), and learning all three TBNA methods (31-7 for hub-against-wall, 31-6 for jabbing, 29-6 for piggyback). Low-fidelity was preferred as an ideal model overall (19-11). Instructors thought that low-fidelity was more useful in teaching TBNA (9-0 for all three methods). Instructors perceived the low-fidelity model overall as an ideal tool for learning TBNA (8-0) and a more effective teaching instrument (8-0). Based on learner and instructor perceptions, a low-fidelity model is superior to a high-fidelity platform for training in three methods of conventional TBNA. Copyright © 2010 S. Karger AG, Basel.

  3. A low-fidelity serious game for medical-based cultural competence education.

    Science.gov (United States)

    Khan, Zain; Kapralos, Bill

    2017-07-01

    Research has shown that the quality of care is compromised when healthcare providers respond inappropriately to patient language and cultural factors. However, research indicates that medical education is not keeping pace with the changing composition of the patient population in culturally diverse societies such as Canada and the United States, and many healthcare providers do not possess the attitudes or skills required to be effective within a culturally diverse healthcare setting. Here, we present Fydlyty, a web-based, low-fidelity serious game for medical-based cultural competence education. Fydlyty includes both a scenario and dialogue editor providing the ability to develop conversations, interpret responses, and respond to questions/answers from the game player. These responses are based on predefined cultural characteristics of the virtual patient and on different moods that the virtual patient may express depending on the situation. The results of a usability experiment conducted with medical professionals and trainees revealed that the game is easy to use, intuitive, and engaging.

  4. HIGH-FIDELITY SIMULATION-DRIVEN MODEL DEVELOPMENT FOR COARSE-GRAINED COMPUTATIONAL FLUID DYNAMICS

    Energy Technology Data Exchange (ETDEWEB)

    Hanna, Botros N.; Dinh, Nam T.; Bolotnov, Igor A.

    2016-06-01

    Nuclear reactor safety analysis requires identifying various credible accident scenarios and determining their consequences. For a full-scale nuclear power plant system behavior, it is impossible to obtain sufficient experimental data for a broad range of risk-significant accident scenarios. In single-phase flow convective problems, Direct Numerical Simulation (DNS) and Large Eddy Simulation (LES) can provide us with high fidelity results when physical data are unavailable. However, these methods are computationally expensive and cannot be afforded for simulation of long transient scenarios in nuclear accidents despite extraordinary advances in high performance scientific computing over the past decades. The major issue is the inability to make the transient computation parallel, thus making number of time steps required in high-fidelity methods unaffordable for long transients. In this work, we propose to apply a high fidelity simulation-driven approach to model sub-grid scale (SGS) effect in Coarse Grained Computational Fluid Dynamics CG-CFD. This approach aims to develop a statistical surrogate model instead of the deterministic SGS model. We chose to start with a turbulent natural convection case with volumetric heating in a horizontal fluid layer with a rigid, insulated lower boundary and isothermal (cold) upper boundary. This scenario of unstable stratification is relevant to turbulent natural convection in a molten corium pool during a severe nuclear reactor accident, as well as in containment mixing and passive cooling. The presented approach demonstrates how to create a correction for the CG-CFD solution by modifying the energy balance equation. A global correction for the temperature equation proves to achieve a significant improvement to the prediction of steady state temperature distribution through the fluid layer.

  5. DNA polymerase conformational dynamics and the role of fidelity-conferring residues: Insights from computational simulations

    Directory of Open Access Journals (Sweden)

    Massimiliano eMeli

    2016-05-01

    Full Text Available Herein we investigate the molecular bases of DNA polymerase I conformational dynamics that underlie the replication fidelity of the enzyme. Such fidelity is determined by conformational changes that promote the rejection of incorrect nucleotides before the chemical ligation step. We report a comprehensive atomic resolution study of wild type and mutant enzymes in different bound states and starting from different crystal structures, using extensive molecular dynamics (MD simulations that cover a total timespan of ~ 5 microseconds. The resulting trajectories are examined via a combination of novel methods of internal dynamics and energetics analysis, aimed to reveal the principal molecular determinants for the (destabilization of a certain conformational state. Our results show that the presence of fidelity-decreasing mutations or the binding of incorrect nucleotides in ternary complexes tend to favor transitions from closed towards open structures, passing through an ensemble of semi-closed intermediates. The latter ensemble includes the experimentally observed ajar conformation which, consistent with previous experimental observations, emerges as a molecular checkpoint for the selection of the correct nucleotide to incorporate. We discuss the implications of our results for the understanding of the relationships between the structure, dynamics and function of DNA polymerase I at the atomistic level.

  6. The history of medical simulation.

    Science.gov (United States)

    Rosen, Kathleen R

    2008-06-01

    The historical roots of simulation might be described with the broadest definition of medical simulation: "an imitation of some real thing, state of affairs, or process" for the practice of skills, problem solving, and judgment. From the first "blue box" flight simulator to the military's impetus in the transfer of modeling and simulation technology to medicine, worldwide acceptance of simulation training is growing. Large collaborative simulation centers support the expectation of increases in multidisciplinary, interprofessional, and multimodal simulation training. Virtual worlds, both immersive and Web-based, are at the frontier of innovation in medical education.

  7. A novel multi-fidelity coupled simulation method for flow systems

    Institute of Scientific and Technical Information of China (English)

    Wang Peng; Zheng Yun; Zou Zhengping; Qi Lei; Zhou Zhixiang

    2013-01-01

    For the numerical simulation of flow systems with various complex components,the traditional one-dimensional (1D) network method has its comparative advantage in time consuming and the CFD method has its absolute advantage in the detailed flow capturing.The proper coupling of the advantages of different dimensional methods can strike balance well between time cost and accuracy and then significantly decrease the whole design cycle for the flow systems in modern machines.A novel multi-fidelity coupled simulation method with numerical zooming is developed for flow systems.This method focuses on the integration of one-,two-and three-dimensional codes for various components.Coupled iterative process for the different dimensional simulation cycles of sub-systems is performed until the concerned flow variables of the whole system achieve convergence.Numerical zooming is employed to update boundary data of components with different dimensionalities.Based on this method,a highly automatic,multi-discipline computing environment with integrated zooming is developed.The numerical results of Y-Junction and the air system of a jet engine are presented to verify the solution method.They indicate that this type of multi-fidelity simulation method can greatly improve the prediction capability for the flow systems.

  8. A high fidelity video delivery system for real-time flight simulation research

    Science.gov (United States)

    Wilkins, Daniel A.; Roach, Carl C.

    1993-01-01

    The Flight Systems and Simulation Research Laboratory (Simlab) at the NASA Ames Research Center, utilizes an extensive network of video image generation, delivery, processing, and display systems coupled with a large amplitude Vertical Motion Simulator (VMS) to provide a high fidelity visual environment for flight simulation research. This paper will explore the capabilities of the current Simlab video distribution system architecture with a view toward technical solutions implemented to resolve a variety of video interface, switching, and distribution issues common to many simulation facilities. Technical discussions include a modular approach to a video switching and distribution system capable of supporting both coax and fiber optic video signal transmission, video scan conversion and processing techniques for lab observation and recording, adaptation of image generation and display system video interfaces to industry standards, an all raster solution for 'glass cockpit' configurations encompassing Head up, Head-down, and Out-the-Window display systems.

  9. A high fidelity video delivery system for real-time flight simulation research

    Science.gov (United States)

    Wilkins, Daniel A.; Roach, Carl C.

    The Flight Systems and Simulation Research Laboratory (Simlab) at the NASA Ames Research Center, utilizes an extensive network of video image generation, delivery, processing, and display systems coupled with a large amplitude Vertical Motion Simulator (VMS) to provide a high fidelity visual environment for flight simulation research. This paper will explore the capabilities of the current Simlab video distribution system architecture with a view toward technical solutions implemented to resolve a variety of video interface, switching, and distribution issues common to many simulation facilities. Technical discussions include a modular approach to a video switching and distribution system capable of supporting both coax and fiber optic video signal transmission, video scan conversion and processing techniques for lab observation and recording, adaptation of image generation and display system video interfaces to industry standards, an all raster solution for 'glass cockpit' configurations encompassing Head up, Head-down, and Out-the-Window display systems.

  10. High Fidelity Thermal Simulators for Non-Nuclear Testing: Analysis and Initial Results

    Science.gov (United States)

    Bragg-Sitton, Shannon M.; Dickens, Ricky; Dixon, David

    2007-01-01

    Non-nuclear testing can be a valuable tool in the development of a space nuclear power system, providing system characterization data and allowing one to work through various fabrication, assembly and integration issues without the cost and time associated with a full ground nuclear test. In a non-nuclear test bed, electric heaters are used to simulate the heat from nuclear fuel. Testing with non-optimized heater elements allows one to assess thermal, heat transfer, and stress related attributes of a given system, but fails to demonstrate the dynamic response that would be present in an integrated, fueled reactor system. High fidelity thermal simulators that match both the static and the dynamic fuel pin performance that would be observed in an operating, fueled nuclear reactor can vastly increase the value of non-nuclear test results. With optimized simulators, the integration of thermal hydraulic hardware tests with simulated neutronie response provides a bridge between electrically heated testing and fueled nuclear testing, providing a better assessment of system integration issues, characterization of integrated system response times and response characteristics, and assessment of potential design improvements' at a relatively small fiscal investment. Initial conceptual thermal simulator designs are determined by simple one-dimensional analysis at a single axial location and at steady state conditions; feasible concepts are then input into a detailed three-dimensional model for comparison to expected fuel pin performance. Static and dynamic fuel pin performance for a proposed reactor design is determined using SINDA/FLUINT thermal analysis software, and comparison is made between the expected nuclear performance and the performance of conceptual thermal simulator designs. Through a series of iterative analyses, a conceptual high fidelity design can developed. Test results presented in this paper correspond to a "first cut" simulator design for a potential

  11. Use of simulated data sets to evaluate the fidelity of Metagenomicprocessing methods

    Energy Technology Data Exchange (ETDEWEB)

    Mavromatis, Konstantinos; Ivanova, Natalia; Barry, Kerri; Shapiro, Harris; Goltsman, Eugene; McHardy, Alice C.; Rigoutsos, Isidore; Salamov, Asaf; Korzeniewski, Frank; Land, Miriam; Lapidus, Alla; Grigoriev, Igor; Richardson, Paul; Hugenholtz, Philip; Kyrpides, Nikos C.

    2006-12-01

    Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity--based (blast hit distribution) and two sequence composition--based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.

  12. Use of simulated data sets to evaluate the fidelity of metagenomic processing methods

    Energy Technology Data Exchange (ETDEWEB)

    Mavromatis, K [U.S. Department of Energy, Joint Genome Institute; Ivanova, N [U.S. Department of Energy, Joint Genome Institute; Barry, Kerrie [U.S. Department of Energy, Joint Genome Institute; Shapiro, Harris [U.S. Department of Energy, Joint Genome Institute; Goltsman, Eugene [U.S. Department of Energy, Joint Genome Institute; McHardy, Alice C. [IBM T. J. Watson Research Center; Rigoutsos, Isidore [IBM T. J. Watson Research Center; Salamov, Asaf [U.S. Department of Energy, Joint Genome Institute; Korzeniewski, Frank [U.S. Department of Energy, Joint Genome Institute; Land, Miriam L [ORNL; Lapidus, Alla L. [U.S. Department of Energy, Joint Genome Institute; Grigoriev, Igor [U.S. Department of Energy, Joint Genome Institute; Hugenholtz, Philip [U.S. Department of Energy, Joint Genome Institute; Kyrpides, Nikos C [U.S. Department of Energy, Joint Genome Institute

    2007-01-01

    Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene-finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity-based ( blast hit distribution) and two sequence composition-based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.

  13. Collective efficacy in a high-fidelity simulation of an airline operations center

    Science.gov (United States)

    Jinkerson, Shanna

    This study investigated the relationships between collective efficacy, teamwork, and team performance. Participants were placed into teams, where they worked together in a high-fidelity simulation of an airline operations center. Each individual was assigned a different role to represent different jobs within an airline (Flight Operations Coordinator, Crew Scheduling, Maintenance, Weather, Flight Scheduling, or Flight Planning.) Participants completed a total of three simulations with an After Action Review between each. Within this setting, both team performance and teamwork behaviors were shown to be positively related to expectations for subsequent performance (collective efficacy). Additionally, teamwork and collective efficacy were not shown to be concomitantly related to subsequent team performance. A chi-square test was used to evaluate existence of performance spirals, and they were not supported. The results of this study were likely impacted by lack of power, as well as a lack of consistency across the three simulations.

  14. Using "The Burns Suite" as a Novel High Fidelity Simulation Tool for Interprofessional and Teamwork Training.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2016-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. The authors recently published the concept of "The Burns Suite" (TBS) as a novel tool to advance the delivery of burns education for residents/clinicians. Effectively, TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. Recently, simulation-based team training (SBTT) has been advocated as a means to improve interprofessional practice. The authors aimed to explore the role of TBS in SBTT. A realistic pediatric burn resuscitation scenario was designed based on "advanced trauma and life support" and "emergency management of severe burns" principles, refined utilizing expert opinion through cognitive task analysis. The focus of this analysis was on nontechnical and interpersonal skills of clinicians and nurses within the scenario, mirroring what happens in real life. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's alpha was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twenty-two participants completed TBS resuscitation scenario. Mean face and content validity ratings were high (4.4 and 4.7 respectively; range 4-5). The internal consistency of questions was high. Qualitative data analysis revealed two new themes. Participants reported that the experience felt particularly authentic because the simulation had high psychological and social fidelity, and there was a demand for such a facility to be made available to improve nontechnical skills and interprofessional relations. TBS provides a realistic, novel tool for SBTT, addressing both nontechnical and interprofessional team skills. Recreating clinical challenge is crucial to optimize SBTT. With a better understanding of the theories underpinning simulation and interprofessional education, future simulation scenarios can be designed to provide

  15. High-fidelity simulation in Neonatology and the Italian experience of Nina

    Directory of Open Access Journals (Sweden)

    Armando Cuttano

    2012-10-01

    Full Text Available The modern methodology of simulation was born in the aeronautical field. In medicine, anesthetists showed great attention for technological advances and simulation, closely followed by surgeons with minimally invasive surgery. In Neonatology training in simulation is actually useful in order to face unexpected dramatic events, to minimize clinical risk preventing errors and to optimize team work. Critical issues in simulation are: teachers-learners relationship, focus on technical and non-technical skills, training coordination, adequate scenarios, effective debriefing. Therefore, the quality of a simulation training center is multi-factorial and is not only related to the mannequin equipment. High-fidelity simulation is the most effective method in education. In Italy simulation for education in Medicine has been used for a few years only. In Pisa we founded Nina (that is the acronymous for the Italian name of the Center, CeNtro di FormazIone e SimulazioNe NeonAtale, the first neonatal simulation center dedicated but integrated within a Hospital Unit in Italy. This paper describes how we manage education in Nina Center, in order to offer a model for other similar experiences.

  16. Assessment of high-fidelity collision models in the direct simulation Monte Carlo method

    Science.gov (United States)

    Weaver, Andrew B.

    Advances in computer technology over the decades has allowed for more complex physics to be modeled in the DSMC method. Beginning with the first paper on DSMC in 1963, 30,000 collision events per hour were simulated using a simple hard sphere model. Today, more than 10 billion collision events can be simulated per hour for the same problem. Many new and more physically realistic collision models such as the Lennard-Jones potential and the forced harmonic oscillator model have been introduced into DSMC. However, the fact that computer resources are more readily available and higher-fidelity models have been developed does not necessitate their usage. It is important to understand how such high-fidelity models affect the output quantities of interest in engineering applications. The effect of elastic and inelastic collision models on compressible Couette flow, ground-state atomic oxygen transport properties, and normal shock waves have therefore been investigated. Recommendations for variable soft sphere and Lennard-Jones model parameters are made based on a critical review of recent ab-initio calculations and experimental measurements of transport properties.

  17. The effectiveness of varied levels of simulation fidelity on integrated performance of technical skills in midwifery students--a randomised intervention trial.

    Science.gov (United States)

    Brady, Susannah; Bogossian, Fiona; Gibbons, Kristen

    2015-03-01

    Simulation as a pedagogical approach is used in health professional education to address the need to safely develop effective clinical skills prior to undertaking clinical practice, in complex healthcare environments. Evidence for the use of simulation in midwifery is largely anecdotal, and research evaluating the effectiveness of different levels of simulation fidelity is lacking. To evaluate the effectiveness of varying levels of fidelity on simulated learning experiences and identify which best contributes to integrated and global clinical skills development in midwifery students. Randomised three arm intervention trial. Midwifery students who had yet to receive theoretical instruction in the performance of the clinical skill of vaginal examination. Midwifery students (n=69) received theoretical instruction in the performance of vaginal examination following random allocation into one of three intervention arms. Participants were recorded performing the procedure using low fidelity (part task trainer only), medium fidelity (part task trainer and life sized poster of a pregnant woman) or progressive fidelity (part task trainer and a simulated standardised patient). Senior midwifery students were recruited to act in the role of standardised patients. There was a statistically significant difference in the mean total Global Rating Scale score between at least two of the three groups (p=0.009). The progressive fidelity group revealed as different from both the low fidelity group (p=0.010) and medium fidelity group (p=0.048). There was a statistically significant difference in the mean total Integrated Procedural Performance Instrument score between at least two of the three groups (p=0.012). The progressive fidelity group revealed as different from both the low fidelity group (p=0.026) and medium fidelity group (p=0.026). Progressive and medium fidelity simulation yields better outcomes than low fidelity simulation and where resources are constrained medium fidelity

  18. SPARTAN: A High-Fidelity Simulation for Automated Rendezvous and Docking Applications

    Science.gov (United States)

    Turbe, Michael A.; McDuffie, James H.; DeKock, Brandon K.; Betts, Kevin M.; Carrington, Connie K.

    2007-01-01

    bd Systems (a subsidiary of SAIC) has developed the Simulation Package for Autonomous Rendezvous Test and ANalysis (SPARTAN), a high-fidelity on-orbit simulation featuring multiple six-degree-of-freedom (6DOF) vehicles. SPARTAN has been developed in a modular fashion in Matlab/Simulink to test next-generation automated rendezvous and docking guidance, navigation,and control algorithms for NASA's new Vision for Space Exploration. SPARTAN includes autonomous state-based mission manager algorithms responsible for sequencing the vehicle through various flight phases based on on-board sensor inputs and closed-loop guidance algorithms, including Lambert transfers, Clohessy-Wiltshire maneuvers, and glideslope approaches The guidance commands are implemented using an integrated translation and attitude control system to provide 6DOF control of each vehicle in the simulation. SPARTAN also includes high-fidelity representations of a variety of absolute and relative navigation sensors that maybe used for NASA missions, including radio frequency, lidar, and video-based rendezvous sensors. Proprietary navigation sensor fusion algorithms have been developed that allow the integration of these sensor measurements through an extended Kalman filter framework to create a single optimal estimate of the relative state of the vehicles. SPARTAN provides capability for Monte Carlo dispersion analysis, allowing for rigorous evaluation of the performance of the complete proposed AR&D system, including software, sensors, and mechanisms. SPARTAN also supports hardware-in-the-loop testing through conversion of the algorithms to C code using Real-Time Workshop in order to be hosted in a mission computer engineering development unit running an embedded real-time operating system. SPARTAN also contains both runtime TCP/IP socket interface and post-processing compatibility with bdStudio, a visualization tool developed by bd Systems, allowing for intuitive evaluation of simulation results. A

  19. Inspiring Careers in STEM and Healthcare Fields through Medical Simulation Embedded in High School Science Education

    Science.gov (United States)

    Berk, Louis J.; Muret-Wagstaff, Sharon L.; Goyal, Riya; Joyal, Julie A.; Gordon, James A.; Faux, Russell; Oriol, Nancy E.

    2014-01-01

    The most effective ways to promote learning and inspire careers related to science, technology, engineering, and mathematics (STEM) remain elusive. To address this gap, we reviewed the literature and designed and implemented a high-fidelity, medical simulation-based Harvard Medical School MEDscience course, which was integrated into high school…

  20. The nature of reality represented in high fidelity human patient simulation: philosophical perspectives and implications for nursing education.

    Science.gov (United States)

    Dunnington, Renee M

    2014-01-01

    Simulation technology is increasingly being used in nursing education. Previously used primarily for teaching procedural, instrumental, or critical incident types of skills, simulation is now being applied to training related to more dynamic, complex, and interpersonal human contexts. While high fidelity human patient simulators have significantly increased in authenticity, human responses have greater complexity and are qualitatively different than current technology represents. This paper examines the texture of representation by simulation. Through a tracing of historical and contemporary philosophical perspectives on simulation, the nature and limits of the reality of human health responses represented by high fidelity human patient simulation (HF-HPS) are explored. Issues concerning nursing education are raised around the nature of reality represented in HF-HPS. Drawing on Waks, a framework for guiding pedagogical considerations around simulation in nursing education is presented for the ultimate purpose of promoting an educative experience with simulation.

  1. PHYSICAL FIDELITY CONSIDERATIONS FOR NRC ADVANCED REACTOR CONTROL ROOM TRAINING SIMULATORS USED FOR INSPECTOR/EXAMINER TRAINING

    Energy Technology Data Exchange (ETDEWEB)

    Branch, Kristi M.; Mitchell, Mark R.; Miller, Mark; Cochrum, Steven

    2010-11-07

    This paper describes research into the physical fidelity requirements of control room simulators to train U.S. Nuclear Regulatory Commission (NRC) staff for their duties as inspectors and license examiners for next-generation nuclear power plants. The control rooms of these power plants are expected to utilize digital instrumentation and controls to a much greater extent than do current plants. The NRC is assessing training facility needs, particularly for control room simulators, which play a central role in NRC training. Simulator fidelity affects both training effectiveness and cost. Research has shown high simulation fidelity sometimes positively affects transfer to the operational environment but sometimes makes no significant difference or actually impedes learning. The conditions in which these different effects occur are often unclear, especially for regulators (as opposed to operators) about whom research is particularly sparse. This project developed an inventory of the tasks and knowledges, skills, and abilities that NRC regulators need to fulfill job duties and used expert panels to characterize the inventory items by type and level of cognitive/behavioral capability needed, difficulty to perform, importance to safety, frequency of performance, and the importance of simulator training for learning these capabilities. A survey of current NRC staff provides information about the physical fidelity of the simulator on which the student trained to the control room to which the student was assigned and the effect lack of fidelity had on learning and job performance. The study concludes that a high level of physical fidelity is not required for effective training of NRC staff.

  2. Effectiveness of high-fidelity simulation for pediatric staff nurse education.

    Science.gov (United States)

    Bultas, Margaret W; Hassler, Margaret; Ercole, Patrick M; Rea, Gail

    2014-01-01

    A pre-test post-test control group design was used to compare the effectiveness of high-fidelity simulation (HFS) with traditional static mannequins as a teaching strategy for pediatric staff nurse education. Thirty-three nurses from a metropolitan pediatric Magnet hospital completed the study that evaluated knowledge retention, skill performance, and team confidence during the American Heart Association's (AHA) Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) course. Written exams, competency and skill performance measures, and the Mayo High Performance Teamwork Scale (MHPTS) were used to compare the outcomes between the two groups. Results indicated that knowledge retention was maintained, skill performance improved, and teamwork performance scores increased in the experimental group. This study provides a foundation supporting the use of HFS as an effective teaching modality when educating pediatric staff nurses in the identification and intervention of the deteriorating pediatric patient.

  3. Validation of High-Fidelity CFD Simulations for Rocket Injector Design

    Science.gov (United States)

    Tucker, P. Kevin; Menon, Suresh; Merkle, Charles L.; Oefelein, Joseph C.; Yang, Vigor

    2008-01-01

    Computational fluid dynamics (CFD) has the potential to improve the historical rocket injector design process by evaluating the sensitivity of performance and injector-driven thermal environments to the details of the injector geometry and key operational parameters. Methodical verification and validation efforts on a range of coaxial injector elements have shown the current production CFD capability must be improved in order to quantitatively impact the injector design process. This paper documents the status of a focused effort to compare and understand the predictive capabilities and computational requirements of a range of CFD methodologies on a set of single element injector model problems. The steady Reynolds-Average Navier-Stokes (RANS), unsteady Reynolds-Average Navier-Stokes (URANS) and three different approaches using the Large Eddy Simulation (LES) technique were used to simulate the initial model problem, a single element coaxial injector using gaseous oxygen and gaseous hydrogen propellants. While one high-fidelity LES result matches the experimental combustion chamber wall heat flux very well, there is no monotonic convergence to the data with increasing computational tool fidelity. Systematic evaluation of key flow field regions such as the flame zone, the head end recirculation zone and the downstream near wall zone has shed significant, though as of yet incomplete, light on the complex, underlying causes for the performance level of each technique. 1 Aerospace Engineer and Combustion CFD Team Leader, MS ER42, NASA MSFC, AL 35812, Senior Member, AIAA. 2 Professor and Director, Computational Combustion Laboratory, School of Aerospace Engineering, 270 Ferst Dr., Atlanta, GA 30332, Associate Fellow, AIAA. 3 Reilly Professor of Engineering, School of Mechanical Engineering, 585 Purdue Mall, West Lafayette, IN 47907, Fellow, AIAA. 4 Principal Member of Technical Staff, Combustion Research Facility, 7011 East Avenue, MS9051, Livermore, CA 94550, Associate

  4. A High-Fidelity Simulation of a Generic Commercial Aircraft Engine and Controller

    Science.gov (United States)

    May, Ryan D.; Csank, Jeffrey; Lavelle, Thomas M.; Litt, Jonathan S.; Guo, Ten-Huei

    2010-01-01

    A new high-fidelity simulation of a generic 40,000 lb thrust class commercial turbofan engine with a representative controller, known as CMAPSS40k, has been developed. Based on dynamic flight test data of a highly instrumented engine and previous engine simulations developed at NASA Glenn Research Center, this non-proprietary simulation was created especially for use in the development of new engine control strategies. C-MAPSS40k is a highly detailed, component-level engine model written in MATLAB/Simulink (The MathWorks, Inc.). Because the model is built in Simulink, users have the ability to use any of the MATLAB tools for analysis and control system design. The engine components are modeled in C-code, which is then compiled to allow faster-than-real-time execution. The engine controller is based on common industry architecture and techniques to produce realistic closed-loop transient responses while ensuring that no safety or operability limits are violated. A significant feature not found in other non-proprietary models is the inclusion of transient stall margin debits. These debits provide an accurate accounting of the compressor surge margin, which is critical in the design of an engine controller. This paper discusses the development, characteristics, and capabilities of the C-MAPSS40k simulation

  5. High-fidelity nursing simulation: impact on student self-confidence and clinical competence.

    Science.gov (United States)

    Blum, Cynthia A; Borglund, Susan; Parcells, Dax

    2010-01-01

    Development of safe nursing practice in entry-level nursing students requires special consideration from nurse educators. The paucity of data supporting high-fidelity patient simulation effectiveness in this population informed the development of a quasi-experimental, quantitative study of the relationship between simulation and student self-confidence and clinical competence. Moreover, the study reports a novel approach to measuring self-confidence and competence of entry-level nursing students. Fifty-three baccalaureate students, enrolled in either a traditional or simulation-enhanced laboratory, participated during their first clinical rotation. Student self-confidence and faculty perception of student clinical competence were measured using selected scale items of the Lasater Clinical Judgment Rubric. The results indicated an overall improvement in self-confidence and competence across the semester, however, simulation did not significantly enhance these caring attributes. The study highlights the need for further examination of teaching strategies developed to promote the transfer of self-confidence and competence from the laboratory to the clinical setting.

  6. Terascale High-Fidelity Simulations of Turbulent Combustion with Detailed Chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Im, Hong G [University of Michigan; Trouve, Arnaud [University of Maryland; Rutland, Christopher J [University of Wisconsin; Chen, Jacqueline H [Sandia National Laboratories

    2012-08-13

    The TSTC project is a multi-university collaborative effort to develop a high-fidelity turbulent reacting flow simulation capability utilizing terascale, massively parallel computer technology. The main paradigm of our approach is direct numerical simulation (DNS) featuring highest temporal and spatial accuracy, allowing quantitative observations of the fine-scale physics found in turbulent reacting flows as well as providing a useful tool for development of sub-models needed in device-level simulations. The code named S3D, developed and shared with Chen and coworkers at Sandia National Laboratories, has been enhanced with new numerical algorithms and physical models to provide predictive capabilities for spray dynamics, combustion, and pollutant formation processes in turbulent combustion. Major accomplishments include improved characteristic boundary conditions, fundamental studies of auto-ignition in turbulent stratified reactant mixtures, flame-wall interaction, and turbulent flame extinction by water spray. The overarching scientific issue in our recent investigations is to characterize criticality phenomena (ignition/extinction) in turbulent combustion, thereby developing unified criteria to identify ignition and extinction conditions. The computational development under TSTC has enabled the recent large-scale 3D turbulent combustion simulations conducted at Sandia National Laboratories.

  7. Nuclear fuel cycle system simulation tool based on high-fidelity component modeling

    Energy Technology Data Exchange (ETDEWEB)

    Ames, David E.,

    2014-02-01

    The DOE is currently directing extensive research into developing fuel cycle technologies that will enable the safe, secure, economic, and sustainable expansion of nuclear energy. The task is formidable considering the numerous fuel cycle options, the large dynamic systems that each represent, and the necessity to accurately predict their behavior. The path to successfully develop and implement an advanced fuel cycle is highly dependent on the modeling capabilities and simulation tools available for performing useful relevant analysis to assist stakeholders in decision making. Therefore a high-fidelity fuel cycle simulation tool that performs system analysis, including uncertainty quantification and optimization was developed. The resulting simulator also includes the capability to calculate environmental impact measures for individual components and the system. An integrated system method and analysis approach that provides consistent and comprehensive evaluations of advanced fuel cycles was developed. A general approach was utilized allowing for the system to be modified in order to provide analysis for other systems with similar attributes. By utilizing this approach, the framework for simulating many different fuel cycle options is provided. Two example fuel cycle configurations were developed to take advantage of used fuel recycling and transmutation capabilities in waste management scenarios leading to minimized waste inventories.

  8. Improving the process of community-based student nurse practice through a high-fidelity simulated clinical experience.

    Science.gov (United States)

    Gotwals, Beth; Yeager, Shelley T

    2014-01-01

    Simulation can be used to facilitate knowledge and practice with clients/families in the community. Because student nurses appreciate the opportunity to practice skills in a nonthreatening environment, and faculty welcome the opportunity to observe all students providing a home visit to a similar type of client, the authors developed such a simulation. In this article, they outline the process taken to develop and evaluate a high-fidelity community simulated clinical experience.

  9. High fidelity simulation of nucleate boiling and transition to critical heat flux on enhanced structures

    Science.gov (United States)

    Yazdani, Miad; Alahyari, Abbas; Radcliff, Thomas; Soteriou, Marios

    2015-11-01

    Surface enhancement is often is the primary approach for improved heat transfer performance of two-phase thermal systems particularly when they operate in nucleate boiling regime. This paper exploits the modeling capability developed by Yazdani et al. for simulation of nucleate boiling and transition to critical heat flux to study the nucleation phenomenon on various enhanced structures. The multi-scale of two-phase flow associated with boiling phenomena is addressed through combination of deterministic CFD for the macro-scale transport, asymptotic based representation of micro-layer, and stochastic representation of surface roughness so as to allow a high-fidelity simulation of boiling on an arbitrary surface. In addition, given the excessive complexity of surface structures often used for enhancement of boiling heat transfer, a phase-field-based method is developed to generate the structures where the numerical parameters in the phase-field model determine the topology of a given structure. The ``generated'' structure is then embedded into the two-phase flow model through virtual boundary method for the boiling simulation. The model is validated against experimental data for the boiling curve and the critical heat flux as well as nucleation and bubble dynamics characteristics.

  10. The Effect of High-Fidelity Cardiopulmonary Resuscitation (CPR) Simulation on Athletic Training Student Knowledge, Confidence, Emotions, and Experiences

    Science.gov (United States)

    Tivener, Kristin Ann; Gloe, Donna Sue

    2015-01-01

    Context: High-fidelity simulation is widely used in healthcare for the training and professional education of students though literature of its application to athletic training education remains sparse. Objective: This research attempts to address a wide-range of data. This includes athletic training student knowledge acquisition from…

  11. Relationship between Fidelity and Dose of Human Patient Simulation, Critical Thinking Skills, and Knowledge in an Associate Degree Nursing Program

    Science.gov (United States)

    Beebe, Rosella I.

    2012-01-01

    This study examined the relationship between human patient simulation (HPS), critical thinking skills, and knowledge acquisition after HPS was integrated across the curriculum of an associate degree nursing program to determine if differences existed in critical thinking and knowledge of students based on the fidelity of HPS used and amount of…

  12. The Effects of Moderate- and High-Fidelity Patient Simulator Use on Critical Thinking in Associate Degree Nursing Students

    Science.gov (United States)

    Vieck, Jana

    2013-01-01

    The purpose of this study was to examine the impact of moderate- and high-fidelity patient simulator use on the critical thinking skills of associate degree nursing students. This quantitative study used a quasi-experimental design and the Health Sciences Reasoning Test (HSRT) to evaluate the critical thinking skills of third semester nursing…

  13. The Effect of High-Fidelity Cardiopulmonary Resuscitation (CPR) Simulation on Athletic Training Student Knowledge, Confidence, Emotions, and Experiences

    Science.gov (United States)

    Tivener, Kristin Ann; Gloe, Donna Sue

    2015-01-01

    Context: High-fidelity simulation is widely used in healthcare for the training and professional education of students though literature of its application to athletic training education remains sparse. Objective: This research attempts to address a wide-range of data. This includes athletic training student knowledge acquisition from…

  14. Quantum Monte Carlo simulations of fidelity at magnetic quantum phase transitions.

    Science.gov (United States)

    Schwandt, David; Alet, Fabien; Capponi, Sylvain

    2009-10-23

    When a system undergoes a quantum phase transition, the ground-state wave function shows a change of nature, which can be monitored using the fidelity concept. We introduce two quantum Monte Carlo schemes that allow the computation of fidelity and its susceptibility for large interacting many-body systems. These methods are illustrated on a two-dimensional Heisenberg model, where fidelity estimators show marked behavior at two successive quantum phase transitions. We also develop a scaling theory which relates the divergence of the fidelity susceptibility to the critical exponent of the correlation length. A good agreement is found with the numerical results.

  15. Developing and Testing a High-Fidelity Simulation Scenario for an Uncommon Life-Threatening Disease: Severe Malaria

    Directory of Open Access Journals (Sweden)

    Andrew Kestler

    2011-01-01

    Full Text Available Background. Severe malaria is prevalent globally, yet it is an uncommon disease posing a challenge to education in nonendemic countries. High-fidelity simulation (sim may be well suited to teaching its management. Objective. To develop and evaluate a teaching tool for severe malaria, using sim. Methods. A severe malaria sim scenario was developed based on 5 learning objectives. Sim sessions, conducted at an academic center, utilized METI ECS mannequin. After sim, participants received standardized debriefing and completed a test assessing learning and a survey assessing views on sim efficacy. Results. 29 participants included 3rd year medical students (65%, 3rd year EM residents (28%, and EM nurses (7%. Participants scored average 85% on questions related to learning objectives. 93% felt that sim was effective or very effective in teaching severe malaria, and 83% rated it most effective. All respondents felt that sim increased their knowledge on malaria. Conclusion. Sim is an effective tool for teaching severe malaria in and may be superior to other modalities.

  16. Are All Manikins Created Equal? A Pilot Study of Simulator Upper Airway Anatomic Fidelity.

    Science.gov (United States)

    Woo, Jennifer A; Malekzadeh, Sonya; Malloy, Kelly M; Deutsch, Ellen S

    2017-06-01

    This study evaluates the anatomic fidelity of several commercially available pediatric and adult manikins, including airway task trainers, which could be used in aerodigestive procedure training. Twenty-three experienced otolaryngologists assessed the aerodigestive anatomy of 5 adult and 5 pediatric manikins in a passive state, using rigid and flexible endoscopy. Anatomic fidelity was rated on a 5-point scale for the following: nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, trachea, esophagus, and neck. Mean scores and standard deviations were tabulated for each manikin at each anatomic site. Ratings by survey participants demonstrated variation in the anatomic fidelity of the aerodigestive tract in a range of manikins. Radar chart display of the results allows comparison of manikin fidelity by anatomic site. Differences in scores may allow instructors to select manikins with the best anatomic fidelity for specific educational purposes, and they may contribute to recommendations to improve future manikin design.

  17. High fidelity simulation of non-synchronous vibration for aircraft engine fan/compressor

    Science.gov (United States)

    Im, Hong-Sik

    The objectives of this research are to develop a high fidelity simulation methodology for turbomachinery aeromechanical problems and to investigate the mechanism of non-synchronous vibration (NSV) of an aircraft engine axial compressor. A fully conservative rotor/stator sliding technique is developed to accurately capture the unsteadiness and interaction between adjacent blade rows. Phase lag boundary conditions (BC) based on the time shift (direct store) method and the Fourier series phase lag BC are implemented to take into account the effect of phase difference for a sector of annulus simulation. To resolve the nonlinear interaction between flow and vibrating blade structure, a fully coupled fluid-structure interaction (FSI) procedure that solves the structural modal equations and time accurate Navier-Stokes equations simultaneously is adopted. An advanced mesh deformation method that generates the blade tip block mesh moving with the blade displacement is developed to ensure the mesh quality. An efficient and low diffusion E-CUSP (LDE) scheme as a Riemann solver designed to minimize numerical dissipation is used with an improved hybrid RANS/LES turbulence strategy, delayed detached eddy simulation (DDES). High order accuracy (3rd and 5th order) weighted essentially non-oscillatory (WENO) schemes for inviscid flux and a conservative 2nd and 4th order viscous flux differencing are employed. Extensive validations are conducted to demonstrate high accuracy and robustness of the high fidelity FSI simulation methodology. The validated cases include: (1) DDES of NACA 0012 airfoil at high angle of attack with massive separation. The DDES accurately predicts the drag whereas the URANS model significantly over predicts the drag. (2) The AGARD Wing 445.6 flutter boundary is accurately predicted including the point at supersonic incoming flow. (3) NASA Rotor 67 validation for steady state speed line and radial profiles at peak efficiency point and near stall point. The

  18. Time to unravel the conceptual confusion of authenticity and fidelity and their contribution to learning within simulation-based nurse education. A discussion paper.

    Science.gov (United States)

    Bland, Andrew J; Topping, Annie; Tobbell, Jane

    2014-07-01

    High-fidelity patient simulation is a method of education increasingly utilised by educators of nursing to provide authentic learning experiences. Fidelity and authenticity, however, are not conceptually equivalent. Whilst fidelity is important when striving to replicate a life experience such as clinical practice, authenticity can be produced with low fidelity. A challenge for educators of undergraduate nursing is to ensure authentic representation of the clinical situation which is a core component for potential success. What is less clear is the relationship between fidelity and authenticity in the context of simulation based learning. Authenticity does not automatically follow fidelity and as a result, educators of nursing cannot assume that embracing the latest technology-based educational tools will in isolation provide a learning environment perceived authentic by the learner. As nursing education programmes increasingly adopt simulators that offer the possibility of representing authentic real world situations, there is an urgency to better articulate and understand the terms fidelity and authenticity. Without such understanding there is a real danger that simulation as a teaching and learning resource in nurse education will never reach its potential and be misunderstood, creating a potential barrier to learning. This paper examines current literature to promote discussion within nurse education, concluding that authenticity in the context of simulation-based learning is complex, relying on far more than engineered fidelity.

  19. High-fidelity simulation capability for virtual testing of seismic and acoustic sensors

    Science.gov (United States)

    Wilson, D. Keith; Moran, Mark L.; Ketcham, Stephen A.; Lacombe, James; Anderson, Thomas S.; Symons, Neill P.; Aldridge, David F.; Marlin, David H.; Collier, Sandra L.; Ostashev, Vladimir E.

    2005-05-01

    This paper describes development and application of a high-fidelity, seismic/acoustic simulation capability for battlefield sensors. The purpose is to provide simulated sensor data so realistic that they cannot be distinguished by experts from actual field data. This emerging capability provides rapid, low-cost trade studies of unattended ground sensor network configurations, data processing and fusion strategies, and signatures emitted by prototype vehicles. There are three essential components to the modeling: (1) detailed mechanical signature models for vehicles and walkers, (2) high-resolution characterization of the subsurface and atmospheric environments, and (3) state-of-the-art seismic/acoustic models for propagating moving-vehicle signatures through realistic, complex environments. With regard to the first of these components, dynamic models of wheeled and tracked vehicles have been developed to generate ground force inputs to seismic propagation models. Vehicle models range from simple, 2D representations to highly detailed, 3D representations of entire linked-track suspension systems. Similarly detailed models of acoustic emissions from vehicle engines are under development. The propagation calculations for both the seismics and acoustics are based on finite-difference, time-domain (FDTD) methodologies capable of handling complex environmental features such as heterogeneous geologies, urban structures, surface vegetation, and dynamic atmospheric turbulence. Any number of dynamic sources and virtual sensors may be incorporated into the FDTD model. The computational demands of 3D FDTD simulation over tactical distances require massively parallel computers. Several example calculations of seismic/acoustic wave propagation through complex atmospheric and terrain environments are shown.

  20. Investigating systematic individual differences in sleep-deprived performance on a high-fidelity flight simulator.

    Science.gov (United States)

    Van Dongen, Hans P A; Caldwell, John A; Caldwell, J Lynn

    2006-05-01

    Laboratory research has revealed considerable systematic variability in the degree to which individuals' alertness and performance are affected by sleep deprivation. However, little is known about whether or not different populations exhibit similar levels of individual variability. In the present study, we examined individual variability in performance impairment due to sleep loss in a highly select population of militaryjet pilots. Ten active-duty F-117 pilots were deprived of sleep for 38 h and studied repeatedly in a high-fidelity flight simulator. Data were analyzed with a mixed-model ANOVA to quantify individual variability. Statistically significant, systematic individual differences in the effects of sleep deprivation were observed, even when baseline differences were accounted for. The findings suggest that highly select populations may exhibit individual differences in vulnerability to performance impairment from sleep loss just as the general population does. Thus, the scientific and operational communities' reliance on group data as opposed to individual data may entail substantial misestimation of the impact of job-related stressors on safety and performance.

  1. Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions.

    Science.gov (United States)

    Bauer, Christian; Rimmelé, Thomas; Duclos, Antoine; Prieto, Nathalie; Cejka, Jean-Christophe; Carry, Pierre-Yves; Grousson, Sébastien; Friggeri, Arnaud; Secco, Julien; Bui-Xuan, Bernard; Lilot, Marc; Lehot, Jean-Jacques

    2016-12-01

    High-fidelity simulation (HFS) calls heavily upon cognitive capacities and generates stress and anxiety. The objectives of this prospective, observational study were to assess trait anxiety and fear of negative evaluation (FNE) in anaesthesiology and critical care residents and appraise their state anxiety levels and cardiovascular responses during HFS training sessions. First-year anaesthesiology and critical care residents completed the French-Canadian adaptation of the State-Trait Anxiety Inventory (IASTA Y-1: state anxiety, IASTA Y-2: trait anxiety) and the French adaptation of the Fear of Negative Evaluation Scale (FNE). Their heart rate (HR) and blood pressure (BP) were assessed before and after the training session. Twenty-three residents (8 women, 15 men) were included in the study. IASTA Y-1 and Y-2 scores were low (respectively 40.2±9.9 and 39.7±8) and FNE scores were moderate (16.7±5.5). HR measurements before and after the training sessions were significantly higher than at rest (respectively 78±19, 80±17 and 63±9b/min; Panxiety and FNE. HFS training increased their HR but not their BP. Their state anxiety also remained low. Several differences between individuals were noted, particularly between men and women. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  2. Application of High-fidelity Human Patient Simulator in Training Anesthe-sia Skills%仿真模拟人在麻醉医生技能训练中的应用

    Institute of Scientific and Technical Information of China (English)

    刘枫; 徐颖

    2016-01-01

    High-fidelity human patient simulator, as a new model of teaching, plays a really important role in training anesthesia skills. Medical students can perform training of anesthesia skills on the model of high-fidelity human patient simulator, which can help to improve the teaching quality and avoid the anesthesia risks as well. The article is aimed to e-laborate the advantages and effects of high-fidelity human patient simulator teaching method and to introduce the commonly used simulation systems in anesthesiology teaching respectively, to discuss the limitations and the potential application prospect of high-fidelity human patient simulator teaching method in training anesthesia.%仿真模拟人教学作为一种新的教学模式,在麻醉技能训练中显得尤为重要。医学生可以在仿真模拟人模型上进行麻醉技能训练,在提高教学质量的同时,还能有效地规避麻醉风险。该研究对仿真模拟人教学的优势与作用进行阐述,分类介绍麻醉教学中常用的模拟系统,探讨仿真模拟人教学在麻醉技能训练中的局限性及应用前景。

  3. A Review of the Literature on Training Simulators: Translators: Transfer of Training and Simulator Fidelity.

    Science.gov (United States)

    1984-04-01

    RD-R142 732 A REVIEW OF THERLITERATURE ON TRAINING SIMULATORS: / TRANSLATORS :TRANSFER 0 .(U) GEORGIAR INST OF TECH ATLANTA CENTER FOR MAN-MACHINE...Crawford and Crawford 1978) 6. Performance Measure : - What to measure measures of problem solving performance ( Henneman and Rouse 1984) criterion...reported to be a reasonable predictor of errors on fault diagnosis tasks ( Henneman and Rouse 1984). It is therefore reasonable to speculate that training

  4. Simulation Learning: PC-Screen Based (PCSB) versus High Fidelity Simulation (HFS)

    Science.gov (United States)

    2013-08-01

    in nursing education; from conceptualization to  evaluation. New York; National  league  for Nursing.  Kardong‐Edgren, S., Anderson, M., & Michaels, J...treatment Legend ----(!!) - Visual cue for student :W -Auditory cue for student School of Nursing and Dental Hygiene University of Hawai’i at Manoa Two...Person C-Collar simulation algorithm Pathway A Scenario A - Spinal stabilization: Sub processes Legend : Pathway Points Complex task to be performed

  5. A survey of modelling methods for high-fidelity wind farm simulations using large eddy simulation

    DEFF Research Database (Denmark)

    Breton, Simon-Philippe; Sumner, J.; Sørensen, Jens Nørkær

    2017-01-01

    Large eddy simulations (LES) of wind farms have the capability to provide valuable and detailed information about the dynamics of wind turbine wakes. For this reason, their use within the wind energy research community is on the rise, spurring the development of new models and methods. This review...... surveys the most common schemes available to model the rotor, atmospheric conditions and terrain effects within current state-of-the-art LES codes, of which an overview is provided. A summary of the experimental research data available for validation of LES codes within the context of single and multiple...

  6. Mapping high-fidelity volume rendering for medical imaging to CPU, GPU and many-core architectures.

    Science.gov (United States)

    Smelyanskiy, Mikhail; Holmes, David; Chhugani, Jatin; Larson, Alan; Carmean, Douglas M; Hanson, Dennis; Dubey, Pradeep; Augustine, Kurt; Kim, Daehyun; Kyker, Alan; Lee, Victor W; Nguyen, Anthony D; Seiler, Larry; Robb, Richard

    2009-01-01

    Medical volumetric imaging requires high fidelity, high performance rendering algorithms. We motivate and analyze new volumetric rendering algorithms that are suited to modern parallel processing architectures. First, we describe the three major categories of volume rendering algorithms and confirm through an imaging scientist-guided evaluation that ray-casting is the most acceptable. We describe a thread- and data-parallel implementation of ray-casting that makes it amenable to key architectural trends of three modern commodity parallel architectures: multi-core, GPU, and an upcoming many-core Intel architecture code-named Larrabee. We achieve more than an order of magnitude performance improvement on a number of large 3D medical datasets. We further describe a data compression scheme that significantly reduces data-transfer overhead. This allows our approach to scale well to large numbers of Larrabee cores.

  7. Evaluation of Heart Rate Assessment Timing, Communication, Accuracy, and Clinical Decision-Making during High Fidelity Simulation of Neonatal Resuscitation

    Directory of Open Access Journals (Sweden)

    Win Boon

    2014-01-01

    Full Text Available Objective. Accurate heart rate (HR determination during neonatal resuscitation (NR informs subsequent NR actions. This study’s objective was to evaluate HR determination timeliness, communication, and accuracy during high fidelity NR simulations that house officers completed during neonatal intensive care unit (NICU rotations. Methods. In 2010, house officers in NICU rotations completed high fidelity NR simulation. We reviewed 80 house officers’ videotaped performance on their initial high fidelity simulation session, prior to training and performance debriefing. We calculated the proportion of cases congruent with NR guidelines, using chi square analysis to evaluate performance across HR ranges relevant to NR decision-making: <60, 60–99, and ≥100 beats per minute (bpm. Results. 87% used umbilical cord palpation, 57% initiated HR assessment within 30 seconds, 70% were accurate, and 74% were communicated appropriately. HR determination accuracy varied significantly across HR ranges, with 87%, 57%, and 68% for HR <60, 60–99, and ≥100 bpm, respectively (P<0.001. Conclusions. Timeliness, communication, and accuracy of house officers’ HR determination are suboptimal, particularly for HR 60–100 bpm, which might lead to inappropriate decision-making and NR care. Training implications include emphasizing more accurate HR determination methods, better communication, and improved HR interpretation during NR.

  8. A practical discrete-adjoint method for high-fidelity compressible turbulence simulations

    Energy Technology Data Exchange (ETDEWEB)

    Vishnampet, Ramanathan [Department of Mechanical Science and Engineering, University of Illinois at Urbana–Champaign, Urbana, IL 61801 (United States); Bodony, Daniel J. [Department of Aerospace Engineering, University of Illinois at Urbana–Champaign, Urbana, IL 61801 (United States); Freund, Jonathan B., E-mail: jbfreund@illinois.edu [Department of Mechanical Science and Engineering, University of Illinois at Urbana–Champaign, Urbana, IL 61801 (United States); Department of Aerospace Engineering, University of Illinois at Urbana–Champaign, Urbana, IL 61801 (United States)

    2015-03-15

    Methods and computing hardware advances have enabled accurate predictions of complex compressible turbulence phenomena, such as the generation of jet noise that motivates the present effort. However, limited understanding of underlying physical mechanisms restricts the utility of such predictions since they do not, by themselves, indicate a route to design improvements. Gradient-based optimization using adjoints can circumvent the flow complexity to guide designs, though this is predicated on the availability of a sufficiently accurate solution of the forward and adjoint systems. These are challenging to obtain, since both the chaotic character of the turbulence and the typical use of discretizations near their resolution limits in order to efficiently represent its smaller scales will amplify any approximation errors made in the adjoint formulation. Formulating a practical exact adjoint that avoids such errors is especially challenging if it is to be compatible with state-of-the-art simulation methods used for the turbulent flow itself. Automatic differentiation (AD) can provide code to calculate a nominally exact adjoint, but existing general-purpose AD codes are inefficient to the point of being prohibitive for large-scale turbulence simulations. Here, we analyze the compressible flow equations as discretized using the same high-order workhorse methods used for many high-fidelity compressible turbulence simulations, and formulate a practical space–time discrete-adjoint method without changing the basic discretization. A key step is the definition of a particular discrete analog of the continuous norm that defines our cost functional; our selection leads directly to an efficient Runge–Kutta-like scheme, though it would be just first-order accurate if used outside the adjoint formulation for time integration, with finite-difference spatial operators for the adjoint system. Its computational cost only modestly exceeds that of the flow equations. We confirm that

  9. A High Fidelity Approach to Data Simulation for Space Situational Awareness Missions

    Science.gov (United States)

    Hagerty, S.; Ellis, H., Jr.

    2016-09-01

    Space Situational Awareness (SSA) is vital to maintaining our Space Superiority. A high fidelity, time-based simulation tool, PROXOR™ (Proximity Operations and Rendering), supports SSA by generating realistic mission scenarios including sensor frame data with corresponding truth. This is a unique and critical tool for supporting mission architecture studies, new capability (algorithm) development, current/future capability performance analysis, and mission performance prediction. PROXOR™ provides a flexible architecture for sensor and resident space object (RSO) orbital motion and attitude control that simulates SSA, rendezvous and proximity operations scenarios. The major elements of interest are based on the ability to accurately simulate all aspects of the RSO model, viewing geometry, imaging optics, sensor detector, and environmental conditions. These capabilities enhance the realism of mission scenario models and generated mission image data. As an input, PROXOR™ uses a library of 3-D satellite models containing 10+ satellites, including low-earth orbit (e.g., DMSP) and geostationary (e.g., Intelsat) spacecraft, where the spacecraft surface properties are those of actual materials and include Phong and Maxwell-Beard bidirectional reflectance distribution function (BRDF) coefficients for accurate radiometric modeling. We calculate the inertial attitude, the changing solar and Earth illumination angles of the satellite, and the viewing angles from the sensor as we propagate the RSO in its orbit. The synthetic satellite image is rendered at high resolution and aggregated to the focal plane resolution resulting in accurate radiometry even when the RSO is a point source. The sensor model includes optical effects from the imaging system [point spread function (PSF) includes aberrations, obscurations, support structures, defocus], detector effects (CCD blooming, left/right bias, fixed pattern noise, image persistence, shot noise, read noise, and quantization

  10. Utilizing high-fidelity crucial conversation simulation in genetic counseling training.

    Science.gov (United States)

    Holt, R Lynn; Tofil, Nancy M; Hurst, Christina; Youngblood, Amber Q; Peterson, Dawn Taylor; Zinkan, J Lynn; White, Marjorie Lee; Clemons, Jason L; Robin, Nathaniel H

    2013-06-01

    Genetics professionals are often required to deliver difficult news to patients and families. This is a challenging task, but one that many genetics trainees have limited opportunity to master during training. This is true for several reasons, including relative scarcity of these events and an understandable hesitation of supervisors allowing a trainee to provide such high stakes information. Medical simulation is effective in other health care disciplines giving trainees opportunities of "hands on" education in similar high stakes situations. We hypothesized that crucial conversations simulation would be effective for genetics trainees to gain experience in communication and counseling skills in a realistic clinical scenario. To test this hypothesis, we designed a prenatal counseling scenario requiring disclosure of an abnormal amniocentesis result and discussion of pregnancy management options; we challenged participants to address common counseling questions. Three medical genetics resident physicians and five genetic counseling students participated. Genetics and simulation experts observed the session via live video feed from a different room. A behavioral checklist was completed in real time assessing trainee's performance and documenting medical information discussed. Debriefing immediately followed the session and included simulation and genetics experts and the actor parents. Participants completed open-ended post evaluations. There was a trend towards participants being more likely to discuss issues the child could have while an infant/toddler rather than issues that could emerge as the child with Down Syndrome transitions to adulthood and end of life (P=.069). All participants found the simulation helpful, notably that it was more realistic than role-playing with colleagues.

  11. The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

    Science.gov (United States)

    Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia

    2012-03-01

    This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.

  12. Towards a Multi-Fidelity Approach for CFD Simulations of Vortex Generator Arrays

    NARCIS (Netherlands)

    Florentie, L.; Van Zuijlen, A.H.; Bijl, H.

    2014-01-01

    This paper is the starting point for the development of a multi-fidelity modeling approach for vortex generators (VG) arrays, where a fully resolved VG model will be coupled with an approximate model in order to improve both accuracy and flexibility without increasing the required computational cost

  13. The Utility of High-Fidelity Simulation for Training Critical Care Fellows in the Management of Extracorporeal Membrane Oxygenation Emergencies: A Randomized Controlled Trial.

    Science.gov (United States)

    Zakhary, Bishoy M; Kam, Lily M; Kaufman, Brian S; Felner, Kevin J

    2017-08-01

    Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. Randomized controlled trial. Academic medical center. Pulmonary/critical care fellows. Participants had a preintervention simulated extracorporeal membrane oxygenation emergency (Sim1-recirculation) then randomized into simulation and traditional groups. Each group participated in three teaching scenarios, via high-fidelity simulation or via water-drills. After 6 weeks and after 1 year, participants returned for two simulated extracorporeal membrane oxygenation emergencies (Sim2-pump failure and Sim3-access insufficiency). Sim2 was a case encountered during teaching, whereas Sim3 was novel. A critical action, necessary for resolution of each scenario, was preidentified for timing. Primary outcome was time required to perform critical actions. Twenty-one fellows participated in the study (simulation, 10; traditional, 11). Groups had similar scenario scores (p = 0.4) and times to critical action (p = 0.8) on Sim1. At 6 weeks, both groups had similar scenario scores on Sim2 (p = 0.5), but the simulation group scored higher on Sim3 (p = 0.03). Times to critical actions were shorter in the simulation group during Sim2 (127 vs 174 s, p = 0.004) and Sim3 (159 vs 300 s; p = 0.04). These findings persisted at 1 year. In novice critical care fellows, simulation-based extracorporeal membrane oxygenation training is superior to traditional training. Benefits transfer to novel scenarios and are maintained over the long term. Further studies evaluating the utility of simulation in other learner groups and for maintenance of proficiency are required.

  14. Effectiveness of using high-fidelity simulation to teach the management of general anesthesia for Cesarean delivery.

    Science.gov (United States)

    Balki, Mrinalini; Chakravarty, Subrata; Salman, Aliya; Wax, Randy S

    2014-10-01

    The objective of this study was to assess the influence of a teaching plan consisting of didactic teaching and repeated simulations on the performance of anesthesia residents in the management of general anesthesia (GA) for emergency Cesarean delivery (CD). Twenty-one postgraduate year 2 (PGY2) and 3 (PGY3) anesthesia residents from the University of Toronto were recruited in this prospective cohort study. All participants received didactic teaching in the management of GA for emergency CD, which was followed one week later by assessment of performance in the same scenario using a high-fidelity simulator. Another simulation assessment was repeated two months later in the same scenario. All simulation video recordings were assessed by two blinded experts using a validated checklist and an Anaesthetists' Non-Technical Skills (ANTS) scale in order to rate their technical and non-technical skills, respectively. The participants' performance (based on the above scales) in the two simulation sessions were then compared. Nineteen residents completed both simulation sessions. There was an improvement in the mean (SD) weighted checklist score from 64.5% (7.1%) in session 1 to 76.7% (6.7%) in session 2 (P technical skills but also the non-technical skills of residents, most likely due to the feedback received after the first simulation session. Repeated simulation sessions may help prepare residents to deal more effectively with similar critical situations in clinical practice with minimum errors.

  15. An Immersed Boundary - Adaptive Mesh Refinement solver (IB-AMR) for high fidelity fully resolved wind turbine simulations

    Science.gov (United States)

    Angelidis, Dionysios; Sotiropoulos, Fotis

    2015-11-01

    The geometrical details of wind turbines determine the structure of the turbulence in the near and far wake and should be taken in account when performing high fidelity calculations. Multi-resolution simulations coupled with an immersed boundary method constitutes a powerful framework for high-fidelity calculations past wind farms located over complex terrains. We develop a 3D Immersed-Boundary Adaptive Mesh Refinement flow solver (IB-AMR) which enables turbine-resolving LES of wind turbines. The idea of using a hybrid staggered/non-staggered grid layout adopted in the Curvilinear Immersed Boundary Method (CURVIB) has been successfully incorporated on unstructured meshes and the fractional step method has been employed. The overall performance and robustness of the second order accurate, parallel, unstructured solver is evaluated by comparing the numerical simulations against conforming grid calculations and experimental measurements of laminar and turbulent flows over complex geometries. We also present turbine-resolving multi-scale LES considering all the details affecting the induced flow field; including the geometry of the tower, the nacelle and especially the rotor blades of a wind tunnel scale turbine. This material is based upon work supported by the Department of Energy under Award Number DE-EE0005482 and the Sandia National Laboratories.

  16. Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.

    Science.gov (United States)

    Fawaz, Mirna A; Hamdan-Mansour, Ayman M

    2016-11-01

    High-fidelity simulation (HFS) offers a strategy to facilitate cognitive, affective, and psychomotor outcomes and motivate the new generation of students. The purpose of this study was to examine the impact of using high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students. A post-test, quasi-experimental design was used. Two private universities in Lebanon were targeted to implement the intervention. A convenience sample of 56 nursing students from two private universities in Lebanon were recruited. Data were collected using the Lasater Clinical Judgment Rubric and the Motivated Strategies for Learning questionnaires. Nursing students exhibited significant improvement in clinical judgment and motivation due to exposure to HFS. There was a significant difference post HFS between the intervention group and the control group in clinical judgment intervention (t=5.23, pmotivation for academic achievement (t=-6.71, pmotivation (198.6, SD=10.5) in the intervention group than in the control group (161.6, SD=20). The analysis related to differences between the intervention and control groups in motivation and clinical judgment; controlling for previous experience in health care services, the analysis showed no significant difference (Wilk's lambda =0.77, F=1.09, p=0.374). There is a need for nursing educators to implement HFS in nursing curricula, where its integration can bridge the gap between theoretical knowledge and nursing practice and enhance critical thinking and motivation among nursing students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Simulation-based medical teaching and learning

    Directory of Open Access Journals (Sweden)

    Abdulmohsen H Al-Elq

    2010-01-01

    Full Text Available One of the most important steps in curriculum development is the introduction of simulation- based medical teaching and learning. Simulation is a generic term that refers to an artificial representation of a real world process to achieve educational goals through experiential learning. Simulation based medical education is defined as any educational activity that utilizes simulation aides to replicate clinical scenarios. Although medical simulation is relatively new, simulation has been used for a long time in other high risk professions such as aviation. Medical simulation allows the acquisition of clinical skills through deliberate practice rather than an apprentice style of learning. Simulation tools serve as an alternative to real patients. A trainee can make mistakes and learn from them without the fear of harming the patient. There are different types and classification of simulators and their cost vary according to the degree of their resemblance to the reality, or ′fidelity′. Simulation- based learning is expensive. However, it is cost-effective if utilized properly. Medical simulation has been found to enhance clinical competence at the undergraduate and postgraduate levels. It has also been found to have many advantages that can improve patient safety and reduce health care costs through the improvement of the medical provider′s competencies. The objective of this narrative review article is to highlight the importance of simulation as a new teaching method in undergraduate and postgraduate education.

  18. Medical Simulation Practices 2010 Survey Results

    Science.gov (United States)

    McCrindle, Jeffrey J.

    2011-01-01

    Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

  19. Efficient partially implicit integration method for stiff chemistry in high-fidelity simulations of turbulent reacting flows

    Science.gov (United States)

    Wu, Hao; Ihme, Matthias

    2016-11-01

    High-fidelity turbulent reactive flow simulations are typically associated with small time step sizes (h combustion simulations due to the reduced number of internal iterations and excessive implicitness. In this study, an improved 4th-order Rosenbrock-Krylov (ROK4L) scheme is developed for the system of chemical reactions. This class of schemes replaces the Jacobian matrix by its low-rank Krylov approximation, thus introducing partial implicitness. The scheme is improved in both accuracy and efficiency by fulfilling additional order conditions and reducing the number of function evaluations. The ROK4L scheme is demonstrated to possess superior efficiency in comparison to CVODE due to the minimal degree of implicitness for small time-step sizes and the avoidance of other overhead associated with the start-up process of multi-step methods. Financial support from NASA Transformational Tools and Technologies Project with Award No. NNX15AV04A.

  20. How valid are commercially available medical simulators?

    NARCIS (Netherlands)

    Stunt, J.J.; Wulms, P.H.; Kerkhoffs, G.M.; Dankelman, J.; Van Dijk, C.N.; Tuijthof, G.J.M.

    2014-01-01

    Background: Since simulators offer important advantages, they are increasingly used in medical education and medical skills training that require physical actions. A wide variety of simulators have become commercially available. It is of high importance that evidence is provided that training on the

  1. Investigation of the impact of high liquid viscosity on jet atomization in crossflow via high-fidelity simulations

    Science.gov (United States)

    Li, Xiaoyi; Gao, Hui; Soteriou, Marios C.

    2017-08-01

    Atomization of extremely high viscosity liquid can be of interest for many applications in aerospace, automotive, pharmaceutical, and food industries. While detailed atomization measurements usually face grand challenges, high-fidelity numerical simulations offer the advantage to comprehensively explore the atomization details. In this work, a previously validated high-fidelity first-principle simulation code HiMIST is utilized to simulate high-viscosity liquid jet atomization in crossflow. The code is used to perform a parametric study of the atomization process in a wide range of Ohnesorge numbers (Oh = 0.004-2) and Weber numbers (We = 10-160). Direct comparisons between the present study and previously published low-viscosity jet in crossflow results are performed. The effects of viscous damping and slowing on jet penetration, liquid surface instabilities, ligament formation/breakup, and subsequent droplet formation are investigated. Complex variations in near-field and far-field jet penetrations with increasing Oh at different We are observed and linked with the underlying jet deformation and breakup physics. Transition in breakup regimes and increase in droplet size with increasing Oh are observed, mostly consistent with the literature reports. The detailed simulations elucidate a distinctive edge-ligament-breakup dominated process with long surviving ligaments for the higher Oh cases, as opposed to a two-stage edge-stripping/column-fracture process for the lower Oh counterparts. The trend of decreasing column deflection with increasing We is reversed as Oh increases. A predominantly unimodal droplet size distribution is predicted at higher Oh, in contrast to the bimodal distribution at lower Oh. It has been found that both Rayleigh-Taylor and Kelvin-Helmholtz linear stability theories cannot be easily applied to interpret the distinct edge breakup process and further study of the underlying physics is needed.

  2. Progress Toward Affordable High Fidelity Combustion Simulations Using Filtered Density Functions for Hypersonic Flows in Complex Geometries

    Science.gov (United States)

    Drozda, Tomasz G.; Quinlan, Jesse R.; Pisciuneri, Patrick H.; Yilmaz, S. Levent

    2012-01-01

    Significant progress has been made in the development of subgrid scale (SGS) closures based on a filtered density function (FDF) for large eddy simulations (LES) of turbulent reacting flows. The FDF is the counterpart of the probability density function (PDF) method, which has proven effective in Reynolds averaged simulations (RAS). However, while systematic progress is being made advancing the FDF models for relatively simple flows and lab-scale flames, the application of these methods in complex geometries and high speed, wall-bounded flows with shocks remains a challenge. The key difficulties are the significant computational cost associated with solving the FDF transport equation and numerically stiff finite rate chemistry. For LES/FDF methods to make a more significant impact in practical applications a pragmatic approach must be taken that significantly reduces the computational cost while maintaining high modeling fidelity. An example of one such ongoing effort is at the NASA Langley Research Center, where the first generation FDF models, namely the scalar filtered mass density function (SFMDF) are being implemented into VULCAN, a production-quality RAS and LES solver widely used for design of high speed propulsion flowpaths. This effort leverages internal and external collaborations to reduce the overall computational cost of high fidelity simulations in VULCAN by: implementing high order methods that allow reduction in the total number of computational cells without loss in accuracy; implementing first generation of high fidelity scalar PDF/FDF models applicable to high-speed compressible flows; coupling RAS/PDF and LES/FDF into a hybrid framework to efficiently and accurately model the effects of combustion in the vicinity of the walls; developing efficient Lagrangian particle tracking algorithms to support robust solutions of the FDF equations for high speed flows; and utilizing finite rate chemistry parametrization, such as flamelet models, to reduce

  3. High Fidelity, Fuel-Like Thermal Simulators for Non-Nuclear Testing: Analysis and Initial Test Results

    Science.gov (United States)

    Bragg-Sitton, Shannon M.; Dickens, Ricky; Dixon, David; Kapernick, Richard

    2007-01-01

    Non-nuclear testing can be a valuable tool in the development of a space nuclear power system, providing system characterization data and allowing one to work through various fabrication, assembly and integration issues without the cost and time associated with a full ground nuclear test. In a non-nuclear test bed, electric heaters are used to simulate the heat from nuclear fuel. Testing with non-optimized heater elements allows one to assess thermal, heat transfer. and stress related attributes of a given system, but fails to demonstrate the dynamic response that would be present in an integrated, fueled reactor system. High fidelity thermal simulators that match both the static and the dynamic fuel pin performance that would be observed in an operating, fueled nuclear reactor can vastly increase the value of non-nuclear test results. With optimized simulators, the integration of thermal hydraulic hardware tests with simulated neutronic response provides a bridge between electrically heated testing and fueled nuclear testing. By implementing a neutronic response model to simulate the dynamic response that would be expected in a fueled reactor system, one can better understand system integration issues, characterize integrated system response times and response characteristics and assess potential design improvements at relatively small fiscal investment. Initial conceptual thermal simulator designs are determined by simple one-dimensional analysis at a single axial location and at steady state conditions; feasible concepts are then input into a detailed three-dimensional model for comparison to expected fuel pin performance. Static and dynamic fuel pin performance for a proposed reactor design is determined using SINDA/FLUINT thermal analysis software, and comparison is made between the expected nuclear performance and the performance of conceptual thermal simulator designs. Through a series of iterative analyses, a conceptual high fidelity design is developed

  4. The Effects of High-Fidelity Simulation on Salivary Cortisol Levels in SRNA Students: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Terri Jones

    2011-01-01

    Full Text Available The use of clinical simulation in graduate level nursing education provides the opportunity for students to learn and apply theoretical practices of nursing care in a safe and controlled environment. It was postulated that laboratory simulation would mimic the stress levels of a real clinical situation as measured by the stress hormone cortisol. The purpose of this study was to determine whether high-fidelity simulation approximates the stress experienced by nurse anesthesia students in the operating room. Participants (n = 21 were recruited from an accredited nurse anesthesia program in the southern U.S. Saliva was collected for 3 days under controlled conditions for baseline data. Next, saliva was collected for 3 days: the day before, the day of, and the day after simulation. The same process was repeated for the first clinical day in the operating room. The participants acted as their own control. There was a significant (p 0.05, and levels were lower than levels during simulation. Laboratory simulation of patient scenarios raised the stress hormone cortisol level threefold above baseline levels in nurse anesthesia students, while actual clinical experience did not.

  5. Benefits of simulation training in medical education

    OpenAIRE

    Abas T; Juma FZ

    2016-01-01

    Tamkin Abas, Fatema Zehra JumaManchester Medical School, University of Manchester, Manchester, UKWe read about the satisfaction of simulation experiences of paramedic students1 with great interest. As medical students, with early clinical experience comparative to paramedic training in the UK, we agree that simulation-based learning is well received in health care education. As part of the curriculum at the University of Manchester, we are exposed to a variety of simulation-based environments...

  6. A hybrid anchored-ANOVA - POD/Kriging method for uncertainty quantification in unsteady high-fidelity CFD simulations

    Science.gov (United States)

    Margheri, Luca; Sagaut, Pierre

    2016-11-01

    To significantly increase the contribution of numerical computational fluid dynamics (CFD) simulation for risk assessment and decision making, it is important to quantitatively measure the impact of uncertainties to assess the reliability and robustness of the results. As unsteady high-fidelity CFD simulations are becoming the standard for industrial applications, reducing the number of required samples to perform sensitivity (SA) and uncertainty quantification (UQ) analysis is an actual engineering challenge. The novel approach presented in this paper is based on an efficient hybridization between the anchored-ANOVA and the POD/Kriging methods, which have already been used in CFD-UQ realistic applications, and the definition of best practices to achieve global accuracy. The anchored-ANOVA method is used to efficiently reduce the UQ dimension space, while the POD/Kriging is used to smooth and interpolate each anchored-ANOVA term. The main advantages of the proposed method are illustrated through four applications with increasing complexity, most of them based on Large-Eddy Simulation as a high-fidelity CFD tool: the turbulent channel flow, the flow around an isolated bluff-body, a pedestrian wind comfort study in a full scale urban area and an application to toxic gas dispersion in a full scale city area. The proposed c-APK method (anchored-ANOVA-POD/Kriging) inherits the advantages of each key element: interpolation through POD/Kriging precludes the use of quadrature schemes therefore allowing for a more flexible sampling strategy while the ANOVA decomposition allows for a better domain exploration. A comparison of the three methods is given for each application. In addition, the importance of adding flexibility to the control parameters and the choice of the quantity of interest (QoI) are discussed. As a result, global accuracy can be achieved with a reasonable number of samples allowing computationally expensive CFD-UQ analysis.

  7. Maximum Fidelity

    CERN Document Server

    Kinkhabwala, Ali

    2013-01-01

    The most fundamental problem in statistics is the inference of an unknown probability distribution from a finite number of samples. For a specific observed data set, answers to the following questions would be desirable: (1) Estimation: Which candidate distribution provides the best fit to the observed data?, (2) Goodness-of-fit: How concordant is this distribution with the observed data?, and (3) Uncertainty: How concordant are other candidate distributions with the observed data? A simple unified approach for univariate data that addresses these traditionally distinct statistical notions is presented called "maximum fidelity". Maximum fidelity is a strict frequentist approach that is fundamentally based on model concordance with the observed data. The fidelity statistic is a general information measure based on the coordinate-independent cumulative distribution and critical yet previously neglected symmetry considerations. An approximation for the null distribution of the fidelity allows its direct conversi...

  8. High-fidelity simulation enhances pediatric residents' retention, knowledge, procedural proficiency, group resuscitation performance, and experience in pediatric resuscitation.

    Science.gov (United States)

    Mills, David M; Wu, Chang L; Williams, Daniel C; King, Lydia; Dobson, Joseph V

    2013-07-01

    The goal of this study was to assess the effect of high-fidelity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls. In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural proficiency, retention, and self-reported comfort and procedural experience. The intervention group was compared with matched-pair historical controls. Forty-one residents participated in HFS training with 32 matched controls. The HFS group displayed significant initial and overall improvement in knowledge (P historical controls but also reported increased real-life resuscitation experiences and related procedures.

  9. Effects of simulation fidelity on user experience in virtual fear of public speaking training - an experimental study.

    Science.gov (United States)

    Poeschl, Sandra; Doering, Nicola

    2014-01-01

    Realistic models in virtual reality training applications are considered to positively influence presence and performance. The experimental study presented, analyzed the effect of simulation fidelity (static vs. animated audience) on presence as a prerequisite for performance in a prototype virtual fear of public speaking application with a sample of N = 40 academic non-phobic users. Contrary to the state of research, no influence was shown on virtual presence and perceived realism, but an animated audience led to significantly higher effects in anxiety during giving a talk. Although these findings could be explained by an application that might not have been realistic enough, they still question the role of presence as a mediating factor in virtual exposure applications.

  10. Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation

    Science.gov (United States)

    Kostopoulou, Olga; Porat, Talya; Corrigan, Derek; Mahmoud, Samhar; Delaney, Brendan C

    2017-01-01

    Background Observational and experimental studies of the diagnostic task have demonstrated the importance of the first hypotheses that come to mind for accurate diagnosis. A prototype decision support system (DSS) designed to support GPs’ first impressions has been integrated with a commercial electronic health record (EHR) system. Aim To evaluate the prototype DSS in a high-fidelity simulation. Design and setting Within-participant design: 34 GPs consulted with six standardised patients (actors) using their usual EHR. On a different day, GPs used the EHR with the integrated DSS to consult with six other patients, matched for difficulty and counterbalanced. Method Entering the reason for encounter triggered the DSS, which provided a patient-specific list of potential diagnoses, and supported coding of symptoms during the consultation. At each consultation, GPs recorded their diagnosis and management. At the end, they completed a usability questionnaire. The actors completed a satisfaction questionnaire after each consultation. Results There was an 8–9% absolute improvement in diagnostic accuracy when the DSS was used. This improvement was significant (odds ratio [OR] 1.41, 95% confidence interval [CI] = 1.13 to 1.77, PGPs coded significantly more data when using the DSS (mean 12.35 with the DSS versus 1.64 without), and were generally satisfied with its usability. Patient satisfaction ratings were the same for consultations with and without the DSS. Conclusion The DSS prototype was successfully employed in simulated consultations of high fidelity, with no measurable influences on patient satisfaction. The substantially increased data coding can operate as motivation for future DSS adoption. PMID:28137782

  11. Near-peer medical student simulation training.

    Science.gov (United States)

    Cash, Thomas; Brand, Eleanor; Wong, Emma; Richardson, Jay; Athorn, Sam; Chowdhury, Faiza

    2017-06-01

    There is growing concern that medical students are inadequately prepared for life as a junior doctor. A lack of confidence managing acutely unwell patients is often cited as a barrier to good clinical care. With medical schools investing heavily in simulation equipment, we set out to explore if near-peer simulation training is an effective teaching format. Medical students in their third year of study and above were invited to attend a 90-minute simulation teaching session. The sessions were designed and delivered by final-year medical students using clinical scenarios mapped to the Sheffield MBChB curriculum. Candidates were required to assess, investigate and manage an acutely unwell simulated patient. Pre- and post-simulation training Likert scale questionnaires were completed relating to self-reported confidence levels. There is growing concern that medical students are inadequately prepared for life as a junior doctor RESULTS: Questionnaires were completed by 25 students (100% response rate); 52 per cent of students had no prior simulation experience. There were statistically significant improvements in self-reported confidence levels in each of the six areas assessed (p < 0.005). Thematic analysis of free-text comments indicated that candidates enjoyed the practical format of the sessions and found the experience useful. Our results suggest that near-peer medical student simulation training benefits both teacher and learner and that this simplistic model could easily be replicated at other medical schools. As the most junior members of the team, medical students are often confined to observer status. Simulation empowers students to practise independently in a safe and protected environment. Furthermore, it may help to alleviate anxiety about starting work as a junior doctor and improve future patient care. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  12. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation.

    Science.gov (United States)

    Sørensen, Jette Led; Østergaard, Doris; LeBlanc, Vicki; Ottesen, Bent; Konge, Lars; Dieckmann, Peter; Van der Vleuten, Cees

    2017-01-21

    Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment. Thus, this intentional blend of simulation and real working environments means that in situ simulation brings simulation to the real working environment and provides training where people work. In situ simulation can be either announced or unannounced, the latter also known as a drill. This article presents and discusses the design of SBME and the advantage and disadvantage of the different simulation settings, such as training in simulation-centres, in-house simulations in hospital departments, announced or unannounced in situ simulations. Non-randomised studies argue that in situ simulation is more effective for educational purposes than other types of simulation settings. Conversely, the few comparison studies that exist, either randomised or retrospective, show that choice of setting does not seem to influence individual or team learning. However, hospital department-based simulations, such as in-house simulation and in situ simulation, lead to a gain in organisational learning. To our knowledge no studies have compared announced and unannounced in situ simulation. The literature suggests some improved organisational learning from unannounced in situ simulation; however, unannounced in situ simulation was also found to be challenging to plan and conduct, and more stressful among participants. The importance of

  13. How valid are commercially available medical simulators?

    Directory of Open Access Journals (Sweden)

    Stunt JJ

    2014-10-01

    Full Text Available JJ Stunt,1 PH Wulms,2 GM Kerkhoffs,1 J Dankelman,2 CN van Dijk,1 GJM Tuijthof1,2 1Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Centre, Amsterdam, the Netherlands; 2Department of Biomechanical Engineering, Faculty of Mechanical, Materials and Maritime Engineering, Delft University of Technology, Delft, the Netherlands Background: Since simulators offer important advantages, they are increasingly used in medical education and medical skills training that require physical actions. A wide variety of simulators have become commercially available. It is of high importance that evidence is provided that training on these simulators can actually improve clinical performance on live patients. Therefore, the aim of this review is to determine the availability of different types of simulators and the evidence of their validation, to offer insight regarding which simulators are suitable to use in the clinical setting as a training modality. Summary: Four hundred and thirty-three commercially available simulators were found, from which 405 (94% were physical models. One hundred and thirty validation studies evaluated 35 (8% commercially available medical simulators for levels of validity ranging from face to predictive validity. Solely simulators that are used for surgical skills training were validated for the highest validity level (predictive validity. Twenty-four (37% simulators that give objective feedback had been validated. Studies that tested more powerful levels of validity (concurrent and predictive validity were methodologically stronger than studies that tested more elementary levels of validity (face, content, and construct validity. Conclusion: Ninety-three point five percent of the commercially available simulators are not known to be tested for validity. Although the importance of (a high level of validation depends on the difficulty level of skills training and possible consequences when skills are

  14. Effects of High Fidelity Simulation on Knowledge Acquisition, Self-Confidence, and Satisfaction with Baccalaureate Nursing Students Using the Solomon-Four Research Design

    Science.gov (United States)

    Hall, Rachel Mattson

    2013-01-01

    High Fidelity Simulation is a teaching strategy that is becoming well-entrenched in the world of nursing education and is rapidly expanding due to the challenges and demands of the health care environment. The problem addressed in this study is the conflicting research results regarding the effectiveness of HFS for students' knowledge acquisition…

  15. High-Fidelity Multi-Rotor Unmanned Aircraft System Simulation Development for Trajectory Prediction Under Off-Nominal Flight Dynamics

    Science.gov (United States)

    Foster, John V.; Hartman, David C.

    2017-01-01

    The NASA Unmanned Aircraft System (UAS) Traffic Management (UTM) project is conducting research to enable civilian low-altitude airspace and UAS operations. A goal of this project is to develop probabilistic methods to quantify risk during failures and off nominal flight conditions. An important part of this effort is the reliable prediction of feasible trajectories during off-nominal events such as control failure, atmospheric upsets, or navigation anomalies that can cause large deviations from the intended flight path or extreme vehicle upsets beyond the normal flight envelope. Few examples of high-fidelity modeling and prediction of off-nominal behavior for small UAS (sUAS) vehicles exist, and modeling requirements for accurately predicting flight dynamics for out-of-envelope or failure conditions are essentially undefined. In addition, the broad range of sUAS aircraft configurations already being fielded presents a significant modeling challenge, as these vehicles are often very different from one another and are likely to possess dramatically different flight dynamics and resultant trajectories and may require different modeling approaches to capture off-nominal behavior. NASA has undertaken an extensive research effort to define sUAS flight dynamics modeling requirements and develop preliminary high fidelity six degree-of-freedom (6-DOF) simulations capable of more closely predicting off-nominal flight dynamics and trajectories. This research has included a literature review of existing sUAS modeling and simulation work as well as development of experimental testing methods to measure and model key components of propulsion, airframe and control characteristics. The ultimate objective of these efforts is to develop tools to support UTM risk analyses and for the real-time prediction of off-nominal trajectories for use in the UTM Risk Assessment Framework (URAF). This paper focuses on modeling and simulation efforts for a generic quad-rotor configuration typical

  16. Objective Evaluation of Flight Simulator Motion Cueing Fidelity Through a Cybernetic Approach

    NARCIS (Netherlands)

    Pool, D.M.

    2012-01-01

    Compared to aircraft, flight simulators are severely limited in their motion envelopes. Presenting the true aircraft motion one-to-one on flight simulators is generally impossible and it is therefore common practice that these motion stimuli are only presented in reduced and attenuated form. Because

  17. High-Fidelity Space-Time Adaptive Multiphysics Simulations in Nuclear Engineering

    Energy Technology Data Exchange (ETDEWEB)

    Solin, Pavel [Univ. of Reno, NV (United States); Ragusa, Jean [Texas A & M Univ., College Station, TX (United States)

    2014-03-09

    We delivered a series of fundamentally new computational technologies that have the potential to significantly advance the state-of-the-art of computer simulations of transient multiphysics nuclear reactor processes. These methods were implemented in the form of a C++ library, and applied to a number of multiphysics coupled problems relevant to nuclear reactor simulations.

  18. Virtual reality simulation training in a high-fidelity procedure suite

    DEFF Research Database (Denmark)

    Lönn, Lars; Edmond, John J; Marco, Jean

    2012-01-01

    To assess the face and content validity of a novel, full physics, full procedural, virtual reality simulation housed in a hybrid procedure suite.......To assess the face and content validity of a novel, full physics, full procedural, virtual reality simulation housed in a hybrid procedure suite....

  19. High fidelity studies of exploding foil initiator bridges, Part 3: ALEGRA MHD simulations

    Science.gov (United States)

    Neal, William; Garasi, Christopher

    2017-01-01

    Simulations of high voltage detonators, such as Exploding Bridgewire (EBW) and Exploding Foil Initiators (EFI), have historically been simple, often empirical, one-dimensional models capable of predicting parameters such as current, voltage, and in the case of EFIs, flyer velocity. Experimental methods have correspondingly generally been limited to the same parameters. With the advent of complex, first principles magnetohydrodynamic codes such as ALEGRA and ALE-MHD, it is now possible to simulate these components in three dimensions, and predict a much greater range of parameters than before. A significant improvement in experimental capability was therefore required to ensure these simulations could be adequately verified. In this third paper of a three part study, the experimental results presented in part 2 are compared against 3-dimensional MHD simulations. This improved experimental capability, along with advanced simulations, offer an opportunity to gain a greater understanding of the processes behind the functioning of EBW and EFI detonators.

  20. Real-Time and High-Fidelity Simulation Environment for Autonomous Ground Vehicle Dynamics

    Science.gov (United States)

    Cameron, Jonathan; Myint, Steven; Kuo, Calvin; Jain, Abhi; Grip, Havard; Jayakumar, Paramsothy; Overholt, Jim

    2013-01-01

    This paper reports on a collaborative project between U.S. Army TARDEC and Jet Propulsion Laboratory (JPL) to develop a unmanned ground vehicle (UGV) simulation model using the ROAMS vehicle modeling framework. Besides modeling the physical suspension of the vehicle, the sensing and navigation of the HMMWV vehicle are simulated. Using models of urban and off-road environments, the HMMWV simulation was tested in several ways, including navigation in an urban environment with obstacle avoidance and the performance of a lane change maneuver.

  1. The birds and the beans: a low-fidelity simulator for chorionic villus sampling skill acquisition.

    Science.gov (United States)

    Wax, Joseph R; Cartin, Angelina; Pinette, Michael G

    2012-08-01

    Because no simulation models are described for chorionic villus sampling (CVS), we sought to design and construct a CVS training simulator. Using materials available from our labor floor and local supermarket, we built and demonstrated a practical model for learning transabdominal and transcervical CVS. The simulator can be used to teach single- or dual-operator transabdominal CVS and traditional transcervical CVS. Aspirated "villi" immediately inform the teacher and learner of successful procedures. No image degradation or sonographically visible tracks resulted from use, permitting more than one trainee to benefit from a model. This model for transabdominal and transcervical CVS provides realistic imaging, tactile sensations, and immediate feedback.

  2. Robust High Fidelity Large Eddy Simulation Tool for Gas Turbine Combustors Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective is to develop and demonstrate the use of Large Eddy Simulation (LES) for computations of gas turbine combustor flow and transport processes, using the...

  3. High Fidelity Multi-Scale Regolith Simulation Tool for ISRU Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA has serious unmet needs for simulation tools capable of predicting the behavior of lunar regolith in proposed excavation, transport and handling systems....

  4. High Fidelity Simulation of Jet Noise Emissions from Rectangular Nozzles Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed SBIR Phase II program will lead to the validation of a state-of-the-art Large Eddy Simulation (LES) model, coupled with a Ffowcs-Williams-Hawkings...

  5. Error correction in multi-fidelity molecular dynamics simulations using functional uncertainty quantification

    CERN Document Server

    Reeve, Samuel

    2016-01-01

    We use functional, Fr\\'echet, derivatives to quantify how thermodynamic outputs of a molecular dynamics (MD) simulation depend on the potential used to compute atomic interactions. Our approach quantifies the sensitivity of the quantities of interest with respect to the input functions as opposed to its parameters as is done in typical uncertainty quantification methods. We show that the functional sensitivity of the average potential energy and pressure in isothermal, isochoric MD simulations using Lennard-Jones two-body interactions can be used to accurately predict those properties for other interatomic potentials (with different functional forms) without re-running the simulations. This is demonstrated under three different thermodynamic conditions, namely a crystal at room temperature, a liquid at ambient pressure, and a high pressure liquid. The method provides accurate predictions as long as the change in potential does not significantly affect the region in phase space explored by the simulation. The ...

  6. A high-order immersed boundary method for high-fidelity turbulent combustion simulations

    Science.gov (United States)

    Minamoto, Yuki; Aoki, Kozo; Osawa, Kosuke; Shi, Tuo; Prodan, Alexandru; Tanahashi, Mamoru

    2016-11-01

    Direct numerical simulations (DNS) have played important roles in the research of turbulent combustion. With the recent advancement in high-performance computing, DNS of slightly complicated configurations such as V-, various jet and swirl flames have been performed, and such DNS will further our understanding on the physics of turbulent combustion. Since these configurations include walls that do not necessarily conform with the preferred mesh coordinates for combustion DNS, most of these simulations use presumed profiles for inflow/near-wall flows as boundary conditions. A high-order immersed boundary method suited for parallel computation is one way to improve these simulations. The present research implements such a boundary technique in a combustion DNS code, and simulations are performed to confirm its accuracy and performance. This work was partly supported by Council for Science, Technology and Innovation, Cross-ministerial Strategic Innovation Promotion Program (SIP), "Innovative Combustion Technology" (Funding agency: JST).

  7. Undergraduate nursing students' experiences when examining nursing skills in clinical simulation laboratories with high-fidelity patient simulators: A phenomenological research study.

    Science.gov (United States)

    Sundler, Annelie J; Pettersson, Annika; Berglund, Mia

    2015-12-01

    Simulation has become a widely used and established pedagogy for teaching clinical nursing skills. Nevertheless, the evidence in favour of this pedagogical approach is weak, and more knowledge is needed in support of its use. The aim of this study was (a) to explore the experiences of undergraduate nursing students when examining knowledge, skills and competences in clinical simulation laboratories with high-fidelity patient simulators and (b) to analyse these students' learning experiences during the examination. A phenomenological approach was used, and qualitative interviews were conducted among 23 second-year undergraduate nursing students-17 women and 6 men. The findings revealed that, irrespective of whether they passed or failed the examination, it was experienced as a valuable assessment of the students' knowledge and skills. Even if the students felt that the examination was challenging, they described it as a learning opportunity. In the examination, the students were able to integrate theory with practice, and earlier established knowledge was scrutinised when reflecting on the scenarios. The examination added aspects to the students' learning that prepared them for the real world of nursing in a safe environment without risking patient safety. The study findings suggest that examinations in clinical simulation laboratories can be a useful teaching strategy in nursing education. The use of high-fidelity patient simulators made the examination authentic. The reflections and feedback on the scenario were described as significant for the students' learning. Undergraduate nursing students can improve their knowledge, understanding, competence and skills when such examinations are performed in the manner used in this study.

  8. Scalability of surrogate-assisted multi-objective optimization of antenna structures exploiting variable-fidelity electromagnetic simulation models

    Science.gov (United States)

    Koziel, Slawomir; Bekasiewicz, Adrian

    2016-10-01

    Multi-objective optimization of antenna structures is a challenging task owing to the high computational cost of evaluating the design objectives as well as the large number of adjustable parameters. Design speed-up can be achieved by means of surrogate-based optimization techniques. In particular, a combination of variable-fidelity electromagnetic (EM) simulations, design space reduction techniques, response surface approximation models and design refinement methods permits identification of the Pareto-optimal set of designs within a reasonable timeframe. Here, a study concerning the scalability of surrogate-assisted multi-objective antenna design is carried out based on a set of benchmark problems, with the dimensionality of the design space ranging from six to 24 and a CPU cost of the EM antenna model from 10 to 20 min per simulation. Numerical results indicate that the computational overhead of the design process increases more or less quadratically with the number of adjustable geometric parameters of the antenna structure at hand, which is a promising result from the point of view of handling even more complex problems.

  9. Error correction in multi-fidelity molecular dynamics simulations using functional uncertainty quantification

    Science.gov (United States)

    Reeve, Samuel Temple; Strachan, Alejandro

    2017-04-01

    We use functional, Fréchet, derivatives to quantify how thermodynamic outputs of a molecular dynamics (MD) simulation depend on the potential used to compute atomic interactions. Our approach quantifies the sensitivity of the quantities of interest with respect to the input functions as opposed to its parameters as is done in typical uncertainty quantification methods. We show that the functional sensitivity of the average potential energy and pressure in isothermal, isochoric MD simulations using Lennard-Jones two-body interactions can be used to accurately predict those properties for other interatomic potentials (with different functional forms) without re-running the simulations. This is demonstrated under three different thermodynamic conditions, namely a crystal at room temperature, a liquid at ambient pressure, and a high pressure liquid. The method provides accurate predictions as long as the change in potential can be reasonably described to first order and does not significantly affect the region in phase space explored by the simulation. The functional uncertainty quantification approach can be used to estimate the uncertainties associated with constitutive models used in the simulation and to correct predictions if a more accurate representation becomes available.

  10. Distributed interactive simulation (DIS) systems engineering fidelity, management, and usability issues in DIS exercises

    Science.gov (United States)

    McDonald, Bruce

    1995-06-01

    This paper is intended to familiarize the sensor design engineer with the capabilities of distributed interactive simulation (DIS) to support the design and test of sensor system. We define DIS terms and then discuss what DIS does to support the design and development process. Fist, DIS provides access to reusable simulation and network components that reduce the cost of tests. Second, it makes user personnel available to interact in the simulation without the expense of bringing the participants to the test site. Third, DIS has reusable computer- generated forces that provide the engineer with sufficient threats and friendlies to load the sensor system in an affordable exercise. Examples of how an engineer would design a study to take advantage of DIS capabilities are provided.

  11. Coupled high fidelity thermal hydraulics and neutronics for reactor safety simulations

    Energy Technology Data Exchange (ETDEWEB)

    Vincent A. Mousseau; Hongbin Zhang; Haihua Zhao

    2008-09-01

    This work is a continuation of previous work on the importance of accuracy in the simulation of nuclear reactor safety transients. This work is qualitative in nature and future work will be more quantitative. The focus of this work will be on a simplified single phase nuclear reactor primary. The transient of interest investigates the importance of accuracy related to passive (inherent) safety systems. The transient run here will be an Unprotected Loss of Flow (ULOF) transient. Here the coolant pump is turned off and the un’SCRAM’ed reactor transitions from forced to free convection (Natural circulation). Results will be presented that show the difference that the first order in time truncation physics makes on the transient. The purpose of this document is to illuminate a possible problem in traditional reactor simulation approaches. Detailed studies need to be done on each simulation code for each transient analyzed to determine if the first order truncation physics plays an important role.

  12. High-Fidelity Simulations of Electrically-Charged Atomizing Diesel-Type Jets

    Science.gov (United States)

    Gaillard, Benoit; Owkes, Mark; van Poppel, Bret

    2015-11-01

    Combustion of liquid fuels accounts for over a third of the energy usage today. Improving efficiency of combustion systems is critical to meet the energy needs while limiting environmental impacts. Additionally, a shift away from traditional fossil fuels to bio-derived alternatives requires fuel injection systems that can atomize fuels with a wide range of properties. In this work, the potential benefits of electrically-charged atomization is investigated using numerical simulations. Particularly, the electrostatic forces on the hydrodynamic jet are quantified and the impact of the forces is analyzed by comparing simulations of Diesel-type jets at realistic flow conditions. The simulations are performed using a state-of-the-art numerical framework that globally conserves mass, momentum, and the electric charge density even at the gas-liquid interface where discontinuities exist.

  13. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Michael Fitch

    2011-05-01

    Full Text Available Introduction: The objective of this study is to identify (1 the current role of simulation in medical student emergency medicine (EM education; (2 the challenges to initiating and sustaining simulationbased programs; and (3 educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting. Results: CDEM members representing 60 EM programs on the list (80% responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%, task trainers (55%, and low-fidelity models (30%. Respondents identified limited faculty time (88.7% and clerkship hours (47.2% as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years. Conclusion: A focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

  14. Benefits of simulation training in medical education

    Directory of Open Access Journals (Sweden)

    Abas T

    2016-07-01

    Full Text Available Tamkin Abas, Fatema Zehra JumaManchester Medical School, University of Manchester, Manchester, UKWe read about the satisfaction of simulation experiences of paramedic students1 with great interest. As medical students, with early clinical experience comparative to paramedic training in the UK, we agree that simulation-based learning is well received in health care education. As part of the curriculum at the University of Manchester, we are exposed to a variety of simulation-based environments, ranging from examining simulated patients to practicing resuscitation and emergency care on mannequins. We would like to provide insight into our understanding of where simulation training fits into health care education and highlight a key aspect of its satisfaction that we feel has been overlooked.View the original paper by Williams and colleagues

  15. Impact of Higher Fidelity Models on Simulation of Active Aerodynamic Load Control For Fatigue Damage Reduction

    NARCIS (Netherlands)

    Resor, B.; Wilson, D.; Berg, D.; Berg, J.; Barlas, T.; Van Wingerden, J.W.; Van Kuik, G.A.M.

    2010-01-01

    Active aerodynamic load control of wind turbine blades is being investigated by the wind energy research community and shows great promise, especially for reduction of turbine fatigue damage in blades and nearby components. For much of this work, full system aeroelastic codes have been used to simul

  16. A protocol for evaluating progressive levels of simulation fidelity in the development of technical skills, integrated performance and woman centred clinical assessment skills in undergraduate midwifery students.

    Science.gov (United States)

    Brady, Susannah; Bogossian, Fiona; Gibbons, Kristen; Wells, Andrew; Lyon, Pauline; Bonney, Donna; Barlow, Melanie; Jackson, Anne

    2013-05-24

    Simulation as a pedagogical approach has been used in health professional education to address the need to safely develop effective clinical skills prior to undertaking clinical practice. However, evidence for the use of simulation in midwifery is largely anecdotal, and research evaluating the effectiveness of different levels of simulation fidelity are lacking.Woman centred care is a core premise of the midwifery profession and describes the behaviours of an individual midwife who demonstrates safe and effective care of the individual woman. Woman centred care occurs when the midwife modifies the care to ensure the needs of each individual woman are respected and addressed. However, a review of the literature demonstrates an absence of a valid and reliable tool to measure the development of woman centred care behaviours. This study aims to determine which level of fidelity in simulated learning experiences provides the most effective learning outcomes in the development of woman centred clinical assessment behaviors and skills in student midwives. Three-arm, randomised, intervention trial.In this research we plan to:a) trial three levels of simulation fidelity - low, medium and progressive, on student midwives performing the procedure of vaginal examination;b) measure clinical assessment skills using the Global Rating Scale (GRS) and Integrated Procedural Performance Instrument (IPPI); andc) pilot the newly developed Woman Centred Care Scale (WCCS) to measure clinical behaviors related to Woman-Centredness. This project aims to enhance knowledge in relation to the appropriate levels of fidelity in simulation that yield the best educational outcomes for the development of woman centred clinical assessment in student midwives. The outcomes of this project may contribute to improved woman centred clinical assessment for student midwives, and more broadly influence decision making regarding education resource allocation for maternity simulation.

  17. High-fidelity simulation of a standing-wave thermoacoustic-piezoelectric engine

    CERN Document Server

    Lin, Jeffrey; Hesselink, Lambertus

    2015-01-01

    We have carried out wall-resolved fully unstructured Navier--Stokes simulations of a complete standing-wave thermoacoustic piezoelectric (TAP) engine model inspired by the experimental work of Smoker et al. (2012). The computational model is axisymmetric and comprises a 51 cm long cylindrical resonator divided into two sections: one of 19.5 mm in diameter, enclosing a thermoacoustic stack where a linear temperature distribution is imposed via isothermal boundary conditions; the other of 71 mm in diameter, capped by a piezoelectric diaphragm modelled via multi-oscillator broadband time-domain impedance boundary conditions (TDIBCs) matching the measured electromechanical impedance of a PZT-5A diaphragm tuned to the thermoacoustically amplified mode (388 Hz) for maximization of acoustic energy extraction. Simulations were first carried out without energy extraction from quiescent conditions to a limit cycle, for hot-to-cold temperature differences in the range $\\Delta T = 340 - 490\\textrm{ K}$, achieving acousti...

  18. Hybrid High Fidelity Modeling of Radar Scenarios Using Atemporal, Discrete Event, and Time Step Simulation

    Science.gov (United States)

    2016-12-01

    computational power. Such simplifications can produce misleading results. For example, Radar Cross Section (RCS) effects in response to time-varying...and corresponding limitations of computational power. Such simplifications can produce misleading results. For example, Radar Cross Section (RCS...135 xvi Figure 6.1 The RCS of F-16 Falcon fighter model which is simulated by CST Studio software with signal frequency = 8 GHz. In (a), the RCS of

  19. Real-Time and High-Fidelity Simulation Environment for Autonomous Ground Vehicle Dynamics

    Science.gov (United States)

    2013-08-01

    was rendered in OpenGL . Urban Environment The environment consisted of a 3D mesh model of a city. The mesh was created using a commercial tool...system. We rendered the 3D scene (in OpenGL ) and read back the depth buffer in a raster that matched the raster characteristics of a typical LIDAR...configure the simulation. Visualization is done using custom 3D graphics software based on OGRE and OpenGL . The software runs on a standard Linux

  20. Predicting growth of graphene nanostructures using high-fidelity atomistic simulations

    Energy Technology Data Exchange (ETDEWEB)

    McCarty, Keven F. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Zhou, Xiaowang [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ward, Donald K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Schultz, Peter A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Foster, Michael E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bartelt, Norman Charles [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    In this project we developed t he atomistic models needed to predict how graphene grows when carbon is deposited on metal and semiconductor surfaces. We first calculated energies of many carbon configurations using first principles electronic structure calculations and then used these energies to construct an empirical bond order potentials that enable s comprehensive molecular dynamics simulation of growth. We validated our approach by comparing our predictions to experiments of graphene growth on Ir, Cu and Ge. The robustness of ou r understanding of graphene growth will enable high quality graphene to be grown on novel substrates which will expand the number of potential types of graphene electronic devices.

  1. A New Coupled CFD/Neutron Kinetics System for High Fidelity Simulations of LWR Core Phenomena: Proof of Concept

    Directory of Open Access Journals (Sweden)

    Jorge Pérez Mañes

    2014-01-01

    Full Text Available The Institute for Neutron Physics and Reactor Technology (INR at the Karlsruhe Institute of Technology (KIT is investigating the application of the meso- and microscale analysis for the prediction of local safety parameters for light water reactors (LWR. By applying codes like CFD (computational fluid dynamics and SP3 (simplified transport reactor dynamics it is possible to describe the underlying phenomena in a more accurate manner than by the nodal/coarse 1D thermal hydraulic coupled codes. By coupling the transport (SP3 based neutron kinetics (NK code DYN3D with NEPTUNE-CFD, within a parallel MPI-environment, the NHESDYN platform is created. The newly developed system will allow high fidelity simulations of LWR fuel assemblies and cores. In NHESDYN, a heat conduction solver, SYRTHES, is coupled to NEPTUNE-CFD. The driver module of NHESDYN controls the sequence of execution of the solvers as well as the communication between the solvers based on MPI. In this paper, the main features of NHESDYN are discussed and the proof of the concept is done by solving a single pin problem. The prediction capability of NHESDYN is demonstrated by a code-to-code comparison with the DYNSUB code. Finally, the future developments and validation efforts are highlighted.

  2. High-fidelity Simulations of the Near-Earth Object Search Performance of the Large Synoptic Survey Telescope

    Science.gov (United States)

    Vereš, Peter; Chesley, Steven R.

    2017-07-01

    We perform high-fidelity simulations of a wide-field telescopic survey searching for Near-Earth Objects (NEOs) larger than 140 m, focusing on the observation and detection model, as well as detection efficiency and accuracy. As a test survey, we select the Large Synoptic Survey Telescope (LSST). We use its proposed pointings for a 10-year mission, and model the detection of NEOs in the fields. We discuss individual model parameters for magnitude losses, vignetting, fading, asteroid rotation and colors, fill factor, limiting magnitude, rate of motion, field shape and rotation, and survey patterns. We assess results in terms of the cumulative completeness of the detected population as a function of size and time. Additionally, we examine the sources of modeling uncertainty, and derive the overall NEO population completeness for the baseline LSST survey to be 55 ± 5% for NEOs with absolute magnitude brighter than 22. Including already discovered objects and ongoing surveys, the NEO completeness at the end of the LSST baseline survey should reach ˜77%.

  3. A novel craniotomy simulation system for evaluation of stereo-pair reconstruction fidelity and tracking

    Science.gov (United States)

    Yang, Xiaochen; Clements, Logan W.; Conley, Rebekah H.; Thompson, Reid C.; Dawant, Benoit M.; Miga, Michael I.

    2016-03-01

    Brain shift compensation using computer modeling strategies is an important research area in the field of image-guided neurosurgery (IGNS). One important source of available sparse data during surgery to drive these frameworks is deformation tracking of the visible cortical surface. Possible methods to measure intra-operative cortical displacement include laser range scanners (LRS), which typically complicate the clinical workflow, and reconstruction of cortical surfaces from stereo pairs acquired with the operating microscopes. In this work, we propose and demonstrate a craniotomy simulation device that permits simulating realistic cortical displacements designed to measure and validate the proposed intra-operative cortical shift measurement systems. The device permits 3D deformations of a mock cortical surface which consists of a membrane made of a Dragon Skin® high performance silicone rubber on which vascular patterns are drawn. We then use this device to validate our stereo pair-based surface reconstruction system by comparing landmark positions and displacements measured with our systems to those positions and displacements as measured by a stylus tracked by a commercial optical system. Our results show a 1mm average difference in localization error and a 1.2mm average difference in displacement measurement. These results suggest that our stereo-pair technique is accurate enough for estimating intra-operative displacements in near real-time without affecting the surgical workflow.

  4. Research on Fidelity Evaluation of Electromagnetic Environment Simulation Construction in Equipment Test%电磁环境模拟逼真度评估顶层研究

    Institute of Scientific and Technical Information of China (English)

    金朝; 徐忠富; 高进涛; 李广东

    2014-01-01

    Objective To study the fidelity evaluation of electromagnetic environment simulation construction in equip-ment test. Methods Based on the analysis of the conception and characteristics of fidelity evaluation of electromagnetic en-vironment, this paper established four hierarchies of the general study framework for fidelity evaluation from methodology, theory, technique and application, and clarified the basic idea for fidelity evaluation, and established the function and process model of evaluation with IDEF0 method, and presented a fidelity evaluation method based on the similarity system theory. Results This paper presented the concept of electromagnetic environment's fidelity, identified the overall theory framework, concrete contents and research methods of electromagnetic environment fidelity evaluation. Conclusion These i-deas formed the basic theory and method system about fidelity evaluation of electromagnetic environment from the top-level.%目的:研究装备试验中电磁环境模拟构建的逼真度评估问题。方法在电磁环境逼真度评估相关概念及特性分析的基础上,从指导层、理论层、方法层及应用层等4个层面建立总体研究框架,阐明评估基本思想,运用 IDEF0建模方法对评估活动及过程进行描述和建模,并提出基于相似系统理论的电磁环境逼真度评估方法。结果给出了电磁环境逼真度评估的相关概念,从总体上明确了电磁环境逼真度评估的理论框架、研究内容及方法思路。结论从顶层设计并形成了电磁环境模拟逼真度评估的基础理论和方法体系。

  5. State-of-the-art, Multi-Fidelity Modeling and Simulation (M&S) Tool for Nonlinear Aeroelasticity Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Research is proposed for the development of a state-of-the-art computational aeroelastic tool. This tool will include various levels of fidelity and the ability to...

  6. The perceptions of undergraduate student nurses of high-fidelity simulation-based learning: a case report from the University of Tasmania.

    Science.gov (United States)

    Reilly, Amanda; Spratt, Christine

    2007-08-01

    This paper reports a qualitatively informed curriculum research project in the three-year Bachelor of Nursing (BN) at the School of Nursing and Midwifery (SNM) at the University of Tasmania. The project investigated the perceptions of second year undergraduate nurses and their academic teachers of their experiences of high-fidelity simulation using the Laerdal Vital Sim Nursing Kelly and Nursing Anne technology(2) as part of their preparation for clinical practice. An associated curriculum benchmarking audit was also undertaken. A voluntary purposeful sample of students enrolled in a clinically-based practise unit(3) participated in the research, along with a small cohort of academic teachers. The results indicated that undergraduate nursing students value the opportunity to practice nursing activities in a safe environment prior to clinical placement. Students believed that simulation is an innovative strategy that promotes active learning and has great potential for developing clinical competence and increasing confidence prior to practise. The academic staff reported a similar belief about the potential of high-fidelity simulation in a case-based curriculum. The associated curriculum benchmarking audit provided evidence to support further integration of high-fidelity simulation in the undergraduate nursing program.

  7. Assessment of a high-fidelity mobile simulator for intrauterine contraception training in ambulatory reproductive health centres

    Directory of Open Access Journals (Sweden)

    Laura E. Dodge

    2016-02-01

    Full Text Available Objectives. Little is known about the utility of simulation-based training in office gynaecology. The objective of this cross-sectional study was to evaluate the self-reported effectiveness and acceptability of the PelvicSim™ (VirtaMed, a high-fidelity mobile simulator, to train clinicians in intrauterine device (IUD insertion. Methods. Clinicians at ambulatory healthcare centres participated in a PelvicSim IUD training programme and completed a self-administered survey. The survey assessed prior experience with IUD insertion, pre- and post-training competency and comfort and opinions regarding the acceptability of the PelvicSim. Results. The 237 participants were primarily female (97.5% nurse practitioners (71.3%. Most had experience inserting the levonorgestrel LNG20 IUD and the copper T380A device, but only 4.1% had ever inserted the LNG14 IUD. For all three devices, participants felt more competent following training, with the most striking change reported for insertion of the LNG14 IUD. The majority of participants reported increased comfort with uterine sounding (57.7%, IUD insertion on a live patient (69.8%, and minimizing patient pain (72.8% following training. Of the respondents, 89.6% reported the PelvicSim IUD insertion activities as “valuable” or “very valuable.” All participants would recommend the PelvicSim for IUD training, and nearly all (97.2% reported that the PelvicSim was a better method to teach IUD insertion than the simple plastic models supplied by IUD manufacturers. Conclusions. These findings support the use of the PelvicSim for IUD training, though whether it is superior to traditional methods and improves patient outcomes requires evaluation.

  8. High-fidelity numerical simulations of compressible turbulence and mixing generated by hydrodynamic instabilities

    Science.gov (United States)

    Movahed, Pooya

    High-speed flows are prone to hydrodynamic interfacial instabilities that evolve to turbulence, thereby intensely mixing different fluids and dissipating energy. The lack of knowledge of these phenomena has impeded progress in a variety of disciplines. In science, a full understanding of mixing between heavy and light elements after the collapse of a supernova and between adjacent layers of different density in geophysical (atmospheric and oceanic) flows remains lacking. In engineering, the inability to achieve ignition in inertial fusion and efficient combustion constitute further examples of this lack of basic understanding of turbulent mixing. In this work, my goal is to develop accurate and efficient numerical schemes and employ them to study compressible turbulence and mixing generated by interactions between shocked (Richtmyer-Meshkov) and accelerated (Rayleigh-Taylor) interfaces, which play important roles in high-energy-density physics environments. To accomplish my goal, a hybrid high-order central/discontinuity-capturing finite difference scheme is first presented. The underlying principle is that, to accurately and efficiently represent both broadband motions and discontinuities, non-dissipative methods are used where the solution is smooth, while the more expensive and dissipative capturing schemes are applied near discontinuous regions. Thus, an accurate numerical sensor is developed to discriminate between smooth regions, shocks and material discontinuities, which all require a different treatment. The interface capturing approach is extended to central differences, such that smooth distributions of varying specific heats ratio can be simulated without generating spurious pressure oscillations. I verified and validated this approach against a stringent suite of problems including shocks, interfaces, turbulence and two-dimensional single-mode Richtmyer-Meshkov instability simulations. The three-dimensional code is shown to scale well up to 4000 cores

  9. Nursing leadership competencies: low-fidelity simulation as a teaching strategy.

    Science.gov (United States)

    Pollard, Cheryl L; Wild, Carol

    2014-11-01

    Nurses must demonstrate leadership and followership competencies within complex adaptive team environments to ensure patient and staff safety, effective use of resources, and an adaptive health care system. These competencies are demonstrated through the use of communication strategies that are embedded within a relational practice. Health care professionals, regardless of formal position, need to assert their opinions and perspectives using a communication style that demonstrates value of all team members in open discussions about quality patient care, appropriate access, and stewardship. Challenges to effective communication and relational practice are the individual and organizational patterns of behavior, and the subsequent impact that these behaviors have on others. Students articulate situational awareness when they conduct a critical analysis of individual, team, and organizational functioning, and then use this information and evidence gained from a critical literature review to develop recommendations to improve individual, team, and/or organizational performance. Leadership and followership simulation exercises, inclusive of public feedback and debriefing, are used as a pedagogical/andragogical strategy in a nursing baccalaureate senior leadership course to facilitate learning of team communication skills and improve situational awareness. We view this strategy as an alternative to traditional classroom learning activities which provide little opportunity for recursive learning.

  10. Toward real-time high-fidelity simulation using integral boundary layer modeling

    CERN Document Server

    Marques, Alexandre; Larsson, Johan; Laskowski, Gregory; Bose, Sanjeeb

    2016-01-01

    One of the greatest challenges to using large-eddy simulations (LES) in engineering applications is the large number of grid points required near walls. To mitigate this issue, researchers often couple LES with a simplified model of the flow close to the wall, known as the wall model. One feature common to most wall models is that the first few (about 3) grid points must be located below the inviscid log-layer, and the grid must have near-isotropic resolution near the wall. Hence, wall-modeled LES may still require a large number of grid points in both the wall-normal and span-wise directions. Because of these requirements, wall-modeled LES is still unfeasible in many applications. We present a new formulation of wall-modeled LES that is being developed to address this issue. In this formulation, LES is used to solve only for the features of the velocity field that can be adequately represented on the LES grid. The effects of the unresolved features are captured by imposing an integral balance of kinetic ener...

  11. [Simulation in medical education: a synopsis].

    Science.gov (United States)

    Corvetto, Marcia; Bravo, María Pía; Montaña, Rodrigo; Utili, Franco; Escudero, Eliana; Boza, Camilo; Varas, Julián; Dagnino, Jorge

    2013-01-01

    Clinical simulation is defined as a technique (not a technology) to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Over the past few years, there has been a significant growth in its use, both as a learning tool and as an assessment for accreditation. Example of this is the fact that simulation is an integral part of medical education curricula abroad. Some authors have cited it as an unavoidable necessity or as an ethical imperative. In Chile, its formal inclusion in Medical Schools' curricula has just begun. This review is an overview of this important educational tool, presenting the evidence about its usefulness in medical education and describing its current situation in Chile.

  12. Medical Image Registration and Surgery Simulation

    DEFF Research Database (Denmark)

    Bro-Nielsen, Morten

    1996-01-01

    This thesis explores the application of physical models in medical image registration and surgery simulation. The continuum models of elasticity and viscous fluids are described in detail, and this knowledge is used as a basis for most of the methods described here. Real-time deformable models......, and the use of selective matrix vector multiplication. Fluid medical image registration A new and faster algorithm for non-rigid registration using viscous fluid models is presented. This algorithm replaces the core part of the original algorithm with multi-resolution convolution using a new filter, which...... for surgery simulation Real-time deformable models, using finite element models of linear elasticity, have been developed for surgery simulation. The time consumption of the finite element method is reduced dramaticly, by the use of condensation techniques, explicit inversion of the stiffness matrix...

  13. The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students.

    Science.gov (United States)

    Tuzer, Hilal; Dinc, Leyla; Elcin, Melih

    2016-10-01

    Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety. The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences. A mixed-method explanatory sequential design. The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital. Fifty-two fourth-year nursing students. Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator. Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (pthorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 一种高逼真度的控制显示组件仿真方法%High Fidelity Control and Display Unit Simulation Method

    Institute of Scientific and Technical Information of China (English)

    廖峰; 郑书朋; 侯伟钦; 姜洪洲

    2011-01-01

    In order to improve the visual feelings and simulation fidelity of Control and Display Unit(CDU) in flight simulator research, based on embedded PC104 CPU and 8255 programmable interface card, this paper designs membrane keyboard hardware circuit and keyboard code scan program and realizes the high fidelity simulation for CDU keyboard. Meanwhile, the CDU simulation page is constructed by utilizing object-oriented simulation technique. It successfully tackles pages system's tiresome generation and management problem. Simulation experimental results show that the method realistically implements routing data and performance parameters input and display in flight simulation.%为增强飞行员对控制显示组件(CDU)的直观感受,提高CDU仿真的逼真度,基于嵌入式PC104 CPU和8255可编程设备接口卡,设计仿真键盘硬件电路和键盘码扫描程序,实现对CDU键盘的高逼真硬件仿真.利用面向对象仿真技术,创建出CDU仿真页面,有效解决了页面系统繁重的生成与管理问题.仿真实验结果表明,该方法能够逼真地实现对飞行计算航路数据和性能参数的输入与显示.

  15. Judicious Use of Simulation Technology in Continuing Medical Education

    Science.gov (United States)

    Curtis, Michael T.; DiazGranados, Deborah; Feldman, Moshe

    2012-01-01

    Use of simulation-based training is fast becoming a vital source of experiential learning in medical education. Although simulation is a common tool for undergraduate and graduate medical education curricula, the utilization of simulation in continuing medical education (CME) is still an area of growth. As more CME programs turn to simulation to…

  16. Optical simulation for imaging reconnaissance and intelligence sensors OSIRIS: High fidelity sensor simulation test bed; Modified user`s manual

    Energy Technology Data Exchange (ETDEWEB)

    Abernathy, M.F.; Puccetti, M.G.

    1988-01-04

    The OSIRIS program is an imaging optical simulation program which has been developed to predict the output of space-borne sensor systems. The simulation is radiometrically precise and includes highly realistic laser, atmosphere, and earth background models, as well as detailed models of optical components. This system was developed by Rockwell Power Services for the Los Alamos National Laboratory. It is based upon the LARC (Los Alamos Radiometry Code, also by Rockwell), and uses a similar command structure and 3d coordinate system as LARC. At present OSIRIS runs on the Cray I computer under the CTSS operating s stem, and is stored in the OSIRIS root directory on LANL CTSS mass storage.

  17. The break-even point: when medical advances are less important than improving the fidelity with which they are delivered.

    Science.gov (United States)

    Woolf, Steven H; Johnson, Robert E

    2005-01-01

    Society invests billions of dollars in the development of new drugs and technologies but comparatively little in the fidelity of health care, that is, improving systems to ensure the delivery of care to all patients in need. Using mathematical arguments and a nomogram, we demonstrate that technological advances must yield dramatic, often unrealistic increases in efficacy to do more good than could be accomplished by improving fidelity. In 2 examples (the development of anti-platelet agents and statins), we show that enhanced efficacy failed to achieve the health gains that would have occurred by delivering older agents to all eligible patients. Society's huge investment in technological innovations that only modestly improve efficacy, by consuming resources needed for improved delivery of care, may cost more lives than it saves. The misalignment of priorities is driven partly by the commercial interests of industry and by the public's appetite for technological breakthroughs, but health outcomes ultimately suffer. Health, economic, and moral arguments make the case for spending less on technological advances and more on improving systems for delivering care.

  18. High fidelity simulation and analysis of liquid jet atomization in a gaseous crossflow at intermediate Weber numbers

    Science.gov (United States)

    Li, Xiaoyi; Soteriou, Marios C.

    2016-08-01

    Recent advances in numerical methods coupled with the substantial enhancements in computing power and the advent of high performance computing have presented first principle, high fidelity simulation as a viable tool in the prediction and analysis of spray atomization processes. The credibility and potential impact of such simulations, however, has been hampered by the relative absence of detailed validation against experimental evidence. The numerical stability and accuracy challenges arising from the need to simulate the high liquid-gas density ratio across the sharp interfaces encountered in these flows are key reasons for this. In this work we challenge this status quo by presenting a numerical model able to deal with these challenges, employing it in simulations of liquid jet in crossflow atomization and performing extensive validation of its results against a carefully executed experiment with detailed measurements in the atomization region. We then proceed to the detailed analysis of the flow physics. The computational model employs the coupled level set and volume of fluid approach to directly capture the spatiotemporal evolution of the liquid-gas interface and the sharp-interface ghost fluid method to stably handle high liquid-air density ratio. Adaptive mesh refinement and Lagrangian droplet models are shown to be viable options for computational cost reduction. Moreover, high performance computing is leveraged to manage the computational cost. The experiment selected for validation eliminates the impact of inlet liquid and gas turbulence and focuses on the impact of the crossflow aerodynamic forces on the atomization physics. Validation is demonstrated by comparing column surface wavelengths, deformation, breakup locations, column trajectories and droplet sizes, velocities, and mass rates for a range of intermediate Weber numbers. Analysis of the physics is performed in terms of the instability and breakup characteristics and the features of downstream

  19. The effect of task load on the occurrence of cognitive lockup in a high-fidelity flight simulator

    NARCIS (Netherlands)

    Looije, R.; Mioch, T.

    2011-01-01

    Motivation To analyse human errors and determine the underlying reason for these errors, in particular by investigating the error production mechanism cognitive lockup. Research approach A within subjects experiment has been conducted with 16 pilots in a high-fidelity and realistic environment. The

  20. A 1-week simulated internship course helps prepare medical students for transition to residency.

    Science.gov (United States)

    Laack, Torrey A; Newman, James S; Goyal, Deepi G; Torsher, Laurence C

    2010-06-01

    The transition from medical student to intern is inherently stressful, with potentially negative consequences for both interns and patients. We describe Internship Boot Camp, an innovative course specifically designed to prepare fourth-year medical students for the transition from medical school to internship. An intensive 1-week course, Internship Boot Camp has simulated, longitudinal patient-care scenarios that use high-fidelity medical simulation, standardized patients, procedural task trainers, and problem-based learning to help students apply their knowledge and develop a framework for response to the challenges they will face as interns. In March 2007, 12 students participated in the course as an elective in their final year of medical school, and the other 28 students in their class did not. After beginning internship and 5 to 7 months after the completion of Internship Boot Camp, all 40 former students were asked to complete a blinded survey about their preparation for internship. The overall response rate for the survey was 80%. Of responders to an open-ended question about the aspects of medical school training that best prepared them for internship, 89% (8 of 9) of course participants listed "Internship Boot Camp." The next highest response ("subinternship") was given by 45% (9 of 20) of nonparticipants and 33% (3 of 9) of course participants. Internship Boot Camp is a unique learning environment that is recalled by participants as the most helpful, of all components of their medical school education, in preparation for internship.

  1. MEDICAL STAFF SCHEDULING USING SIMULATED ANNEALING

    Directory of Open Access Journals (Sweden)

    Ladislav Rosocha

    2015-07-01

    Full Text Available Purpose: The efficiency of medical staff is a fundamental feature of healthcare facilities quality. Therefore the better implementation of their preferences into the scheduling problem might not only rise the work-life balance of doctors and nurses, but also may result into better patient care. This paper focuses on optimization of medical staff preferences considering the scheduling problem.Methodology/Approach: We propose a medical staff scheduling algorithm based on simulated annealing, a well-known method from statistical thermodynamics. We define hard constraints, which are linked to legal and working regulations, and minimize the violations of soft constraints, which are related to the quality of work, psychic, and work-life balance of staff.Findings: On a sample of 60 physicians and nurses from gynecology department we generated monthly schedules and optimized their preferences in terms of soft constraints. Our results indicate that the final value of objective function optimized by proposed algorithm is more than 18-times better in violations of soft constraints than initially generated random schedule that satisfied hard constraints.Research Limitation/implication: Even though the global optimality of final outcome is not guaranteed, desirable solutionwas obtained in reasonable time. Originality/Value of paper: We show that designed algorithm is able to successfully generate schedules regarding hard and soft constraints. Moreover, presented method is significantly faster than standard schedule generation and is able to effectively reschedule due to the local neighborhood search characteristics of simulated annealing.

  2. Severe Trauma Stress Inoculation Training for Combat Medics using High Fidelity Simulation

    Science.gov (United States)

    2013-12-01

    mentally, psychologically, or technically prepared to treat such emotionally disturbing wounds. Soldiers treating such wounds must be trained in a...a new area of research, pain response (Bieri, Reeve , Champion, & Addicoat, 1990; Botvinick et al., 2005; Craig, 1992; Deyo, Prkachin, & Mercer...personnel emotionally , physically, and psychologically for the real battlefield, mitigating the incidences of PTSD in the long run. The results from

  3. A critical review of simulation-based medical education research: 2003-2009.

    Science.gov (United States)

    McGaghie, William C; Issenberg, S Barry; Petrusa, Emil R; Scalese, Ross J

    2010-01-01

    This article reviews and critically evaluates historical and contemporary research on simulation-based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969-2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003-2009. The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high-stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record. Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation-based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts.

  4. Using ensembles of simulations to find high-fidelity post-shot models of inertial confinement implosions at the National Ignition Facility

    Science.gov (United States)

    Nora, Ryan; Field, John E.; Spears, Brian; Thomas, Cliff A.

    2016-10-01

    The inertial confinement fusion program at the National Ignition Facility is performing subscale experiments for a variety of implosion designs. Successful designs, those with experiments that are similar to postshot simulation, will be fielded at larger scale. This work supports the program's effort by establishing high fidelity post-shot simulations matching all experimental observables: scalar data, such as the neutron yield and areal densities; vector data, such as flange nuclear activation diagnostics; and image data, such as time-dependent x-ray self-emission images. We will present a metric for measuring the nearness of postshot simulations to experiments. In particular, we will emphasize area-based (as opposed to contour-based) image analysis metrics (e.g., Zernike moments) for comparison of x-ray self-emission images. The postshot metrics and methodology will be applied to the Big Foot implosion design as an example.

  5. Status report on multigroup cross section generation code development for high-fidelity deterministic neutronics simulation system.

    Energy Technology Data Exchange (ETDEWEB)

    Yang, W. S.; Lee, C. H. (Nuclear Engineering Division)

    2008-05-16

    Under the fast reactor simulation program launched in April 2007, development of an advanced multigroup cross section generation code was initiated in July 2007, in conjunction with the development of the high-fidelity deterministic neutron transport code UNIC. The general objectives are to simplify the existing multi-step schemes and to improve the resolved and unresolved resonance treatments. Based on the review results of current methods and the fact that they have been applied successfully to fast critical experiment analyses and fast reactor designs for last three decades, the methodologies of the ETOE-2/MC{sup 2}-2/SDX code system were selected as the starting set of methodologies for multigroup cross section generation for fast reactor analysis. As the first step for coupling with the UNIC code and use in a parallel computing environment, the MC{sup 2}-2 code was updated by modernizing the memory structure and replacing old data management package subroutines and functions with FORTRAN 90 based routines. Various modifications were also made in the ETOE-2 and MC{sup 2}-2 codes to process the ENDF/B-VII.0 data properly. Using the updated ETOE-2/MC{sup 2}-2 code system, the ENDF/B-VII.0 data was successfully processed for major heavy and intermediate nuclides employed in sodium-cooled fast reactors. Initial verification tests of the MC{sup 2}-2 libraries generated from ENDF/B-VII.0 data were performed by inter-comparison of twenty-one group infinite dilute total cross sections obtained from MC{sup 2}-2, VIM, and NJOY. For almost all nuclides considered, MC{sup 2}-2 cross sections agreed very well with those from VIM and NJOY. Preliminary validation tests of the ENDF/B-VII.0 libraries of MC{sup 2}-2 were also performed using a set of sixteen fast critical benchmark problems. The deterministic results based on MC{sup 2}-2/TWODANT calculations were in good agreement with MCNP solutions within {approx}0.25% {Delta}{rho}, except a few small LANL fast assemblies

  6. Simulation in Medical School Education: Review for Emergency Medicine

    OpenAIRE

    Shahram Lotfipour; T. Kent Denmark; Christopher Erik McCoy; Srinidhi Subraya Bhat; Elizabeth ter Haar; Bharath Chakravarthy

    2011-01-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documente...

  7. Medical image archive node simulation and architecture

    Science.gov (United States)

    Chiang, Ted T.; Tang, Yau-Kuo

    1996-05-01

    It is a well known fact that managed care and new treatment technologies are revolutionizing the health care provider world. Community Health Information Network and Computer-based Patient Record projects are underway throughout the United States. More and more hospitals are installing digital, `filmless' radiology (and other imagery) systems. They generate a staggering amount of information around the clock. For example, a typical 500-bed hospital might accumulate more than 5 terabytes of image data in a period of 30 years for conventional x-ray images and digital images such as Magnetic Resonance Imaging and Computer Tomography images. With several hospitals contributing to the archive, the storage required will be in the hundreds of terabytes. Systems for reliable, secure, and inexpensive storage and retrieval of digital medical information do not exist today. In this paper, we present a Medical Image Archive and Distribution Service (MIADS) concept. MIADS is a system shared by individual and community hospitals, laboratories, and doctors' offices that need to store and retrieve medical images. Due to the large volume and complexity of the data, as well as the diversified user access requirement, implementation of the MIADS will be a complex procedure. One of the key challenges to implementing a MIADS is to select a cost-effective, scalable system architecture to meet the ingest/retrieval performance requirements. We have performed an in-depth system engineering study, and developed a sophisticated simulation model to address this key challenge. This paper describes the overall system architecture based on our system engineering study and simulation results. In particular, we will emphasize system scalability and upgradability issues. Furthermore, we will discuss our simulation results in detail. The simulations study the ingest/retrieval performance requirements based on different system configurations and architectures for variables such as workload, tape

  8. Face and content validity of a novel, web-based otoscopy simulator for medical education.

    Science.gov (United States)

    Wickens, Brandon; Lewis, Jordan; Morris, David P; Husein, Murad; Ladak, Hanif M; Agrawal, Sumit K

    2015-02-24

    Despite the fact that otoscopy is a widely used and taught diagnostic tool during medical training, errors in diagnosis are common. Physical otoscopy simulators have high fidelity, but they can be expensive and only a limited number of students can use them at a given time. 1) To develop a purely web-based otoscopy simulator that can easily be distributed to students over the internet. 2) To assess face and content validity of the simulator by surveying experts in otoscopy. An otoscopy simulator, OtoTrain™, was developed at Western University using web-based programming and Unity 3D. Eleven experts from academic institutions in North America were recruited to test the simulator and respond to an online questionnaire. A 7-point Likert scale was used to answer questions related to face validity (realism of the simulator), content validity (expert evaluation of subject matter and test items), and applicability to medical training. The mean responses for the face validity, content validity, and applicability to medical training portions of the questionnaire were all ≤3, falling between the "Agree", "Mostly Agree", and "Strongly Agree" categories. The responses suggest good face and content validity of the simulator. Open-ended questions revealed that the primary drawbacks of the simulator were the lack of a haptic arm for force feedback, a need for increased focus on pneumatic otoscopy, and few rare disorders shown on otoscopy. OtoTrain™ is a novel, web-based otoscopy simulator that can be easily distributed and used by students on a variety of platforms. Initial face and content validity was encouraging, and a skills transference study is planned following further modifications and improvements to the simulator.

  9. Medical simulation topic interests in a pediatric healthcare system.

    Science.gov (United States)

    Deutsch, Ellen S; Olivieri, Jason J; Hossain, Jobayer; Sobolewski, Heather L

    2010-10-01

    Encouraged by evidence suggesting that simulation-based educational programs can translate to improved patient care, interest and investment in medical simulation have grown considerably in the past decade. Despite such growth, simulation is still a developing field, and little is known of the perceived needs for simulation training among practicing clinicians. This study describes medical simulation interests among clinicians in a pediatric health care system. A web-based survey addressing previous medical simulation experience, medical simulation interests, and demographics was distributed to physicians, nurses, and respiratory therapists within a pediatric healthcare system in the Delaware Valley. All three groups expressed the highest level of interest in simulated resuscitation events ("mock codes") and the least interest in simulations involving communication and electronic medical records. "Airway problems" was identified as the most popular medical simulation topic of interest. Although the rank order of interest in medical simulation categories was similar across groups, physicians reported the lowest levels of interest in all simulation categories. Characteristics such as previous simulation experience and group (eg, nurses and respiratory therapists) were associated with medical simulation interests. Years in practice did not impact interest. For adult learners, educational experiences should be targeted to the learners' perceived needs but should also address unrecognized deficits. Collectively, physicians, nurses, and respiratory therapists were most interested in participating in simulations addressing "codes" (emergency resuscitations) and airway management; these perceptions may provide a focus for designing simulation events that appeal to diverse learning styles. Prior experience with medical simulation seems to increase interest in subsequent simulation activities and offers the optimistic possibility that first-hand experience with simulation

  10. Simulation in Medical School Education: Review for Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Shahram Lotfipour

    2011-05-01

    Full Text Available Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM. The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

  11. Simulation in medical school education: review for emergency medicine.

    Science.gov (United States)

    Chakravarthy, Bharath; Ter Haar, Elizabeth; Bhat, Srinidhi Subraya; McCoy, Christopher Eric; Denmark, T Kent; Lotfipour, Shahram

    2011-11-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

  12. Playing doctor: Simulation in medical school as affective practice.

    Science.gov (United States)

    Underman, Kelly

    2015-07-01

    Simulated patient encounters, in which a trained layperson role-plays a patient, have become increasingly important in medical education. One such type is the gynecological teaching associate (GTA), who teaches medical students how to perform the pelvic examination using her own body. This paper considers the role that simulation like the GTA session plays in medical students' professional socialization. Drawn from interviews and archival sources gathered from medical students, medical faculty, and GTAs, this paper explores the tensions between artificiality and authenticity in order to understand how, through pedagogical practice, medical students come to embody medical culture through simulation. This paper uses the theoretical framework of the medical habitus to understand the role of emotion in medical student socialization. It argues that simulation is an example of affective practice: any rehearsal of techniques or styles of expressing, experiencing, or managing emotion that reshape the body's capacity to feel. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. A proposal of monitoring and forecasting system for crustal activity in and around Japan using a large-scale high-fidelity finite element simulation codes

    Science.gov (United States)

    Hori, T.; Ichimura, T.

    2015-12-01

    Here we propose a system for monitoring and forecasting of crustal activity, especially great interplate earthquake generation and its preparation processes in subduction zone. Basically, we model great earthquake generation as frictional instability on the subjecting plate boundary. So, spatio-temporal variation in slip velocity on the plate interface should be monitored and forecasted. Although, we can obtain continuous dense surface deformation data on land and partly at the sea bottom, the data obtained are not fully utilized for monitoring and forecasting. It is necessary to develop a physics-based data analysis system including (1) a structural model with the 3D geometry of the plate interface and the material property such as elasticity and viscosity, (2) calculation code for crustal deformation and seismic wave propagation using (1), (3) inverse analysis or data assimilation code both for structure and fault slip using (1)&(2). To accomplish this, it is at least necessary to develop highly reliable large-scale simulation code to calculate crustal deformation and seismic wave propagation for 3D heterogeneous structure. Actually, Ichimura et al. (2014, SC14) has developed unstructured FE non-linear seismic wave simulation code, which achieved physics-based urban earthquake simulation enhanced by 10.7 BlnDOF x 30 K time-step. Ichimura et al. (2013, GJI) has developed high fidelity FEM simulation code with mesh generator to calculate crustal deformation in and around Japan with complicated surface topography and subducting plate geometry for 1km mesh. Further, for inverse analyses, Errol et al. (2012, BSSA) has developed waveform inversion code for modeling 3D crustal structure, and Agata et al. (2015, this meeting) has improved the high fidelity FEM code to apply an adjoint method for estimating fault slip and asthenosphere viscosity. Hence, we have large-scale simulation and analysis tools for monitoring. Furthermore, we are developing the methods for

  14. The Numerical Nuclear Reactor for High-Fidelity Integrated Simulation of Neutronic, Thermal-Hydraulic, and Thermo-Mechanical Phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. S.; Ju, H. G.; Jeon, T. H. and others

    2005-03-15

    A comprehensive high fidelity reactor core modeling capability has been developed for detailed analysis of current and advanced reactor designs as part of a US-ROK collaborative I-NERI project. High fidelity was accomplished by integrating highly refined solution modules for the coupled neutronic, thermal-hydraulic, and thermo-mechanical phenomena. Each solution module employs methods and models that are formulated faithfully to the first-principles governing the physics, real geometry, and constituents. Specifically, the critical analysis elements that are incorporated in the coupled code capability are whole-core neutron transport solution, ultra-fine-mesh computational fluid dynamics/heat transfer solution, and finite-element-based thermo-mechanics solution, all obtained with explicit (fuel pin cell level) heterogeneous representations of the components of the core. The vast computational problem resulting from such highly refined modeling is solved on massively parallel computers, and serves as the 'numerical nuclear reactor'. Relaxation of modeling parameters were also pursued to make problems run on clusters of workstations and PCs for smaller scale applications as well.

  15. A randomized trial comparing didactics, demonstration, and simulation for teaching teamwork to medical residents.

    Science.gov (United States)

    Semler, Matthew W; Keriwala, Raj D; Clune, Jennifer K; Rice, Todd W; Pugh, Meredith E; Wheeler, Arthur P; Miller, Alison N; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A

    2015-04-01

    Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel "Recognize, Respond, Reassess" score. Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs(2)] = 0.267, P teamwork training by expert demonstration resulted in similar teamwork behavior to participation in high-fidelity simulation and was more effective than traditional didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities.

  16. Exploration of high-fidelity simulation: Nurse educators’ perceptions and experiences at a school of nursing in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    T Munangatire

    2017-03-01

    Full Text Available Background. Simulations are defined as situations where models are used for practice and to gain experience that will enhance students’ practical skills. The use of simulations in clinical skills training can stimulate deep learning and help students to bridge the gap between theory and practice in nursing. This has been revealed in many studies where simulations positively impacted on clinical decision-making and patient care, and there has been great interest in the use of simulation in nurse training. However, the introduction of technologically driven simulators, especially in resourceconstrained settings, has been met with mixed feelings. Objective. To explore the perceptions and experiences of nurse educators in using high-fidelity simulation (HFS in teaching. Methods. A qualitative case study design was utilised. Seven educators at a school of nursing, which has HFS, participated in a focus group discussion. Data were thematically analysed. Results. Four themes emerged from the educators’ experiences and perceptions. The use and benefits of HFS were generally accepted by educators. They valued its positive impact on learning outcomes in learners and the ability to simulate more complex scenarios during training. Lack of prior planning, inadequate training and lack of resources impacted negatively on the effective use and implementation of HFS. Conclusion. The results indicated that nurse educators perceived HFS as a learning pedagogy that can improve students’ learning outcomes if used effectively. They believed that to realise the potential of HFS, more support should be provided through training, the availability of necessary resources, and improved planning and organisation.

  17. Simulation based virtual learning environment in medical genetics counseling

    DEFF Research Database (Denmark)

    Makransky, Guido; Bonde, Mads T.; Wulff, Julie S. G.

    2016-01-01

    BACKGROUND: Simulation based learning environments are designed to improve the quality of medical education by allowing students to interact with patients, diagnostic laboratory procedures, and patient data in a virtual environment. However, few studies have evaluated whether simulation based lea...

  18. Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

    Directory of Open Access Journals (Sweden)

    Jeremy D. Sperling

    2013-04-01

    Full Text Available Introduction: Simulation-based medical education (SBME is increasingly being utilized for teaching clinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teaching clinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students’ knowledge acquisition, comfort, and perceived competence with regards to the AMS patient. Methods: AMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS. Results: A total of 154 students completed the post-test and survey and 65 (42% attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (p<0.001. Students who participated in a simulation session were more comfortable in their overall approach to treating AMS patients (p=0.05. They were also more likely to state that they could articulate a differential diagnosis (p=0.03, know what initial diagnostic tests are needed (p=0.01, and understand what interventions are useful in the first few minutes (p=0.003. Students who participated in a simulation session

  19. Physiological and self assessed psychological stress induced by a high fidelity simulation course among third year anaesthesia and critical care residents: an observational study.

    Science.gov (United States)

    Geeraerts, Pr Thomas

    2017-06-22

    The use of high-fidelity simulators in Medicine can improve knowledge, behavior and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anesthesia and critical care residents. A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session. Technical and non-technical (using the Aberdeen Anaesthetists' Non Technical Skills scale) performances were assessed through videotapes analysis. The median stress score was 5 [2-8] before and 7 [2-10] after the simulation session (ptechnical performance. Simulation-induced stress, as measured by self-assessment and biological parameter, is high before the session and increases significantly during the course. While this stress did not seem to impact performance negatively, it should be taken into account. Copyright © 2017. Published by Elsevier Masson SAS.

  20. Information Processing, Specificity of Practice, and the Transfer of Learning: Considerations for Reconsidering Fidelity

    Science.gov (United States)

    Grierson, Lawrence E. M.

    2014-01-01

    Much has been made in the recent medical education literature of the incorrect characterization of simulation along a continuum of low to high fidelity (Cook et al. "JAMA" 306(9): 978-988, 2011; Norman et al. "Med Educ" 46(7): 636-647, 2012; Teteris et al. "Adv Health Sci Educ" 17(1): 137-144, 2012). For the most…

  1. Medical simulation: Overview, and application to wound modelling and management

    Directory of Open Access Journals (Sweden)

    Dinker R Pai

    2012-01-01

    Full Text Available Simulation in medical education is progressing in leaps and bounds. The need for simulation in medical education and training is increasing because of a overall increase in the number of medical students vis-à-vis the availability of patients; b increasing awareness among patients of their rights and consequent increase in litigations and c tremendous improvement in simulation technology which makes simulation more and more realistic. Simulation in wound care can be divided into use of simulation in wound modelling (to test the effect of projectiles on the body and simulation for training in wound management. Though this science is still in its infancy, more and more researchers are now devising both low-technology and high-technology (virtual reality simulators in this field. It is believed that simulator training will eventually translate into better wound care in real patients, though this will be the subject of further research.

  2. Low-Fidelity Haptic Simulation Versus Mental Imagery Training for Epidural Anesthesia Technical Achievement in Novice Anesthesiology Residents: A Randomized Comparative Study.

    Science.gov (United States)

    Lim, Grace; Krohner, Robert G; Metro, David G; Rosario, Bedda L; Jeong, Jong-Hyeon; Sakai, Tetsuro

    2016-05-01

    There are many teaching methods for epidural anesthesia skill acquisition. Previous work suggests that there is no difference in skill acquisition whether novice learners engage in low-fidelity (LF) versus high-fidelity haptic simulation for epidural anesthesia. No study, however, has compared the effect of LF haptic simulation for epidural anesthesia versus mental imagery (MI) training in which no physical practice is attempted. We tested the hypothesis that MI training is superior to LF haptic simulation training for epidural anesthesia skill acquisition. Twenty Post-Graduate Year 2 (PGY-2) anesthesiology residents were tested at the beginning of the training year. After a didactic lecture on epidural anesthesia, they were randomized into 2 groups. Group LF had LF simulation training for epidural anesthesia using a previously described banana simulation technique. Group MI had guided, scripted MI training in which they initially were oriented to the epidural kit components and epidural anesthesia was described stepwise in detail, followed by individual mental rehearsal; no physical practice was undertaken. Each resident then individually performed epidural anesthesia on a partial-human task trainer on 3 consecutive occasions under the direct observation of skilled evaluators who were blinded to group assignment. Technical achievement was assessed with the use of a modified validated skills checklist. Scores (0-21) and duration to task completion (minutes) were recorded. A linear mixed-effects model analysis was performed to determine the differences in scores and duration between groups and over time. There was no statistical difference between the 2 groups for scores and duration to task completion. Both groups showed similarly significant increases (P = 0.0015) in scores over time (estimated mean score [SE]: group MI, 15.9 [0.55] to 17.4 [0.55] to 18.6 [0.55]; group LF, 16.2 [0.55] to 17.7 [0.55] to 18.9 [0.55]). Time to complete the procedure decreased

  3. Medical Students as Facilitators for Laparoscopic Simulator Training

    DEFF Research Database (Denmark)

    Vedel, Cathrine; Bjerrum, Flemming; Mahmood, Badar

    2015-01-01

    BACKGROUND: Teaching basic clinical skills to student peers and residents by medical students has previously been shown effective. This study examines if medical students can facilitate laparoscopic procedural tasks to residents using a virtual reality simulator. METHODS: This was a retrospective...... practicing on a laparoscopic virtual reality simulator....

  4. The effectiveness of and satisfaction with high-fidelity simulation to teach cardiac surgical resuscitation skills to nurses.

    Science.gov (United States)

    McRae, Marion E; Chan, Alice; Hulett, Renee; Lee, Ai Jin; Coleman, Bernice

    2017-06-01

    There are few reports of the effectiveness or satisfaction with simulation to learn cardiac surgical resuscitation skills. To test the effect of simulation on the self-confidence of nurses to perform cardiac surgical resuscitation simulation and nurses' satisfaction with the simulation experience. A convenience sample of sixty nurses rated their self-confidence to perform cardiac surgical resuscitation skills before and after two simulations. Simulation performance was assessed. Subjects completed the Satisfaction with Simulation Experience scale and demographics. Self-confidence scores to perform all cardiac surgical skills as measured by paired t-tests were significantly increased after the simulation (d=-0.50 to 1.78). Self-confidence and cardiac surgical work experience were not correlated with time to performance. Total satisfaction scores were high (mean 80.2, SD 1.06) indicating satisfaction with the simulation. There was no correlation of the satisfaction scores with cardiac surgical work experience (τ=-0.05, ns). Self-confidence scores to perform cardiac surgical resuscitation procedures were higher after the simulation. Nurses were highly satisfied with the simulation experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Medical simulation in respiratory and critical care medicine.

    Science.gov (United States)

    Lam, Godfrey; Ayas, Najib T; Griesdale, Donald E; Peets, Adam D

    2010-12-01

    Simulation-based medical education has gained tremendous popularity over the past two decades. Driven by the patient safety movement, changes in the educational opportunities available to trainees and the rapidly evolving capabilities of computer technology, simulation-based medical education is now being used across the continuum of medical education. This review provides the reader with a perspective on simulation specific to respiratory and critical care medicine, including an overview of historical and modern simulation modalities and the current evidence supporting their use.

  6. Inspiring careers in STEM and healthcare fields through medical simulation embedded in high school science education.

    Science.gov (United States)

    Berk, Louis J; Muret-Wagstaff, Sharon L; Goyal, Riya; Joyal, Julie A; Gordon, James A; Faux, Russell; Oriol, Nancy E

    2014-09-01

    The most effective ways to promote learning and inspire careers related to science, technology, engineering, and mathematics (STEM) remain elusive. To address this gap, we reviewed the literature and designed and implemented a high-fidelity, medical simulation-based Harvard Medical School MEDscience course, which was integrated into high school science classes through collaboration between medical school and K-12 faculty. The design was based largely on the literature on concepts and mechanisms of self-efficacy. A structured telephone survey was conducted with 30 program alumni from the inaugural school who were no longer in high school. Near-term effects, enduring effects, contextual considerations, and diffusion and dissemination were queried. Students reported high incoming attitudes toward STEM education and careers, and these attitudes showed before versus after gains (P < .05). Students in this modest sample overwhelmingly attributed elevated and enduring levels of impact on their interest and confidence in pursuing a science or healthcare-related career to the program. Additionally, 63% subsequently took additional science or health courses, 73% participated in a job or educational experience that was science related during high school, and 97% went on to college. Four of every five program graduates cited a health-related college major, and 83% offered their strongest recommendation of the program to others. Further study and evaluation of simulation-based experiences that capitalize on informal, naturalistic learning and promote self-efficacy are warranted.

  7. Views on group simulation in an integrated medical curriculum

    OpenAIRE

    Salaria M; Oyewole T; Shah S

    2017-01-01

    Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, i...

  8. Performance optimization of web-based medical simulation.

    Science.gov (United States)

    Halic, Tansel; Ahn, Woojin; De, Suvranu

    2013-01-01

    This paper presents a technique for performance optimization of multimodal interactive web-based medical simulation. A web-based simulation framework is promising for easy access and wide dissemination of medical simulation. However, the real-time performance of the simulation highly depends on hardware capability on the client side. Providing consistent simulation in different hardware is critical for reliable medical simulation. This paper proposes a non-linear mixed integer programming model to optimize the performance of visualization and physics computation while considering hardware capability and application specific constraints. The optimization model identifies and parameterizes the rendering and computing capabilities of the client hardware using an exploratory proxy code. The parameters are utilized to determine the optimized simulation conditions including texture sizes, mesh sizes and canvas resolution. The test results show that the optimization model not only achieves a desired frame per second but also resolves visual artifacts due to low performance hardware.

  9. Medical simulation technology: educational overview, industry leaders, and what's missing.

    Science.gov (United States)

    Spooner, Nicholas; Hurst, Stephen; Khadra, Mohamed

    2012-01-01

    Modern medical simulation technology (MST) debuted in 1960 with the development of Resusci Annie (Laerdal 2007), which assisted students in the acquisition of proper ventilation and compression techniques used during basic life support. Following a steady stream of subsequent technological advances and innovations, MST manufacturers are now able to offer training aids capable of facilitating innovative learning in such diverse areas as human patient simulators, simulated clinical environments, virtual procedure stations, virtual medical environments, electronic tutors, and performance recording. The authors list a number of the most popular MSTs presently available while citing evaluative efforts undertaken to date regarding the efficacy of MST to the medical profession. They conclude by proposing a variety of simulation innovations of prospective interest to both medical and technology personnel while offering healthcare administrators a series of recommended considerations when planning to integrate MST into existing medical systems.

  10. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    Directory of Open Access Journals (Sweden)

    Evelyn Porter

    2014-07-01

    Full Text Available Introduction: The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods: The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error rate and performed a separate multiple logistic regression analysis on the significant univariate variables to assess the association between the selected variables. Results: We reviewed 49 simulated resuscitations . The final medication error rate for the simulation was 26.5% (95% CI 13.7% - 39.3%. On univariate analysis, statistically significant findings for decreased prescribing medication error rates included senior residents in charge, presence of a pharmacist, sleeping greater than 8 hours prior to the simulation, and a visual analog scale score showing more confidence in caring for critically ill children. Multiple logistic regression analysis using the above significant variables showed only the presence of a pharmacist to remain significantly associated with decreased medication error, odds ratio of 0.09 (95% CI 0.01 - 0.64. Conclusion: Our results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees.

  11. Effects of high-fidelity patient simulation led clinical reasoning course: Focused on nursing core competencies, problem solving, and academic self-efficacy.

    Science.gov (United States)

    Lee, JuHee; Lee, Yoonju; Lee, Senah; Bae, Juyeon

    2016-01-01

    To examine the effects of high-fidelity patient simulation (HFPS) led clinical reasoning course among undergraduate nursing students. A quasi-experimental study of non-equivalent control group pretest-post test design was applied. A total of 49 senior nursing students participated in this study. The experimental group consisted of the students who took the "clinical reasoning" course (n = 23) while the control group consisted of students who did not (n = 26). Self-administered scales including the nursing core competencies, problem solving, academic self-efficacy, and Kolb learning style inventory were analyzed quantitatively using SPSS version 20.0. Data analysis was conducted using one-way ancova due to a significant difference in nursing core competencies between the experimental group and control group. There was a significant improvement in nursing core competencies in the experimental group (F = 7.747, P = 0.008). The scores of problem solving and academic self-efficacy were higher in the experimental group after the HFPS led clinical reasoning course without statistical difference. There is a need for the development of effective instructional methods to improve learning outcomes in nursing education. Future research is needed related to simulation education as well as management strategies so that learning outcomes can be achieved within different students' learning style. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  12. Simulated Screens of DNA Encoded Libraries: The Potential Influence of Chemical Synthesis Fidelity on Interpretation of Structure-Activity Relationships.

    Science.gov (United States)

    Satz, Alexander L

    2016-07-11

    Simulated screening of DNA encoded libraries indicates that the presence of truncated byproducts complicates the relationship between library member enrichment and equilibrium association constant (these truncates result from incomplete chemical reactions during library synthesis). Further, simulations indicate that some patterns observed in reported experimental data may result from the presence of truncated byproducts in the library mixture and not structure-activity relationships. Potential experimental methods of minimizing the presence of truncates are assessed via simulation; the relationship between enrichment and equilibrium association constant for libraries of differing purities is investigated. Data aggregation techniques are demonstrated that allow for more accurate analysis of screening results, in particular when the screened library contains significant quantities of truncates.

  13. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation

    NARCIS (Netherlands)

    Sorensen, J.L.; Ostergaard, D.; Leblanc, V.; Ottesen, B.; Konge, L.; Dieckmann, P.; Vleuten, C. van der

    2017-01-01

    BACKGROUND: Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities

  14. An online interactive simulation system for medical imaging education.

    Science.gov (United States)

    Dikshit, Aditya; Wu, Dawei; Wu, Chunyan; Zhao, Weizhao

    2005-09-01

    This report presents a recently developed web-based medical imaging simulation system for teaching students or other trainees who plan to work in the medical imaging field. The increased importance of computer and information technology widely applied to different imaging techniques in clinics and medical research necessitates a comprehensive medical imaging education program. A complete tutorial of simulations introducing popular imaging modalities, such as X-ray, MRI, CT, ultrasound and PET, forms an essential component of such an education. Internet technologies provide a vehicle to carry medical imaging education online. There exist a number of internet-based medical imaging hyper-books or online documentations. However, there are few providing interactive computational simulations. We focus on delivering knowledge of the physical principles and engineering implementation of medical imaging techniques through an interactive website environment. The online medical imaging simulation system presented in this report outlines basic principles underlying different imaging techniques and image processing algorithms and offers trainees an interactive virtual laboratory. For education purposes, this system aims to provide general understanding of each imaging modality with comprehensive explanations, ample illustrations and copious references as its thrust, rather than complex physics or detailed math. This report specifically describes the development of the tutorial for commonly used medical imaging modalities. An internet-accessible interface is used to simulate various imaging algorithms with user-adjustable parameters. The tutorial is under the MATLAB Web Server environment. Macromedia Director MX is used to develop interactive animations integrating theory with graphic-oriented simulations. HTML and JavaScript are used to enable a user to explore these modules online in a web browser. Numerous multiple choice questions, links and references for advanced study are

  15. Cuba after Fidel Castro.

    Science.gov (United States)

    1986-04-07

    domestic policies, and implications for U.S. policies posed by a post-Fidel Castro Cuban government. Born August 13, 1926, Fidel Castro Ruz is no longer...an area important to U.S.* interests. * The most probable successor to Fidel Castro is his * younger brother Raul Castro Ruz . Born June 3, 1931, Raul...Raul Castro Ruz was elected second secretary."I While Raul appears to be the mostly likely successor to his brother Fidel, he is not the only

  16. The Dialysis Exercise: A Clinical Simulation for Preclinical Medical Students.

    Science.gov (United States)

    And Others; Bernstein, Richard A.

    1980-01-01

    A clinical decision-making simulation that helps students understand the relationship between psychosocial factors and medical problem-solving is described. A group of medical students and one faculty member comprise a selection committee to agree on the order in which four patients will be selected for renal dialysis. (MLW)

  17. Views on group simulation in an integrated medical curriculum

    Directory of Open Access Journals (Sweden)

    Salaria M

    2017-03-01

    Full Text Available Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, illustrated the clinical relevance of basic sciences. What is more, students felt that these practices provided chances for direct application of scientific knowledge, as well as simulating real world experience. The development of clinical reasoning was also noted, and as medical students ourselves, we agree that this aspect is cemented by simulation scenarios.View the original paper by Ginzburg and colleagues.

  18. Hybrid High-Fidelity Modeling of Radar Scenarios Using Atemporal, Discrete-Event, and Time-Step Simulation

    Science.gov (United States)

    2016-12-01

    computational power. Such simplifications can produce misleading results. For example, Radar Cross Section (RCS) effects in response to time-varying...and corresponding limitations of computational power. Such simplifications can produce misleading results. For example, Radar Cross Section (RCS...135 xvi Figure 6.1 The RCS of F-16 Falcon fighter model which is simulated by CST Studio software with signal frequency = 8 GHz. In (a), the RCS of

  19. 护理临床课程高仿真情景模拟教学实施过程的质性研究%Performing high-fidelity simulation teaching on nursing clinical courses:a qualitative study

    Institute of Scientific and Technical Information of China (English)

    肖树芹; 许亚红; 王艳玲

    2016-01-01

    目的:从教师视角下探讨护理临床课程高仿真情景模拟教学实施的过程。方法采用半结构访谈的方法对10名授课教师针对仿真情景教学过程中的问题和感受进行访谈,采用内容分析法进行资料分析。结果仿真教学对学生解决临床问题的能力、动手能力、批判性思维等能力有较好的培养,教师付出时间精力较多,教学中的各个环节仍存在改善的空间,尤其是病情观察的仿真环境设置、健康教育的形式、教师的引导性反馈需要进一步改善提高,教学组织过程的细节需要进一步规范。结论高仿真情景模拟教学有助于学生能力的培养,但实施的过程仍需进一步精益求精。%Objective To explore the implementation process of high-fidelity simulation teaching on nursing clinical courses at teachers′perspectives.Methods A total of 1 0 teachers were interviewed on the problems and feelings of the high-fidelity simulation teaching via semi-structured interviews.The data was analyzed by content analysis.Results The high-fidelity simulation teaching was effective on ability of clinical problem resolving,manipulative skills,critical thinking for nursing students.Teachers spended much time on the classes and different processes needed improvement.More time and attentions needed to be paid for teachers to enhance the quality of high-fidelity simulation teaching through improving settings of clinical observation, health education and directed debriefing.Standard teaching process of high-fidelity simulation teaching should be established.Conclusions The high-fidelity simulation is effective in improving the ability of nursing students, but teaching processes need to be standardized and improved.

  20. Medical simulation: a virtual world at your doorstep.

    Science.gov (United States)

    Oak, S N

    2014-01-01

    Medical simulation has come a long way in Western health care; however, in developing world, health education sectors have not adequately addressed its significance and role in preparing and updating heath care personnel. Validification, standardization, paucity of trainers, deficiency of a structured syllabus, and cost of equipments need to be overcome in the next decade. Despite these problems, worldwide acceptance of the concept of medical simulation is growing. It is undoubtedly the wave of future. Multidisciplinary, interprofessional, and multimodal simulation training is possible. Virtual worlds are increasing the vistas of training, making the actual health care dispensing more skilled and safe.

  1. An information theoretic approach to use high-fidelity codes to calibrate low-fidelity codes

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Allison, E-mail: lewis.allison10@gmail.com [Department of Mathematics, North Carolina State University, Raleigh, NC 27695 (United States); Smith, Ralph [Department of Mathematics, North Carolina State University, Raleigh, NC 27695 (United States); Williams, Brian [Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Figueroa, Victor [Sandia National Laboratories, Albuquerque, NM 87185 (United States)

    2016-11-01

    For many simulation models, it can be prohibitively expensive or physically infeasible to obtain a complete set of experimental data to calibrate model parameters. In such cases, one can alternatively employ validated higher-fidelity codes to generate simulated data, which can be used to calibrate the lower-fidelity code. In this paper, we employ an information-theoretic framework to determine the reduction in parameter uncertainty that is obtained by evaluating the high-fidelity code at a specific set of design conditions. These conditions are chosen sequentially, based on the amount of information that they contribute to the low-fidelity model parameters. The goal is to employ Bayesian experimental design techniques to minimize the number of high-fidelity code evaluations required to accurately calibrate the low-fidelity model. We illustrate the performance of this framework using heat and diffusion examples, a 1-D kinetic neutron diffusion equation, and a particle transport model, and include initial results from the integration of the high-fidelity thermal-hydraulics code Hydra-TH with a low-fidelity exponential model for the friction correlation factor.

  2. Integrated Variable-Fidelity Tool Set for Modeling and Simulation of Aeroservothermoelasticity-Propulsion (ASTE-P) Effects for Aerospace Vehicles Ranging From Subsonic to Hypersonic Flight Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed research program aims at developing a variable-fidelity software tool set for aeroservothermoelastic-propulsive (ASTE-P) modeling that can be routinely...

  3. Integrated Variable-Fidelity Tool Set For Modeling and Simulation of Aeroservothermoelasticity -Propulsion (ASTE-P) Effects For Aerospace Vehicles Ranging From Subsonic to Hypersonic Flight Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed research program aims at developing a variable-fidelity software tool set for aeroservothermoelastic-propulsive (ASTE-P) modeling that can be routinely...

  4. Using machine learning and real-time workload assessment in a high-fidelity UAV simulation environment

    Science.gov (United States)

    Monfort, Samuel S.; Sibley, Ciara M.; Coyne, Joseph T.

    2016-05-01

    Future unmanned vehicle operations will see more responsibilities distributed among fewer pilots. Current systems typically involve a small team of operators maintaining control over a single aerial platform, but this arrangement results in a suboptimal configuration of operator resources to system demands. Rather than devoting the full-time attention of several operators to a single UAV, the goal should be to distribute the attention of several operators across several UAVs as needed. Under a distributed-responsibility system, operator task load would be continuously monitored, with new tasks assigned based on system needs and operator capabilities. The current paper sought to identify a set of metrics that could be used to assess workload unobtrusively and in near real-time to inform a dynamic tasking algorithm. To this end, we put 20 participants through a variable-difficulty multiple UAV management simulation. We identified a subset of candidate metrics from a larger pool of pupillary and behavioral measures. We then used these metrics as features in a machine learning algorithm to predict workload condition every 60 seconds. This procedure produced an overall classification accuracy of 78%. An automated tasker sensitive to fluctuations in operator workload could be used to efficiently delegate tasks for teams of UAV operators.

  5. Learning in Technology-Enhanced Medical Simulation: Locations and Knowings

    Directory of Open Access Journals (Sweden)

    Song-ee Ahn

    2015-06-01

    Full Text Available This qualitative study focuses on how knowings and learning take place in full-scale simulation training of medical and nursing students, by drawing upon actor-network theory (ANT. ANT situates materiality as a part of the social practices. Knowing and learning, according to ANT, are not simply cognitive or social phenomena, but are seen as emerging as effects of the relation between material assemblages and human actors being performed into being in particular locations. Data consists of observations of simulations performed by ten groups of students. The analysis focuses on the emerging knowings in the socio-material—arrangements of three locations involved in the simulation—the simulation room, the observation room and the reflection room. The findings indicate that medical knowing, affective knowing and communicative knowing are produced in different ways in the different locations and material arrangements of the simulation cycle.Keywords: simulation, locations, knowings, actor-network theory, collaborate learning, multiprofessional learning.

  6. As Simple As Possible, but Not Simpler: Exploring the Fidelity of Coarse-Grained Protein Models for Simulated Force Spectroscopy

    Science.gov (United States)

    Rottler, Jörg; Plotkin, Steven S.

    2016-01-01

    Mechanical unfolding of a single domain of loop-truncated superoxide dismutase protein has been simulated via force spectroscopy techniques with both all-atom (AA) models and several coarse-grained models having different levels of resolution: A Gō model containing all heavy atoms in the protein (HA-Gō), the associative memory, water mediated, structure and energy model (AWSEM) which has 3 interaction sites per amino acid, and a Gō model containing only one interaction site per amino acid at the Cα position (Cα-Gō). To systematically compare results across models, the scales of time, energy, and force had to be suitably renormalized in each model. Surprisingly, the HA-Gō model gives the softest protein, exhibiting much smaller force peaks than all other models after the above renormalization. Clustering to render a structural taxonomy as the protein unfolds showed that the AA, HA-Gō, and Cα-Gō models exhibit a single pathway for early unfolding, which eventually bifurcates repeatedly to multiple branches only after the protein is about half-unfolded. The AWSEM model shows a single dominant unfolding pathway over the whole range of unfolding, in contrast to all other models. TM alignment, clustering analysis, and native contact maps show that the AWSEM pathway has however the most structural similarity to the AA model at high nativeness, but the least structural similarity to the AA model at low nativeness. In comparison to the AA model, the sequence of native contact breakage is best predicted by the HA-Gō model. All models consistently predict a similar unfolding mechanism for early force-induced unfolding events, but diverge in their predictions for late stage unfolding events when the protein is more significantly disordered. PMID:27898663

  7. [Full-scale simulation in German medical schools and anesthesia residency programs : Status quo].

    Science.gov (United States)

    Baschnegger, H; Meyer, O; Zech, A; Urban, B; Rall, M; Breuer, G; Prückner, S

    2017-01-01

    Simulation has been increasingly used in medicine. In 2003 German university departments of anesthesiology were provided with a full-scale patient simulator, designated for use with medical students. Meanwhile simulation courses are also offered to physicians and nurses. Currently, the national model curriculum for residency programs in anesthesiology is being revised, possibly to include mandatory simulation training. To assess the status quo of full-scale simulation training for medical school, residency and continuing medical education in German anesthesiology. All 38 German university chairs for anesthesiology as well as five arbitrarily chosen non-university facilities were invited to complete an online questionnaire regarding their centers' infrastructure and courses held between 2010 and 2012. The overall return rate was 86 %. In university simulation centers seven non-student staff members, mainly physicians, were involved, adding up to a full-time equivalent of 1.2. All hours of work were paid by 61 % of the centers. The median center size was 100 m(2) (range 20-500 m(2)), equipped with three patient simulators (1-32). Simulators of high or very high fidelity are available at 80 % of the centers. Scripted scenarios were used by 91 %, video debriefing by 69 %. Of the participating university centers, 97 % offered courses for medical students, 81 % for the department's employees, 43 % for other departments of their hospital, and 61 % for external participants. In 2012 the median center reached 46 % of eligible students (0-100), 39 % of the department's physicians (8-96) and 16 % of its nurses (0-56) once. For physicians and nurses from these departments that equals one simulation-based training every 2.6 and 6 years, respectively. 31 % made simulation training mandatory for their residents, 29 % for their nurses and 24 % for their attending physicians. The overall rates of staff ever exposed to simulation were 45 % of

  8. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation

    DEFF Research Database (Denmark)

    Sørensen, Jette Led; Østergaard, Doris; LeBlanc, Vicki

    2017-01-01

    simulations. DISCUSSION: Non-randomised studies argue that in situ simulation is more effective for educational purposes than other types of simulation settings. Conversely, the few comparison studies that exist, either randomised or retrospective, show that choice of setting does not seem to influence......BACKGROUND: Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities...... that choice of setting for simulations does not seem to influence individual and team learning. Department-based local simulation, such as simulation in-house and especially in situ simulation, leads to gains in organisational learning. The overall objectives of simulation-based education and factors...

  9. Simulator Fidelity: A Concept Paper

    Science.gov (United States)

    1980-11-01

    RESOURCES RSCH 0Mb (HUMkwO) 1 HU14RHU. LIRRARY I FU5TIb DIHECTONATE, USAAMWUL TLCHNICAL LINRARY I RANUl CORPURAiIUN / I RAND CONPPUAlIUN ATrN: LIBRARY U 1...Iq5LQ.H AIIN: AIiLA-LSi I (IS AotMY AYN NO~i LIbRARY AITN: 4LMI&1 LIHI44AHIA14 I USAAu’fJC ATTN.- ATIU-U I iUS t4iLlIAHy ACAI~t.Y UIHLLIUI4 01

  10. The masked educator-innovative simulation in an Australian undergraduate Medical Sonography and Medical Imaging program.

    Science.gov (United States)

    Reid-Searl, Kerry; Bowman, Anita; McAllister, Margaret; Cowling, Cynthia; Spuur, Kelly

    2014-12-01

    Clinical learning experiences for sonography and medical imaging students can sometimes involve the practice of technical procedures with less of a focus on developing communication skills with patients. Whilst patient-based simulation scenarios have been widely reported in other health education programmes, there is a paucity of research in sonography and medical imaging. The aim of this study was to explore the effectiveness of Mask-Ed™ (KRS Simulation) in the learning and teaching of clinical communication skills to undergraduate medical sonography and medical imaging students. Mask-Ed™ (KRS Simulation) is a simulation technique where the educator is hidden behind wearable realistic silicone body props including masks. Focus group interviews were conducted with 11 undergraduate medical sonography and medical imaging students at CQUniversity, Australia. The number of participants was limited to the size of the cohort of students enrolled in the course. Prior to these interviews participants were engaged in learning activities that featured the use of the Mask-Ed™ (KRS Simulation) method. Thematic analysis was employed to explore how the introduction of Mask-Ed™ (KRS Simulation) contributed to students' learning in relation to clinical communication skills. Key themes included: benefits of interacting with someone real rather than another student, learning made fun, awareness of empathy, therapeutic communication skills, engaged problem solving and purposeful reflection. Mask-Ed™ (KRS Simulation) combined with interactive sessions with an expert facilitator, contributed positively to students' learning in relation to clinical communication skills. Participants believed that interacting with someone real, as in the Mask-Ed characters was beneficial. In addition to the learning being described as fun, participants gained an awareness of empathy, therapeutic communication skills, engaged problem solving and purposeful reflection.

  11. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation

    DEFF Research Database (Denmark)

    Sørensen, Jette Led; Østergaard, Doris; LeBlanc, Vicki

    2017-01-01

    BACKGROUND: Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities...... that choice of setting for simulations does not seem to influence individual and team learning. Department-based local simulation, such as simulation in-house and especially in situ simulation, leads to gains in organisational learning. The overall objectives of simulation-based education and factors...... are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care...

  12. A Review of Simulators with Haptic Devices for Medical Training.

    Science.gov (United States)

    Escobar-Castillejos, David; Noguez, Julieta; Neri, Luis; Magana, Alejandra; Benes, Bedrich

    2016-04-01

    Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

  13. The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

    Science.gov (United States)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  14. The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

    Science.gov (United States)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  15. Students' Emotions in Simulation-Based Medical Education

    Science.gov (United States)

    Keskitalo, Tuulikki; Ruokamo, Heli

    2017-01-01

    Medical education is emotionally charged for many reasons, especially the fact that simulation-based learning is designed to generate emotional experiences. However, there are very few studies that concentrate on learning and emotions, despite widespread interest in the topic, especially within healthcare education. The aim of this research is to…

  16. Medical teachers' perception towards simulation-based medical education: A multicenter study in Saudi Arabia.

    Science.gov (United States)

    Ahmed, Shabnam; Al-Mously, Najwa; Al-Senani, Fahmi; Zafar, Muhammad; Ahmed, Muhammad

    2016-01-01

    This study aims to evaluate the perception of medical teachers toward the integration of simulation-based medical education (SBME) in undergraduate curriculum and also identify contextual barriers faced by medical teachers. This cross-sectional observational study included medical teachers from three universities. A questionnaire was used to report teachers' perception. SBME was perceived by medical teachers (basic sciences/clinical, respectively) as enjoyable (71.1%/75.4%), effective assessment tool to evaluate students' learning (60%/73.9%) and can improve learning outcome (88.8%/79.7%). Similarly, (91.1%/71%) of teachers think that simulation should be part of the curriculum and not stand alone one time activity. Teachers' training for SBME has created a significant difference in perception (p medical curriculum are major perceived barriers for effective SBME. Results highlight the positive perception and attitude of medical teachers toward the integration of SBME in undergraduate curriculum. Prior formal training of teachers created a different perception. Top perceived barriers for effective SBME include teachers' formal training supported with time and resources and the early integration into the curriculum. These critical challenges need to be addressed by medical schools in order to enhance the integration SBME in undergraduate curricula.

  17. SHOULD MEDICAL SIMULATION BE AN INTEGRAL PART OF MEDICAL EDUCATIONAL CURRICULUM? A REVIEW

    Directory of Open Access Journals (Sweden)

    Varsha

    2015-08-01

    Full Text Available With increasing concern about patient safety and focus on quality care delivery, there is a shift of teaching paradigm from bedside teaching to simulation based training. A number of research papers have shown simulation to be a valuable tool and it is eme rging as an educational technique very rapidly. Simulation has increasingly become a part of mainstream postgraduate medical education in most of the western countries. Many centres in USA, UK and Canada have built curricula incorporating simulators in tea ching programs. In India, around twelve to fifteen simulation centres are in existence and are developing new programs in different domains of medicine. Various Medical Councils, professional societies and industries could collaborate to advance medical ed ucation to the next level by developing curricula that employ the technology of simulation to improve clinical skills and assess performance and set a bench mark. For maximal effectiveness, Simulation based education needs to be integrated into the curricu lum and not used as a stand - alone intervention

  18. Obstetric simulation for medical student, resident, and fellow education.

    Science.gov (United States)

    Deering, Shad; Auguste, Tamika; Lockrow, Ernest

    2013-06-01

    Simulation for training new providers is no longer the wave of the future, but the reality of the present. It provides significant activation and allows for both the integration of concepts with actual application and the ability to practice a wide range of procedural skills at an earlier stage of training than would otherwise be possible. It is also an optimal method to sharpen teamwork and communication skills that are critical to patient safety. These concepts are especially relevant in the field of obstetrics, where even routine deliveries may become life-threatening emergencies and the health of the mother and child are dependent on correct and timely interventions and teamwork. Almost all of the skills needed, even for advanced invasive procedures, in obstetrics can be taught with currently available simulators. In this report we will discuss the use of medical simulation for training obstetric providers from medical school through subspecialty level training. Copyright © 2013. Published by Elsevier Inc.

  19. Nuclear Energy Advanced Modeling and Simulation (NEAMS) waste Integrated Performance and Safety Codes (IPSC) : gap analysis for high fidelity and performance assessment code development.

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon H.; Siegel, Malcolm Dean; Arguello, Jose Guadalupe, Jr.; Webb, Stephen Walter; Dewers, Thomas A.; Mariner, Paul E.; Edwards, Harold Carter; Fuller, Timothy J.; Freeze, Geoffrey A.; Jove-Colon, Carlos F.; Wang, Yifeng

    2011-03-01

    needed for repository modeling are severely lacking. In addition, most of existing reactive transport codes were developed for non-radioactive contaminants, and they need to be adapted to account for radionuclide decay and in-growth. The accessibility to the source codes is generally limited. Because the problems of interest for the Waste IPSC are likely to result in relatively large computational models, a compact memory-usage footprint and a fast/robust solution procedure will be needed. A robust massively parallel processing (MPP) capability will also be required to provide reasonable turnaround times on the analyses that will be performed with the code. A performance assessment (PA) calculation for a waste disposal system generally requires a large number (hundreds to thousands) of model simulations to quantify the effect of model parameter uncertainties on the predicted repository performance. A set of codes for a PA calculation must be sufficiently robust and fast in terms of code execution. A PA system as a whole must be able to provide multiple alternative models for a specific set of physical/chemical processes, so that the users can choose various levels of modeling complexity based on their modeling needs. This requires PA codes, preferably, to be highly modularized. Most of the existing codes have difficulties meeting these requirements. Based on the gap analysis results, we have made the following recommendations for the code selection and code development for the NEAMS waste IPSC: (1) build fully coupled high-fidelity THCMBR codes using the existing SIERRA codes (e.g., ARIA and ADAGIO) and platform, (2) use DAKOTA to build an enhanced performance assessment system (EPAS), and build a modular code architecture and key code modules for performance assessments. The key chemical calculation modules will be built by expanding the existing CANTERA capabilities as well as by extracting useful components from other existing codes.

  20. Scattering fidelity in elastodynamics

    Science.gov (United States)

    Gorin, T.; Seligman, T. H.; Weaver, R. L.

    2006-01-01

    The recent introduction of the concept of scattering fidelity causes us to revisit the experiment by Lobkis and Weaver [Phys. Rev. Lett. 90, 254302 (2003)]. There, the “distortion” of the coda of an acoustic signal is measured under temperature changes. This quantity is, in fact, the negative logarithm of scattering fidelity. We reanalyze their experimental data for two samples, and we find good agreement with random matrix predictions for the standard fidelity. Usually, one may expect such an agreement for chaotic systems, only. While the first sample may indeed be assumed chaotic, for the second sample, a perfect cuboid, such an agreement is surprising. For the first sample, the random matrix analysis yields perturbation strengths compatible with semiclassical predictions. For the cuboid, the measured perturbation strengths are by a common factor of (5)/(3) too large. Apart from that, the experimental curves for the distortion are well reproduced.

  1. Simulation of Interval Censored Data in Medical and Biological Studies

    Science.gov (United States)

    Kiani, Kaveh; Arasan, Jayanthi

    This research looks at the simulation of interval censored data when the survivor function of the survival time is known and attendance probability of the subjects for follow-ups can take any number between 0 to 1. Interval censored data often arise in the medical and biological follow-up studies where the event of interest occurs somewhere between two known times. Regardless of the methods used to analyze these types of data, simulation of interval censored data is an important and challenging step toward model building and prediction of survival time. The simulation itself is rather tedious and very computer intensive due to the interval monitoring of subjects at prescheduled times and subject's incomplete attendance to follow-ups. In this paper the simulated data by the proposed method were assessed using the bias, standard error and root mean square error (RMSE) of the parameter estimates where the survival time T is assumed to follow the Gompertz distribution function.

  2. Virtual patient simulation at US and Canadian medical schools.

    Science.gov (United States)

    Huang, Grace; Reynolds, Robby; Candler, Chris

    2007-05-01

    "Virtual patients" are computer-based simulations designed to complement clinical training. These applications possess numerous educational benefits but are costly to develop. Few medical schools can afford to create them. The purpose of this inventory was to gather information regarding in-house virtual patient development at U.S. and Canadian medical schools to promote the sharing of existing cases and future collaboration. From February to September 2005, the authors contacted 142 U.S. and Canadian medical schools and requested that they report on virtual patient simulation activities at their respective institutions. The inventory elicited information regarding the pedagogic and technical characteristics of each virtual patient application. The schools were also asked to report on their willingness to share virtual patients. Twenty-six out of 108 responding schools reported that they were producing virtual patients. Twelve schools provided additional data on 103 cases and 111 virtual patients. The vast majority of virtual patients were media rich and were associated with significant production costs and time. The reported virtual patient cases tended to focus on primary care disciplines and did not as a whole exhibit racial or ethnic diversity. Funding sources, production costs, and production duration influenced the extent of schools' willingness to share. Broader access to and cooperative development of these resources would allow medical schools to enhance their clinical curricula. Virtual patient development should include basic science objectives for more integrative learning, simulate the consequences of clinical decision making, and include additional cases in cultural competency. Together, these efforts can enhance medical education despite external constraints on clinical training.

  3. PSYCHE: An Object-Oriented Approach to Simulating Medical Education

    Science.gov (United States)

    Mullen, Jamie A.

    1990-01-01

    Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

  4. Application of Computer Simulation Modeling to Medication Administration Process Redesign

    Directory of Open Access Journals (Sweden)

    Nathan Huynh

    2012-01-01

    Full Text Available The medication administration process (MAP is one of the most high-risk processes in health care. MAP workflow redesign can precipitate both unanticipated and unintended consequences that can lead to new medication safety risks and workflow inefficiencies. Thus, it is necessary to have a tool to evaluate the impact of redesign approaches in advance of their clinical implementation. This paper discusses the development of an agent-based MAP computer simulation model that can be used to assess the impact of MAP workflow redesign on MAP performance. The agent-based approach is adopted in order to capture Registered Nurse medication administration performance. The process of designing, developing, validating, and testing such a model is explained. Work is underway to collect MAP data in a hospital setting to provide more complex MAP observations to extend development of the model to better represent the complexity of MAP.

  5. Simulation in Medical Education: Focus on Anesthesiology and Critical Care Medicine

    Directory of Open Access Journals (Sweden)

    D. John Doyle

    2002-12-01

    Full Text Available Simulation refers to the artificial representation of a complex real-world process with sufficient fidelity to achieve a particular objective, usually for the purposes of training or performance testing. While simulation has been important from early times (as in the rehearsal of animal hunting activities or preparing for warfare, the needs of World War II greatly accelerated simulation technology for use in flight training. With the available of inexpensive computer technology in recent years, simulation technology has blossomed again, especially in the field of medicine, where applications range from scientific modeling to clinical performance appraisal in the setting of crisis management.

  6. 基于高仿真重症医学模拟训练的非技术技能培训研究%Discussion on training of non-technical skills (NTS) in critical care medicine based on high fidelity human patient simulator

    Institute of Scientific and Technical Information of China (English)

    颜洪; 黄河清; 鲁开智; 尹昌林

    2013-01-01

    近年来,高仿真模拟病人技术已成为临床医学教学非常重要的手段.其中非技术技能(non-technical skills,NTS)对于医疗质量的提高有着十分重要的作用.在此,将基于科室自身教学经验,探讨NTS融入重症医学模拟训练的理论和实践,并评价实施效果.%High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.

  7. Multi-fidelity stochastic collocation method for computation of statistical moments

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xueyu, E-mail: xueyu-zhu@uiowa.edu [Department of Mathematics, University of Iowa, Iowa City, IA 52242 (United States); Linebarger, Erin M., E-mail: aerinline@sci.utah.edu [Department of Mathematics, University of Utah, Salt Lake City, UT 84112 (United States); Xiu, Dongbin, E-mail: xiu.16@osu.edu [Department of Mathematics, The Ohio State University, Columbus, OH 43210 (United States)

    2017-07-15

    We present an efficient numerical algorithm to approximate the statistical moments of stochastic problems, in the presence of models with different fidelities. The method extends the multi-fidelity approximation method developed in . By combining the efficiency of low-fidelity models and the accuracy of high-fidelity models, our method exhibits fast convergence with a limited number of high-fidelity simulations. We establish an error bound of the method and present several numerical examples to demonstrate the efficiency and applicability of the multi-fidelity algorithm.

  8. Survey of medical student preference for simulation models for basic dermatologic surgery skills: simulation platforms in medical education.

    Science.gov (United States)

    Adams, Chad C; Marquart, Jason D; Nicholas, Luke L; Sperling, Leonard C; Meyerle, Jon H

    2014-04-01

    The authors investigated the use of simulator platforms in fourth-year medical student education. To evaluate which simulation platform students preferred for learning dermatologic procedures and to assess the effectiveness of the exercise in terms of the change in confidence that the students had performing dermatologic procedures. After medical students were instructed on how to perform a punch biopsy and then assisted in executing the task, they were surveyed to determine their preferred simulation platform and simulator properties. Students were surveyed at the beginning and completion of the teaching block. One hundred fifty-seven students completed the skills laboratory, and 78 completed the preference questionnaire. Of the 11 surveyed categories, students preferred the pig foot in eight categories. Seventy students responded to a surgical skills questionnaire that assessed their overall confidence in planning and executing the procedure before and after the skills laboratory. The students had a statistically significant increase in confidence in dermatologic procedural skills as a result of the activity. Preference data show that the pig foot model is preferred for teaching dermatologic surgical skills. These results re-affirm that the pig foot model is an effective, low-cost solution for training. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  9. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum.

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.

  10. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    Aim There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Methods Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. Results The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Conclusion Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized

  11. Simulation of induced radioactivity for Heavy Ion Medical Machine

    CERN Document Server

    Jun-Kui, Xu; Wu-Yuan, Li; Wang, Mao; Jia-Wen, Xia; Xi-Meng, Chen; Wei-Wei, Yan; Chong, Xu

    2013-01-01

    For radiation protection and environmental impact assessment purpose, the radioactivity induced by carbon ion of Heavy Ion Medical Machine (HIMM) was studied. Radionuclides in accelerator component, cooling water and air at target area which are induced from primary beam and secondary particles are simulated by FLUKA Monte Carlo code. It is found that radioactivity in cooling water and air is not very important at the required beam intensity and energy which is needed for treatment, radionuclides in accelerator component may cause some problem for maintenance work, suitable cooling time is needed after the machine are shut down.

  12. Effects of high-fidelity simulation teaching on pre-job training in new nurses%高仿真模拟教学在新护士岗前培训中的应用效果

    Institute of Scientific and Technical Information of China (English)

    杜丽; 毛红波; 施娣; 张盟; 梅菁; 涂小朋; 游锦坤

    2015-01-01

    Objective To evaluate the effects of high-fidelity simulation teaching on the clinical decision-making ability and critical thinking ability of new nurses. Methods A total of 39 newly recruited nurses in our hospital in 2014 were included in this study, and high-fidelity simulation teaching was used in pre-job training. They were investigated by the clinical decision-making ability measuring tool and critical thinking disposition inventory-Chinese version before and after the training. Results Before the high-fidelity simulation teaching, the scores of the new nurses′ clinical decision-making ability and critical thinking ability were (81. 50 ± 6. 87) and (309. 90 ± 28. 15). After the high-fidelity simulation teaching, the scores increased to (92. 91 ± 6. 35) and (318. 13 ± 26. 24). The differences before and after the training were statistically significant (t=10. 19, 2. 83;P<0. 01). Conclusions The high-fidelity simulation teaching in pre-job training can improve the clinical decision-making ability and critical thinking ability of new nurses.%目的:了解高仿真模拟教学对新护士的临床决策能力和评判性思维能力的影响。方法从我院2014年新招聘的新护士中选取39名为研究对象,在新护士的岗前培训中,对39名新护士进行高仿真模拟教学培训,在培训前后,使用临床决策能力测量工具和评判性思维能力量表进行问卷调查。结果高仿真模拟培训前新护士的临床决策能力得分和评判性思维能力得分分别为(81.50±6.87)分和(309.90±28.15)分,培训后新护士的临床决策能力得分和评判性思维能力得分分别为(92.91±6.35)分和(318.13±26.24)分,培训前后比较差异有统计学意义( t值分别为10.19,2.83;P<0.01)。结论岗前培训中应用高仿真模拟教学,可以有效地提高新护士的临床决策能力和评判性思维能力。

  13. AN INTERNAL MEDICINE SIMULATED PRACTICAL EXAM FOR ASSESSMENT OF CLINICAL COMPETENCY IN 3RD YEAR MEDICAL STUDENTS

    Science.gov (United States)

    Bodamer, Cheryl; Feldman, Moshe; Kushinka, Jeffrey; Brock, Ellen; Dow, Alan; Evans, Jessica A.; Bearman, Gonzalo

    2015-01-01

    Introduction Achieving standardized assessment of medical student competency in patient care is a challenge. Simulation may provide unique contributions to overall assessment. We developed an Internal Medicine Standardized Simulation Based Examination (SSBE) for the 3rd year clerkship to assess students’ medical knowledge, diagnostic skills, and clinical management skills. We assessed convergent and test-criterion validity by comparing the relationship of SSBE scores with USMLE Step 2 clinical knowledge, shelf exam, eQuiz, OSCE, ward evaluation scores, and overall clerkship grades. We hypothesize that use of the SSBE will allow for a more reliable assessment of these competencies and add value to existing assessments. Methods A prospective study design was used. The SSBE consisted of a computer based photo quiz and cases on high fidelity simulators. Performance on the SSBE was compared to standardized examinations, clinical evaluations, and overall clerkship grades. Students completed an evaluation of the experience. Results Two hundred seven students completed the SSBE, with a mean score of 76.69 (SD 7.78). SSBE performance was positively related to other assessments of medical knowledge (eQuiz scores (r(203) =.33, p< .01), shelf exam scores (r(158) =.53, p< .01), and clinical performance (ward scores) (r(163) =.31, p<.01) but not to OSCE scores. There was a positive relationship to final class grades (r(163) = .45, p<.01), shelf exam (r (158) =.52, p<.01) and Step 2 clinical knowledge scores (r(76) =.54, p<.01). The majority (93%) of students agreed that it was a fair exam. Conclusion Our results provide validity evidence for the SSBE as an additional assessment tool that uses a novel approach for evaluating competency in patient care at the clerkship level. PMID:26650701

  14. The medical simulation markup language - simplifying the biomechanical modeling workflow.

    Science.gov (United States)

    Suwelack, Stefan; Stoll, Markus; Schalck, Sebastian; Schoch, Nicolai; Dillmann, Rüdiger; Bendl, Rolf; Heuveline, Vincent; Speidel, Stefanie

    2014-01-01

    Modeling and simulation of the human body by means of continuum mechanics has become an important tool in diagnostics, computer-assisted interventions and training. This modeling approach seeks to construct patient-specific biomechanical models from tomographic data. Usually many different tools such as segmentation and meshing algorithms are involved in this workflow. In this paper we present a generalized and flexible description for biomechanical models. The unique feature of the new modeling language is that it not only describes the final biomechanical simulation, but also the workflow how the biomechanical model is constructed from tomographic data. In this way, the MSML can act as a middleware between all tools used in the modeling pipeline. The MSML thus greatly facilitates the prototyping of medical simulation workflows for clinical and research purposes. In this paper, we not only detail the XML-based modeling scheme, but also present a concrete implementation. Different examples highlight the flexibility, robustness and ease-of-use of the approach.

  15. Medical students' medication communication skills regarding drug prescription-a qualitative analysis of simulated physician-patient consultations.

    Science.gov (United States)

    Hauser, Katarina; Matthes, Jan

    2017-04-01

    Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians' deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students' communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs. Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription. In 2015, 21 consultations were recorded, transcribed and subjected to qualitative content analysis based on the method of inductive coding. Even essential information on drug therapy was often lacking (e.g. adverse effects, drug administration). Some aspects were addressed more frequently than others. This seemed to differ depending on the diagnosis underlying the particular treatment (acute event vs. chronic disease). The extent of information on drug treatments given in simulated physician-patient consultations varied significantly between students. Fifth year medical students showed appreciable deficits in communicating drug prescriptions to patients though there were remarkable inter-individual differences. Our findings suggest that communication on drug therapy to patients is no self-evolving skill. Thus, there is obviously a need for emphasizing medication communication in the training of medical students. Communication aids specifically aiming at medication communication might facilitate learning of adequate medication communication skills.

  16. Using Simulation-Based Medical Education to Meet the Competency Requirements for the Single Accreditation System.

    Science.gov (United States)

    Riley, Bernadette

    2015-08-01

    Simulation-based medical education can provide medical training in a nonjudgmental, patient-safe, and effective environment. Although simulation has been a relatively new addition to medical education, the aeronautical, judicial, and military fields have used simulation training for hundreds of years, with positive outcomes. Simulation-based medical education can be used in a variety of settings, such as hospitals, outpatient clinics, medical schools, and simulation training centers. As the author describes in the present article, residencies currently accredited by the American Osteopathic Association can use a simulation-based medical education curriculum to meet training requirements of the 6 competencies identified by the Accreditation Council for Graduate Medical Education. The author also provides specific guidance on providing training and assessment in the professionalism competency.

  17. New frontiers in medical education: simulation technology at Campbell University School of Osteopathic Medicine.

    Science.gov (United States)

    Maddox, Ronald W; Schmid, Robert J

    2014-01-01

    Campbell University School of Osteopathic Medicine is using a variety of medical simulation systems in the training of its medical students. The simulators allow students to learn and practice skills in a controlled environment, and they enable faculty to challenge students with a broader range of conditions than might ordinarily be encountered during medical training.

  18. Large Eddy Simulation of FDA's Idealized Medical Device.

    Science.gov (United States)

    Delorme, Yann T; Anupindi, Kameswararao; Frankel, Steven H

    2013-12-01

    A hybrid large eddy simulation (LES) and immersed boundary method (IBM) computational approach is used to make quantitative predictions of flow field statistics within the Food and Drug Administration's (FDA) idealized medical device. An in-house code is used, hereafter (W enoHemo(™) ), that combines high-order finite-difference schemes on structured staggered Cartesian grids with an IBM to facilitate flow over or through complex stationary or rotating geometries and employs a subgrid-scale (SGS) turbulence model that more naturally handles transitional flows [2]. Predictions of velocity and wall shear stress statistics are compared with previously published experimental measurements from Hariharan et al. [6] for the four Reynolds numbers considered.

  19. Cellular automata simulation of medication-induced autoimmune diseases

    Science.gov (United States)

    Stauffer, Dietrich; Proykova, Ana

    2004-01-01

    We implement the cellular automata model proposed by Stauffer and Weisbuch in 1992 to describe the response of the immune system to antigens in the presence of medications. The model contains two thresholds, θ1 and θ2, suggested by de Boer, Segel, and Perelson to present the minimum field needed to stimulate the proliferation of the receptors and to suppress it, respectively. The influence of the drug is mimicked by increasing the second threshold, thus enhancing the immune response. If this increase is too strong, the immune response is triggered in the whole immune repertoire, causing it to attack the own body. This effect is seen in our simulations to depend both on the ratio of the thresholds and on their absolute values.

  20. Simulation of medical irradiation and X-ray detector signals

    Energy Technology Data Exchange (ETDEWEB)

    Kreisler, Bjoern

    2010-02-08

    This thesis aims for an improved understanding of medical irradiation. Two major parts are investigated: the beam shaping components of a medical linear accelerator, i.e. the source of the radiation, and the signal generation inside semiconductor sensors, i.e. the detection of the radiation. The direct measurement of the spatial and spectral particle distribution in the irradiation beam is not possible with state of the art detectors due to the high particle flux. The development of new advanced detectors is the goal of the first part of this thesis. The focus is set on the signal generation inside the sensor volume of a semiconductor detector. Incoming particles interact with the sensor material and generate clouds of electron hole pairs. These pairs get separated by an applied bias voltage. The motion of the charge clouds is simulated with a finite element programme taking into account the drift and diffusion. Mirror charges are induced on the electrodes which move due to the motion of the charge cloud. The motion of the induced mirror charges leads to the signal that is detected. The transient calculation of the signals is based on Ramo's theorem. The efficient adjoint formulation of the induction solution is adjusted to doped materials, as for example the electric bias field and hence the motion of the charge cloud is changing with the doping level. The effect of the doping of the material on the signal shape is shown together with influences of different voltages and pixel geometries. Smaller pixels and higher bias voltages can lead to shorter signals which is preferable for high flux measurements. Possible count rate improvements are limited by electric break through, high dark current across the sensor layer and charge sharing. Another option to shorten the signals is the use of steering grid electrodes which modify the electric and the weighting field. This results in shorter signals and thus in a higher possible rate. The detailed Monte

  1. Simulation and optimization models for emergency medical systems planning.

    Science.gov (United States)

    Bettinelli, Andrea; Cordone, Roberto; Ficarelli, Federico; Righini, Giovanni

    2014-01-01

    The authors address strategic planning problems for emergency medical systems (EMS). In particular, the three following critical decisions are considered: i) how many ambulances to deploy in a given territory at any given point in time, to meet the forecasted demand, yielding an appropriate response time; ii) when ambulances should be used for serving nonurgent requests and when they should better be kept idle for possible incoming urgent requests; iii) how to define an optimal mix of contracts for renting ambulances from private associations to meet the forecasted demand at minimum cost. In particular, analytical models for decision support, based on queuing theory, discrete-event simulation, and integer linear programming were presented. Computational experiments have been done on real data from the city of Milan, Italy.

  2. Evaluation of a computer-based educational intervention to improve medical teamwork and performance during simulated patient resuscitations.

    Science.gov (United States)

    Fernandez, Rosemarie; Pearce, Marina; Grand, James A; Rench, Tara A; Jones, Kerin A; Chao, Georgia T; Kozlowski, Steve W J

    2013-11-01

    To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams. A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011. This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine. Participants (n = 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (nteams = 45). Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module. Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (e.g., "chest radiograph findings communicated to team" and "team member assists with intubation preparation") were standardized before combining to create overall teamwork scores. Similarly, patient care items ("chest radiograph correctly interpreted"; "time to start of compressions") were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity. When controlling for team members' medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42] = 4.81, p teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.

  3. The introduction and effectiveness of simulation-based learning in medical education.

    Science.gov (United States)

    Nara, Nobuo; Beppu, Masashi; Tohda, Shuji; Suzuki, Toshiya

    2009-01-01

    To contribute to reforming the medical education system in Japan, we visited overseas medical schools and observed the methods utilized in medical education. We visited 28 medical schools and five institutes in the United States, Europe, Australia and Asia in 2008. We met deans and specialists in medical affairs and observed the medical schools' facilities. Among the several effective educational methods used in overseas medical schools, simulation-based learning was being used in all that we visited. Simulation-based learning is used to promote medical students' mastery of communication skills, medical interviewing, physical examination and basic clinical procedures. Students and tutors both recognize the effectiveness of simulation-based learning in medical education. In contrast to overseas medical schools, simulation-based learning is not common in Japan. There remain many barriers to introduce simulation-based education in Japan, such as a shortage of medical tutors, staff, mannequins and budget. However, enhancing the motivation of tutors is likely the most important factor to facilitate simulation-based education in Japanese medical schools to become common place.

  4. RTI Fidelity of Implementation Rubric

    Science.gov (United States)

    National Center on Response to Intervention, 2014

    2014-01-01

    The Response to Intervention (RTI) Fidelity Rubric is for use by individuals who are responsible for monitoring school-level fidelity of RTI implementation. The rubric is aligned with the essential components of RTI and the infrastructure that is necessary for successful implementation. It is accompanied by a worksheet with guiding questions and…

  5. Fidelity in Archaeal Information Processing

    Directory of Open Access Journals (Sweden)

    Bart de Koning

    2010-01-01

    Full Text Available A key element during the flow of genetic information in living systems is fidelity. The accuracy of DNA replication influences the genome size as well as the rate of genome evolution. The large amount of energy invested in gene expression implies that fidelity plays a major role in fitness. On the other hand, an increase in fidelity generally coincides with a decrease in velocity. Hence, an important determinant of the evolution of life has been the establishment of a delicate balance between fidelity and variability. This paper reviews the current knowledge on quality control in archaeal information processing. While the majority of these processes are homologous in Archaea, Bacteria, and Eukaryotes, examples are provided of nonorthologous factors and processes operating in the archaeal domain. In some instances, evidence for the existence of certain fidelity mechanisms has been provided, but the factors involved still remain to be identified.

  6. The utility of simulation in medical education: what is the evidence?

    Science.gov (United States)

    Okuda, Yasuharu; Bryson, Ethan O; DeMaria, Samuel; Jacobson, Lisa; Quinones, Joshua; Shen, Bing; Levine, Adam I

    2009-08-01

    Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are "practicing" on them, clinical medicine is becoming focused more on patient safety and quality than on bedside teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap. This article reviews the evidence for the utility of simulation in medical education. We conducted a MEDLINE search of original articles and review articles related to simulation in education with key words such as simulation, mannequin simulator, partial task simulator, graduate medical education, undergraduate medical education, and continuing medical education. Articles, related to undergraduate medical education, graduate medical education, and continuing medical education were used in the review. One hundred thirteen articles were included in this review. Simulation-based training was demonstrated to lead to clinical improvement in 2 areas of simulation research. Residents trained on laparoscopic surgery simulators showed improvement in procedural performance in the operating room. The other study showed that residents trained on simulators were more likely to adhere to the advanced cardiac life support protocol than those who received standard training for cardiac arrest patients. In other areas of medical training, simulation has been demonstrated to lead to improvements in medical

  7. Clinical simulation training improves the clinical performance of Chinese medical students

    Directory of Open Access Journals (Sweden)

    Ming-ya Zhang

    2015-10-01

    Full Text Available Background: Modern medical education promotes medical students’ clinical operating capacity rather than the mastery of theoretical knowledge. To accomplish this objective, clinical skill training using various simulations was introduced into medical education to cultivate creativity and develop the practical ability of students. However, quantitative analysis of the efficiency of clinical skill training with simulations is lacking. Methods: In the present study, we compared the mean scores of medical students (Jinan University who graduated in 2013 and 2014 on 16 stations between traditional training (control and simulative training groups. In addition, in a clinical skill competition, the objective structured clinical examination (OSCE scores of participating medical students trained using traditional and simulative training were compared. The data were statistically analyzed and qualitatively described. Results: The results revealed that simulative training could significantly enhance the graduate score of medical students compared with the control. The OSCE scores of participating medical students in the clinical skill competition, trained using simulations, were dramatically higher than those of students trained through traditional methods, and we also observed that the OSCE marks were significantly increased for the same participant after simulative training for the clinical skill competition. Conclusions: Taken together, these data indicate that clinical skill training with a variety of simulations could substantially promote the clinical performance of medical students and optimize the resources used for medical education, although a precise analysis of each specialization is needed in the future.

  8. Virtual patient simulator for distributed collaborative medical education.

    Science.gov (United States)

    Caudell, Thomas P; Summers, Kenneth L; Holten, Jim; Hakamata, Takeshi; Mowafi, Moad; Jacobs, Joshua; Lozanoff, Beth K; Lozanoff, Scott; Wilks, David; Keep, Marcus F; Saiki, Stanley; Alverson, Dale

    2003-01-01

    Project TOUCH (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) investigates the feasibility of using advanced technologies to enhance education in an innovative problem-based learning format currently being used in medical school curricula, applying specific clinical case models, and deploying to remote sites/workstations. The University of New Mexico's School of Medicine and the John A. Burns School of Medicine at the University of Hawai'i face similar health care challenges in providing and delivering services and training to remote and rural areas. Recognizing that health care needs are local and require local solutions, both states are committed to improving health care delivery to their unique populations by sharing information and experiences through emerging telehealth technologies by using high-performance computing and communications resources. The purpose of this study is to describe the deployment of a problem-based learning case distributed over the National Computational Science Alliance's Access Grid. Emphasis is placed on the underlying technical components of the TOUCH project, including the virtual reality development tool Flatland, the artificial intelligence-based simulation engine, the Access Grid, high-performance computing platforms, and the software that connects them all. In addition, educational and technical challenges for Project TOUCH are identified.

  9. The use of CBL with high fidelity human patient simulator in training of first aid skills%CBL结合高仿真电脑模拟人在急救培训中的应用

    Institute of Scientific and Technical Information of China (English)

    王长远; 曹涛; 秦俭; 孙长怡

    2016-01-01

    Objective To study the application effect of case-based learning (CBL) with high fidelity human patient simulator in non-technical skills training of first aid skills. Methods The first aid skills training were given to 128 doctors in the emergency department, including team cardiopulmonary resuscitation (CPR), trauma, etc. The doctors were randomly divided into observation group (n=67) and control group (n=61). While the control group were trained with the conventional method of teaching and simple simulation, observation group was provided with CBL with high fidelity Human Patient Simulator in its training. The training focus on the students’non-technical skills, such as decision-making, teamwork, strain capacity, communication between doctor and patient, organization and coordination, and etc. The difference of non-technical ability scores before and after the training between the two groups were compared. A questionnaire was completed by the observation in evaluating the high fidelity human patient simulator teaching method. Results Both groups’non-technical skills significantly increased after training in (P<0.01). Yet, the score of the observation group was significantly higher than that of the control group (P=0.001);100%of the emergency doctors preferred CBL with high fidelity human patient simulator, and 96.3%of them believed that the teaching method might improve the students’non-technical abilities. Conclusion CBL with high fidelity human patient simulator is considered being effective in improving students’the non-technical skills of first aid skills. Furthermore, it may stimulate students’learning interest and team cooperation ability.%目的:研究以案例为基础的教学(Case-Based learning,CBL)结合高仿真电脑模拟人在急救技能非技术能力培训中的应用效果。方法对128名我院急诊科医生和在急诊轮转的医生进行急救技能培训,内容包括团队心肺复苏,

  10. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Directory of Open Access Journals (Sweden)

    Ginzburg SB

    2017-01-01

    Full Text Available Samara B Ginzburg,1 Judith Brenner,1 Michael Cassara,2 Thomas Kwiatkowski,1 Joanne M Willey,1 1Department of Science Education, Hofstra Northwell School of Medicine, Hempstead, 2Department of Emergency Medicine, Northwell Health, Great Neck, NY, USA Aim: There has been a call for increased integration of basic and clinical sciences during ­preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.  Methods: Small groups of first -and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience.  Results: The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students. In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences.  Conclusion: Small-group simulation followed by a debrief that integrates basic and clinical

  11. Fidelity for kicked atoms with gravity near a quantum resonance

    CERN Document Server

    Dubertrand, Rémy; Wimberger, Sandro

    2012-01-01

    Kicked atoms under a constant Stark or gravity field are investigated for experimental setups with cold and ultra cold atoms. The parametric stability of the quantum dynamics is studied using the fidelity. In the case of a quantum resonance, it is shown that the behavior of the fidelity depends on arithmetic properties of the gravity parameter. Close to a quantum resonance, the long time asymptotics of the fidelity is studied by means of a {\\em pseudo-classical} approximation first introduced by Fishman {\\em et al.} [J. Stat. Phys. {\\bf 110}, 911 (2003)]. The long-time decay of fidelity arises from the tunneling out of pseudo-classical stable islands, and a simple ansatz is proposed which satisfactorily reproduces the main features observed in numerical simulations.

  12. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  13. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  14. Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children: A Randomized Pilot Study.

    Science.gov (United States)

    Bragard, Isabelle; Farhat, Nesrine; Seghaye, Marie-Christine; Karam, Oliver; Neuschwander, Arthur; Shayan, Yasaman; Schumacher, Katharina

    2016-10-18

    Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval. Questionnaires assessed self-reported changes in self-efficacy, stress, and satisfaction about skills. Blinded evaluators assessed changes in leaders' TSs and NTSs during the simulations and the time to initiate cardiopulmonary resuscitation. After training, stress decreased and satisfaction about skills increased in the EG, whereas it remained the same in the CG (P = 0.014 and P < 0.001, respectively). There was no significant change in self-efficacy. Analyses of video-recorded skills showed significant improvements in TSs and NTSs of the EG leaders after training, but not of the CG leaders (P = 0.026, P = 0.038, respectively). The comparison of the evolution of the 2 groups concerning time to initiate cardiopulmonary resuscitation was not significantly different between the first and last simulation sessions. A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.

  15. Possibilities of the ErgoScope high fidelity work simulator in skill assessment, skill development and vocational aptitude tests of physically disabled persons.

    Science.gov (United States)

    Izsó, Lajos; Székely, Ildikó; Dános, László

    2015-01-01

    The aim of this paper - based on the extensive experiences of the authors gained by using one particular work simulator - is to present some promising possibilities of the application of this (and any other similar) work simulator in the field of skill assessment, skill development and vocational aptitude tests of physically disabled persons. During skill assessment and development, as parts of the therapy, the focus is on the disabled functions. During vocational aptitude tests, however, the focus is already on the functions that remained intact and therefore can be the basis of returning to work. Some factual examples are provided to realize the proposed possibilities in practice.

  16. A framework for web browser-based medical simulation using WebGL.

    Science.gov (United States)

    Halic, Tansel; Ahn, Woojin; De, Suvranu

    2012-01-01

    This paper presents a web browser-based software framework that provides accessibility, portability, and platform independence for medical simulation. Typical medical simulation systems are restricted to the underlying platform and device, which limits widespread use. Our framework allows realistic and efficient medical simulation using only the web browser for anytime anywhere access using a variety of platforms ranging from desktop PCs to tablets. The framework consists of visualization, simulation, and hardware integration modules that are fundamental components for multimodal interactive simulation. Benchmark tests are performed to validate the rendering and computing performance of our framework with latest web browsers including Chrome and Firefox. The results are quite promising opening up the possibility of developing web-based medical simulation technology.

  17. Measuring third year undergraduate nursing students' reflective thinking skills and critical reflection self-efficacy following high fidelity simulation: A pilot study.

    Science.gov (United States)

    Tutticci, Naomi; Lewis, Peter A; Coyer, Fiona

    2016-05-01

    Critical reflection underpins critical thinking, a highly desirable generic nursing graduate capability. To improve the likelihood of critical thinking transferring to clinical practice, reflective thinking needs to be measured within the learning space of simulation. This study was divided into two phases to address the reliability and validity measures of previously untested surveys. Phase One data was collected from individuals (n = 6) using a 'think aloud' approach and an expert panel to review content validity, and verbatim comment analysis was undertaken. The Reflective Thinking Instrument and Critical Reflection Self-Efficacy Visual Analogue Scale items were contextualised to simulation. The expert review confirmed these instruments exhibited content validity. Phase Two data was collected through an online survey (n = 58). Cronbach's alpha measured internal consistency and was demonstrated by all subscales and the Instrument as a whole (.849). There was a small to medium positive correlation between critical reflection self-efficacy and general self-efficacy (r = .324, n = 56, p = .048). Participant responses were positive regarding the simulation experience. The research findings demonstrated that the Reflective Thinking and Simulation Satisfaction survey is reliable. Further development of this survey to establish validity is recommended to make it viable. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. A report on the piloting of a novel computer-based medical case simulation for teaching and formative assessment of diagnostic laboratory testing

    Directory of Open Access Journals (Sweden)

    Clarence D. Kreiter

    2011-01-01

    Full Text Available Objectives: Insufficient attention has been given to how information from computer-based clinical case simulations is presented, collected, and scored. Research is needed on how best to design such simulations to acquire valid performance assessment data that can act as useful feedback for educational applications. This report describes a study of a new simulation format with design features aimed at improving both its formative assessment feedback and educational function. Methods: Case simulation software (LabCAPS was developed to target a highly focused and well-defined measurement goal with a response format that allowed objective scoring. Data from an eight-case computer-based performance assessment administered in a pilot study to 13 second-year medical students was analyzed using classical test theory and generalizability analysis. In addition, a similar analysis was conducted on an administration in a less controlled setting, but to a much large sample (n=143, within a clinical course that utilized two random case subsets from a library of 18 cases. Results: Classical test theory case-level item analysis of the pilot assessment yielded an average case discrimination of 0.37, and all eight cases were positively discriminating (range=0.11–0.56. Classical test theory coefficient alpha and the decision study showed the eight-case performance assessment to have an observed reliability of σ=G=0.70. The decision study further demonstrated that a G=0.80 could be attained with approximately 3 h and 15 min of testing. The less-controlled educational application within a large medical class produced a somewhat lower reliability for eight cases (G=0.53. Students gave high ratings to the logic of the simulation interface, its educational value, and to the fidelity of the tasks. Conclusions: LabCAPS software shows the potential to provide formative assessment of medical students’ skill at diagnostic test ordering and to provide valid feedback to

  19. Simulation based virtual learning environment in medical genetics counseling

    DEFF Research Database (Denmark)

    Makransky, Guido; Bonde, Mads T; Wulff, Julie S G;

    2016-01-01

    understanding of medical genetics, 82 % thought that medical genetics was more interesting, 93 % indicated that they were more interested and motivated, and had gained confidence by having experienced working on a case story that resembled the real working situation of a doctor, and 78 % indicated...

  20. Computer Simulation of an Anesthesia Service at a U.S. Army Medical Treatment Facility

    Science.gov (United States)

    1999-08-01

    Anesthesia Simulation Study 1 Running head : ANESTHESIA SIMULATION Computer Simulation of an Anesthesia Service at a U.S. Army Medical Treatment...bettering marketing efforts). There are several articles that address staffing from the perspective of what type of provider is the most cost

  1. Nursing students' evaluation of a new feedback and reflection tool for use in high-fidelity simulation - Formative assessment of clinical skills. A descriptive quantitative research design.

    Science.gov (United States)

    Solheim, Elisabeth; Plathe, Hilde Syvertsen; Eide, Hilde

    2017-09-04

    Clinical skills training is an important part of nurses' education programmes. Clinical skills are complex. A common understanding of what characterizes clinical skills and learning outcomes needs to be established. The aim of the study was to develop and evaluate a new reflection and feedback tool for formative assessment. The study has a descriptive quantitative design. 129 students participated who were at the end of the first year of a Bachelor degree in nursing. After highfidelity simulation, data were collected using a questionnaire with 19 closed-ended and 2 open-ended questions. The tool stimulated peer assessment, and enabled students to be more thorough in what to assess as an observer in clinical skills. The tool provided a structure for selfassessment and made visible items that are important to be aware of in clinical skills. This article adds to simulation literature and provides a tool that is useful in enhancing peer learning, which is essential for nurses in practice. The tool has potential for enabling students to learn about reflection and developing skills for guiding others in practice after they have graduated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Simulation based virtual learning environment in medical genetics counseling

    DEFF Research Database (Denmark)

    Makransky, Guido; Bonde, Mads T.; Wulff, Julie S. G.

    2016-01-01

    that they would feel more confident counseling a patient after the simulation. CONCLUSIONS: The simulation based learning environment increased students' learning, intrinsic motivation, and self-efficacy (although the strength of these effects differed depending on their pre-test knowledge), and increased...

  3. Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory

    OpenAIRE

    Rybing, Jonas; Prytz, Erik; Hornwall, Johan; Nilsson, Helene; Jonson, Carl-Oscar; Bång, Magnus

    2017-01-01

    Background Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments. Purpose This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine managem...

  4. Learning curves and long-term outcome of simulation-based thoracentesis training for medical students

    Directory of Open Access Journals (Sweden)

    Chen Kezhong

    2011-06-01

    Full Text Available Abstract Background Simulation-based medical education has been widely used in medical skills training; however, the effectiveness and long-term outcome of simulation-based training in thoracentesis requires further investigation. The purpose of this study was to assess the learning curve of simulation-based thoracentesis training, study skills retention and transfer of knowledge to a clinical setting following simulation-based education intervention in thoracentesis procedures. Methods Fifty-two medical students were enrolled in this study. Each participant performed five supervised trials on the simulator. Participant's performance was assessed by performance score (PS, procedure time (PT, and participant's confidence (PC. Learning curves for each variable were generated. Long-term outcome of the training was measured by the retesting and clinical performance evaluation 6 months and 1 year, respectively, after initial training on the simulator. Results Significant improvements in PS, PT, and PC were noted among the first 3 to 4 test trials (p 0.05. Clinical competency in thoracentesis was improved in participants who received simulation training relative to that of first year medical residents without such experience (p Conclusions This study demonstrates that simulation-based thoracentesis training can significantly improve an individual's performance. The saturation of learning from the simulator can be achieved after four practice sessions. Simulation-based training can assist in long-term retention of skills and can be partially transferred to clinical practice.

  5. Laparoscopic skill improvement after virtual reality simulator training in medical students as assessed by augmented reality simulator.

    Science.gov (United States)

    Nomura, Tsutomu; Mamada, Yasuhiro; Nakamura, Yoshiharu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Isturo; Mizuguchi, Yoshiaki; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

    2015-11-01

    Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. In the object-positioning module, the execution time of the task (P reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  6. Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

    Science.gov (United States)

    Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

    2015-01-01

    This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

  7. High-fidelity quantum driving

    DEFF Research Database (Denmark)

    Bason, Mark George; Viteau, Matthieu; Malossi, Nicola

    2011-01-01

    Accurately controlling a quantum system is a fundamental requirement in quantum information processing and the coherent manipulation of molecular systems. The ultimate goal in quantum control is to prepare a desired state with the highest fidelity allowed by the available resources and the experi......Accurately controlling a quantum system is a fundamental requirement in quantum information processing and the coherent manipulation of molecular systems. The ultimate goal in quantum control is to prepare a desired state with the highest fidelity allowed by the available resources...

  8. High-fidelity quantum driving

    DEFF Research Database (Denmark)

    Bason, Mark George; Viteau, Matthieu; Malossi, Nicola

    2011-01-01

    Accurately controlling a quantum system is a fundamental requirement in quantum information processing and the coherent manipulation of molecular systems. The ultimate goal in quantum control is to prepare a desired state with the highest fidelity allowed by the available resources...... and the experimental constraints. Here we experimentally implement two optimal high-fidelity control protocols using a two-level quantum system comprising Bose–Einstein condensates in optical lattices. The first is a short-cut protocol that reaches the maximum quantum-transformation speed compatible...

  9. Curriculum Fidelity and Factors Affecting Fidelity in the Turkish Context

    Science.gov (United States)

    Bumen, Nilay T.; Cakar, Esra; Yildiz, Derya G.

    2014-01-01

    Although a centralist education system is in place in Turkey, studies show that while implementing the curriculum developed by the Ministry of Education, teachers make changes based on their own preferences or depending on students. Curriculum fidelity can be defined as the degree to which teachers or stakeholders abide by a curriculum's original…

  10. A social cybernetic analysis of simulation-based, remotely delivered medical skills training in an austere environment: developing a test bed for spaceflight medicine.

    Science.gov (United States)

    Musson, David M; Doyle, Thomas E

    2012-01-01

    This paper describes analysis of medical skills training exercises that were conducted at an arctic research station. These were conducted as part of an ongoing effort to establish high fidelity medical simulation test bed capabilities in remote and extreme "space analogue" environments for the purpose studying medical care in spaceflight. The methodological orientation followed by the authors is that of "second order cybernetics," or the science of studying human systems where the observer is involved within the system in question. Analyses presented include the identification of three distinct phases of the training activity, and two distinct levels of work groups-- termed "first-order teams" and "second-order teams." Depending on the phase of activity, first-order and second-order teams are identified, each having it own unique structure, composition, communications, goals, and challenges. Several specific teams are highlighted as case examples. Limitations of this approach are discussed, as are potential benefits to ongoing and planned research activity in this area.

  11. Medical Robotic and Tele surgical Simulation Education Research

    Science.gov (United States)

    2017-05-01

    Baheti A, Chandrashekar R, Wilding G and Guru K. (2010). Can Image Based Virtual Reality Help Teach Anatomy? Journal of Endourology, 24(4):629-34. Seixas... virtual reality environment for training operating room staff in robotic surgery. Develop design for simulators in hard-tissue robotic surgery (spinal...Simulation in Training.” IEEE International Systems Conference, April 2016. 5. Julian, Tanaka, Smith, “A Side-by-Side Comparison of Virtual Reality

  12. Use of medical simulation to teach bioterrorism preparedness: the anthrax example.

    Science.gov (United States)

    Olsen, Martin E

    2013-01-01

    The 2001 anthrax bioterrorism attacks demonstrated vulnerability for future similar attacks. This article describes mechanisms that can be used to prepare the medical community and healthcare facilities for the diagnosis and management of a subsequent bioterrorism attack should such an event occur and the fundamentals of medical simulation and its use in teaching learners about the diagnosis of management of anthrax exposure.

  13. Patient Simulation and Team-Teaching in a Medical Interviewing Course.

    Science.gov (United States)

    Coulehan, John L.; Nardini, Donna

    1982-01-01

    A physical diagnosis course is described that introduced an interviewing segment with patient simulation at a medical school where medical interviewing or communications skills were not in the required curriculum. Physicians' responsibility for the quality of the physician-patient relationships was stressed. (MSE)

  14. Improving Confidence in Competencies for International Medical Trips Using a Curriculum with Simulation.

    Science.gov (United States)

    Birckhead, Brandon J; Mullikin, Trey C; Zubair, Adeel S; Alniemi, Dema; Franz, Walter B; Bachman, John W

    2015-01-01

    Many incoming medical and undergraduate students seek out international medical mission trips to supplement their education and training. However, few have the necessary skills to perform simple clinical tasks such as taking vital signs or conducting an initial patient interview. We conducted a small pilot study to assess the impact of simulation exercises on teaching incoming first-year medical students and undergraduate students basic clinical skills and teamwork. Our study population consisted of nine incoming medical students and 11 undergraduate students who participated in a training session involving simulated tasks prior to taking a medical mission trip to Nicaragua. Participants completed a survey before and after the simulation and at the end of the trip. All 20 indicated the simulation was effective in teaching clinical and team-building skills. In addition, the simulation exercise improved participants' confidence in their ability to perform certain clinical tasks and work as a team prior to the mission trip. We concluded that simulation is effective for incoming medical and undergraduate students and can be used prior to global health trips to increase their confidence in performing tasks required for a successful experience.

  15. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    Directory of Open Access Journals (Sweden)

    Ricci LH

    2017-06-01

    Full Text Available Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP, Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP, São Paulo (SP, Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four national and international databases – PubMed, Scielo, Medline and Cochrane. Initial set of articles was screened based on title and abstracts, followed by full text analysis. It comprises of articles that were published in the past fifteen years (2002–2017.Results: Eighty-three articles concerning simulation models for medical education were found in national and international databases, with only a few describing important aspects of ophthalmoscopy training and current application of simulation in medical education. After secondary analysis, 38 articles were included.Conclusion: Different ophthalmoscopy simulation models have been described, but only very few studies appraise the effectiveness of each individual model. Comparison studies are still required to determine best approaches for medical education and skill enhancement through simulation models, applied to both medical students as well as young ophthalmologists in training. Keywords: direct ophthalmoscopy, indirect ophthalmoscopy, skills, simulator, simulation models

  16. Discrete event simulation of administrative and medical processes

    Directory of Open Access Journals (Sweden)

    Robert Leskovar

    2011-05-01

    Conclusions: Discrete event simulation provedthat joint administration would contribute to a more even workload distribution among administrative personnel, higher quality of service and easier human resource management. The presented approach can be efficiently applied to large-scale systems e.g. organizational changes of processes in Specialist Outpatient Clinics.

  17. The National Center for Collaboration in Medical Modeling and Simulation

    Science.gov (United States)

    2005-05-01

    4 T ask 2 - T echnology D evelopm ent ...................................................................... 9 Task 3 - Simulators and Curriculum...offices, clinics, and even in mobile blood vehicles. Further, there are a number of concerns with respect to patient safety. According to Mishori... mobilization exposes more personnel to novel pathogens or if the stress of war down regulates immune function. Table 7. Similarity of ICD Profiles for

  18. Medical Robotic and Telesurgical Simulation and Education Research

    Science.gov (United States)

    2012-09-01

    Acquaintance Period. The subjects walked through the curriculum of 4 tasks on the robot/simulator. They were allowed to get acquainted with the...Jensen P, et al. Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series. J Am CollSurg 1997; 184: 571–578. 2. Merrie AE

  19. Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine

    OpenAIRE

    Heitz, Corey; Eyck, Raymond Ten; Smith, Michael; Fitch, Michael

    2011-01-01

    Introduction The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges. Methods We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey el...

  20. Influence of imaging resolution on color fidelity in digital archiving.

    Science.gov (United States)

    Zhang, Pengchang; Toque, Jay Arre; Ide-Ektessabi, Ari

    2015-11-01

    Color fidelity is of paramount importance in digital archiving. In this paper, the relationship between color fidelity and imaging resolution was explored by calculating the color difference of an IT8.7/2 color chart with a CIELAB color difference formula for scanning and simulation images. Microscopic spatial sampling was used in selecting the image pixels for the calculations to highlight the loss of color information. A ratio, called the relative imaging definition (RID), was defined to express the correlation between image resolution and color fidelity. The results show that in order for color differences to remain unrecognizable, the imaging resolution should be at least 10 times higher than the physical dimension of the smallest feature in the object being studied.

  1. Medical Robotic and Telesurgical Simulation and Education Research

    Science.gov (United States)

    2014-09-01

    Cleveland, OH) for integration into the DVSS. This expansion of the system demonstrates the ability of the simulator platform to blend together... rubber resins. Since we were still 11 experimenting with the placement of the exercises, the first 3D printed dome structure was created with a...heavier shell material also solved the problem of anchoring the dome. The devices weight was now sufficient so that the natural movements of the

  2. Crisis resource management, simulation training and the medical emergency team.

    Science.gov (United States)

    Gillon, Stuart; Radford, Sam; Chalwin, Richard; Devita, Michael; Endacott, Ruth; Jones, Daryl

    2012-09-01

    Recently there has been increased focus on improved detection and management of deteriorating patients in Australian hospitals. Since the introduction of the medical emergency team (MET) model there has been an increased role for intensive care unit staff in responding to deterioration of patients in hospital wards. Review and management of MET patients differs from the traditional model of ward patient review, as ICU staff may not know the patient. Furthermore, assessment and intervention is often time-critical and must occur simultaneously. Finally, about 10% of MET patients require intensive care-level interventions to be commenced on the ward, and this requires participation of non-ICU-trained ward staff. • To date, the interventions performed by MET staff and approaches to training responders have been relatively under investigated, particularly in the Australian and New Zealand context. In this article we briefly review the principles of the MET and contend that activation of the MET by ward staff represents a response to a medical crisis. We then outline why MET intervention differs from traditional ward-based doctor-patient encounters, and emphasise the importance of non-technical skills during the MET response. Finally, we suggest ways in which the skills required for crisis resource management within the MET can be taught to ICU staff, and the potential benefits, barriers and difficulties associated with the delivery of such training in New Zealand and Australia.

  3. High-Fidelity Lunar Dust Simulant Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The severity of the lunar dust problems encountered during the Apollo missions were consistently underestimated by ground tests, illustrating the need to develop...

  4. Toward Improved Fidelity of Thermal Explosion Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, A L; Becker, R; Howard, W M; Wemhoff, A

    2009-07-17

    We will present results of an effort to improve the thermal/chemical/mechanical modeling of HMX based explosive like LX04 and LX10 for thermal cook-off. The original HMX model and analysis scheme were developed by Yoh et.al. for use in the ALE3D modeling framework. The current results were built to remedy the deficiencies of that original model. We concentrated our efforts in four areas. The first area was addition of porosity to the chemical material model framework in ALE3D that is used to model the HMX explosive formulation. This is needed to handle the roughly 2% porosity in solid explosives. The second area was the improvement of the HMX reaction network, which included the inclusion of a reactive phase change model base on work by Henson et.al. The third area required adding early decomposition gas species to the CHEETAH material database to develop more accurate equations of state for gaseous intermediates and products. Finally, it was necessary to improve the implicit mechanics module in ALE3D to more naturally handle the long time scales associated with thermal cook-off. The application of the resulting framework to the analysis of the Scaled Thermal Explosion (STEX) experiments will be discussed.

  5. Improving combat medic learning using a personal computer-based virtual training simulator.

    Science.gov (United States)

    Hemman, Eileen A

    2005-09-01

    The new military occupational specialty for combat medics, the 91W, requires that all medics successfully pass the National Registry of Emergency Medical Technicians examination. The objective of this study was to supplement standard emergency medical technician training with a three-dimensional, computer-based, virtual training simulator and to assess whether scores and pass rates could be increased. Combat medics (N=167) were selected for training through the usual noncommissioned officer unit selection process and were randomized by cohort to the training simulator. Results showed no significant differences in National Registry of Emergency Medical Technicians examination scores (t = 1.019, df = 153, p = 0.745, one-tailed) or pass rates (chi2 = 1.575, df = 1, p = 0.209). The findings, however, were used to construct two models of combat medic characteristics that can be used to assist in initial selection for emergency medical technician courses and subsequent counseling of soldiers on course completion. With further research, these models could be refined for Army-wide use to increase the cost-effectiveness of combat medic recruitment, training, and testing.

  6. Statistical simulation of variations in medical characteristic during heliogeophysical disturbances

    Science.gov (United States)

    Sergeenko, N. P.

    2016-12-01

    Heliobiological studies, although recently very active, have failed to provide a full understanding of the Sun-biosphere interaction mechanisms. This is because the forecasts of bio tropic effects of the active Sun, like geophysical forecasts, are mostly determined by empirical patterns and are of a probability character. To obtain probability predictions, an adequate statistical model should be prepared. This is what is treated in this work. The time series of data from medical studies have undergone the trend treatment. The samples were sorted by the state of heliogeophysical conditions, and statistical distributions and invariants have been calculated down to the forth order. The analysis has shown that during heliogeomagnetic disturbances the obtained distributions differ from the Gaussian law. Therefore, an attempt at a statistical description of medical characteristics was made on the basis of the Poisson model. For our samples, the characteristic function of the exponential kind was chosen under the assumption that time series are the superposition of some, determined or random, process. Through the Fourier transform, the characteristic function was transformed into a nonholomorphic expressiveasymmetrical function of the probability density. The statistical distributions, calculated for the studied samples over perturbation periods, were compared with the obtained model function of distribution. The probability of coincidence for a posteriori distributions by the criterion χ2 is P 0.7-0.9. Our analysis has allowed a conclusion about the applicability of a model based on the Poisson random process for statistical description and appraisals of the probability of changes in the number of vascular bouts and strokes during heliogeophysical perturbations.

  7. Helicopter Emergency Medical Service Simulation Training in the Extreme: Simulation-based Training in a Mountain Weather Chamber.

    Science.gov (United States)

    Pietsch, Urs; Ney, Ludwig; Kreuzer, Oliver; Berner, Armin; Lischke, Volker

    Mountain rescue operations often confront crews with extreme weather conditions. Extremely cold temperatures make standard treatment sometimes difficult or even impossible. It is well-known that most manual tasks, including those involved in mountain rescue operations, are slowed by extremely cold weather. To lessen and improve the decrement in performance of emergency medical treatment caused by cold-induced manual impairment and inadequate medical equipment and supplies, simulation training in a weather chamber, which can produce wind and temperatures up to -22°C, was developed. It provides a promising tool to train the management of complex multidisciplinary settings, thus reducing the occurrence of fatal human and technical errors and increasing the safety for both the patient and the mountain emergency medical service crew. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  8. Computer-delivered patient simulations in the United States Medical Licensing Examination (USMLE).

    Science.gov (United States)

    Dillon, Gerard F; Clauser, Brian E

    2009-01-01

    To obtain a full and unrestricted license to practice medicine in the United States, students and graduates of the MD-granting US medical schools and of medical schools located outside of the United States must take and pass the United States Medical Licensing Examination. United States Medical Licensing Examination began as a series of paper-and-pencil examinations in the early 1990s and converted to computer-delivery in 1999. With this change to the computerized format came the opportunity to introduce computer-simulated patients, which had been under development at the National Board of Medical Examiners for a number of years. This testing format, called a computer-based case simulation, requires the examinee to manage a simulated patient in simulated time. The examinee can select options for history-taking and physical examination. Diagnostic studies and treatment are ordered via free-text entry, and the examinee controls the advance of simulated time and the location of the patient in the health care setting. Although the inclusion of this format has brought a number of practical, psychometric, and security challenges, its addition has allowed a significant expansion in ways to assess examinees on their diagnostic decision making and therapeutic intervention skills and on developing and implementing a reasonable patient management plan.

  9. Clinical clerkship course for medical students on lumbar puncture using simulators.

    Science.gov (United States)

    Adachi, Koji; Yoshimura, Akinobu; Aso, Ryoko; Miyashita, Tsuguhiro; Yoshida, Daizo; Teramoto, Akira; Shimura, Toshiro

    2012-01-01

    Lumbar puncture is a medical technique that physicians must learn and is, therefore, considered a basic medical procedure. The lumbar puncture simulators Lumbar-Kun (Lumbar Puncture Simulator) and Lumbar-Kun II (Lumbar Puncture Simulator II) (Kyoto Kagaku, Kyoto, Japan) are teaching aids designed for practicing spinal insertions. We describe and results of a lumbar puncture clerkship course, provided to 5th-year medical students during clinical clerkship activity. The aim of this study was to evaluate the effectiveness of the lumbar puncture clerkship course in the medical education program. Comprehension, technical achievement, and satisfaction were scored by students and instructors using a 6-point Likert scale. Scores for both comprehension and technical achievement were high, but technical achievement scores tended to be higher than comprehension scores. In addition, the scores students gave themselves were higher than the scores they were given by instructors. Student satisfaction was high. The lumbar puncture simulators, Lumbar-Kun and Lumbar-Kun II, achieved excellent overall impressions and represent useful tools for training in lumbar puncture procedures. In addition to the simulators, an appropriate preparatory text and a short lecture before training seemed to increase the educational effect of this lumbar puncture clerkship course for medical students.

  10. Towards Interactive Medical Content Delivery Between Simulated Body Sensor Networks and Practical Data Center.

    Science.gov (United States)

    Shi, Xiaobo; Li, Wei; Song, Jeungeun; Hossain, M Shamim; Mizanur Rahman, Sk Md; Alelaiwi, Abdulhameed

    2016-10-01

    With the development of IoT (Internet of Thing), big data analysis and cloud computing, traditional medical information system integrates with these new technologies. The establishment of cloud-based smart healthcare application gets more and more attention. In this paper, semi-physical simulation technology is applied to cloud-based smart healthcare system. The Body sensor network (BSN) of system transmit has two ways of data collection and transmission. The one is using practical BSN to collect data and transmitting it to the data center. The other is transmitting real medical data to practical data center by simulating BSN. In order to transmit real medical data to practical data center by simulating BSN under semi-physical simulation environment, this paper designs an OPNET packet structure, defines a gateway node model between simulating BSN and practical data center and builds a custom protocol stack. Moreover, this paper conducts a large amount of simulation on the real data transmission through simulation network connecting with practical network. The simulation result can provides a reference for parameter settings of fully practical network and reduces the cost of devices and personnel involved.

  11. Using Simulation to Improve First-Year Pharmacy Students' Ability to Identify Medication Errors Involving the Top 100 Prescription Medications.

    Science.gov (United States)

    Atayee, Rabia S; Awdishu, Linda; Namba, Jennifer

    2016-06-25

    Objective. To evaluate first-year pharmacy students' ability to identify medication errors involving the top 100 prescription medications. Design. In the first quarter of a 3-quarter pharmacy self-care course, a didactic lecture on the most common prescribing and dispensing prescription errors was presented to first-year pharmacy students (P1) in preparation for a prescription review simulation done individually and as a group. In the following quarter, they were given a formal prescription review workshop before a second simulation involving individual and group review of a different set of prescriptions. Students were evaluated based on the number of correctly checked prescriptions and a self-assessment of their confidence in reviewing prescriptions. Assessment. All 63 P1 students completed the prescription review simulations. The individual scores did not significantly change, but group scores improved from 79 (16.2%) in the fall quarter to 98.6 (4.7%) in the winter quarter. Students perceived improvement of their prescription checking skills, specifically in their ability to fill a prescription on their own, identify prescribing and dispensing errors, and perform pharmaceutical calculations. Conclusion. A prescription review module consisting of a didactic lecture, workshop and simulation-based methods to teach prescription analysis was successful at improving first year pharmacy students' knowledge, confidence, and application of these skills.

  12. The emerging role of screen based simulators in the training and assessment of colonoscopists

    OpenAIRE

    Cunningham, Morven; Fernando, Bimbi; Berlingieri, Pasquale

    2010-01-01

    Incorporation of screen based simulators into medical training has recently gained momentum, as advances in technology have coincided with a government led drive to increase the use of medical simulation training to improve patient safety with progressive reductions in working hours available for junior doctors to train. High fidelity screen based simulators hold great appeal for endoscopy training. Potentially, their incorporation into endoscopy training curricula could enhance speed of acqu...

  13. Stepwise mechanism for transcription fidelity

    Directory of Open Access Journals (Sweden)

    Zorov Savva

    2010-05-01

    Full Text Available Abstract Background Transcription is the first step of gene expression and is characterized by a high fidelity of RNA synthesis. During transcription, the RNA polymerase active centre discriminates against not just non-complementary ribo NTP substrates but also against complementary 2'- and 3'-deoxy NTPs. A flexible domain of the RNA polymerase active centre, the Trigger Loop, was shown to play an important role in this process, but the mechanisms of this participation remained elusive. Results Here we show that transcription fidelity is achieved through a multi-step process. The initial binding in the active centre is the major discrimination step for some non-complementary substrates, although for the rest of misincorporation events discrimination at this step is very poor. During the second step, non-complementary and 2'-deoxy NTPs are discriminated against based on differences in reaction transition state stabilization and partly in general base catalysis, for correct versus non-correct substrates. This step is determined by two residues of the Trigger Loop that participate in catalysis. In the following step, non-complementary and 2'-deoxy NTPs are actively removed from the active centre through a rearrangement of the Trigger Loop. The only step of discrimination against 3'-deoxy substrates, distinct from the ones above, is based on failure to orient the Trigger Loop catalytic residues in the absence of 3'OH. Conclusions We demonstrate that fidelity of transcription by multi-subunit RNA polymerases is achieved through a stepwise process. We show that individual steps contribute differently to discrimination against various erroneous substrates. We define the mechanisms and contributions of each of these steps to the overall fidelity of transcription.

  14. FT. Sam 91 Whiskey Combat Medic Medical Simulation Training Quantitative Integration Enhancement Program

    Science.gov (United States)

    2011-07-01

    the number of predefined clinical steps performed and the completion times recorded for each of the procedural skills examined in this study. The...emergency medical care to patrons of large events such as concerts, NBA basketball games, Conventions and many other events in San Antonio. (Contact...SEMESTER HOURS RECORDED Military 71.00 Civilian 28.00 Exam 6.00 All Sources 105.00 REFERENCES Ian Coon USAF MSgt Phone Number: (210)262-9422

  15. Mathematical simulation of hemodynamical processes and medical technologies

    Science.gov (United States)

    Tsitsyura, Nadiya; Novyc'kyy, Victor V.; Lushchyk, Ulyana B.

    2001-06-01

    Vascular pathologies constitute a significant part of human's diseases and their rate tends to increase. Numerous investigations of brain blood flow in a normal condition and in a pathological one has created a new branch of modern medicine -- angioneurology. It combines the information on brain angioarchitecture and on blood supply in a normal condition and in a pathological one. Investigations of a disease's development constitute an important problem of a modern medicine. Cerebrum blood supply is regulated by arterial inflow and venous outflow, but, unfortunately, in the literature available arterial and venous beds are considered separately. This causes an one-sided interpretation of atherosclerotical and discirculatory encefalopathies. As arterial inflow and venous outflow are interrelated, it seems to be expedient to perform a complex estimation of arteriovenous interactions, prove a correlation dependence connection between the beds and find a dependence in a form of mathematical function. The results will be observed clearly in the graphs. There were 139 patients aged from 2 up to 70 examined in the 'Istyna' Scientific Medical Ultrasound Center by means of a Logidop 2 apparatus manufactured by Kranzbuhler, Germany using a technique of cerebral arteries and veins ultrasound location (invented and patented by Ulyana Lushchyk, State Patent of Ukraine N10262 of 19/07/1995). A clinical interpretation of the results obtained was performed. With the help of this technique and ultrasound Dopplerography the blood flow in major head and cervical arteries was investigated. While performing a visual graphic analysis we paid attention to the changes of carotid artery (CA), internal jugular vein (IJV) and supratrochlear artery's (STA) hemodynamical parameters. Generally accepted blood flow parameters: FS -- maximal systolic frequency and FD -- minimal diastolic frequency were measured. The correlation between different combinations of parameters in the vessels mentioned

  16. SIMMEON-Prep study: SIMulation of Medication Errors in ONcology: prevention of antineoplastic preparation errors.

    Science.gov (United States)

    Sarfati, L; Ranchon, F; Vantard, N; Schwiertz, V; Gauthier, N; He, S; Kiouris, E; Gourc-Berthod, C; Guédat, M G; Alloux, C; Gustin, M-P; You, B; Trillet-Lenoir, V; Freyer, G; Rioufol, C

    2015-02-01

    Medication errors (ME) in oncology are known to cause serious iatrogenic complications. However, MEs still occur at each step in the anticancer chemotherapy process, particularly when injections are prepared in the hospital pharmacy. This study assessed whether a ME simulation program would help prevent ME-associated iatrogenic complications. The 5-month prospective study, consisting of three phases, was undertaken in the centralized pharmaceutical unit of a university hospital of Lyon, France. During the first simulation phase, 25 instruction sheets each containing one simulated error were inserted among various instruction sheets issued to blinded technicians. The second phase consisted of activity aimed at raising pharmacy technicians' awareness of risk of medication errors associated with antineoplastic drugs. The third phase consisted of re-enacting the error simulation process 3 months after the awareness campaign. The rate and severity of undetected medication errors were measured during the two simulation (first and third) phases. The potential seriousness of the ME was assessed using the NCC MERP(®) index. The rate of undetected medication errors decreased from 12 in the first simulation phase (48%) to five in the second simulation phase (20%, P = 0.04). The number of potential deaths due to administration of a faulty preparation decreased from three to zero. Awareness of iatrogenic risk through error simulation allowed pharmacy technicians to improve their ability to identify errors. This study is the first demonstration of the successful application of a simulation-based learning tool for reducing errors in the preparation of injectable anticancer drugs. Such a program should form part of the continuous quality improvement of risk management strategies for cancer patients. © 2014 John Wiley & Sons Ltd.

  17. Translating medical documents improves students' communication skills in simulated physician-patient encounters.

    Science.gov (United States)

    Bittner, Anja; Bittner, Johannes; Jonietz, Ansgar; Dybowski, Christoph; Harendza, Sigrid

    2016-02-27

    Patient-physician communication should be based on plain and simple language. Despite communication skill trainings in undergraduate medical curricula medical students and physicians are often still not aware of using medical jargon when communicating with patients. The aim of this study was to compare linguistic communication skills of undergraduate medical students who voluntarily translate medical documents into plain language with students who do not participate in this voluntary task. Fifty-nine undergraduate medical students participated in this study. Twenty-nine participants were actively involved in voluntarily translating medical documents for real patients into plain language on the online-platform https://washabich.de (WHI group) and 30 participants were not (non-WHI group). The assessment resembled a virtual consultation hour, where participants were connected via skype to six simulated patients (SPs). The SPs assessed participants' communication skills. All conversations were transcribed and assessed for communication skills and medical correctness by a blinded expert. All participants completed a self-assessment questionnaire on their communication skills. Across all raters, the WHI group was assessed significantly (p = .007) better than the non-WHI group regarding the use of plain language. The blinded expert assessed the WHI group significantly (p = .018) better regarding the use of stylistic devices of communication. The SPs would choose participants from the WHI group significantly (p = .041) more frequently as their personal physician. No significant differences between the two groups were observed with respect to the medical correctness of the consultations. Written translation of medical documents is associated with significantly more frequent use of plain language in simulated physician-patient encounters. Similar extracurricular exercises might be a useful tool for medical students to enhance their communication skills with

  18. Discrete event simulation of administrative and medical processes: Diskretna dogodkovna simulacija administrativnih in medicinskih postopkov:

    OpenAIRE

    Accetto, Rok; Baggia, Alenka; Lazarevič, Zlatko; Leskovar, Robert; Požun, Peter; Vukovič, Goran

    2011-01-01

    Background: Medical processes are often obstructed by administrative ones. Themain issue in administrative processes is uneven workload resulting in an increased possibility of human errors. The system approach assures that medical and administrative processes are integrated. According to research reports and best practices, discrete event simulation is a proper method to implement the system approach. Methods: A detailed analysis of the administrative processes was performed using interviews...

  19. Using mixed reality, force feedback and tactile augmentation to improve the realism of medical simulation.

    Science.gov (United States)

    Fisher, J Brian; Porter, Susan M

    2002-01-01

    This paper describes an application of a display approach which uses chromakey techniques to composite real and computer-generated images allowing a user to see his hands and medical instruments collocated with the display of virtual objects during a medical training simulation. Haptic feedback is provided through the use of a PHANTOM force feedback device in addition to tactile augmentation, which allows the user to touch virtual objects by introducing corresponding real objects in the workspace. A simplified catheter introducer insertion simulation was developed to demonstrate the capabilities of this approach.

  20. Aprendizaje de la historia clínica con pacientes simulados en el grado de Medicina Learning to take medical histories through patients simulation in undergraduate Medical School students

    Directory of Open Access Journals (Sweden)

    M. Cristina Rodríguez-Díez

    2012-03-01

    methods have been proposed: virtual patients, high fidelity devices and standard patients. We propose the use of 5th-6th year Medical School students acting as patients when teaching history taking to their 1st year colleagues. Subjects and methods. A total of 207 students from 1st year Medical School underwent training in history taking at the Simulation Center, with senior students acting as actors. The quality of the written medical records was evaluated by two medical doctors. The satisfaction of all students involved in the course was evaluated through an anonymous voluntary questionnaire. Results. The average score of the written medical histories was 8.2/10, more than satisfactory for our goals. Students' satisfaction rate was high. Mean score on questions inquiring the usefulness of patient simulation in learning how to perform a clinical history was 9/10 and 9.2/10 for first and fifth-sixth year students respectively. Questions on improvement of communication skills scored 8.6/10 and 8.6/10 respectively. The fruitfulness of training with simulated patients before practicing with real patients was 9.3/10 and 9.3/10 respectively. Finally, the assessment of the whole course with simulated patients was of 9.3/10. Conclusion. Learning history taking in first year Medical School with simulated patients acted by senior students was beneficial and user-friendly for both students and actors. An early contact with the clinical practice through simulated patients could improve performance and safety.

  1. A Parallel, High-Fidelity Radar Model

    Science.gov (United States)

    Horsley, M.; Fasenfest, B.

    2010-09-01

    Accurate modeling of Space Surveillance sensors is necessary for a variety of applications. Accurate models can be used to perform trade studies on sensor designs, locations, and scheduling. In addition, they can be used to predict system-level performance of the Space Surveillance Network to a collision or satellite break-up event. A high fidelity physics-based radar simulator has been developed for Space Surveillance applications. This simulator is designed in a modular fashion, where each module describes a particular physical process or radar function (radio wave propagation & scattering, waveform generation, noise sources, etc.) involved in simulating the radar and its environment. For each of these modules, multiple versions are available in order to meet the end-users needs and requirements. For instance, the radar simulator supports different atmospheric models in order to facilitate different methods of simulating refraction of the radar beam. The radar model also has the capability to use highly accurate radar cross sections generated by the method of moments, accelerated by the fast multipole method. To accelerate this computationally expensive model, it is parallelized using MPI. As a testing framework for the radar model, it is incorporated into the Testbed Environment for Space Situational Awareness (TESSA). TESSA is based on a flexible, scalable architecture, designed to exploit high-performance computing resources and allow physics-based simulation of the SSA enterprise. In addition to the radar models, TESSA includes hydrodynamic models of satellite intercept and debris generation, orbital propagation algorithms, optical brightness calculations, optical system models, object detection algorithms, orbit determination algorithms, simulation analysis and visualization tools. Within this framework, observations and tracks generated by the new radar model are compared to results from a phenomenological radar model. In particular, the new model will be

  2. Virtual Reality Compared with Bench-Top Simulation in the Acquisition of Arthroscopic Skill: A Randomized Controlled Trial.

    Science.gov (United States)

    Banaszek, Daniel; You, Daniel; Chang, Justues; Pickell, Michael; Hesse, Daniel; Hopman, Wilma M; Borschneck, Daniel; Bardana, Davide

    2017-04-05

    Work-hour restrictions as set forth by the Accreditation Council for Graduate Medical Education (ACGME) and other governing bodies have forced training programs to seek out new learning tools to accelerate acquisition of both medical skills and knowledge. As a result, competency-based training has become an important part of residency training. The purpose of this study was to directly compare arthroscopic skill acquisition in both high-fidelity and low-fidelity simulator models and to assess skill transfer from either modality to a cadaveric specimen, simulating intraoperative conditions. Forty surgical novices (pre-clerkship-level medical students) voluntarily participated in this trial. Baseline demographic data, as well as data on arthroscopic knowledge and skill, were collected prior to training. Subjects were randomized to 5-week independent training sessions on a high-fidelity virtual reality arthroscopic simulator or on a bench-top arthroscopic setup, or to an untrained control group. Post-training, subjects were asked to perform a diagnostic arthroscopy on both simulators and in a simulated intraoperative environment on a cadaveric knee. A more difficult surprise task was also incorporated to evaluate skill transfer. Subjects were evaluated using the Global Rating Scale (GRS), the 14-point arthroscopic checklist, and a timer to determine procedural efficiency (time per task). Secondary outcomes focused on objective measures of virtual reality simulator motion analysis. Trainees on both simulators demonstrated a significant improvement (p virtual reality simulation group consistently outperformed the bench-top model group in the diagnostic arthroscopy crossover tests and in the simulated cadaveric setup. Furthermore, the virtual reality group demonstrated superior skill transfer in the surprise skill transfer task. Both high-fidelity and low-fidelity simulation trainings were effective in arthroscopic skill acquisition. High-fidelity virtual reality

  3. Does teaching non-technical skills to medical students improve those skills and simulated patient outcome?

    Science.gov (United States)

    Hagemann, Vera; Herbstreit, Frank; Kehren, Clemens; Chittamadathil, Jilson; Wolfertz, Sandra; Dirkmann, Daniel; Kluge, Annette; Peters, Jürgen

    2017-03-29

    The purpose of this study is to evaluate the effects of a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment. Seventy-seven students were randomized to either a non-technical skills seminar (NTS group, n=43) or a medical seminar (control group, n=34). The human patient simulation was used as an evaluation tool. Before the seminars, all students performed the same simulated emergency scenario to provide baseline measurements. After the seminars, all students were exposed to a second scenario, and behavioural markers for evaluating their non-technical skills were rated. Furthermore, teamwork-relevant attitudes were measured before and after the scenarios, and perceived stress was measured following each simulation. All simulations were also evaluated for various medical endpoints. Non-technical skills concerning situation awareness (pskills to improve student's non-technical skills. In a next step, to improve student's handling of emergencies and patient outcomes, non-technical skills seminars should be accompanied by exercises and more broadly embedded in the medical school curriculum.

  4. Living with 'melanoma' … for a day: a phenomenological analysis of medical students' simulated experiences.

    Science.gov (United States)

    Corr, M; Roulston, G; King, N; Dornan, T; Blease, C; Gormley, G J

    2017-09-01

    Despite the rising incidence of melanoma, medical students have progressively fewer opportunities to encounter patients with this important condition. Curricula tend to attach the greatest value to intellectual forms of learning. However, compared with intellectual learning, experiential learning affords students deep insights about a condition. Doctors who experience ill health are more empathic towards patients. However, opportunities to learn about cancer experientially are limited. Temporary transfer tattoos can simulate the ill health associated with melanoma. We reasoned that if doctors who have been sick are more empathic temporarily 'having' melanoma might have a similar effect. To explore the impact of wearing a melanoma tattoo on medical students' understanding of patienthood and attitudes towards patients with melanoma. Ten fourth-year medical students were recruited to a simulation. They wore a melanoma tattoo for 24 h and listened to a patient's account of receiving their diagnosis. Data were captured using audio diaries and face-to-face interviews, transcribed and analysed phenomenologically using the template analysis method. There were four themes: (i) melanoma simulation: opening up new experiences; (ii) drawing upon past experiences; (iii) a transformative introduction to patienthood; (iv) doctors in the making: seeing cancer patients in a new light. By means of a novel simulation, medical students were introduced to lived experiences of having a melanoma. Such an inexpensive simulation can prompt students to reflect critically on the empathetic care of such patients in the future. © 2017 British Association of Dermatologists.

  5. The Role of Haptics in Medical Training Simulators: A Survey of the State of the Art.

    Science.gov (United States)

    Coles, T R; Meglan, D; John, N W

    2011-01-01

    This review paper discusses the role of haptics within virtual medical training applications, particularly, where it can be used to aid a practitioner to learn and practice a task. The review summarizes aspects to be considered in the deployment of haptics technologies in medical training. First, both force/torque and tactile feedback hardware solutions that are currently produced commercially and in academia are reviewed, followed by the available haptics-related software and then an in-depth analysis of medical training simulations that include haptic feedback. The review is summarized with scrutiny of emerging technologies and discusses future directions in the field.

  6. The Relationship Between Fidelity and Learning in Aviation Training and Assessment

    Science.gov (United States)

    Noble, Cliff

    2002-01-01

    Flight simulators can be designed to train pilots or assess their flight performance. Low-Fidelity simulators maximize the initial learning rate of novice pilots and minimize initial costs; whereas, expensive, high-fidelity simulators predict the realworld in-flight performance of expert pilots (Fink & Shriver, 1978 Hays & Singer 1989; Kinkade & Wheaton. 1972). Although intuitively appealing and intellectually convenient to generalize concepts of learning and assessment, what holds true for the role of fidelity in assessment may not always hold true for learning, and vice versa. To bring clarity to this issue, the author distinguishes the role of fidelity in learning from its role in assessment as a function of skill level by applying the hypothesis of Alessi (1988) and reviewing the Laughery, Ditzian, and Houtman (1982) study on simulator validity. Alessi hypothesized that there is it point beyond which one additional unit of flight-simulator fidelity results in a diminished rate of learning. The author of this current paper also suggests the existence of an optimal point beyond which one additional unit of flight-simulator fidelity results in a diminished rate of practical assessment of nonexpert pilot performance.

  7. Use of simulator-based medical procedural curriculum: the learner's perspectives

    Directory of Open Access Journals (Sweden)

    Nair Parvathy

    2010-11-01

    Full Text Available Abstract Background Simulation is increasingly used for teaching medical procedures. The goal of this study was to assess learner preferences for how simulators should be used in a procedural curriculum. Methods A 26-item survey was constructed to assess the optimal use of simulators for the teaching of medical procedures in an internal medicine residency curriculum. Survey domains were generated independently by two investigators and validated by an expert panel (n = 7. Final survey items were revised based on pilot survey and distributed to 128 internal medicine residents. Results Of the 128 residents surveyed, 106 (83% responded. Most responders felt that simulators should be used to learn technical skills (94%, refine technical skills (84%, and acquire procedural teaching skills (87%. Respondents felt that procedures most effectively taught by simulators include: central venous catheterization, thoracentesis, intubation, lumbar puncture, and paracentesis. The majority of learners felt that teaching should be done early in residency (97%. With regards to course format, 62% of respondents felt that no more than 3-4 learners per simulator and an instructor to learner ratio of 1:3-4 would be acceptable. The majority felt that the role of instructors should include demonstration of technique (92%, observe learner techniques (92%, teach evidence behind procedural steps (84% and provide feedback (89%. Commonly cited barriers to procedural teaching were limitations in time, number of instructors and simulators, and lack of realism of some simulators. Conclusions Our results suggest that residents value simulator-based procedural teaching in the form of small-group sessions. Simulators should be an integral part of medical procedural education.

  8. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine

    OpenAIRE

    Michael Fitch; Michael Smith; Raymond Ten Eyck; Corey Heitz

    2011-01-01

    Introduction: The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulationbased programs; and (3) educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey ...

  9. Medical simulation is needed in anesthesia training to achieve patient's safety

    OpenAIRE

    Chang, Chul-Ho

    2013-01-01

    Many medical schools and hospitals throughout the world are equipped with a simulation center for the purpose of training anesthesiologists to perform both technical and non-technical skills. Because induction, maintenance, and emergence of general anesthesia are critical to patient welfare, various simulation mannequins and tools are utilized for the purpose of training anesthesiologists for safer patient care. Traditionally, anesthesia residency training mostly consisted of didactic lecture...

  10. Differences in observers' and teachers' fidelity assessments.

    Science.gov (United States)

    Hansen, William B; Pankratz, Melinda M; Bishop, Dana C

    2014-10-01

    As evidence-based programs become disseminated, understanding the degree to which they are implemented with fidelity is crucial. This study tested the validity of fidelity ratings made by observers versus those made by teachers. We hypothesized that teachers' reports about fidelity would have a positivity bias when compared to observers' reports. Further, we hypothesized that there would generally be low correspondence between teachers' and observers' ratings of fidelity. We examined teachers' and observers' ratings as they were related to mediating variables targeted for change by the intervention. Finally, we examined the role that years of teaching experience played in achieving fidelity. Eighteen teachers and four research assistants participated in this project as raters. Teachers made video recordings of their implementation of All Stars and completed fidelity assessment forms. Trained observers independently completed parallel forms for 215 sampled classroom sessions. Both teachers and observers rated adherence, quality of delivery, attendance, and participant engagement. Teachers made more positive fidelity ratings than did observers. With the exception of ratings for attendance, teachers and observers failed to agree on fidelity ratings. Observers' ratings were significantly related to students' pretest assessments of targeted program mediators. That observers' ratings were related to students' pretest scores, suggests it is easier to teach well when students are predisposed to program success. Teachers' ratings were infrequently related to mediators, but when they were, the relationship was counterintuitive. Experienced teachers taught with greater fidelity than novice teachers. While possibly inflated and inaccurate, gathering fidelity assessments from teachers may sensitize them to issues of fidelity as a result of requiring form completion. Assessing fidelity through observers' ratings of video recordings has significant merit. As a longterm investment

  11. Mannequin simulation improves the confidence of medical students performing tube thoracostomy: a prospective, controlled trial.

    Science.gov (United States)

    Hishikawa, Shuji; Kawano, Masaki; Tanaka, Hozumi; Konno, Kenjiro; Yasuda, Yoshikazu; Kawano, Ryutaro; Kobayashi, Eiji; Lefor, Alan T

    2010-01-01

    This study was undertaken to determine the educational benefits of mannequin simulation for performance of tube thoracostomy in a porcine model by medical students. Thirty medical students were randomized into two groups; the first performed tube thoracostomy on a mannequin simulator and then a porcine model; the second used only the porcine model. Performance measures included completion of subtasks, time to perform the procedure, a global score assigned by faculty raters, and a self-evaluation survey. Subtask completion rate was similar in both groups (P > 0.05). Mean time to perform the procedure was 9.8 minutes (+/- 0.9, simulator), and 9.3 minutes (+/- 1.0, nonsimulator, P > 0.05). Global scores were 12.3 (+/- 1.3, simulator) and 11.0 (+/- 1.4, non-simulator, P > 0.05). Self-evaluation of confidence (1 = "very", 7 = "not at all") showed the simulator group was significantly more confident (3.4 +/- 0.42) than the nonsimulator group (4.7 +/- 0.49, P thoracostomy. The simulator group felt significantly more confident to subsequently perform the procedure on a patient, whereas performance was not statistically significantly different for the two groups. Further trials may be needed to delineate the optimal role for these simulators in teaching tube thoracostomy.

  12. Cellular Scanning Strategy for Selective Laser Melting: Capturing Thermal Trends with a Low-Fidelity, Pseudo-Analytical Model

    DEFF Research Database (Denmark)

    Mohanty, Sankhya; Hattel, Jesper Henri

    2014-01-01

    Simulations of additivemanufacturing processes are known to be computationally expensive.The resulting large runtimes prohibit their application in secondary analysis requiring several complete simulations such as optimization studies, and sensitivity analysis. In this paper, a low-fidelity pseud...

  13. High Fidelity Tool for Turbulent Combustion in Liquid Launch Propulsion Systems Based on Spray-Flamelet Methodology Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation proposed here is a high-performance, high-fidelity simulation capability for simulating liquid rocket spray combustion based on a novel spray-flamelet...

  14. Multi-fidelity construction of explicit boundaries: Application to aeroelasticity

    Science.gov (United States)

    Dribusch, Christoph

    SVM only requires classification of training samples as feasible or infeasible, the presence of discontinuities in the simulation results does not affect the proposed algorithm. For the same reason, multiple failure modes such as aeroelastic stability, maximum stress or geometric constraints, may be represented by a single SVM predictor. Often, multiple models are available to simulate a given design at different levels of fidelity and small improvements in accuracy may increase simulation cost by an order of magnitude. In many cases, a lower-fidelity model will classify a case correctly as feasible or infeasible. Therefore a multi-fidelity algorithm is proposed that takes advantage of lower-fidelity models when appropriate to minimize the overall computational burden of training the SVM. To this end, the algorithm combines the concepts of adaptive sampling and multi-fidelity analysis to iteratively select not only the training samples, but also the appropriate level of fidelity for evaluation. The proposed algorithm, referred to as multi-fidelity explicit design space decomposition (MF-EDSD), is demonstrated on various models of aeroelastic stability to either build the stability boundary and/or to perform design optimization. The aeroelastic models range from linear and nonlinear analytical models to commercial software (ZAERO) and represent divergence, flutter, and limit cycle oscillation instabilities. Additional analytical test problems have the advantage that the accuracy of the SVM predictor and the convergence to optimal designs are more easily verified. On the other hand the more sophisticated models demonstrate the applicability to real aerospace applications where the solutions are not known a priori. In conclusion, the presented MF-EDSD algorithm is well suited for approximating stability boundaries associated with aeroelastic instabilities in high-dimensional parameter spaces. The adaptive selection of training samples and use of multi-fidelity models

  15. The importance of organ geometry and boundary constraints for planning of medical interventions

    NARCIS (Netherlands)

    Misra, S.; Macura, K.J.; Ramesh, K.T.; Okamura, A.M.

    2009-01-01

    Realistic modeling of medical interventions involving tool–tissue interactions has been considered to be a key requirement in the development of high-fidelity simulators and planners. Organ geometry, soft-tissue constitutive laws, and boundary conditions imposed by the connective tissues surrounding

  16. Experiences with a simulated learning environment - the SimuScape©: Virtual environments in medical education

    Directory of Open Access Journals (Sweden)

    Anna-Lena Thies

    2014-03-01

    Full Text Available INTRODUCTION: Simulation as a tool for medical education has gained considerable importance in the past years. Various studies have shown that the mastering of basic skills happens best if taught in a realistic and workplace-based context. It is necessary that simulation itself takes place in the realistic background of a genuine clinical or in an accordingly simulated learning environment. METHODS: A panoramic projection system that allows the simulation of different scenarios has been created at the medical school of the Westphalian Wilhelms-University  Muenster/Germany. The SimuScape© is a circular training room of six meters in diameter and has the capacity to generate pictures or moving images as well as the corresponding background noises for medical students, who are then able to interact with simulated patients inside a realistic environment. RESULTS: About 1,000 students have been instructed using the SimuScape© in the courses of emergency medicine, family medicine and anesthesia. The SimuScape©, with its 270°-panoramic projection, gives the students the impression “of being right in the center of action”.  It is a flexible learning environment that can be easily integrated into curricular teaching and which is in full operation for 10 days per semester. CONCLUSION: The SimuScape© allows the establishment of new medical areas outside the hospital and surgery for simulation and it is an extremely adaptable and cost-effective utilization of a lecture room. In this simulated environment it is possible to teach objectives like self-protection and patient care during disturbing environmental influences in practice.

  17. The impact of assessing simulated bad news consultations on medical students' stress response and communication performance.

    NARCIS (Netherlands)

    Dulmen, S. van; Tromp, F.; Grosfeld, F.; Cate, O. ten; Bensing, J.M.

    2007-01-01

    Seventy second-year medical students volunteered to participate in a study with the aim of evaluating the impact of the assessment of simulated bad news consultations on their physiological and psychological stress and communication performance. Measurements were taken of salivary cortisol, systolic

  18. Effects of Crew Resource Management Training on Medical Errors in a Simulated Prehospital Setting

    Science.gov (United States)

    Carhart, Elliot D.

    2012-01-01

    This applied dissertation investigated the effect of crew resource management (CRM) training on medical errors in a simulated prehospital setting. Specific areas addressed by this program included situational awareness, decision making, task management, teamwork, and communication. This study is believed to be the first investigation of CRM…

  19. The Use of Live Simulation in Teaching the Mental Status Examination to Medical Students.

    Science.gov (United States)

    Rubenstein, Ralph; And Others

    1979-01-01

    An approach to teaching the mental status examination to sophomore medical students at the Wayne State University School of Medicine incorporates live simulations, a detailed handout, a pretest and post-test, and a short lecture and discussion. The data suggest significant post-test gains, but there were negative findings regarding the handout.…

  20. Speed-accuracy trade-offs in computing spatial impulse responses for simulating medical ultrasound imaging

    DEFF Research Database (Denmark)

    Jensen, Jørgen Arendt

    2001-01-01

    Medical ultrasound imaging can be simulated realistically using linear acoustics. One of the most powerful approaches is to employ spatial impulse responses. Hereby both emitted fields and pulse-echo responses from point scatterers can be determined. Also any kind of dynamic focusing...

  1. Medical Simulation in the Community College Health Science Curriculum: A Matrix for Future Implementation

    Science.gov (United States)

    McLaughlin, Michael P.; Starobin, Soko S.; Laanan, Frankie Santos

    2010-01-01

    As the nation's healthcare education system struggles to keep pace with the demand for its services, educators are seeking creative and innovative solutions to meet the needs of a growing number of students. The integration of medical simulation technology into the community college health science curriculum is a creative solution that can meet…

  2. Team Communication Influence on Procedure Performance: Findings From Interprofessional Simulations with Nursing and Medical Students.

    Science.gov (United States)

    Reising, Deanna L; Carr, Douglas E; Gindling, Sally; Barnes, Roxie; Garletts, Derrick; Ozdogan, Zulfukar

    Interprofessional team performance is believed to be dependent on the development of effective team communication skills. Yet, little evidence exists in undergraduate nursing programs on whether team communication skills affect team performance. A secondary analysis of a larger study on interprofessional student teams in simulations was conducted to determine if there is a relationship between team communication and team procedure performance. The results showed a positive, significant correlation between interprofessional team communication ratings and procedure accuracy in the simulation. Interprofessional team training in communication skills for nursing and medical students improves the procedure accuracy in a simulated setting.

  3. Examining the Fidelity of Climate model via Shadowing Time

    Science.gov (United States)

    Du, H.; Smith, L. A.

    2015-12-01

    Fully fledged climate models provide the best available simulations for reflecting the future, yet we have scant insight into their fidelity, in particular as to the duration into the future at which the real world should be expected to evolve in a manner today's models cannot foresee. We know now that our best available models are not adequate for many sought after purposes. To throw some light on the maximum fidelity expected from a given generation of models, and thereby aid both policy making and model development, we can test the weaknesses of a model as a dynamical system to get an informed idea of its potential applicability at various lead times. Shadowing times reflect the duration on which a GCM reflects the observations; extracting the shortcomings of the model which limit shadowing times allows informed speculation regarding the fidelity of the model in the future. More specifically, the relevant phenomena limiting model fidelity can be learned by identifying the reasons models cannot shadow; the time scales on which feedbacks on the system (which are not active in the model) are likely to result in model irrelevance can be discerned. The methodology is developed in the "low dimensional laboratory" of relatively simple dynamical systems, for example Lorenz 95 systems. The results are presented in Lorenz 95 systems, high dimensional fluid dynamical simulations of rotating annulus and GCMs. There are severe limits on the light shadowing experiments can shine on GCM predictions. Never the less, they appear to be one of the brightest lights we can shine to illuminate the likely fidelity of GCM extrapolations into the future.

  4. Simulator-Based Air Medical Training Program Christoph Life: From Concept to Course.

    Science.gov (United States)

    Winkelmann, Marcel; Friedrich, Lars; Schröter, Christian; Flemming, Andreas; Eismann, Hendrik; Sieg, Lion; Mommsen, Philipp; Krettek, Christian; Zeckey, Christian

    2016-01-01

    Christoph Life is a simulator-based air medical training program and a new and innovative educational concept. Participants pass different scenarios with a fully equipped and movable helicopter simulator. Main focuses of the program are crew resource management (CRM) elements and team training. Information about expectations end effectiveness of the training is sparse. During a 2-day training, participants learn CRM basics and complete various emergency medical scenarios. For evaluation, we used an anonymous questionnaire either with polar questions or a 6-coded psychometric Likert scale. The Wilcoxon test was used for statistical analysis. The significance level was set at P CRM basics (3.5 ± 1.2 vs. 5.4 ± 0.7, P benefit for the participants' nontechnical skills. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  5. Simulation of medical emergencies in dental practice: development and evaluation of an undergraduate training programme.

    Science.gov (United States)

    Newby, J P; Keast, J; Adam, W R

    2010-12-01

    The evidence available suggests that many dentists on graduation do not feel competent managing medical emergencies; a problem requiring improved undergraduate training. This study developed a comprehensive simulation based training programme for final year undergraduate dental students and assessed student attitudes towards training. Final year dental students (n = 52) from The University of Melbourne were required to complete simulation training incorporating an interactive tutorial and realistic, simulated emergency scenarios conducted in the students' real clinical environment. A post-participation questionnaire utilizing a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) assessed student attitudes. Student responses supported simulation training, evidenced by the following selected questionnaire responses: achieved greater confidence in managing emergencies 4.65 ± 0.48 (n = 52); prefer lecture to simulation 1.46 ± 0.74 (n = 52); simulation training is important in undergraduate teaching 4.86 ± 0.35 (n = 43). Realistic simulation training in management of medical emergencies for dental students is an effective adjunct to traditional lecture style teaching. Given the importance of this subject, this mode of training would benefit students if incorporated into undergraduate dental courses. © 2010 Australian Dental Association.

  6. SIMulation of Medication Error induced by Clinical Trial drug labeling: the SIMME-CT study.

    Science.gov (United States)

    Dollinger, Cecile; Schwiertz, Vérane; Sarfati, Laura; Gourc-Berthod, Chloé; Guédat, Marie-Gabrielle; Alloux, Céline; Vantard, Nicolas; Gauthier, Noémie; He, Sophie; Kiouris, Elena; Caffin, Anne-Gaelle; Bernard, Delphine; Ranchon, Florence; Rioufol, Catherine

    2016-06-01

    To assess the impact of investigational drug labels on the risk of medication error in drug dispensing. A simulation-based learning program focusing on investigational drug dispensing was conducted. The study was undertaken in an Investigational Drugs Dispensing Unit of a University Hospital of Lyon, France. Sixty-three pharmacy workers (pharmacists, residents, technicians or students) were enrolled. Ten risk factors were selected concerning label information or the risk of confusion with another clinical trial. Each risk factor was scored independently out of 5: the higher the score, the greater the risk of error. From 400 labels analyzed, two groups were selected for the dispensing simulation: 27 labels with high risk (score ≥3) and 27 with low risk (score ≤2). Each question in the learning program was displayed as a simulated clinical trial prescription. Medication error was defined as at least one erroneous answer (i.e. error in drug dispensing). For each question, response times were collected. High-risk investigational drug labels correlated with medication error and slower response time. Error rates were significantly 5.5-fold higher for high-risk series. Error frequency was not significantly affected by occupational category or experience in clinical trials. SIMME-CT is the first simulation-based learning tool to focus on investigational drug labels as a risk factor for medication error. SIMME-CT was also used as a training tool for staff involved in clinical research, to develop medication error risk awareness and to validate competence in continuing medical education. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  7. Geant4-based Monte Carlo simulations on GPU for medical applications.

    Science.gov (United States)

    Bert, Julien; Perez-Ponce, Hector; El Bitar, Ziad; Jan, Sébastien; Boursier, Yannick; Vintache, Damien; Bonissent, Alain; Morel, Christian; Brasse, David; Visvikis, Dimitris

    2013-08-21

    Monte Carlo simulation (MCS) plays a key role in medical applications, especially for emission tomography and radiotherapy. However MCS is also associated with long calculation times that prevent its use in routine clinical practice. Recently, graphics processing units (GPU) became in many domains a low cost alternative for the acquisition of high computational power. The objective of this work was to develop an efficient framework for the implementation of MCS on GPU architectures. Geant4 was chosen as the MCS engine given the large variety of physics processes available for targeting different medical imaging and radiotherapy applications. In addition, Geant4 is the MCS engine behind GATE which is actually the most popular medical applications' simulation platform. We propose the definition of a global strategy and associated structures for such a GPU based simulation implementation. Different photon and electron physics effects are resolved on the fly directly on GPU without any approximations with respect to Geant4. Validations have shown equivalence in the underlying photon and electron physics processes between the Geant4 and the GPU codes with a speedup factor of 80-90. More clinically realistic simulations in emission and transmission imaging led to acceleration factors of 400-800 respectively compared to corresponding GATE simulations.

  8. Integrated Variable Fidelity Conceptual Design Project

    Data.gov (United States)

    National Aeronautics and Space Administration — CADNexus proposes to develop an Integrated Variable Fidelity Conceptual Design tool. The application will enable design and analysis of unconventional and advanced...

  9. Variable Fidelity Aeroelastic Toolkit - Structural Model Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation is a methodology to incorporate variable fidelity structural models into steady and unsteady aeroelastic and aeroservoelastic analyses in...

  10. High fidelity quantum gates with vibrational qubits.

    Science.gov (United States)

    Berrios, Eduardo; Gruebele, Martin; Shyshlov, Dmytro; Wang, Lei; Babikov, Dmitri

    2012-11-26

    Physical implementation of quantum gates acting on qubits does not achieve a perfect fidelity of 1. The actual output qubit may not match the targeted output of the desired gate. According to theoretical estimates, intrinsic gate fidelities >99.99% are necessary so that error correction codes can be used to achieve perfect fidelity. Here we test what fidelity can be accomplished for a CNOT gate executed by a shaped ultrafast laser pulse interacting with vibrational states of the molecule SCCl(2). This molecule has been used as a test system for low-fidelity calculations before. To make our test more stringent, we include vibrational levels that do not encode the desired qubits but are close enough in energy to interfere with population transfer by the laser pulse. We use two complementary approaches: optimal control theory determines what the best possible pulse can do; a more constrained physical model calculates what an experiment likely can do. Optimal control theory finds pulses with fidelity >0.9999, in excess of the quantum error correction threshold with 8 × 10(4) iterations. On the other hand, the physical model achieves only 0.9992 after 8 × 10(4) iterations. Both calculations converge as an inverse power law toward unit fidelity after >10(2) iterations/generations. In principle, the fidelities necessary for quantum error correction are reachable with qubits encoded by molecular vibrations. In practice, it will be challenging with current laboratory instrumentation because of slow convergence past fidelities of 0.99.

  11. Designing and using computer simulations in medical education and training: an introduction.

    Science.gov (United States)

    Friedl, Karl E; O'Neil, Harold F

    2013-10-01

    Computer-based technologies informed by the science of learning are becoming increasingly prevalent in education and training. For the Department of Defense (DoD), this presents a great potential advantage to the effective preparation of a new generation of technologically enabled service members. Military medicine has broad education and training challenges ranging from first aid and personal protective skills for every service member to specialized combat medic training; many of these challenges can be met with gaming and simulation technologies that this new generation has embraced. However, comprehensive use of medical games and simulation to augment expert mentorship is still limited to elite medical provider training programs, but can be expected to become broadly used in the training of first responders and allied health care providers. The purpose of this supplement is to review the use of computer games and simulation to teach and assess medical knowledge and skills. This review and other DoD research policy sources will form the basis for development of a research and development road map and guidelines for use of this technology in military medicine. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  12. Cognitive aid use improves transition of care by graduating medical students during a simulated crisis

    Directory of Open Access Journals (Sweden)

    Brooke Bauer

    2016-07-01

    Full Text Available Background: Residents are expected to have transition of care (ToC skills upon entering graduate medical education. It is unclear whether experience and training during medical school is adequate. Objective: The aim of the project was to assess: 1 graduating medical students’ ability to perform ToC in a crisis situation, and 2 whether using a cognitive aid improves the ToC quality. Methods: The authors developed simulation scenarios for rapid response teams and a cognitive aid to assist in the ToC during crisis situations. Graduating medical students were enrolled and randomly divided into teams of three students, randomly assigned into one of two groups: teams using a cognitive aid for ToC (CA, or not using a cognitive aid (nCA. In the scenario, teams respond to a deteriorating patient and then transfer care to the next provider after stabilization. Three faculty reviewed the recording to assess completeness of the ToC and the overall quality. A completeness score was expressed as a fraction of the maximum score. Statistical analysis was performed using a t-test and Mann-Whitney U test. Results: A total of 112 senior medical students participated: CA n=19, nCA n=17. The completeness score of the ToC and overall quality improved when using the cognitive aid (completeness score: CA 0.80±0.06 vs. nCA 0.52±0.07, p<0.01; ToC quality: CA 3.16±0.65 vs. nCA 1.92±0.56, p<0.01. Participants’ rating of knowledge and comfort with the ToC process increased after the simulation. Conclusion: The completeness of information transfer during the ToC process by graduating medical students improved by using a cognitive aid in a simulated patient crisis.

  13. DEVELOPMENT OF CLINICAL SCENARIO’S INFORMATION MODEL IN THE MEDICAL SIMULATION CENTER

    Directory of Open Access Journals (Sweden)

    I. V. Tolmachyov

    2014-01-01

    Full Text Available There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center.Objectives:– to analyze the process of scenario conducting;– to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock with specialist’s help.The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees.By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed.As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones.Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax, pulmonary edema, hypertensive crisis, respiratory

  14. Perceptions of the roles of social networking in simulation augmented medical education and training.

    Science.gov (United States)

    Martin, Rob; Rojas, David; Cheung, Jeffrey J H; Weber, Bryce; Kapralos, Bill; Dubrowski, Adam

    2013-01-01

    Simulation-augmented education and training (SAET) is an expensive educational tool that may be facilitated through social networking technologies or Computer Supported Collaborative Learning (CSCL). This study examined the perceptions of medical undergraduates participating in SAET for knot tying skills to identify perceptions and barriers to implementation of social networking technologies within a broader medical education curriculum. The majority of participants (89%) found CSCL aided their learning of the technical skill and identified privacy and accessibility as major barriers to the tools implementation.

  15. A Mobile Device App to Reduce Time to Drug Delivery and Medication Errors During Simulated Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial

    Science.gov (United States)

    Combescure, Christophe; Lacroix, Laurence; Haddad, Kevin; Sanchez, Oliver; Gervaix, Alain; Lovis, Christian; Manzano, Sergio

    2017-01-01

    Background During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusion is both complex and time-consuming, placing children at higher risk than adults for medication errors. Following an evidence-based ergonomic-driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion. Objective The aim of our study was to determine whether the use of PedAMINES reduces drug preparation time (TDP) and time to delivery (TDD; primary outcome), as well as medication errors (secondary outcomes) when compared with conventional preparation methods. Methods The study was a randomized controlled crossover trial with 2 parallel groups comparing PedAMINES with a conventional and internationally used drugs infusion rate table in the preparation of continuous drug infusion. We used a simulation-based pediatric CPR cardiac arrest scenario with a high-fidelity manikin in the shock room of a tertiary care pediatric emergency department. After epinephrine-induced return of spontaneous circulation, pediatric emergency nurses were first asked to prepare a continuous infusion of dopamine, using either PedAMINES (intervention group) or the infusion table (control group), and second, a continuous infusion of norepinephrine by crossing the procedure. The primary outcome was the elapsed time in seconds, in each allocation group, from the oral prescription by the physician to TDD by the nurse. TDD included TDP. The secondary outcome was the medication dosage error rate during the sequence from drug preparation to drug injection. Results A total of 20 nurses were randomized into 2 groups. During the first study period, mean TDP while using PedAMINES and conventional preparation methods was 128.1 s (95% CI 102-154) and 308.1 s (95% CI 216-400), respectively (180 s reduction, P=.002). Mean

  16. Average fidelity between random quantum states

    CERN Document Server

    Zyczkowski, K; Zyczkowski, Karol; Sommers, Hans-Jurgen

    2003-01-01

    We analyze mean fidelity between random density matrices of size N, generated with respect to various probability measures in the space of mixed quantum states: Hilbert-Schmidt measure, Bures (statistical) measure, the measures induced by partial trace and the natural measure on the space of pure states. In certain cases explicit probability distributions for fidelity are derived.

  17. A virtual imaging platform for multi-modality medical image simulation.

    Science.gov (United States)

    Glatard, Tristan; Lartizien, Carole; Gibaud, Bernard; da Silva, Rafael Ferreira; Forestier, Germain; Cervenansky, Frédéric; Alessandrini, Martino; Benoit-Cattin, Hugues; Bernard, Olivier; Camarasu-Pop, Sorina; Cerezo, Nadia; Clarysse, Patrick; Gaignard, Alban; Hugonnard, Patrick; Liebgott, Hervé; Marache, Simon; Marion, Adrien; Montagnat, Johan; Tabary, Joachim; Friboulet, Denis

    2013-01-01

    This paper presents the Virtual Imaging Platform (VIP), a platform accessible at http://vip.creatis.insa-lyon.fr to facilitate the sharing of object models and medical image simulators, and to provide access to distributed computing and storage resources. A complete overview is presented, describing the ontologies designed to share models in a common repository, the workflow template used to integrate simulators, and the tools and strategies used to exploit computing and storage resources. Simulation results obtained in four image modalities and with different models show that VIP is versatile and robust enough to support large simulations. The platform currently has 200 registered users who consumed 33 years of CPU time in 2011.

  18. Method for Building a Medical Training Simulator with Bayesian Networks: SimDeCS.

    Science.gov (United States)

    Flores, Cecilia Dias; Fonseca, João Marcelo; Bez, Marta Rosecler; Respício, Ana; Coelho, Helder

    2014-01-01

    Distance education has grown in importance with the advent of the internet. An adequate evaluation of students in this mode is still difficult. Distance tests or occasional on-site exams do not meet the needs of evaluation of the learning process for distance education. Bayesian networks are adequate for simulating several aspects of clinical reasoning. The possibility of integrating them in distance education student evaluation has not yet been explored much. The present work describes a Simulator based on probabilistic networks built to represent knowledge of clinical practice guidelines in Family and Community Medicine. The Bayesian Network, the basis of the simulator, was modeled to playable by the student, to give immediate feedback according to pedagogical strategies adapted to the student according to past performance, and to give a broad evaluation of performance at the end of the game. Simulators structured by Bayesian Networks may become alternatives in the evaluation of students of Medical Distance Education.

  19. Local Interaction Simulation Approach for Fault Detection in Medical Ultrasonic Transducers

    Directory of Open Access Journals (Sweden)

    Z. Hashemiyan

    2015-01-01

    Full Text Available A new approach is proposed for modelling medical ultrasonic transducers operating in air. The method is based on finite elements and the local interaction simulation approach. The latter leads to significant reductions of computational costs. Transmission and reception properties of the transducer are analysed using in-air reverberation patterns. The proposed approach can help to provide earlier detection of transducer faults and their identification, reducing the risk of misdiagnosis due to poor image quality.

  20. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    OpenAIRE

    Ricci LH; Ferraz CA

    2017-01-01

    Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP), Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo (SP), Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four ...

  1. Simulation Modeling of a Check-in and Medication Reconciliation Ambulatory Clinic Kiosk

    Directory of Open Access Journals (Sweden)

    Blake Lesselroth

    2011-01-01

    Full Text Available Gaps in information about patient medication adherence may contribute to preventable adverse drug events and patient harm. Hence, health-quality advocacy groups, including the Joint Commission, have called for the implementation of standardized processes to collect and compare patient medication lists. This manuscript describes the implementation of a self-service patient kiosk intended to check in patients for a clinic appointment and collect a medication adherence history, which is then available through the electronic health record. We used business process engineering and simulation modeling to analyze existing workflow, evaluate technology impact on clinic throughput, and predict future infrastructure needs. Our empiric data indicated that a multi-function healthcare kiosk offers a feasible platform to collect medical history data. Furthermore, our simulation model showed a non-linear association between patient arrival rate, kiosk number, and estimated patient wait times. This study provides important data to help administrators and healthcare executives predict infrastructure needs when considering the use of self-service kiosks.

  2. Training Effectiveness of a Wide Area Virtual Environment in Medical Simulation.

    Science.gov (United States)

    Wier, Grady S; Tree, Rebekah; Nusr, Rasha

    2017-02-01

    The success of war fighters and medical personnel handling traumatic injuries largely depends on the quality of training they receive before deployment. The purpose of this study was to gauge the utility of a Wide Area Virtual Environment (WAVE) as a training adjunct by comparing and evaluating student performance, measuring sense of realism, and assessing the impact on student satisfaction with their training exposure in an immersive versus a field environment. This comparative prospective cohort study examined the utility of a three-screen WAVE where subjects were immersed in the training environment with medical simulators. Standard field training commenced for the control group subjects. Medical skills, time to completion, and Team Strategies and Tools to Enhance Performance and Patient Safety objective metrics were assessed for each team (n = 94). In addition, self-efficacy questionnaires were collected for each subject (N = 470). Medical teams received poorer overall team scores (F1,186 = 0.756, P = 0.001), took longer to complete the scenario (F1,186 = 25.15, P = 0.001), and scored lower on The National Registry of Emergency Medical Technicians trauma assessment checklist (F1,186 = 1.13, P = 0.000) in the WAVE versus the field environment. Critical thinking and realism factors within the self-efficacy questionnaires scored higher in the WAVE versus the field [(F1,466 = 8.04, P = 0.005), (F1,465 = 18.57, P = 0.000), and (F1,466 = 53.24, P = 0.000), respectively]. Environmental and emotional stressors may negatively affect critical thinking and clinical skill performance of medical teams. However, by introducing more advanced simulation trainings with added stressors, students may be able to adapt and overcome barriers to performance found in high-stress environments.

  3. Improving advanced cardiovascular life support skills in medical students: simulation-based education approach

    Directory of Open Access Journals (Sweden)

    Hamidreza Reihani

    2015-01-01

    Full Text Available Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012 participated in this study. Advanced Cardiovascular Life Support (ACLS workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100. This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001. Also the mean score of each station had a significant improvement (P< 0.001. Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students.

  4. Medical images of patients in voxel structures in high resolution for Monte Carlo simulation

    Energy Technology Data Exchange (ETDEWEB)

    Boia, Leonardo S.; Menezes, Artur F.; Silva, Ademir X., E-mail: lboia@con.ufrj.b, E-mail: ademir@con.ufrj.b [Universidade Federal do Rio de Janeiro (PEN/COPPE/UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia. Programa de Engenharia Nuclear; Salmon Junior, Helio A. [Clinicas Oncologicas Integradas (COI), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    This work aims to present a computational process of conversion of tomographic and MRI medical images from patients in voxel structures to an input file, which will be manipulated in Monte Carlo Simulation code for tumor's radiotherapic treatments. The problem's scenario inherent to the patient is simulated by such process, using the volume element (voxel) as a unit of computational tracing. The head's voxel structure geometry has voxels with volumetric dimensions around 1 mm{sup 3} and a population of millions, which helps - in that way, for a realistic simulation and a decrease in image's digital process techniques for adjustments and equalizations. With such additional data from the code, a more critical analysis can be developed in order to determine the volume of the tumor, and the protection, beside the patients' medical images were borrowed by Clinicas Oncologicas Integradas (COI/RJ), joined to the previous performed planning. In order to execute this computational process, SAPDI computational system is used in a digital image process for optimization of data, conversion program Scan2MCNP, which manipulates, processes, and converts the medical images into voxel structures to input files and the graphic visualizer Moritz for the verification of image's geometry placing. (author)

  5. Efficient and Effective Use of Peer Teaching for Medical Student Simulation

    Directory of Open Access Journals (Sweden)

    House, Joseph

    2017-01-01

    Full Text Available Simulation is increasingly used in medical education, promoting active learning and retention; however, increasing use also requires considerable instructor resources. Simulation may provide a safe environment for students to teach each other, which many will need to do when they enter residency. Along with reinforcing learning and increasing retention, peer teaching could decrease instructor demands. Our objective was to determine the effectiveness of peer-taught simulation compared to physician-led simulation. We hypothesized that peer-taught simulation would lead to equivalent knowledge acquisition when compared to physician-taught sessions and would be viewed positively by participants. This was a quasi-experimental study in an emergency medicine clerkship. The control group was faculty taught. In the peer-taught intervention group, students were assigned to teach one of the three simulation-based medical emergency cases. Each student was instructed to master their topic and teach it to their peers using the provided objectives and resource materials. The students were assigned to groups of three, with all three cases represented; students took turns leading their case. Three groups ran simultaneously. During the intervention sessions, one physician was present to monitor the accuracy of learning and to answer questions, while three physicians were required for the control groups. Outcomes compared pre-test and post-test knowledge and student reaction between control and intervention groups. Both methods led to equally improved knowledge; mean score for the post-test was 75% for both groups (p=0.6 and were viewed positively. Students in the intervention group agreed that peer-directed learning was an effective way to learn. However, students in the control group scored their simulation experience more favorably. In general, students’ response to peer teaching was positive, students learned equally well, and found peer-taught sessions to be

  6. Sequential kriging optimization using multiple-fidelity evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Deng; Allen, T. T.; Notz, W. I.; Miller, R. A.

    2006-05-23

    When cost per evaluation on a system of interest is high, surrogate systems can provide cheaper but lower-fidelity information. In the proposed extension of the sequential kriging optimization method, surrogate systems are exploited to reduce the total evaluation cost. The method utilizes data on all systems to build a kriging metamodel that provides a global prediction of the objective function and a measure of prediction uncertainty. The location and fidelity level of the next evaluation are selected by maximizing an augmented expected improvement function, which is connected with the evaluation costs. The proposed method was applied to test functions from the literature and a metal-forming process design problem via finite element simulations. The method manifests sensible search patterns, robust performance, and appreciable reduction in total evaluation cost as compared to the original method.

  7. Sequential kriging optimization using multiple-fidelity evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Deng; Allen, T. T.; Notz, W. I.; Miller, R. A.

    2006-11-01

    When cost per evaluation on a system of interest is high, surrogate systems can provide cheaper but lower-fidelity information. In the proposed extension of the sequential kriging optimization method, surrogate systems are exploited to reduce the total evaluation cost. The method utilizes data on all systems to build a kriging metamodel that provides a global prediction of the objective function and a measure of prediction uncertainty. The location and fidelity level of the next evaluation are selected by maximizing an augmented expected improvement function, which is connected with the evaluation costs. The proposed method was applied to test functions from the literature and a metal-forming process design problem via finite element simulations. The method manifests sensible search patterns, robust performance, and appreciable reduction in total evaluation cost as compared to the original method.

  8. Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education

    DEFF Research Database (Denmark)

    Sørensen, Jette Led; Navne, Laura Emdal; Martin, Helle Max;

    2015-01-01

    OBJECTIVE: To examine how the setting in in situ simulation (ISS) and off-site simulation (OSS) in simulation-based medical education affects the perceptions and learning experience of healthcare professionals. DESIGN: Qualitative study using focus groups and content analysis. PARTICIPANTS: Twenty...

  9. Integration of soft tissue model and open haptic device for medical training simulator

    Science.gov (United States)

    Akasum, G. F.; Ramdhania, L. N.; Suprijanto; Widyotriatmo, A.

    2016-03-01

    Minimally Invasive Surgery (MIS) has been widely used to perform any surgical procedures nowadays. Currently, MIS has been applied in some cases in Indonesia. Needle insertion is one of simple MIS procedure that can be used for some purposes. Before the needle insertion technique used in the real situation, it essential to train this type of medical student skills. The research has developed an open platform of needle insertion simulator with haptic feedback that providing the medical student a realistic feel encountered during the actual procedures. There are three main steps in build the training simulator, which are configure hardware system, develop a program to create soft tissue model and the integration of hardware and software. For evaluating its performance, haptic simulator was tested by 24 volunteers on a scenario of soft tissue model. Each volunteer must insert the needle on simulator until rearch the target point with visual feedback that visualized on the monitor. From the result it can concluded that the soft tissue model can bring the sensation of touch through the perceived force feedback on haptic actuator by looking at the different force in accordance with different stiffness in each layer.

  10. EL USO DE LAS SIMULACIONES EN EDUCACIÓN MÉDICA SIMULATION IN MEDICAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Jorge L. Palés Argullós

    2010-06-01

    Full Text Available En los últimos 20 años estamos asistiendo de forma progresiva al uso generalizado de las simulaciones en la formación de los médicos y de otros profesionales de las ciencias de la salud, en las diferentes etapas de su continuum educativo (grado, postgrado y formación continua. Tanto es así que ha surgido el concepto de la educación médica basada en las simulaciones, reconocida actualmente como una ayuda fundamental para asegurar el aprendizaje del estudiante y del médico y para mejorar la seguridad del paciente. En este artículo describiremos las razones por las que surge y se desarrolla esta nueva metodología, sus ventajas, los diferentes modelos y recursos disponibles en la actualidad y las características de los denominados centros de simulación o de habilidades clínicas que se han ido desarrollando en todo el mundo, en los cuales se lleva a cabo esta nueva modalidad de enseñanza médica. Así mismo trataremos brevemente  la situación en nuestro país y finalmente nos referiremos a los principios en los que se basa un desarrollo adecuado de la educación médica basada en las simulaciones. In last twenty years, we are seeing increasingly widespread use of simulations in the training of doctors and other professionals of health sciences at the different stages of their educational continuum (undergraduate, postgraduate and continuing medical education. So much so that the concept of simulations-based medical education has emerged and it is now recognized as a vital tool to ensure the learning of medical students and doctors, and to improve patient safety. This article will describe the reasons for the introduction and development of this new methodology, its advantages and the different models and currently available resources. We will describe also the characteristics of so-called simulation centres or clinical skills laboratories that have been developed worldwide, where the simulation-based medical education take place

  11. [Effects of Training Students through a Program Simulating Medication Administration and Patient Instructions in Pre-training for Practical Training].

    Science.gov (United States)

    Kikuchi, Chigusa; Matsunaga, Tamihide; Suzuki, Tadashi

    2015-01-01

    Pharmacy school students were trained in a program simulating medication administration and giving adherence instructions. Following the training, the educational effects were evaluated. Students were separated into two groups. One group of students played the role of pharmacists and instructed simulated patients on medication adherence. Another group of students played the role of patients receiving simulated drug therapy; they were instructed on medication adherence by the students playing the role of pharmacists. The educational effects were evaluated using a questionnaire. The scores for "recognition of factors that influence medication adherence" tended to increase after the simulation, and they increased significantly after practical training. The scores for "self-evaluation of technique for instructing patients on medication adherence" increased significantly after the simulation, and they increased even more after practical training. The students' understanding of the effects on patients who were being instructed also increased significantly after the simulation, and these changes were maintained after practical training. In particular, students became more aware of the influence of pharmacists' attitudes. In practical training, the simulation training was helpful for bedside practice at hospital pharmacies and over-the-counter service at community pharmacies. Thus, the use of role play and simulated patients was an effective method for training pharmacy students to instruct patients on medication adherence.

  12. Electro-Quasistatic Simulations in Bio-Systems Engineering and Medical Engineering

    Science.gov (United States)

    van Rienen, U.; Flehr, J.; Schreiber, U.; Schulze, S.; Gimsa, U.; Baumann, W.; Weiss, D. G.; Gimsa, J.; Benecke, R.; Pau, H.-W.

    2005-05-01

    Slowly varying electromagnetic fields play a key role in various applications in bio-systems and medical engineering. Examples are the electric activity of neurons on neurochips used as biosensors, the stimulating electric fields of implanted electrodes used for deep brain stimulation in patients with Morbus Parkinson and the stimulation of the auditory nerves in deaf patients, respectively. In order to simulate the neuronal activity on a chip it is necessary to couple Maxwell's and Hodgkin-Huxley's equations. First numerical results for a neuron coupling to a single electrode are presented. They show a promising qualitative agreement with the experimentally recorded signals. Further, simulations are presented on electrodes for deep brain stimulation in animal experiments where the question of electrode ageing and energy deposition in the surrounding tissue are of major interest. As a last example, electric simulations for a simple cochlea model are presented comparing the field in the skull bones for different electrode types and stimulations in different positions.

  13. Simulation of Emergency Medical Services Delivery Performance Based on Real Map

    Directory of Open Access Journals (Sweden)

    Mohd Hafiz Azizan

    2013-06-01

    Full Text Available Performance of Emergency Medical Services (EMS delivery is normally measured via ambulance response time. Quick ambulance response can effectively reduce the disability, morbidity and mortality of the emergency patients. Ambulance dispatch policy and ambulance location model both have a significant impact on the ambulance response time. In this paper, we present a prototype of simulation framework to study the performance of local EMS delivery in terms of a simulation model that consists of both ambulance dispatch policy and ambulance location model. Several real-life dispatch policies are simulated in a real map to evaluate the efficiency of local EMS delivery in Johor Bahru. By using a suitable dispatch policy, the results show an improvement in average response time for higher priority call. The total calls covered are also found to increase significantly with the application of Maximal Covering Location Problem (MCLP, especially at a bigger fleet size.

  14. Manned Flight Simulator (MFS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Aircraft Simulation Division, home to the Manned Flight Simulator (MFS), provides real-time, high fidelity, hardware-in-the-loop flight simulation capabilities...

  15. High Reproduction Rate versus Sexual Fidelity

    OpenAIRE

    Sousa, A. O.; de Oliveira, S. Moss

    2000-01-01

    We introduce fidelity into the bit-string Penna model for biological ageing and study the advantage of this fidelity when it produces a higher survival probability of the offspring due to paternal care. We attribute a lower reproduction rate to the faithful males but a higher death probability to the offspring of non-faithful males that abandon the pups to mate other females. The fidelity is considered as a genetic trait which is transmitted to the male offspring (with or without error). We s...

  16. A generalized fidelity amplitude for open systems.

    Science.gov (United States)

    Gorin, T; Moreno, H J; Seligman, T H

    2016-06-13

    We consider a central system which is coupled via dephasing to an open system, i.e. an intermediate system which in turn is coupled to another environment. Considering the intermediate and far environment as one composite system, the coherences in the central system are given in the form of fidelity amplitudes for a certain perturbed echo dynamics in the composite environment. On the basis of the Born-Markov approximation, we derive a master equation for the reduction of that dynamics to the intermediate system alone. In distinction to an earlier paper (Moreno et al 2015 Phys. Rev. A 92, 030104. (doi:10.1103/PhysRevA.92.030104)), where we discussed the stabilizing effect of the far environment on the decoherence in the central system, we focus here on the possibility of using the measurable coherences in the central system for probing the open quantum dynamics in the intermediate system. We illustrate our results for the case of chaotic dynamics in the near environment, where we compare random matrix simulations with our analytical result.

  17. Impact of endovascular simulator training on vascular surgery as a career choice in medical students.

    Science.gov (United States)

    Markovic, Jovan; Peyser, Chris; Cavoores, Ted; Fletcher, Erin; Peterson, David; Shortell, Cynthia

    2012-05-01

    The primary goal of this study was to determine whether exposure to endovascular simulator training increases interest in vascular surgery among medical students. Secondary goals were to determine whether interest in vascular surgery is inversely related to the time after exposure, to identify factors associated with interest, and to identify students' characteristics that positively influence performance metrics. This was a prospective, randomized, crossover study comprising 80 medical students who were randomized into group A (n = 40) and group B (n = 40). Participants completed a survey of their interest in vascular surgery and attitudinal factors using Vascular Surgery Interest Form (VSIF) before exposure to the simulator (pretest). At 1 month after exposure of group A to the simulator, both groups were tested using VSIF (test). Upon completion of testing, group B was exposed to simulator training, whereas group A received no further training. At 2 months after exposure of group B to the simulator, both groups were posttested using VSIF, which asked the students' level of interest in vascular surgery using a 1 to 10 scale. Performance metrics were recorded during each exposure. Differences among cohort demographics were determined using Pearson χ(2) analysis. Differences in interest were determined with paired sample correlations. Linear regression and analysis of variance were used to correlate VSIF responses with interest and the performance metrics. Both student cohorts had significant increases in interest after exposure to simulation. In group A, test interest (mean ± standard deviation) was significantly higher than pretest and posttest interests (5.51 ± 1.73 vs 4.00 ± 1.88 vs 4.18 ± 1.82; P training, radiation concerns, gender identification of a mentor, and personality fit with occupation were not correlated with interest. Sex, medical school year, comfort with endovascular procedures, willingness to work long hours, interest in performing

  18. Teaching emergency medical services management skills using a computer simulation exercise.

    Science.gov (United States)

    Hubble, Michael W; Richards, Michael E; Wilfong, Denise

    2011-02-01

    Simulation exercises have long been used to teach management skills in business schools. However, this pedagogical approach has not been reported in emergency medical services (EMS) management education. We sought to develop, deploy, and evaluate a computerized simulation exercise for teaching EMS management skills. Using historical data, a computer simulation model of a regional EMS system was developed. After validation, the simulation was used in an EMS management course. Using historical operational and financial data of the EMS system under study, students designed an EMS system and prepared a budget based on their design. The design of each group was entered into the model that simulated the performance of the EMS system. Students were evaluated on operational and financial performance of their system design and budget accuracy and then surveyed about their experiences with the exercise. The model accurately simulated the performance of the real-world EMS system on which it was based. The exercise helped students identify operational inefficiencies in their system designs and highlighted budget inaccuracies. Most students rated the exercise as moderately or very realistic in ambulance deployment scheduling, budgeting, personnel cost calculations, demand forecasting, system design, and revenue projections. All students indicated the exercise was helpful in gaining a top management perspective, and 89% stated the exercise was helpful in bridging the gap between theory and reality. Preliminary experience with a computer simulator to teach EMS management skills was well received by students in a baccalaureate paramedic program and seems to be a valuable teaching tool. Copyright © 2011 Society for Simulation in Healthcare

  19. Augmented reality intravenous injection simulator based 3D medical imaging for veterinary medicine.

    Science.gov (United States)

    Lee, S; Lee, J; Lee, A; Park, N; Lee, S; Song, S; Seo, A; Lee, H; Kim, J-I; Eom, K

    2013-05-01

    Augmented reality (AR) is a technology which enables users to see the real world, with virtual objects superimposed upon or composited with it. AR simulators have been developed and used in human medicine, but not in veterinary medicine. The aim of this study was to develop an AR intravenous (IV) injection simulator to train veterinary and pre-veterinary students to perform canine venipuncture. Computed tomographic (CT) images of a beagle dog were scanned using a 64-channel multidetector. The CT images were transformed into volumetric data sets using an image segmentation method and were converted into a stereolithography format for creating 3D models. An AR-based interface was developed for an AR simulator for IV injection. Veterinary and pre-veterinary student volunteers were randomly assigned to an AR-trained group or a control group trained using more traditional methods (n = 20/group; n = 8 pre-veterinary students and n = 12 veterinary students in each group) and their proficiency at IV injection technique in live dogs was assessed after training was completed. Students were also asked to complete a questionnaire which was administered after using the simulator. The group that was trained using an AR simulator were more proficient at IV injection technique using real dogs than the control group (P ≤ 0.01). The students agreed that they learned the IV injection technique through the AR simulator. Although the system used in this study needs to be modified before it can be adopted for veterinary educational use, AR simulation has been shown to be a very effective tool for training medical personnel. Using the technology reported here, veterinary AR simulators could be developed for future use in veterinary education.

  20. Learning curves and effect of high-fidelity simulation-based training with virtual reality simulator in flexible fiberoptic intubation%高仿真模拟训练在纤维支气管镜插管教学中的应用及学习曲线研究

    Institute of Scientific and Technical Information of China (English)

    姜柏林; 赵莹; 鞠辉; 姚兰; 冯艺

    2016-01-01

    目的:拟合高仿真模拟教学中纤维支气管镜插管的学习曲线,验证高仿真模拟教学的教学效果。方法选择在北京大学人民医院接受住院医师第一阶段培训,且无纤支镜插管经验的45名麻醉学住院医师作为本研究对象,将其随机分为两组:实验组25人,对照组20人。实验组和对照组医师均观看教学短片,观摩纤支镜插管操作。实验组医师采用 Simbionix GI-Bronch Mentor虚拟真实模拟平台完成25次纤支镜置入气道的模拟操作,对照组医师不进行模拟操作。两组医师均在模拟人头上进行5次考核。记录实验组医师每次模拟培训的操作时间,拟合学习曲线。对比两组医师操作时间和纤支镜操作能力评分。对比实验组医师培训前后的信心评分。结果学习曲线拟合的专业级操作时间为9.3(8.7,10.0)秒,19(15,26)次操作后学习曲线进入平台期。实验组医师的操作时间及操作能力评分均优于对照组医师,F =24.993、P <0.001,F=107.357、P <0.001,差异具有统计学意义。培训后,实验组医师信心评分高于培训前,t =10.708,P <0.001,差异具有统计学意义。结论高仿真模拟教学可以使无纤支镜使用经验的初学者快速通过学习曲线的陡峭段,达到专业级操作时间。19次训练和操作时间趋近9.0秒,可以结合使用,作为达到学习目标的终点设置。%Objective To evaluate the learning curves of residents performing flexible fiberoptic intubation in high-fidelity simulation environment,and assess the effects of training.Methods A total of 45 anesthesia residents in their first stage of training in anesthesiology with no experience in flexible fiber-optic intubation at Peking University People’s Hospital were enrolled in the study,and were divided into two groups randomly:the simulator group (25 residents),and the control group (20

  1. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

    Directory of Open Access Journals (Sweden)

    Ahmadi Koorosh

    2013-06-01

    Full Text Available 【Abstract】Objective: Since appropriate and time-table methods in trauma care have an important impact on patients’ outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS program on medical interns' performance in simulated trauma patient management. Methods: A descriptive and analytical study before and after the training was conducted on 24 randomly se-lected undergraduate medical interns from Imam Reza Hos-pital in Mashhad, Iran. On the first day, we assessed in-terns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre-and post- ATLS periods, were compared through SPSS ver-sion 15.0 software. P values less than 0.05 were considered statistically significant. Results: Our findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P<0.001, P=0.016 and P=0.01 respectively. Conclusion: ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns. Key words: Advanced Trauma Life Support Care; Knowledge; Inservice training; Wounds and injuries

  2. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

    Institute of Scientific and Technical Information of China (English)

    Koorosh Ahmadi; Mohammad Sedaghat; Mahdi Safdarian; Amir Masoud Hashemian; Zahra Nezamdoust; Mohammad Vaseie; Vafa Rahimi-Movaghar

    2013-01-01

    Since appropriate and timetable methods in trauma care have an important impact on patients' outcome,we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns'performance in simulated trauma patient management.Methods:A descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad,Iran.On the first day,we assessed interns' clinical knowledge and their practical skill performance in confronting simulated trauma patients.After 2 days of ATLS training,we performed the same study and evaluated their score again on the fourth day.The two findings,preand post-ATLS periods,were compared through SPSS version 15.0 software.P values less than 0.05 were considered statistically significant.Results:Our findings showed that interns' ability in all the three tasks improved after the training course.On the fourth day after training,there was a statistically significant increase in interns' clinical knowledge of ATLS procedures,the sequence of procedures and skill performance in trauma situations (P<0.001,P=0.016 and P=0.01 respectively).Conclusion:ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

  3. A conceptual framework for implementation fidelity

    Directory of Open Access Journals (Sweden)

    Booth Andrew

    2007-11-01

    Full Text Available Abstract Background Implementation fidelity refers to the degree to which an intervention or programme is delivered as intended. Only by understanding and measuring whether an intervention has been implemented with fidelity can researchers and practitioners gain a better understanding of how and why an intervention works, and the extent to which outcomes can be improved. Discussion The authors undertook a critical review of existing conceptualisations of implementation fidelity and developed a new conceptual framework for understanding and measuring the process. The resulting theoretical framework requires testing by empirical research. Summary Implementation fidelity is an important source of variation affecting the credibility and utility of research. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation.

  4. Hybrid High-Fidelity Auscultation Scope Project

    Data.gov (United States)

    National Aeronautics and Space Administration — To address the NASA Johnson Space Center's need for a space auscultation capability, Physical Optics Corporation proposes to develop a Hybrid High-Fidelity...

  5. The effect of degree of immersion upon learning performance in virtual reality simulations for medical education.

    Science.gov (United States)

    Gutiérrez, Fátima; Pierce, Jennifer; Vergara, Víctor M; Coulter, Robert; Saland, Linda; Caudell, Thomas P; Goldsmith, Timothy E; Alverson, Dale C

    2007-01-01

    Simulations are being used in education and training to enhance understanding, improve performance, and assess competence. However, it is important to measure the performance of these simulations as learning and training tools. This study examined and compared knowledge acquisition using a knowledge structure design. The subjects were first-year medical students at The University of New Mexico School of Medicine. One group used a fully immersed virtual reality (VR) environment using a head mounted display (HMD) and another group used a partially immersed (computer screen) VR environment. The study aims were to determine whether there were significant differences between the two groups as measured by changes in knowledge structure before and after the VR simulation experience. The results showed that both groups benefited from the VR simulation training as measured by the significant increased similarity to the expert knowledge network after the training experience. However, the immersed group showed a significantly higher gain than the partially immersed group. This study demonstrated a positive effect of VR simulation on learning as reflected by improvements in knowledge structure but an enhanced effect of full-immersion using a HMD vs. a screen-based VR system.

  6. Simulation of leakage current measurement on medical devices using helmholtz coil configuration with different current flow

    Science.gov (United States)

    Sutanto, E.; Chandra, F.; Dinata, R.

    2017-05-01

    Leakage current measurement which can follow IEC standard for medical device is one of many challenges to be answered. The IEC 60601-1 has defined that the limit for a leakage current for Medical Device can be as low as 10 µA and as high as 500 µA, depending on which type of contact (applied part) connected to the patient. Most people are using ELCB (Earth-leakage circuit breaker) for safety purpose as this is the most common and available safety device in market. One type of ELCB devices is RCD (Residual Current Device) and this RCD type can measure the leakage current directly. This work will show the possibility on how Helmholtz Coil Configuration can be made to be like the RCD. The possibility is explored by comparing the magnetic field formula from each device, then it proceeds with a simulation using software EJS (Easy Java Simulation). The simulation will make sure the concept of magnetic field current cancellation follows the RCD concept. Finally, the possibility of increasing the measurement’s sensitivity is also analyzed. The sensitivity is needed to see the possibility on reaching the minimum leakage current limit defined by IEC, 0.01mA.

  7. The effects of high-fidelity simulation training on academic self-efficacy and learning motivation in undergraduate nursing students%高仿真模拟教学对本科护生学习自我效能及学习动机的影响

    Institute of Scientific and Technical Information of China (English)

    高海霞; 徐桂华; 高洪莲; 孙志岭; 王丹文; 张姮

    2014-01-01

    目的 探讨高仿真模拟教学对本科护生学习自我效能及学习动机的影响,为高仿真模拟教学效果提供实证依据.方法 将2011级2个班84名本科护生随机分为实验组和对照组各42名,对照组健康评估实训课采用传统教学方法,实验组采用高仿真模拟教学,通过学习自我效能、学习动机和健康评估实践考核成绩优秀率评价教学效果.结果 2组本科护生学习自我效能评分、学习动机评分、健康评估实践考核成绩优秀率之间的差异均具有统计学意义.结论 高仿真模拟教学可提升本科护生学习自我效能、学习动机和健康评估实践考核成绩优秀率,建议在高等院校课程设置中增加高仿真模拟教学时数,促进护生实践能力发展.%Objective To evaluate the effects of high-fidelity simulation training on academic selfefficacy and learning motivation in undergraduate nursing students.Methods 84 undergraduate nursing students were randomized into the control group and the intervention group,nursing students in the control group received traditional health assessment training,while nursing students in the intervention group received health assessment training by high-fidelity simulator.The effects were evaluated by academic self-efficacy,learning motivation and skill performance in undergraduate nursing students.Results There were significant differences on academic self-efficacy,learning motivation and skill performance in undergraduate nursing students between the two groups.Conclusions High-fidelity simulation training can effectively enhance undergraduate nursing students’ academic self-efficacy,learning motivation and skill performance.It is proved to be helpful for competence development in clinical practice.

  8. Teaching empathy to undergraduate medical students using a temporary tattoo simulating psoriasis.

    Science.gov (United States)

    Latham, Lesley; MacDonald, Aimee; Kimball, Alexa B; Langley, Richard G

    2012-07-01

    Psoriasis has a profound negative effect on quality of life that is often underappreciated by health care professionals and the public. We sought to assess the perception of the burden of psoriasis relative to other medical conditions in first-year medical students, and to determine if wearing a temporary tattoo simulating psoriasis during a teaching exercise would change their perceptions. Participants completed a questionnaire assessing their perception of the impact of psoriasis and other common medical conditions (visual analog scale). Participants then wore a temporary tattoo of a psoriatic lesion for 24 hours and completed the same questionnaire after this exercise. Of 91 students approached, 61 completed the study. At baseline, psoriasis (mean = 23.6) and eczema (mean = 23.3) were perceived as having the lowest physical burden of diseases queried (P perception of the impact of eczema (physical: mean = 37.3, P tattoos are a novel and effective method of teaching medical students about the psychological burden of psoriasis. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  9. BACLAB: A Computer Simulation of a Medical Bacteriology Laboratory--An Aid for Teaching Tertiary Level Microbiology.

    Science.gov (United States)

    Lewington, J.; And Others

    1985-01-01

    Describes a computer simulation program which helps students learn the main biochemical tests and profiles for identifying medically important bacteria. Also discusses the advantages and applications of this type of approach. (ML)

  10. Characteristics of simulation activities at North American medical schools and teaching hospitals: an AAMC-SSH-ASPE-AACN collaboration.

    Science.gov (United States)

    Huang, Grace C; Sacks, Heather; Devita, Michael; Reynolds, Robby; Gammon, Wendy; Saleh, Michael; Gliva-McConvey, Gayle; Owens, Tamara; Anderson, Julie; Stillsmoking, Kristina; Cantrell, Mary; Passiment, Morgan

    2012-12-01

    In September 2011, the Association of American Medical Colleges released the results of a survey conducted in 2010 on simulation activities at its member medical schools and teaching hospitals. In this commentary, we offer a synthesis of data and conclude that (1) simulation is used broadly at Association of American Medical Colleges member institutions, for many types of learners, including other health care professionals; (2) it addresses core training competencies and has many educational purposes; (3) its use in learner assessment is more prevalent at medical schools but is still significant at teaching hospitals; and (4) it requires a considerable investment of money, space, personnel, and time. These data confirm general perceptions about the state of simulation in North America for physician training. Future endeavors should include a more granular examination of how simulation is integrated into curricula, a similar survey of other health care-related institutions and professions, and a periodic assessment to characterize trends over time.

  11. Does bench model fidelity interfere in the acquisition of suture skills by novice medical students? Será que a fidelidade do modelo de bancada interfere na aquisição das habilidades de sutura por estudantes de medicina iniciantes na prática cirúrgica?

    Directory of Open Access Journals (Sweden)

    Rafael Denadai

    2012-10-01

    Full Text Available OBJECTIVE: Although several inanimate bench models have been described for training of suture skills, so far, there is no ideal method for teaching and learning this skill during medical education. The aim was to evaluate whether bench model fidelity interferes in the acquisition of suture skills by novice medical students. METHODS: 36 medical students with no surgical skills' background (novices were randomized to three groups (n = 12: theoretical suture training alone (control; low-fidelity suture training model (synthetic ethylene-vinyl acetate bench model; or high-fidelity suture training model (pig feet skin bench model. Pre- and post-tests were applied (performance of simple interrupted sutures and subdermal interrupted sutures on ox tongue. Three tools (Global Rating Scale with blinded assessment, effect size, and self-perceived confidence based on Likert scale were used to measure all suture performances. RESULTS: The post-training analysis showed that the students that practiced on bench models (hands-on training presented better (all p 0.80 in all measurements. Students felt more confident (all p OBJETIVO: Embora vários modelos de bancada inanimados tenham sido descritos para o treinamento de habilidades de sutura, até o momento, não existe um método ideal para esse ensino e aprendizagem durante a formação médica. O objetivo foi avaliar se a fidelidade dos modelos de bancada interfere na aquisição de habilidades de sutura em estudantes de medicina iniciantes na prática cirúrgica. MÉTODOS: 36 estudantes de medicina sem exposição prévia a habilidades cirúrgicas foram randomizados em três grupos (n = 12: treinamento de suturas baseado em materiais didáticos (controle; treinamento de suturas em modelo de baixa-fidelidade (modelo de bancada de etileno vinil acetato; ou treinamento de suturas em modelo de alta-fidelidade (modelo de bancada de pele de pata de porco. Foram aplicados pré e pós-testes (realização de pontos

  12. MCNP6 Simulation of Reactions of Interest to FRIB, Medical, and Space Applications

    CERN Document Server

    Mashnik, Stepan G

    2014-01-01

    The latest, production, version of the Los Alamos Monte Carlo N-Particle transport code MCNP6 has been used to simulate a variety of particle-nucleus and nucleus-nucleus reactions of academic and applied interest to the Facility for Rare Isotope Beams (FRIB), medical isotope production, space-radiation shielding, cosmic-ray propagation, and accelerator applications, including several reactions induced by radioactive isotopes, analyzing production of both stable and radioactive residual nuclei. Here, we discuss examples of validation and verification of MCNP6 compared to recent neutron spectra measured at the Heavy Ion Medical Accelerator in Chiba, Japan; to spectra of light fragments from several reactions measured recently at GANIL, France; INFN Laboratori Nazionali del Sud, Catania, Italy; COSY of the Julich Research Center, Germany; and to cross sections of products from several reactions measured lately at GSI, Darmstadt, Germany; ITEP, Moscow, Russia; LANSCE, LANL, Los Alamos, USA. As a rule, MCNP6 provi...

  13. Testing of junctional tourniquets by military medics to control simulated groin hemorrhage.

    Science.gov (United States)

    Kragh, John F; Parsons, Donald L; Kotwal, Russ S; Kheirabadi, Bijan S; Aden, James K; Gerhardt, Robert T; Baer, David G; Dubick, Michael A

    2014-01-01

    Junctional hemorrhage is a common cause of death on the battlefield, but there is no documented direct comparison for the use of junctional tourniquet models by US medics. The purpose of this testing is to assess military medic experience with the use of junctional tourniquets in simulated out-of-hospital trauma care. Nine medics (seven men and two women) used four different junctional tourniquets: Combat Ready Clamp™ (CRoC™; http://www.combatmedicalsystems .com), Abdominal Aortic and Junctional Tourniquet™ (AAJT™; http://www.compressionworks.net), Junctional Emergency Treatment Tool (JETT™; http://www.narescue .com), and SAM Junctional Tourniquet® (SJT®; http://www.sammedical.com/products). These medics also acted as simulated casualties. Effectiveness percentages, as measured by stopped distal pulse by Doppler auscultation, and time to effectiveness were recorded in two tests per tourniquet (72 total tests). Tourniquet users ranked their preference of model by answering the question: "If you had to go to war today and you could only choose one, which tourniquet would you choose to bring?" All tourniquets used were safe under the conditions of this study. Both the SJT and the CRoC had high effectiveness percentages; their rate difference was not statistically significant. The SJT and the CRoC had fast times to effectiveness; their time difference was not statistically significant. Users preferred the SJT and the CRoC; their ranked difference was not statistically significant. The SJT and the CRoC were equally effective and fast and were preferred by the participants. 2014.

  14. Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?

    Science.gov (United States)

    Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

    2010-02-01

    Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education.

  15. Simulation curriculum can improve medical student assessment and management of acute coronary syndrome during a clinical practice exam.

    Science.gov (United States)

    DeWaay, Deborah J; McEvoy, Matthew D; Kern, Donna H; Alexander, Louise A; Nietert, Paul J

    2014-06-01

    It has been noted that increased focus on learning acute care skills is needed in undergraduate medical curricula. This study investigated whether a simulation-based curriculum improved a senior medical student's ability to manage acute coronary syndrome as measured during a clinical performance examination (CPX). The authors hypothesized that simulation training would improve overall performance when compared with targeted didactics or historical controls. All 4th-year medical students (n = 291) over 2 years at the authors' institution were included in this study. In the 3rd year of medical school, the "control" group received no intervention, the "didactic" group received a targeted didactic curriculum, and the "simulation" group participated in small group simulation training and the didactic curriculum. For intergroup comparison on the CPX, the authors calculated the percentage of correct actions completed by the student. Data are presented as mean ± standard deviation with significance defined as P simulation versus both didactics and control (P simulation versus both didactics and control, as was for diagnosis: simulation versus both didactics and control (P Simulation training had a modest impact on overall CPX performance in the management of a simulated acute coronary syndrome. Additional studies are needed to evaluate how to further improve curricula regarding unstable patients.

  16. Enhancing learning through optimal sequencing of web-based and manikin simulators to teach shock physiology in the medical curriculum.

    Science.gov (United States)

    Cendan, Juan C; Johnson, Teresa R

    2011-12-01

    The Association of American Medical Colleges has encouraged educators to investigate proper linkage of simulation experiences with medical curricula. The authors aimed to determine if student knowledge and satisfaction differ between participation in web-based and manikin simulations for learning shock physiology and treatment and to determine if a specific training sequencing had a differential effect on learning. All 40 second-year medical students participated in a randomized, counterbalanced study with two interventions: group 1 (n = 20) participated in a web-based simulation followed by a manikin simulation and group 2 (n = 20) participated in reverse order. Knowledge and attitudes were documented. Mixed-model ANOVA indicated a significant main effect of time (F(1,38) = 18.6, P learning when web-based simulation precedes manikin use. This finding warrants further study.

  17. Commissioning of a medical accelerator photon beam Monte Carlo simulation using wide-field profiles

    Science.gov (United States)

    Pena, J.; Franco, L.; Gómez, F.; Iglesias, A.; Lobato, R.; Mosquera, J.; Pazos, A.; Pardo, J.; Pombar, M.; Rodríguez, A.; Sendón, J.

    2004-11-01

    A method for commissioning an EGSnrc Monte Carlo simulation of medical linac photon beams through wide-field lateral profiles at moderate depth in a water phantom is presented. Although depth-dose profiles are commonly used for nominal energy determination, our study shows that they are quite insensitive to energy changes below 0.3 MeV (0.6 MeV) for a 6 MV (15 MV) photon beam. Also, the depth-dose profile dependence on beam radius adds an additional uncertainty in their use for tuning nominal energy. Simulated 40 cm × 40 cm lateral profiles at 5 cm depth in a water phantom show greater sensitivity to both nominal energy and radius. Beam parameters could be determined by comparing only these curves with measured data.

  18. Commissioning of a medical accelerator photon beam Monte Carlo simulation using wide-field profiles

    Energy Technology Data Exchange (ETDEWEB)

    Pena, J [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Franco, L [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Gomez, F [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Iglesias, A [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Lobato, R [Hospital ClInico Universitario de Santiago, Santiago de Compostela (Spain); Mosquera, J [Hospital ClInico Universitario de Santiago, Santiago de Compostela (Spain); Pazos, A [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Pardo, J [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Pombar, M [Hospital ClInico Universitario de Santiago, Santiago de Compostela (Spain); RodrIguez, A [Departamento de Fisica de PartIculas, Facultade de Fisica, 15782 Santiago de Compostela (Spain); Sendon, J [Hospital ClInico Universitario de Santiago, Santiago de Compostela (Spain)

    2004-11-07

    A method for commissioning an EGSnrc Monte Carlo simulation of medical linac photon beams through wide-field lateral profiles at moderate depth in a water phantom is presented. Although depth-dose profiles are commonly used for nominal energy determination, our study shows that they are quite insensitive to energy changes below 0.3 MeV (0.6 MeV) for a 6 MV (15 MV) photon beam. Also, the depth-dose profile dependence on beam radius adds an additional uncertainty in their use for tuning nominal energy. Simulated 40 cm x 40 cm lateral profiles at 5 cm depth in a water phantom show greater sensitivity to both nominal energy and radius. Beam parameters could be determined by comparing only these curves with measured data.

  19. Enhancing the effectiveness of team debriefings in medical simulation: more best practices.

    Science.gov (United States)

    Lyons, Rebecca; Lazzara, Elizabeth H; Benishek, Lauren E; Zajac, Stephanie; Gregory, Megan; Sonesh, Shirley C; Salas, Eduardo

    2015-03-01

    Teamwork is a vital component of optimal patient care. In both clinical settings and medical education, a variety of approaches are used for the development of teamwork skills. Yet, for team members to receive the full educational benefit of these experiential learning opportunities, postsimulation feedback regarding the team's performance must be incorporated. Debriefings are among the most widely used form of feedback regarding team performance. A team debriefing is a facilitated or guided dialogue that takes place between team members following an action period to review and reflect on team performance. Team members discuss their perceptions of what occurred, why it occurred, and how they can enhance their performance. Simulation debriefing allows for greater control and planning than are logistically feasible for on-the-job performance. It is also unique in that facilitators of simulation-based training are generally individuals external to the team, whereas debriefing on the job is commonly led by an internal team member or conducted without a specified facilitator. Consequently, there is greater opportunity for selecting and training facilitators for team simulation events. Thirteen Best Practices: The 13 best practices, extracted from existing training and debriefing research, are organized under three general categories: (1) preparing for debriefing, (2) facilitator responsibilities during debriefing, and (3) considerations for debriefing content. For each best practice, considerations and practical implications are provided to facilitate the implementation of the recommended practices. The 13 best practices presented in this article should help health care organizations by guiding team simulation administrators, self-directed medical teams, and debriefing facilitators in the optimization of debriefing to support learning for all team members.

  20. The proton therapy nozzles at Samsung Medical Center: A Monte Carlo simulation study using TOPAS

    Science.gov (United States)

    Chung, Kwangzoo; Kim, Jinsung; Kim, Dae-Hyun; Ahn, Sunghwan; Han, Youngyih

    2015-07-01

    To expedite the commissioning process of the proton therapy system at Samsung Medical Center (SMC), we have developed a Monte Carlo simulation model of the proton therapy nozzles by using TOol for PArticle Simulation (TOPAS). At SMC proton therapy center, we have two gantry rooms with different types of nozzles: a multi-purpose nozzle and a dedicated scanning nozzle. Each nozzle has been modeled in detail following the geometry information provided by the manufacturer, Sumitomo Heavy Industries, Ltd. For this purpose, the novel features of TOPAS, such as the time feature or the ridge filter class, have been used, and the appropriate physics models for proton nozzle simulation have been defined. Dosimetric properties, like percent depth dose curve, spreadout Bragg peak (SOBP), and beam spot size, have been simulated and verified against measured beam data. Beyond the Monte Carlo nozzle modeling, we have developed an interface between TOPAS and the treatment planning system (TPS), RayStation. An exported radiotherapy (RT) plan from the TPS is interpreted by using an interface and is then translated into the TOPAS input text. The developed Monte Carlo nozzle model can be used to estimate the non-beam performance, such as the neutron background, of the nozzles. Furthermore, the nozzle model can be used to study the mechanical optimization of the design of the nozzle.

  1. Medical simulation is needed in anesthesia training to achieve patient's safety.

    Science.gov (United States)

    Chang, Chul-Ho

    2013-03-01

    Many medical schools and hospitals throughout the world are equipped with a simulation center for the purpose of training anesthesiologists to perform both technical and non-technical skills. Because induction, maintenance, and emergence of general anesthesia are critical to patient welfare, various simulation mannequins and tools are utilized for the purpose of training anesthesiologists for safer patient care. Traditionally, anesthesia residency training mostly consisted of didactic lectures and observations. After completion of "traditional" training, anesthesia residents were allowed to perform procedures on patients under supervision. However, simulation would be a more effective training tool for which to teach anesthesiologists the skills necessary to perform invasive procedures, such as endotracheal intubation, central venous catheter insertion, and epidural catheter insertion. Recently, non-technical skills, such as the Anesthesia Non-Technical Skills developed by anesthesiologists from Aberdeen University, have been emphasized as an important training resource. Technical skills and non-technical skills can be learned by anesthesiology residents through a standardized and organized simulation program. Such programs would be beneficial in training anesthesia residents to work efficiently as a team in the operation room.

  2. Fidelity of an electron in one-dimensional determined potentials

    Institute of Scientific and Technical Information of China (English)

    Song Wen-Guang; Tong Pei-Qing

    2009-01-01

    We numerically study the fidelity of an electron in the one-dimensional Harper model and in the one-dimensional slowly varying potential model. Our results show that many properties of the two models can be well reflected by the fidelity: (i) the mobility edge and metal-insulator transition can be characterized by the static fidelity; (ii) the extended state and localized state can be identified by the dynamic fidelity. Therefore, it may broaden the applied areas of the fidelity.

  3. Measuring Fidelity in Preschool Interventions: A Microanalysis of Fidelity Instruments Used in Curriculum Interventions

    Science.gov (United States)

    Darrow, Catherine L.

    2010-01-01

    This paper examines measures used by studies associated with Preschool Curriculum Evaluation Research Initiative (PCER) funded by the Institute of Education Sciences. Analysis of 17 measures of fidelity used by 13 curriculum interventions highlights how research in preschools is and is not measuring fidelity of implementation. The following…

  4. [Clinical Simulation and Emotional Learning].

    Science.gov (United States)

    Afanador, Adalberto Amaya

    2012-01-01

    At present, the clinical simulation has been incorporated into medical school curriculum. It is considered that the simulation is useful to develop skills, and as such its diffusion. Within the acquisition of skills, meaningful learning is an essential emotional component for the student and this point is essential to optimize the results of the simulation experience. Narrative description on the subject of simulation and the degree of "emotionality." The taxonomy is described for the types of clinical simulation fidelity and correlates it with the degree of emotionality required to achieve significant and lasting learning by students. It is essential to take into account the student's level of emotion in the learning process through simulation strategy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Impact of a medical student alcohol intervention workshop using recovering alcoholics as simulated patients

    Directory of Open Access Journals (Sweden)

    Johnson JA

    2014-05-01

    Full Text Available J Aaron Johnson,1 J Paul Seale,1 Sylvia Shellenberger,1 Mary M Velasquez,2 Candice Alick,1 Katherine Turk3 1Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA, 2School of Social Work, University of Texas-Austin, Austin, TX, 3Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, USA Background: Alcohol screening and brief intervention (SBI reduces drinking among at-risk drinkers. Lack of training and negative attitudes represents a barrier to SBI performance. This study evaluates the impact of a medical student workshop using recovering alcoholics in simulated patient interviews to teach SBI skills. Methods: Third-year students (n=94 were surveyed before and after a 3-hour alcohol SBI workshop regarding their perceived importance and confidence in performing eleven SBI behaviors. Students were also asked to list factors increasing and decreasing motivation to conduct SBI. Students completing off-campus rotations (n=71 served as controls, completing surveys during the same time period but without attending the workshop. Results: Analysis of variance found a significant interaction effect between the students participating in the workshop and control students on both importance scores [F(2,174=3.34] and confidence scores [F(2,174=9.13], indicating higher scores for the workshop students at the follow-up time periods. Commonly listed motivators for performing SBI included clinical experience with alcohol misuse and the impact of alcohol on health and relationships. High relapse rates and patient reactions to questions about alcohol use decreased the motivation to perform SBI. Conclusion: SBI workshops that include recovering alcoholics as simulated patients can produce long-term improvements in students' perceived importance and confidence in performing SBI. Keywords: alcohol, screening, medical students, brief intervention

  6. Point-of-care ultrasound education: the increasing role of simulation and multimedia resources.

    Science.gov (United States)

    Lewiss, Resa E; Hoffmann, Beatrice; Beaulieu, Yanick; Phelan, Mary Beth

    2014-01-01

    This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.

  7. New hybrid voxelized/analytical primitive in Monte Carlo simulations for medical applications

    Science.gov (United States)

    Bert, Julien; Lemaréchal, Yannick; Visvikis, Dimitris

    2016-05-01

    Monte Carlo simulations (MCS) applied in particle physics play a key role in medical imaging and particle therapy. In such simulations, particles are transported through voxelized phantoms derived from predominantly patient CT images. However, such voxelized object representation limits the incorporation of fine elements, such as artificial implants from CAD modeling or anatomical and functional details extracted from other imaging modalities. In this work we propose a new hYbrid Voxelized/ANalytical primitive (YVAN) that combines both voxelized and analytical object descriptions within the same MCS, without the need to simultaneously run two parallel simulations, which is the current gold standard methodology. Given that YVAN is simply a new primitive object, it does not require any modifications on the underlying MC navigation code. The new proposed primitive was assessed through a first simple MCS. Results from the YVAN primitive were compared against an MCS using a pure analytical geometry and the layer mass geometry concept. A perfect agreement was found between these simulations, leading to the conclusion that the new hybrid primitive is able to accurately and efficiently handle phantoms defined by a mixture of voxelized and analytical objects. In addition, two application-based evaluation studies in coronary angiography and intra-operative radiotherapy showed that the use of YVAN was 6.5% and 12.2% faster than the layered mass geometry method, respectively, without any associated loss of accuracy. However, the simplification advantages and differences in computational time improvements obtained with YVAN depend on the relative proportion of the analytical and voxelized structures used in the simulation as well as the size and number of triangles used in the description of the analytical object meshes.

  8. New hybrid voxelized/analytical primitive in Monte Carlo simulations for medical applications.

    Science.gov (United States)

    Bert, Julien; Lemaréchal, Yannick; Visvikis, Dimitris

    2016-05-01

    Monte Carlo simulations (MCS) applied in particle physics play a key role in medical imaging and particle therapy. In such simulations, particles are transported through voxelized phantoms derived from predominantly patient CT images. However, such voxelized object representation limits the incorporation of fine elements, such as artificial implants from CAD modeling or anatomical and functional details extracted from other imaging modalities. In this work we propose a new hYbrid Voxelized/ANalytical primitive (YVAN) that combines both voxelized and analytical object descriptions within the same MCS, without the need to simultaneously run two parallel simulations, which is the current gold standard methodology. Given that YVAN is simply a new primitive object, it does not require any modifications on the underlying MC navigation code. The new proposed primitive was assessed through a first simple MCS. Results from the YVAN primitive were compared against an MCS using a pure analytical geometry and the layer mass geometry concept. A perfect agreement was found between these simulations, leading to the conclusion that the new hybrid primitive is able to accurately and efficiently handle phantoms defined by a mixture of voxelized and analytical objects. In addition, two application-based evaluation studies in coronary angiography and intra-operative radiotherapy showed that the use of YVAN was 6.5% and 12.2% faster than the layered mass geometry method, respectively, without any associated loss of accuracy. However, the simplification advantages and differences in computational time improvements obtained with YVAN depend on the relative proportion of the analytical and voxelized structures used in the simulation as well as the size and number of triangles used in the description of the analytical object meshes.

  9. Geant4 simulations on medical Linac operation at 18 MV: Experimental validation based on activation foils

    Science.gov (United States)

    Vagena, E.; Stoulos, S.; Manolopoulou, M.

    2016-03-01

    The operation of a medical linear accelerator was simulated using the Geant4 code regarding to study the characteristics of an 18 MeV photon beam. Simulations showed that (a) the photon spectrum at the isocenter is not influenced by changes of the primary electron beam's energy distribution and spatial spread (b) 98% of the photon energy fluence scored at the isocenter is primary photons that have only interacted with the target (c) the number of contaminant electrons is not negligible since it fluctuated around 5×10-5 per primary electron or 2.40×10-3 per photon at the isocenter (d) the number of neutrons that are created by (γ, n) reactions is 3.13×10-6 per primary electron or 1.50×10-3 per photon at the isocenter (e) a flattening filter free beam needs less primary electrons in order to deliver the same photon fluence at the isocenter than a normal flattening filter operation (f) there is no significant increase of the surface dose due to the contaminant electrons by removing the flattening filter (g) comparing the neutron fluences per incident electron for the flattened and unflattened beam, the neutron fluencies is 7% higher for the unflattened beams. To validate the simulations results, the total neutron and photon fluence at the isocenter field were measured using nickel, indium, and natural uranium activation foils. The percentage difference between simulations and measurements was 1.26% in case of uranium and 2.45% in case of the indium foil regarding photon fluencies while for neutrons the discrepancy is higher up to 8.0%. The photon and neutron fluencies of the simulated experiments fall within a range of ±1 and ±2 sigma error, respectively, compared to the ones obtained experimentally.

  10. Simulation-guided cardiac auscultation improves medical students' clinical skills: the Pavia pilot experience.

    Science.gov (United States)

    Perlini, Stefano; Salinaro, Francesco; Santalucia, Paola; Musca, Francesco

    2014-03-01

    Clinical evaluation is the cornerstone of any cardiac diagnosis, although excessive over-specialisation often leads students to disregard the value of clinical skills, and to overemphasize the approach to instrumental cardiac diagnosis. Time restraints, low availability of "typical" cardiac patients on whom to perform effective bedside teaching, patients' respect and the underscoring of the value of clinical skills all lead to a progressive decay in teaching. Simulation-guided cardiac auscultation may improve clinical training in medical students and residents. Harvey(©) is a mannequin encompassing more than 50 cardiac diagnoses that was designed and developed at the University of Miami (Florida, USA). One of the advantages of Harvey(©) simulation resides in the possibility of listening, comparing and discussing "real" murmurs. To objectively assess its teaching performance, the capability to identify five different cardiac diagnoses (atrial septal defect, normal young subject, mitral stenosis with tricuspid regurgitation, chronic mitral regurgitation, and pericarditis) out of more than 50 diagnostic possibilities was assessed in 523 III-year medical students (i.e. at the very beginning of their clinical experience), in 92 VI-year students, and in 42 residents before and after a formal 10-h teaching session with Harvey(©). None of them had previously experienced simulation-based cardiac auscultation in addition to formal lecturing (all three groups) and bedside teaching (VI-year students and residents). In order to assess the "persistence" of the acquired knowledge over time, the test was repeated after 3 years in 85 students, who did not repeat the formal 10-h teaching session with Harvey(©) after the III year. As expected, the overall response was poor in the "beginners" who correctly identified 11.0 % of the administered cardiac murmurs. After simulation-guided training, the ability to recognise the correct cardiac diagnoses was much better (72.0 %; p

  11. Electro-Quasistatic Simulations in Bio-Systems Engineering and Medical Engineering

    Directory of Open Access Journals (Sweden)

    U. van Rienen

    2005-01-01

    Full Text Available Slowly varying electromagnetic fields play a key role in various applications in bio-systems and medical engineering. Examples are the electric activity of neurons on neurochips used as biosensors, the stimulating electric fields of implanted electrodes used for deep brain stimulation in patients with Morbus Parkinson and the stimulation of the auditory nerves in deaf patients, respectively. In order to simulate the neuronal activity on a chip it is necessary to couple Maxwell's and Hodgkin-Huxley's equations. First numerical results for a neuron coupling to a single electrode are presented. They show a promising qualitative agreement with the experimentally recorded signals. Further, simulations are presented on electrodes for deep brain stimulation in animal experiments where the question of electrode ageing and energy deposition in the surrounding tissue are of major interest. As a last example, electric simulations for a simple cochlea model are presented comparing the field in the skull bones for different electrode types and stimulations in different positions.

  12. The ultrasound detection of simulated long bone fractures by U.S. Army Special Forces Medics.

    Science.gov (United States)

    Heiner, Jason D; Baker, Benjamin L; McArthur, Todd J

    2010-01-01

    U.S. Army Special Forces Medics (18Ds) operate in austere environments where decisions regarding patient management may be limited by available resources. Portable ultrasound may allow for the detection of fractures in environments where other imaging modalities such as radiography are not readily available or practical. We used a simulation training model for the ultrasound diagnosis of long bone fractures to study the ability of 18Ds to detect the presence or absence of a fracture using a portable ultrasound. The fracture simulation model is composed of a bare turkey leg bone that is mechanically fractured and housed in a shallow plastic container within an opaque gelatin base solution. Five fracture patterns were created: transverse, segmental, oblique, comminuted, and no fracture. After a brief orientation session, twenty 18Ds evaluated the models in a blinded fashion with a SonoSite M-Turbo portable ultrasound device for the presence or absence of a fracture. 18Ds demonstrated 100% sensitivity (95% CI: 94.2% to 100%) in fracture detection and an overall specificity of 90% (95% CI: 66.8-98.2%) due to two false positive assessments of the no fracture model. Using a portable ultrasound device, 18Ds were able to correctly detect the presence or absence of a simulated long bone fracture with a high degree of sensitivity and specificity. Future studies are needed to investigate the clinical impact of this diagnostic ability. 2010.

  13. Negotiating frame ambiguity: a study of simulated encounters in medical education.

    Science.gov (United States)

    Seale, Clive; Butler, Christopher C; Hutchby, Ian; Kinnersley, Paul; Rollnick, Stephen

    2007-01-01

    We report an investigation of the sociolinguistic characteristics of simulated encounters (role plays) in medical education, focusing in particular on frame negotiation. The role played by context in influencing the nature of out-of-frame activity is noted through comparison with another published study of simulations (Linell and Thunqvist 2003). While in general sustaining a role-playing frame that involved an orientation to exact mimicry of clinical situations, the interactional work done to sustain this appearance of 'authenticity' at certain moments was revealed by out-of-frame utterances. One participating doctor in particular used humor to exploit the ambiguous realism of the role-playing frame. The success of this doctor in acquiring and applying new communication behaviors problematizes the view that 'realism', achieved through mimicry, is solely responsible for the success of training interventions. The implications for studying other kinds of simulated encounters, including an outline for a program of research into the sociolinguistics of acting tasks in general, are outlined. Sociolinguistic researchers involved in observational studies of talk would benefit from adopting the view that role-played, rehearsed, and even scripted talk of the sort used in dramatic performance is a variety of naturally occurring data and therefore worthy of study.

  14. The Proton Therapy Nozzles at Samsung Medical Center: A Monte Carlo Simulation Study using TOPAS

    CERN Document Server

    Chung, Kwangzoo; Kim, Dae-Hyun; Ahn, Sunghwan; Han, Youngyih

    2015-01-01

    To expedite the commissioning process of the proton therapy system at Samsung Medical Center (SMC), we have developed a Monte Carlo simulation model of the proton therapy nozzles using TOPAS. At SMC proton therapy center, we have two gantry rooms with different types of nozzles; a multi-purpose nozzle and a dedicated scanning nozzle. Each nozzle has been modeled in detail following the geometry information provided by the manufacturer, Sumitomo Heavy Industries, Ltd. For this purpose, novel features of TOPAS, such as the time feature or the ridge filter class, have been used. And the appropriate physics models for proton nozzle simulation were defined. Dosimetric properties, like percent depth dose curve, spread-out Bragg peak (SOBP), beam spot size, have been simulated and verified against measured beam data. Beyond the Monte Carlo nozzle modeling, we have developed an interface between TOPAS and the treatment planning system (TPS), RayStation. An exported RT plan data from the TPS has been interpreted by th...

  15. Tube thoracostomy training with a medical simulator is associated with faster, more successful performance of the procedure

    Science.gov (United States)

    Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Chung, Hyun Soo

    2016-01-01

    Objective Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator. Methods This is a simulation study. Eligible participants were emergency medicine residents with very few (≤3 times) TT experience. Participants were randomized to two groups: the conventional training group, and the simulator training group. While the simulator training group used the simulator to train TT, the conventional training group watched the instructor performing TT on a cadaver. After training, all participants performed a TT on a cadaver. The performance quality was measured as correct placement and time delay. Subjects were graded if they had difficulty on process. Results Estimated median procedure time was 228 seconds in the conventional training group and 75 seconds in the simulator training group, with statistical significance (P=0.040). The difficulty grading did not show any significant difference among groups (overall performance scale, 2 vs. 3; P=0.094). Conclusion Tube thoracostomy training with a medical simulator, when compared to no simulator training, is associated with a significantly faster procedure, when performed on a human cadaver. PMID:27752610

  16. Fidelity approach in topological superconductors with disorders

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Wen-Chuan; Huang, Guang-Yao; Wang, Zhi, E-mail: physicswangzhi@gmail.com; Yao, Dao-Xin, E-mail: yaodaox@mail.sysu.edu.cn

    2015-03-20

    We apply the fidelity approach to study the topological superconductivity in spin–orbit coupling nanowire system. The wire is modeled as a one layer lattice chain with Zeeman energy and spin–orbit coupling, which is in proximity to a multi-layer superconductor. In particular, we study the effects of disorders and find that the fidelity susceptibility has multiple peaks. It is revealed that one peak indicates the topological quantum phase transition, while other peaks are signaling the pinning of the Majorana bound states by disorders. - Highlights: • We introduce fidelity approach to study the topological superconducting nanowire with disorders. • We study the quantum phase transition in the wire. • We investigate the disorder pinning of the Majorana bound states in the wire.

  17. Advanced airway management simulation training in medical education: a systematic review and meta-analysis.

    Science.gov (United States)

    Kennedy, Cassie C; Cannon, Eric K; Warner, David O; Cook, David A

    2014-01-01

    To perform a systematic review and meta-analysis of the literature on teaching airway management using technology-enhanced simulation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, and Scopus for eligible articles through May 11, 2011. Observational or controlled trials instructing medical professionals in direct or fiberoptic intubation, surgical airway, and/or supraglottic airway using technology-enhanced simulation were included. Two reviewers determined eligibility. Study quality, instructional design, and outcome data were abstracted independently and in duplicate. Of 10,904 articles screened, 76 studies were included (n = 5,226 participants). We used random effects meta-analysis to pool results. In comparison with no intervention, simulation training was associated with improved outcomes for knowledge (standardized mean difference, 0.77 [95% CI, 0.19-1.35]; n = 7 studies) and skill (1.01 [0.68-1.34]; n = 28) but not for behavior (0.52 [-0.30 to 1.34]; n = 4) or patient outcomes (-0.12 [-0.41 to 0.16]; n = 4). In comparison with nonsimulation interventions, simulation training was associated with increased learner satisfaction (0.54 [0.37-0.71]; n = 2), improved skills (0.64 [0.12-1.16]; n = 5), and patient outcomes (0.86 [0.12-1.59]; n = 3) but not knowledge (0.29 [-0.28 to 0.86]; n = 4). We found few comparative effectiveness studies exploring how to optimize the use of simulation-based training, and these revealed inconsistent results. For example, animal models were found superior to manikins in one study (p = 0.004) using outcome of task speed but inferior in another study in terms of skill ratings (p = 0.02). Five studies comparing simulators of high versus low technical sophistication found no significant difference in skill outcomes (p > 0.31). Limitations of this review include heterogeneity (I2 > 50% for most analysis) and variation in quality among primary studies. Simulation-based airway management curriculum is superior to

  18. Simulation

    DEFF Research Database (Denmark)

    Gould, Derek A; Chalmers, Nicholas; Johnson, Sheena J

    2012-01-01

    Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable p...... performance assessments. Human factors research is central to simulator model development that is relevant to real-world imaging-guided interventional tasks and to the credentialing programs in which it would be used.......Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable...

  19. Fidelity enhancement by logical qubit encoding.

    Science.gov (United States)

    Henry, Michael K; Ramanathan, Chandrasekhar; Hodges, Jonathan S; Ryan, Colm A; Ditty, Michael J; Laflamme, Raymond; Cory, David G

    2007-11-30

    We demonstrate coherent control of two logical qubits encoded in a decoherence free subspace (DFS) of four dipolar-coupled protons in an NMR quantum information processor. A pseudopure fiducial state is created in the DFS, and a unitary logical qubit entangling operator evolves the system to a logical Bell state. The four-spin molecule is partially aligned by a liquid crystal solvent, which introduces strong dipolar couplings among the spins. Although the system Hamiltonian is never fully specified, we demonstrate high fidelity control over the logical degrees of freedom. In fact, the DFS encoding leads to higher fidelity control than is available in the full four-spin Hilbert space.

  20. Quantum phase transition, quantum fidelity and fidelity susceptibility in the Yang-Baxter system

    Science.gov (United States)

    Hu, Taotao; Yang, Qi; Xue, Kang; Wang, Gangcheng; Zhang, Yan; Li, Xiaodan; Ren, Hang

    2017-01-01

    In this paper, we investigate the ground-state fidelity and fidelity susceptibility in the many-body Yang-Baxter system and analyze their connections with quantum phase transition. The Yang-Baxter system was perturbed by a twist of e^{iφ} at each bond, where the parameter φ originates from the q-deformation of the braiding operator U with q = e^{-iφ} (Jimbo in Yang-Baxter equations in integrable systems, World Scientific, Singapore, 1990), and φ has a physical significance of magnetic flux (Badurek et al. in Phys. Rev. D 14:1177, 1976). We test the ground-state fidelity related by a small parameter variation φ which is a different term from the one used for driving the system toward a quantum phase transition. It shows that ground-state fidelity develops a sharp drop at the transition. The drop gets sharper as system size N increases. It has been verified that a sufficiently small value of φ used has no effect on the location of the critical point, but affects the value of F(gc,φ) . The smaller the twist φ, the more the value of F(gc,φ) is close to 0. In order to avoid the effect of the finite value of φ, we also calculate the fidelity susceptibility. Our results demonstrate that in the Yang-Baxter system, the quantum phase transition can be well characterized by the ground-state fidelity and fidelity susceptibility in a special way.

  1. A simulation-based curriculum to introduce key teamwork principles to entering medical students.

    Science.gov (United States)

    Banerjee, Arna; Slagle, Jason M; Mercaldo, Nathaniel D; Booker, Ray; Miller, Anne; France, Daniel J; Rawn, Lisa; Weinger, Matthew B

    2016-11-16

    Failures of teamwork and interpersonal communication have been cited as a major patient safety issue. Although healthcare is increasingly being provided in interdisciplinary teams, medical school curricula have traditionally not explicitly included the specific knowledge, skills, attitudes, and behaviors required to function effectively as part of such teams. As part of a new "Foundations" core course for beginning medical students that provided a two-week introduction to the most important themes in modern healthcare, a multidisciplinary team, in collaboration with the Center for Experiential Learning and Assessment, was asked to create an experiential introduction to teamwork and interpersonal communication. We designed and implemented a novel, all-day course to teach second-week medical students basic teamwork and interpersonal principles and skills using immersive simulation methods. Students' anonymous comprehensive course evaluations were collected at the end of the day. Through four years of iterative refinement based on students' course evaluations, faculty reflection, and debriefing, the course changed and matured. Four hundred twenty evaluations were collected. Course evaluations were positive with almost all questions having means and medians greater than 5 out of 7 across all 4 years. Sequential year comparisons were of greatest interest for examining the effects of year-to-year curricular improvements. Differences were not detected among any of the course evaluation questions between 2007 and 2008 except that more students in 2008 felt that the course further developed their "Decision Making Abilities" (OR 1.69, 95% CI 1.07-2.67). With extensive changes to the syllabus and debriefer selection/assignment, concomitant improvements were observed in these aspects between 2008 and 2009 (OR = 2.11, 95% CI: 1.28-3.50). Substantive improvements in specific exercises also yielded significant improvements in the evaluations of those exercises. This

  2. Design and evaluation of a medical teamwork training simulator using consumer-level equipment.

    Science.gov (United States)

    Marks, Stefan; Windsor, John A; Wünsche, Burkhard

    2012-01-01

    Virtual environments (VE) are increasingly used for teamwork training purposes, e.g., for medical teams. One shortcoming is lack of support for nonverbal communication channels, essential for teamwork. We address this issue by using an inexpensive webcam to track the user's head and using that data for controlling avatar head movement, thereby conveying head gestures and adding a nonverbal communication channel. In addition, navigation and orientation within the virtual environment is simplified. We present the design and evaluation of a simulation framework based on a game engine and consumer-level hardware and the results of two user studies showing, among other results, an improvement in the usability of the VE and in the perceived quality of realism and communication within the VE by using head tracking avatar and view control.

  3. Developing effective serious games: the effect of background sound on visual fidelity perception with varying texture resolution.

    Science.gov (United States)

    Rojas, David; Kapralos, Bill; Cristancho, Sayra; Collins, Karen; Hogue, Andrew; Conati, Cristina; Dubrowski, Adam

    2012-01-01

    Despite the benefits associated with virtual learning environments and serious games, there are open, fundamental issues regarding simulation fidelity and multi-modal cue interaction and their effect on immersion, transfer of knowledge, and retention. Here we describe the results of a study that examined the effect of ambient (background) sound on the perception of visual fidelity (defined with respect to texture resolution). Results suggest that the perception of visual fidelity is dependent on ambient sound and more specifically, white noise can have detrimental effects on our perception of high quality visuals. The results of this study will guide future studies that will ultimately aid in developing an understanding of the role that fidelity, and multi-modal interactions play with respect to knowledge transfer and retention for users of virtual simulations and serious games.

  4. A medical hand tool physical interaction evaluation approach for prototype testing using patient care simulators.

    Science.gov (United States)

    Browne, Aleksandra; O'Sullivan, Leonard

    2012-05-01

    The purpose of this study was to develop and test a physical ergonomics assessment approach for medical device handles. The method assesses wrist posture and force of exertion simultaneously by task element. Electrogoniometers and EMG sensors were connected through a data acquisition module for synchronization with video recordings of trials. Task analysis of video recordings were performed offline with Observer XT software. Average posture and force data across several repetitions of individual task elements were calculated and presented in a format suitable for informing product designers of specific issues during a test trial. A handle comfort questionnaire is proposed to survey subjective responses. The evaluation approach was applied to an endoscope needle in sampling a biopsy from the stomach wall using a gastrointestinal track simulator with ten physician surrogates. The results showed that for all task elements the wrist was in extension (33(°)-45(°)). Peak muscle forces ranged from 28% to 68% MVC across the three muscles studied. Muscle peak forces were above ACGIH HAL maximum threshold limits for four of the seven task elements, and above the action limit for all seven task elements for two muscles. The handle comfort questionnaire data also supported the high muscle force findings, and also on force distribution on the handle due to contact stresses. This combined approach could be used to collect and report detailed early stage ergonomics data from user trials on patient care simulators. The approach is proposed for use by medical device designers at the design stage of new products using prototypes, but it could also be used on existing products with real patients.

  5. Well, you have hepatic metastases: Use of technical language by medical students in simulated patient interviews.

    Science.gov (United States)

    Bourquin, Céline; Stiefel, Friedrich; Mast, Marianne Schmid; Bonvin, Raphael; Berney, Alexandre

    2015-03-01

    This research explored medical students' use and perception of technical language in a practical training setting to enhance skills in breaking bad news in oncology. Terms potentially confusing to laypeople were selected from 108 videotaped interviews conducted in an undergraduate Communication Skills Training. A subset of these terms was included in a questionnaire completed by students (N=111) with the aim of gaining insight into their perceptions of different speech registers and of patient understanding. Excerpts of interviews were analyzed qualitatively to investigate students' communication strategies with respect to these technical terms. Fewer than half of the terms were clarified. Students checked for simulated patients' understanding of the terms palliative and metastasis/to metastasize in 22-23% of the interviews. The term ambulatory was spontaneously explained in 75% of the interviews, hepatic and metastasis/to metastasize in 22-24%. Most provided explanations were in plain language; metastasis/to metastasize and ganglion/ganglionic were among terms most frequently explained in technical language. A significant number of terms potentially unfamiliar and confusing to patients remained unclarified in training interviews conducted by senior medical students, even when they perceived the terms as technical. This exploration may offer important insights for improving future physicians' skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. [Key technologies and implementation of the medical equipment road transportation simulation platform based on 6-DOF parallel robots].

    Science.gov (United States)

    Pei, Yidong; Pei, Baoqing; Li, Hui; Fan, Yubo

    2013-01-01

    In view of the shortage of medical equipment road transportation simulation platform, we put forward a road transportation simulation method based on 6-DOF parallel robots. A 3D road spectrum model was built by the improvement of the harmonic superposition method. The simulation model was then compared with the standard model to verify its performance. Taking the road spectrum as the excitation, we could get the robot motion data to control the parallel robot through the S-shaped linear interpolation of the absolute position. It can simulate the movement of vehicles with different speed under various road conditions efficiently and accurately.

  7. Simulation based Virtual Learning Environment in Medical Genetics Counseling: An example of Bridging the Gap between Theory and Practice in Medical Education

    DEFF Research Database (Denmark)

    Makransky, Guido; Bonde, Mads Tvillinggaard; Wulff, Julie S. G.

    2016-01-01

    Background: Simulation based learning environments are designed to improve the quality of medical education by allowing students to interact with patients, diagnostic laboratory procedures, and patient data in a virtual environment. However, few studies have evaluated whether simulation based...... learning environments increase students’ knowledge, intrinsic motivation, and self-efficacy, and help them generalize from laboratory analyses to clinical practice and health decision-making. Methods: An entire class of 300 University of Copenhagen first-year undergraduate students, most with a major...... in medicine, received a 2-hour training session in a simulation based learning environment. The main outcomes were pre- to post- changes in knowledge, intrinsic motivation, and self-efficacy, together with post-intervention evaluation of the effect of the simulation on student understanding of everyday...

  8. Evaluation of an interactive case simulation system in dermatology and venereology for medical students

    Directory of Open Access Journals (Sweden)

    Hindbeck Hans

    2006-08-01

    Full Text Available Abstract Background Most of the many computer resources used in clinical teaching of dermatology and venereology for medical undergraduates are information-oriented and focus mostly on finding a "correct" multiple-choice alternative or free-text answer. We wanted to create an interactive computer program, which facilitates not only factual recall but also clinical reasoning. Methods Through continuous interaction with students, a new computerised interactive case simulation system, NUDOV, was developed. It is based on authentic cases and contains images of real patients, actors and healthcare providers. The student selects a patient and proposes questions for medical history, examines the skin, and suggests investigations, diagnosis, differential diagnoses and further management. Feedback is given by comparing the user's own suggestions with those of a specialist. In addition, a log file of the student's actions is recorded. The program includes a large number of images, video clips and Internet links. It was evaluated with a student questionnaire and by randomising medical students to conventional teaching (n = 85 or conventional teaching plus NUDOV (n = 31 and comparing the results of the two groups in a final written examination. Results The questionnaire showed that 90% of the NUDOV students stated that the program facilitated their learning to a large/very large extent, and 71% reported that extensive working with authentic computerised cases made it easier to understand and learn about diseases and their management. The layout, user-friendliness and feedback concept were judged as good/very good by 87%, 97%, and 100%, respectively. Log files revealed that the students, in general, worked with each case for 60–90 min. However, the intervention group did not score significantly better than the control group in the written examination. Conclusion We created a computerised case simulation program allowing students to manage patients in a non

  9. Information, entropy and fidelity in visual communication

    Science.gov (United States)

    Huck, Friedrich O.; Fales, Carl L.; Alter-Gartenberg, Rachel; Rahman, Zia-Ur

    1992-01-01

    This paper presents an assessment of visual communication that integrates the critical limiting factors of image gathering and display with the digital processing that is used to code and restore images. The approach focuses on two mathematical criteria, information and fidelity, and on their relationships to the entropy of the encoded data and to the visual quality of the restored image.

  10. A new universal colour image fidelity metric

    NARCIS (Netherlands)

    Toet, A.; Lucassen, M.P.

    2003-01-01

    We extend a recently introduced universal grayscale image quality index to a newly developed perceptually decorrelated colour space. The resulting colour image fidelity metric quantifies the distortion of a processed colour image relative to its original version. We evaluated the new colour image fi

  11. Investigation of a pulse compression technique for medical ultrasound: a simulation study.

    Science.gov (United States)

    Rao, N A

    1994-03-01

    Pulse compression techniques that are capable of producing a large signal-to-noise (SNR) enhancement, have been used successfully in many different fields. For medical applications, frequency-dependent attenuation in soft tissue can limit the usefulness of this method. In the paper, this issue is examined through model-simulation studies. Frequency-modulation (FM) chirp, considered in the study, is just one form of pulse coding technique. Pulse propagation effects in soft tissue are modelled as a linear zero phase filter. A method to perform simulations and estimate the effective time-bandwidth product K is outlined. K describes the SNR enhancement attainable under limitations imposed by the soft-tissue medium. An effective time-bandwidth product is evaluated as a function of soft-tissue linear attenuation coefficient alpha o, scatterer depth z and the bandwidth of the interrogating FM pulse, under realistic conditions. Results indicate that, under certain conditions, K can be significantly lower than its expected value in a non-attenuating medium. It is argued that although limitations exist, pulse compression techniques can still be used to improve resolution or increase penetrational depth. The real advantage over conventional short-pulse imaging comes from the possibility that these improvements can be accomplished without increasing the peak intensity of the interrogating pulse above any threshold levels set by possible bio-effect considerations.

  12. Model-implementation fidelity in cyber physical system design

    CERN Document Server

    Fabre, Christian

    2017-01-01

    This book puts in focus various techniques for checking modeling fidelity of Cyber Physical Systems (CPS), with respect to the physical world they represent. The authors' present modeling and analysis techniques representing different communities, from very different angles, discuss their possible interactions, and discuss the commonalities and differences between their practices. Coverage includes model driven development, resource-driven development, statistical analysis, proofs of simulator implementation, compiler construction, power/temperature modeling of digital devices, high-level performance analysis, and code/device certification. Several industrial contexts are covered, including modeling of computing and communication, proof architectures models and statistical based validation techniques. Addresses CPS design problems such as cross-application interference, parsimonious modeling, and trustful code production Describes solutions, such as simulation for extra-functional properties, extension of cod...

  13. Enhancing Fidelity in Adventure Education and Adventure Therapy

    Science.gov (United States)

    Tucker, Anita R.; Rheingold, Alison

    2010-01-01

    Although the importance of addressing and evaluating treatment and program fidelity is clearly emphasized in the literature on psychology, education, and health, little attention has been given to fidelity in adventure literature or research. Program fidelity refers to whether or not, and how well, a specific intervention or program was…

  14. Long-term educational impact of a simulator curriculum on medical student education in an internal medicine clerkship.

    Science.gov (United States)

    Brim, Nancy M; Venkatan, Suresh K; Gordon, James A; Alexander, Erik K

    2010-04-01

    Medical simulation is frequently used in postgraduate medical training, but its value and sustainability in medical student education are less clear. We report the first long-term experience of mannequin simulation in an internal medicine clerkship. During a 6-year period (2002-2009), 327 Harvard medical students participated in a simulator-based teaching experience designed to expose students to the principles of myocardial infarction (MI). This experience was additive to a 12-week clerkship curriculum. Through blinded survey instruments, we sought to determine how the simulator exercise modified student exposure to a core curricular objective in the traditional clerkship. We also sought student and faculty perception of this educational tool and factors important to sustainability. Three hundred twenty-seven consecutive students were exposed to the simulation exercise and their experiences evaluated. Three hundred twenty-six students (99%) described the simulation experience as valuable, with >69% requesting multiple sessions be provided during each clerkship. Although a core objective, only 78% of students reported having a didactic teaching session on MI during the clerkship, and only 47% of students reported exposure to a live patient with MI. Furthermore, only 15% of students reported exposure to at least two different clinical presentations of MI, allowing comparison and reflection. Thus, the simulation exercise provided the only exposure to this topic for 22% of students and facilitated comparisons of different clinical presentations for 85% of students. When students participated in both the simulator and the didactic sessions, 74% favored the simulation exercise. Faculty cited small group size, once monthly delivery and focused curricula as key points for sustainability of this effort. Mannequin simulation is a valuable and sustainable addition to a third-year internal medicine clerkship. For some students, simulation provides otherwise unavailable

  15. The Fidelity of Ocean Models With Explicit Eddies (Chapter 17)

    Energy Technology Data Exchange (ETDEWEB)

    McClean, J; Jayne, S; Maltrud, M; Ivanova, D

    2007-08-01

    Current practices within the oceanographic community have been reviewed with regard to the use of metrics to assess the realism of the upper-ocean circulation, ventilation processes diagnosed by time-evolving mixed layer depth and mode water formation, and eddy heat fluxes in large-scale fine resolution ocean model simulations. We have striven to understand the fidelity of these simulations in the context of their potential use in future fine-resolution coupled climate system studies. A variety of methodologies are used to assess the veracity of the numerical simulations. Sea surface height variability and the location of western boundary current paths from altimetry have been used routinely as basic indicators of fine-resolution model performance. Drifters and floats have also been used to provide pseudo-Eulerian measures of the mean and variability of surface and sub-surface flows, while statistical comparisons of observed and simulated means have been carried out using James tests. Probability density functions have been used to assess the Gaussian nature of the observed and simulated flows. Length and time scales have been calculated in both Eulerian and Lagrangian frameworks from altimetry and drifters, respectively. Concise measures of multiple model performance have been obtained from Taylor diagrams. The time-evolution of the mixed layer depth at monitoring stations has been compared with simulated time series. Finally, eddy heat fluxes are compared to climatological inferences.

  16. Recreating simulation scenarios for interprofessional education: an example of educational interprofessional practice.

    Science.gov (United States)

    Tullmann, Dorothy F; Shilling, Ashley M; Goeke, Lucy H; Wright, Elisabeth B; Littlewood, Keith E

    2013-09-01

    High-fidelity simulation has proliferated in healthcare education. Once a novelty, simulation is now a mainstay of many curricula and even required by some accrediting bodies. Interprofessional behaviors, manifested through interprofessional education and practice are believed to improve patients' lives. The exciting potential of simulation-interprofessional education (SIM-IPE) is now being explored. This report details a SIM-IPE experience from a university medical simulation center and Schools of Nursing and Medicine. Circumstances required an existing scenario to be "retrofitted" for interprofessional education. Key decision points, challenges and practices are highlighted in the hope that they may be of use to other simulation educators.

  17. Administrator and Fidelity Based Secure Routing (AFSR Protocol in MANET

    Directory of Open Access Journals (Sweden)

    Rohit Singh

    2016-03-01

    Full Text Available The proliferation of mobile computing and communication devices are driving a revolutionary change in our information society. Among all the applications and services run by mobile devices, network connections and corresponding data services are without doubt the most demanded services by mobile users. A MANET is a continuously self-configuring, infrastructure-less network of mobile devices connected without wires, which makes it ideal for the present scenario. But, due to lack of any centralized infrastructure and access to trusted authorities, the security in MANET poses a huge threat. The prominent routing protocols we know are generally designed for environments where the nodes within a network are non-malicious. Due to the vulnerable nature of the mobile ad hoc network, there are numerous security threats that disturb its development. We propose a protocol for MANETs named “Administrator and Fidelity Based Secure Routing Protocol” (AFSR, which ensures secure routing through the network: by electing an Administrator node on the basis of Willingness and Fidelity, after which a node only communicates to that secure Admin node. This selection of secured admin nodes results in mitigation of various threats. We have evaluated our proposed protocol by simulating and comparing in GloMoSim.

  18. American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment.

    Science.gov (United States)

    Glass, Charity C; Acton, Robert D; Blair, Patrice G; Campbell, Andre R; Deutsch, Ellen S; Jones, Daniel B; Liscum, Kathleen R; Sachdeva, Ajit K; Scott, Daniel J; Yang, Stephen C

    2014-02-01

    Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners. A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests. Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors. Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. National Clinical Skills Competition: an effective simulation-based method to improve undergraduate medical education in China.

    Science.gov (United States)

    Jiang, Guanchao; Chen, Hong; Wang, Qiming; Chi, Baorong; He, Qingnan; Xiao, Haipeng; Zhou, Qinghuan; Liu, Jing; Wang, Shan

    2016-01-01

    The National Clinical Skills Competition has been held in China for 5 consecutive years since 2010 to promote undergraduate education reform and improve the teaching quality. The effects of the simulation-based competition will be analyzed in this study. Participation in the competitions and the compilation of the questions used in the competition finals are summarized, and the influence and guidance quality are further analyzed. Through the nationwide distribution of questionnaires in medical colleges, the effects of the simulation-based competition on promoting undergraduate medical education reform were evaluated. The results show that approximately 450 students from more than 110 colleges (accounting for 81% of colleges providing undergraduate clinical medical education in China) participated in the competition each year. The knowledge, skills, and attitudes were comprehensively evaluated by simulation-based assessment. Eight hundred and eighty copies of the questionnaires were distributed to 110 participating medical schools in 2015. In total, 752 valid responses were received across 95 schools. The majority of the interviewees agreed or strongly agreed that competition promoted the adoption of advanced educational principles (76.8%), updated the curriculum model and instructional methods (79.8%), strengthened faculty development (84.0%), improved educational resources (82.1%), and benefited all students (53.4%). The National Clinical Skills Competition is widely accepted in China. It has effectively promoted the reform and development of undergraduate medical education in China.

  20. National Clinical Skills Competition: an effective simulation-based method to improve undergraduate medical education in China

    Directory of Open Access Journals (Sweden)

    Guanchao Jiang

    2016-02-01

    Full Text Available Background: The National Clinical Skills Competition has been held in China for 5 consecutive years since 2010 to promote undergraduate education reform and improve the teaching quality. The effects of the simulation-based competition will be analyzed in this study. Methods: Participation in the competitions and the compilation of the questions used in the competition finals are summarized, and the influence and guidance quality are further analyzed. Through the nationwide distribution of questionnaires in medical colleges, the effects of the simulation-based competition on promoting undergraduate medical education reform were evaluated. Results: The results show that approximately 450 students from more than 110 colleges (accounting for 81% of colleges providing undergraduate clinical medical education in China participated in the competition each year. The knowledge, skills, and attitudes were comprehensively evaluated by simulation-based assessment. Eight hundred and eighty copies of the questionnaires were distributed to 110 participating medical schools in 2015. In total, 752 valid responses were received across 95 schools. The majority of the interviewees agreed or strongly agreed that competition promoted the adoption of advanced educational principles (76.8%, updated the curriculum model and instructional methods (79.8%, strengthened faculty development (84.0%, improved educational resources (82.1%, and benefited all students (53.4%. Conclusions: The National Clinical Skills Competition is widely accepted in China. It has effectively promoted the reform and development of undergraduate medical education in China.

  1. The effect of medical trainees on pediatric emergency department flow: a discrete event simulation modeling study.

    Science.gov (United States)

    Genuis, Emerson D; Doan, Quynh

    2013-11-01

    Providing patient care and medical education are both important missions of teaching hospital emergency departments (EDs). With medical school enrollment rising, and ED crowding becoming an increasing prevalent issue, it is important for both pediatric EDs (PEDs) and general EDs to find a balance between these two potentially competing goals. The objective was to determine how the number of trainees in a PED affects patient wait time, total ED length of stay (LOS), and rates of patients leaving without being seen (LWBS) for PED patients overall and stratified by acuity level as defined by the Pediatric Canadian Triage and Acuity Scale (CTAS) using discrete event simulation (DES) modeling. A DES model of an urban tertiary care PED, which receives approximately 40,000 visits annually, was created and validated. Thirteen different trainee schedules, which ranged from averaging zero to six trainees per shift, were input into the DES model and the outcome measures were determined using the combined output of five model iterations. An increase in LOS of approximately 7 minutes was noted to be associated with each additional trainee per attending emergency physician working in the PED. The relationship between the number of trainees and wait time varied with patients' level of acuity and with the degree of PED utilization. Patient wait time decreased as the number of trainees increased for low-acuity visits and when the PED was not operating at full capacity. With rising numbers of trainees, the PED LWBS rate decreased in the whole department and in the CTAS 4 and 5 patient groups, but it rose in patients triaged CTAS 3 or higher. A rising numbers of trainees was not associated with any change to flow outcomes for CTAS 1 patients. The results of this study demonstrate that trainees in PEDs have an impact mainly on patient LOS and that the effect on wait time differs between patients presenting with varying degrees of acuity. These findings will assist PEDs in finding a

  2. SOWFA Super-Controller: A High-Fidelity Tool for Evaluating Wind Plant Control Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, P.; Gebraad, P.; van Wingerden, J. W.; Lee, S.; Churchfield, M.; Scholbrock, A.; Michalakes, J.; Johnson, K.; Moriarty, P.

    2013-01-01

    This paper presents a new tool for testing wind plant controllers in the Simulator for Offshore Wind Farm Applications (SOWFA). SOWFA is a high-fidelity simulator for the interaction between wind turbine dynamics and the fluid flow in a wind plant. The new super-controller testing environment in SOWFA allows for the implementation of the majority of the wind plant control strategies proposed in the literature.

  3. Modelling and Numerical Simulations of In-Air Reverberation Images for Fault Detection in Medical Ultrasonic Transducers: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    W. Kochański

    2015-01-01

    Full Text Available A simplified two-dimensional finite element model which simulates the in-air reverberation image produced by medical ultrasonic transducers has been developed. The model simulates a linear array consisting of 128 PZT-5A crystals, a tungsten-epoxy backing layer, an Araldite matching layer, and a Perspex lens layer. The thickness of the crystal layer is chosen to simulate pulses centered at 4 MHz. The model is used to investigate whether changes in the electromechanical properties of the individual transducer layers (backing layer, crystal layer, matching layer, and lens layer have an effect on the simulated in-air reverberation image generated. Changes in the electromechanical properties are designed to simulate typical medical transducer faults such as crystal drop-out, lens delamination, and deterioration in piezoelectric efficiency. The simulations demonstrate that fault-related changes in transducer behaviour can be observed in the simulated in-air reverberation image pattern. This exploratory approach may help to provide insight into deterioration in transducer performance and help with early detection of faults.

  4. Development and Validation of a High Anatomical Fidelity FE Model for the Buttock and Thigh of a Seated Individual.

    Science.gov (United States)

    Al-Dirini, Rami M A; Reed, Matthew P; Hu, Jingwen; Thewlis, Dominic

    2016-09-01

    Current practices for designing new cushions for seats depend on superficial measurements, such as pressure mapping, which do not provide sufficient information about the condition of sub-dermal tissues. Finite element (FE) modelling offers a unique alternative to integrate assessment of sub-dermal tissue condition into seat/cushion design and development processes. However, the development and validation of such FE models for seated humans requires accurate representation of the anatomy and material properties, which remain challenges that are yet to be addressed. This paper presents the development and validation of a detailed 3D FE model with high anatomical fidelity of the buttock and thigh, for a specific seated subject. The developed model consisted of 28 muscles, the pelvis, sacrum, femur, and one layer of inter-muscular fat, subcutaneous fat and skin. Validation against in vivo measurements from MRI data confirmed that the FE model can simulate the deformation of soft tissues under sitting loads with an accuracy of (mean ± SD) 4.7 ± 4.4 mm. Simulation results showed that the maximum strains (compressive, shear and von-Mises) on muscles (41, 110, 79%) were higher than fat tissues (21, 62, 41%). The muscles that experienced the highest mechanical loads were the gluteus maximus, adductor magnus and muscles in the posterior aspect of the thighs (biceps femoris, semitendinosus and semimembranosus muscles). The developed FE model contributes to the progression towards bio-fidelity in modelling the human body in seated postures by providing insight into the distribution of stresses/strains in individual muscles and inter-muscular fat in the buttock and thigh of seated individuals. Industrial applications for the developed FE model include improving the design of office and household furniture, automotive and airplane seats and wheelchairs as well as customisation and assessment of sporting and medical equipment to meet individual requirements.

  5. Monte Carlo Simulation Of Emission Tomography And Other Medical Imaging Techniques.

    Science.gov (United States)

    Harrison, Robert L

    2010-01-05

    An introduction to Monte Carlo simulation of emission tomography. This paper reviews the history and principles of Monte Carlo simulation, then applies these principles to emission tomography using the public domain simulation package SimSET (a Simulation System for Emission Tomography) as an example. Finally, the paper discusses how the methods are modified for X-ray computed tomography and radiotherapy simulations.

  6. Fidelity Susceptibility as Holographic PV criticality

    CERN Document Server

    Momeni, Davood; Myrzakulov, Ratbay

    2016-01-01

    Motivated by the fact that the quantum entanglement entropy is dual to an area in AdS, quantities dual to a volume in the AdS have also been recently proposed. These include the holographic complexity and fidelity susceptibility of a quantum system. Even though both of them are dual to an volume in the bulk, there are some interesting difference between them. In this letter, we will explicitly compare them for an $ AdS _4$ solution, and clarify the main differences between them from thermodynamic point of the view. We will also obtain the correct and appropriate holographic dual of the thermodynamic volume of AdS blackhole, and demonstrate that to explain therodynamic in extended phase PV picture, from the AdS/CFT point of view,fidelity susceptibility is the preferred quantity in comparison to holographic complexity.

  7. Dynamics of Loschmidt echoes and fidelity decay

    Energy Technology Data Exchange (ETDEWEB)

    Gorin, Thomas [Max-Planck-Institut fuer Physik komplexer Systeme, Noethnitzer Street 38, D-01187 Dresden (Germany)]. E-mail: gorin@mpipks-dresden.mpg.de; Prosen, Tomaz [Physics Department, Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, SI-1000 Ljubljana (Slovenia)]. E-mail: tomaz.prosen@fmf.uni-lj.si; Seligman, Thomas H. [Centro Internacional de Ciencias, Apartado postal 6-101, C.P.62132 Cuernavaca, Morelos (Mexico) and Instituto de Ciencias Fisicas, University of Mexico - UNAM, C.P.62132 Cuernavaca, Morelos (Mexico)]. E-mail: seligman@fis.unam.mx; Znidaric, Marko [Physics Department, Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, SI-1000 Ljubljana (Slovenia)]. E-mail: marko.znidaric@fmf.uni-lj.si

    2006-11-15

    Fidelity serves as a benchmark for the reliability in quantum information processes, and has recently attracted much interest as a measure of the susceptibility of dynamics to perturbations. A rich variety of regimes for fidelity decay have emerged. The purpose of the present review is to describe these regimes, to give the theory that supports them, and to show some important applications and experiments. While we mention several approaches we use time correlation functions as a backbone for the discussion. Vanicek's uniform approach to semiclassics and random matrix theory provides important alternatives or complementary aspects. Other methods will be mentioned as we go along. Recent experiments in micro-wave cavities and in elastodynamic systems as well as suggestions for experiments in quantum optics shall be discussed.

  8. Dynamics of Loschmidt echoes and fidelity decay

    CERN Document Server

    Gorin, T; Seligman, T H; Znidaric, M; Gorin, Thomas; Prosen, Tomaz; Seligman, Thomas H.; Znidaric, Marko

    2006-01-01

    Fidelity serves as a benchmark for the relieability in quantum information processes, and has recently atracted much interest as a measure of the susceptibility of dynamics to perturbations. A rich variety of regimes for fidelity decay have emerged. The purpose of the present review is to describe these regimes, to give the theory that supports them, and to show some important applications and experiments. While we mention several approaches we use time correlation functions as a backbone for the discussion. Vanicek's uniform approach to semiclassics and random matrix theory provides an important alternative or complementary aspects. Other methods will be mentioned as we go along. Recent experiments in micro-wave cavities and in elastodynamic systems as well as suggestions for experiments in quantum optics shall be discussed.

  9. Subjective Information Measure and Rate Fidelity Theory

    CERN Document Server

    Lu, Chenguang

    2007-01-01

    Using fish-covering model, this paper intuitively explains how to extend Hartley's information formula to the generalized information formula step by step for measuring subjective information: metrical information (such as conveyed by thermometers), sensory information (such as conveyed by color vision), and semantic information (such as conveyed by weather forecasts). The pivotal step is to differentiate condition probability and logical condition probability of a message. The paper illustrates the rationality of the formula, discusses the coherence of the generalized information formula and Popper's knowledge evolution theory. For optimizing data compression, the paper discusses rate-of-limiting-errors and its similarity to complexity-distortion based on Kolmogorov's complexity theory, and improves the rate-distortion theory into the rate-fidelity theory by replacing Shannon's distortion with subjective mutual information. It is proved that both the rate-distortion function and the rate-fidelity function ar...

  10. Quantum fidelity for arbitrary Gaussian states

    CERN Document Server

    Banchi, Leonardo; Pirandola, Stefano

    2015-01-01

    We derive a computable analytical formula for the quantum fidelity between two arbitrary multimode Gaussian states which is simply expressed in terms of their first- and second-order statistical moments. We also show how such a formula can be written in terms of symplectic invariants and used to derive closed forms for a variety of basic quantities and tools, such as the Bures metric, the quantum Fisher information and various fidelity-based bounds. Our result can be used to extend the study of continuous-variable protocols, such as quantum teleportation and cloning, beyond the current one-mode or two-mode analyses, and paves the way to solve general problems in quantum metrology and quantum hypothesis testing with arbitrary multimode Gaussian resources.

  11. Simulation Training at a Medical Institute: An integral Part of the Educational Process

    Directory of Open Access Journals (Sweden)

    P. V. Ligatyuk

    2015-01-01

    Full Text Available Objective: to master and practically execute cardiopulmonary resuscitation (CPR procedural techniques, to acquire skills to use state-of-art equipment, and to teach work in the team. Subjects and methods. Forty-six interns and residents took a simulation course of training in basic CPR and automatic external defibrillation. Three-four days before the course, its participants received the certified translation of the European Resuscitation Council (ERC information material and studied it. The course education program encompasses lectures, lessons on a medical care algorithm in sudden cardiac arrest, and practical works using models, including chest compression, ventilation, and automatic external defibrillator (AED training. The duration of the course is 6—7 hours. Results. All the interns and residents were motivated to learn: to acquire first aid skills to manage sudden cardiac arrest. The ERC algorithm and a 4-stepped model to have practical skills were used. The taken course met expectations in 100% of the participants; all the interns and residents adequately acquired practical CPR skills and successfully completed their training. A questionnaire survey at the end of the course showed the high efficiency of the course. The training enhanced motivation in 29 interns and residents; they obtained an ERC provider degree; 10 interns and residents continue to take a course of training as an ERC instructor. 

  12. Migrability of PVC plasticizers from medical devices into a simulant of infused solutions.

    Science.gov (United States)

    Bernard, L; Cueff, R; Breysse, C; Décaudin, B; Sautou, V

    2015-05-15

    Medical devices (MD) for infusion and artificial nutrition are essentially made of plasticized PVC. The plasticizers in the PVC matrix can leach out into the infused solutions and may enter into contact with the patients. In order to assess the risk of patient exposure to these plasticizers we evaluated the migration performance of DEHP, DEHT, DINCH, and TOTM using a model adapted to the clinical use of the MDs. Each PVC tubing sample was immersed in a simulant consisting of a mixture of ethanol/water (50/50v/v) at 40°C and migration tests were carried out after 24h, 72h, and 10 days.DEHP had the highest migration ability, which increased over time. The amount of TOTM released was more than 20 times less than that of DEHP, which makes it an interesting alternative. DEHT is also promising, with a migration level three times smaller than DEHP. However, the migration ability of DINCH was similar to DEHP, with the released amounts equaling 1/8th of the initial amount in the tubing after 24h of contact. Taking into account the available toxicological data, TOTM and DEHT appear to be of particular interest. However, these data should be supplemented and correlated with clinical and toxicological studies on plasticizers and their metabolites.

  13. Assessment of the production of medical isotopes using the Monte Carlo code FLUKA: Simulations against experimental measurements

    Energy Technology Data Exchange (ETDEWEB)

    Infantino, Angelo, E-mail: angelo.infantino@unibo.it [Department of Industrial Engineering, Montecuccolino Laboratory, University of Bologna, Via dei Colli 16, 40136 Bologna (Italy); Oehlke, Elisabeth [TRIUMF, 4004 Wesbrook Mall, V6T 2A3 Vancouver, BC (Canada); Department of Radiation Science & Technology, Delft University of Technology, Postbus 5, 2600 AA Delft (Netherlands); Mostacci, Domiziano [Department of Industrial Engineering, Montecuccolino Laboratory, University of Bologna, Via dei Colli 16, 40136 Bologna (Italy); Schaffer, Paul; Trinczek, Michael; Hoehr, Cornelia [TRIUMF, 4004 Wesbrook Mall, V6T 2A3 Vancouver, BC (Canada)

    2016-01-01

    The Monte Carlo code FLUKA is used to simulate the production of a number of positron emitting radionuclides, {sup 18}F, {sup 13}N, {sup 94}Tc, {sup 44}Sc, {sup 68}Ga, {sup 86}Y, {sup 89}Zr, {sup 52}Mn, {sup 61}Cu and {sup 55}Co, on a small medical cyclotron with a proton beam energy of 13 MeV. Experimental data collected at the TR13 cyclotron at TRIUMF agree within a factor of 0.6 ± 0.4 with the directly simulated data, except for the production of {sup 55}Co, where the simulation underestimates the experiment by a factor of 3.4 ± 0.4. The experimental data also agree within a factor of 0.8 ± 0.6 with the convolution of simulated proton fluence and cross sections from literature. Overall, this confirms the applicability of FLUKA to simulate radionuclide production at 13 MeV proton beam energy.

  14. A simulated hospital pharmacy module using an electronic medical record in a pharmaceutical care skills laboratory course.

    Science.gov (United States)

    Kirwin, Jennifer L; DiVall, Margarita V; Guerra, Christina; Brown, Todd

    2013-04-12

    OBJECTIVES. To implement and evaluate the effects of a simulated hospital pharmacy module using an electronic medical record on student confidence and abilities to perform hospital pharmacist duties. DESIGN. A module was developed that simulated typical hospital pharmacist tasks. Learning activities were modified based upon student feedback and instructor assessment. ASSESSMENTS. Ninety-seven percent of respondents reported full-time hospital internship experience and 72% had electronic medical record experience prior to completing the module. Mean scores on confidence with performing typical hospital pharmacist tasks significantly increased from the pre-module survey to the post-module survey from 1.5-2.9 (low comfort/confidence) to 2.0-3.4 (moderate comfort/confidence). Course assessments confirmed student achievement of covered competencies. CONCLUSIONS. A simulated hospital pharmacy module improved pharmacy students' hospital practice skills and their perceived comfort and confidence in completing the typical duties of a hospital pharmacist.

  15. A random matrix formulation of fidelity decay

    Energy Technology Data Exchange (ETDEWEB)

    Gorin, T [Theoretische Quantendynamik, Albert-Ludwigs-Universitaet, Hermann-Herder-Str. 3, D-79104 Freiburg (Germany); Prosen, T [Physics Department, Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, SI-1000 Ljubljana (Slovenia); Seligman, T H [Centro Internacional de Ciencias, C.P. 62131 Cuernavaca, Morelos (Mexico)

    2004-02-01

    We propose to study echo dynamics in a random-matrix framework, where we assume that the perturbation is time-independent, random and orthogonally invariant. This allows us to use a basis in which the unperturbed Hamiltonian is diagonal and its properties are thus largely determined by its spectral statistics. We concentrate on the effect of spectral correlations usually associated with chaos and disregard secular variations in spectral density. We obtain analytical results for the fidelity decay in the linear-response regime. To extend the domain of validity, we heuristically exponentiate the linear-response result. The resulting expressions, exact in the perturbative limit, are accurate approximations in the transition region between the 'Fermi golden rule' and the perturbative regimes, as verified by example for a deterministic chaotic system. To sense the effect of spectral stiffness, we apply our model also to the extreme cases of random spectra and equidistant spectra. In our analytical approximations as well as in extensive Monte Carlo calculations, we find that fidelity decay is fastest for random spectra and slowest for equidistant ones, while the classical ensembles lie in between. We conclude that spectral stiffness systematically enhances fidelity.

  16. A random matrix formulation of fidelity decay

    Science.gov (United States)

    Gorin, T.; Prosen, T.; Seligman, T. H.

    2004-02-01

    We propose to study echo dynamics in a random-matrix framework, where we assume that the perturbation is time-independent, random and orthogonally invariant. This allows us to use a basis in which the unperturbed Hamiltonian is diagonal and its properties are thus largely determined by its spectral statistics. We concentrate on the effect of spectral correlations usually associated with chaos and disregard secular variations in spectral density. We obtain analytical results for the fidelity decay in the linear-response regime. To extend the domain of validity, we heuristically exponentiate the linear-response result. The resulting expressions, exact in the perturbative limit, are accurate approximations in the transition region between the 'Fermi golden rule' and the perturbative regimes, as verified by example for a deterministic chaotic system. To sense the effect of spectral stiffness, we apply our model also to the extreme cases of random spectra and equidistant spectra. In our analytical approximations as well as in extensive Monte Carlo calculations, we find that fidelity decay is fastest for random spectra and slowest for equidistant ones, while the classical ensembles lie in between. We conclude that spectral stiffness systematically enhances fidelity.

  17. Fidelity susceptibility and geometric phase in critical phenomenon

    Institute of Scientific and Technical Information of China (English)

    Tian Li-Jun; Zhu Chang-Qing; Zhang Hong-Biao; Qin Li-Guo

    2011-01-01

    Motivated by recent developments in quantum fidelity and fidelity susceptibility, we study relations among Lie algebra, fidelity susceptibility and quantum phase transition for a two-state system and the Lipkin-Meshkov-click model. We obtain the fidelity susceptibilities for SU(2)and SU(1, 1)algebraic structure models. From this relation,the validity of the fidelity susceptibility to signal for the quantum phase transition is also verified in these two systems.At the same time, we obtain the geometric phases in these two systems by calculating the fidelity susceptibility. In addition, the new method of calculating fidelity susceptibility is used to explore the two-dimensional XXZ model and the Bose-Einstein condensate(BEC).

  18. Human factors in resuscitation: Lessons learned from simulator studies

    Directory of Open Access Journals (Sweden)

    Hunziker S

    2010-01-01

    Full Text Available Medical algorithms, technical skills, and repeated training are the classical cornerstones for successful cardiopulmonary resuscitation (CPR. Increasing evidence suggests that human factors, including team interaction, communication, and leadership, also influence the performance of CPR. Guidelines, however, do not yet include these human factors, partly because of the difficulties of their measurement in real-life cardiac arrest. Recently, clinical studies of cardiac arrest scenarios with high-fidelity video-assisted simulations have provided opportunities to better delineate the influence of human factors on resuscitation team performance. This review focuses on evidence from simulator studies that focus on human factors and their influence on the performance of resuscitation teams. Similar to studies in real patients, simulated cardiac arrest scenarios revealed many unnecessary interruptions of CPR as well as significant delays in defibrillation. These studies also showed that human factors play a major role in these shortcomings and that the medical performance depends on the quality of leadership and team-structuring. Moreover, simulated video-taped medical emergencies revealed that a substantial part of information transfer during communication is erroneous. Understanding the impact of human factors on the performance of a complex medical intervention like resuscitation requires detailed, second-by-second, analysis of factors involving the patient, resuscitative equipment such as the defibrillator, and all team members. Thus, high-fidelity simulator studies provide an important research method in this challenging field.

  19. The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

    Science.gov (United States)

    Everett, T C; Morgan, P J; Brydges, R; Kurrek, M; Tregunno, D; Cunningham, L; Chan, A; Forde, D; Tarshis, J

    2017-03-01

    Although the incidence of major adverse events in surgical daycare centres is low, these critical events may not be managed optimally due to the absence of resources that exist in larger hospitals. We aimed to study the impact of operating theatre critical event checklists on medical management and teamwork during whole-team operating theatre crisis simulations staged in a surgical daycare facility. We studied 56 simulation encounters (without and with a checklist available) divided between an initial session and then a retention session several months later. Medical management and teamwork were quantified via percentage adherence to key processes and the Team Emergency Assessment Measure, respectively. In the initial session, medical management was not improved by the presence of a checklist (56% without checklist vs. 62% with checklist; p = 0.50). In the retention session, teams performed significantly worse without the checklists (36% without checklist vs. 60% with checklist; p = 0.04). We did not observe a change in non-technical skills in the presence of a checklist in either the initial or retention sessions (68% without checklist vs. 69% with checklist (p = 0.94) and 69% without checklist vs. 65% with checklist (p = 0.36), respectively). Critical events checklists do not improve medical management or teamwork during simulated operating theatre crises in an ambulatory surgical daycare setting.

  20. [Simulated-patient-based educational programs for improvement of physicians' communication skills with adolescents: 7-years experience at the Israel Center For Medical Simulation].

    Science.gov (United States)

    Hardoff, Daniel; Ziv, Amitai

    2011-04-01

    Appropriate communication between healthcare providers and adolescent patients and their parents is the key for successful medical care that recognizes the unique needs of teenagers, who remain their parents' responsibility but deserve individual attention separately. Guidelines addressing adolescents' healthcare have been developed, and include recommendations for appropriate communication with adolescents. Simulated-patient-based education has become a significant tool for improving communication skills of heaLthcare providers. To describe the experience gained at the Israel Center for Medical Simulation (MSRJ during the past 7 years in communication training for physicians who encounter adolescents in their cLinical practice. Simulated-patient-based communication workshops were conducted dedicated to physicians who provide healthcare to adolescents. Eight to twelve physicians participated in each workshop, where 8 scenarios were exercised from a pooL of 20 typical scenarios of adolescent-physician encounters that have been prepared at MSR. The participants completed a feedback questionnaire at the end of each workshop regarding its quality, its contribution and its value as an educational tool. Five hundred physicians--pediatricians, family practitioners, gynecologists and military recruitment centers physicians--were trained in simulated-patient-based workshops on communication with adolescents between the years 2002 and 2008. Feedback questionnaires of 470 physicians completed at the end of 41 workshops were surveyed. High ranks were given to all the evaluation issues in the questionnaire. Training physicians in communication with adolescents at simulated-patient-based workshops is a powerful educational tool, enabling hands-on Learning and application of communication skills. These workshops are highly appreciated and recommended by the participating physicians as useful mechanisms in various medical education Levels.

  1. Monte Carlo Simulation Of Emission Tomography And Other Medical Imaging Techniques

    Science.gov (United States)

    Harrison, Robert L.

    2010-01-01

    An introduction to Monte Carlo simulation of emission tomography. This paper reviews the history and principles of Monte Carlo simulation, then applies these principles to emission tomography using the public domain simulation package SimSET (a Simulation System for Emission Tomography) as an example. Finally, the paper discusses how the methods are modified for X-ray computed tomography and radiotherapy simulations. PMID:20733931

  2. Numerical Simulation of the Medical Linear Accelerator Electron Beams Absorption by ABS-Plastic doped with Metal

    Science.gov (United States)

    Stuchebrov, S. G.; Miloichikova, I. A.; Krasnykh, A. A.

    2016-07-01

    In this paper the numerical simulation results of the dose spatial distribution of the medical electron beams in ABS-plastic doped with different concentrations of lead and zinc are shown. The dependences of the test material density on the lead and zinc mass concentrations are illustrated. The depth dose distributions of the medical electron beams in the modified ABS-plastic for three energies 6 MeV, 12 MeV and 20 MeV are tested. The electron beam shapes in the transverse plane in ABS-plastic doped with different concentrations of lead and zinc are presented.

  3. The Need for High-Fidelity Robotics Sensor Models

    Directory of Open Access Journals (Sweden)

    Phillip J. Durst

    2011-01-01

    Full Text Available Simulations provide a safe, controlled setting for testing and are therefore ideal for rapidly developing and testing autonomous mobile robot behaviors. However, algorithms for mobile robots are notorious for transitioning poorly from simulations to fielded platforms. The difficulty can in part be attributed to the use of simplistic sensor models that do not recreate important phenomena that affect autonomous navigation. The differences between the output of simple sensor models and true sensors are highlighted using results from a field test exercise with the National Robotics Engineering Center's Crusher vehicle. The Crusher was manually driven through an area consisting of a mix of small vegetation, rocks, and hay bales. LIDAR sensor data was collected along the path traveled and used to construct a model of the area. LIDAR data were simulated using a simple point-intersection model for a second, independent path. Cost maps were generated by the Crusher autonomy system using both the real-world and simulated sensor data. The comparison of these cost maps shows consistencies on most solid, large geometry surfaces such as the ground, but discrepancies around vegetation indicate that higher fidelity models are required to truly capture the complex interactions of the sensors with complex objects.

  4. Teaching global health with simulations and case discussions in a medical student selective

    OpenAIRE

    Bertelsen, Nathan; DallaPiazza, M.; Hopkins, M.A.; Ogedegbe, G.; DallaPiazza, M.; Hopkins, M.A.; Ogedegbe, G.

    2016-01-01

    Background: Among US medical schools, demand for Global Health (GH) programs continues to grow. At the same time, cultural competency training has become a priority for medical students who will care for an increasingly diverse US patient population. We describe a pilot period for a new GH Selectivedesigned to introduce medical students to global medicine and enhance culturally-sensitive communication skills. Methods: As a 4-week clinical clerkship, the GH Selective was offered annually over ...

  5. The application of additive technologies in creation a medical simulator-trainer of the human head operating field

    Science.gov (United States)

    Kashapov, L. N.; Kashapov, N. F.; Kashapov, R. N.; Pashaev, B. Y.

    2016-06-01

    The aim of the work was to determine the possible application of additive manufacturing technology during the manufacturing process as close as possible to reality of medical simulator-trainers. In work were used some additive manufacturing technologies: selective laser sintering (SLS), fused deposition modeling (FDM), binder Jetting. As a result, a prototype of simulator-trainer of the human head operating field, which based on the CT real patient, was manufactured and conducted its tests. It was found that structure, which is obtained with the use of 3D-printers ProJet 160, most appropriate and closest to the real properties of the bone.

  6. Elucidating the turbulence nature of the intracardiac flow: from medical images to multi-cycle Large Eddy Simulations

    CERN Document Server

    Chnafa, Christophe; Nicoud, Franck

    2013-01-01

    This brief article accompanies a fluid dynamics video presenting the results of a large-eddy simulation of the flow in a realistic left heart. The left heart geometry, from the pulmonary veins to the aortic root, is extracted from medical images and the endocardium movements are reconstructed through image registration. Large-eddy simulations are thus performed in a patient-specific heart model, where the patient-specific movements of the geometry are prescribed. The flow obtained is intermittent, showing both in the left atrium and in the left ventricle turbulent spots correlated to flow decelerations.

  7. CATCC/AATCC Simulator

    Data.gov (United States)

    Federal Laboratory Consortium — The 15G30 CATCC/AATCC simulator provides high fidelity training for Navy Air Traffic Control (ATC) trainees in a realistic shipboard air traffic control environment....

  8. Efficient Calibration of Computationally Intensive Groundwater Models through Surrogate Modelling with Lower Levels of Fidelity

    Science.gov (United States)

    Razavi, S.; Anderson, D.; Martin, P.; MacMillan, G.; Tolson, B.; Gabriel, C.; Zhang, B.

    2012-12-01

    Many sophisticated groundwater models tend to be computationally intensive as they rigorously represent detailed scientific knowledge about the groundwater systems. Calibration (model inversion), which is a vital step of groundwater model development, can require hundreds or thousands of model evaluations (runs) for different sets of parameters and as such demand prohibitively large computational time and resources. One common strategy to circumvent this computational burden is surrogate modelling which is concerned with developing and utilizing fast-to-run surrogates of the original computationally intensive models (also called fine models). Surrogates can be either based on statistical and data-driven models such as kriging and neural networks or simplified physically-based models with lower fidelity to the original system (also called coarse models). Fidelity in this context refers to the degree of the realism of a simulation model. This research initially investigates different strategies for developing lower-fidelity surrogates of a fine groundwater model and their combinations. These strategies include coarsening the fine model, relaxing the numerical convergence criteria, and simplifying the model geological conceptualisation. Trade-offs between model efficiency and fidelity (accuracy) are of special interest. A methodological framework is developed for coordinating the original fine model with its lower-fidelity surrogates with the objective of efficiently calibrating the parameters of the original model. This framework is capable of mapping the original model parameters to the corresponding surrogate model parameters and also mapping the surrogate model response for the given parameters to the original model response. This framework is general in that it can be used with different optimization and/or uncertainty analysis techniques available for groundwater model calibration and parameter/predictive uncertainty assessment. A real-world computationally

  9. Fidelity of adiabatic holonomic quantum gates

    Science.gov (United States)

    Malinovsky, Vladimir; Rudin, Sergey

    2016-05-01

    During last few years non-Abelian geometric phases are attracting increasing interest due to possible experimental applications in quantum computation. Here we discuss universal set of holonomic quantum gates using the geometric phase that the qubit wave function acquires after a cyclic evolution. The proposed scheme utilizes ultrafast pulses and provides a possibility to substantially suppress transient population of the ancillary states. Fidelity of the holonomic quantum gates in the presence of dephasing and dissipation is discussed. Example of electron spin qubit system in the InGaN/GaN, GaN/AlN quantum dot is considered in details.

  10. Direct competition assay for transcription fidelity.

    Science.gov (United States)

    Lubkowska, Lucyna; Kireeva, Maria L

    2015-01-01

    Accurate transcription is essential for faithful information flow from DNA to RNA and to the protein. Mechanisms of cognate substrate selection by RNA polymerases are currently elucidated by structural, genetic, and biochemical approaches. Here, we describe a fast and reliable approach to quantitative analyses of transcription fidelity, applicable to analyses of RNA polymerase selectivity against misincorporation, incorporation of dNMPs, and chemically modified rNMP analogues. The method is based on different electrophoretic mobility of RNA oligomers of the same length but differing in sequence.

  11. Chemical fidelity of an RNA polymerase ribozyme

    DEFF Research Database (Denmark)

    Attwater, J.; Tagami, S.; Kimoto, M.

    2013-01-01

    The emergence of catalytically active RNA enzymes (ribozymes) is widely believed to have been an important transition in the origin of life. In the context of a likely heterogeneous chemical environment, substrate specificity and selectivity of these primordial enzymes would have been critical...... for function. Here we have explored the chemical fidelity, i.e. substrate selectivity and specificity for both single and multiple catalytic steps of the Z RNA polymerase ribozyme-a modern day analogue of the primordial RNA replicase. Using a wide range of nucleotide analogues and ionic conditions, we observe...

  12. An experimental study on the effects of a simulation game on students' clinical cognitive skills and motivation.

    Science.gov (United States)

    Dankbaar, Mary E W; Alsma, Jelmer; Jansen, Els E H; van Merrienboer, Jeroen J G; van Saase, Jan L C M; Schuit, Stephanie C E

    2016-08-01

    Simulation games are becoming increasingly popular in education, but more insight in their critical design features is needed. This study investigated the effects of fidelity of open patient cases in adjunct to an instructional e-module on students' cognitive skills and motivation. We set up a three-group randomized post-test-only design: a control group working on an e-module; a cases group, combining the e-module with low-fidelity text-based patient cases, and a game group, combining the e-module with a high-fidelity simulation game with the same cases. Participants completed questionnaires on cognitive load and motivation. After a 4-week study period, blinded assessors rated students' cognitive emergency care skills in two mannequin-based scenarios. In total 61 students participated and were assessed; 16 control group students, 20 cases students and 25 game students. Learning time was 2 h longer for the cases and game groups than for the control group. Acquired cognitive skills did not differ between groups. The game group experienced higher intrinsic and germane cognitive load than the cases group (p = 0.03 and 0.01) and felt more engaged (p game, although engaging, probably distracted students and impeded learning. Medical educators designing motivating and effective skills training for novices should align case complexity and fidelity with students' proficiency level. The relation between case-fidelity, motivation and skills development is an important field for further study.

  13. 'The Move', an innovative simulation-based medical education program using roleplay to teach neurological semiology: Students' and teachers' perceptions.

    Science.gov (United States)

    Roze, E; Flamand-Roze, C; Méneret, A; Ruiz, M; Le Liepvre, H; Duguet, A; Renaud, M-C; Alamowitch, S; Steichen, O

    2016-01-01

    Neurological disorders are frequently being managed by general practitioners. It is therefore critical that future physicians become comfortable with neurological examination and physical diagnosis. Graduating medical students often consider neurological examination as one of the clinical skills they are least comfortable with, and they even tend to be neurophobic. One way to improve the learning of neurological semiology is to design innovative learner-friendly educational methods, including simulation training. The feasibility of mime-based roleplaying was tested by a simulation training program in neurological semiology called 'The Move'. The program was proposed to third-year medical students at Pierre and Marie Curie University in Paris during their neurology rotation. Students were trained to roleplay patients by miming various neurological syndromes (pyramidal, vestibular, cerebellar, parkinsonian) as well as distal axonopathy, chorea and tonic-clonic seizures. Using an anonymous self-administered questionnaire, the students' and teachers' emotional experience and views on the impact of the program were then investigated. A total of 223/365 students (61%) chose to participate in the study. Both students and teachers felt their participation was pleasant. Students stated that The Move increased their motivation to learn neurological semiology (78%), and improved both their understanding of the subject (77%) and their long-term memorization of the teaching content (86%). Although only a minority thought The Move was likely to improve their performance on their final medical examination (32%), a clear majority (77%) thought it would be useful for their future clinical practice. Both students (87%) and teachers (95%) thought The Move should be included in the medical curriculum. Mime-based roleplaying simulation may be a valuable tool for training medical students in neurological semiology, and may also help them to overcome neurophobia. Copyright © 2016

  14. Interns' Day in Surgery: improving intern performance through a simulation-based course for final year medical students.

    Science.gov (United States)

    Sinha, Sankar N; Page, Wendy

    2015-01-01

    The transition from final year medical student into the first year of clinical practice is known to be associated with anxiety and stress that ultimately affects job performance. Studies have shown that much of this stress and anxiety results from a junior doctor's lack of confidence in performing a number of basic tasks. We investigated if implementation of a half-day simulation-based course in the final year medical students results in increased confidence in performing these tasks. Final year medical students of the University of Tasmania's School of Medicine posted at the Royal Hobart Hospital participated in a half-day simulation course, comprised of multiple simulation stations, which required students to perform the basic tasks a competent surgical intern would be expected to complete. Students completed a survey which investigated their confidence with each task before and after the course. Overall, the majority of students thought that the Interns' Day in Surgery course was useful. The most significant improvements perceived were in case presentation (57.5% to 94.6%; P = 0.02) and communication with patients and other professional colleagues (55.5% to 75.5%; P = 0.01). A follow-up survey of doctors who attended this course reinforced its benefits. Simulation-based courses in clinical practice provide good learning opportunities for final year medical students within the curriculum. This study confirms significant gains in all skills categories practised during the course with perceived benefits subsequently identified by interns. This should lead to a less stressful and more successful transition from student to doctor and ultimately, better patient care. © 2014 Royal Australasian College of Surgeons.

  15. Simulation as an ethical imperative and epistemic responsibility for the implementation of medical guidelines in health care.

    Science.gov (United States)

    Garbayo, Luciana; Stahl, James

    2017-03-01

    Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued. In this article we argue that to systematically identify, predict and prevent medical guideline implementation errors is both an epistemic responsibility and an ethical imperative in health care, in order to properly provide beneficence, minimize or avoid harm, show respect for persons, and administer justice. Furthermore, we suggest that implementation knowledge is best achieved technically by providing simulation modeling studies to anticipate the realization of medical guidelines, in multiple contexts, with system and scenario analysis, in its alignment with the emerging field of implementation science and in recognition of learning health systems. It follows from both claims that it is an ethical imperative and an epistemic responsibility to simulate medical guidelines in context to minimize (avoidable) harm in health care, before guideline implementation.

  16. A Quantitative Analysis of the Effect of Simulation on Medication Administration in Nursing Students

    Science.gov (United States)

    Scudmore, Casey

    2013-01-01

    Medication errors are a leading cause of injury and death in health care, and nurses are the last line of defense for patient safety. Nursing educators must develop curriculum to effectively teach nursing students to prevent medication errors and protect the public. The purpose of this quantitative, quasi-experimental study was to determine if…

  17. Evaluation of Safe Medication Administration through the Use of Simulation in an Academic Setting

    Science.gov (United States)

    Dover, Cheryl D.

    2013-01-01

    Nursing educational programs are struggling with how to educate students to safely and efficiently administer medications. There is no doubt education programs need to find a way to assist students to acquire the skill of medication administration and to also transfer the skill into practice. Knowledge, skills, and abilities are requirements for…

  18. High Fidelity Single Qubit Operations using Pulsed EPR

    CERN Document Server

    Morton, J J L; Ardavan, A; Porfyrakis, K; Lyon, S A; Briggs, G A D; Morton, John J. L.; Tyryshkin, Alexei M.; Ardavan, Arzhang; Porfyrakis, Kyriakos

    2005-01-01

    The fidelity of quantum logic operations performed on electron spin qubits using simple RF pulses falls well below the threshold for the application of quantum algorithms. Using three independent techniques, we demonstrate the use of composite pulses to improve this fidelity by several orders of magnitude. The observed high-fidelity operations are limited by pulse phase errors, but nevertheless fall within the limits required for the application of quantum error correction algorithms.

  19. Equation of motion for estimation fidelity of monitored oscillating qubits

    Science.gov (United States)

    Bassa, Humairah; Konrad, Thomas; Diósi, Lajos; Uys, Hermann

    2017-08-01

    We study the convergence properties of state estimates of an oscillating qubit being monitored by a sequence of discrete, unsharp measurements. Our method derives a differential equation determining the evolution of the estimation fidelity from a single incremental step. If the oscillation frequency Ω is precisely known, the estimation fidelity converges exponentially fast to unity. For imprecise knowledge of Ω we derive the asymptotic estimation fidelity.

  20. Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies.

    Science.gov (United States)

    Smith, Heather A; Reade, Maurianne; Marr, Marion; Jeeves, Nicholas

    2017-01-01

    Interprofessional collaboration is a complex process that has the potential to transform patient care for the better in urban, rural and remote healthcare settings. Simulation has been found to improve participants' interprofessional competencies, but the mechanisms by which interprofessionalism is learned have yet to be understood. A rural wilderness medicine conference (WildER Med) in northern Ontario, Canada with simulated medical scenarios has been demonstrated to be effective in improving participants' collaboration without formal interprofessional education (IPE) curriculum. Interprofessionalism may be taught through rural and remote medical simulation, as done in WildER Med where participants' interprofessional competencies improved without any formal IPE curriculum. This learning may be attributed to the informal and hidden curriculum. Understanding the mechanism by which this rural educational experience contributed to participants' learning to collaborate requires insight into the events before, during and after the simulations. The authors drew upon feedback from facilitators and patient actors in one-on-one interviews to develop a grounded theory for how collaboration is taught and learned. Sharing emerged as the core concept of a grounded theory to explain how team members acquired interprofessional collaboration competencies. Sharing was enacted through the strategies of developing common goals, sharing leadership, and developing mutual respect and understanding. Further analysis of the data and literature suggests that the social wilderness environment was foundational in enabling sharing to occur. Medical simulations in other rural and remote settings may offer an environment conducive to collaboration and be effective in teaching collaboration. When designing interprofessional education, health educators should consider using emergency response teams or rural community health teams to optimize the informal and hidden curriculum contributing to