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Sample records for model simulation skill

  1. Comparison of the development of performance skills in ultrasound-guided regional anesthesia simulations with different phantom models.

    Science.gov (United States)

    Liu, Yang; Glass, Nancy L; Glover, Chris D; Power, Robert W; Watcha, Mehernoor F

    2013-12-01

    Ultrasound-guided regional anesthesia (UGRA) skills are traditionally obtained by supervised performance on patients, but practice on phantom models improves success. Currently available models are expensive or use perishable products, for example, olive-in-chicken breasts (OCB). We constructed 2 inexpensive phantom (transparent and opaque) models with readily available nonperishable products and compared the process of learning UGRA skills by novice practitioners on these models with the OCB model. Three experts first established criteria for a satisfactory completion of the simulated UGRA task in the 3 models. Thirty-six novice trainees (simulations was accomplished. The number of errors, needle passes, and time for task completion per attempt progressively decreased in all 3 groups. However, failure to identify the target and to visualize the needle on the ultrasound image occurred more frequently with the OCB model. The time to complete simulator training was shortest with the transparent model, owing to shorter target identification times. However, trainees were less likely to agree strongly that this model was realistic for teaching UGRA skills. Training on inexpensive synthetic simulation models with no perishable products permits learning of UGRA skills by novices. The OCB model has disadvantages of containing potentially infective material, requires refrigeration, cannot be used after multiple needle punctures, and is associated with more failures during simulated UGRA. Direct visualization of the target in the transparent model allows the trainee to focus on needle insertion skills, but the opaque model may be more realistic for learning target identification skills required when UGRA is performed on real patients in the operating room.

  2. MJO simulation in CMIP5 climate models: MJO skill metrics and process-oriented diagnosis

    Science.gov (United States)

    Ahn, Min-Seop; Kim, Daehyun; Sperber, Kenneth R.; Kang, In-Sik; Maloney, Eric; Waliser, Duane; Hendon, Harry

    2017-12-01

    The Madden-Julian Oscillation (MJO) simulation diagnostics developed by MJO Working Group and the process-oriented MJO simulation diagnostics developed by MJO Task Force are applied to 37 Coupled Model Intercomparison Project phase 5 (CMIP5) models in order to assess model skill in representing amplitude, period, and coherent eastward propagation of the MJO, and to establish a link between MJO simulation skill and parameterized physical processes. Process-oriented diagnostics include the Relative Humidity Composite based on Precipitation (RHCP), Normalized Gross Moist Stability (NGMS), and the Greenhouse Enhancement Factor (GEF). Numerous scalar metrics are developed to quantify the results. Most CMIP5 models underestimate MJO amplitude, especially when outgoing longwave radiation (OLR) is used in the evaluation, and exhibit too fast phase speed while lacking coherence between eastward propagation of precipitation/convection and the wind field. The RHCP-metric, indicative of the sensitivity of simulated convection to low-level environmental moisture, and the NGMS-metric, indicative of the efficiency of a convective atmosphere for exporting moist static energy out of the column, show robust correlations with a large number of MJO skill metrics. The GEF-metric, indicative of the strength of the column-integrated longwave radiative heating due to cloud-radiation interaction, is also correlated with the MJO skill metrics, but shows relatively lower correlations compared to the RHCP- and NGMS-metrics. Our results suggest that modifications to processes associated with moisture-convection coupling and the gross moist stability might be the most fruitful for improving simulations of the MJO. Though the GEF-metric exhibits lower correlations with the MJO skill metrics, the longwave radiation feedback is highly relevant for simulating the weak precipitation anomaly regime that may be important for the establishment of shallow convection and the transition to deep convection.

  3. Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design

    Directory of Open Access Journals (Sweden)

    Westli Heidi

    2010-08-01

    Full Text Available Abstract Background Non-technical skills are seen as an important contributor to reducing adverse events and improving medical management in healthcare teams. Previous research on the effectiveness of teams has suggested that shared mental models facilitate coordination and team performance. The purpose of the study was to investigate whether demonstrated teamwork skills and behaviour indicating shared mental models would be associated with observed improved medical management in trauma team simulations. Methods Revised versions of the 'Anesthetists' Non-Technical Skills Behavioural marker system' and 'Anti-Air Teamwork Observation Measure' were field tested in moment-to-moment observation of 27 trauma team simulations in Norwegian hospitals. Independent subject matter experts rated medical management in the teams. An independent group design was used to explore differences in teamwork skills between higher-performing and lower-performing teams. Results Specific teamwork skills and behavioural markers were associated with indicators of good team performance. Higher and lower-performing teams differed in information exchange, supporting behaviour and communication, with higher performing teams showing more effective information exchange and communication, and less supporting behaviours. Behavioural markers of shared mental models predicted effective medical management better than teamwork skills. Conclusions The present study replicates and extends previous research by providing new empirical evidence of the significance of specific teamwork skills and a shared mental model for the effective medical management of trauma teams. In addition, the study underlines the generic nature of teamwork skills by demonstrating their transferability from different clinical simulations like the anaesthesia environment to trauma care, as well as the potential usefulness of behavioural frequency analysis in future research on non-technical skills.

  4. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

  5. Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

    Science.gov (United States)

    Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

    2015-06-01

    Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  6. Desktop Modeling and Simulation: Parsimonious, yet Effective Discrete-Event Simulation Analysis

    Science.gov (United States)

    Bradley, James R.

    2012-01-01

    This paper evaluates how quickly students can be trained to construct useful discrete-event simulation models using Excel The typical supply chain used by many large national retailers is described, and an Excel-based simulation model is constructed of it The set of programming and simulation skills required for development of that model are then determined we conclude that six hours of training are required to teach the skills to MBA students . The simulation presented here contains all fundamental functionallty of a simulation model, and so our result holds for any discrete-event simulation model. We argue therefore that Industry workers with the same technical skill set as students having completed one year in an MBA program can be quickly trained to construct simulation models. This result gives credence to the efficacy of Desktop Modeling and Simulation whereby simulation analyses can be quickly developed, run, and analyzed with widely available software, namely Excel.

  7. Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

    Science.gov (United States)

    Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

    2018-02-05

    To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior

  8. Correlations between technical skills and behavioral skills in simulated neonatal resuscitations.

    Science.gov (United States)

    Sawyer, T; Leonard, D; Sierocka-Castaneda, A; Chan, D; Thompson, M

    2014-10-01

    Neonatal resuscitation requires both technical and behavioral skills. Key behavioral skills in neonatal resuscitation have been identified by the Neonatal Resuscitation Program. Correlations and interactions between technical skills and behavioral skills in neonatal resuscitation were investigated. Behavioral skills were evaluated via blinded video review of 45 simulated neonatal resuscitations using a validated assessment tool. These were statistically correlated with previously obtained technical skill performance data. Technical skills and behavioral skills were strongly correlated (ρ=0.48; P=0.001). The strongest correlations were seen in distribution of workload (ρ=0.60; P=0.01), utilization of information (ρ=0.55; P=0.03) and utilization of resources (ρ=0.61; P=0.01). Teams with superior behavioral skills also demonstrated superior technical skills, and vice versa. Technical and behavioral skills were highly correlated during simulated neonatal resuscitations. Individual behavioral skill correlations are likely dependent on both intrinsic and extrinsic factors.

  9. Simulation skill of APCC set of global climate models for Asian summer monsoon rainfall variability

    Science.gov (United States)

    Singh, U. K.; Singh, G. P.; Singh, Vikas

    2015-04-01

    The performance of 11 Asia-Pacific Economic Cooperation Climate Center (APCC) global climate models (coupled and uncoupled both) in simulating the seasonal summer (June-August) monsoon rainfall variability over Asia (especially over India and East Asia) has been evaluated in detail using hind-cast data (3 months advance) generated from APCC which provides the regional climate information product services based on multi-model ensemble dynamical seasonal prediction systems. The skill of each global climate model over Asia was tested separately in detail for the period of 21 years (1983-2003), and simulated Asian summer monsoon rainfall (ASMR) has been verified using various statistical measures for Indian and East Asian land masses separately. The analysis found a large variation in spatial ASMR simulated with uncoupled model compared to coupled models (like Predictive Ocean Atmosphere Model for Australia, National Centers for Environmental Prediction and Japan Meteorological Agency). The simulated ASMR in coupled model was closer to Climate Prediction Centre Merged Analysis of Precipitation (CMAP) compared to uncoupled models although the amount of ASMR was underestimated in both models. Analysis also found a high spread in simulated ASMR among the ensemble members (suggesting that the model's performance is highly dependent on its initial conditions). The correlation analysis between sea surface temperature (SST) and ASMR shows that that the coupled models are strongly associated with ASMR compared to the uncoupled models (suggesting that air-sea interaction is well cared in coupled models). The analysis of rainfall using various statistical measures suggests that the multi-model ensemble (MME) performed better compared to individual model and also separate study indicate that Indian and East Asian land masses are more useful compared to Asia monsoon rainfall as a whole. The results of various statistical measures like skill of multi-model ensemble, large spread

  10. Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program.

    Science.gov (United States)

    Denadai, Rafael; Saad-Hossne, Rogério; Martinhão Souto, Luís Ricardo

    2013-05-01

    Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

  11. Comparison of the Effectiveness of a Virtual Simulator With a Plastic Arm Model in Teaching Intravenous Catheter Insertion Skills.

    Science.gov (United States)

    Günay İsmailoğlu, Elif; Zaybak, Ayten

    2018-02-01

    The objective of this study was to compare the effectiveness of a virtual intravenous simulator with a plastic arm model in teaching intravenous catheter insertion skills to nursing students. We used a randomized controlled quasi-experimental trial design and recruited 65 students who were assigned to the experimental (n = 33) and control (n = 32) groups using the simple random sampling method. The experimental group received intravenous catheterization skills training on the virtual intravenous simulator, and the control group received the same training on a plastic model of a human arm. Data were collected using the personal information form, intravenous catheterization knowledge assessment form, Intravenous Catheterization Skill Test, Self-Confidence and Satisfaction Scale, and Fear Symptoms Scale. In the study, the mean scores in the control group were 20.44 for psychomotor skills, 15.62 for clinical psychomotor skills, 31.78 for self-confidence, and 21.77 for satisfaction. The mean scores in the experimental group were 45.18 for psychomotor skills, 16.28 for clinical psychomotor skills, 34.18 for self-confidence, and 43.89 for satisfaction. The results indicated that psychomotor skills and satisfaction scores were higher in the experimental group, while the clinical psychomotor skills and self-confidence scores were similar in both groups. More students in the control group reported experiencing symptoms such as cold and sweaty hands, significant restlessness, and tense muscles than those in the experimental group.

  12. A Simulated Learning Environment for Teaching Medicine Dispensing Skills.

    Science.gov (United States)

    McDowell, Jenny; Styles, Kim; Sewell, Keith; Trinder, Peta; Marriott, Jennifer; Maher, Sheryl; Naidu, Som

    2016-02-25

    To develop an authentic simulation of the professional practice dispensary context for students to develop their dispensing skills in a risk-free environment. A development team used an Agile software development method to create MyDispense, a web-based simulation. Modeled on virtual learning environments elements, the software employed widely available standards-based technologies to create a virtual community pharmacy environment. Assessment. First-year pharmacy students who used the software in their tutorials, were, at the end of the second semester, surveyed on their prior dispensing experience and their perceptions of MyDispense as a tool to learn dispensing skills. The dispensary simulation is an effective tool for helping students develop dispensing competency and knowledge in a safe environment.

  13. Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

    Directory of Open Access Journals (Sweden)

    Rafael Denadai

    2013-01-01

    Full Text Available Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

  14. Business Simulation as an Active Learning Activity for Developing Soft Skills

    Science.gov (United States)

    Levant, Yves; Coulmont, Michel; Sandu, Raluca

    2016-01-01

    Business simulations are innovative instruction models for active or cooperative learning. In this paper, we look at the social constructionist roots of these education models in light of the current efforts to enhance employability skills in undergraduate and graduate studies. More specifically, we analyse the role of business simulations in…

  15. 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

  16. Evaluation of skill at simulating heatwave and heat-humidity indices in Global and Regional Climate Models

    Science.gov (United States)

    Goldie, J. K.; Alexander, L. V.; Lewis, S. C.; Sherwood, S. C.

    2017-12-01

    A wide body of literature now establishes the harm of extreme heat on human health, and work is now emerging on the projection of future health impacts. However, heat-health relationships vary across different populations (Gasparrini et al. 2015), so accurate simulation of regional climate is an important component of joint health impact projection. Here, we evaluate the ability of nine Global Climate Models (GCMs) from CMIP5 and the NARCliM Regional Climate Model to reproduce a selection of 15 health-relevant heatwave and heat-humidity indices over the historical period (1990-2005) using the Perkins skill score (Perkins et al. 2007) in five Australian cities. We explore the reasons for poor model skill, comparing these modelled distributions to both weather station observations and gridded reanalysis data. Finally, we show changes in the modelled distributions from the highest-performing models under RCP4.5 and RCP8.5 greenhouse gas scenarios and discuss the implications of simulated heat stress for future climate change adaptation. ReferencesGasparrini, Antonio, Yuming Guo, Masahiro Hashizume, Eric Lavigne, Antonella Zanobetti, Joel Schwartz, Aurelio Tobias, et al. "Mortality Risk Attributable to High and Low Ambient Temperature: A Multicountry Observational Study." The Lancet 386, no. 9991 (July 31, 2015): 369-75. doi:10.1016/S0140-6736(14)62114-0. Perkins, S. E., A. J. Pitman, N. J. Holbrook, and J. McAneney. "Evaluation of the AR4 Climate Models' Simulated Daily Maximum Temperature, Minimum Temperature, and Precipitation over Australia Using Probability Density Functions." Journal of Climate 20, no. 17 (September 1, 2007): 4356-76. doi:10.1175/JCLI4253.1.

  17. Simulation-based medical education in clinical skills laboratory.

    Science.gov (United States)

    Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

    2012-01-01

    Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens' participation and cooperation in medical education.

  18. 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 (ptechnical skills 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.

  19. Airway skills training using a human patient simulator | Moodley ...

    African Journals Online (AJOL)

    ... of airway management skills using the simulator. Participant satisfaction was much better in the simulator group. The importance of psychomotor reinforcement should be borne in mind when designing simulation courses. Keywords: human patient simulator, simulation, airway management, psychomotor skills ...

  20. Combination of inquiry learning model and computer simulation to improve mastery concept and the correlation with critical thinking skills (CTS)

    Science.gov (United States)

    Nugraha, Muhamad Gina; Kaniawati, Ida; Rusdiana, Dadi; Kirana, Kartika Hajar

    2016-02-01

    Among the purposes of physics learning at high school is to master the physics concepts and cultivate scientific attitude (including critical attitude), develop inductive and deductive reasoning skills. According to Ennis et al., inductive and deductive reasoning skills are part of critical thinking. Based on preliminary studies, both of the competence are lack achieved, it is seen from student learning outcomes is low and learning processes that are not conducive to cultivate critical thinking (teacher-centered learning). One of learning model that predicted can increase mastery concepts and train CTS is inquiry learning model aided computer simulations. In this model, students were given the opportunity to be actively involved in the experiment and also get a good explanation with the computer simulations. From research with randomized control group pretest-posttest design, we found that the inquiry learning model aided computer simulations can significantly improve students' mastery concepts than the conventional (teacher-centered) method. With inquiry learning model aided computer simulations, 20% of students have high CTS, 63.3% were medium and 16.7% were low. CTS greatly contribute to the students' mastery concept with a correlation coefficient of 0.697 and quite contribute to the enhancement mastery concept with a correlation coefficient of 0.603.

  1. Role of simulator training in developing teamwork and diagnostic skills

    International Nuclear Information System (INIS)

    Grimme, W.E.

    1987-01-01

    A review of the evolution of the control room team is necessary to understand team training needs. As control room responsibilities have increased and members have been added to the operating crews, teamwork and strong leadership has become crucial to the efficiency of these operating crews. In order to conduct effective team training in a simulated control room, it is essential that the fundamental principles of role definition and common team values are fully developed. The diagnostics model used to develop problem-solving skills must be adaptable to the dynamic environment of the control room. Once the fundamental principles of team building and a good diagnostics model are mastered, many training techniques using a simulator are available to perfect the development of team building and diagnostic skills

  2. An Agent-Based Labor Market Simulation with Endogenous Skill-Demand

    Science.gov (United States)

    Gemkow, S.

    This paper considers an agent-based labor market simulation to examine the influence of skills on wages and unemployment rates. Therefore less and highly skilled workers as well as less and highly productive vacancies are implemented. The skill distribution is exogenous whereas the distribution of the less and highly productive vacancies is endogenous. The different opportunities of the skill groups on the labor market are established by skill requirements. This means that a highly productive vacancy can only be filled by a highly skilled unemployed. Different skill distributions, which can also be interpreted as skill-biased technological change, are simulated by incrementing the skill level of highly skilled persons exogenously. This simulation also provides a microeconomic foundation of the matching function often used in theoretical approaches.

  3. Retention of Mastoidectomy Skills After Virtual Reality Simulation Training

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per

    2016-01-01

    IMPORTANCE: The ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR......) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training. OBJECTIVES: To determine the retention of mastoidectomy skills after VR simulation training...... with distributed and massed practice and to investigate participants' cognitive load during retention procedures. DESIGN, SETTING, AND PARTICIPANTS: A prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical...

  4. Laparoscopic skills acquisition: a study of simulation and traditional training.

    Science.gov (United States)

    Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy J

    2014-12-01

    Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment. A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared. A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used. The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills. © 2013 Royal Australasian College of Surgeons.

  5. Teaching basic lung isolation skills on human anatomy simulator: attainment and retention of lung isolation skills.

    Science.gov (United States)

    Latif, Rana K; VanHorne, Edgar M; Kandadai, Sunitha Kanchi; Bautista, Alexander F; Neamtu, Aurel; Wadhwa, Anupama; Carter, Mary B; Ziegler, Craig H; Memon, Mohammed Faisal; Akça, Ozan

    2016-01-20

    Lung isolation skills, such as correct insertion of double lumen endobronchial tube and bronchial blocker, are essential in anesthesia training; however, how to teach novices these skills is underexplored. Our aims were to determine (1) if novices can be trained to a basic proficiency level of lung isolation skills, (2) whether video-didactic and simulation-based trainings are comparable in teaching lung isolation basic skills, and (3) whether novice learners' lung isolation skills decay over time without practice. First, five board certified anesthesiologist with experience of more than 100 successful lung isolations were tested on Human Airway Anatomy Simulator (HAAS) to establish Expert proficiency skill level. Thirty senior medical students, who were naive to bronchoscopy and lung isolation techniques (Novice) were randomized to video-didactic and simulation-based trainings to learn lung isolation skills. Before and after training, Novices' performances were scored for correct placement using pass/fail scoring and a 5-point Global Rating Scale (GRS); and time of insertion was recorded. Fourteen novices were retested 2 months later to assess skill decay. Experts' and novices' double lumen endobronchial tube and bronchial blocker passing rates showed similar success rates after training (P >0.99). There were no differences between the video-didactic and simulation-based methods. Novices' time of insertion decayed within 2 months without practice. Novices could be trained to basic skill proficiency level of lung isolation. Video-didactic and simulation-based methods we utilized were found equally successful in training novices for lung isolation skills. Acquired skills partially decayed without practice.

  6. Simulation-based Mastery Learning Improves Cardiac Auscultation Skills in Medical Students

    Science.gov (United States)

    McGaghie, William C.; Cohen, Elaine R.; Kaye, Marsha; Wayne, Diane B.

    2010-01-01

    Background Cardiac auscultation is a core clinical skill. However, prior studies show that trainee skills are often deficient and that clinical experience is not a proxy for competence. Objective To describe a mastery model of cardiac auscultation education and evaluate its effectiveness in improving bedside cardiac auscultation skills. Design Untreated control group design with pretest and posttest. Participants Third-year students who received a cardiac auscultation curriculum and fourth year students who did not. Intervention A cardiac auscultation curriculum consisting of a computer tutorial and a cardiac patient simulator. All third-year students were required to meet or exceed a minimum passing score (MPS) set by an expert panel at posttest. Measurements Diagnostic accuracy with simulated heart sounds and actual patients. Results Trained third-year students (n = 77) demonstrated significantly higher cardiac auscultation accuracy compared to untrained fourth year students (n = 31) in assessment of simulated heart sounds (93.8% vs. 73.9%, p auscultation curriculum consisting of deliberate practice with a computer-based tutorial and a cardiac patient simulator resulted in improved assessment of simulated heart sounds and more accurate examination of actual patients. PMID:20339952

  7. Discussion of skill improvement in marine ecosystem dynamic models based on parameter optimization and skill assessment

    Science.gov (United States)

    Shen, Chengcheng; Shi, Honghua; Liu, Yongzhi; Li, Fen; Ding, Dewen

    2016-07-01

    Marine ecosystem dynamic models (MEDMs) are important tools for the simulation and prediction of marine ecosystems. This article summarizes the methods and strategies used for the improvement and assessment of MEDM skill, and it attempts to establish a technical framework to inspire further ideas concerning MEDM skill improvement. The skill of MEDMs can be improved by parameter optimization (PO), which is an important step in model calibration. An efficient approach to solve the problem of PO constrained by MEDMs is the global treatment of both sensitivity analysis and PO. Model validation is an essential step following PO, which validates the efficiency of model calibration by analyzing and estimating the goodness-of-fit of the optimized model. Additionally, by focusing on the degree of impact of various factors on model skill, model uncertainty analysis can supply model users with a quantitative assessment of model confidence. Research on MEDMs is ongoing; however, improvement in model skill still lacks global treatments and its assessment is not integrated. Thus, the predictive performance of MEDMs is not strong and model uncertainties lack quantitative descriptions, limiting their application. Therefore, a large number of case studies concerning model skill should be performed to promote the development of a scientific and normative technical framework for the improvement of MEDM skill.

  8. 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

  9. Virtual Reality Simulator Developed Welding Technology Skills

    Science.gov (United States)

    Yunus, Faizal Amin Nur; Baser, Jamil Abd; Masran, Saiful Hadi; Razali, Nizamuddin; Rahim, Bekri

    2011-01-01

    The purpose of this study was to identify the suitability of VR welding simulator application towards CBT in developing welding skills upon new trainees at the Centre of Instructor and Advanced Skills Training (CIAST) Shah Alam Selangor and National Youth Skills Institute (IKBN) Pagoh Johor. The significance of the study was to create a…

  10. The role of simulation in developing surgical skills.

    Science.gov (United States)

    Akhtar, K S N; Chen, Alvin; Standfield, N J; Gupte, C M

    2014-06-01

    Surgical training has followed the master-apprentice model for centuries but is currently undergoing a paradigm shift. The traditional model is inefficient with no guarantee of case mix, quality, or quantity. There is a growing focus on competency-based medical education in response to restrictions on doctors' working hours and the traditional mantra of "see one, do one, teach one" is being increasingly questioned. The medical profession is subject to more scrutiny than ever before and is facing mounting financial, clinical, and political pressures. Simulation may be a means of addressing these challenges. It provides a way for trainees to practice technical tasks in a protected environment without putting patients at risk and helps to shorten the learning curve. The evidence for simulation-based training in orthopedic surgery using synthetic models, cadavers, and virtual reality simulators is constantly developing, though further work is needed to ensure the transfer of skills to the operating theatre.

  11. Enhancing Higher Order Thinking Skills through Clinical Simulation

    Science.gov (United States)

    Varutharaju, Elengovan; Ratnavadivel, Nagendralingan

    2014-01-01

    Purpose: The study aimed to explore, describe and analyse the design and implementation of clinical simulation as a pedagogical tool in bridging the deficiency of higher order thinking skills among para-medical students, and to make recommendations on incorporating clinical simulation as a pedagogical tool to enhance thinking skills and align the…

  12. Surgical skills simulation in trauma and orthopaedic training.

    Science.gov (United States)

    Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

    2014-12-19

    Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

  13. Retention of Vaginal Breech Delivery Skills Taught in Simulation.

    Science.gov (United States)

    Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

    2018-02-01

    The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  14. Medical simulation-based education improves medicos' clinical skills.

    Science.gov (United States)

    Wang, Zhaoming; Liu, Qiaoyu; Wang, Hai

    2013-03-01

    Clinical skill is an essential part of clinical medicine and plays quite an important role in bridging medicos and physicians. Due to the realities in China, traditional medical education is facing many challenges. There are few opportunities for students to practice their clinical skills and their dexterities are generally at a low level. Medical simulation-based education is a new teaching modality and helps to improve medicos' clinical skills to a large degree. Medical simulation-based education has many significant advantages and will be further developed and applied.

  15. The effects of video games on laparoscopic simulator skills.

    Science.gov (United States)

    Jalink, Maarten B; Goris, Jetse; Heineman, Erik; Pierie, Jean-Pierre E N; ten Cate Hoedemaker, Henk O

    2014-07-01

    Recently, there has been a growth in studies supporting the hypothesis that video games have positive effects on basic laparoscopic skills. This review discusses all studies directly related to these effects. A search in the PubMed and EMBASE databases was performed using synonymous terms for video games and laparoscopy. All available articles concerning video games and their effects on skills on any laparoscopic simulator (box trainer, virtual reality, and animal models) were selected. Video game experience has been related to higher baseline laparoscopic skills in different studies. There is currently, however, no standardized method to assess video game experience, making it difficult to compare these studies. Several controlled experiments have, nevertheless, shown that video games cannot only be used to improve laparoscopic basic skills in surgical novices, but are also used as a temporary warming-up before laparoscopic surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Psycho-Motor and Error Enabled Simulations: Modeling Vulnerable Skills in the Pre Mastery Phase - Medical Practice Initiative Procedural Skill Decay and Maintenance (MPI-PSD)

    Science.gov (United States)

    2016-12-01

    B were set between 10% and 90% of the maximum closed loop force handled by the device (14.5 N/mm), or between 1.45 and 13.05 N/mm. The effective...include administration of vasoactive medications , rapid resuscitation, total parenteral nutrition, and delivery of caustic medications .2 When considering...Award Number: W81XWH-13-1-0080 TITLE: "Psycho-Motor and Error Enabled Simulations: Modeling Vulnerable Skills in the Pre-Mastery Phase - Medical

  17. Using peer-assisted learning and role-playing to teach generic skills to dental students: the health care simulation model.

    Science.gov (United States)

    El Tantawi, Maha M A; Abdelaziz, Hytham; AbdelRaheem, Amira S; Mahrous, Ahmed A

    2014-01-01

    Increasing importance is attached to teaching generic skills to undergraduate students in various disciplines. This article describes an extracurricular, student-led activity for teaching generic skills using the Model United Nations over three months. The activity used the Health Care Simulation Model (HCSM) with peer learning and role-playing to accomplish its objectives. An interview was used to select from undergraduate and postgraduate dental students at Alexandria University, Alexandria, Egypt, to develop a group of staff to act as peer teachers after receiving training (n=77). These peer teachers provided training for 123 undergraduate dental students to serve as delegates who acted as trainees or peer learners. At the end of the training sessions, a conference was held in which the students played the roles of delegates representing officials responsible for health care systems in ten countries. The students reported improvement in generic skills, enjoyed several aspects of the experience, and disliked other aspects of the model to a lesser extent. In multivariate analysis, perceived usefulness of the HCSM was significantly greater for staff than delegates and increased as self-reported improvement in knowledge of health care systems increased. This study suggests that innovative, student-centered educational methods can be effective for teaching generic skills and factual information.

  18. A Simulation Method Measuring Psychomotor Nursing Skills.

    Science.gov (United States)

    McBride, Helena; And Others

    1981-01-01

    The development of a simulation technique to evaluate performance of psychomotor skills in an undergraduate nursing program is described. This method is used as one admission requirement to an alternate route nursing program. With modifications, any health profession could use this technique where psychomotor skills performance is important.…

  19. Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises.

    Science.gov (United States)

    Doumouras, A G; Hamidi, M; Lung, K; Tarola, C L; Tsao, M W; Scott, J W; Smink, D S; Yule, S

    2017-07-01

    Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses. Behaviour was assessed by four trained raters using the Non-Technical Skills for Surgeons (NOTSS) and Anaesthetists' Non-Technical Skills (ANTS) rating scales before and during the crisis phase of each scenario. The primary endpoint was time to crisis resolution; secondary endpoints included NTS scores before and during the crisis. A cross-classified linear mixed-effects model was used for the final analysis. Thirteen different surgical teams were assessed. Higher NTS ratings resulted in significantly faster crisis resolution. For anaesthetists, every 1-point increase in ANTS score was associated with a decrease of 53·50 (95 per cent c.i. 31·13 to 75·87) s in time to crisis resolution (P technical skills scores were lower during the crisis phase of the scenarios than those measured before the crisis for both surgeons and anaesthetists. A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  20. Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.

    Science.gov (United States)

    Paddock, Michael T; Bailitz, John; Horowitz, Russ; Khishfe, Basem; Cosby, Karen; Sergel, Michelle J

    2015-03-01

    Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team. We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups. We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between

  1. Assessing problem-solving skills in construction education with the virtual construction simulator

    Science.gov (United States)

    Castronovo, Fadi

    problem-solving skills, a new version of the VCS(4) was developed, with new building modules and assessment framework. The design and development of the VCS4 leveraged research in educational psychology, multimedia learning, human-computer interaction, and Building Information Modeling. In this dissertation the researcher aimed to evaluate the pedagogical value of the VCS4 in fostering problem-solving skills. To answer the research questions, a crossover repeated measures quasi-experiment was designed to assess the educational gains that the VCS can provide to construction education. A group of 34 students, attending a fourth-year construction course at a university in the United States was chosen to participate in the experiment. The three learning modules of the VCS were used, which challenged the students to plan and manage the construction process of a wooden pavilion, the steel erection of a dormitory, and the concrete placement of the same dormitory. Based on the results the researcher was able to provide evidence supporting the hypothesis that the chosen sample of construction students were able to gain and retain problem-solving skills necessary to solve complex construction simulation problems, no matter what the sequence with which these modules were played. In conclusion, the presented results provide evidence supporting the theory that educational simulation games can help the learning and retention of transferable problem-solving skills, which are necessary to solve complex construction problems.

  2. Transferability of laparoscopic skills using the virtual reality simulator.

    Science.gov (United States)

    Yang, Cui; Kalinitschenko, Uljana; Helmert, Jens R; Weitz, Juergen; Reissfelder, Christoph; Mees, Soeren Torge

    2018-03-30

    Skill transfer represents an important issue in surgical education, and is not well understood. The aim of this randomized study is to assess the transferability of surgical skills between two laparoscopic abdominal procedures using the virtual reality simulator in surgical novices. From September 2016 to July 2017, 44 surgical novices were randomized into two groups and underwent a proficiency-based basic training consisting of five selected simulated laparoscopic tasks. In group 1, participants performed an appendectomy training on the virtual reality simulator until they reached a defined proficiency. They moved on to the tutorial procedural tasks of laparoscopic cholecystectomy. Participants in group 2 started with the tutorial procedural tasks of laparoscopic cholecystectomy directly. Finishing the training, participants of both groups were required to perform a complete cholecystectomy on the simulator. Time, safety and economy parameters were analysed. Significant differences in the demographic characteristics and previous computer games experience between the two groups were not noted. Both groups took similar time to complete the proficiency-based basic training. Participants in group 1 needed significantly less movements (388.6 ± 98.6 vs. 446.4 ± 81.6; P virtual reality simulator; however, the transfer of cognitive skills is limited. Separate training curricula seem to be necessary for each procedure for trainees to practise task-specific cognitive skills effectively. Mentoring could help trainees to get a deeper understanding of the procedures, thereby increasing the chance for the transfer of acquired skills.

  3. Airway skills training using a human patient simulator

    African Journals Online (AJOL)

    Thesegan Moodley

    2016-04-11

    Apr 11, 2016 ... Airway management problems may be particularly challenging to junior doctors.1 ... They respond to real-time, real-life clinical ... Keywords: human patient simulator, simulation, airway management, psychomotor skills.

  4. Are revised models better models? A skill score assessment of regional interannual variability

    Science.gov (United States)

    Sperber, Kenneth R.; Participating AMIP Modelling Groups

    1999-05-01

    Various skill scores are used to assess the performance of revised models relative to their original configurations. The interannual variability of all-India, Sahel and Nordeste rainfall and summer monsoon windshear is examined in integrations performed under the experimental design of the Atmospheric Model Intercomparison Project. For the indices considered, the revised models exhibit greater fidelity at simulating the observed interannual variability. Interannual variability of all-India rainfall is better simulated by models that have a more realistic rainfall climatology in the vicinity of India, indicating the beneficial effect of reducing systematic model error.

  5. Simulation-based interpersonal communication skills training for neurosurgical residents.

    Science.gov (United States)

    Harnof, Sagi; Hadani, Moshe; Ziv, Amitai; Berkenstadt, Haim

    2013-09-01

    Communication skills are an important component of the neurosurgery residency training program. We developed a simulation-based training module for neurosurgery residents in which medical, communication and ethical dilemmas are presented by role-playing actors. To assess the first national simulation-based communication skills training for neurosurgical residents. Eight scenarios covering different aspects of neurosurgery were developed by our team: (1) obtaining informed consent for an elective surgery, (2) discharge of a patient following elective surgery, (3) dealing with an unsatisfied patient, (4) delivering news of intraoperative complications, (5) delivering news of a brain tumor to parents of a 5 year old boy, (6) delivering news of brain death to a family member, (7) obtaining informed consent for urgent surgery from the grandfather of a 7 year old boy with an epidural hematoma, and (8) dealing with a case of child abuse. Fifteen neurosurgery residents from all major medical centers in Israel participated in the training. The session was recorded on video and was followed by videotaped debriefing by a senior neurosurgeon and communication expert and by feedback questionnaires. All trainees participated in two scenarios and observed another two. Participants largely agreed that the actors simulating patients represented real patients and family members and that the videotaped debriefing contributed to the teaching of professional skills. Simulation-based communication skill training is effective, and together with thorough debriefing is an excellent learning and practical method for imparting communication skills to neurosurgery residents. Such simulation-based training will ultimately be part of the national residency program.

  6. Simulated parents: developing paediatric trainees' skills in giving bad news.

    Science.gov (United States)

    Gough, Jenny K; Frydenberg, Alexis R; Donath, Susan K; Marks, Michael M

    2009-03-01

    In curriculum documents for medicine in undergraduate, post-graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence-based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme. Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters - another actor and a paediatrician. Brief written reports and conducted semi-structured interviews provided more insights into the trainees' experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme. Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those 'parent-centred' communication skills that trainees may neglect in difficult conversations: 'ask about support', 'encourage the parent to ask questions' and 'repeat key messages'. The evaluation highlighted the value of an early-career experiential programme to highlight the importance of communication skills in post-graduate paediatrics practice.

  7. Retention of Mastoidectomy Skills After Virtual Reality Simulation Training.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-07-01

    The ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training. To determine the retention of mastoidectomy skills after VR simulation training with distributed and massed practice and to investigate participants' cognitive load during retention procedures. A prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical students: 19 from a cohort trained with distributed practice and 17 from a cohort trained with massed practice. Participants performed 2 virtual mastoidectomies in a VR simulator a mean of 3.2 months (range, 2.4-5.0 months) after completing initial training with 12 repeated procedures. Practice blocks were spaced apart in time (distributed), or all procedures were performed in 1 day (massed). Performance of the virtual mastoidectomy as assessed by 2 masked senior otologists using a modified Welling scale, as well as cognitive load as estimated by reaction time to perform a secondary task. Among 36 participants, mastoidectomy final-product skills were largely retained at 3 months (mean change in score, 0.1 points; P = .89) regardless of practice schedule, but the group trained with massed practice took more time to complete the task. The performance of the massed practice group increased significantly from the first to the second retention procedure (mean change, 1.8 points; P = .001), reflecting that skills were less consolidated. For both groups, increases in reaction times in the secondary task (distributed practice group: mean

  8. The Effect of Simulation-Based Learning on Prospective Teachers' Inference Skills in Teaching Probability

    Science.gov (United States)

    Koparan, Timur; Yilmaz, Gül Kaleli

    2015-01-01

    The effect of simulation-based probability teaching on the prospective teachers' inference skills has been examined with this research. In line with this purpose, it has been aimed to examine the design, implementation and efficiency of a learning environment for experimental probability. Activities were built on modeling, simulation and the…

  9. Interprofessional teamwork skills as predictors of clinical outcomes in a simulated healthcare setting.

    Science.gov (United States)

    Shrader, Sarah; Kern, Donna; Zoller, James; Blue, Amy

    2013-01-01

    Teaching interprofessional (IP) teamwork skills is a goal of interprofessional education. The purpose of this study was to examine the relationship between IP teamwork skills, attitudes and clinical outcomes in a simulated clinical setting. One hundred-twenty health professions students (medicine, pharmacy, physician assistant) worked in interprofessional teams to manage a "patient" in a health care simulation setting. Students completed the Interdisciplinary Education Perception Scale (IEPS) attitudinal survey instrument. Students' responses were averaged by team to create an IEPS attitudes score. Teamwork skills for each team were rated by trained observers using a checklist to calculate a teamwork score (TWS). Clinical outcome scores (COS) were determined by summation of completed clinical tasks performed by the team based on an expert developed checklist. Regression analyses were conducted to determine the relationship of IEPS and TWS with COS. IEPS score was not a significant predictor of COS (p=0.054), but TWS was a significant predictor (pstudents' interprofessional teamwork skills are significant predictors of positive clinical outcomes. Interprofessional curricular models that produce effective teamwork skills can improve student performance in clinical environments and likely improve teamwork practice to positively affect patient care outcomes.

  10. The effectiveness of CCDSR learning model to improve skills of creating lesson plan and worksheet science process skill (SPS) for pre-service physics teacher

    Science.gov (United States)

    Limatahu, I.; Suyatno; Wasis; Prahani, B. K.

    2018-03-01

    In the previous research, CCDSR (Condition, Construction, Development, Simulation, and Reflection) learning model has been developed to improve science process skills for pre-service physics teacher. This research is aimed to analyze the effectiveness of CCDSR learning model towards the improvement skills of creating lesson plan and worksheet of Science Process Skill (SPS) for pre-service physics teacher in academic year 2016/2017. This research used one group pre-test and post-test design on 12 pre-service physics teacher at Physics Education, University of Khairun. Data collection was conducted through test and observation. Creating lesson plan and worksheet SPS skills of pre-service physics teacher measurement were conducted through Science Process Skill Evaluation Sheet (SPSES). The data analysis technique was done by Wilcoxon t-test and n-gain. The CCDSR learning model consists of 5 phases, including (1) Condition, (2) Construction, (3) Development, (4) Simulation, and (5) Reflection. The results showed that there was a significant increase in creating lesson plan and worksheet SPS skills of pre-service physics teacher at α = 5% and n-gain average of moderate category. Thus, the CCDSR learning model is effective for improving skills of creating lesson plan and worksheet SPS for pre-service physics teacher.

  11. Effect of high-fidelity shoulder dystocia simulation on emergency obstetric skills and crew resource management skills among residents.

    Science.gov (United States)

    Mannella, Paolo; Palla, Giulia; Cuttano, Armando; Boldrini, Antonio; Simoncini, Tommaso

    2016-12-01

    To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario. After 8weeks, the residents were again exposed to the shoulder dystocia scenario and reassessed. Participants were scored on their demonstration of technical and nontechnical skills. In the first set of scenarios, the mean score was higher in the simulation group than the control group in terms of both technical skills (P=0.008) and nontechnical skills (Pdystocia. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Comparison of projection skills of deterministic ensemble methods using pseudo-simulation data generated from multivariate Gaussian distribution

    Science.gov (United States)

    Oh, Seok-Geun; Suh, Myoung-Seok

    2017-07-01

    The projection skills of five ensemble methods were analyzed according to simulation skills, training period, and ensemble members, using 198 sets of pseudo-simulation data (PSD) produced by random number generation assuming the simulated temperature of regional climate models. The PSD sets were classified into 18 categories according to the relative magnitude of bias, variance ratio, and correlation coefficient, where each category had 11 sets (including 1 truth set) with 50 samples. The ensemble methods used were as follows: equal weighted averaging without bias correction (EWA_NBC), EWA with bias correction (EWA_WBC), weighted ensemble averaging based on root mean square errors and correlation (WEA_RAC), WEA based on the Taylor score (WEA_Tay), and multivariate linear regression (Mul_Reg). The projection skills of the ensemble methods improved generally as compared with the best member for each category. However, their projection skills are significantly affected by the simulation skills of the ensemble member. The weighted ensemble methods showed better projection skills than non-weighted methods, in particular, for the PSD categories having systematic biases and various correlation coefficients. The EWA_NBC showed considerably lower projection skills than the other methods, in particular, for the PSD categories with systematic biases. Although Mul_Reg showed relatively good skills, it showed strong sensitivity to the PSD categories, training periods, and number of members. On the other hand, the WEA_Tay and WEA_RAC showed relatively superior skills in both the accuracy and reliability for all the sensitivity experiments. This indicates that WEA_Tay and WEA_RAC are applicable even for simulation data with systematic biases, a short training period, and a small number of ensemble members.

  13. Supporting Third Year Medical Students' Skill Acquisition and Self-Efficacy with Coping Models and Process Feedback during Laparoscopic Knot Tying Simulation.

    Science.gov (United States)

    Dempsey, Michael S; Kauffman, Douglas F

    2017-01-01

    Background: During the third year general surgery clerkship, medical students are required to develop laparoscopic knot-tying skills. Knot-tying skills studies often rely on objective variables (e.g., time, materials used, number of iterations) that lend themselves to correlational analysis of pre- and post-intervention skill level. This study differs by examining how instructional interventions-role modeling and feedback-affect medical students' skill acquisition and self-efficacy during a laparoscopic surgical simulation training session. Methods: Seventy-eight surgical clerkship students were assigned randomly to one cell of a 2X2 factorial design. Participants observed one of two types of role modeling (expert vs. coping) and received either process-oriented or outcome-oriented feedback during a 30-min laparoscopic training session. Participants also completed several surveys that assessed their interest in surgery and their self-efficacy for laparoscopic knot tying. Results: Coping model groups tended to perform better on the knot tying task, though this was less the case in the presence of outcome feedback. Expert model groups slightly outperformed the coping model group on the peg transfer task, but in the presence of outcome feedback they reported the lowest satisfaction with their performance and the lowest self-efficacy for the knot tying task. The coping model combined with process feedback had a positive influence on students' efficiency in learning the task, on their satisfaction with their performance, and on their self-efficacy for laparoscopic knot typing. Conclusions: Results are discussed relative to self-regulated learning theory.

  14. Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.

    Science.gov (United States)

    Brydges, Ryan; Hatala, Rose; Mylopoulos, Maria

    2016-07-01

    Simulation-based training is currently embedded in most health professions education curricula. Without evidence for how trainees think about their simulation-based learning, some training techniques may not support trainees' learning strategies. This study explored how residents think about and self-regulate learning during a lumbar puncture (LP) training session using a simulator. In 2010, 20 of 45 postgraduate year 1 internal medicine residents attended a mandatory procedural skills training boot camp. Independently, residents practiced the entire LP skill on a part-task trainer using a clinical LP tray and proper sterile technique. We interviewed participants regarding how they thought about and monitored their learning processes, and then we conducted a thematic analysis of the interview data. The analysis suggested that participants considered what they could and could not learn from the simulator; they developed their self-confidence by familiarizing themselves with the LP equipment and repeating the LP algorithmic steps. Participants articulated an idiosyncratic model of learning they used to interpret the challenges and successes they experienced. Participants reported focusing on obtaining cerebrospinal fluid and memorizing the "routine" version of the LP procedure. They did not report much thinking about their learning strategies (eg, self-questioning). During simulation-based training, residents described assigning greater weight to achieving procedural outcomes and tended to think that the simulated task provided them with routine, generalizable skills. Over this typical 1-hour session, trainees did not appear to consider their strategic mindfulness (ie, awareness and use of learning strategies).

  15. Development of Technical Skills: Education, Simulation, and Maintenance of Certification.

    Science.gov (United States)

    Sullivan, Sarah A; Anderson, Barbara M H; Pugh, Carla M

    2015-11-01

    The goal of this article is to provide a focused overview of technical skills education inside the operating room (OR), opportunities for learning outside of the OR (with a focus on simulation), and methods for measuring technical skills. In addition, the authors review the role of maintenance of certification in continuing education and quality improvement and consider the role that simulation plays in this process. The perspectives on teaching in the OR of both residents and faculty going into the case affect the learning environment, and preoperative interactions between attendings and residents to establish learning needs and goals are important. Furthermore, in regards to attending surgeons improving their skills, interaction with more experienced peers and feedback during and after a procedure can be beneficial. Simulation is increasingly being utilized as an education tool outside of the OR. Training in plastic surgery is poised to exploit simulation in multiple technical areas. There is potential to utilize these simulation environments to collect real-time data, such as motion, visual focus, and pressure. How to incorporate technical skill evaluation results in ways that are most beneficial for learning should be the focus of future research and curriculum development. Finally, simulation could be better utilized as a mechanism for both self and peer evaluation and assessment for continuing education and quality improvement. Professional development for faculty and surgery trainees on how to engage with simulation for teaching and learning and how to translate these experiences into improving patient care will be required.

  16. Assessment of summer rainfall forecast skill in the Intra-Americas in GFDL high and low-resolution models

    Science.gov (United States)

    Krishnamurthy, Lakshmi; Muñoz, Ángel G.; Vecchi, Gabriel A.; Msadek, Rym; Wittenberg, Andrew T.; Stern, Bill; Gudgel, Rich; Zeng, Fanrong

    2018-05-01

    The Caribbean low-level jet (CLLJ) is an important component of the atmospheric circulation over the Intra-Americas Sea (IAS) which impacts the weather and climate both locally and remotely. It influences the rainfall variability in the Caribbean, Central America, northern South America, the tropical Pacific and the continental Unites States through the transport of moisture. We make use of high-resolution coupled and uncoupled models from the Geophysical Fluid Dynamics Laboratory (GFDL) to investigate the simulation of the CLLJ and its teleconnections and further compare with low-resolution models. The high-resolution coupled model FLOR shows improvements in the simulation of the CLLJ and its teleconnections with rainfall and SST over the IAS compared to the low-resolution coupled model CM2.1. The CLLJ is better represented in uncoupled models (AM2.1 and AM2.5) forced with observed sea-surface temperatures (SSTs), emphasizing the role of SSTs in the simulation of the CLLJ. Further, we determine the forecast skill for observed rainfall using both high- and low-resolution predictions of rainfall and SSTs for the July-August-September season. We determine the role of statistical correction of model biases, coupling and horizontal resolution on the forecast skill. Statistical correction dramatically improves area-averaged forecast skill. But the analysis of spatial distribution in skill indicates that the improvement in skill after statistical correction is region dependent. Forecast skill is sensitive to coupling in parts of the Caribbean, Central and northern South America, and it is mostly insensitive over North America. Comparison of forecast skill between high and low-resolution coupled models does not show any dramatic difference. However, uncoupled models show improvement in the area-averaged skill in the high-resolution atmospheric model compared to lower resolution model. Understanding and improving the forecast skill over the IAS has important implications

  17. Urology technical and non-technical skills development: the emerging role of simulation.

    Science.gov (United States)

    Rashid, Prem; Gianduzzo, Troy R J

    2016-04-01

    To review the emerging role of technical and non-technical simulation in urological education and training. A review was conducted to examine the current role of simulation in urology training. A PUBMED search of the terms 'urology training', 'urology simulation' and 'urology education' revealed 11,504 titles. Three hundred and fifty-seven abstracts were identified as English language, peer reviewed papers pertaining to the role of simulation in urology and related topics. Key papers were used to explore themes. Some cross-referenced papers were also included. There is an ongoing need to ensure that training time is efficiently utilised while ensuring that optimal technical and non-technical skills are achieved. Changing working conditions and the need to minimise patient harm by inadvertent errors must be taken into account. Simulation models for specific technical aspects have been the mainstay of graduated step-wise low and high fidelity training. Whole scenario environments as well as non-technical aspects can be slowly incorporated into the curriculum. Doing so should also help define what have been challenging competencies to teach and evaluate. Dedicated time, resources and trainer up-skilling are important. Concurrent studies are needed to help evaluate the effectiveness of introducing step-wise simulation for technical and non-technical competencies. Simulation based learning remains the best avenue of progressing surgical education. Technical and non-technical simulation could be used in the selection process. There are good economic, logistic and safety reasons to pursue the process of ongoing development of simulation co-curricula. While the role of simulation is assured, its progress will depend on a structured program that takes advantage of what can be delivered via this medium. Overall, simulation can be developed further for urological training programs to encompass technical and non-technical skill development at all stages, including

  18. The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change.

    Science.gov (United States)

    Cohen, Daniel; Vlaev, Ivo; McMahon, Laurie; Harvey, Sarah; Mitchell, Andy; Borovoi, Leah; Darzi, Ara

    2017-05-11

    The Health and Social Care Act 2012 represents the most complex National Health Service reforms in history. High-quality clinical leadership is important for successful implementation of health service reform. However, little is known about the effectiveness of current leadership training. This study describes the use of a behavioral simulation to improve the knowledge and leadership of a cohort of medical doctors expected to take leadership roles in the National Health Service. A day-long behavioral simulation (The Crucible) was developed and run based on a fictitious but realistic health economy. Participants completed pre- and postsimulation questionnaires generating qualitative and quantitative data. Leadership skills, knowledge, and behavior change processes described by the "theory of planned behavior" were self-assessed pre- and postsimulation. Sixty-nine medical doctors attended. Participants deemed the simulation immersive and relevant. Significant improvements were shown in perceived knowledge, capability, attitudes, subjective norms, intentions, and leadership competency following the program. Nearly one third of participants reported that they had implemented knowledge and skills from the simulation into practice within 4 weeks. This study systematically demonstrates the effectiveness of behavioral simulation for clinical management training and understanding of health policy reform. Potential future uses and strategies for analysis are discussed. High-quality care requires understanding of health systems and strong leadership. Policymakers should consider the use of behavioral simulation to improve understanding of health service reform and development of leadership skills in clinicians, who readily adopt skills from simulation into everyday practice.

  19. Using Simulation to Develop Entrepreneurial Skills and Mind-Set: An Exploratory Case Study

    Science.gov (United States)

    Costin, Yvonne; O'Brien, Michael P.; Slattery, Darina M.

    2018-01-01

    Entrepreneurs need to develop a range of skills to be successful, including skills in decision making, risk management, problem solving, communication, and teamwork. Games and simulations are increasingly being used in both academia and business to encourage such skills development. This paper describes a business simulation module whereby…

  20. Teaching surgical skills in obstetrics using a cesarean section simulator – bringing simulation to life

    Directory of Open Access Journals (Sweden)

    Venkata Sujatha Vellanki

    2010-12-01

    Full Text Available Venkata Sujatha Vellanki1, Sarath Babu Gillellamudi21Department of Obstetrics and Gynaecology 2Department of General Surgery Kamineni Institute of Medical Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, IndiaPurpose: Cesarean section is the most common surgery performed in obstetrics. Incorporating a simulation model into training provides a safe, low-stress environment in which students can gain skills and receive feedback. The purpose of this study was to determine the effectiveness of obstetrics simulator training for medical students doing their internship.Methods: Twenty-five students posted in the Department of Obstetrics and Gynecology received a formal lecture on cesarean section and demonstration of the procedure on a mannequin in the first week of their internship, The study group (n = 12 practiced their skills on an obstetrics simulator under the direct supervision of a faculty member. The control group received no simulator-based training (n = 13 or further instruction. All students were asked to complete a prevalidated questionnaire to assess their level of confidence in performing the procedure after the educational session.Results: Compared with their peers in the study, students in the simulator group were significantly more likely to define the steps of cesarean section (91% vs 61.5%, and were comfortable in assisting cesarean section (100% vs 46.15% as they were able to identify the layers of abdomen opened during cesarean section. All 12 students reported this as an excellent experience.Conclusion: We were able to construct an inexpensive cesarean section trainer that facilitates instruction in cesarean section technique in a low-stress environment.Keywords: simulation, obstetrics, medical students

  1. PENGEMBANGAN MODEL PEMBELAJARAN SOFT SKILLS DAN HARD SKILLS UNTUK SISWA SMK

    OpenAIRE

    Widarto Noto Widodo, Pardjono

    2013-01-01

    Abstrak: Pengembangan Model Pembelajaran Soft Skills dan Hard Skills untuk Siswa SMK. Era global menuntut sumber daya manusia yang memiliki daya saing, adaptif dan antisipatif, mampu belajar, terampil, mudah beradaptasi dengan teknologi baru. Profil tenaga kerja yang dibutuhkan pasar adalah yang kuat pada aspek soft skills dan hard skills. Ada tiga alternatif model pendidikan yang memadukan hard skills dan soft skills, yaitu (1) aspek soft skills dan hard skills dilaksanakan di sekolah; (2) a...

  2. Psychomotor skills training in pediatric airway endoscopy simulation.

    Science.gov (United States)

    Jabbour, Noel; Reihsen, Troy; Sweet, Robert M; Sidman, James D

    2011-07-01

    To develop a robust psychomotor skills curriculum to teach pediatric airway foreign body retrieval and to assess the effect of this curriculum on residents' confidence in and ability to perform the complete task in an infant airway mannequin. Instructional course. Objective Structured Assessment of Technical Skills (OSATS). Surgical simulation laboratory. A half-day simulation-based course was developed to train otolaryngology residents in bronchoscopic foreign body retrieval. This complex psychomotor skill was deconstructed into subtasks. The following curricular learning objectives were presented and assessed: understanding of tracheobronchial anatomy, ability to adequately visualize the larynx with laryngoscopy, proficiency in rigid bronchoscopy, and familiarity with foreign body instrumentation. Residents were objectively evaluated on their ability to perform the complete task on a simulator before and after the course using an OSATS grading system. Confidence in successfully assembling the instruments and completing the task was assessed at these time periods. Seventeen otolaryngology residents completed the study. Confidence in assembling the instruments and in performing the complete task increased on average by 81% and 43%, respectively (P < .001). Using a 15-point OSATS grading system, the average score for the precourse was 7 and for the postcourse was 11.3 (P < .001). Simulation-based subtask training shows promise as an effective and reproducible method to teach the complex psychomotor task of airway foreign body retrieval. Completion of the curriculum led to a significant improvement in residents' confidence in and ability to perform bronchoscopic foreign body retrieval in an infant airway mannequin.

  3. Critical thinking skills in nursing students: comparison of simulation-based performance with metrics

    Science.gov (United States)

    Fero, Laura J.; O’Donnell, John M.; Zullo, Thomas G.; Dabbs, Annette DeVito; Kitutu, Julius; Samosky, Joseph T.; Hoffman, Leslie A.

    2018-01-01

    Aim This paper is a report of an examination of the relationship between metrics of critical thinking skills and performance in simulated clinical scenarios. Background Paper and pencil assessments are commonly used to assess critical thinking but may not reflect simulated performance. Methods In 2007, a convenience sample of 36 nursing students participated in measurement of critical thinking skills and simulation-based performance using videotaped vignettes, high-fidelity human simulation, the California Critical Thinking Disposition Inventory and California Critical Thinking Skills Test. Simulation- based performance was rated as ‘meeting’ or ‘not meeting’ overall expectations. Test scores were categorized as strong, average, or weak. Results Most (75·0%) students did not meet overall performance expectations using videotaped vignettes or high-fidelity human simulation; most difficulty related to problem recognition and reporting findings to the physician. There was no difference between overall performance based on method of assessment (P = 0·277). More students met subcategory expectations for initiating nursing interventions (P ≤ 0·001) using high-fidelity human simulation. The relationship between video-taped vignette performance and critical thinking disposition or skills scores was not statistically significant, except for problem recognition and overall critical thinking skills scores (Cramer’s V = 0·444, P = 0·029). There was a statistically significant relationship between overall high-fidelity human simulation performance and overall critical thinking disposition scores (Cramer’s V = 0·413, P = 0·047). Conclusion Students’ performance reflected difficulty meeting expectations in simulated clinical scenarios. High-fidelity human simulation performance appeared to approximate scores on metrics of critical thinking best. Further research is needed to determine if simulation-based performance correlates with critical thinking skills

  4. Critical thinking skills in nursing students: comparison of simulation-based performance with metrics.

    Science.gov (United States)

    Fero, Laura J; O'Donnell, John M; Zullo, Thomas G; Dabbs, Annette DeVito; Kitutu, Julius; Samosky, Joseph T; Hoffman, Leslie A

    2010-10-01

    This paper is a report of an examination of the relationship between metrics of critical thinking skills and performance in simulated clinical scenarios. Paper and pencil assessments are commonly used to assess critical thinking but may not reflect simulated performance. In 2007, a convenience sample of 36 nursing students participated in measurement of critical thinking skills and simulation-based performance using videotaped vignettes, high-fidelity human simulation, the California Critical Thinking Disposition Inventory and California Critical Thinking Skills Test. Simulation-based performance was rated as 'meeting' or 'not meeting' overall expectations. Test scores were categorized as strong, average, or weak. Most (75.0%) students did not meet overall performance expectations using videotaped vignettes or high-fidelity human simulation; most difficulty related to problem recognition and reporting findings to the physician. There was no difference between overall performance based on method of assessment (P = 0.277). More students met subcategory expectations for initiating nursing interventions (P ≤ 0.001) using high-fidelity human simulation. The relationship between videotaped vignette performance and critical thinking disposition or skills scores was not statistically significant, except for problem recognition and overall critical thinking skills scores (Cramer's V = 0.444, P = 0.029). There was a statistically significant relationship between overall high-fidelity human simulation performance and overall critical thinking disposition scores (Cramer's V = 0.413, P = 0.047). Students' performance reflected difficulty meeting expectations in simulated clinical scenarios. High-fidelity human simulation performance appeared to approximate scores on metrics of critical thinking best. Further research is needed to determine if simulation-based performance correlates with critical thinking skills in the clinical setting. © 2010 The Authors. Journal of Advanced

  5. Assessment of the potential forecasting skill of a global hydrological model in reproducing the occurrence of monthly flow extremes

    Directory of Open Access Journals (Sweden)

    N. Candogan Yossef

    2012-11-01

    Full Text Available As an initial step in assessing the prospect of using global hydrological models (GHMs for hydrological forecasting, this study investigates the skill of the GHM PCR-GLOBWB in reproducing the occurrence of past extremes in monthly discharge on a global scale. Global terrestrial hydrology from 1958 until 2001 is simulated by forcing PCR-GLOBWB with daily meteorological data obtained by downscaling the CRU dataset to daily fields using the ERA-40 reanalysis. Simulated discharge values are compared with observed monthly streamflow records for a selection of 20 large river basins that represent all continents and a wide range of climatic zones.

    We assess model skill in three ways all of which contribute different information on the potential forecasting skill of a GHM. First, the general skill of the model in reproducing hydrographs is evaluated. Second, model skill in reproducing significantly higher and lower flows than the monthly normals is assessed in terms of skill scores used for forecasts of categorical events. Third, model skill in reproducing flood and drought events is assessed by constructing binary contingency tables for floods and droughts for each basin. The skill is then compared to that of a simple estimation of discharge from the water balance (PE.

    The results show that the model has skill in all three types of assessments. After bias correction the model skill in simulating hydrographs is improved considerably. For most basins it is higher than that of the climatology. The skill is highest in reproducing monthly anomalies. The model also has skill in reproducing floods and droughts, with a markedly higher skill in floods. The model skill far exceeds that of the water balance estimate. We conclude that the prospect for using PCR-GLOBWB for monthly and seasonal forecasting of the occurrence of hydrological extremes is positive. We argue that this conclusion applies equally to other similar GHMs and

  6. Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

    Science.gov (United States)

    Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

    2015-07-01

    The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. The role of nontechnical skills in simulated trauma resuscitation.

    Science.gov (United States)

    Briggs, Alexandra; Raja, Ali S; Joyce, Maurice F; Yule, Steven J; Jiang, Wei; Lipsitz, Stuart R; Havens, Joaquim M

    2015-01-01

    Trauma team training provides instruction on crisis management through debriefing and discussion of teamwork and leadership skills during simulated trauma scenarios. The effects of team leader's nontechnical skills (NTSs) on technical performance have not been thoroughly studied. We hypothesized that team's and team leader's NTSs correlate with technical performance of clinical tasks. Retrospective cohort study. Brigham and Women's Hospital, STRATUS Center for Surgical Simulation A total of 20 teams composed of surgical residents, emergency medicine residents, emergency department nurses, and emergency services assistants underwent 2 separate, high-fidelity, simulated trauma scenarios. Each trauma scenario was recorded on video for analysis and divided into 4 consecutive sections. For each section, 2 raters used the Non-Technical Skills for Surgeons framework to assess NTSs of the team. To evaluate the entire team's NTS, 2 additional raters used the Modified Non-Technical Skills Scale for Trauma system. Clinical performance measures including adherence to guidelines and time to perform critical tasks were measured independently. NTSs performance by both teams and team leaders in all NTS categories decreased from the beginning to the end of the scenario (all p team's and team leader's cognitive skills and critical task performance, with correlation coefficients between 0.351 and 0.478 (p team leader highly correlated with that of the entire team, with correlation coefficients between 0.602 and 0.785 (p teams and team leaders deteriorate as clinical scenarios progress, and the performance of team leaders and teams is highly correlated. Cognitive NTS scores correlate with critical task performance. Increased attention to NTSs during trauma team training may lead to sustained performance throughout trauma scenarios. Decision making and situation awareness skills are critical for both team leaders and teams and should be specifically addressed to improve performance

  8. Laparoscopic skills maintenance: a randomized trial of virtual reality and box trainer simulators.

    Science.gov (United States)

    Khan, Montaha W; Lin, Diwei; Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy

    2014-01-01

    A number of simulators have been developed to teach surgical trainees the basic skills required to effectively perform laparoscopic surgery; however, consideration needs to be given to how well the skills taught by these simulators are maintained over time. This study compared the maintenance of laparoscopic skills learned using box trainer and virtual reality simulators. Participants were randomly allocated to be trained and assessed using either the Society of American Gastrointestinal Endoscopic Surgeons Fundamentals of Laparoscopic Surgery (FLS) simulator or the Surgical Science virtual reality simulator. Once participants achieved a predetermined level of proficiency, they were assessed 1, 3, and 6 months later. At each assessment, participants were given 2 practice attempts and assessed on their third attempt. The study was conducted through the Simulated Surgical Skills Program that was held at the Royal Australasian College of Surgeons, Adelaide, Australia. Overall, 26 participants (13 per group) completed the training and all follow-up assessments. There were no significant differences between simulation-trained cohorts for age, gender, training level, and the number of surgeries previously performed, observed, or assisted. Scores for the FLS-trained participants did not significantly change over the follow-up period. Scores for LapSim-trained participants significantly deteriorated at the first 2 follow-up points (1 and 3 months) (p < 0.050), but returned to be near initial levels by the final follow-up (6 months). This research showed that basic laparoscopic skills learned using the FLS simulator were maintained more consistently than those learned on the LapSim simulator. However, by the final follow-up, both simulator-trained cohorts had skill levels that were not significantly different to those at proficiency after the initial training period. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

  9. Simulation as a surgical teaching model.

    Science.gov (United States)

    Ruiz-Gómez, José Luis; Martín-Parra, José Ignacio; González-Noriega, Mónica; Redondo-Figuero, Carlos Godofredo; Manuel-Palazuelos, José Carlos

    2018-01-01

    Teaching of surgery has been affected by many factors over the last years, such as the reduction of working hours, the optimization of the use of the operating room or patient safety. Traditional teaching methodology fails to reduce the impact of these factors on surgeońs training. Simulation as a teaching model minimizes such impact, and is more effective than traditional teaching methods for integrating knowledge and clinical-surgical skills. Simulation complements clinical assistance with training, creating a safe learning environment where patient safety is not affected, and ethical or legal conflicts are avoided. Simulation uses learning methodologies that allow teaching individualization, adapting it to the learning needs of each student. It also allows training of all kinds of technical, cognitive or behavioural skills. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Enhancing Student Communication Skills Through Arabic Language Competency and Simulated Patient Assessments.

    Science.gov (United States)

    Hasan, Sanah; Tarazi, Hamadeh M Khier; Halim Hilal, Dana Abdel

    2017-05-01

    Objective. To assess student communication and patient management skill with introduction of Arabic and use of simulated patient assessments to a communication and counseling course. Design. Five, 3-hour tutorials (clinical skill laboratory) were added to the course covering: listening and empathic responding, non-verbal communications, interviewing skills, assertiveness, counseling in special situations: conflict, anger, worry or rushed situations, and professional decision making. Arabic content was introduced to the course to enhance Arabic communications and competence among students. Simulated patient assessment was used to evaluate student skills. Students' feedback about course changes was evaluated. Assessment. The course now covers a wider content and Arabic language. Students' scores were similar in the assessment and other assessments within the course and between Arabic and English groups. Students favorably rated the changes in the course and provided constructive feedback on content usefulness and adequacy. Conclusion. Expanding the course to include Arabic language and content and simulated patient assessments enhanced student communication skills.

  11. Integrating Problem-Based Learning and Simulation: Effects on Student Motivation and Life Skills.

    Science.gov (United States)

    Roh, Young Sook; Kim, Sang Suk

    2015-07-01

    Previous research has suggested that a teaching strategy integrating problem-based learning and simulation may be superior to traditional lecture. The purpose of this study was to assess learner motivation and life skills before and after taking a course involving problem-based learning and simulation. The design used repeated measures with a convenience sample of 83 second-year nursing students who completed the integrated course. Data from a self-administered questionnaire measuring learner motivation and life skills were collected at pretest, post-problem-based learning, and post-simulation time points. Repeated-measures analysis of variance determined that the mean scores for total learner motivation (F=6.62, P=.003), communication (F=8.27, Plearning (F=4.45, P=.016) differed significantly between time points. Post hoc tests using the Bonferroni correction revealed that total learner motivation and total life skills significantly increased both from pretest to postsimulation and from post-problem-based learning test to postsimulation test. Subscales of learner motivation and life skills, intrinsic goal orientation, self-efficacy for learning and performance, problem-solving skills, and self-directed learning skills significantly increased both from pretest to postsimulation test and from post-problem-based learning test to post-simulation test. The results demonstrate that an integrating problem-based learning and simulation course elicits significant improvement in learner motivation and life skills. Simulation plus problem-based learning is more effective than problem-based learning alone at increasing intrinsic goal orientation, task value, self-efficacy for learning and performance, problem solving, and self-directed learning.

  12. Novel real-time feedback and integrated simulation model for teaching and evaluating ultrasound-guided regional anesthesia skills in pediatric anesthesia trainees.

    Science.gov (United States)

    Moore, David L; Ding, Lili; Sadhasivam, Senthilkumar

    2012-09-01

    To assess, teach, and improve core competencies and skills sets associated with ultrasound-guided regional anesthesia (UGRA) of pediatric anesthesia trainees. To effectively assess and improve UGRA-associated cognitive and technical skills and proficiency of pediatric anesthesia trainees using simulators and real-time feedback. Ultrasound usage has been increasingly adopted by anesthesiologists to perform regional anesthesia. Pediatric UGRA performance significantly lags behind adult UGRA practice. Lack of effective UGRA training is the major reason for this unfortunate lag. Integration of ultrasound imaging, target location, and needling skills are crucial in safely performing UGRA. However, there are no standards to ensure proficiency in practice, nor in training. We implemented an UGRA instructional program for all trainees, in two parts. First, we used a unique training model for initial assessment and training of technical skills. Second, we used an instructional program that encompasses UGRA and equipment-associated cognitive skills. After baseline assessment at 0 months, we retested these trainees at 6 and 12 months to identify progression of proficiency over time. Cognitive and technical UGRA skills of trainees improved significantly over the course of time. UGRA performance average accuracy improved to 79% at 12 months from the baseline accuracy of 57%. Cognitive UGRA-related skills of trainees improved from baseline results of 52.5-79.2% at 12 months. Implementing a multifaceted assessment and real-time feedback-based training has significantly improved UGRA-related cognitive and technical skills and proficiency of pediatric anesthesia trainees. © 2012 Blackwell Publishing Ltd.

  13. Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial.

    Science.gov (United States)

    Brunckhorst, Oliver; Shahid, Shahab; Aydin, Abdullatif; McIlhenny, Craig; Khan, Shahid; Raza, Syed Johar; Sahai, Arun; Brewin, James; Bello, Fernando; Kneebone, Roger; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2015-09-01

    Current training modalities within ureteroscopy have been extensively validated and must now be integrated within a comprehensive curriculum. Additionally, non-technical skills often cause surgical error and little research has been conducted to combine this with technical skills teaching. This study therefore aimed to develop and validate a curriculum for semi-rigid ureteroscopy, integrating both technical and non-technical skills teaching within the programme. Delphi methodology was utilised for curriculum development and content validation, with a randomised trial then conducted (n = 32) for curriculum evaluation. The developed curriculum consisted of four modules; initially developing basic technical skills and subsequently integrating non-technical skills teaching. Sixteen participants underwent the simulation-based curriculum and were subsequently assessed, together with the control cohort (n = 16) within a full immersion environment. Both technical (Time to completion, OSATS and a task specific checklist) and non-technical (NOTSS) outcome measures were recorded with parametric and non-parametric analyses used depending on the distribution of our data as evaluated by a Shapiro-Wilk test. Improvements within the intervention cohort demonstrated educational value across all technical and non-technical parameters recorded, including time to completion (p technical and non-technical skills teaching is both educationally valuable and feasible. Additionally, the curriculum offers a validated simulation-based training modality within ureteroscopy and a framework for the development of other simulation-based programmes.

  14. Do technical skills correlate with non-technical skills in crisis resource management: a simulation study.

    Science.gov (United States)

    Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N

    2012-11-01

    Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

  15. Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-01-01

    The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads.

    Science.gov (United States)

    Lee, Gyusung I; Lee, Mija R

    2018-01-01

    While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG's TPM was initially long but substantially shortened as the group became familiar with PM. Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

  17. Transesophageal echocardiography simulation is an effective tool in teaching psychomotor skills to novice echocardiographers.

    Science.gov (United States)

    Sohmer, Benjamin; Hudson, Christopher; Hudson, Jordan; Posner, Glenn D; Naik, Viren

    2014-03-01

    Performance of transesophageal echocardiography (TEE) requires the psychomotor ability to obtain interpretable echocardiographic images. The purpose of this study was to determine the effectiveness of a simulation-based curriculum in which a TEE simulator is used to teach the psychomotor skills to novice echocardiographers and to compare instructor-guided with self-directed online delivery of the curriculum. After institutional review board approval, subjects inexperienced in TEE completed an online review of TEE material prior to a baseline pre-test of TEE psychomotor skills using the simulator. Subjects were randomized to two groups. The first group received an instructor-guided lesson of TEE psychomotor skills with the simulator. The second group received a self-directed slide presentation of TEE psychomotor skills with the simulator. Both lessons delivered identical information. Following their respective training sessions, all subjects performed a post-test of their TEE psychomotor skills using the simulator. Two assessors rated the TEE performances using a validated scoring system for acquisition of images. Pre-test TEE simulator scores were similar between the two instruction groups (9.0 vs 5.0; P = 0.28). The scores in both groups improved significantly following training, regardless of the method of instruction (P psychomotor skills. There was no difference in improvement between the different modalities of instruction. Further research will examine the need for a faculty resource for a curriculum in which a simulator is used as an adjunct.

  18. Using computer simulation to improve high order thinking skills of physics teacher candidate students in Compton effect

    Science.gov (United States)

    Supurwoko; Cari; Sarwanto; Sukarmin; Fauzi, Ahmad; Faradilla, Lisa; Summa Dewi, Tiarasita

    2017-11-01

    The process of learning and teaching in Physics is often confronted with abstract concepts. It makes difficulty for students to understand and teachers to teach the concept. One of the materials that has an abstract concept is Compton Effect. The purpose of this research is to evaluate computer simulation model on Compton Effect material which is used to improve high thinking ability of Physics teacher candidate students. This research is a case study. The subject is students at physics educations who have attended Modern Physics lectures. Data were obtained through essay test for measuring students’ high-order thinking skills and quisioners for measuring students’ responses. The results obtained indicate that computer simulation model can be used to improve students’ high order thinking skill and can be used to improve students’ responses. With this result it is suggested that the audiences use the simulation media in learning

  19. Assessment of comparative skills between hand-assisted and straight laparoscopic colorectal training on an augmented reality simulator.

    Science.gov (United States)

    Leblanc, F; Delaney, C P; Neary, P C; Rose, J; Augestad, K M; Senagore, A J; Ellis, C N; Champagne, B J

    2010-09-01

    The aim of this study was to compare skills sets during a hand-assisted and straight laparoscopic colectomy on an augmented reality simulator. Twenty-nine surgeons, assigned randomly in 2 groups, performed laparoscopic sigmoid colectomies on a simulator: group A (n = 15) performed hand-assisted then straight procedures; group B (n = 14) performed straight then hand-assisted procedures. Groups were compared according to prior laparoscopic colorectal experience, performance (time, instrument path length, and instrument velocity changes), technical skills, and operative error. Prior laparoscopic colorectal experience was similar in both groups. Both groups had better performances with the hand-assisted approach, although technical skill scores were similar between approaches. The error rate was higher with the hand-assisted approach in group A, but similar between both approaches in group B. These data define the metrics of performance for hand-assisted and straight laparoscopic colectomy on an augmented reality simulator. The improved scores with the hand-assisted approach suggest that with this simulator a hand-assisted model may be technically easier to perform, although it is associated with increased intraoperative errors.

  20. Impact of vegetation variability on potential predictability and skill of EC-Earth simulations

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, Martina; Hurk, Bart van den; Haarsma, Reindert; Hazeleger, Wilco [Royal Netherlands Meteorological Institute (KNMI), De Bilt (Netherlands)

    2012-12-15

    Climate models often use a simplified and static representation of vegetation characteristics to determine fluxes of energy, momentum and water vapour between surface and lower atmosphere. In order to analyse the impact of short term variability in vegetation phenology, we use remotely-sensed leaf area index and albedo products to examine the role of vegetation in the coupled land-atmosphere system. Perfect model experiments are carried out to determine the impact of realistic temporal variability of vegetation on potential predictability of evaporation and temperature, as well as model skill of EC-Earth simulations. The length of the simulation period is hereby limited by the availability of satellite products to 2000-2010. While a realistic representation of vegetation positively influences the simulation of evaporation and its potential predictability, a positive impact on 2 m temperature is of smaller magnitude, regionally confined and more pronounced in climatically extreme years. (orig.)

  1. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    Science.gov (United States)

    Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

    2012-01-01

    Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

  2. Physically realistic modeling of maritime training simulation

    OpenAIRE

    Cieutat , Jean-Marc

    2003-01-01

    Maritime training simulation is an important matter of maritime teaching, which requires a lot of scientific and technical skills.In this framework, where the real time constraint has to be maintained, all physical phenomena cannot be studied; the most visual physical phenomena relating to the natural elements and the ship behaviour are reproduced only. Our swell model, based on a surface wave simulation approach, permits to simulate the shape and the propagation of a regular train of waves f...

  3. Evaluating clinical simulations for learning procedural skills: a theory-based approach.

    Science.gov (United States)

    Kneebone, Roger

    2005-06-01

    Simulation-based learning is becoming widely established within medical education. It offers obvious benefits to novices learning invasive procedural skills, especially in a climate of decreasing clinical exposure. However, simulations are often accepted uncritically, with undue emphasis being placed on technological sophistication at the expense of theory-based design. The author proposes four key areas that underpin simulation-based learning, and summarizes the theoretical grounding for each. These are (1) gaining technical proficiency (psychomotor skills and learning theory, the importance of repeated practice and regular reinforcement), (2) the place of expert assistance (a Vygotskian interpretation of tutor support, where assistance is tailored to each learner's needs), (3) learning within a professional context (situated learning and contemporary apprenticeship theory), and (4) the affective component of learning (the effect of emotion on learning). The author then offers four criteria for critically evaluating new or existing simulations, based on the theoretical framework outlined above. These are: (1) Simulations should allow for sustained, deliberate practice within a safe environment, ensuring that recently-acquired skills are consolidated within a defined curriculum which assures regular reinforcement; (2) simulations should provide access to expert tutors when appropriate, ensuring that such support fades when no longer needed; (3) simulations should map onto real-life clinical experience, ensuring that learning supports the experience gained within communities of actual practice; and (4) simulation-based learning environments should provide a supportive, motivational, and learner-centered milieu which is conducive to learning.

  4. Simulation-based rhomboid flap skills training during medical education: comparing low- and high-fidelity bench models.

    Science.gov (United States)

    Denadai, Rafael; Saad-Hossne, Rogerio; Raposo-Amaral, Cassio Eduardo

    2014-11-01

    To assess if the bench model fidelity interferes in the acquisition of rhomboid flap skills by medical students. Sixty novice medical students were randomly assigned to 5 practice conditions with instructor-directed Limberg rhomboid flap skills training: didactic materials (control group 1), low-fidelity rubberized line (group 2) or ethylene-vinyl acetate (group 3) bench models; high-fidelity chicken leg skin (group 4) or pig foot skin (group 5) bench models. Pretests and posttests were applied, and Global Rating Scale, effect size, and self-perceived confidence were used to evaluate all flap performances. Medical students from groups 2 to 5 showed better flap performances based on the Global Rating Scale (all P 0.05). The magnitude of the effect was considered large (>0.80) in all measurements. There was acquisition of rhomboid flap skills regardless of bench model fidelity.

  5. Evaluating Behavioral Skills Training with and without Simulated in Situ Training for Teaching Safety Skills to Children

    Science.gov (United States)

    Miltenberger, Raymond; Gross, Amy; Knudson, Peter; Bosch, Amanda; Jostad, Candice; Breitwieser, Carrie Brower

    2009-01-01

    This study compared the effectiveness of behavioral skills training (BST) to BST plus simulated in situ training (SIT) for teaching safety skills to children to prevent gun play. The results were evaluated in a posttest only control group design. Following the first assessment, participants in both training groups and the control group who did not…

  6. Basic airway skills acquisition using the American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum: Initial results.

    Science.gov (United States)

    Muratore, Sydne; Kim, Michael; Olasky, Jaisa; Campbell, Andre; Acton, Robert

    2017-02-01

    The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario). A proportion of students completed pre/post-test surveys regarding experience, satisfaction, comfort, and self-perceived proficiency. Over 16 months, 240 students were enrolled with 98% deemed proficient in a simulated or clinical scenario. Pre/post-test surveys (n = 126) indicated improvement in self-perceived proficiency by 99% of learners. All students felt moderately to very comfortable performing basic airway skills and 94% had moderate to considerable satisfaction after completing the module. The ACS/ASE Surgical Skills Curriculum is a feasible and effective way to teach medical students basic airway skills using simulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

    Science.gov (United States)

    Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

    2015-01-01

    To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. An interprofessional course using human patient simulation to teach patient safety and teamwork skills.

    Science.gov (United States)

    Vyas, Deepti; McCulloh, Russell; Dyer, Carla; Gregory, Gretchen; Higbee, Dena

    2012-05-10

    To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards. Pharmacy students' scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students' scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication. Simulation training provided an opportunity to improve pharmacy students' ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills.

  9. Collecting Validity Evidence for Simulation-Based Assessment of Point-of-Care Ultrasound Skills

    DEFF Research Database (Denmark)

    Jensen, Jesper Kørup; Dyre, Liv; Jørgensen, Mattis Enggaard

    2017-01-01

    OBJECTIVES: The aim of this study was to examine the validity of a simulator test designed to evaluate focused assessment with sonography for trauma (FAST) skills. METHODS: Participants included a group of ultrasound novices (n = 25) and ultrasound experts (n = 10). All participants had their FAST...... skills assessed using a virtual reality ultrasound simulator. Procedural performance on the 4 FAST windows was assessed by automated simulator metrics, which received a passing or failing score. The validity evidence for these simulator metrics was examined by a stepwise approach according...

  10. Adaptation of non-technical skills behavioural markers for delivery room simulation.

    Science.gov (United States)

    Bracco, Fabrizio; Masini, Michele; De Tonetti, Gabriele; Brogioni, Francesca; Amidani, Arianna; Monichino, Sara; Maltoni, Alessandra; Dato, Andrea; Grattarola, Claudia; Cordone, Massimo; Torre, Giancarlo; Launo, Claudio; Chiorri, Carlo; Celleno, Danilo

    2017-03-17

    Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room). The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected. The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories. The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.

  11. Developing a calibrated CONUS-wide watershed-scale simulation platform for quantifying the influence of different sources of uncertainty on streamflow forecast skill

    Science.gov (United States)

    Newman, A. J.; Sampson, K. M.; Wood, A. W.; Hopson, T. M.; Brekke, L. D.; Arnold, J.; Raff, D. A.; Clark, M. P.

    2013-12-01

    Skill in model-based hydrologic forecasting depends on the ability to estimate a watershed's initial moisture and energy conditions, to forecast future weather and climate inputs, and on the quality of the hydrologic model's representation of watershed processes. The impact of these factors on prediction skill varies regionally, seasonally, and by model. We are investigating these influences using a watershed simulation platform that spans the continental US (CONUS), encompassing a broad range of hydroclimatic variation, and that uses the current simulation models of National Weather Service streamflow forecasting operations. The first phase of this effort centered on the implementation and calibration of the SNOW-17 and Sacramento soil moisture accounting (SAC-SMA) based hydrologic modeling system for a range of watersheds. The base configuration includes 630 basins in the United States Geological Survey's Hydro-Climatic Data Network 2009 (HCDN-2009, Lins 2012) conterminous U.S. basin subset. Retrospective model forcings were derived from Daymet (http://daymet.ornl.gov/), and where available, a priori parameter estimates were based on or compared with the operational NWS model parameters. Model calibration was accomplished by several objective, automated strategies, including the shuffled complex evolution (SCE) optimization approach developed within the NWS in the early 1990s (Duan et al. 1993). This presentation describes outcomes from this effort, including insights about measuring simulation skill, and on relationships between simulation skill and model parameters, basin characteristics (climate, topography, vegetation, soils), and the quality of forcing inputs. References: %Z Thornton, P.; Thornton, M.; Mayer, B.; Wilhelmi, N.; Wei, Y.; Devarakonda, R; Cook, R. Daymet: Daily Surface Weather on a 1 km Grid for North America. 1980-2008; Oak Ridge National Laboratory Distributed Active Archive Center: Oak Ridge, TN, USA, 2012; Volume 10.

  12. 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 virtual 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.

  13. Ecosystem Model Skill Assessment. Yes We Can!

    Science.gov (United States)

    Olsen, Erik; Fay, Gavin; Gaichas, Sarah; Gamble, Robert; Lucey, Sean; Link, Jason S

    2016-01-01

    Accelerated changes to global ecosystems call for holistic and integrated analyses of past, present and future states under various pressures to adequately understand current and projected future system states. Ecosystem models can inform management of human activities in a complex and changing environment, but are these models reliable? Ensuring that models are reliable for addressing management questions requires evaluating their skill in representing real-world processes and dynamics. Skill has been evaluated for just a limited set of some biophysical models. A range of skill assessment methods have been reviewed but skill assessment of full marine ecosystem models has not yet been attempted. We assessed the skill of the Northeast U.S. (NEUS) Atlantis marine ecosystem model by comparing 10-year model forecasts with observed data. Model forecast performance was compared to that obtained from a 40-year hindcast. Multiple metrics (average absolute error, root mean squared error, modeling efficiency, and Spearman rank correlation), and a suite of time-series (species biomass, fisheries landings, and ecosystem indicators) were used to adequately measure model skill. Overall, the NEUS model performed above average and thus better than expected for the key species that had been the focus of the model tuning. Model forecast skill was comparable to the hindcast skill, showing that model performance does not degenerate in a 10-year forecast mode, an important characteristic for an end-to-end ecosystem model to be useful for strategic management purposes. We identify best-practice approaches for end-to-end ecosystem model skill assessment that would improve both operational use of other ecosystem models and future model development. We show that it is possible to not only assess the skill of a complicated marine ecosystem model, but that it is necessary do so to instill confidence in model results and encourage their use for strategic management. Our methods are applicable

  14. Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology.

    Science.gov (United States)

    Brewin, James; Tang, Jessica; Dasgupta, Prokar; Khan, Muhammad S; Ahmed, Kamran; Bello, Fernando; Kneebone, Roger; Jaye, Peter

    2015-07-01

    To evaluate the face, content and construct validity of the distributed simulation (DS) environment for technical and non-technical skills training in endourology. To evaluate the educational impact of DS for urology training. DS offers a portable, low-cost simulated operating room environment that can be set up in any open space. A prospective mixed methods design using established validation methodology was conducted in this simulated environment with 10 experienced and 10 trainee urologists. All participants performed a simulated prostate resection in the DS environment. Outcome measures included surveys to evaluate the DS, as well as comparative analyses of experienced and trainee urologist's performance using real-time and 'blinded' video analysis and validated performance metrics. Non-parametric statistical methods were used to compare differences between groups. The DS environment demonstrated face, content and construct validity for both non-technical and technical skills. Kirkpatrick level 1 evidence for the educational impact of the DS environment was shown. Further studies are needed to evaluate the effect of simulated operating room training on real operating room performance. This study has shown the validity of the DS environment for non-technical, as well as technical skills training. DS-based simulation appears to be a valuable addition to traditional classroom-based simulation training. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

  15. Meningkatkan Hard Skills dan Soft Skills Siswa melalui Model Pembelajaran Koooperatif Tipe Stad

    OpenAIRE

    Alfiansyah, Muhammad; Jamal, M. Arifuddin; An'nur, Syubhan

    2014-01-01

    Penelitian ini secara umum bertujuan untuk mendeskripsikan keefektifan model pembelajaran kooperatif tipe STAD dalam meningkatkan hard skills dan soft skills siswa SMAN 8 Barabai pada pokok bahasan fluida statis. Secara khusus untuk mendeskripsikan keterlaksanaan RPP model kooperatif tipe STAD, hard skills siswa, soft skills siswa dan respon siswa. Metode penelitian yang digunakan merupakan penelitian tindakan kelas model Kemmis dan Mc Taggart. Hasil penelitian menunjukkan bahwa terjadi pen...

  16. Simulation model for transcervical laryngeal injection providing real-time feedback.

    Science.gov (United States)

    Ainsworth, Tiffiny A; Kobler, James B; Loan, Gregory J; Burns, James A

    2014-12-01

    This study aimed to develop and evaluate a model for teaching transcervical laryngeal injections. A 3-dimensional printer was used to create a laryngotracheal framework based on de-identified computed tomography images of a human larynx. The arytenoid cartilages and intrinsic laryngeal musculature were created in silicone from clay casts and thermoplastic molds. The thyroarytenoid (TA) muscle was created with electrically conductive silicone using metallic filaments embedded in silicone. Wires connected TA muscles to an electrical circuit incorporating a cell phone and speaker. A needle electrode completed the circuit when inserted in the TA during simulated injection, providing real-time feedback of successful needle placement by producing an audible sound. Face validation by the senior author confirmed appropriate tactile feedback and anatomical realism. Otolaryngologists pilot tested the model and completed presimulation and postsimulation questionnaires. The high-fidelity simulation model provided tactile and audio feedback during needle placement, simulating transcervical vocal fold injections. Otolaryngology residents demonstrated higher comfort levels with transcervical thyroarytenoid injection on postsimulation questionnaires. This is the first study to describe a simulator for developing transcervical vocal fold injection skills. The model provides real-time tactile and auditory feedback that aids in skill acquisition. Otolaryngologists reported increased confidence with transcervical injection after using the simulator. © The Author(s) 2014.

  17. A study for production simulation model generation system based on data model at a shipyard

    Directory of Open Access Journals (Sweden)

    Myung-Gi Back

    2016-09-01

    Full Text Available Simulation technology is a type of shipbuilding product lifecycle management solution used to support production planning or decision-making. Normally, most shipbuilding processes are consisted of job shop production, and the modeling and simulation require professional skills and experience on shipbuilding. For these reasons, many shipbuilding companies have difficulties adapting simulation systems, regardless of the necessity for the technology. In this paper, the data model for shipyard production simulation model generation was defined by analyzing the iterative simulation modeling procedure. The shipyard production simulation data model defined in this study contains the information necessary for the conventional simulation modeling procedure and can serve as a basis for simulation model generation. The efficacy of the developed system was validated by applying it to the simulation model generation of the panel block production line. By implementing the initial simulation model generation process, which was performed in the past with a simulation modeler, the proposed system substantially reduced the modeling time. In addition, by reducing the difficulties posed by different modeler-dependent generation methods, the proposed system makes the standardization of the simulation model quality possible.

  18. Can the learning of laparoscopic skills be quantified by the measurements of skill parameters performed in a virtual reality simulator?

    Directory of Open Access Journals (Sweden)

    Natascha Silva Sandy

    2013-06-01

    Full Text Available Purpose To ensure patient safety and surgical efficiency, much emphasis has been placed on the training of laparoscopic skills using virtual reality simulators. The purpose of this study was to determine whether laparoscopic skills can be objectively quantified by measuring specific skill parameters during training in a virtual reality surgical simulator (VRSS. Materials and Methods Ten medical students (with no laparoscopic experience and ten urology residents (PGY3-5 with limited laparoscopic experience were recruited to participate in a ten-week training course in basic laparoscopic skills (camera, cutting, peg transfer and clipping skills on a VRSS. Data were collected from the training sessions. The time that individuals took to complete each task and the errors that they made were analyzed independently. Results The mean time that individuals took to complete tasks was significantly different between the groups (p < 0.05, with the residents being faster than the medical students. The residents' group also completed the tasks with fewer errors. The majority of the subjects in both groups exhibited a significant improvement in their task completion time and error rate. Conclusion The findings in this study demonstrate that laparoscopic skills can be objectively measured in a VRSS based on quantified skill parameters, including the time spent to complete skill tasks and the associated error rate. We conclude that a VRSS is a feasible tool for training and assessing basic laparoscopic skills.

  19. High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

    Science.gov (United States)

    Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

    2012-04-01

    Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents

  20. Development and evaluation of a decision-based simulation for assessment of team skills.

    Science.gov (United States)

    Andrew, Brandon; Plachta, Stephen; Salud, Lawrence; Pugh, Carla M

    2012-08-01

    There is a need to train and evaluate a wide variety of nontechnical surgical skills. The goal of this project was to develop and evaluate a decision-based simulation to assess team skills. The decision-based exercise used our previously validated Laparoscopic Ventral Hernia simulator and a newly developed team evaluation survey. Five teams of 3 surgical residents (N = 15) were tasked with repairing a 10 × 10-cm right upper quadrant hernia. During the simulation, independent observers (N = 6) completed a 6-item survey assessing: (1) work quality; (2) communication; and (3) team effectiveness. After the simulation, team members self-rated their performance by using the same survey. Survey reliability revealed a Cronbach's alpha of r = .811. Significant differences were found when we compared team members' (T) and observers' (O) ratings for communication (T = 4.33/5.00 vs O = 3.00/5.00, P work quality (T = 4.33/5.00 vs O = 3.33/5.00, P performance on the simulator. Our current and previous work provides strong evidence that nontechnical and team related skills can be assessed without simulating a crisis situation. Copyright © 2012 Mosby, Inc. All rights reserved.

  1. Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

    Science.gov (United States)

    Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

    2016-08-18

    To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the

  2. Virtual reality simulators: current status in acquisition and assessment of surgical skills.

    Science.gov (United States)

    Cosman, Peter H; Cregan, Patrick C; Martin, Christopher J; Cartmill, John A

    2002-01-01

    Medical technology is currently evolving so rapidly that its impact cannot be analysed. Robotics and telesurgery loom on the horizon, and the technology used to drive these advances has serendipitous side-effects for the education and training arena. The graphical and haptic interfaces used to provide remote feedback to the operator--by passing control to a computer--may be used to generate simulations of the operative environment that are useful for training candidates in surgical procedures. One additional advantage is that the metrics calculated inherently in the controlling software in order to run the simulation may be used to provide performance feedback to individual trainees and mentors. New interfaces will be required to undergo evaluation of the simulation fidelity before being deemed acceptable. The potential benefits fall into one of two general categories: those benefits related to skill acquisition, and those related to skill assessment. The educational value of the simulation will require assessment, and comparison to currently available methods of training in any given procedure. It is also necessary to determine--by repeated trials--whether a given simulation actually measures the performance parameters it purports to measure. This trains the spotlight on what constitutes good surgical skill, and how it is to be objectively measured. Early results suggest that virtual reality simulators have an important role to play in this aspect of surgical training.

  3. Exploring the use of high-fidelity simulation training to enhance clinical skills.

    Science.gov (United States)

    Ann Kirkham, Lucy

    2018-02-07

    The use of interprofessional simulation training to enhance nursing students' performance of technical and non-technical clinical skills is becoming increasingly common. Simulation training can involve the use of role play, virtual reality or patient simulator manikins to replicate clinical scenarios and assess the nursing student's ability to, for example, undertake clinical observations or work as part of a team. Simulation training enables nursing students to practise clinical skills in a safe environment. Effective simulation training requires extensive preparation, and debriefing is necessary following a simulated training session to review any positive or negative aspects of the learning experience. This article discusses a high-fidelity simulated training session that was used to assess a group of third-year nursing students and foundation level 1 medical students. This involved the use of a patient simulator manikin in a scenario that required the collaborative management of a deteriorating patient. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  4. Simulated and Virtual Science Laboratory Experiments: Improving Critical Thinking and Higher-Order Learning Skills

    Science.gov (United States)

    Simon, Nicole A.

    Virtual laboratory experiments using interactive computer simulations are not being employed as viable alternatives to laboratory science curriculum at extensive enough rates within higher education. Rote traditional lab experiments are currently the norm and are not addressing inquiry, Critical Thinking, and cognition throughout the laboratory experience, linking with educational technologies (Pyatt & Sims, 2007; 2011; Trundle & Bell, 2010). A causal-comparative quantitative study was conducted with 150 learners enrolled at a two-year community college, to determine the effects of simulation laboratory experiments on Higher-Order Learning, Critical Thinking Skills, and Cognitive Load. The treatment population used simulated experiments, while the non-treatment sections performed traditional expository experiments. A comparison was made using the Revised Two-Factor Study Process survey, Motivated Strategies for Learning Questionnaire, and the Scientific Attitude Inventory survey, using a Repeated Measures ANOVA test for treatment or non-treatment. A main effect of simulated laboratory experiments was found for both Higher-Order Learning, [F (1, 148) = 30.32,p = 0.00, eta2 = 0.12] and Critical Thinking Skills, [F (1, 148) = 14.64,p = 0.00, eta 2 = 0.17] such that simulations showed greater increases than traditional experiments. Post-lab treatment group self-reports indicated increased marginal means (+4.86) in Higher-Order Learning and Critical Thinking Skills, compared to the non-treatment group (+4.71). Simulations also improved the scientific skills and mastery of basic scientific subject matter. It is recommended that additional research recognize that learners' Critical Thinking Skills change due to different instructional methodologies that occur throughout a semester.

  5. Assessing Practical Skills in Physics Using Computer Simulations

    Science.gov (United States)

    Walsh, Kevin

    2018-01-01

    Computer simulations have been used very effectively for many years in the teaching of science but the focus has been on cognitive development. This study, however, is an investigation into the possibility that a student's experimental skills in the real-world environment can be judged via the undertaking of a suitably chosen computer simulation…

  6. Sensitivity of inferred climate model skill to evaluation decisions: a case study using CMIP5 evapotranspiration

    International Nuclear Information System (INIS)

    Schwalm, Christopher R; Huntinzger, Deborah N; Michalak, Anna M; Fisher, Joshua B; Kimball, John S; Mueller, Brigitte; Zhang, Ke; Zhang Yongqiang

    2013-01-01

    Confrontation of climate models with observationally-based reference datasets is widespread and integral to model development. These comparisons yield skill metrics quantifying the mismatch between simulated and reference values and also involve analyst choices, or meta-parameters, in structuring the analysis. Here, we systematically vary five such meta-parameters (reference dataset, spatial resolution, regridding approach, land mask, and time period) in evaluating evapotranspiration (ET) from eight CMIP5 models in a factorial design that yields 68 700 intercomparisons. The results show that while model–data comparisons can provide some feedback on overall model performance, model ranks are ambiguous and inferred model skill and rank are highly sensitive to the choice of meta-parameters for all models. This suggests that model skill and rank are best represented probabilistically rather than as scalar values. For this case study, the choice of reference dataset is found to have a dominant influence on inferred model skill, even larger than the choice of model itself. This is primarily due to large differences between reference datasets, indicating that further work in developing a community-accepted standard ET reference dataset is crucial in order to decrease ambiguity in model skill. (letter)

  7. Effect of a Simulation Exercise on Restorative Identification Skills of First Year Dental Hygiene Students.

    Science.gov (United States)

    Lemaster, Margaret; Flores, Joyce M; Blacketer, Margaret S

    2016-02-01

    This study explored the effectiveness of simulated mouth models to improve identification and recording of dental restorations when compared to using traditional didactic instruction combined with 2-dimensional images. Simulation has been adopted into medical and dental education curriculum to improve both student learning and patient safety outcomes. A 2-sample, independent t-test analysis of data was conducted to compare graded dental recordings of dental hygiene students using simulated mouth models and dental hygiene students using 2-dimensional photographs. Evaluations from graded dental charts were analyzed and compared between groups of students using the simulated mouth models containing random placement of custom preventive and restorative materials and traditional 2-dimensional representations of didactically described conditions. Results demonstrated a statistically significant (p≤0.0001) difference: for experimental group, students using the simulated mouth models to identify and record dental conditions had a mean of 86.73 and variance of 33.84. The control group students using traditional 2-dimensional images mean graded dental chart scores were 74.43 and variance was 14.25. Using modified simulation technology for dental charting identification may increase level of dental charting skill competency in first year dental hygiene students. Copyright © 2016 The American Dental Hygienists’ Association.

  8. The assessment of knowledge and learning in competence spaces: The gain-loss model for dependent skills.

    Science.gov (United States)

    Anselmi, Pasquale; Stefanutti, Luca; de Chiusole, Debora; Robusto, Egidio

    2017-11-01

    The gain-loss model (GaLoM) is a formal model for assessing knowledge and learning. In its original formulation, the GaLoM assumes independence among the skills. Such an assumption is not reasonable in several domains, in which some preliminary knowledge is the foundation for other knowledge. This paper presents an extension of the GaLoM to the case in which the skills are not independent, and the dependence relation among them is described by a well-graded competence space. The probability of mastering skill s at the pretest is conditional on the presence of all skills on which s depends. The probabilities of gaining or losing skill s when moving from pretest to posttest are conditional on the mastery of s at the pretest, and on the presence at the posttest of all skills on which s depends. Two formulations of the model are presented, in which the learning path is allowed to change from pretest to posttest or not. A simulation study shows that models based on the true competence space obtain a better fit than models based on false competence spaces, and are also characterized by a higher assessment accuracy. An empirical application shows that models based on pedagogically sound assumptions about the dependencies among the skills obtain a better fit than models assuming independence among the skills. © 2017 The British Psychological Society.

  9. Innovative integrative bedside teaching model improves tutors' self-assessments of teaching skills and attitudes.

    Science.gov (United States)

    Gat, Itai; Pessach-Gelblum, Liat; Givati, Gili; Haim, Nadav; Paluch-Shimon, Shani; Unterman, Avraham; Bar-Shavit, Yochay; Grabler, Galit; Sagi, Doron; Achiron, Anat; Ziv, Amitai

    2016-01-01

    Patient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST) practiced during tutor training workshop and its resulting effect on practitioners' self assessment of teaching skills and perceptions. One-day tutor training workshop included theoretical knowledge supplementation regarding tutors' roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared. Analysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5) compared with pre-training (mean 2.6, SD 0.6; pteaching skills in this challenging environment.

  10. A Reconfigurable Simulation-Based Test System for Automatically Assessing Software Operating Skills

    Science.gov (United States)

    Su, Jun-Ming; Lin, Huan-Yu

    2015-01-01

    In recent years, software operating skills, the ability in computer literacy to solve problems using specific software, has become much more important. A great deal of research has also proven that students' software operating skills can be efficiently improved by practicing customized virtual and simulated examinations. However, constructing…

  11. The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment.

    Science.gov (United States)

    Brunckhorst, Oliver; Shahid, Shahab; Aydin, Abdullatif; Khan, Shahid; McIlhenny, Craig; Brewin, James; Sahai, Arun; Bello, Fernando; Kneebone, Roger; Shamim Khan, Muhammad; Dasgupta, Prokar; Ahmed, Kamran

    2015-01-01

    Little integration of technical and nontechnical skills (e.g., situational awareness, communication, decision making, teamwork, and leadership) teaching exists within surgery. We therefore aimed to (1) evaluate the relationship between these 2 skill sets within a simulation-based environment and (2) assess if certain nontechnical skill components are of particular relevance to technical performance. A prospective analysis of data acquired from a comparative study of simulation vs nonsimulation training was conducted. Half of the participants underwent training of technical and nontechnical skills within ureteroscopy, with the remaining half undergoing no training. All were assessed within a full immersion environment against both technical (time to completion, Objective Structured Assessment of Technical Skills, and task-specific checklist scores) and nontechnical parameters (Nontechnical Skills for Surgeons [NOTSS] rating scale). The data of whole and individual cohorts were analyzed using Pearson correlation coefficient. The trial took place within the Simulation and Interactive Learning Centre at Guy's Hospital, London, UK. In total, 32 novice participants with no prior practical ureteroscopy experience were included within the data analysis. A correlation was found within all outcome measures analyzed. For the whole cohort, a strong negative correlation was found between time to completion and NOTSS scores (r = -0.75, p Technical Skills (r = 0.89, p technical skill parameters, regardless of training. A strong correlation between technical and nontechnical performance exists, which was demonstrated to be irrespective of training received. This may suggest an inherent link between skill sets. Furthermore, all nontechnical skill sets are important in technical performance. This supports the notion that both of these skills should be trained and assessed together within 1 curriculum. Copyright © 2015 Association of Program Directors in Surgery. Published by

  12. Effect of simulated emergency skills training and assessments on ...

    African Journals Online (AJOL)

    ... of emergency skills in simulation was highly effective in enhancing the competence and confidence of medical students when managing a clinical emergency. However, students appeared to be overconfident, which could be ascribed to ignorance, and possibly indicates that feedback during training should be improved.

  13. Efficacy of simulation-based trauma team training of non-technical skills. A systematic review.

    Science.gov (United States)

    Gjeraa, K; Møller, T P; Østergaard, D

    2014-08-01

    Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question was: Does simulation-based trauma team training of non-technical skills have effect on reaction, learning, behaviour or patient outcome? The authors searched PubMed, EMBASE and the Cochrane Library and found 13 studies eligible for analysis. We described and compared the educational interventions and the evaluations of effect according to the four Kirkpatrick levels: reaction, learning (knowledge, skills, attitudes), behaviour (in a clinical setting) and patient outcome. No studies were randomised, controlled and blinded, resulting in a moderate to high risk of bias. The multi-professional trauma teams had positive reactions to simulation-based training of non-technical skills. Knowledge and skills improved in all studies evaluating the effect on learning. Three studies found improvements in team performance (behaviour) in the clinical setting. One of these found difficulties in maintaining these skills. Two studies evaluated on patient outcome, of which none showed improvements in mortality, complication rate or duration of hospitalisation. A significant effect on learning was found after simulation-based training of the multi-professional trauma team in non-technical skills. Three studies demonstrated significantly increased clinical team performance. No effect on patient outcome was found. All studies had a moderate to high risk of bias. More comprehensive randomised studies are needed to evaluate the effect on patient outcome. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  14. Feedback Simulation for Acupressure Training and Skill Assessment.

    Science.gov (United States)

    Noll, Eric; Romeiser, Jamie; Shodhan, Shivam; Madariaga, Maria Cecilia; Guo, Xiaojun; Rizwan, Sabeen; Al-Bizri, Ehab; Bennett-Guerrero, Elliott

    2017-08-01

    Previous acupressure studies have yielded varying results. This could be due to differences in the amount of pressure applied to the acupressure point (acupoint) by study personnel within a study as well as between studies. Standardizing the level of pressure applied at an acupoint could improve clinical care and future research. As part of an ongoing randomized clinical trial of postoperative acupressure, five trainees were asked to perform 2 minutes of acupressure and light touch sessions on a simulator. The applied weight was recorded every minute. Individual skill assessment was performed using cumulative sum analysis. Six pretraining and 20 posttraining measurements in each acupressure and light touch group were compared with an expert's simulation values. Before training (baseline), there was significant difference in applied weight (grams) between the expert [5705 (636)] and five trainees [2998 (798), P = 0.004]. Four of the five trainees crossed the lower decision limit assessing proficiency in the acupressure group, and all five trainees were successful in the light touch group. The trainees' average number of measurements needed to cross the lower decision limit (H0), that is, defining that an individual failure rate does not statistically differ from the acceptable failure rate, was 21.3 measurements for acupressure. After this feedback simulation, trainees' scores showed no significant difference (P > 0.05) when assessed against the expert. Feedback simulation for acupressure training and skill assessment, evaluated by cumulative sum analysis, may help in improving the standardization of acupressure therapy performed during clinical practice or research.

  15. Decision making in trauma settings: simulation to improve diagnostic skills.

    Science.gov (United States)

    Murray, David J; Freeman, Brad D; Boulet, John R; Woodhouse, Julie; Fehr, James J; Klingensmith, Mary E

    2015-06-01

    In the setting of acute injury, a wrong, missed, or delayed diagnosis can impact survival. Clinicians rely on pattern recognition and heuristics to rapidly assess injuries, but an overreliance on these approaches can result in a diagnostic error. Simulation has been advocated as a method for practitioners to learn how to recognize the limitations of heuristics and develop better diagnostic skills. The objective of this study was to determine whether simulation could be used to provide teams the experiences in managing scenarios that require the use of heuristic as well as analytic diagnostic skills to effectively recognize and treat potentially life-threatening injuries. Ten scenarios were developed to assess the ability of trauma teams to provide initial care to a severely injured patient. Seven standard scenarios simulated severe injuries that once diagnosed could be effectively treated using standard Advanced Trauma Life Support algorithms. Because diagnostic error occurs more commonly in complex clinical settings, 3 complex scenarios required teams to use more advanced diagnostic skills to uncover a coexisting condition and treat the patient. Teams composed of 3 to 5 practitioners were evaluated in the performance of 7 (of 10) randomly selected scenarios (5 standard, 2 complex). Expert rates scored teams using standardized checklists and global scores. Eighty-three surgery, emergency medicine, and anesthesia residents constituted 21 teams. Expert raters were able to reliably score the scenarios. Teams accomplished fewer checklist actions and received lower global scores on the 3 analytic scenarios (73.8% [12.3%] and 5.9 [1.6], respectively) compared with the 7 heuristic scenarios (83.2% [11.7%] and 6.6 [1.3], respectively; P heuristic scenarios but were less effective when managing the scenarios that require a more analytic approach. Simulation can be used to provide teams with decision-making experiences in trauma settings and could be used to improve

  16. A satellite simulator for TRMM PR applied to climate model simulations

    Science.gov (United States)

    Spangehl, T.; Schroeder, M.; Bodas-Salcedo, A.; Hollmann, R.; Riley Dellaripa, E. M.; Schumacher, C.

    2017-12-01

    Climate model simulations have to be compared against observation based datasets in order to assess their skill in representing precipitation characteristics. Here we use a satellite simulator for TRMM PR in order to evaluate simulations performed with MPI-ESM (Earth system model of the Max Planck Institute for Meteorology in Hamburg, Germany) performed within the MiKlip project (https://www.fona-miklip.de/, funded by Federal Ministry of Education and Research in Germany). While classical evaluation methods focus on geophysical parameters such as precipitation amounts, the application of the satellite simulator enables an evaluation in the instrument's parameter space thereby reducing uncertainties on the reference side. The CFMIP Observation Simulator Package (COSP) provides a framework for the application of satellite simulators to climate model simulations. The approach requires the introduction of sub-grid cloud and precipitation variability. Radar reflectivities are obtained by applying Mie theory, with the microphysical assumptions being chosen to match the atmosphere component of MPI-ESM (ECHAM6). The results are found to be sensitive to the methods used to distribute the convective precipitation over the sub-grid boxes. Simple parameterization methods are used to introduce sub-grid variability of convective clouds and precipitation. In order to constrain uncertainties a comprehensive comparison with sub-grid scale convective precipitation variability which is deduced from TRMM PR observations is carried out.

  17. Modeling of magnetic particle suspensions for simulations

    CERN Document Server

    Satoh, Akira

    2017-01-01

    The main objective of the book is to highlight the modeling of magnetic particles with different shapes and magnetic properties, to provide graduate students and young researchers information on the theoretical aspects and actual techniques for the treatment of magnetic particles in particle-based simulations. In simulation, we focus on the Monte Carlo, molecular dynamics, Brownian dynamics, lattice Boltzmann and stochastic rotation dynamics (multi-particle collision dynamics) methods. The latter two simulation methods can simulate both the particle motion and the ambient flow field simultaneously. In general, specialized knowledge can only be obtained in an effective manner under the supervision of an expert. The present book is written to play such a role for readers who wish to develop the skill of modeling magnetic particles and develop a computer simulation program using their own ability. This book is therefore a self-learning book for graduate students and young researchers. Armed with this knowledge,...

  18. Lack of transfer of skills after virtual reality simulator training with haptic feedback.

    Science.gov (United States)

    Våpenstad, Cecilie; Hofstad, Erlend Fagertun; Bø, Lars Eirik; Kuhry, Esther; Johnsen, Gjermund; Mårvik, Ronald; Langø, Thomas; Hernes, Toril Nagelhus

    2017-12-01

    Virtual reality (VR) simulators enrich surgical training and offer training possibilities outside of the operating room (OR). In this study, we created a criterion-based training program on a VR simulator with haptic feedback and tested it by comparing the performances of a simulator group against a control group. Medical students with no experience in laparoscopy were randomly assigned to a simulator group or a control group. In the simulator group, the candidates trained until they reached predefined criteria on the LapSim ® VR simulator (Surgical Science AB, Göteborg, Sweden) with haptic feedback (Xitact TM IHP, Mentice AB, Göteborg, Sweden). All candidates performed a cholecystectomy on a porcine organ model in a box trainer (the clinical setting). The performances were video rated by two surgeons blinded to subject training status. In total, 30 students performed the cholecystectomy and had their videos rated (N = 16 simulator group, N = 14 control group). The control group achieved better video rating scores than the simulator group (p training program did not transfer skills to the clinical setting. Poor mechanical performance of the simulated haptic feedback is believed to have resulted in a negative training effect.

  19. Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery.

    Science.gov (United States)

    Phé, Véronique; Cattarino, Susanna; Parra, Jérôme; Bitker, Marc-Olivier; Ambrogi, Vanina; Vaessen, Christophe; Rouprêt, Morgan

    2017-06-01

    The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons' performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Effectiveness of simulation-based learning on student nurses' self-efficacy and performance while learning fundamental nursing skills.

    Science.gov (United States)

    Lin, Hsin-Hsin

    2015-01-01

    It was noted worldwide while learning fundamental skills and facing skills assessments, nursing students seemed to experience low confidence and high anxiety levels. Could simulation-based learning help to enhance students' self-efficacy and performance? Its effectiveness is mostly unidentified. This study was conducted to provide a shared experience to give nurse educators confidence and an insight into how simulation-based teaching can fit into nursing skills learning. A pilot study was completed with 50 second-year undergraduate nursing students, and the main study included 98 students where a pretest-posttest design was adopted. Data were gathered through four questionnaires and a performance assessment under scrutinized controls such as previous experiences, lecturers' teaching skills, duration of teaching, procedure of skills performance assessment and the inter-rater reliability. The results showed that simulation-based learning significantly improved students' self-efficacy regarding skills learning and the skills performance that nurse educators wish students to acquire. However, technology anxiety, examiners' critical attitudes towards students' performance and their unpredicted verbal and non-verbal expressions, have been found as possible confounding factors. The simulation-based learning proved to have a powerful positive effect on students' achievement outcomes. Nursing skills learning is one area that can benefit greatly from this kind of teaching and learning method.

  1. A modeling framework for supply chain simulation : opportunities for improved decision-making

    NARCIS (Netherlands)

    van der Zee, D.J.; van der Vorst, J.G.A.J.

    Owing to its inherent modeling flexibility, simulation is often regarded as the proper means for supporting decision making on supply chain design. The ultimate success of supply chain simulation, however, is determined by a combination of the analyst's skills, the chain members' involvement, and

  2. A Modeling Framework for Supply Chain Simulation: Opportunities for Improved Decision Making

    NARCIS (Netherlands)

    Zee, van der D.J.; Vorst, van der J.G.A.J.

    2005-01-01

    Owing to its inherent modeling flexibility, simulation is often regarded as the proper means for supporting decision making on supply chain design. The ultimate success of supply chain simulation, however, is determined by a combination of the analyst's skills, the chain members' involvement, and

  3. Fostering the development of effective person-centered healthcare communication skills: an interprofessional shared learning model.

    Science.gov (United States)

    Cavanaugh, James T; Konrad, Shelley Cohen

    2012-01-01

    To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

  4. 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.

  5. Manual Skill Acquisition During Transesophageal Echocardiography Simulator Training of Cardiology Fellows: A Kinematic Assessment.

    Science.gov (United States)

    Matyal, Robina; Montealegre-Gallegos, Mario; Mitchell, John D; Kim, Han; Bergman, Remco; Hawthorne, Katie M; O'Halloran, David; Wong, Vanessa; Hess, Phillip E; Mahmood, Feroze

    2015-12-01

    To investigate whether a transesophageal echocardiography (TEE) simulator with motion analysis can be used to impart proficiency in TEE in an integrated curriculum-based model. A prospective cohort study. A tertiary-care university hospital. TEE-naïve cardiology fellows. Participants underwent an 8-session multimodal TEE training program. Manual skills were assessed at the end of sessions 2 and 8 using motion analysis of the TEE simulator's probe. At the end of the course, participants performed an intraoperative TEE; their examinations were video captured, and a blinded investigator evaluated the total time and image transitions needed for each view. Results are reported as mean±standard deviation, or median (interquartile range) where appropriate. Eleven fellows completed the knowledge and kinematic portions of the study. Five participants were excluded from the evaluation in the clinical setting because of interim exposure to TEE or having participated in a TEE rotation after the training course. An increase of 12.95% in post-test knowledge scores was observed. From the start to the end of the course, there was a significant reduction (pcardiology fellows can be complemented with kinematic analyses to objectify acquisition of manual skills during simulator-based training. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The effect of dyad versus individual simulation-based ultrasound training on skills transfer

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Madsen, Mette E; Oxlund, Birgitte S

    2015-01-01

    : This study was conducted to compare the effectiveness of simulation-based ultrasound training in pairs (dyad practice) with that of training alone (single-student practice) on skills transfer. METHODS: In a non-inferiority trial, 30 ultrasound novices were randomised to dyad (n = 16) or single-student (n...... through pre-, post- and transfer tests. The transfer test involved the assessment of a transvaginal ultrasound scan by one of two clinicians using the Objective Structured Assessment of Ultrasound Skills (OSAUS). RESULTS: Thirty participants completed the simulation-based training and 24...... interactions between training type and performance (p = 0.59). The dyad group demonstrated higher training efficiency in terms of simulator score per number of attempts compared with the single-student group (p = 0.03). CONCLUSION: Dyad practice improves the efficiency of simulation-based training and is non...

  7. A novel 3D-printed hybrid simulation model for robotic-assisted kidney transplantation (RAKT).

    Science.gov (United States)

    Uwechue, Raphael; Gogalniceanu, Petrut; Kessaris, Nicos; Byrne, Nick; Chandak, Pankaj; Olsburgh, Jonathon; Ahmed, Kamran; Mamode, Nizam; Loukopoulos, Ioannis

    2018-01-27

    Robotic-assisted kidney transplantation (RAKT) offers key benefits for patients that have been demonstrated in several studies. A barrier to the wider uptake of RAKT is surgical skill acquisition. This is exacerbated by the challenges of modern surgery with reduced surgical training time, patient safety concerns and financial pressures. Simulation is a well-established method of developing surgical skill in a safe and controlled environment away from the patient. We have developed a 3D printed simulation model for the key step of the kidney transplant operation which is the vascular anastomosis. The model is anatomically accurate, based on the CT scans of patients and it incorporates deceased donor vascular tissue. Crucially, it was developed to be used in the robotic operating theatre with the operating robot to enhance its fidelity. It is portable and relatively inexpensive when compared with other forms of simulation such as virtual reality or animal lab training. It thus has the potential of being more accessible as a training tool for the safe acquisition of RAKT specific skills. We demonstrate this model here.

  8. Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.

    Science.gov (United States)

    Luigi Ingrassia, Pier; Ragazzoni, Luca; Carenzo, Luca; Colombo, Davide; Ripoll Gallardo, Alba; Della Corte, Francesco

    2015-04-01

    This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session. Fifty-six students in their last year of medical school were randomized into two groups (A and B). The same scenario, a car accident, was developed identically on the two simulation methodologies: virtual reality and live simulation. On day 1, group A was exposed to the live scenario and group B was exposed to the virtual reality scenario, aiming to triage 10 victims. On day 2, all students attended a 2-h lecture on mass casualty triage, specifically the START triage method. On day 3, groups A and B were crossed over. The groups' abilities to perform mass casualty triage in terms of triage accuracy, intervention correctness, and speed in the scenarios were assessed. Triage and lifesaving treatment scores were assessed equally by virtual reality and live simulation on day 1 and on day 3. Both simulation methodologies detected an improvement in triage accuracy and treatment correctness from day 1 to day 3 (PVirtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills.

  9. Acquisition of Skill Proficiency Over Multiple Sessions of a Novel Rover Simulation

    Science.gov (United States)

    Dean, S. L.; DeDios,Y. E.; MacDougall, H. G.; Moore, S. T.; Wood, S. J.

    2011-01-01

    Following long-duration exploration transits, adaptive changes in sensorimotor function may impair the crew's ability to safely perform manual control tasks such as operating pressurized rovers. Postflight performance will also be influenced by the level of preflight skill proficiency they have attained. The purpose of this study was to characterize the acquisition of skills in a motion-based rover simulation over multiple sessions, and to investigate the effects of varying the simulation scenarios. METHODS: Twenty healthy subjects were tested in 5 sessions, with 1-3 days between sessions. Each session consisted of a serial presentation of 8 discrete tasks to be completed as quickly and accurately as possible. Each task consisted of 1) perspective-taking, using a map that defined a docking target, 2) navigation toward the target around a Martian outpost, and 3) docking a side hatch of the rover to a visually guided target. The simulator utilized a Stewart-type motion base (CKAS, Australia), single-seat cabin with triple scene projection covering 150 deg horizontal by 50 deg vertical, and joystick controller. Subjects were randomly assigned to a control group (tasks identical in the first 4 sessions) or a varied-practice group. The dependent variables for each task included accuracy toward the target and time to completion. RESULTS: The greatest improvements in time to completion occurred during the docking phase. The varied-practice group showed more improvement in perspective-taking accuracy. Perspective-taking accuracy was also affected by the relative orientation of the rover to the docking target. Skill acquisition was correlated with self-ratings of previous gaming experience. DISCUSSION: Varying task selection and difficulty will optimize the preflight acquisition of skills when performing novel operational tasks. Simulation of operational manual control will provide functionally relevant evidence regarding the impact of sensorimotor adaptation on early

  10. Do Simulation-Based Skill Exercises and Post-Encounter Notes Add Additional Value to a Standardized Patient-Based Clinical Skills Examination?

    Directory of Open Access Journals (Sweden)

    Michael D. Prislin

    2011-01-01

    Full Text Available Background. Standardized patient (SP clinical assessments have limited utility in assessing higher-level clinical competencies. This study explores the value of including simulation exercises and postencounter notes in an SP clinical skills examination. Methods. Two exercises involving cardiac auscultation and ophthalmic funduscopy simulations along with written post encounter notes were added to an SP-based performance examination. Descriptive analyses of students' performance and correlations with SP-based performance measures were obtained. Results. Students' abilities to detect abnormalities on physical exam were highly variable. There were no correlations between SP-based and simulation-derived measures of physical examination competency. Limited correlations were found between students' abilities to perform and document physical examinations and their formulation of appropriate differential diagnoses. Conclusions. Clinical simulation exercises add depth to SP-based assessments of performance. Evaluating the content of post encounter notes offers some insight into students' integrative abilities, and this appears to be improved by the addition of simulation-based post encounter skill exercises. However, further refinement of this methodology is needed.

  11. Effect of Simulation on the Confidence of University Nursing Students in Applying Cardiopulmonary Assessment Skills: A Randomized Controlled Trial.

    Science.gov (United States)

    Tawalbeh, Loai I

    2017-08-01

    Simulation is an effective teaching strategy. However, no study in Jordan has examined the effect of simulation on the confidence of university nursing students in applying heart and lung physical examination skills. The current study aimed to test the effect of simulation on the confidence of university nursing students in applying heart and lung physical examination skills. A randomized controlled trial design was applied. The researcher introduced the simulation scenario regarding cardiopulmonary examination skills. This scenario included a 1-hour PowerPoint presentation and video for the experimental group (n= 35) and a PowerPoint presentation and a video showing a traditional demonstration in the laboratory for the control group (n = 34). Confidence in applying cardiopulmonary physical examination skills was measured for both groups at baseline and at 1 day and 3 months posttest. A paired t test showed that confidence was significantly higher in the posttest than in the pretest for both groups. An independent t test showed a statistically significant difference (t(67) = -42.95, p skills. Both simulation and traditional training in the laboratory significantly improved the confidence of participants in applying cardiopulmonary assessment skills. However, the simulation training had a more significant effect than usual training in enhancing the confidence of nursing students in applying physical examination skills.

  12. 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.

  13. Modeling and simulation in inquiry learning: Checking solutions and giving intelligent advice

    NARCIS (Netherlands)

    Bravo, C.; van Joolingen, W.R.; de Jong, T.

    2006-01-01

    Inquiry learning is a didactic approach in which students acquire knowledge and skills through processes of theory building and experimentation. Computer modeling and simulation can play a prominent role within this approach. Students construct representations of physical systems using modeling.

  14. A Model for Evaluating Student Clinical Psychomotor Skills.

    Science.gov (United States)

    And Others; Fiel, Nicholas J.

    1979-01-01

    A long-range plan to evaluate medical students' physical examination skills was undertaken at the Ingham Family Medical Clinic at Michigan State University. The development of the psychomotor skills evaluation model to evaluate the skill of blood pressure measurement, tests of the model's reliability, and the use of the model are described. (JMD)

  15. Validation of the second-generation Olympus colonoscopy simulator for skills assessment.

    Science.gov (United States)

    Haycock, A V; Bassett, P; Bladen, J; Thomas-Gibson, S

    2009-11-01

    Simulators have potential value in providing objective evidence of technical skill for procedures within medicine. The aim of this study was to determine face and construct validity for the Olympus colonoscopy simulator and to establish which assessment measures map to clinical benchmarks of expertise. Thirty-four participants were recruited: 10 novices with no prior colonoscopy experience, 13 intermediate (trainee) endoscopists with fewer than 1000 previous colonoscopies, and 11 experienced endoscopists with more than 1000 previous colonoscopies. All participants completed three standardized cases on the simulator and experts gave feedback regarding the realism of the simulator. Forty metrics recorded automatically by the simulator were analyzed for their ability to distinguish between the groups. The simulator discriminated participants by experience level for 22 different parameters. Completion rates were lower for novices than for trainees and experts (37 % vs. 79 % and 88 % respectively, P variable stiffness function ( P = 0.004), number of sigmoid N-loops ( P = 0.02); size of sigmoid N-loops ( P = 0.01), and time to remove alpha loops ( P = 0.004). Out of 10, experts rated the realism of movement at 6.4, force feedback at 6.6, looping at 6.6, and loop resolution at 6.8. The Olympus colonoscopy simulator has good face validity and excellent construct validity. It provides an objective assessment of colonoscopic skill on multiple measures and benchmarks have been set to allow its use as both a formative and a summative assessment tool. Georg Thieme Verlag KG Stuttgart. New York.

  16. Objective assessment of gynecologic laparoscopic skills using the LapSimGyn virtual reality simulator

    DEFF Research Database (Denmark)

    Larsen, C R; Grantcharov, Teodor; Aggarwal, R

    2006-01-01

    Safe realistic training and unbiased quantitative assessment of technical skills are required for laparoscopy. Virtual reality (VR) simulators may be useful tools for training and assessing basic and advanced surgical skills and procedures. This study aimed to investigate the construct validity...

  17. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

    Science.gov (United States)

    Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

    2015-01-01

    Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  18. Model simulations and proxy-based reconstructions for the European region in the past millennium (Invited)

    Science.gov (United States)

    Zorita, E.

    2009-12-01

    One of the objectives when comparing simulations of past climates to proxy-based climate reconstructions is to asses the skill of climate models to simulate climate change. This comparison may accomplished at large spatial scales, for instance the evolution of simulated and reconstructed Northern Hemisphere annual temperature, or at regional or point scales. In both approaches a 'fair' comparison has to take into account different aspects that affect the inevitable uncertainties and biases in the simulations and in the reconstructions. These efforts face a trade-off: climate models are believed to be more skillful at large hemispheric scales, but climate reconstructions are these scales are burdened by the spatial distribution of available proxies and by methodological issues surrounding the statistical method used to translate the proxy information into large-spatial averages. Furthermore, the internal climatic noise at large hemispheric scales is low, so that the sampling uncertainty tends to be also low. On the other hand, the skill of climate models at regional scales is limited by the coarse spatial resolution, which hinders a faithful representation of aspects important for the regional climate. At small spatial scales, the reconstruction of past climate probably faces less methodological problems if information from different proxies is available. The internal climatic variability at regional scales is, however, high. In this contribution some examples of the different issues faced when comparing simulation and reconstructions at small spatial scales in the past millennium are discussed. These examples comprise reconstructions from dendrochronological data and from historical documentary data in Europe and climate simulations with global and regional models. These examples indicate that the centennial climate variations can offer a reasonable target to assess the skill of global climate models and of proxy-based reconstructions, even at small spatial scales

  19. Using simulation pedagogy to teach clinical education skills: A randomized trial.

    Science.gov (United States)

    Holdsworth, Clare; Skinner, Elizabeth H; Delany, Clare M

    2016-05-01

    Supervision of students is a key role of senior physiotherapy clinicians in teaching hospitals. The objective of this study was to test the effect of simulated learning environments (SLE) on educators' self-efficacy in student supervision skills. A pilot prospective randomized controlled trial with concealed allocation was conducted. Clinical educators were randomized to intervention (SLE) or control groups. SLE participants completed two 3-hour workshops, which included simulated clinical teaching scenarios, and facilitated debrief. Standard Education (StEd) participants completed two online learning modules. Change in educator clinical supervision self-efficacy (SE) and student perceptions of supervisor skill were calculated. Between-group comparisons of SE change scores were analyzed with independent t-tests to account for potential baseline differences in education experience. Eighteen educators (n = 18) were recruited (SLE [n = 10], StEd [n = 8]). Significant improvements in SE change scores were seen in SLE participants compared to control participants in three domains of self-efficacy: (1) talking to students about supervision and learning styles (p = 0.01); (2) adapting teaching styles for students' individual needs (p = 0.02); and (3) identifying strategies for future practice while supervising students (p = 0.02). This is the first study investigating SLE for teaching skills of clinical education. SLE improved educators' self-efficacy in three domains of clinical education. Sample size limited the interpretation of student ratings of educator supervision skills. Future studies using SLE would benefit from future large multicenter trials evaluating its effect on educators' teaching skills, student learning outcomes, and subsequent effects on patient care and health outcomes.

  20. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  1. Sodium bicarbonate supplementation prevents skilled tennis performance decline after a simulated match

    Directory of Open Access Journals (Sweden)

    Huang Ming-Hsiang

    2010-10-01

    Full Text Available Abstract The supplementation of sodium bicarbonate (NaHCO3 could increase performance or delay fatigue in intermittent high-intensity exercise. Prolonged tennis matches result in fatigue, which impairs skilled performance. The aim of this study was to investigate the effect of NaHCO3 supplementation on skilled tennis performance after a simulated match. Nine male college tennis players were recruited for this randomized cross-over, placebo-controlled, double-blind study. The participants consumed NaHCO3 (0.3 g. kg-1 or NaCl (0.209 g. kg-1 before the trial. An additional supplementation of 0.1 g. kg-1 NaHCO3 or 0.07 g. kg-1 NaCl was ingested after the third game in the simulated match. The Loughborough Tennis Skill Test was performed before and after the simulated match. Post-match [HCO3-] and base excess were significantly higher in the bicarbonate trial than those in the placebo trial. Blood [lactate] was significantly increased in the placebo (pre: 1.22 ± 0.54; post: 2.17 ± 1.46 mM and bicarbonate (pre: 1.23 ± 0.41; post: 3.21 ± 1.89 mM trials. The match-induced change in blood [lactate] was significantly higher in the bicarbonate trial. Blood pH remained unchanged in the placebo trial (pre: 7.37 ± 0.32; post: 7.37 ± 0.14 but was significantly increased in the bicarbonate trial (pre: 7.37 ± 0.26; post: 7.45 ± 0.63, indicating a more alkaline environment. The service and forehand ground stroke consistency scores were declined significantly after the simulated match in the placebo trial, while they were maintained in the bicarbonate trial. The match-induced declines in the consistency scores were significantly larger in the placebo trial than those in the bicarbonate trial. This study suggested that NaHCO3 supplementation could prevent the decline in skilled tennis performance after a simulated match.

  2. Instructional Model and Thinking Skill in Chemistry Class

    Science.gov (United States)

    Langkudi, H. H.

    2018-02-01

    Chemistry course are considered a difficult lesson for students as evidenced by low learning outcomes on daily tests, mid-semester tests as well as final semester tests. This research intended to investigate the effect of instructional model, thinking skill and the interaction of these variables on students’ achievement in chemistry. Experimental method was applying used 2 x 2 factorial design. The results showed that the use of instructional model with thinking skill influences student’s learning outcomes, so that the chemistry teacher is recommended to pay attention to the learning model, and adjusted to the student’s skill thinking on the chemistry material being taught. The conclusion of this research is that discovery model is suitable for students who have formal thinking skill and conventional model is fit for the students that have concrete thinking skill.

  3. 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.

  4. Innovative integrative bedside teaching model improves tutors’ self-assessments of teaching skills and attitudes

    Directory of Open Access Journals (Sweden)

    Itai Gat

    2016-02-01

    Full Text Available Introduction: Patient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST practiced during tutor training workshop and its resulting effect on practitioners’ self assessment of teaching skills and perceptions. Methods: One-day tutor training workshop included theoretical knowledge supplementation regarding tutors’ roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared. Results: Analysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5 compared with pre-training (mean 2.6, SD 0.6; p<0.001 with significant increase in most examined parameters. Significantly improved tutor's roles internalization was demonstrated after training completion (mean 3.7, SD 0.3 compared with pre-workshop (mean 3.5 SD 0.5; p=0.002. Discussion: Successful BST involves combination of clinical and communication skills. BST model practiced during the workshop may contribute to improved teaching skills in this challenging environment.

  5. 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

  6. Evaluation of leadership skills during the simulation education course for the initial management of blunt trauma.

    Science.gov (United States)

    Schott, Eric; Brautigam, Robert T; Smola, Jacqueline; Burns, Karyl J

    2012-04-01

    Leadership skills of senior residents, trauma fellows, and a nurse practitioner were assessed during simulation training for the initial management of blunt trauma. This was a pilot, observational study, that in addition to skill development and assessment also sought to determine the need for a dedicated leadership training course for surgical residents. The study evaluated the leadership skills and adherence to Advance Trauma Life Support (ATLS) guidelines of the team leaders during simulation training. The team leaders' performances on criteria regarding prearrival planning, critical actions based on ATLS, injury identification, patient management, and communication were evaluated for each of five blunt-trauma scenarios. Although there was a statistically significant increase in leadership skills for performing ATLS critical actions, P skills for team leadership willbe a worthwhile endeavor at our institution.

  7. First of all: Do not harm! Use of simulation for the training of regional anaesthesia techniques: Which skills can be trained without the patient as substitute for a mannequin.

    Science.gov (United States)

    Sujatta, Susanne

    2015-03-01

    Character of clinical skills training is always influenced by technical improvement and cultural changes. Over the last years, two trends have changed the way of traditional apprenticeship-style training in regional anaesthesia: firstly, the development in ultrasound-guided regional anaesthesia, and secondly, the reduced acceptance of using patients as mannequins for invasive techniques. Against this background, simulation techniques are explored, ranging from simple low-fidelity part-task training models to train skills in needle application, to highly sophisticated virtual reality models – the full range is covered. This review tries to discuss all available options with benefits and neglects. The task in clinical practice will be in choosing the right level of sophistication for the desired approach and trainee level. However, the transfer of simulated skills to clinical practice has not been evaluated. It has to be proven whether simulation-trained skills could, as a last consequence, reduce the risk to patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.

    Science.gov (United States)

    McKenzie, Carly T; Tilashalski, Ken R; Peterson, Dawn Taylor; White, Marjorie Lee

    2017-10-01

    The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

  9. Surgical simulation: Current practices and future perspectives for technical skills training.

    Science.gov (United States)

    Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

    2018-06-17

    Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

  10. Effect of music on surgical skill during simulated intraocular surgery.

    Science.gov (United States)

    Kyrillos, Ralph; Caissie, Mathieu

    2017-12-01

    To evaluate the effect of Mozart music compared to silence on anterior segment surgical skill in the context of simulated intraocular surgery. Prospective stratified and randomized noninferiority trial. Fourteen ophthalmologists and 12 residents in ophthalmology. All participants were asked to perform 4 sets of predetermined tasks on the EyeSI surgical simulator (VRmagic, Mannheim, Germany). The participants completed 1 Capsulorhexis task and 1 Anti-Tremor task during 3 separate visits. The first 2 sets determined the basic level on day 1. Then, the participants were stratified by surgical experience and randomized to be exposed to music (Mozart sonata for 2 pianos in D-K448) during either the third or the fourth set of tasks (day 2 or 3). Surgical skill was evaluated using the parameters recorded by the simulator such as "Total score" and "Time" for both tasks and task-specific parameters such as "Out of tolerance percentage" for the Anti-Tremor task and "Deviation of rhexis radius from 2.5 mm," "Roundness," and "Centering" for the Capsulorhexis task. The data were analyzed using the Wilcoxon signed-rank test. No statistically significant differences were noted between exposure and nonexposure for all the Anti-Tremor task parameters as well as most parameters for the Capsulorhexis task. Two parameters for the Capsulorhexis task showed a strong trend for improvement with exposure to music ("Total score" +23.3%, p = 0.025; "Roundness" +33.0%, p = 0.037). Exposure to music did not negatively impact surgical skills. Moreover, a trend for improvement was shown while listening to Mozart music. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  11. Prior video game utilization is associated with improved performance on a robotic skills simulator.

    Science.gov (United States)

    Harbin, Andrew C; Nadhan, Kumar S; Mooney, James H; Yu, Daohai; Kaplan, Joshua; McGinley-Hence, Nora; Kim, Andrew; Gu, Yiming; Eun, Daniel D

    2017-09-01

    Laparoscopic surgery and robotic surgery, two forms of minimally invasive surgery (MIS), have recently experienced a large increase in utilization. Prior studies have shown that video game experience (VGE) may be associated with improved laparoscopic surgery skills; however, similar data supporting a link between VGE and proficiency on a robotic skills simulator (RSS) are lacking. The objective of our study is to determine whether volume or timing of VGE had any impact on RSS performance. Pre-clinical medical students completed a comprehensive questionnaire detailing previous VGE across several time periods. Seventy-five subjects were ultimately evaluated in 11 training exercises on the daVinci Si Skills Simulator. RSS skill was measured by overall score, time to completion, economy of motion, average instrument collision, and improvement in Ring Walk 3 score. Using the nonparametric tests and linear regression, these metrics were analyzed for systematic differences between non-users, light, and heavy video game users based on their volume of use in each of the following four time periods: past 3 months, past year, past 3 years, and high school. Univariate analyses revealed significant differences between heavy and non-users in all five performance metrics. These trends disappeared as the period of VGE went further back. Our study showed a positive association between video game experience and robotic skills simulator performance that is stronger for more recent periods of video game use. The findings may have important implications for the evolution of robotic surgery training.

  12. 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.

  13. Skill and independence weighting for multi-model assessments

    International Nuclear Information System (INIS)

    Sanderson, Benjamin M.; Wehner, Michael; Knutti, Reto

    2017-01-01

    We present a weighting strategy for use with the CMIP5 multi-model archive in the fourth National Climate Assessment, which considers both skill in the climatological performance of models over North America as well as the inter-dependency of models arising from common parameterizations or tuning practices. The method exploits information relating to the climatological mean state of a number of projection-relevant variables as well as metrics representing long-term statistics of weather extremes. The weights, once computed can be used to simply compute weighted means and significance information from an ensemble containing multiple initial condition members from potentially co-dependent models of varying skill. Two parameters in the algorithm determine the degree to which model climatological skill and model uniqueness are rewarded; these parameters are explored and final values are defended for the assessment. The influence of model weighting on projected temperature and precipitation changes is found to be moderate, partly due to a compensating effect between model skill and uniqueness. However, more aggressive skill weighting and weighting by targeted metrics is found to have a more significant effect on inferred ensemble confidence in future patterns of change for a given projection.

  14. [Simulation training in surgical education - application of virtual reality laparoscopic simulators in a surgical skills course].

    Science.gov (United States)

    Lehmann, K S; Gröne, J; Lauscher, J C; Ritz, J-P; Holmer, C; Pohlen, U; Buhr, H-J

    2012-04-01

    Training and simulation are gaining importance in surgical education. Today, virtual reality surgery simulators provide sophisticated laparoscopic training scenarios and offer detailed assessment methods. This also makes simulators interesting for the application in surgical skills courses. The aim of the current study was to assess the suitability of a virtual surgery simulator for training and assessment in an established surgical training course. The study was conducted during the annual "Practical Course for Visceral Surgery" (Warnemuende, Germany). 36 of 108 course participants were assigned at random for the study. Training was conducted in 15 sessions over 5 days with 4 identical virtual surgery simulators (LapSim) and 2 standardised training tasks. The simulator measured 16 individual parameters and calculated 2 scores. Questionnaires were used to assess the test persons' laparoscopic experience, their training situation and the acceptance of the simulator training. Data were analysed with non-parametric tests. A subgroup analysis for laparoscopic experience was conducted in order to assess the simulator's construct validity and assessment capabilities. Median age was 32 (27 - 41) years; median professional experience was 3 (1 - 11) years. Typical laparoscopic learning curves with initial significant improvements and a subsequent plateau phase were measured over 5 days. The individual training sessions exhibited a rhythmic variability in the training results. A shorter night's sleep led to a marked drop in performance. The participants' different experience levels could clearly be discriminated ( ≤ 20 vs. > 20 laparoscopic operations; p ≤ 0.001). The questionnaire showed that the majority of the participants had limited training opportunities in their hospitals. The simulator training was very well accepted. However, the participants severely misjudged the real costs of the simulators that were used. The learning curve on the

  15. The effect of a simulation training package on skill acquisition for duplex arterial stenosis detection.

    Science.gov (United States)

    Jaffer, Usman; Normahani, Pasha; Singh, Prashant; Aslam, Mohammed; Standfield, Nigel J

    2015-01-01

    In vascular surgery, duplex ultrasonography is a valuable diagnostic tool in patients with peripheral vascular disease, and there is increasing demand for vascular surgeons to be able to perform duplex scanning. This study evaluates the role of a novel simulation training package on vascular ultrasound (US) skill acquisition. A total of 19 novices measured predefined stenosis in a simulated pulsatile vessel using both peak systolic velocity ratio (PSVR) and diameter reduction (DR) methods before and after a short period of training using a simulated training package. The training package consisted of a simulated pulsatile vessel phantom, a set of instructional videos, duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool, and a portable US scanner. Quantitative metrics (procedure time, percentage error using PSVR and DR methods, DUOSAT scores, and global rating scores) before and after training were compared. Subjects spent a median time of 144 mins (IQR: 60-195) training using the simulation package. Subjects exhibited statistically significant improvements when comparing pretraining and posttraining DUOSAT scores (pretraining = 17 [16-19.3] vs posttraining = 30 [27.8-31.8]; p duplex images in a pulsatile simulated phantom following a short period of goal direct training using a simulation training package. A simulation training package may be a valuable tool for integration into a vascular training program. However, further work is needed to explore whether these newly attained skills are translated into clinical assessment. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  16. Validation of a novel basic virtual reality simulator, the LAP-X, for training basic laparoscopic skills.

    Science.gov (United States)

    Kawaguchi, Koji; Egi, Hiroyuki; Hattori, Minoru; Sawada, Hiroyuki; Suzuki, Takahisa; Ohdan, Hideki

    2014-10-01

    Virtual reality surgical simulators are becoming popular as a means of providing trainees with an opportunity to practice laparoscopic skills. The Lap-X (Epona Medical, Rotterdam, the Netherlands) is a novel VR simulator for training basic skills in laparoscopic surgery. The objective of this study was to validate the LAP-X laparoscopic virtual reality simulator by assessing the face and construct validity in order to determine whether the simulator is adequate for basic skills training. The face and content validity were evaluated using a structured questionnaire. To assess the construct validity, the participants, nine expert surgeons (median age: 40 (32-45)) (>100 laparoscopic procedures) and 11 novices performed three basic laparoscopic tasks using the Lap-X. The participants reported a high level of content validity. No significant differences were found between the expert surgeons and the novices (Ps > 0.246). The performance of the expert surgeons on the three tasks was significantly better than that of the novices in all parameters (Ps training device.

  17. Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management.

    Science.gov (United States)

    Jirativanont, T; Raksamani, K; Aroonpruksakul, N; Apidechakul, P; Suraseranivongse, S

    2017-07-01

    We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants, composed of 24 PGY-1, 24 PGY-2 and 22 PGY-3 residents. Both instruments differentiated the non-technical skills of PGY-1 from PGY-3 residents ( P skills were 0.86, 0.83, 0.84, 0.87, 0.80 and 0.86, respectively. The Cronbach's alpha for internal consistency of the ANTS instrument was 0.93, and was 0.96 for the Ottawa GRS. There was a high correlation between the ANTS and Ottawa GRS. The raters reported the ease of use of the Ottawa GRS compared to the ANTS. We found sufficient evidence of validity in the ANTS instrument and the Ottawa GRS for the evaluation of non-technical skills in a simulated anaesthesia setting, but the Ottawa GRS was more practical and had higher reliability.

  18. The relationship between managerial skills and managerial effectiveness in a Managerial simulation game

    OpenAIRE

    Smutný Petr; Procházka Jakub; Vaculík Martin

    2016-01-01

    The study explores the relationship between managerial skills and managerial effectiveness, measuring managerial effectiveness by four different methods. Evaluation of 96 top managers of fictitious companies by a group of 1,746 subordinates took place after three months of intensive cooperation during a managerial simulation game. All respondents were college students. Results show that different managerial effectiveness indicators have different sets of managerial skills predictors: Group pe...

  19. Perception versus reality: a comparative study of the clinical judgment skills of nurses during a simulated activity.

    Science.gov (United States)

    Fenske, Cynthia L; Harris, Margaret A; Aebersold, Michelle L; Hartman, Laurie S

    2013-09-01

    This study was conducted to determine how closely nurses' perceptions of their clinical judgment abilities matched their demonstrated clinical judgment skills during a simulation. Seventy-four registered nurses participated in a simulation using a video format. After the simulation, the nurses self-assessed their performance using the Lasater Clinical Judgment Rubric. This rubric was then used to rate the nurses' actual performance in the simulation activity. The study results showed a significant discrepancy between nurses' perceptions of their own clinical judgment abilities and their demonstrated clinical judgment skills. Age and length of nursing experience enhanced the difference between the findings of self-assessment and actual performance. Younger nurses and those with 1 year or less of nursing experience were significantly more likely to have self-assessed their abilities at a much higher level compared with their actual skills. Copyright 2013, SLACK Incorporated.

  20. Retention of skills 2 years after completion of a postpartum hemorrhage simulation training program in rural Rwanda.

    Science.gov (United States)

    Nathan, Lisa M; Patauli, Desire; Nsabimana, Damien; Bernstein, Peter S; Rulisa, Stephen; Goffman, Dena

    2016-09-01

    To evaluate the long-term retention of skills gained by rural physicians who completed a postpartum hemorrhage simulation-training program. A quasi-experimental pre-post intervention study enrolled a convenience sample of generalist physicians in rural Rwanda. Participants underwent initial simulation training including pre- and post-training testing in February 2012. Simulation drills to assess skill retention were conducted in March 2014. Participants were scored based on their communication, evaluation, and management skills. Median scores and inter-quartile ranges were calculated and the Wilcoxon signed-rank sum test was used to compare the pre-training, post-training, and retention scores. Physician confidence was assessed using a survey. In total, 11 physicians were enrolled; eight were available for the 2-year skill-retention evaluation. Significant improvements were observed when comparing participants' pre-training and post-training communication (P=0.03), evaluation (P=0.05), and management (P=0.02) scores, and there were no changes between participants' post-training and 2-year communication (P>0.99), evaluation (P=0.16), and management (P=0.46) scores. There were no differences in the self-reported confidence measures across the duration of the study. Simulation training is an effective method for teaching postpartum hemorrhage-management skills to generalist physicians in rural areas and skills are retained for at least 2 years. Further studies could determine the optimal time intervals for refresher training. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Implementing a Cardiac Skills Orientation and Simulation Program.

    Science.gov (United States)

    Hemingway, Maureen W; Osgood, Patrice; Mannion, Mildred

    2018-02-01

    Patients with cardiac morbidities admitted for cardiac surgical procedures require perioperative nurses with a high level of complex nursing skills. Orienting new cardiac team members takes commitment and perseverance in light of variable staffing levels, high-acuity patient populations, an active cardiac surgical schedule, and the unpredictability of scheduling patients undergoing cardiac transplantation. At an academic medical center in Boston, these issues presented opportunities to orient new staff members to the scrub person role, but hampered efforts to provide active learning opportunities in a safe environment. As a result, facility personnel created a program to increase new staff members' skills, confidence, and proficiency, while also increasing the number of staff members who were proficient at scrubbing complex cardiac procedures. To address the safe learning requirement, personnel designed a simulation program to provide scrubbing experience, decrease orientees' supervision time, and increase staff members' confidence in performing the scrub person role. © AORN, Inc, 2018.

  2. On the influence of model physics on simulations of Arctic and Antarctic sea ice

    Directory of Open Access Journals (Sweden)

    F. Massonnet

    2011-09-01

    Full Text Available Two hindcast (1983–2007 simulations are performed with the global, ocean-sea ice models NEMO-LIM2 and NEMO-LIM3 driven by atmospheric reanalyses and climatologies. The two simulations differ only in their sea ice component, while all other elements of experimental design (resolution, initial conditions, atmospheric forcing are kept identical. The main differences in the sea ice models lie in the formulation of the subgrid-scale ice thickness distribution, of the thermodynamic processes, of the sea ice salinity and of the sea ice rheology. To assess the differences in model skill over the period of investigation, we develop a set of metrics for both hemispheres, comparing the main sea ice variables (concentration, thickness and drift to available observations and focusing on both mean state and seasonal to interannual variability. Based upon these metrics, we discuss the physical processes potentially responsible for the differences in model skill. In particular, we suggest that (i a detailed representation of the ice thickness distribution increases the seasonal to interannual variability of ice extent, with spectacular improvement for the simulation of the recent observed summer Arctic sea ice retreats, (ii the elastic-viscous-plastic rheology enhances the response of ice to wind stress, compared to the classical viscous-plastic approach, (iii the grid formulation and the air-sea ice drag coefficient affect the simulated ice export through Fram Strait and the ice accumulation along the Canadian Archipelago, and (iv both models show less skill in the Southern Ocean, probably due to the low quality of the reanalyses in this region and to the absence of important small-scale oceanic processes at the models' resolution (~1°.

  3. Learning health 'safety' within non-technical skills interprofessional simulation education: a qualitative study.

    Science.gov (United States)

    Gordon, Morris; Fell, Christopher W R; Box, Helen; Farrell, Michael; Stewart, Alison

    2017-01-01

    Healthcare increasingly recognises and focusses on the phenomena of 'safe practice' and 'patient safety.' Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of 'safety' amongst learners. Participants receiving a non-technical skills (NTS) safety focussed training package were invited to take part in a focus group interview which set out to explore communication, teamwork, and the phenomenon of safety in the context of the learning experiences they had within the training programme. The analysis was aligned with a constructivist paradigm and took an interactive methodological approach. The analysis proceeded through three stages, consisting of open, axial, and selective coding, with constant comparisons taking place throughout each phase. Each stage provided categories that could be used to explore the themes of the data. Additionally, to ensure thematic saturation, transcripts of observed simulated learning encounters were then analysed. Six themes were established at the axial coding level, i.e., analytical skills, personal behaviours, communication, teamwork, context, and pedagogy. Underlying these themes, two principal concepts emerged, namely: intergroup contact anxiety - as both a result of and determinant of communication - and teamwork, both of which must be considered in relation to context. These concepts have subsequently been used to propose a framework for NTS learning. This study highlights the role of intergroup contact anxiety and teamwork as factors in NTS behaviour and its dissipation through interprofessional simulation learning. Therefore, this should be a key consideration in NTS education. Future research is needed to consider the role of the affective non

  4. WDM Systems and Networks Modeling, Simulation, Design and Engineering

    CERN Document Server

    Ellinas, Georgios; Roudas, Ioannis

    2012-01-01

    WDM Systems and Networks: Modeling, Simulation, Design and Engineering provides readers with the basic skills, concepts, and design techniques used to begin design and engineering of optical communication systems and networks at various layers. The latest semi-analytical system simulation techniques are applied to optical WDM systems and networks, and a review of the various current areas of optical communications is presented. Simulation is mixed with experimental verification and engineering to present the industry as well as state-of-the-art research. This contributed volume is divided into three parts, accommodating different readers interested in various types of networks and applications. The first part of the book presents modeling approaches and simulation tools mainly for the physical layer including transmission effects, devices, subsystems, and systems), whereas the second part features more engineering/design issues for various types of optical systems including ULH, access, and in-building system...

  5. 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

  6. Evaluating the influence of goal setting on intravenous catheterization skill acquisition and transfer in a hybrid simulation training context.

    Science.gov (United States)

    Brydges, Ryan; Mallette, Claire; Pollex, Heather; Carnahan, Heather; Dubrowski, Adam

    2012-08-01

    Educators often simplify complex tasks by setting learning objectives that focus trainees on isolated skills rather than the holistic task. We designed 2 sets of learning objectives for intravenous catheterization using goal setting theory. We hypothesized that setting holistic goals related to technical, cognitive, and communication skills would result in superior holistic performance, whereas setting isolated goals related to technical skills would result in superior technical performance. We randomly assigned practicing health care professionals to set holistic (n = 14) or isolated (n = 15) goals. All watched an instructional video and studied a list of 9 goals specific to their group. Participants practiced independently in a hybrid simulation (standardized patient combined with an arm simulator). The first and the last practice trials were videotaped for analysis. One-week later, participants completed a transfer test in another hybrid simulation scenario. Blinded experts evaluated performance on all 3 trials using the Direct Observation of Procedural Skills tool. The holistic group scored higher than the isolated group on the holistic Direct Observation of Procedural Skills score for all 3 trials [mean (SD), 45.0 (9.16) vs. 38.4 (9.17); P = 0.01]. The isolated group did not perform better than the holistic group on the technical skills score [10.3 (2.73) vs. 11.6 (3.01); P = 0.11]. Our results suggest that asking learners to set holistic goals did not interfere with their attaining competent holistic and technical skills during hybrid simulation training. This exploratory trial provides preliminary evidence for how to consider integrating hybrid simulation into medical curricula and for the design of learning goals in simulation-based education.

  7. Developing model-making and model-breaking skills using direct measurement video-based activities

    Science.gov (United States)

    Vonk, Matthew; Bohacek, Peter; Militello, Cheryl; Iverson, Ellen

    2017-12-01

    This study focuses on student development of two important laboratory skills in the context of introductory college-level physics. The first skill, which we call model making, is the ability to analyze a phenomenon in a way that produces a quantitative multimodal model. The second skill, which we call model breaking, is the ability to critically evaluate if the behavior of a system is consistent with a given model. This study involved 116 introductory physics students in four different sections, each taught by a different instructor. All of the students within a given class section participated in the same instruction (including labs) with the exception of five activities performed throughout the semester. For those five activities, each class section was split into two groups; one group was scaffolded to focus on model-making skills and the other was scaffolded to focus on model-breaking skills. Both conditions involved direct measurement videos. In some cases, students could vary important experimental parameters within the video like mass, frequency, and tension. Data collected at the end of the semester indicate that students in the model-making treatment group significantly outperformed the other group on the model-making skill despite the fact that both groups shared a common physical lab experience. Likewise, the model-breaking treatment group significantly outperformed the other group on the model-breaking skill. This is important because it shows that direct measurement video-based instruction can help students acquire science-process skills, which are critical for scientists, and which are a key part of current science education approaches such as the Next Generation Science Standards and the Advanced Placement Physics 1 course.

  8. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program

    Science.gov (United States)

    Keleekai, Nowai L.; Schuster, Catherine A.; Murray, Connie L.; King, Mary Anne; Stahl, Brian R.; Labrozzi, Laura J.; Gallucci, Susan; LeClair, Matthew W.; Glover, Kevin R.

    2016-01-01

    Introduction Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. Methods The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. Results At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Conclusions Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored. PMID:27504890

  9. Impact of sleep deprivation on anaesthesia residents' non-technical skills: a pilot simulation-based prospective randomized trial.

    Science.gov (United States)

    Neuschwander, A; Job, A; Younes, A; Mignon, A; Delgoulet, C; Cabon, P; Mantz, J; Tesniere, A

    2017-07-01

    Sleep deprivation is common in anaesthesia residents, but its impact on performance remains uncertain. Non-technical skills (team working, situation awareness, decision making, and task management) are key components of quality of care in anaesthesia, particularly in crisis situations occurring in the operating room. The impact of sleep deprivation on non-technical skills is unknown. We tested the hypothesis that in anaesthesia residents sleep deprivation is associated with impaired non-technical skills. Twenty anaesthesia residents were randomly allocated to undergo a simulation session after a night shift [sleep-deprived (SLD) group, n =10] or after a night of rest [rested (R) group, n =10] from January to March 2015. The simulated scenario was a situation of crisis management in the operating room. The primary end point was a composite score of anaesthetists' non-technical skills (ANTS) assessed by two blinded evaluators. Non-technical skills were significantly impaired in the SLD group [ANTS score 12.2 (interquartile range 10.5-13)] compared with the R group [14.5 (14-15), P technical skills of anaesthesia residents in a simulated anaesthesia intraoperative crisis scenario. NCT02622217. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  10. Design of a Screen Based Simulation for Training and Automated Assessment of Teamwork Skills

    Science.gov (United States)

    2017-08-01

    assessable teamwork skills and actions that were identified. Since the last quarterly report, a few modifications regarding the relationship ...and team’s) medical actions and decision-making. Like with the development of so many pedagogical games and simulations, educators can find...approach offers utility not only to team training simulation, but to any pedagogical simulation development. References Douglass, B. P. (2016

  11. Simulation for the training of human performance and technical skills: the intersection of how we will train health care professionals in the future.

    Science.gov (United States)

    Hamman, William R; Beaubien, Jeffrey M; Beaudin-Seiler, Beth M

    2009-12-01

    The aims of this research are to begin to understand health care teams in their operational environment, establish metrics of performance for these teams, and validate a series of scenarios in simulation that elicit team and technical skills. The focus is on defining the team model that will function in the operational environment in which health care professionals work. Simulations were performed across the United States in 70- to 1000-bed hospitals. Multidisciplinary health care teams analyzed more than 300 hours of videos of health care professionals performing simulations of team-based medical care in several different disciplines. Raters were trained to enhance inter-rater reliability. The study validated event sets that trigger team dynamics and established metrics for team-based care. Team skills were identified and modified using simulation scenarios that employed the event-set-design process. Specific skills (technical and team) were identified by criticality measurement and task analysis methodology. In situ simulation, which includes a purposeful and Socratic Method of debriefing, is a powerful intervention that can overcome inertia found in clinician behavior and latent environmental systems that present a challenge to quality and patient safety. In situ simulation can increase awareness of risks, personalize the risks, and encourage the reflection, effort, and attention needed to make changes to both behaviors and to systems.

  12. Use of static picture prompts versus video modeling during simulation instruction.

    Science.gov (United States)

    Alberto, Paul A; Cihak, David F; Gama, Robert I

    2005-01-01

    The purpose of this study was to compare the effectiveness and efficiency of static picture prompts and video modeling as classroom simulation strategies in combination with in vivo community instruction. Students with moderate intellectual disabilities were instructed in the tasks of withdrawing money from an ATM and purchasing items using a debit card. Both simulation strategies were effective and efficient at teaching the skills. The two simulation strategies were not functionally different in terms of number of trials to acquisition, number of errors, and number of instructional sessions to criterion.

  13. Computer simulations in the high school: students' cognitive stages, science process skills and academic achievement in microbiology

    Science.gov (United States)

    Huppert, J.; Michal Lomask, S.; Lazarowitz, R.

    2002-08-01

    Computer-assisted learning, including simulated experiments, has great potential to address the problem solving process which is a complex activity. It requires a highly structured approach in order to understand the use of simulations as an instructional device. This study is based on a computer simulation program, 'The Growth Curve of Microorganisms', which required tenth grade biology students to use problem solving skills whilst simultaneously manipulating three independent variables in one simulated experiment. The aims were to investigate the computer simulation's impact on students' academic achievement and on their mastery of science process skills in relation to their cognitive stages. The results indicate that the concrete and transition operational students in the experimental group achieved significantly higher academic achievement than their counterparts in the control group. The higher the cognitive operational stage, the higher students' achievement was, except in the control group where students in the concrete and transition operational stages did not differ. Girls achieved equally with the boys in the experimental group. Students' academic achievement may indicate the potential impact a computer simulation program can have, enabling students with low reasoning abilities to cope successfully with learning concepts and principles in science which require high cognitive skills.

  14. A major trauma course based on posters, audio-guides and simulation improves the management skills of medical students: Evaluation via medical simulator.

    Science.gov (United States)

    Cuisinier, Adrien; Schilte, Clotilde; Declety, Philippe; Picard, Julien; Berger, Karine; Bouzat, Pierre; Falcon, Dominique; Bosson, Jean Luc; Payen, Jean-François; Albaladejo, Pierre

    2015-12-01

    Medical competence requires the acquisition of theoretical knowledge and technical skills. Severe trauma management teaching is poorly developed during internship. Nevertheless, the basics of major trauma management should be acquired by every future physician. For this reason, the major trauma course (MTC), an educational course in major traumatology, has been developed for medical students. Our objective was to evaluate, via a high fidelity medical simulator, the impact of the MTC on medical student skills concerning major trauma management. The MTC contains 3 teaching modalities: posters with associated audio-guides, a procedural workshop on airway management and a teaching session using a medical simulator. Skills evaluation was performed 1 month before (step 1) and 1 month after (step 3) the MTC (step 2). Nineteen students were individually evaluated on 2 different major trauma scenarios. The primary endpoint was the difference between steps 1 and 3, in a combined score evaluating: admission, equipment, monitoring and safety (skill set 1) and systematic clinical examinations (skill set 2). After the course, the combined primary outcome score improved by 47% (P<0.01). Scenario choice or the order of use had no significant influence on the skill set evaluations. This study shows improvement in student skills for major trauma management, which we attribute mainly to the major trauma course developed in our institution. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  15. Incorporating simulation into gynecologic surgical training.

    Science.gov (United States)

    Wohlrab, Kyle; Jelovsek, J Eric; Myers, Deborah

    2017-11-01

    Today's educational environment has made it more difficult to rely on the Halstedian model of "see one, do one, teach one" in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted learning from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training. We review high- and low-fidelity surgical simulators, discuss the progression of surgical skills, and provide options for skills competency assessment. Time and money are major hurdles when designing a simulation curriculum, but low-fidelity models, intradepartmental cost sharing, and utilizing local experts for simulation proctoring can aid in developing a simulation program. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Modeling attacking of high skills volleyball players

    Directory of Open Access Journals (Sweden)

    Vladimir Gamaliy

    2014-12-01

    Full Text Available Purpose: to determine the model indicators of technical and tactical actions in the attack highly skilled volleyball players. Material and Methods: the study used statistical data of major international competitions: Olympic Games – 2012 World Championships – 2010, World League – 2010–2014 European Championship – 2010–2014. A total of 130 analyzed games. Methods were used: analysis and generalization of scientific and methodological literature, analysis of competitive activity highly skilled volleyball players, teacher observation, modeling technical and tactical actions in attacking highly skilled volleyball players. Results: it was found that the largest volume application of technical and tactical actions in the attack belongs to the group tactics «supple movement», whose indicator is 21,3%. The smallest amount of application belongs to the group tactics «flight level» model whose indicators is 5,4%, the efficiency of 3,4%, respectively. It is found that the power service in the jump from model parameters used in 51,6% of cases, the planning targets – 21,7% and 4,4% planning to reduce. Attacks performed with the back line, on model parameters used in the amount of 20,8% efficiency –13,7%. Conclusions: we prove that the performance of technical and tactical actions in the attack can be used as model in the control system of training and competitive process highly skilled volleyball players

  17. Multi-material 3D Models for Temporal Bone Surgical Simulation.

    Science.gov (United States)

    Rose, Austin S; Kimbell, Julia S; Webster, Caroline E; Harrysson, Ola L A; Formeister, Eric J; Buchman, Craig A

    2015-07-01

    A simulated, multicolor, multi-material temporal bone model can be created using 3-dimensional (3D) printing that will prove both safe and beneficial in training for actual temporal bone surgical cases. As the process of additive manufacturing, or 3D printing, has become more practical and affordable, a number of applications for the technology in the field of Otolaryngology-Head and Neck Surgery have been considered. One area of promise is temporal bone surgical simulation. Three-dimensional representations of human temporal bones were created from temporal bone computed tomography (CT) scans using biomedical image processing software. Multi-material models were then printed and dissected in a temporal bone laboratory by attending and resident otolaryngologists. A 5-point Likert scale was used to grade the models for their anatomical accuracy and suitability as a simulation of cadaveric and operative temporal bone drilling. The models produced for this study demonstrate significant anatomic detail and a likeness to human cadaver specimens for drilling and dissection. Simulated temporal bones created by this process have potential benefit in surgical training, preoperative simulation for challenging otologic cases, and the standardized testing of temporal bone surgical skills. © The Author(s) 2015.

  18. Assessment of skills using a virtual reality temporal bone surgery simulator.

    Science.gov (United States)

    Linke, R; Leichtle, A; Sheikh, F; Schmidt, C; Frenzel, H; Graefe, H; Wollenberg, B; Meyer, J E

    2013-08-01

    Surgery on the temporal bone is technically challenging due to its complex anatomy. Precise anatomical dissection of the human temporal bone is essential and is fundamental for middle ear surgery. We assessed the possible application of a virtual reality temporal bone surgery simulator to the education of ear surgeons. Seventeen ENT physicians with different levels of surgical training and 20 medical students performed an antrotomy with a computer-based virtual temporal bone surgery simulator. The ease, accuracy and timing of the simulated temporal bone surgery were assessed using the automatic assessment software provided by the simulator device and additionally with a modified Final Product Analysis Scale. Trained ENT surgeons, physicians without temporal bone surgical training and medical students were all able to perform the antrotomy. However, the highly trained ENT surgeons were able to complete the surgery in approximately half the time, with better handling and accuracy as assessed by the significant reduction in injury to important middle ear structures. Trained ENT surgeons achieved significantly higher scores using both dissection analysis methods. Surprisingly, there were no significant differences in the results between medical students and physicians without experience in ear surgery. The virtual temporal bone training system can stratify users of known levels of experience. This system can be used not only to improve the surgical skills of trained ENT surgeons for more successful and injury-free surgeries, but also to train inexperienced physicians/medical students in developing their surgical skills for the ear.

  19. Use of simulated patients to develop communication skills in nursing education: An integrative review.

    Science.gov (United States)

    MacLean, Sharon; Kelly, Michelle; Geddes, Fiona; Della, Phillip

    2017-01-01

    Registered nurses are expected to communicate effectively with patients. To improve on this skill education programmes in both hospital and tertiary settings are increasingly turning to simulation modalities when training undergraduate and registered nurses. The roles simulated patients (SPs) assume can vary according to training purposes and approach. The first aim is to analyse how SPs are used in nursing education to develop communication skills. The second aim is to evaluate the evidence that is available to support the efficacy of using SPs for training nurses in communication skills and finally to review the SP recruitment and training procedure. An Integrative review. A search was conducted on CINAHL, Psych-info, PubMed, Google Scholar, Scopus, Ovid, Medline, and ProQuest databases. Keywords and inclusion/exclusion criteria were determined and applied to the search strategy. The integrative review included Nineteen studies from 2006-2016. Critical Appraisal Skills Program (CASP) method of evaluation was utilised. Emergent themes were extracted with similar and divergent perspectives. Analysis identified seven clinical contexts for communication skills training (CST) and two SP roles from the eighteen studies. SPs were either directly involved in the teaching of communication (active role) or used in the evaluation of the effectiveness of a communication skills program (passive role). A majority of studies utilised faculty-designed measurement instruments. The evidence presented in the 19 articles indicates that the use of SPs to teach nurse-patient communication skills targets more challenging clinical interactions. Engaging SPs in both CST program facilitation and course evaluation provides nurse educators with a strong foundation to develop further pedagogical and research capacity. Expanding the utilisation of SPs to augment nurses' communication skills and ability to engage with patients in a broader range of clinical contexts with increased

  20. Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

    Science.gov (United States)

    Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

    2017-12-19

    To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p Technical performance scores correlated with NOTSS scores (p technical performance (p technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Modeling and simulating human teamwork behaviors using intelligent agents

    Science.gov (United States)

    Fan, Xiaocong; Yen, John

    2004-12-01

    Among researchers in multi-agent systems there has been growing interest in using intelligent agents to model and simulate human teamwork behaviors. Teamwork modeling is important for training humans in gaining collaborative skills, for supporting humans in making critical decisions by proactively gathering, fusing, and sharing information, and for building coherent teams with both humans and agents working effectively on intelligence-intensive problems. Teamwork modeling is also challenging because the research has spanned diverse disciplines from business management to cognitive science, human discourse, and distributed artificial intelligence. This article presents an extensive, but not exhaustive, list of work in the field, where the taxonomy is organized along two main dimensions: team social structure and social behaviors. Along the dimension of social structure, we consider agent-only teams and mixed human-agent teams. Along the dimension of social behaviors, we consider collaborative behaviors, communicative behaviors, helping behaviors, and the underpinning of effective teamwork-shared mental models. The contribution of this article is that it presents an organizational framework for analyzing a variety of teamwork simulation systems and for further studying simulated teamwork behaviors.

  2. Specifying and Refining a Measurement Model for a Simulation-Based Assessment. CSE Report 619.

    Science.gov (United States)

    Levy, Roy; Mislevy, Robert J.

    2004-01-01

    The challenges of modeling students' performance in simulation-based assessments include accounting for multiple aspects of knowledge and skill that arise in different situations and the conditional dependencies among multiple aspects of performance in a complex assessment. This paper describes a Bayesian approach to modeling and estimating…

  3. Testing the skill of numerical hydraulic modeling to simulate spatiotemporal flooding patterns in the Logone floodplain, Cameroon

    Science.gov (United States)

    Fernández, Alfonso; Najafi, Mohammad Reza; Durand, Michael; Mark, Bryan G.; Moritz, Mark; Jung, Hahn Chul; Neal, Jeffrey; Shastry, Apoorva; Laborde, Sarah; Phang, Sui Chian; Hamilton, Ian M.; Xiao, Ningchuan

    2016-08-01

    Recent innovations in hydraulic modeling have enabled global simulation of rivers, including simulation of their coupled wetlands and floodplains. Accurate simulations of floodplains using these approaches may imply tremendous advances in global hydrologic studies and in biogeochemical cycling. One such innovation is to explicitly treat sub-grid channels within two-dimensional models, given only remotely sensed data in areas with limited data availability. However, predicting inundated area in floodplains using a sub-grid model has not been rigorously validated. In this study, we applied the LISFLOOD-FP hydraulic model using a sub-grid channel parameterization to simulate inundation dynamics on the Logone River floodplain, in northern Cameroon, from 2001 to 2007. Our goal was to determine whether floodplain dynamics could be simulated with sufficient accuracy to understand human and natural contributions to current and future inundation patterns. Model inputs in this data-sparse region include in situ river discharge, satellite-derived rainfall, and the shuttle radar topography mission (SRTM) floodplain elevation. We found that the model accurately simulated total floodplain inundation, with a Pearson correlation coefficient greater than 0.9, and RMSE less than 700 km2, compared to peak inundation greater than 6000 km2. Predicted discharge downstream of the floodplain matched measurements (Nash-Sutcliffe efficiency of 0.81), and indicated that net flow from the channel to the floodplain was modeled accurately. However, the spatial pattern of inundation was not well simulated, apparently due to uncertainties in SRTM elevations. We evaluated model results at 250, 500 and 1000-m spatial resolutions, and found that results are insensitive to spatial resolution. We also compared the model output against results from a run of LISFLOOD-FP in which the sub-grid channel parameterization was disabled, finding that the sub-grid parameterization simulated more realistic

  4. Simulation training using cadaver sheep chest in pleuroscopy - A step towards skills enhancement

    International Nuclear Information System (INIS)

    Mahmud, T.; Saqib, M.; Nasir, T.; Siddique, N.

    2017-01-01

    Objectives: For assessing the use of if simulation training on animal cadavers as a useful tool for training in pleuroscopy. Methods: The email-based cross-sectional study was conducted in December 2014 at Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan, and comprised respiratory physicians and trainees after their participation in a two-day hands-on training course on pleuroscopy and pleural medical procedures. The responses were analysed and the responses of physicians and trainees were compared. Results: Of the 44 individuals who attended the course and were contacted through emails, 38(86.4%) responded, including 20(52.6%) physicians and 18(47.3%) trainees. All the 38(100%) subjects uniformly accepted the utility of simulation training in enhancing education, improving skill, and improving confidence by repeated practice, and felt that the inclusion of animal models for learning fundamental pleuroscopic procedures can help a lot in teaching. Conclusion: Animal cadavers can be used as an effective teaching tool for pleuroscopy training. (author)

  5. The Development of a Novel Perfused Cadaver Model With Dynamic Vital Sign Regulation and Real-World Scenarios to Teach Surgical Skills and Error Management.

    Science.gov (United States)

    Minneti, Michael; Baker, Craig J; Sullivan, Maura E

    The landscape of graduate medical education has changed dramatically over the past decade and the traditional apprenticeship model has undergone scrutiny and modifications. The mandate of the 80-hour work-week, the introduction of integrated residency programs, increased global awareness about patient safety along with financial constraints have spurred changes in graduate educational practices. In addition, new technologies, more complex procedures, and a host of external constraints have changed where and how we teach technical and procedural skills. Simulation-based training has been embraced by the surgical community and has quickly become an essential component of most residency programs as a method to add efficacy to the traditional learning model. The purpose of this paper is twofold: (1) to describe the development of a perfused cadaver model with dynamic vital sign regulation, and (2) to assess the impact of a curriculum using this model and real world scenarios to teach surgical skills and error management. By providing a realistic training environment our aim is to enhance the acquisition of surgical skills and provide a more thorough assessment of resident performance. Twenty-six learners participated in the scenarios. Qualitative data showed that participants felt that the simulation model was realistic, and that participating in the scenarios helped them gain new knowledge, learn new surgical techniques and increase their confidence performing the skill in a clinical setting. Identifying the importance of both technical and nontechnical skills in surgical education has hastened the need for more realistic simulators and environments in which they are placed. Team members should be able to interact in ways that allow for a global display of their skills thus helping to provide a more comprehensive assessment by faculty and learners. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. A serious game skills competition increases voluntary usage and proficiency of a virtual reality laparoscopic simulator during first-year surgical residents' simulation curriculum.

    Science.gov (United States)

    El-Beheiry, Mostafa; McCreery, Greig; Schlachta, Christopher M

    2017-04-01

    The objective of this study was to assess the effect of a serious game skills competition on voluntary usage of a laparoscopic simulator among first-year surgical residents' standard simulation curriculum. With research ethics board approval, informed consent was obtained from first-year surgical residents enrolled in an introductory surgical simulation curriculum. The class of 2013 served as a control cohort following the standard curriculum which mandates completion of six laparoscopic simulator skill tasks. For the 2014 competition cohort, the only change introduced was the biweekly and monthly posting of a leader board of the top three and ten fastest peg transfer times. Entry surveys were administered assessing attitudes towards simulation-based training and competition. Cohorts were observed for 5 months. There were 24 and 25 residents in the control and competition cohorts, respectively. The competition cohort overwhelmingly (76 %) stated that they were not motivated to deliberate practice by competition. Median total simulator usage time was 132 min (IQR = 214) in the competition cohort compared to 89 (IQR = 170) in the control cohort. The competition cohort completed their course requirements significantly earlier than the control cohort (χ 2  = 6.5, p = 0.01). There was a significantly greater proportion of residents continuing to use the simulator voluntarily after completing their course requirements in the competition cohort (44 vs. 4 %; p = 0.002). Residents in the competition cohort were significantly faster at peg transfer (194 ± 66 vs. 233 ± 53 s, 95 % CI of difference = 4-74 s; p = 0.03) and significantly decreased their completion time by 33 ± 54 s (95 % CI 10-56 s; paired t test, p = 0.007). A simple serious games skills competition increased voluntary usage and performance on a laparoscopic simulator, despite a majority of participants reporting they were not motivated by competition. Future directions should

  7. Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator.

    Science.gov (United States)

    Sánchez-Peralta, L F; Sánchez-Margallo, F M; Moyano-Cuevas, J L; Pagador, J B; Enciso, S; Gómez-Aguilera, E J; Usón-Gargallo, J

    2012-11-01

    Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to five tasks included in SINERGIA laparoscopic virtual reality simulator. Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1-R8) of the five mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of R1, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program.

  8. An "intermediate curriculum" for advanced laparoscopic skills training with virtual reality simulation.

    Science.gov (United States)

    Schreuder, Henk W R; van Hove, P Diederick; Janse, Juliënne A; Verheijen, Rene R M; Stassen, Laurents P S; Dankelman, Jenny

    2011-01-01

    To estimate face and construct validity for a novel curriculum designed for intermediately skilled laparoscopic surgeons on a virtual reality simulator. It consists of 5 exercises that focus on training precision and coordination between both hands. Prospective study (Canadian Task Force II-2). Three university hospitals and 4 teaching hospitals in the Netherlands. Residents, consultants, and laparoscopic experts (n = 69) in the fields of general surgery, gynecology, and urology participated. Participants were divided into 4 groups on the basis of their level of laparoscopic experience: resident, years 1-3 (n = 15); resident, years 4-6 (n = 17); consultant (n = 19); and laparoscopic experts (n = 18). Participants completed 3 runs of 5 exercises. The first run was an introduction, and the second and third runs were used for analysis. The parameters time, path length, collisions, and displacement were compared between groups. Afterward the participants completed a questionnaire to evaluate their laparoscopic experience and identify issues concerning the simulator and exercises. The expert group was significantly faster (p virtual reality curriculum for intermediately skilled laparoscopic surgeons. The results indicate that the curriculum is suitable for training of residents and consultants and to assess and maintain their laparoscopic skills. Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.

  9. A Simulated Clinical Skills Scenario to Teach Interprofessional Teamwork to Health Profession Students

    Directory of Open Access Journals (Sweden)

    Eileen Adel Herge

    2015-01-01

    Full Text Available The Eastern Pennsylvania Delaware Geriatric Education Center developed an Interprofessional Clinical Skills Scenario (CSS to facilitate development of teamwork skills, specifically decision making, communication and collaboration, in health professions students in medicine, nursing, pharmacy, occupational and physical therapy programs. The case scenario provides students with the opportunity to practice communication and collaboration with a team and standardized patient and caregiver in a simulated clinical setting. The CSS was integrated into an existing occupational therapy course in 2011. Students were recruited by faculty from various schools (health professions, pharmacy, nursing, medicine throughout the university to participate in the CSS. The program evaluation included demographic assessment, process, and outcome measures. 166 students have participated in the CSS. Pre- and post-tests measured students' attitude toward healthcare teams. A Team Observation Tool was used by faculty and standardized patients/caregivers to evaluate student teams on communication, information sharing, and team interaction. A satisfaction survey was completed by the learners at the end of the CSS. This simulated Clinical Skills Scenario is a practical, interactive exercise that allows teams of interprofessional students to practice teamwork skills and patient-centered care with standardized patients and caregivers. Following a review of the learning activity and evaluation tools, the authors reflect on the effectiveness of the evaluation process for this CSS.

  10. THE EFFECT OF INQUIRY TRAINING MODEL USE THE MEDIA PHET AGAINST SCIENCE PROCESS SKILLS AND LOGICAL THINKING SKILLS STUDENTS

    Directory of Open Access Journals (Sweden)

    Fajrul Wahdi Ginting

    2015-12-01

    Full Text Available The Purpose of The study: science process skills and logical thinking ability of students who use inquiry learning model training using PhET media; science process skills and logical thinking ability of students who use conventional learning model; and the difference science process skills and logical thinking ability of students to use learning model Inquiry Training using PhET media and conventional learning models. This research is a quasi experimental. Sample selection is done by cluster random sampling are two classes of classes VIII-E and class VIII-B, where the class VIII-E is taught by inquiry training model using media PhET and VIII-B with conventional learning model. The instrument used consisted of tests science process skills such as essay tests and tests of the ability to think logically in the form of multiple-choice tests. The data were analyzed using t test. The results showed that physics science process skills use Inquiry Training models using PhET media is different and showed better results compared with conventional learning model, and logical thinking skills students use Inquiry Training model using PhET media is different and show better results compared with conventional learning, and there is a difference between the ability to think logically and science process skills of students who use Inquiry Training model using PhET media and conventional learning models.

  11. SimLife a new model of simulation using a pulsated revascularized and reventilated cadaver for surgical education.

    Science.gov (United States)

    Delpech, P O; Danion, J; Oriot, D; Richer, J P; Breque, C; Faure, J P

    2017-02-01

    Alike becoming a pilot requires competences, acquisition of technical skills is essential to become a surgeon. Halsted's theory on surgical education "See one, do one, and teach one" is not currently compatible with the reality of socio-economic constraints of the operating room, the patient's safety demand and the reduction of residents' work hours. In all countries, this brings mandatory to simulation education for surgery resident's training. Many models are available: video trainers or pelvi-trainers, computed simulator, animal models or human cadaver… Human cadaveric dissection has long been used to teach surgical anatomy. Surgery on human cadaveric model brings greatest accuracy to the haptic characteristics of surgical procedures. Learning in an appropriate and realistic simulation context increases the level of acquisition of the residents' skills and reduces stress and anxiety when performing real procedures. We present a technique of perfusion and ventilation of a fresh human cadaver that restores pulsatile circulation and respiratory movements of the model. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

    Directory of Open Access Journals (Sweden)

    Serkan Toy

    2017-03-01

    Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education ... Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed ...

  14. Breaking News: Utilizing Video Simulations to Improve Educational Leaders' Public Speaking Skills

    Science.gov (United States)

    Friend, Jennifer; Adams, April; Curry, George

    2011-01-01

    This article examines specific uses of video simulations in one educational leadership preparation program to advance future school and district leaders' skills related to public speaking and participation in televised news interviews. One faculty member and two advanced educational leadership candidates share their perspectives of several…

  15. Using simulation to improve the cognitive and psychomotor skills of novice students in advanced laparoscopic surgery: a meta-analysis.

    Science.gov (United States)

    Al-Kadi, Azzam S; Donnon, Tyrone

    2013-01-01

    Advances in simulation technologies have enhanced the ability to introduce the teaching and learning of laparoscopic surgical skills to novice students. In this meta-analysis, a total of 18 randomized controlled studies were identified that specifically looked at training novices in comparison with a control group as it pertains to knowledge retention, time to completion and suturing and knotting skills. The combined random-effect sizes (ESs) showed that novice students who trained on laparoscopic simulators have considerably developed better laparoscopic suturing and knot tying skills (d = 1.96, p < 0.01), conducted fewer errors (d = 2.13, p < 0.01), retained more knowledge (d = 1.57, p < 0.01) than their respective control groups, and were significantly faster on time to completion (d = 1.98, p < 0.01). As illustrated in corresponding Forest plots, the majority of the primary study outcomes included in this meta-analysis show statistically significant support (p < 0.05) for the use of laparoscopic simulators for novice student training on both knowledge and advanced surgical skill development (28 of 35 outcomes, 80%). The findings of this meta-analysis support strongly the use of simulators for teaching laparoscopic surgery skills to novice students in surgical residency programs.

  16. Crisis management on surgical wards: a simulation-based approach to enhancing technical, teamwork, and patient interaction skills.

    Science.gov (United States)

    Arora, Sonal; Hull, Louise; Fitzpatrick, Maureen; Sevdalis, Nick; Birnbach, David J

    2015-05-01

    To establish the efficacy of simulation-based training for improving residents' management of postoperative complications on a surgical ward. Effective postoperative care is a crucial determinant of patient outcome, yet trainees learn this through the Halstedian approach. Little evidence exists on the efficacy of simulation in this safety-critical environment. A pre-/postintervention design was employed with 185 residents from 5 hospitals. Residents participated in 2 simulated ward-based scenarios consisting of a deteriorating postoperative patient. A debriefing intervention was implemented between scenarios. Resident performance was evaluated by calibrated, blinded assessors using the validated Global Assessment Toolkit for Ward Care. This included an assessment of clinical skills (checklist of 35 tasks), team-working skills (score range 1-6 per skill), and physician-patient interaction skills. Excellent interrater reliability was achieved in all assessments (reliability 0.89-0.99, P pre = 73.7% vs post = 94.8%, P pre = 21.1% vs post = 84.2% P pre = 42.1% vs post = 100%, P pre = 36.8% vs post = 89.8%, P pre = 1.75 vs post = 3.43), leadership (pre = 2.43 vs post = 4.20), and decision-making skills (pre = 2.20 vs post = 3.81, P < 0.001). Finally, residents improved in all elements of interaction with patients: empathy, organization, and verbal and nonverbal expression (Ps < 0.001). The study provides evidence for the efficacy of ward-based team training using simulation. Such exercises should be formally incorporated into training curricula to enhance patient safety in the high-risk surgical ward environment.

  17. Structured training on the da Vinci Skills Simulator leads to improvement in technical performance of robotic novices.

    Science.gov (United States)

    Walliczek-Dworschak, U; Mandapathil, M; Förtsch, A; Teymoortash, A; Dworschak, P; Werner, J A; Güldner, C

    2017-02-01

    The increasing use of minimally invasive techniques such as robotic-assisted devices raises the question of how to acquire robotic surgery skills. The da Vinci Skills Simulator has been demonstrated to be an effective training tool in previous reports. To date, little data are available on how to acquire proficiency through simulator training. We investigated the outcome of a structured training programme for robotic surgical skills by robotic novices. This prospective study was conducted from January to December 2013 using the da Vinci Skills Simulator. Twenty participants, all robotic novices, were enrolled in a 4-week training curriculum. After a brief introduction to the simulator system, three consecutive repetitions of five selected exercises (Match Board 1, 2, 3 and Ring and Rail 1, 2) were performed in a defined order on days 1, 8, 15 and 22. On day 22, one repetition of a previously unpractised more advanced module (Needle Targeting) was also performed. After completion of each study day, the overall performance, time to completion, economy in motion, instrument collisions, excessive instrument force, instruments out of view, master workspace range and number of drops were analysed. Comparing the first and final repetition, overall score and time needed to complete all exercises, economy of motion and instrument collisions were significantly improved in nearly all exercises. Regarding the new exercise, a positive training effect could be demonstrated. While its overall entry score was significantly higher, the time to completion and economy of motion were significantly lower than the scores on the first repetition of the previous 5 exercises. It could be shown that training on the da Vinci Skills Simulator led to an improvement in technical performance of robotic novices. With regard to a new exercise, the training had a positive effect on the technical performance. © 2016 John Wiley & Sons Ltd.

  18. Simulation models applied to practical learning and skill enhancement in direct and indirect ophthalmoscopy: a review

    Directory of Open Access Journals (Sweden)

    Lucas Holderegger Ricci

    2014-10-01

    Full Text Available The purpose of this review was to analyze and describe simulation methods for practical learning and training of the ophthalmoscopy exam and to organize them into specific topics relative to each principle of operation, while evaluating their preliminary results. A critical review of articles that described and evaluated simulated models for ophthalmoscopy published in the last ten years (2004-2014 was performed. One hundred articles about ophthalmology and simulation were found in national and international periodicals, but only a few discussed the examination of the posterior pole of the eye. For this study, 25 articles were considered; those articles described simulation methods, general concepts, and its actual use in ophthalmoscopy. There were many different simulation methods described, but only few articles proved their efficacy or performed a comparison between models. Review of this topic may give information for the critical analysis of the simulation devices and ideas for the development of new ones.

  19. The Effect of Educational Software, Video Modelling and Group Discussion on Social-Skill Acquisition Among Students with Mild Intellectual Disabilities.

    Science.gov (United States)

    Hetzroni, Orit E; Banin, Irit

    2017-07-01

    People with intellectual and developmental disabilities (IDD) often demonstrate difficulties in social skills. The purpose of this study was to examine the effects of a comprehensive intervention program on the acquisition of social skills among students with mild IDD. Single subject multiple baseline design across situations was used for teaching five school-age children with mild IDD social skills embedded in school-based situations. Results demonstrate that the intervention program that included video modelling and games embedded with group discussions and simulations increased the level and use of adequate social behaviours within the school's natural environment. Results demonstrate the unique attribution of a comprehensive interactive program for acquisition and transfer of participants' social skills such as language pragmatics and social rules within the school environment. Group discussions and simulations were beneficial and enabled both group and personalized instruction through the unique application of the program designed for the study. © 2016 John Wiley & Sons Ltd.

  20. High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

    NARCIS (Netherlands)

    Vries, A.H. de; Schout, B.M.A.; Merriënboer, J.J.G. van; Pelger, R.C.M.; Koldewijn, E.L.; Wagner, C.

    2017-01-01

    Background: Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical

  1. Accomplishments and challenges of surgical simulation.

    Science.gov (United States)

    Satava, R M

    2001-03-01

    For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

  2. Evaluating the skills of isotope-enabled general circulation models against in situ atmospheric water vapor isotope observations

    DEFF Research Database (Denmark)

    Steen-Larsen, Hans Christian; Risi, C.; Werner, M.

    2017-01-01

    The skills of isotope-enabled general circulation models are evaluated against atmospheric water vapor isotopes. We have combined in situ observations of surface water vapor isotopes spanning multiple field seasons (2010, 2011, and 2012) from the top of the Greenland Ice Sheet (NEEM site: 77.45°N......: 2014). This allows us to benchmark the ability to simulate the daily water vapor isotope variations from five different simulations using isotope-enabled general circulation models. Our model-data comparison documents clear isotope biases both on top of the Greenland Ice Sheet (1-11% for δ18O and 4...... boundary layer water vapor isotopes of the Baffin Bay region show strong influence on the water vapor isotopes at the NEEM deep ice core-drilling site in northwest Greenland. Our evaluation of the simulations using isotope-enabled general circulation models also documents wide intermodel spatial...

  3. Simulation-based instruction of technical skills

    Science.gov (United States)

    Towne, Douglas M.; Munro, Allen

    1991-01-01

    A rapid intelligent tutoring development system (RAPIDS) was developed to facilitate the production of interactive, real-time graphical device models for use in instructing the operation and maintenance of complex systems. The tools allowed subject matter experts to produce device models by creating instances of previously defined objects and positioning them in the emerging device model. These simulation authoring functions, as well as those associated with demonstrating procedures and functional effects on the completed model, required no previous programming experience or use of frame-based instructional languages. Three large simulations were developed in RAPIDS, each involving more than a dozen screen-sized sections. Seven small, single-view applications were developed to explore the range of applicability. Three workshops were conducted to train others in the use of the authoring tools. Participants learned to employ the authoring tools in three to four days and were able to produce small working device models on the fifth day.

  4. A Comparison of Robotic Simulation Performance on Basic Virtual Reality Skills: Simulator Subjective Versus Objective Assessment Tools.

    Science.gov (United States)

    Dubin, Ariel K; Smith, Roger; Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia

    To answer the question of whether there is a difference between robotic virtual reality simulator performance assessment and validated human reviewers. Current surgical education relies heavily on simulation. Several assessment tools are available to the trainee, including the actual robotic simulator assessment metrics and the Global Evaluative Assessment of Robotic Skills (GEARS) metrics, both of which have been independently validated. GEARS is a rating scale through which human evaluators can score trainees' performances on 6 domains: depth perception, bimanual dexterity, efficiency, force sensitivity, autonomy, and robotic control. Each domain is scored on a 5-point Likert scale with anchors. We used 2 common robotic simulators, the dV-Trainer (dVT; Mimic Technologies Inc., Seattle, WA) and the da Vinci Skills Simulator (dVSS; Intuitive Surgical, Sunnyvale, CA), to compare the performance metrics of robotic surgical simulators with the GEARS for a basic robotic task on each simulator. A prospective single-blinded randomized study. A surgical education and training center. Surgeons and surgeons in training. Demographic information was collected including sex, age, level of training, specialty, and previous surgical and simulator experience. Subjects performed 2 trials of ring and rail 1 (RR1) on each of the 2 simulators (dVSS and dVT) after undergoing randomization and warm-up exercises. The second RR1 trial simulator performance was recorded, and the deidentified videos were sent to human reviewers using GEARS. Eight different simulator assessment metrics were identified and paired with a similar performance metric in the GEARS tool. The GEARS evaluation scores and simulator assessment scores were paired and a Spearman rho calculated for their level of correlation. Seventy-four subjects were enrolled in this randomized study with 9 subjects excluded for missing or incomplete data. There was a strong correlation between the GEARS score and the simulator metric

  5. A large-scale mass casualty simulation to develop the non-technical skills medical students require for collaborative teamwork.

    Science.gov (United States)

    Jorm, Christine; Roberts, Chris; Lim, Renee; Roper, Josephine; Skinner, Clare; Robertson, Jeremy; Gentilcore, Stacey; Osomanski, Adam

    2016-03-08

    There is little research on large-scale complex health care simulations designed to facilitate student learning of non-technical skills in a team-working environment. We evaluated the acceptability and effectiveness of a novel natural disaster simulation that enabled medical students to demonstrate their achievement of the non-technical skills of collaboration, negotiation and communication. In a mixed methods approach, survey data were available from 117 students and a thematic analysis undertaken of both student qualitative comments and tutor observer participation data. Ninety three per cent of students found the activity engaging for their learning. Three themes emerged from the qualitative data: the impact of fidelity on student learning, reflexivity on the importance of non-technical skills in clinical care, and opportunities for collaborative teamwork. Physical fidelity was sufficient for good levels of student engagement, as was sociological fidelity. We demonstrated the effectiveness of the simulation in allowing students to reflect upon and evidence their acquisition of skills in collaboration, negotiation and communication, as well as situational awareness and attending to their emotions. Students readily identified emerging learning opportunities though critical reflection. The scenarios challenged students to work together collaboratively to solve clinical problems, using a range of resources including interacting with clinical experts. A large class teaching activity, framed as a simulation of a natural disaster is an acceptable and effective activity for medical students to develop the non-technical skills of collaboration, negotiation and communication, which are essential to team working. The design could be of value in medical schools in disaster prone areas, including within low resource countries, and as a feasible intervention for learning the non-technical skills that are needed for patient safety.

  6. A Structural and Functional Model for Forming Management Skills in Junior Schoolchildren

    Science.gov (United States)

    Knissarina, Malika M.; Valikhanov, Sharidyar A.; Medeubayeva, Kenzhekhan T.; Zhazykova, Makpal K.; Rakhmetova, Bazar A.; Seytenova, Salima S.; Abil, Akmaral S.; Mukhangaliyeva, Shnargul Ai.

    2016-01-01

    The purpose of the study is to analyze theoretically and simulate the formation of management skills in junior schoolchildren. The authors classified junior schoolchildren's management skills, defined psychological and pedagogical principles of their formation. Empirically obtained results of questionnaires for teachers and parents (n=550)…

  7. Fundamental arthroscopic skill differentiation with virtual reality simulation.

    Science.gov (United States)

    Rose, Kelsey; Pedowitz, Robert

    2015-02-01

    The purpose of this study was to investigate the use and validity of virtual reality modules as part of the educational approach to mastering arthroscopy in a safe environment by assessing the ability to distinguish between experience levels. Additionally, the study aimed to evaluate whether experts have greater ambidexterity than do novices. Three virtual reality modules (Swemac/Augmented Reality Systems, Linkoping, Sweden) were created to test fundamental arthroscopic skills. Thirty participants-10 experts consisting of faculty, 10 intermediate participants consisting of orthopaedic residents, and 10 novices consisting of medical students-performed each exercise. Steady and Telescope was designed to train centering and image stability. Steady and Probe was designed to train basic triangulation. Track and Moving Target was designed to train coordinated motions of arthroscope and probe. Metrics reflecting speed, accuracy, and efficiency of motion were used to measure construct validity. Steady and Probe and Track a Moving Target both exhibited construct validity, with better performance by experts and intermediate participants than by novices (P virtual reality modules developed through task deconstruction. Participants with the most arthroscopic experience performed better and were more consistent than novices on all 3 virtual reality modules. Greater arthroscopic experience correlates with more symmetry of ambidextrous performance. However, further adjustment of the modules may better simulate fundamental arthroscopic skills and discriminate between experience levels. Arthroscopy training is a critical element of orthopaedic surgery resident training. Developing techniques to safely and effectively train these skills is critical for patient safety and resident education. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Efficiency of Motivation Development Models for Hygienic Skills

    Directory of Open Access Journals (Sweden)

    Alexander V. Tscymbalystov

    2017-09-01

    Full Text Available The combined influence of a family and a state plays an important role in the development of an individual. This study is aimed at the model effectiveness evaluation concerning the development of oral hygiene skills among children living in families (n = 218 and being under the care of a state (n = 229. The groups were created among the children who took part in the study: the preschoolers of 5-7 years, schoolchildren of 8-11 years and adolescents of 12-15 years. During the initial examination, the hygienic status of the oral cavity before and after tooth brushing was evaluated. After that, subgroups were formed in each age group according to three models of hygienic skills training: 1 computer presentation lesson; 2 one of the students acted as a demonstrator of the skill; 3 an individual training by a hygienist. During the next 48 hours children did not take hygienic measures. Then the children were invited for a control session to demonstrate the acquired skills of oral care and evaluate the effectiveness of a model developing the skills of individual oral hygiene. During the control examination, the hygienic status was determined before and after the tooth cleaning, which allowed to determine the regimes of hygienic measure performance for children with different social status and the effectiveness of hygiene training models.

  9. Helping Mothers Survive Bleeding After Birth: retention of knowledge, skills, and confidence nine months after obstetric simulation-based training.

    Science.gov (United States)

    Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjørg; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle

    2015-08-25

    It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of knowledge, skills, and confidence before, immediately after, and nine months after simulation-based training in obstetric care in order to understand the impact of training on these components. An educational intervention study was carried out in 2012 in a rural referral hospital in Northern Tanzania. Eighty-nine healthcare workers of different cadres were trained in "Helping Mothers Survive Bleeding After Birth", which addresses basic delivery skills including active management of third stage of labour and management of postpartum haemorrhage (PPH). Knowledge, skills, and confidence were tested before, immediately after, and nine months after training amongst 38 healthcare workers. Knowledge was tested by completing a written 26-item multiple-choice questionnaire. Skills were tested in two simulated scenarios "basic delivery" and "management of PPH". Confidence in active management of third stage of labour, management of PPH, determination of completeness of the placenta, bimanual uterine compression, and accessing advanced care was self-assessed using a written 5-item questionnaire. Mean knowledge scores increased immediately after training from 70 % to 77 %, but decreased close to pre-training levels (72 %) at nine-month follow-up (p = 0.386) (all p-levels are compared to pre-training). The mean score in basic delivery skills increased after training from 43 % to 51 %, and was 49 % after nine months (p = 0.165). Mean scores of management of PPH increased from 39 % to 51 % and were sustained at 50 % at nine months (p = 0.003). Bimanual uterine compression skills increased from 19 % before, to 43 % immediately after, to 48 % nine months after training (p = 0

  10. Simulation as a tool for improving acquisition of neonatal resuscitation skills for obstetric residents.

    Science.gov (United States)

    Bruno, C J; Angert, R; Rosen, O; Lee, C; Vega, M; Kim, M; Yu, Y; Bernstein, P S; Goffman, D

    2016-01-01

    Our goal was to compare the confidence, knowledge, and performance of obstetric residents taught initial neonatal resuscitation steps in a simulation-based versus lecture-based format. Our study was a prospective randomized controlled trial of 33 obstetric residents. Baseline confidence, knowledge, and clinical skills assessments were performed. Subjects were randomized to traditional lecture (n = 14) or simulation-based (n = 19) neonatal resuscitation curriculum with a focus on initial steps. Follow-up assessments were performed at 3 and 6 months. Total confidence, knowledge, and clinical performance scores and change from baseline in these scores were calculated and compared between groups. Both the lecture-based and simulated-based groups demonstrated significant improvement in confidence, knowledge, and performance over time. However, compared with the lecture group, the magnitude of the mean change from baseline in performance scores was significantly greater in the simulation group at 3 months (2.9 versus 10.1; p < 0.001), but not at 6 months (7.0 versus 9.3; p = 0.11). Our study demonstrates the superiority of simulation in teaching obstetric residents initial neonatal resuscitation steps compared with a traditional lecture format. Skills are retained for upwards of 3-6 months. Refresher instruction by 6 months post-instruction may be beneficial.

  11. Improving knowledge, technical skills, and confidence among pediatric health care providers in the management of chronic tracheostomy using a simulation model.

    Science.gov (United States)

    Agarwal, Amit; Marks, Nancy; Wessel, Valerie; Willis, Denise; Bai, Shasha; Tang, Xinyu; Ward, Wendy L; Schellhase, Dennis E; Carroll, John L

    2016-07-01

    The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program. The prospective observational study was comprised of 33 subjects including pediatric residents, internal medicine-pediatric residents, pediatric hospitalist faculty physicians, and advanced practice registered nurses who are involved in the care of patients with tracheostomies within a tertiary-care children's hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course that employed patient simulation. The outcome measurements included pre- and post-course questionnaires, pre- and post-course test scores, and observational data from the simulation sessions. Before the education and simulation, the subjects' comfort and confidence levels on a five-point Likert scale in performing routine tracheostomy tube care, routine tracheostomy tube change, and an emergency tracheostomy tube change were as follows (median (Q1, Q3)): 1 (1, 2), 1 (1, 2), and 1 (1, 2), respectively (n = 28). The levels of comfort and confidence after completing the course improved significantly to 4 (4, 5), 4 (4, 5), 4 (4, 5), respectively (P tracheostomy tubes (e.g., cuffed versus uncuffed), physiological significance of the cuff, mechanism of action and physiological significance of the speaking valve, and the importance of the obturator in changing the tracheostomy tube

  12. 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

  13. [The effect of a scenario-based simulation communication course on improving the communication skills of nurses].

    Science.gov (United States)

    Huang, Ya-Hsuan; Hsieh, Suh-Ing; Hsu, Li-Ling

    2014-04-01

    Limited disease knowledge is frequently the cause of disease-related anxiety in myocardial infarction patients. The ability to communicate effectively serves multiple purposes in the professional nursing practice. By communicating effectively with myocardial infarction patients, nurses may help reduce their anxiety by keeping them well informed about their disease and teaching them self-care strategies. This research evaluates the communication skills of nurses following scenario-based simulation education in the context of communication with myocardial infarction patients. This study used an experimental design and an educational intervention. The target population comprised nurses of medicine (clinical qualified level N to N2 for nursing) working at a municipal hospital in Taipei City, Taiwan. A total 122 participants were enrolled. Stratified block randomization divided participants into an experimental group and a control group. The experimental group received clinical scenario-based simulation education for communication. The control group received traditional class-based education for communication. Both groups received a pre-test and a Communication Skills Checklist post-test assessment. Results were analyzed using SPSS 17.0 for Windows software. A t-test showed significant increases in communication skills (p skills following the education intervention. The results indicate that clinical scenario-based simulation education for communication is significantly more effective than traditional class-based education in enhancing the ability of nurses to communicate effectively with myocardial infarction patients.

  14. A tool for assessing case history and feedback skills in audiology students working with simulated patients.

    Science.gov (United States)

    Hughes, Jane; Wilson, Wayne J; MacBean, Naomi; Hill, Anne E

    2016-12-01

    To develop a tool for assessing audiology students taking a case history and giving feedback with simulated patients (SP). Single observation, single group design. Twenty-four first-year audiology students, five simulated patients, two clinical educators, and three evaluators. The Audiology Simulated Patient Interview Rating Scale (ASPIRS) was developed consisting of six items assessing specific clinical skills, non-verbal communication, verbal communication, interpersonal skills, interviewing skills, and professional practice skills. These items are applied once for taking a case history and again for giving feedback. The ASPIRS showed very high internal consistency (α = 0.91-0.97; mean inter-item r = 0.64-0.85) and fair-to-moderate agreement between evaluators (29.2-54.2% exact and 79.2-100% near agreement; κ weighted up to 0.60). It also showed fair-to-moderate absolute agreement amongst evaluators for single evaluator scores (intraclass correlation coefficient [ICC] r = 0.35-0.59) and substantial consistency of agreement amongst evaluators for three-evaluator averaged scores (ICC r = 0.62-0.81). Factor analysis showed the ASPIRS' 12 items fell into two components, one containing all feedback items and one containing all case history items. The ASPIRS shows promise as the first published tool for assessing audiology students taking a case history and giving feedback with an SP.

  15. Current status of robotic simulators in acquisition of robotic surgical skills.

    Science.gov (United States)

    Kumar, Anup; Smith, Roger; Patel, Vipul R

    2015-03-01

    This article provides an overview of the current status of simulator systems in robotic surgery training curriculum, focusing on available simulators for training, their comparison, new technologies introduced in simulation focusing on concepts of training along with existing challenges and future perspectives of simulator training in robotic surgery. The different virtual reality simulators available in the market like dVSS, dVT, RoSS, ProMIS and SEP have shown face, content and construct validity in robotic skills training for novices outside the operating room. Recently, augmented reality simulators like HoST, Maestro AR and RobotiX Mentor have been introduced in robotic training providing a more realistic operating environment, emphasizing more on procedure-specific robotic training . Further, the Xperience Team Trainer, which provides training to console surgeon and bed-side assistant simultaneously, has been recently introduced to emphasize the importance of teamwork and proper coordination. Simulator training holds an important place in current robotic training curriculum of future robotic surgeons. There is a need for more procedure-specific augmented reality simulator training, utilizing advancements in computing and graphical capabilities for new innovations in simulator technology. Further studies are required to establish its cost-benefit ratio along with concurrent and predictive validity.

  16. Effects of nursing process-based simulation for maternal child emergency nursing care on knowledge, attitude, and skills in clinical nurses.

    Science.gov (United States)

    Kim, Sunghee; Shin, Gisoo

    2016-02-01

    Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Effect of simulation-based emergency cardiac arrest education on nursing students' self-efficacy and critical thinking skills: Roleplay versus lecture.

    Science.gov (United States)

    Kim, Eunsook

    2018-02-01

    Simulation education is a learning method for improving self-efficacy and critical thinking skills. However, not much study has been done on how to use it for education on emergency cardiac arrest situations, for which a multidisciplinary team approach is required. This study investigated the effects of simulation education on nursing students' self-efficacy and critical thinking skills in emergency cardiac arrest situations. A quasi-experimental research approach with a crossover design was used to compare two types of simulation instruction methods. This study was conducted with 76 nursing students divided into two groups by order of instruction methods, in November and December 2016. Both groups of participants experienced a simulation lesson based on the same emergency scenario. Group A first completed a roleplay of an emergency cardiac arrest situation in a clinical setting, while Group B first listened to a lecture on the procedure. After ten days, Group A repeated the simulation exercise after listening to the lecture, while Group B completed the simulation exercise after the roleplay. The students' self-efficacy and critical thinking skills were measured using a questionnaire before and after each session. In the first session, self-efficacy and critical thinking skills scores increased greatly from pretest to posttest for Group A in comparison to Group B; no statistically significant difference was found between the two groups. In the second session, Group B showed a significant increase between pretest and posttest, while Group A showed no significant difference. Conducting the simulation exercise after the roleplay was a more effective teaching method than conducting it after the lecture. Moreover, having the nursing students assume various roles in realistic roleplay situations combined with simulation exercises led to a deeper understanding of clinical situations and improved their self-efficacy and critical thinking skills. Copyright © 2017 Elsevier

  18. How Do Trading Firms Upgrade Skills and Technology: A Theoretical Model

    Directory of Open Access Journals (Sweden)

    Mojca Lindic

    2015-12-01

    Full Text Available This paper studies the mechanisms of skill upgrading in trading firms by developing a theoretical model that relates the individual’s incentives for acquiring higher skills to the profit-maximizing behaviour of trading firms. The model shows that only the high ability individuals have incentives for acquiring higher skills, as long as they are compensated with higher wages after entering employment. Furthermore, high-productive firms have incentives for investing in higher technology, to employ high-skilled labour, and to engage in international trade. The decisions for technology dress-up and skill upgrading coincide with firm’s decisions to start importing and exporting as the latter requires higher technology and high-skilled labour. Contributions of the paper are twofold: gaining new insights by combining fragments of models on individual’s and firm’s behaviours, and broadening the content of the Melitz (2003 model by introducing importers and controlling for skilled and unskilled labour.

  19. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program: A Randomized Trial.

    Science.gov (United States)

    Keleekai, Nowai L; Schuster, Catherine A; Murray, Connie L; King, Mary Anne; Stahl, Brian R; Labrozzi, Laura J; Gallucci, Susan; LeClair, Matthew W; Glover, Kevin R

    2016-12-01

    Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored.

  20. European Working Time Directive and the use of simulators and models in Irish orthopaedics.

    LENUS (Irish Health Repository)

    Egan, C

    2011-09-07

    OBJECTIVE: To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. METHODS: A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. RESULTS: There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. CONCLUSIONS: While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

  1. European Working Time Directive and the use of simulators and models in Irish orthopaedics.

    Science.gov (United States)

    Egan, C; Elliott, R; Fleming, P

    2012-03-01

    To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

  2. Implementing simulated learning modules to improve students’ pharmacy practice skills and professionalism

    Directory of Open Access Journals (Sweden)

    Fejzic J

    2015-09-01

    Full Text Available Background: Effective communication enables healthcare professionals and students to practise their disciplines in a professional and competent manner. Simulated-based education (SBE has been increasingly used to improve students’ communication and practice skills in Health Education. Objective: Simulated learning modules (SLMs were developed using practice-based scenarios grounded in effective communication competencies. The effect of the SLMs on Pharmacy students’ (i Practice skills and (ii Professionalism were evaluated. Methods: SLMs integrating EXCELL competencies were applied in the classroom to study their effect on a number of learning outcomes. EXcellence in Cultural Experiential Learning and Leadership (EXCELL Program is a schematic, evidence-based professional development resource centred around developing participants’ self-efficacy and generic communication competencies. Students (N=95 completed three hours of preliminary lectures and eight hours of SLM workshops including six scenarios focused on Pharmacy Practice and Experiential Placements. Each SLM included briefing, role-plays with actors, facilitation, and debriefing on EXCELL social interaction maps (SIMs. Evaluations comprised quantitative and qualitative survey responsed by students before and post-workshops, and post-placements, and teachers’ reflections. Surveys examine specific learning outcomes by using pharmacy professionalism and pharmacy practice effectiveness scales. Responses were measured prior to the commencement of SLMs, after completion of the two workshops and after students completed their block placement. Self-report measures enabled students to self-assess whether any improvements occurred. Results: Student responses were overwhelmingly positive and indicated significant improvements in their Pharmacy practice and professionalism skills, and commitment to professional ethics. Qualitative feedback strongly supported students’ improved communication

  3. Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

    Science.gov (United States)

    Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

    2015-03-01

    The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

  4. Communication skills training: describing a new conceptual model.

    Science.gov (United States)

    Brown, Richard F; Bylund, Carma L

    2008-01-01

    Current research in communication in physician-patient consultations is multidisciplinary and multimethodological. As this research has progressed, a considerable body of evidence on the best practices in physician-patient communication has been amassed. This evidence provides a foundation for communication skills training (CST) at all levels of medical education. Although the CST literature has demonstrated that communication skills can be taught, one critique of this literature is that it is not always clear which skills are being taught and whether those skills are matched with those being assessed. The Memorial Sloan-Kettering Cancer Center Comskil Model for CST seeks to answer those critiques by explicitly defining the important components of a consultation, based on Goals, Plans, and Actions theories and sociolinguistic theory. Sequenced guidelines as a mechanism for teaching about particular communication challenges are adapted from these other methods. The authors propose that consultation communication can be guided by an overarching goal, which is achieved through the use of a set of predetermined strategies. Strategies are common in CST; however, strategies often contain embedded communication skills. These skills can exist across strategies, and the Comskil Model seeks to make them explicit in these contexts. Separate from the skills are process tasks and cognitive appraisals that need to be addressed in teaching. The authors also describe how assessment practices foster concordance between skills taught and those assessed through careful coding of trainees' communication encounters and direct feedback.

  5. Construct validity for eye-hand coordination skill on a virtual reality laparoscopic surgical simulator.

    Science.gov (United States)

    Yamaguchi, Shohei; Konishi, Kozo; Yasunaga, Takefumi; Yoshida, Daisuke; Kinjo, Nao; Kobayashi, Kiichiro; Ieiri, Satoshi; Okazaki, Ken; Nakashima, Hideaki; Tanoue, Kazuo; Maehara, Yoshihiko; Hashizume, Makoto

    2007-12-01

    This study was carried out to investigate whether eye-hand coordination skill on a virtual reality laparoscopic surgical simulator (the LAP Mentor) was able to differentiate among subjects with different laparoscopic experience and thus confirm its construct validity. A total of 31 surgeons, who were all right-handed, were divided into the following two groups according to their experience as an operator in laparoscopic surgery: experienced surgeons (more than 50 laparoscopic procedures) and novice surgeons (fewer than 10 laparoscopic procedures). The subjects were tested using the eye-hand coordination task of the LAP Mentor, and performance was compared between the two groups. Assessment of the laparoscopic skills was based on parameters measured by the simulator. The experienced surgeons completed the task significantly faster than the novice surgeons. The experienced surgeons also achieved a lower number of movements (NOM), better economy of movement (EOM) and faster average speed of the left instrument than the novice surgeons, whereas there were no significant differences between the two groups for the NOM, EOM and average speed of the right instrument. Eye-hand coordination skill of the nondominant hand, but not the dominant hand, measured using the LAP Mentor was able to differentiate between subjects with different laparoscopic experience. This study also provides evidence of construct validity for eye-hand coordination skill on the LAP Mentor.

  6. The ribbon microphone - an educational aid: use of a ribbon microphone to teach multi-discipline computer simulation skills

    CSIR Research Space (South Africa)

    Van Wyk, Marius

    2016-07-01

    Full Text Available The ribbon microphone serves as an excellent aid to learn computer simulation and computational skills. Simulation of this seemingly simple device is all but trivial. The ribbon microphone is an all-in-one example for simulations in acoustics...

  7. Procedural Skills Education – Colonoscopy as a Model

    Directory of Open Access Journals (Sweden)

    Maitreyi Raman

    2008-01-01

    Full Text Available Traditionally, surgical and procedural apprenticeship has been an assumed activity of students, without a formal educational context. With increasing barriers to patient and operating room access such as shorter work week hours for residents, and operating room and endoscopy time at a premium, alternate strategies to maximizing procedural skill development are being considered. Recently, the traditional surgical apprenticeship model has been challenged, with greater emphasis on the need for surgical and procedural skills training to be more transparent and for alternatives to patient-based training to be considered. Colonoscopy performance is a complex psychomotor skill requiring practioners to integrate multiple sensory inputs, and involves higher cortical centres for optimal performance. Colonoscopy skills involve mastery in the cognitive, technical and process domains. In the present review, we propose a model for teaching colonoscopy to the novice trainee based on educational theory.

  8. Exploring Students' Computational Thinking Skills in Modeling and Simulation Projects: : A Pilot Study

    NARCIS (Netherlands)

    Grgurina, Natasa; van Veen, Klaas; Barendsen, Erik; Zwaneveld, Bert; Suhre, Cor; Gal-Ezer, Judith; Sentance, Sue; Vahrenhold, Jan

    2015-01-01

    Computational Thinking (CT) is gaining a lot of attention in education. We explored how to discern the occurrences of CT in the projects of 12th grade high school students in the computer science (CS) course. Within the projects, they constructed models and ran simulations of phenomena from other

  9. Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time.

    Science.gov (United States)

    Dunn, John C; Belmont, Philip J; Lanzi, Joseph; Martin, Kevin; Bader, Julia; Owens, Brett; Waterman, Brian R

    2015-01-01

    Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and

  10. Influence of carbohydrate supplementation on skill performance during a soccer match simulation.

    Science.gov (United States)

    Russell, Mark; Benton, David; Kingsley, Michael

    2012-07-01

    This study investigated the influence of carbohydrate supplementation on skill performance throughout exercise that replicates soccer match-play. Experimentation was conducted in a randomised, double-blind and cross-over study design. After familiarization, 15 professional academy soccer players completed a soccer match simulation incorporating passing, dribbling and shooting on two separate occasions. Participants received a 6% carbohydrate-electrolyte solution (CHO) or electrolyte solution (PL). Precision, success rate, ball speed and an overall index (speed-precision-success; SPS) were determined for all skills. Blood samples were taken at rest, immediately before exercise, every 15 min during exercise (first half: 15, 30 and 45 min; second half: 60, 75 and 90 min), and 10 min into the half time (half-time). Carbohydrate supplementation influenced shooting (time×treatment interaction: pinteraction: pCarbohydrate supplementation attenuated decrements in shooting performance during simulated soccer match-play; however, further research is warranted to optimise carbohydrate supplementation regimes for high-intensity intermittent sports. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  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. What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel.

    Science.gov (United States)

    Brezis, Mayer; Lahat, Yael; Frankel, Meir; Rubinov, Alan; Bohm, Davina; Cohen, Matan J; Koslowsky, Meni; Shalomson, Orit; Sprung, Charles L; Perry-Mezare, Henia; Yahalom, Rina; Ziv, Amitai

    2017-11-06

    Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care. We analyzed perceptions emerging from group discussions following simulations, from questionnaires before and after each workshop, and from video-recorded simulations using a validated coding system. We used the simulation setting as a novel tool for action research. We used a participatory inquiry paradigm, with repetitive cycles of exploring barriers and challenges with participants in an iterative pattern of observation, discussion and reflection - including a description of our own responses and evolution of thought as well as system effects. The themes transpiring included lack of training, knowledge and time, technology overuse, uncertainty in decision-making, poor skills for communication and teamwork. Specific scenarios demonstrated lack of experience at eliciting preferences for EOL care and at handling conflicts or dilemmas. Content analysis of simulations showed predominance of cognitive utterances - by an order of magnitude more prevalent than emotional expressions. Providers talked more than actors did and episodes of silence were rare. Workshop participants acknowledged needs to improve listening skills, attention to affect and teamwork. They felt that the simulation-based workshop is likely to ameliorate future handling of EOL situations. We observed unanticipated consequences from our project manifested as a field study of preparedness to EOL in nursing homes, followed by a national survey on quality of care, leading to expansion of

  13. Battle of the bots: a comparison of the standard da Vinci and the da Vinci Surgical Skills Simulator in surgical skills acquisition.

    Science.gov (United States)

    Brown, Kevin; Mosley, Natalie; Tierney, James

    2017-06-01

    Virtual reality simulators are increasingly used to gain robotic surgical skills. This study compared use of the da Vinci Surgical Skills Simulator (dVSSS) to the standard da Vinci (SdV) robot for skills acquisition in a prospective randomized study. Residents from urology, gynecology, and general surgery programs performed three virtual reality tasks (thread the ring, ring rail, and tubes) on the dvSSS. Participants were then randomized to one of the two study groups (dVSSS and SdV). Each participant then practiced on either the dVSSS or the SdV (depending on randomization) for 30 min per week over a 4-week time period. The dVSSS arm was not permitted to practice ring rail (due to no similar practice scenario available for the SdV group). Following 4 weeks of practice, participants performed the same three virtual reality tasks and the results were recorded and compared to baseline. Overall and percent improvement were recorded for all participants from pre-test to post-test. Two-way ANOVA analyses were used to compare the dVSSS and SdV groups and three tasks. Initially, 30 participants were identified and enrolled in the study. Randomization resulted in 15 participants in each arm. During the course of the study, four participants were unable to complete all tasks and practice sessions and were, therefore, excluded. This resulted in a total of 26 participants (15 in the dVSSS group and 11 in the SdV group) who completed the study. Overall total improvement score was found to be 23.23 and 23.48 for the SdV and dVSSS groups, respectively (p = 0.9245). The percent improvement was 60 and 47 % for the SdV and dVSSS groups respectively, which was a statistically significant difference between the two groups and three tasks. Practicing on the standard da Vinci is comparable to practicing on the da Vinci simulator for acquiring robotic surgical skills. In spite of several potential advantages, the dVSSS arm performed no better than the SdV arm in the final

  14. Early acquisition of non-technical skills using a blended approach to simulation-based medical education.

    Science.gov (United States)

    Coggins, Andrew; Desai, Mihir; Nguyen, Khanh; Moore, Nathan

    2017-01-01

    Non-technical skills are emerging as an important component of postgraduate medical education. Between 2013 and 2016, a new blended training program incorporating non-technical skills was introduced at an Australian university affiliated hospital. Program participants were medical officers in years 1 and 2 of postgraduate training. An interdisciplinary faculty trained in simulation-based education led the program. The blended approach combined open access online resources with multiple opportunities to participate in simulation-based learning. The aim of the study was to examine the value of the program to the participants and the effects on the wider hospital system. The mixed methods evaluation included data from simulation centre records, hospital quality improvement data, and a post-hoc reflective survey of the enrolled participants ( n  = 68). Over 30 months, 283 junior doctors were invited to participate in the program. Enrolment in a designated simulation-based course was completed by 169 doctors (59.7%). Supplementary revision sessions were made available to the cohort with a median weekly attendance of five participants. 56/68 (82.4%) of survey respondents reported increased confidence in managing deteriorating patients. During the period of implementation, the overall rate of hospital cardiac arrests declined by 42.3%. Future objectives requested by participants included training in graded assertiveness and neurological emergencies. Implementation of a non-technical skills program was achieved with limited simulation resources and was associated with observable improvements in clinical performance. The participants surveyed reported increased confidence in managing deteriorating patients, and the program introduction coincided with a significant reduction in the rate of in-hospital cardiac arrests.

  15. Developing Leadership Skills in a Virtual Simulation: Coaching the Affiliative Style Leader

    Science.gov (United States)

    Gurley, Kathy; Wilson, Dawn

    2011-01-01

    This study looked at the use of a business simulation that focused on improving the leadership skills of students in an MBA class at an HBCU in North Carolina. The students were asked to complete a questionnaire that identified their dominant leadership style. The study then compared the students who had an affiliative style of management against…

  16. Modelling and Manufacturing of a 3D Printed Trachea for Cricothyroidotomy Simulation.

    Science.gov (United States)

    Doucet, Gregory; Ryan, Stephen; Bartellas, Michael; Parsons, Michael; Dubrowski, Adam; Renouf, Tia

    2017-08-18

    Cricothyroidotomy is a life-saving medical procedure that allows for tracheal intubation. Most current cricothyroidotomy simulation models are either expensive or not anatomically accurate and provide the learner with an unrealistic simulation experience. The goal of this project is to improve current simulation techniques by utilizing rapid prototyping using 3D printing technology and expert opinions to develop inexpensive and anatomically accurate trachea simulators. In doing so, emergency cricothyroidotomy simulation can be made accessible, accurate, cost-effective and reproducible. Three-dimensional modelling software was used in conjunction with a desktop three-dimensional (3D) printer to design and manufacture an anatomically accurate model of the cartilage within the trachea (thyroid cartilage, cricoid cartilage, and the tracheal rings). The initial design was based on dimensions found in studies of tracheal anatomical configuration. This ensured that the landmarking necessary for emergency cricothyroidotomies was designed appropriately. Several revisions of the original model were made based on informal opinion from medical professionals to establish appropriate anatomical accuracy of the model for use in rural/remote cricothyroidotomy simulation. Using an entry-level desktop 3D printer, a low cost tracheal model was successfully designed that can be printed in less than three hours for only $1.70 Canadian dollars (CAD). Due to its anatomical accuracy, flexibility and durability, this model is great for use in emergency medicine simulation training. Additionally, the model can be assembled in conjunction with a membrane to simulate tracheal ligaments. Skin has been simulated as well to enhance the realism of the model. The result is an accurate simulation that will provide users with an anatomically correct model to practice important skills used in emergency airway surgery, specifically landmarking, incision and intubation. This design is a novel and easy

  17. Self vs expert assessment of technical and non-technical skills in high fidelity simulation.

    Science.gov (United States)

    Arora, Sonal; Miskovic, Danilo; Hull, Louise; Moorthy, Krishna; Aggarwal, Rajesh; Johannsson, Helgi; Gautama, Sanjay; Kneebone, Roger; Sevdalis, Nick

    2011-10-01

    Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. Twenty-five surgeons performed a laparoscopic cholecystectomy (LC) in a simulated operating room. Technical and nontechnical performance was assessed by participants and faculty members using the validated Objective Structured Assessment of Technical Skills (OSATS) and the Non-Technical Skills for Surgeons scale (NOTSS). Assessment of technical performance correlated between self and faculty members' ratings for experienced (median score, 30.0 vs 31.0; ρ = .831; P = .001) and inexperienced (median score, 22.0 vs 28.0; ρ = .761; P = .003) surgeons. Assessment of nontechnical skills between self and faculty members did not correlate for experienced surgeons (median score, 8.0 vs 10.5; ρ = -.375; P = .229) or their more inexperienced counterparts (median score, 9.0 vs 7.0; ρ = -.018; P = .953). Surgeons can accurately self-assess their technical skills in virtual reality LC. Conversely, formal assessment with faculty members' input is required for nontechnical skills, for which surgeons lack insight into their behaviours. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Impact of simulation training on Jordanian nurses' performance of basic life support skills: A pilot study.

    Science.gov (United States)

    Toubasi, Samar; Alosta, Mohammed R; Darawad, Muhammad W; Demeh, Waddah

    2015-09-01

    Providing efficient basic life support (BLS) training is crucial for practicing nurses who provide direct patient care. Nevertheless, data addressing the impact of BLS courses on the skills and performance of Jordanian nurses are scarce. This study aimed to assess the effectiveness of a BLS simulation training on Jordanian nurses' skill improvement in cardiopulmonary resuscitation. A prospective quasi-experimental, single group pretest-posttest design was used to study the effect of BLS simulation; using a 9-item checklist; on the spot training; American Heart Association, on a group of Jordanian nurses. A pre-test was conducted following a CPR scenario to test the skills using 9-item checklist extrapolated from the American Heart Association guidelines. After debriefing, an interactive on spot training was provided. Later, participants undertook an unscheduled post-test after four weeks that included the same nine items. Thirty registered nurses with a mean clinical experience of 6.1years participated in the study. Comparing pre-test (M=4.6, SD=2.9, range=0 to 9) with post-test results (M=7.5, SD=1.7, range=4 to 9) showed an overall improvement in skills and BLS scores after the simulation training program (t=7.4, df=29, pskills and performance among Jordanian nurses. A refreshment BLS training session for nurses is highly recommended to guarantee nurses' preparedness in actual CPR scenarios. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Factors associated with simulator-assessed laparoscopic surgical skills of veterinary students.

    Science.gov (United States)

    Kilkenny, Jessica J; Singh, Ameet; Kerr, Carolyn L; Khosa, Deep K; Fransson, Boel A

    2017-06-01

    OBJECTIVE To determine whether simulator-assessed laparoscopic skills of veterinary students were associated with training level and prior experience performing nonlaparoscopic veterinary surgery and other activities requiring hand-eye coordination and manual dexterity. DESIGN Experiment. SAMPLE 145 students without any prior laparoscopic surgical or fundamentals of laparoscopic surgery (FLS) simulator experience in years 1 (n = 39), 2 (34), 3 (39), and 4 (33) at a veterinary college. PROCEDURES A questionnaire was used to collect data from participants regarding experience performing veterinary surgery, playing video games, and participating in other activities. Participants performed a peg transfer, pattern cutting, and ligature loop-placement task on an FLS simulator, and FLS scores were assigned by an observer. Scores were compared among academic years, and correlations between amounts of veterinary surgical experience and FLS scores were assessed. A general linear model was used to identify predictors of FLS scores. RESULTS Participants were predominantly female (75%), right-hand dominant (92%), and between 20 and 29 years of age (98%). No significant differences were identified among academic years in FLS scores for individual tasks or total FLS score. Scores were not significantly associated with prior surgical or video game experience. Participants reporting no handicraft experience had significantly lower total FLS scores and FLS scores for task 2 than did participants reporting a lot of handicraft experience. CONCLUSIONS AND CLINICAL RELEVANCE Prior veterinary surgical and video game experience had no influence on FLS scores in this group of veterinary students, suggesting that proficiency of veterinary students in FLS may require specific training.

  20. A novel virtual reality simulation for hemostasis in a brain surgical cavity: perceived utility for visuomotor skills in current and aspiring neurosurgery residents.

    Science.gov (United States)

    Gasco, Jaime; Patel, Achal; Luciano, Cristian; Holbrook, Thomas; Ortega-Barnett, Juan; Kuo, Yong-Fang; Rizzi, Silvio; Kania, Patrick; Banerjee, Pat; Roitberg, Ben Z

    2013-12-01

    To understand the perceived utility of a novel simulator to improve operative skill, eye-hand coordination, and depth perception. We used the ImmersiveTouch simulation platform (ImmersiveTouch, Inc., Chicago, Illinois, USA) in two U.S. Accreditation Council for Graduate Medical Education-accredited neurosurgical training programs: the University of Chicago and the University of Texas Medical Branch. A total of 54 trainees participated in the study, which consisted of 14 residents (group A), 20 senior medical students who were neurosurgery candidates (group B), and 20 junior medical students (group C). The participants performed a simulation task that established bipolar hemostasis in a virtual brain cavity and provided qualitative feedback regarding perceived benefits in eye-hand coordination, depth perception, and potential to assist in improving operating skills. The perceived ability of the simulator to positively influence skills judged by the three groups: group A, residents; group B, senior medical students; and group C, junior medical students was, respectively, 86%, 100%, and 100% for eye-hand coordination; 86%, 100%, and 95% for depth perception; and 79%, 100%, and 100% for surgical skills in the operating room. From all groups, 96.2% found the simulation somewhat or very useful to improve eye-hand coordination, and 94% considered it beneficial to improve depth perception and operating room skills. This simulation module may be suitable for resident training, as well as for the development of career interest and skill acquisition; however, validation for this type of simulation needs to be further developed. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Understanding the impact of simulated patients on health care learners' communication skills: a systematic review.

    Science.gov (United States)

    Kaplonyi, Jessica; Bowles, Kelly-Ann; Nestel, Debra; Kiegaldie, Debra; Maloney, Stephen; Haines, Terry; Williams, Cylie

    2017-12-01

    Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap exists in the body of research on the effectiveness of SP-based education to teach communication skills that impact patient outcomes. The aim of this systematic review was to critically analyse the existing research, investigating whether SP-based communication skills training improves learner-patient communication, how communication skill improvement is measured, and who measures these improvements. The databases Medline, ProQuest (Health & Medical Complete, Nursing and Allied Health Source) and CINAHL (EBSCOhost) Education Resources Information Centre (ERIC) were searched for articles that investigated the effects of SP-based education on the communication skills of medical, nursing and allied health learners. There were 60 studies included in the review. Only two studies reported direct patient outcomes, one reporting some negative impact, and no studies included an economic analysis. Many studies reported statistically significant third-party ratings of improved communication effectiveness following SP-based education; however, studies were unable to be pooled for meta-analysis because of the outcome collection methods. There were a small number of studies comparing SP with no training at all and there were no differences between communication skills, contradicting the results from studies reporting benefits. Of the 60 studies included for analysis, 54 (90%) met the minimum quality score of 7/11, with four articles (7%) scoring 11/11. SP-based education is widely accepted as a valuable and effective means of teaching communication skills but there is limited evidence of how this translates to patient outcomes and no indication of economic benefit for this

  2. Following the Template: Transferring Modeling Skills to Nonstandard Problems

    Science.gov (United States)

    Tyumeneva, Yu. A.; Goncharova, M. V.

    2017-01-01

    This study seeks to analyze how students apply a mathematical modeling skill that was previously learned by solving standard word problems to the solution of word problems with nonstandard contexts. During the course of an experiment involving 106 freshmen, we assessed how well they were able to transfer the mathematical modeling skill that is…

  3. The Gain-Loss Model: A Probabilistic Skill Multimap Model for Assessing Learning Processes

    Science.gov (United States)

    Robusto, Egidio; Stefanutti, Luca; Anselmi, Pasquale

    2010-01-01

    Within the theoretical framework of knowledge space theory, a probabilistic skill multimap model for assessing learning processes is proposed. The learning process of a student is modeled as a function of the student's knowledge and of an educational intervention on the attainment of specific skills required to solve problems in a knowledge…

  4. Implementation and outcome evaluation of high-fidelity simulation scenarios to integrate cognitive and psychomotor skills for Korean nursing students.

    Science.gov (United States)

    Ahn, Heejung; Kim, Hyun-Young

    2015-05-01

    This study is involved in designing high-fidelity simulations reflecting the Korean nursing education environment. In addition, it evaluated the simulations by nursing students' learning outcomes and perceptions of the simulation design features. A quantitative design was used in two separate phases. For the first phase, five nursing experts participated in verifying the appropriateness of two simulation scenarios that reflected the intended learning objectives. For the second phase, 69 nursing students in the third year of a bachelor's degree at a nursing school participated in evaluating the simulations and were randomized according to their previous course grades. The first phase verified the two simulation scenarios using a questionnaire. The second phase evaluated students' perceptions of the simulation design, self-confidence, and critical thinking skills using a quasi-experimental post-test design. ANCOVA was used to compare the experimental and control groups, and correlation coefficient analysis was used to determine the correlation among them. We created 2 simulation scenarios to integrate cognitive and psychomotor skills according to the learning objectives and clinical environment in Korea. The experimental group had significantly higher scores on self-confidence in the first scenario. The positive correlations between perceptions of the simulation design features, self-confidence, and critical thinking skill scores were statistically significant. Students with a more positive perception of the design features of the simulations had better learning outcomes. Based on this result, simulations need to be designed and implemented with more differentiation in order to be perceived more appropriately by students. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The nature and use of prediction skills in a biological computer simulation

    Science.gov (United States)

    Lavoie, Derrick R.; Good, Ron

    The primary goal of this study was to examine the science process skill of prediction using qualitative research methodology. The think-aloud interview, modeled after Ericsson and Simon (1984), let to the identification of 63 program exploration and prediction behaviors.The performance of seven formal and seven concrete operational high-school biology students were videotaped during a three-phase learning sequence on water pollution. Subjects explored the effects of five independent variables on two dependent variables over time using a computer-simulation program. Predictions were made concerning the effect of the independent variables upon dependent variables through time. Subjects were identified according to initial knowledge of the subject matter and success at solving three selected prediction problems.Successful predictors generally had high initial knowledge of the subject matter and were formal operational. Unsuccessful predictors generally had low initial knowledge and were concrete operational. High initial knowledge seemed to be more important to predictive success than stage of Piagetian cognitive development.Successful prediction behaviors involved systematic manipulation of the independent variables, note taking, identification and use of appropriate independent-dependent variable relationships, high interest and motivation, and in general, higher-level thinking skills. Behaviors characteristic of unsuccessful predictors were nonsystematic manipulation of independent variables, lack of motivation and persistence, misconceptions, and the identification and use of inappropriate independent-dependent variable relationships.

  6. Feedforward self-modeling enhances skill acquisition in children learning trampoline skills.

    Science.gov (United States)

    Ste-Marie, Diane M; Vertes, Kelly; Rymal, Amanda M; Martini, Rose

    2011-01-01

    The purpose of this research was to examine whether children would benefit from a feedforward self-modeling (FSM) video and to explore possible explanatory mechanisms for the potential benefits, using a self-regulation framework. To this end, children were involved in learning two five-skill trampoline routines. For one of the routines, a FSM video was provided during acquisition, whereas only verbal instructions were provided for the alternate routine. The FSM involved editing video footage such that it showed the learner performing the trampoline routine at a higher skill level than their current capability. Analyses of the data showed that while physical performance benefits were observed for the routine that was learned with the FSM video, no differences were obtained in relation to the self-regulatory measures. Thus, the FSM video enhanced motor skill acquisition, but this could not be explained by changes to the varied self-regulatory processes examined.

  7. Simulation-based end-of-life care training during surgical clerkship: assessment of skills and perceptions.

    Science.gov (United States)

    Parikh, Priti P; Brown, Ronald; White, Mary; Markert, Ronald J; Eustace, Rosemary; Tchorz, Kathryn

    2015-06-15

    Assessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. Medical students underwent simulation-based end-of-life care OSCE training that involved standardized patients who evaluated students' communication skills and physician trust with the Kalamazoo Essential Elements Communication Checklist and the Wake Forest Physician Trust Scale. Students also completed the Jefferson Scale of Physician Empathy. Pearson correlation was used to examine the relationship between OSCE performance grades and communication, trust, and empathy scores. Student comments were analyzed using the constant comparative method of analysis to identify dominant themes. The 389 students (mean age 26.6 ± 2.8 y; 54.5% female) had OSCE grades that were positively correlated with physician trust scores (r = 0.325, P training to be a valuable learning experience and appreciated its placement early in clinical training. We found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative comments of students regarding the opportunity to practice difficult patient conversations suggest that attention to these professional characteristics and skills is a valued element of clinical training and conceivably a step toward better patient outcomes and satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Numerical simulation of rainfall and temperature over Kenya using weather research and forecasting-environmental modelling system (WRF-EMS

    Directory of Open Access Journals (Sweden)

    Sagero Obaigwa Philip

    2016-01-01

    Full Text Available This paper focuses on one of the high resolution models used for weather forecasting at Kenya Meteorological Department (KMD. It reviews the skill and accuracy of the Weather Research and Forecasting (WRF - Environmental Modeling System (EMS model, in simulating weather over Kenya. The study period was March to May 2011, during the rainy season over Kenya. The model output was compared with the observed data from 27 synoptic stations spread over the study area, to determine the performance of the model in terms of its skill and accuracy in forecasting. The spatial distribution of rainfall and temperature showed that the WRF model was capable of reproducing the observed general pattern especially for temperature. The model has skill in forecasting both rainfall and temperature over the study area. However, the model may underestimate rainfall of more than 10 mm/day and displace its location and overestimate rainfall of less than 1 mm/day. Therefore, during the period of enhanced rainfall especially in the month of April and part of May the model forecast needs to be complemented by other models or forecasting methods before giving a forecast. There is need to improve its performance over the domain through review of the parameterization of small scale physical processes and more observed data need to be simulated into the model.

  9. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

    Science.gov (United States)

    Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large

  10. A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools.

    Science.gov (United States)

    Shen, Zhanlong; Yang, Fan; Gao, Pengji; Zeng, Li; Jiang, Guanchao; Wang, Shan; Ye, Yingjiang; Zhu, Fengxue

    2017-06-21

    Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination. Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation. Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

  11. Tuning a RANS k-e model for jet-in-crossflow simulations.

    Energy Technology Data Exchange (ETDEWEB)

    Lefantzi, Sophia; Ray, Jaideep; Arunajatesan, Srinivasan; DeChant, Lawrence Justin

    2013-09-01

    We develop a novel calibration approach to address the problem of predictive ke RANS simulations of jet-incrossflow. Our approach is based on the hypothesis that predictive ke parameters can be obtained by estimating them from a strongly vortical flow, specifically, flow over a square cylinder. In this study, we estimate three ke parameters, C%CE%BC, Ce2 and Ce1 by fitting 2D RANS simulations to experimental data. We use polynomial surrogates of 2D RANS for this purpose. We conduct an ensemble of 2D RANS runs using samples of (C%CE%BC;Ce2;Ce1) and regress Reynolds stresses to the samples using a simple polynomial. We then use this surrogate of the 2D RANS model to infer a joint distribution for the ke parameters by solving a Bayesian inverse problem, conditioned on the experimental data. The calibrated (C%CE%BC;Ce2;Ce1) distribution is used to seed an ensemble of 3D jet-in-crossflow simulations. We compare the ensemble's predictions of the flowfield, at two planes, to PIV measurements and estimate the predictive skill of the calibrated 3D RANS model. We also compare it against 3D RANS predictions using the nominal (uncalibrated) values of (C%CE%BC;Ce2;Ce1), and find that calibration delivers a significant improvement to the predictive skill of the 3D RANS model. We repeat the calibration using surrogate models based on kriging and find that the calibration, based on these more accurate models, is not much better that those obtained with simple polynomial surrogates. We discuss the reasons for this rather surprising outcome.

  12. Secrets to Success: Business Skills and Knowledge That Students Find Most Useful in Succeeding in a Capstone Course Simulation

    Science.gov (United States)

    Gresch, Eric; Rawls, Janita

    2017-01-01

    This exploratory research examines students' perceptions of a capstone business simulation game by identifying (a) courses that were most useful in preparing students for the simulation and (b) interpersonal skills students found most helpful when working with teammates on the simulation. Also identified are the simulation's impact on student…

  13. Simulations in Cyber-Security: A Review of Cognitive Modeling of Network Attackers, Defenders, and Users.

    Science.gov (United States)

    Veksler, Vladislav D; Buchler, Norbou; Hoffman, Blaine E; Cassenti, Daniel N; Sample, Char; Sugrim, Shridat

    2018-01-01

    Computational models of cognitive processes may be employed in cyber-security tools, experiments, and simulations to address human agency and effective decision-making in keeping computational networks secure. Cognitive modeling can addresses multi-disciplinary cyber-security challenges requiring cross-cutting approaches over the human and computational sciences such as the following: (a) adversarial reasoning and behavioral game theory to predict attacker subjective utilities and decision likelihood distributions, (b) human factors of cyber tools to address human system integration challenges, estimation of defender cognitive states, and opportunities for automation, (c) dynamic simulations involving attacker, defender, and user models to enhance studies of cyber epidemiology and cyber hygiene, and (d) training effectiveness research and training scenarios to address human cyber-security performance, maturation of cyber-security skill sets, and effective decision-making. Models may be initially constructed at the group-level based on mean tendencies of each subject's subgroup, based on known statistics such as specific skill proficiencies, demographic characteristics, and cultural factors. For more precise and accurate predictions, cognitive models may be fine-tuned to each individual attacker, defender, or user profile, and updated over time (based on recorded behavior) via techniques such as model tracing and dynamic parameter fitting.

  14. MODEL AUTHENTIC SELF-ASSESSMENT DALAM PENGEMBANGAN EMPLOYABILITY SKILLS MAHASISWA PENDIDIKAN TINGGI VOKASI

    Directory of Open Access Journals (Sweden)

    I Made Suarta

    2015-06-01

    ______________________________________________________________ AUTHENTIC SELF-ASSESSMENT MODEL FOR DEVELOPING EMPLOYABILITY SKILLS STUDENT IN HIGHER VOCATIONAL EDUCATION Abstract The purpose of this research is to develop assessment tools to evaluate achievement of employability skills which are integrated in the learning database applications. The assessment model developed is a combination of self-assessment and authentic assessment, proposed as models of authentic self-assessment. The steps of developing authentic self-assessment models include: identifying the standards, selecting an authentic task, identifying the criteria for the task, and creating the rubric. The results of development assessment tools include: (1 problem solving skills assessment model, (2 self-management skills assessment model, and (3 competence database applications assessment model. This model can be used to assess the cognitive, affective, and psychomotor achievement. The results indicate: achievement of problem solving and self-management ability was in good category, and competencies in designing conceptual and logical database was in high category. This model also has met the basic principles of assessment, i.e.: validity, reliability, focused on competencies, comprehen-sive, objectivity, and the principle of educating. Keywords: authentic assessment, self-assessment, problem solving skills, self-management skills, vocational education

  15. Local and national laparoscopic skill competitions: residents' opinions and impact on adoption of simulation-based training.

    Science.gov (United States)

    McCreery, Greig L; El-Beheiry, Mostafa; Schlachta, Christopher M

    2017-11-01

    Dedicated practice using laparoscopic simulators improves operative performance. Yet, voluntary utilization is minimal. We hypothesized that skill competition between peers, at the local and national level, positively influences residents' use of laparoscopic simulators. A web-based survey evaluated the relationship between Canadian General Surgery residents' use of laparoscopic simulation and participation in competition. Secondary outcomes assessed attitudes regarding simulation training, factors limiting use, and associations between competition level and usage. One hundred ninety (23%) of 826 potential participants responded. Eighty-three percent rated their laparoscopic abilities as novice or intermediate. More than 70% agreed that use of simulation practice improves intra-operative performance, and should be a mandatory component of training. However, 58% employed simulator practice less than once per month, and 18% never used a simulator. Sixty-five percent engaged in simulator training for 5 h or less over the preceding 6 months. Seventy-three percent had participated in laparoscopic skill competition. Of those, 51% agreed that competition was a motivation for simulation practice. No association was found between those with competition experience and simulator use. However, 83% of those who had competed nationally reported >5 h of simulator use in the previous 6 months compared to those with no competition experience (26%), local competition (40%), and local national-qualifying competition (23%) (p simulation-based training, with only the minority of individuals competing at the national level demonstrated significantly higher simulation use. However, simulation training was perceived as a valuable exercise. Lack of time and access to simulators, as opposed to lack of interest, were the most commonly reported to limited use.

  16. Key issues and challenges in developing a pedagogical intervention in the simulation skills center--an action research study.

    Science.gov (United States)

    Reierson, Inger Åse; Hvidsten, Anne; Wighus, Marianne; Brungot, Solvor; Bjørk, Ida Torunn

    2013-07-01

    Simulation skills centers (SSC) are considered important learning arenas for preparing and qualifying nursing students. Limited clinical placements and claims of diminished learning opportunities raise concerns that newly educated nurses lack proficiency in many psychomotor skills. Accordingly, there is an increased focus on learning in the SSC. However, it has been questioned if the pedagogical underpinning of teaching and learning in the SSC is missing or unclear. At a bachelor nursing education in Norway, there was a desire to change practice and enhance learning in the SSC by systematic use of The Model of Practical Skill Performance (Bjørk and Kirkevold, 2000). A participatory action research design was chosen. A pedagogical intervention was developed and implemented in 2010 in a cohort of eighty-seven first year bachelor nursing students during their basic nursing skill course. The intervention is shortly described. This article reports key issues and challenges that emerged during development of the new intervention. Data to inform the study were collected via thorough meeting minutes and the project leader's logbook, and analyzed using fieldnotes analysis. Six key issues and challenges were identified. These are presented and discussed consecutively in light of their importance for development and implementation of the new intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective.

    Science.gov (United States)

    Peña, Adolfo

    2010-06-14

    The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. Such a model is being accepted almost without debate from physicians to explain the 'acquisition' of clinical skills. This paper reviews such a model, discusses several controversial points, clarifies what kind of knowledge the model is about, and examines its coherence in terms of problem-solving skills. Dreyfus' main idea that intuition is a major aspect of expertise is also discussed in some detail. Relevant scientific evidence from cognitive science, psychology, and neuroscience is reviewed to accomplish these aims. Although the Dreyfus model may partially explain the 'acquisition' of some skills, it is debatable if it can explain the acquisition of clinical skills. The complex nature of clinical problem-solving skills and the rich interplay between the implicit and explicit forms of knowledge must be taken into consideration when we want to explain 'acquisition' of clinical skills. The idea that experts work from intuition, not from reason, should be evaluated carefully.

  18. Skill and reliability of climate model ensembles at the Last Glacial Maximum and mid-Holocene

    Directory of Open Access Journals (Sweden)

    J. C. Hargreaves

    2013-03-01

    Full Text Available Paleoclimate simulations provide us with an opportunity to critically confront and evaluate the performance of climate models in simulating the response of the climate system to changes in radiative forcing and other boundary conditions. Hargreaves et al. (2011 analysed the reliability of the Paleoclimate Modelling Intercomparison Project, PMIP2 model ensemble with respect to the MARGO sea surface temperature data synthesis (MARGO Project Members, 2009 for the Last Glacial Maximum (LGM, 21 ka BP. Here we extend that work to include a new comprehensive collection of land surface data (Bartlein et al., 2011, and introduce a novel analysis of the predictive skill of the models. We include output from the PMIP3 experiments, from the two models for which suitable data are currently available. We also perform the same analyses for the PMIP2 mid-Holocene (6 ka BP ensembles and available proxy data sets. Our results are predominantly positive for the LGM, suggesting that as well as the global mean change, the models can reproduce the observed pattern of change on the broadest scales, such as the overall land–sea contrast and polar amplification, although the more detailed sub-continental scale patterns of change remains elusive. In contrast, our results for the mid-Holocene are substantially negative, with the models failing to reproduce the observed changes with any degree of skill. One cause of this problem could be that the globally- and annually-averaged forcing anomaly is very weak at the mid-Holocene, and so the results are dominated by the more localised regional patterns in the parts of globe for which data are available. The root cause of the model-data mismatch at these scales is unclear. If the proxy calibration is itself reliable, then representativity error in the data-model comparison, and missing climate feedbacks in the models are other possible sources of error.

  19. High-fidelity simulation-based team training in urology: evaluation of technical and nontechnical skills of urology residents during laparoscopic partial nephrectomy.

    Science.gov (United States)

    Abdelshehid, Corollos S; Quach, Stephen; Nelson, Corey; Graversen, Joseph; Lusch, Achim; Zarraga, Jerome; Alipanah, Reza; Landman, Jaime; McDougall, Elspeth M

    2013-01-01

    The use of low-risk simulation training for resident education is rapidly expanding as teaching centers integrate simulation-based team training (SBTT) sessions into their education curriculum. SBTT is a valuable tool in technical and communication skills training and assessment for residents. We created a unique SBTT scenario for urology residents involving a laparoscopic partial nephrectomy procedure. Urology residents were randomly paired with a certified registered nurse anesthetists or an anesthesia resident. The scenario incorporated a laparoscopic right partial nephrectomy utilizing a unique polyvinyl alcohol kidney model with an embedded 3cm lower pole exophytic tumor and the high-fidelity SimMan3G mannequin. The Urology residents were instructed to pay particular attention to the patient's identifying information provided at the beginning of the case. Two scripted events occurred, the patient had an anaphylactic reaction to a drug and, after tumor specimen was sent for a frozen section, the confederate pathologist called into the operating room (OR) twice, first with the wrong patient name and subsequently with the wrong specimen. After the scenario was complete, technical performance and nontechnical performance were evaluated and assessed. A debriefing session followed the scenario to discuss and assess technical performance and interdisciplinary nontechnical communication between the team. All Urology residents (n = 9) rated the SBTT scenario as a useful tool in developing communication skills among the OR team and 88% rated the model as useful for technical skills training. Despite cuing to note patient identification, only 3 of 9 (33%) participants identified that the wrong patient information was presented when the confederate "pathologist" called in to report pathology results. All urology residents rated SBTT sessions as useful for the development of communication skills between different team members and making residents aware of unlikely but

  20. Experiential learning model on entrepreneurship subject for improving students’ soft skills

    Directory of Open Access Journals (Sweden)

    Lina Rifda Naufalin

    2017-01-01

    Full Text Available The objective of the research was to improve students’ soft skills on entrepreneurship subject by using experiential learning model. It was expected that the learning model could upgrade students’ soft skills which were indicated by the higher confidence, result and job oriented, being courageous to take risks, leadership, originality, and future-oriented. It was a class action research using Kemmis and Mc Tagart’s design model. The research was conducted for two cycles. The subject of the study was economics education students in 2015/2016.  The result of the research showed that the experiential learning model could improve students’ soft skills. The research showed that there were increases at the dimension of confidence, (52.1%, result-oriented (22.9%, being courageous to take risks (10.4%, leadership (12.5%, originality (10.4%, and future-oriented (18.8%. It could be concluded that the experiential learning model was effective to improve students’ soft skills on entrepreneurship subject. It also showed that the dimension of confidence had the highest rise. Students’ soft skills were shaped through the continuous stimulus when they got involved at the implementation.Penelitian ini bertujuan untuk meningkatkan soft skills mahasiswa dalam mata kuliah kewirausahaan dengan menggunakan model experietial learning. Diharapkan dengan model pembelajaran ini terjadi peningkatan soft skills mahasiswa yang ditandai dengan peningkatan rasa percaya diri, berorientasi tugas dan hasil, berani mengambil resiko, kepemimpinan, keorisinilan, dan berorientasi masa depan. Penelitian ini menggunakan metode penelitian tindakan kelas dengan menggunakan model desain menurut Kemmis dan Mc Tagart. Penelitian ini dilakukan dalam dua siklus, yaitu siklus I dan siklus II. Penelitian ini dilaksanakan di kelas pendidikan ekonomi angkatan 2015/2016. Hasil penelitian ini menunjukkan bahwa penggunaan model experiential learning dapat meningkatkan soft skills

  1. Comparison of 3D Echocardiogram-Derived 3D Printed Valve Models to Molded Models for Simulated Repair of Pediatric Atrioventricular Valves.

    Science.gov (United States)

    Scanlan, Adam B; Nguyen, Alex V; Ilina, Anna; Lasso, Andras; Cripe, Linnea; Jegatheeswaran, Anusha; Silvestro, Elizabeth; McGowan, Francis X; Mascio, Christopher E; Fuller, Stephanie; Spray, Thomas L; Cohen, Meryl S; Fichtinger, Gabor; Jolley, Matthew A

    2018-03-01

    Mastering the technical skills required to perform pediatric cardiac valve surgery is challenging in part due to limited opportunity for practice. Transformation of 3D echocardiographic (echo) images of congenitally abnormal heart valves to realistic physical models could allow patient-specific simulation of surgical valve repair. We compared materials, processes, and costs for 3D printing and molding of patient-specific models for visualization and surgical simulation of congenitally abnormal heart valves. Pediatric atrioventricular valves (mitral, tricuspid, and common atrioventricular valve) were modeled from transthoracic 3D echo images using semi-automated methods implemented as custom modules in 3D Slicer. Valve models were then both 3D printed in soft materials and molded in silicone using 3D printed "negative" molds. Using pre-defined assessment criteria, valve models were evaluated by congenital cardiac surgeons to determine suitability for simulation. Surgeon assessment indicated that the molded valves had superior material properties for the purposes of simulation compared to directly printed valves (p 3D echo-derived molded valves are a step toward realistic simulation of complex valve repairs but require more time and labor to create than directly printed models. Patient-specific simulation of valve repair in children using such models may be useful for surgical training and simulation of complex congenital cases.

  2. Feedforward self-modeling enhances skill acquisition in children learning trampoline skills

    Directory of Open Access Journals (Sweden)

    Diane M. Ste-Marie

    2011-07-01

    Full Text Available The purpose of this research was to examine whether children would benefit from a feedforward self-modeling (FSM video and to explore possible explanatory mechanisms for the potential benefits, using a self-regulation framework. To this end, children were involved in learning two five-skill trampoline routines. For one of the routines, a FSM video was provided during acquisition, whereas only verbal instructions were provided for the alternate routine. The FSM involved editing video footage such that it showed the learner performing the trampoline routine at a higher skill level than their current capability. Analyses of the data showed that while physical performance benefits were observed for the routine that was learned with the FSM video, no differences were obtained in relation to the self-regulatory measures. Thus, the FSM video enhanced motor skill acquisition, but this could not be explained by changes to the varied self-regulatory processes examined.

  3. Are Live Ultrasound Models Replaceable? Traditional vs. Simulated Education Module for FAST

    Directory of Open Access Journals (Sweden)

    Suzanne Bentley

    2015-10-01

    Full Text Available Introduction: The focused assessment with sonography for trauma (FAST is a commonly used and life-saving tool in the initial assessment of trauma patients. The recommended emergency medicine (EM curriculum includes ultrasound and studies show the additional utility of ultrasound training for medical students. EM clerkships vary and often do not contain formal ultrasound instruction. Time constraints for facilitating lectures and hands-on learning of ultrasound are challenging. Limitations on didactics call for development and inclusion of novel educational strategies, such as simulation. The objective of this study was to compare the test, survey, and performance of ultrasound between medical students trained on an ultrasound simulator versus those trained via traditional, hands-on patient format. Methods: This was a prospective, blinded, controlled educational study focused on EM clerkship medical students. After all received a standardized lecture with pictorial demonstration of image acquisition, students were randomized into two groups: control group receiving traditional training method via practice on a human model and intervention group training via practice on an ultrasound simulator. Participants were tested and surveyed on indications and interpretation of FAST and training and confidence with image interpretation and acquisition before and after this educational activity. Evaluation of FAST skills was performed on a human model to emulate patient care and practical skills were scored via objective structured clinical examination (OSCE with critical action checklist. Results: There was no significant difference between control group (N=54 and intervention group (N=39 on pretest scores, prior ultrasound training/education, or ultrasound comfort level in general or on FAST. All students (N=93 showed significant improvement from pre- to post-test scores and significant improvement in comfort level using ultrasound in general and on FAST

  4. Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.

    Science.gov (United States)

    Ghobrial, George M; Anderson, Paul A; Chitale, Rohan; Campbell, Peter G; Lobel, Darlene A; Harrop, James

    2013-10-01

    In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity. To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model. The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine. Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all. Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.

  5. Reliable assessment of general surgeons' non-technical skills based on video-recordings of patient simulated scenarios.

    Science.gov (United States)

    Spanager, Lene; Beier-Holgersen, Randi; Dieckmann, Peter; Konge, Lars; Rosenberg, Jacob; Oestergaard, Doris

    2013-11-01

    Nontechnical skills are essential for safe and efficient surgery. The aim of this study was to evaluate the reliability of an assessment tool for surgeons' nontechnical skills, Non-Technical Skills for Surgeons dk (NOTSSdk), and the effect of rater training. A 1-day course was conducted for 15 general surgeons in which they rated surgeons' nontechnical skills in 9 video recordings of scenarios simulating real intraoperative situations. Data were gathered from 2 sessions separated by a 4-hour training session. Interrater reliability was high for both pretraining ratings (Cronbach's α = .97) and posttraining ratings (Cronbach's α = .98). There was no statistically significant development in assessment skills. The D study showed that 2 untrained raters or 1 trained rater was needed to obtain generalizability coefficients >.80. The high pretraining interrater reliability indicates that videos were easy to rate and Non-Technical Skills for Surgeons dk easy to use. This implies that Non-Technical Skills for Surgeons dk (NOTSSdk) could be an important tool in surgical training, potentially improving safety and quality for surgical patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. 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.

  7. Impact of current video game playing on robotic simulation skills among medical students.

    Science.gov (United States)

    Öge, Tufan; Borahay, Mostafa A; Achjian, Tamar; Kılıç, Sami Gökhan

    2015-01-01

    To evaluate the impact of current and prior video game playing on initial robotic simulation skill acquisition. This cross-sectional descriptive study (Canadian Task Force Classification II-1) was conducted at a medical university training center. The study subjects were medical students who currently played video games (Group I) and those who had not played video games in the last 2 years (Group II). The robotic skills of both groups were assessed using simulation. Twenty-two students enrolled in this study; however, only 21 completed it. The median age of the participants was 23 (22-24) years and 24 (23-26) years in Groups I and II, respectively. Among the participants, 15 (71.4%) were male and 6 (28.5%) were female, and 90.4% of the students started playing video games in primary school. When the 2 groups were compared according to the completion time of each exercise, Group I finished more quickly than Group II in the Peg Board-1 exercise (p>0.05), whereas Group II had better results in 3 exercises including Pick and Place, Ring and Rail, and Thread the Rings-1. However, none of the differences were found to be statistically significant (p>.05), and according to the overall scores based on the time to complete exercises, economy of motion, instrument collision, use of excessive instrument force, instruments out of view, and master workspace range, the scores were not statistically different between Groups I and II (p>.05). According to the basic robotic simulation exercise results, there was no difference between medical students who used to play video games and those who still played video games. Studies evaluating baseline visuospatial skills with larger sample sizes are needed.

  8. Effect of Continuous Motion Parameter Feedback on Laparoscopic Simulation Training: A Prospective Randomized Controlled Trial on Skill Acquisition and Retention.

    Science.gov (United States)

    Buescher, Julian Frederik; Mehdorn, Anne-Sophie; Neumann, Philipp-Alexander; Becker, Felix; Eichelmann, Ann-Kathrin; Pankratius, Ulrich; Bahde, Ralf; Foell, Daniel; Senninger, Norbert; Rijcken, Emile

    To investigate the effect of motion parameter feedback on laparoscopic basic skill acquisition and retention during a standardized box training curriculum. A Lap-X Hybrid laparoscopic simulator was designed to provide individual and continuous motion parameter feedback in a dry box trainer setting. In a prospective controlled trial, surgical novices were randomized into 2 groups (regular box group, n = 18, and Hybrid group, n = 18) to undergo an identical 5-day training program. In each group, 7 standardized tasks on laparoscopic basic skills were completed twice a day on 4 consecutive days in fixed pairs. Additionally, each participant performed a simulated standard laparoscopic cholecystectomy before (day 1) and after training (day 5) on a LAP Mentor II virtual reality (VR) trainer, allowing an independent control of skill progress in both groups. A follow-up assessment of skill retention was performed after 6 weeks with repetition of both the box tasks and VR cholecystectomy. Muenster University Hospital Training Center, Muenster, Germany. Medical students without previous surgical experience. Laparoscopic skills in both groups improved significantly during the training period, measured by the overall task performance time. The 6 week follow-up showed comparable skill retention in both groups. Evaluation of the VR cholecystectomies demonstrated significant decrease of operation time (p Simulation training on both trainers enables reliable acquisition of laparoscopic basic skills. Furthermore, individual and continuous motion feedback improves laparoscopic skill enhancement significantly in several aspects. Thus, training systems with feedback of motion parameters should be considered to achieve long-term improvement of motion economy among surgical trainees. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. High-Fidelity Roadway Modeling and Simulation

    Science.gov (United States)

    Wang, Jie; Papelis, Yiannis; Shen, Yuzhong; Unal, Ozhan; Cetin, Mecit

    2010-01-01

    Roads are an essential feature in our daily lives. With the advances in computing technologies, 2D and 3D road models are employed in many applications, such as computer games and virtual environments. Traditional road models were generated by professional artists manually using modeling software tools such as Maya and 3ds Max. This approach requires both highly specialized and sophisticated skills and massive manual labor. Automatic road generation based on procedural modeling can create road models using specially designed computer algorithms or procedures, reducing the tedious manual editing needed for road modeling dramatically. But most existing procedural modeling methods for road generation put emphasis on the visual effects of the generated roads, not the geometrical and architectural fidelity. This limitation seriously restricts the applicability of the generated road models. To address this problem, this paper proposes a high-fidelity roadway generation method that takes into account road design principles practiced by civil engineering professionals, and as a result, the generated roads can support not only general applications such as games and simulations in which roads are used as 3D assets, but also demanding civil engineering applications, which requires accurate geometrical models of roads. The inputs to the proposed method include road specifications, civil engineering road design rules, terrain information, and surrounding environment. Then the proposed method generates in real time 3D roads that have both high visual and geometrical fidelities. This paper discusses in details the procedures that convert 2D roads specified in shape files into 3D roads and civil engineering road design principles. The proposed method can be used in many applications that have stringent requirements on high precision 3D models, such as driving simulations and road design prototyping. Preliminary results demonstrate the effectiveness of the proposed method.

  10. Assessing the skill of hydrology models at simulating the water cycle in the HJ Andrews LTER: Assumptions, strengths and weaknesses

    Science.gov (United States)

    Simulated impacts of climate on hydrology can vary greatly as a function of the scale of the input data, model assumptions, and model structure. Four models are commonly used to simulate streamflow in model assumptions, and model structure. Four models are commonly used to simu...

  11. Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study

    Directory of Open Access Journals (Sweden)

    Vilma Mejía

    Full Text Available Abstract Introduction: The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. Methods: After institutional ethical committee approval, 31 first year anesthesiology residents were enrolled in this prospective randomized single-blinded study. Participants were randomized to either a High Fidelity Simulation Scenario or a computer-based Case Study about malignant hyperthermia. After the intervention, all subjects' performance in was assessed through a high fidelity simulation scenario using a previously validated assessment rubric. Additionally, knowledge tests and a satisfaction survey were applied. Finally, a semi-structured interview was done to assess self-perception of reasoning process and decision-making. Results: 28 first year residents finished successfully the study. Resident's management skill scores were globally higher in High Fidelity Simulation versus Case Study, however they were significant in 4 of the 8 performance rubric elements: recognize signs and symptoms (p = 0.025, prioritization of initial actions of management (p = 0.003, recognize complications (p = 0.025 and communication (p = 0.025. Average scores from pre- and post-test knowledge questionnaires improved from 74% to 85% in the High Fidelity Simulation group, and decreased from 78% to 75% in the Case Study group (p = 0.032. Regarding the qualitative analysis, there was no difference in factors influencing the student's process of reasoning and decision-making with both teaching strategies. Conclusion: Simulation-based training with a malignant hyperthermia high-fidelity scenario was superior to computer-based case study, improving knowledge and skills in malignant hyperthermia crisis management, with a very good satisfaction level in anesthesia residents.

  12. Experiential Learning Model on Entrepreneurship Subject to Improve Students’ Soft Skills

    Directory of Open Access Journals (Sweden)

    Lina Rifda Naufalin

    2016-06-01

    Full Text Available This research aims to improve students’ soft skills on entrepreneurship subject by using experiential learning model. It was expected that the learning model could upgrade students’ soft skills which were indicated by the higher confidence, result and job oriented, being courageous to take risks, leadership, originality, and future-oriented. It was a class action research using Kemmis and Mc Tagart’s design model. The research was conducted for two cycles. The subject of the study was economics education students in the year of 2015/2016.  Findings show that the experiential learning model could improve students’ soft skills. The research showed that there is increased at the dimension of confidence by 52.1%, result-oriented by 22.9%, being courageous to take risks by 10.4%, leadership by 12.5%, originality by 10.4%, and future-oriented by 18.8%. It could be concluded that the experiential learning model is effective model to improve students’ soft skills on entrepreneurship subject. Dimension of confidence has the highest rise. Students’ soft skills are shaped through the continuous stimulus when they get involved at the implementation.

  13. Development of a patient-doctor communication skills model for medical students.

    Science.gov (United States)

    Lee, Young Hee; Lee, Young-Mee

    2010-09-01

    Communication is a core clinical skill that can be taught and learned. The authors intended to develop a patient-doctor communication model for teaching and assessing undergraduate medical students in Korea. To develop a model, literature reviews and an iterative process of discussion between faculty members of a communication skills course for second year medical students were conducted. The authors extracted common communication skill competencies by comparing the Kalamazoo Consensus Statement, SEGUE framework communication skills, the Calgary Cambridge Observation Guides, and previous communication skills lists that have been used by the authors. The content validity, with regard to clinical importance and feasibility, was surveyed by both faculty physicians and students. The first version of the model consisted of 36 items under 7 categories: initiating the session (8 items), building a relationship (6), gathering information (8), understanding a patient's perspectives (4), sharing information (4), reaching an agreement (3), and closing the session (3). It was used as a guide for both students and teachers in an actual communication skills course. At the end of the course, student performance was assessed using two 7-minute standardized patient interviews with a 34-item checklist. This assessment tool was modified from the first version of the model to reflect the case specificity of the scenarios. A patient-doctor communication model, which can be taught to those with limited patient care experience, was finally developed. We recommended a patient-doctor communication skills model that can be used for teaching and evaluating preclinical and clinical students. Further studies are needed to verify its validity and reliability.

  14. Causes of skill in seasonal predictions of the Arctic Oscillation

    Science.gov (United States)

    Kumar, Arun; Chen, Mingyue

    2017-11-01

    Based on an analysis of hindcasts from a seasonal forecast system, complemented by the analysis of a large ensemble of AMIP simulations, possible causes for skillful prediction of the winter Arctic Oscillation (AO) on a seasonal time-scale are analyzed. The possibility that the recent increase in AO skill could be due to model improvements, or due to changes in the persistence characteristics of the AO, is first discounted. The analysis then focuses on exploring the possibility that the recent increase in prediction skill in AO may be due to sampling variations or could have physical causes. Temporal variations in AO skill due entirely to sampling alone cannot be discounted as this is a fundamental constraint on verifications over a short time-series. This notion is supported from theoretical considerations, and from the analysis of the temporal variations in the perfect model skill where substantial variations in skill due to sampling alone are documented. As for the physical causes, the analysis indicates possible links in the prediction skill of AO with the SST forcing from the tropics, particularly related to the SST variations associated with the Trans-Niño Index (TNI). Interannual and low frequency variations in the TNI could have contributed to similar temporal variations in AO skill. For example, a dominance of central Pacific El Niño events after 2000 (a reflection of low-frequency variations in TNI) coincided with an increase in the prediction skill of AO. The analysis approach and results provide an avenue for further investigations; for example, model simulations forced with the SST pattern associated with the TNI, to establish or reaffirm causes for AO skill.

  15. Use of high fidelity operating room simulation to assess and teach communication, teamwork and laparoscopic skills: initial experience.

    Science.gov (United States)

    Gettman, Matthew T; Pereira, Claudio W; Lipsky, Katja; Wilson, Torrence; Arnold, Jacqueline J; Leibovich, Bradley C; Karnes, R Jeffrey; Dong, Yue

    2009-03-01

    Structured opportunities for learning communication, teamwork and laparoscopic principles are limited for urology residents. We evaluated and taught teamwork, communication and laparoscopic skills to urology residents in a simulated operating room. Scenarios related to laparoscopy (insufflator failure, carbon dioxide embolism) were developed using mannequins, urology residents and nurses. These scenarios were developed based on Accreditation Council for Graduate Medical Education core competencies and performed in a simulation center. Between the pretest scenario (insufflation failure) and the posttest scenario (carbon dioxide embolism) instruction was given on teamwork, communication and laparoscopic skills. A total of 19 urology residents participated in the training that involved participation in at least 2 scenarios. Performance was evaluated using validated teamwork instruments, questionnaires and videotape analysis. Significant improvement was noted on validated teamwork instruments between scenarios based on resident (pretest 24, posttest 27, p = 0.01) and expert (pretest 16, posttest 25, p = 0.008) evaluation. Increased teamwork and team performance were also noted between scenarios on videotape analysis with significant improvement for adherence to best practice (p = 0.01) and maintenance of positive rapport among team members (p = 0.02). Significant improvement in the setup of the laparoscopic procedure was observed (p = 0.01). Favorable face and content validity was noted for both scenarios. Teamwork, intraoperative communication and laparoscopic skills of urology residents improved during the high fidelity simulation course. Face and content validity of the individual sessions was favorable. In this study high fidelity simulation was effective for assessing and teaching Accreditation Council for Graduate Medical Education core competencies related to intraoperative communication, teamwork and laparoscopic skills.

  16. A simulated training model for laparoscopic pyloromyotomy: Is 3D printing the way of the future?

    Science.gov (United States)

    Williams, Andrew; McWilliam, Morgan; Ahlin, James; Davidson, Jacob; Quantz, Mackenzie A; Bütter, Andreana

    2018-05-01

    Hypertrophic pyloric stenosis (HPS) is a common neonatal condition treated with open or laparoscopic pyloromyotomy. 3D-printed organs offer realistic simulations to practice surgical techniques. The purpose of this study was to validate a 3D HPS stomach model and assess model reliability and surgical realism. Medical students, general surgery residents, and adult and pediatric general surgeons were recruited from a single center. Participants were videotaped three times performing a laparoscopic pyloromyotomy using box trainers and 3D-printed stomachs. Attempts were graded independently by three reviewers using GOALS and Task Specific Assessments (TSA). Participants were surveyed using the Index of Agreement of Assertions on Model Accuracy (IAAMA). Participants reported their experience levels as novice (22%), inexperienced (26%), intermediate (19%), and experienced (33%). Interrater reliability was similar for overall average GOALS and TSA scores. There was a significant improvement in GOALS (p3D-printed stomach model for simulated laparoscopic pyloromyotomy is a useful training tool for learners to improve laparoscopic skills. The GOALS and TSA provide reliable technical skills assessments. II. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Validation of precipitation over Japan during 1985-2004 simulated by three regional climate models and two multi-model ensemble means

    Energy Technology Data Exchange (ETDEWEB)

    Ishizaki, Yasuhiro [Meteorological Research Institute, Tsukuba (Japan); National Institute for Environmental Studies, Tsukuba (Japan); Nakaegawa, Toshiyuki; Takayabu, Izuru [Meteorological Research Institute, Tsukuba (Japan)

    2012-07-15

    We dynamically downscaled Japanese reanalysis data (JRA-25) for 60 regions of Japan using three regional climate models (RCMs): the Non-Hydrostatic Regional Climate Model (NHRCM), modified RAMS version 4.3 (NRAMS), and modified Weather Research and Forecasting model (TWRF). We validated their simulations of the precipitation climatology and interannual variations of summer and winter precipitation. We also validated precipitation for two multi-model ensemble means: the arithmetic ensemble mean (AEM) and an ensemble mean weighted according to model reliability. In the 60 regions NRAMS simulated both the winter and summer climatological precipitation better than JRA-25, and NHRCM simulated the wintertime precipitation better than JRA-25. TWRF, however, overestimated precipitation in the 60 regions in both the winter and summer, and NHRCM overestimated precipitation in the summer. The three RCMs simulated interannual variations, particularly summer precipitation, better than JRA-25. AEM simulated both climatological precipitation and interannual variations during the two seasons more realistically than JRA-25 and the three RCMs overall, but the best RCM was often superior to the AEM result. In contrast, the weighted ensemble mean skills were usually superior to those of the best RCM. Thus, both RCMs and multi-model ensemble means, especially multi-model ensemble means weighted according to model reliability, are powerful tools for simulating seasonal and interannual variability of precipitation in Japan under the current climate. (orig.)

  18. Saving robots improves laparoscopic performance: transfer of skills from a serious game to a virtual reality simulator.

    Science.gov (United States)

    IJgosse, Wouter M; van Goor, Harry; Luursema, Jan-Maarten

    2018-01-18

    Residents find it hard to commit to structural laparoscopic skills training. Serious gaming has been proposed as a solution on the premise that it is effective and more motivating than traditional simulation. We establish construct validity for the laparoscopic serious game Underground by comparing laparoscopic simulator performance for a control group and an Underground training group. A four-session laparoscopic basic skills course is part of the medical master students surgical internship at the Radboud University Medical Centre. Four cohorts, representing 107 participants, were assigned to either the Underground group or the control group. The control group trained on the FLS video trainer and the LapSim virtual reality simulator for four sessions. The Underground group played Underground for three sessions followed by a transfer session on the FLS video trainer and the LapSim. To assess the effect of engaging in serious gameplay on performance on two validated laparoscopic simulators, initial performance on the FLS video trainer and the LapSim was compared between the control group (first session) and the Underground group (fourth session). We chose task duration as a proxy for laparoscopic performance. The Underground group outperformed the control group on all three LapSim tasks: Camera navigation F(1) = 12.71, p game and validated laparoscopic simulator technology. Serious gaming may become a valuable, cost-effective addition to the skillslab, if transfer to the operating room can be established. Additionally, we discuss sources of transferable skills to help explain our and previous findings.

  19. Toward a Model of Human Information Processing for Decision-Making and Skill Acquisition in Laparoscopic Colorectal Surgery.

    Science.gov (United States)

    White, Eoin J; McMahon, Muireann; Walsh, Michael T; Coffey, J Calvin; O Sullivan, Leonard

    To create a human information-processing model for laparoscopic surgery based on already established literature and primary research to enhance laparoscopic surgical education in this context. We reviewed the literature for information-processing models most relevant to laparoscopic surgery. Our review highlighted the necessity for a model that accounts for dynamic environments, perception, allocation of attention resources between the actions of both hands of an operator, and skill acquisition and retention. The results of the literature review were augmented through intraoperative observations of 7 colorectal surgical procedures, supported by laparoscopic video analysis of 12 colorectal procedures. The Wickens human information-processing model was selected as the most relevant theoretical model to which we make adaptions for this specific application. We expanded the perception subsystem of the model to involve all aspects of perception during laparoscopic surgery. We extended the decision-making system to include dynamic decision-making to account for case/patient-specific and surgeon-specific deviations. The response subsystem now includes dual-task performance and nontechnical skills, such as intraoperative communication. The memory subsystem is expanded to include skill acquisition and retention. Surgical decision-making during laparoscopic surgery is the result of a highly complex series of processes influenced not only by the operator's knowledge, but also patient anatomy and interaction with the surgical team. Newer developments in simulation-based education must focus on the theoretically supported elements and events that underpin skill acquisition and affect the cognitive abilities of novice surgeons. The proposed human information-processing model builds on established literature regarding information processing, accounting for a dynamic environment of laparoscopic surgery. This revised model may be used as a foundation for a model describing robotic

  20. The reality behind the assumptions: Modelling and simulation support for the SAAF

    CSIR Research Space (South Africa)

    Naidoo, K

    2015-10-01

    Full Text Available : Modelling and simulation support for the SAAF Kavendra Naidoo Military Aerospace Trends & Strategy Military aerospace trends • National security includes other dimensions: social, economic development, environmental, energy security, etc.... • Military budgets constrained • Changing nature of the threat, asymmetric, non-conventional, innovative, etc. • Proliferation and availability of technology, information, skills and experience • Defence Review: official strategy to respond to global...

  1. Simulated job interview skill training for people with psychiatric disability: feasibility and tolerability of virtual reality training.

    Science.gov (United States)

    Bell, Morris D; Weinstein, Andrea

    2011-09-01

    The job interview is an important step toward successful employment and often a significant challenge for people with psychiatric disability. Vocational rehabilitation specialists can benefit from a systematic approach to training job interview skills. The investigators teamed up with a company that specializes in creating simulated job interview training to create software that provides a virtual reality experience with which learners can systematically improve their job interview skills, reduce their fears, and increase their confidence about going on job interviews. The development of this software is described and results are presented from a feasibility and tolerability trial with 10 participants with psychiatric disability referred from their vocational service programs. Results indicate that this representative sample had a strongly positive response to the prototype job interview simulation. They found it easy to use, enjoyed the experience, and thought it realistic and helpful. Almost all described the interview as anxiety provoking but that the anxiety lessened as they became more skilled. They saw the benefit of its special features such as ongoing feedback from a "coach in the corner" and from being able to review a transcript of the interview. They believed that they could learn the skills being taught through these methods. Participants were enthusiastic about wanting to use the final product when it becomes available. The advantages of virtual reality technology for training important skills for rehabilitation are discussed.

  2. Decadal Prediction Skill in the GEOS-5 Forecast System

    Science.gov (United States)

    Ham, Yoo-Geun; Rienecker, Michele M.; Suarez, Max J.; Vikhliaev, Yury; Zhao, Bin; Marshak, Jelena; Vernieres, Guillaume; Schubert, Siegfried D.

    2013-01-01

    A suite of decadal predictions has been conducted with the NASA Global Modeling and Assimilation Office's (GMAO's) GEOS-5 Atmosphere-Ocean general circulation model. The hind casts are initialized every December 1st from 1959 to 2010, following the CMIP5 experimental protocol for decadal predictions. The initial conditions are from a multivariate ensemble optimal interpolation ocean and sea-ice reanalysis, and from GMAO's atmospheric reanalysis, the modern-era retrospective analysis for research and applications. The mean forecast skill of a three-member-ensemble is compared to that of an experiment without initialization but also forced with observed greenhouse gases. The results show that initialization increases the forecast skill of North Atlantic sea surface temperature compared to the uninitialized runs, with the increase in skill maintained for almost a decade over the subtropical and mid-latitude Atlantic. On the other hand, the initialization reduces the skill in predicting the warming trend over some regions outside the Atlantic. The annual-mean Atlantic meridional overturning circulation index, which is defined here as the maximum of the zonally-integrated overturning stream function at mid-latitude, is predictable up to a 4-year lead time, consistent with the predictable signal in upper ocean heat content over the North Atlantic. While the 6- to 9-year forecast skill measured by mean squared skill score shows 50 percent improvement in the upper ocean heat content over the subtropical and mid-latitude Atlantic, prediction skill is relatively low in the sub-polar gyre. This low skill is due in part to features in the spatial pattern of the dominant simulated decadal mode in upper ocean heat content over this region that differ from observations. An analysis of the large-scale temperature budget shows that this is the result of a model bias, implying that realistic simulation of the climatological fields is crucial for skillful decadal forecasts.

  3. Basic visual observation skills training course: Appendix A. Final report

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the course manual and materials

  4. Basic visual observation skills training course: Appendix A. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the course manual and materials.

  5. Simulation Technology for Skills Training and Competency Assessment in Medical Education

    Science.gov (United States)

    Obeso, Vivian T.; Issenberg, S. Barry

    2007-01-01

    Medical education during the past decade has witnessed a significant increase in the use of simulation technology for teaching and assessment. Contributing factors include: changes in health care delivery and academic environments that limit patient availability as educational opportunities; worldwide attention focused on the problem of medical errors and the need to improve patient safety; and the paradigm shift to outcomes-based education with its requirements for assessment and demonstration of competence. The use of simulators addresses many of these issues: they can be readily available at any time and can reproduce a wide variety of clinical conditions on demand. In lieu of the customary (and arguably unethical) system, whereby novices carry out the practice required to master various techniques—including invasive procedures—on real patients, simulation-based education allows trainees to hone their skills in a risk-free environment. Evaluators can also use simulators for reliable assessments of competence in multiple domains. For those readers less familiar with medical simulators, this article aims to provide a brief overview of these educational innovations and their uses; for decision makers in medical education, we hope to broaden awareness of the significant potential of these new technologies for improving physician training and assessment, with a resultant positive impact on patient safety and health care outcomes. PMID:18095044

  6. Multi-model global assessment of subseasonal prediction skill of atmospheric rivers

    Science.gov (United States)

    Deflorio, M. J.

    2017-12-01

    Atmospheric rivers (ARs) are global phenomena that are characterized by long, narrow plumes of water vapor transport. They are most often observed in the midlatitudes near climatologically active storm track regions. Because of their frequent association with floods, landslides, and other hydrological impacts on society, there is significant incentive at the intersection of academic research, water management, and policymaking to understand the skill with which state-of-the-art operational weather models can predict ARs weeks-to-months in advance. We use the newly assembled Subseasonal-to-Seasonal (S2S) database, which includes extensive hindcast records of eleven operational weather models, to assess global prediction skill of atmospheric rivers on S2S timescales. We develop a metric to assess AR skill that is suitable for S2S timescales by counting the total number of AR days which occur over each model and observational grid cell during a 2-week time window. This "2-week AR occurrence" metric is suitable for S2S prediction skill assessment because it does not consider discrete hourly or daily AR objects, but rather a smoothed representation of AR occurrence over a longer period of time. Our results indicate that several of the S2S models, especially the ECMWF model, show useful prediction skill in the 2-week forecast window, with significant interannual variation in some regions. We also present results from an experimental forecast of S2S AR prediction skill using the ECMWF and NCEP models.

  7. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. Skills Decay in Military Medical Training: A Meta-synthesis of Research Outcomes.

    Science.gov (United States)

    Linde, Amber S; Caridha, Jona; Kunkler, Kevin J

    2018-01-01

    In fiscal year 2012, the Medical Simulation and Information Sciences Research Program released two Skills Decay (SD) research program announcements (PAs) under the Medical Readiness Initiative entitled "Medical Practice Initiative Breadth of Medical Practice & Disease Frequency Exposure (MPI-BMP)" and the "Medical Practice Initiative Procedural Skill Decay and Maintenance (MPI-PSD)." The Office of Naval Research also released a PA entitled "Medical Modeling and Simulation (MM&S) for Military Training and Education." A total investment of $12 M was made. This article provides a meta-synthesis of the Skills Decay research conducted under these efforts. The MSIRRP Medical Simulation Portfolio collected, reviewed, and analyzed the final reports of the Skills Decay research efforts from the three PAs. This paper provides a meta-synthesis of the outcomes of those studies. Focus of this study was to determine if the anticipated goals of the Skills Decay PAs were met as well as to provide a summary of lessons learned to the research community. Fourteen research questions posed by the PAs were structured into four main goals: (1) Skills Decay identification, (2) creation/validity of Skills Decay tools and feasibility and viability of data extraction project, (3) refreshment training to prevent or alleviate Skills Decay project, and (4) Skills Decay education content. Using a combination of training styles, choosing variables known to have Skills Decay predication value, and developing better ways of mining available data that can, in turn, provide feedback to training needs, it is possible for accurate Skills Decay models to be developed. These technologies have the ability not only capture the learner's reaction during the simulation, but to capture the simulation outcomes to predict a medical professional's level of experience and background. Lessons learned from the investments made by the government are extremely important in order to ensure that the outcomes of the

  9. Impact of subject related factors and position of flight control stick on acquisition of simulated flying skills using a flight simulator

    Science.gov (United States)

    Cho, Bo-Keun

    Increasing demand on aviation industry calls for more pilots. Thus, pilot training systems and pilot-candidate screening systems are essential for civil and military flying training institutes. Before actual flight training, it is not easy to determine whether a flight trainee will be successful in the training. Due to the high cost of actual flight training, it would be better if there were low cost methods for screening and training candidates prior to the actual flight training. This study intended to determine if subject related factors and flight control stick position have an impact on acquisition of simulated flying skills using a PC-based flight simulator. The experimental model was a factorial design with repeated measures. Sixty-four subjects participated in the experiment and were divided into 8 groups. Experiment consisted of 8 sessions in which performance data, such as heading, altitude and airspeed were collected every 15 seconds. Collected data were analyzed using SAS statistical program. Result of multivariate analysis of variance indicated that the three independent variables: nationality, computer game experience, and flight stick position have significant impact on acquiring simulated flying skill. For nationality, Americans recorded higher scores in general (mean: 81.7) than Koreans (mean: 78.9). The difference in mean scores between Americans and Koreans was 2.8 percent. Regarding computer game experience, the difference between high experience group (82.3) and low experience group (78.3) is significant. For high experience group, American side-stick group recorded the highest (mean: 85.6), and Korean side-stick group (mean: 77.2) scored the lowest. For the low experience group, American center-stick group scored the highest (80.6), and the Korean side-stick group (74.2) scored the lowest points. Therefore, there is a significant difference between high experience group and low experience group. The results also reveal that the center

  10. Simulations in Cyber-Security: A Review of Cognitive Modeling of Network Attackers, Defenders, and Users

    Directory of Open Access Journals (Sweden)

    Vladislav D. Veksler

    2018-05-01

    Full Text Available Computational models of cognitive processes may be employed in cyber-security tools, experiments, and simulations to address human agency and effective decision-making in keeping computational networks secure. Cognitive modeling can addresses multi-disciplinary cyber-security challenges requiring cross-cutting approaches over the human and computational sciences such as the following: (a adversarial reasoning and behavioral game theory to predict attacker subjective utilities and decision likelihood distributions, (b human factors of cyber tools to address human system integration challenges, estimation of defender cognitive states, and opportunities for automation, (c dynamic simulations involving attacker, defender, and user models to enhance studies of cyber epidemiology and cyber hygiene, and (d training effectiveness research and training scenarios to address human cyber-security performance, maturation of cyber-security skill sets, and effective decision-making. Models may be initially constructed at the group-level based on mean tendencies of each subject's subgroup, based on known statistics such as specific skill proficiencies, demographic characteristics, and cultural factors. For more precise and accurate predictions, cognitive models may be fine-tuned to each individual attacker, defender, or user profile, and updated over time (based on recorded behavior via techniques such as model tracing and dynamic parameter fitting.

  11. Simulations in Cyber-Security: A Review of Cognitive Modeling of Network Attackers, Defenders, and Users

    Science.gov (United States)

    Veksler, Vladislav D.; Buchler, Norbou; Hoffman, Blaine E.; Cassenti, Daniel N.; Sample, Char; Sugrim, Shridat

    2018-01-01

    Computational models of cognitive processes may be employed in cyber-security tools, experiments, and simulations to address human agency and effective decision-making in keeping computational networks secure. Cognitive modeling can addresses multi-disciplinary cyber-security challenges requiring cross-cutting approaches over the human and computational sciences such as the following: (a) adversarial reasoning and behavioral game theory to predict attacker subjective utilities and decision likelihood distributions, (b) human factors of cyber tools to address human system integration challenges, estimation of defender cognitive states, and opportunities for automation, (c) dynamic simulations involving attacker, defender, and user models to enhance studies of cyber epidemiology and cyber hygiene, and (d) training effectiveness research and training scenarios to address human cyber-security performance, maturation of cyber-security skill sets, and effective decision-making. Models may be initially constructed at the group-level based on mean tendencies of each subject's subgroup, based on known statistics such as specific skill proficiencies, demographic characteristics, and cultural factors. For more precise and accurate predictions, cognitive models may be fine-tuned to each individual attacker, defender, or user profile, and updated over time (based on recorded behavior) via techniques such as model tracing and dynamic parameter fitting. PMID:29867661

  12. Hands-On Defibrillation Skills of Pediatric Acute Care Providers During a Simulated Ventricular Fibrillation Cardiac Arrest Scenario.

    Science.gov (United States)

    Bhalala, Utpal S; Balakumar, Niveditha; Zamora, Maria; Appachi, Elumalai

    2018-01-01

    Introduction: Timely defibrillation in ventricular fibrillation cardiac arrest (VFCA) is associated with good outcome. While defibrillation skills of pediatric providers have been reported to be poor, the factors related to poor hands-on defibrillation skills of pediatric providers are largely unknown. The aim of our study was to evaluate delay in individual steps of the defibrillation and human and non-human factors associated with poor hands-on defibrillation skills among pediatric acute care providers during a simulated VFCA scenario. Methods: We conducted a prospective observational study of video evaluation of hands-on defibrillation skills of pediatric providers in a simulated VFCA in our children's hospital. Each provider was asked to use pads followed by paddles to provide 2 J/kg shock to an infant mannequin in VFCA. The hands-on skills were evaluated for struggle with any step of defibrillation, defined a priori as >10 s delay with particular step. The data was analyzed using chi-square test with significant p -value 10 s delay) with each of connecting the pads/paddles to the device, using pads/paddles on the mannequin and using buttons on the machine was 34 (50%), 26 (38%), and 31 (46%), respectively. Conclusions: The defibrillation skills of providers in a tertiary care children's hospital are poor. Both human and machine-related factors are associated with delay in defibrillation. Prior use of the study defibrillator is associated with a significantly shorter time-to-first shock as compared to prior use of any other defibrillator or no prior use of any defibrillator.

  13. The effects of laryngeal mask airway passage simulation training on the acquisition of undergraduate clinical skills: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lilford Richard J

    2011-08-01

    Full Text Available Abstract Background Effective use of the laryngeal mask airway (LMA requires learning proper insertion technique in normal patients undergoing routine surgical procedures. However, there is a move towards simulation training for learning practical clinical skills, such as LMA placement. The evidence linking different amounts of mannequin simulation training to the undergraduate clinical skill of LMA placement in real patients is limited. The purpose of this study was to compare the effectiveness in vivo of two LMA placement simulation courses of different durations. Methods Medical students (n = 126 enrolled in a randomised controlled trial. Seventy-eight of these students completed the trial. The control group (n = 38 received brief mannequin training while the intervention group (n = 40 received additional more intensive mannequin training as part of which they repeated LMA insertion until they were proficient. The anaesthetists supervising LMA placements in real patients rated the participants' performance on assessment forms. Participants completed a self-assessment questionnaire. Results Additional mannequin training was not associated with improved performance (37% of intervention participants received an overall placement rating of > 3/5 on their first patient compared to 48% of the control group, X2 = 0.81, p = 0.37. The agreement between the participants and their instructors in terms of LMA placement success rates was poor to fair. Participants reported that mannequins were poor at mimicking reality. Conclusions The results suggest that the value of extended mannequin simulation training in the case of LMA placement is limited. Educators considering simulation for the training of practical skills should reflect on the extent to which the in vitro simulation mimics the skill required and the degree of difficulty of the procedure.

  14. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    Science.gov (United States)

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  15. Constraining Stochastic Parametrisation Schemes Using High-Resolution Model Simulations

    Science.gov (United States)

    Christensen, H. M.; Dawson, A.; Palmer, T.

    2017-12-01

    Stochastic parametrisations are used in weather and climate models as a physically motivated way to represent model error due to unresolved processes. Designing new stochastic schemes has been the target of much innovative research over the last decade. While a focus has been on developing physically motivated approaches, many successful stochastic parametrisation schemes are very simple, such as the European Centre for Medium-Range Weather Forecasts (ECMWF) multiplicative scheme `Stochastically Perturbed Parametrisation Tendencies' (SPPT). The SPPT scheme improves the skill of probabilistic weather and seasonal forecasts, and so is widely used. However, little work has focused on assessing the physical basis of the SPPT scheme. We address this matter by using high-resolution model simulations to explicitly measure the `error' in the parametrised tendency that SPPT seeks to represent. The high resolution simulations are first coarse-grained to the desired forecast model resolution before they are used to produce initial conditions and forcing data needed to drive the ECMWF Single Column Model (SCM). By comparing SCM forecast tendencies with the evolution of the high resolution model, we can measure the `error' in the forecast tendencies. In this way, we provide justification for the multiplicative nature of SPPT, and for the temporal and spatial scales of the stochastic perturbations. However, we also identify issues with the SPPT scheme. It is therefore hoped these measurements will improve both holistic and process based approaches to stochastic parametrisation. Figure caption: Instantaneous snapshot of the optimal SPPT stochastic perturbation, derived by comparing high-resolution simulations with a low resolution forecast model.

  16. Development of three-dimensional patient face model that enables real-time collision detection and cutting operation for a dental simulator.

    Science.gov (United States)

    Yamaguchi, Satoshi; Yamada, Yuya; Yoshida, Yoshinori; Noborio, Hiroshi; Imazato, Satoshi

    2012-01-01

    The virtual reality (VR) simulator is a useful tool to develop dental hand skill. However, VR simulations with reactions of patients have limited computational time to reproduce a face model. Our aim was to develop a patient face model that enables real-time collision detection and cutting operation by using stereolithography (STL) and deterministic finite automaton (DFA) data files. We evaluated dependence of computational cost and constructed the patient face model using the optimum condition for combining STL and DFA data files, and assessed the computational costs for operation in do-nothing, collision, cutting, and combination of collision and cutting. The face model was successfully constructed with low computational costs of 11.3, 18.3, 30.3, and 33.5 ms for do-nothing, collision, cutting, and collision and cutting, respectively. The patient face model could be useful for developing dental hand skill with VR.

  17. Developing an Evaluation Tool for Assessing Clinical Ethics Consultation Skills in Simulation Based Education: The ACES Project.

    Science.gov (United States)

    Wasson, Katherine; Parsi, Kayhan; McCarthy, Michael; Siddall, Viva Jo; Kuczewski, Mark

    2016-06-01

    The American Society for Bioethics and Humanities has created a quality attestation (QA) process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (ACES) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described.

  18. A model to teach concomitant patient communication during psychomotor skill development.

    Science.gov (United States)

    Nicholls, Delwyn; Sweet, Linda; Muller, Amanda; Hyett, Jon

    2018-01-01

    Many health professionals use psychomotor or task-based skills in clinical practice that require concomitant communication with a conscious patient. Verbally engaging with the patient requires highly developed verbal communication skills, enabling the delivery of patient-centred care. Historically, priority has been given to learning the psychomotor skills essential to clinical practice. However, there has been a shift towards also ensuring competent communication with the patient during skill performance. While there is literature outlining the steps to teach and learn verbal communication skills, little is known about the most appropriate instructional approach to teach how to verbally engage with the patient when also learning to perform a task. A literature review was performed and it identified that there was no model or proven approach which could be used to integrate the learning of both psychomotor and communication skills. This paper reviews the steps to teach a communication skill and provides a suggested model to guide the acquisition and development of the concomitant -communication skills required with a patient at the time a psychomotor skill is performed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. [Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study].

    Science.gov (United States)

    Mejía, Vilma; Gonzalez, Carlos; Delfino, Alejandro E; Altermatt, Fernando R; Corvetto, Marcia A

    The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. After institutional ethical committee approval, 31 first year anesthesiology residents were enrolled in this prospective randomized single-blinded study. Participants were randomized to either a High Fidelity Simulation Scenario or a computer-based Case Study about malignant hyperthermia. After the intervention, all subjects' performance in was assessed through a high fidelity simulation scenario using a previously validated assessment rubric. Additionally, knowledge tests and a satisfaction survey were applied. Finally, a semi-structured interview was done to assess self-perception of reasoning process and decision-making. 28 first year residents finished successfully the study. Resident's management skill scores were globally higher in High Fidelity Simulation versus Case Study, however they were significant in 4 of the 8 performance rubric elements: recognize signs and symptoms (p = 0.025), prioritization of initial actions of management (p = 0.003), recognize complications (p = 0.025) and communication (p = 0.025). Average scores from pre- and post-test knowledge questionnaires improved from 74% to 85% in the High Fidelity Simulation group, and decreased from 78% to 75% in the Case Study group (p = 0.032). Regarding the qualitative analysis, there was no difference in factors influencing the student's process of reasoning and decision-making with both teaching strategies. Simulation-based training with a malignant hyperthermia high-fidelity scenario was superior to computer-based case study, improving knowledge and skills in malignant hyperthermia crisis management, with a very good satisfaction level in anesthesia residents. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights

  20. Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

    Science.gov (United States)

    Kron, Frederick W; Fetters, Michael D; Scerbo, Mark W; White, Casey B; Lypson, Monica L; Padilla, Miguel A; Gliva-McConvey, Gayle A; Belfore, Lee A; West, Temple; Wallace, Amelia M; Guetterman, Timothy C; Schleicher, Lauren S; Kennedy, Rebecca A; Mangrulkar, Rajesh S; Cleary, James F; Marsella, Stacy C; Becker, Daniel M

    2017-04-01

    To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

    Science.gov (United States)

    Kron, Frederick W.; Fetters, Michael D.; Scerbo, Mark W.; White, Casey B.; Lypson, Monica L.; Padilla, Miguel A.; Gliva-McConvey, Gayle A.; Belfore, Lee A.; West, Temple; Wallace, Amelia M.; Guetterman, Timothy C.; Schleicher, Lauren S.; Kennedy, Rebecca A.; Mangrulkar, Rajesh S.; Cleary, James F.; Marsella, Stacy C.; Becker, Daniel M.

    2016-01-01

    Objectives To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group’s experiences and learning preferences. Methods A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR’s intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. Secondary outcomes: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. Results MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. Conclusions MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. Practice Implications MPathic-VR’s virtual human simulation offers an effective and engaging means of advanced communication training. PMID:27939846

  2. The reliability of a modified Kalamazoo Consensus Statement Checklist for assessing the communication skills of multidisciplinary clinicians in the simulated environment.

    Science.gov (United States)

    Peterson, Eleanor B; Calhoun, Aaron W; Rider, Elizabeth A

    2014-09-01

    With increased recognition of the importance of sound communication skills and communication skills education, reliable assessment tools are essential. This study reports on the psychometric properties of an assessment tool based on the Kalamazoo Consensus Statement Essential Elements Communication Checklist. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF), a modified version of an existing communication skills assessment tool, the Kalamazoo Essential Elements Communication Checklist-Adapted, was used to assess learners in a multidisciplinary, simulation-based communication skills educational program using multiple raters. 118 simulated conversations were available for analysis. Internal consistency and inter-rater reliability were determined by calculating a Cronbach's alpha score and intra-class correlation coefficients (ICC), respectively. The GKCSAF demonstrated high internal consistency with a Cronbach's alpha score of 0.844 (faculty raters) and 0.880 (peer observer raters), and high inter-rater reliability with an ICC of 0.830 (faculty raters) and 0.89 (peer observer raters). The Gap-Kalamazoo Communication Skills Assessment Form is a reliable method of assessing the communication skills of multidisciplinary learners using multi-rater methods within the learning environment. The Gap-Kalamazoo Communication Skills Assessment Form can be used by educational programs that wish to implement a reliable assessment and feedback system for a variety of learners. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Interannual Tropical Rainfall Variability in General Circulation Model Simulations Associated with the Atmospheric Model Intercomparison Project.

    Science.gov (United States)

    Sperber, K. R.; Palmer, T. N.

    1996-11-01

    The interannual variability of rainfall over the Indian subcontinent, the African Sahel, and the Nordeste region of Brazil have been evaluated in 32 models for the period 1979-88 as part of the Atmospheric Model Intercomparison Project (AMIP). The interannual variations of Nordeste rainfall are the most readily captured, owing to the intimate link with Pacific and Atlantic sea surface temperatures. The precipitation variations over India and the Sahel are less well simulated. Additionally, an Indian monsoon wind shear index was calculated for each model. Evaluation of the interannual variability of a wind shear index over the summer monsoon region indicates that the models exhibit greater fidelity in capturing the large-scale dynamic fluctuations than the regional-scale rainfall variations. A rainfall/SST teleconnection quality control was used to objectively stratify model performance. Skill scores improved for those models that qualitatively simulated the observed rainfall/El Niño- Southern Oscillation SST correlation pattern. This subset of models also had a rainfall climatology that was in better agreement with observations, indicating a link between systematic model error and the ability to simulate interannual variations.A suite of six European Centre for Medium-Range Weather Forecasts (ECMWF) AMIP runs (differing only in their initial conditions) have also been examined. As observed, all-India rainfall was enhanced in 1988 relative to 1987 in each of these realizations. All-India rainfall variability during other years showed little or no predictability, possibly due to internal chaotic dynamics associated with intraseasonal monsoon fluctuations and/or unpredictable land surface process interactions. The interannual variations of Nordeste rainfall were best represented. The State University of New York at Albany/National Center for Atmospheric Research Genesis model was run in five initial condition realizations. In this model, the Nordeste rainfall

  4. Temperature sensitivity to the land-surface model in MM5 climate simulations over the Iberian Peninsula

    Energy Technology Data Exchange (ETDEWEB)

    Jerez, Sonia; Montavez, Juan P.; Gomez-Navarro, Juan J.; Jimenez-Guerrero, Pedro [Dept. de Fisica, Univ. de Murcia (Spain); Jimenez, Jose M.; Gonzalez-Rouco, Jesus F. [Dept. de Astrofisica y CC. de la Atmosfera, Univ. Complutense de Madrid (Spain)

    2010-06-15

    Three different Land Surface Models have been used in three high resolution climate simulations performed with the mesoscale model MM5 over the Iberian Peninsula. The main difference among them lies in the soil moisture treatment, which is dynamically modelled by only two of them (Noah and Pleim and Xiu models), while in the simplest model (Simple Five-Layers) it is fixed to climatological values. The simulated period covers 1958-2002, using the ERA40 reanalysis data as driving conditions. Focusing on near-surface air temperature, this work evaluates the skill of each simulation in reproducing mean values and temporal variability, by comparing the simulations with observed temperature series. When the simplest simulation was analyzed, the greatest discrepances were observed for the summer season, when both, the mean values and the temporal variability of the temperature series, were badly underestimated. These weaknesses are largely overcome in the other two simulations (performed by coupling a more advanced soil model to MM5), and there was greater concordance between the simulated and observed spatial patterns. The influence of a dynamic soil moisture parameterization and, therefore, a more realistic simulation of the latent and sensible heat fluxes between the land and the atmosphere, helps to explain these results. (orig.)

  5. Standardized simulated palpation training--development of a palpation trainer and assessment of palpatory skills in experienced and inexperienced clinicians

    DEFF Research Database (Denmark)

    Larsen, Anders Holsgaard; Myburgh, Corrie; Hartvigsen, Jan

    2010-01-01

    Specific palpation skills are required to identify and treat myofascial pain. The aim of this study was to develop a device that reflects absolute pressure values during simulated palpation, and to test the hypothesis that training through standardized manual palpation results in improved skills...... palpation training, experienced examiners improved palpatory skills related to P(peak) and RPD (i.e. performed closer to predetermined guidelines and with reduced inter-examiner variation), while inexperienced examiners only improved RPD (p

  6. Impact of Assimilation on Heavy Rainfall Simulations Using WRF Model: Sensitivity of Assimilation Results to Background Error Statistics

    Science.gov (United States)

    Rakesh, V.; Kantharao, B.

    2017-03-01

    Data assimilation is considered as one of the effective tools for improving forecast skill of mesoscale models. However, for optimum utilization and effective assimilation of observations, many factors need to be taken into account while designing data assimilation methodology. One of the critical components that determines the amount and propagation observation information into the analysis, is model background error statistics (BES). The objective of this study is to quantify how BES in data assimilation impacts on simulation of heavy rainfall events over a southern state in India, Karnataka. Simulations of 40 heavy rainfall events were carried out using Weather Research and Forecasting Model with and without data assimilation. The assimilation experiments were conducted using global and regional BES while the experiment with no assimilation was used as the baseline for assessing the impact of data assimilation. The simulated rainfall is verified against high-resolution rain-gage observations over Karnataka. Statistical evaluation using several accuracy and skill measures shows that data assimilation has improved the heavy rainfall simulation. Our results showed that the experiment using regional BES outperformed the one which used global BES. Critical thermo-dynamic variables conducive for heavy rainfall like convective available potential energy simulated using regional BES is more realistic compared to global BES. It is pointed out that these results have important practical implications in design of forecast platforms while decision-making during extreme weather events

  7. The Effect of Model Fidelity on Learning Outcomes of a Simulation-Based Education Program for Central Venous Catheter Insertion.

    Science.gov (United States)

    Diederich, Emily; Mahnken, Jonathan D; Rigler, Sally K; Williamson, Timothy L; Tarver, Stephen; Sharpe, Matthew R

    2015-12-01

    Simulation-based education for central venous catheter (CVC) insertion has been repeatedly documented to improve performance, but the impact of simulation model fidelity has not been described. The aim of this study was to examine the impact of the physical fidelity of the simulation model on learning outcomes for a simulation-based education program for CVC insertion. Forty consecutive residents rotating through the medical intensive care unit of an academic medical center completed a simulation-based education program for CVC insertion. The curriculum was designed in accordance with the principles of deliberate practice and mastery learning. Each resident underwent baseline skills testing and was then randomized to training on a commercially available CVC model with high physical fidelity (High-Fi group) or a simply constructed model with low physical fidelity (Low-Fi group) in a noninferiority trial. Upon completion of their medical intensive care unit rotation 4 weeks later, residents returned for repeat skills testing on the high-fidelity model using a 26-item checklist. The mean (SD) posttraining score on the 26-item checklist for the Low-Fi group was 23.8 (2.2) (91.5%) and was not inferior to the mean (SD) score for the High-Fi group of 22.5 (2.6) (86.5%) (P Simulation-based education using equipment with low physical fidelity can achieve learning outcomes comparable with those with high-fidelity equipment, as long as other aspects of fidelity are maintained and robust educational principles are applied during the design of the curriculum.

  8. Role modelling in medical education: the importance of teaching skills.

    Science.gov (United States)

    Burgess, Annette; Oates, Kim; Goulston, Kerry

    2016-04-01

    By observation of role models, and participation in activities, students develop their attitudes, values and professional competencies. Literature suggests that clinical skills and knowledge, personality, and teaching skills are three main areas that students consider central to the identification of positive role models. The aim of this study was to explore junior medical students' opinions of the ideal attributes of a good role model in clinical tutors. The study was conducted with one cohort (n = 301) of students who had completed year 1 of the medical programme in 2013. All students were asked to complete a questionnaire regarding the ideal attributes of a good role model in a clinical tutor. The questionnaire consisted of seven closed items and one open-ended question. The response rate to the questionnaire was 265/301 (88%). Although students found all three key areas important in a good role model, students emphasised the importance of excellence in teaching skills. Specifically, students see good role models as being able to provide a constructive learning environment, a good understanding of the curriculum and an ability to cater to the learning needs of all students. Students see good role models as being able to provide a constructive learning environment While acknowledging the importance of a patient-centred approach, as well as clinical knowledge and skills, our findings reinforce the importance of the actual teaching abilities of role models within medical education. © 2015 John Wiley & Sons Ltd.

  9. Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills.

    Science.gov (United States)

    Rahm, Stefan; Wieser, Karl; Bauer, David E; Waibel, Felix Wa; Meyer, Dominik C; Gerber, Christian; Fucentese, Sandro F

    2018-05-16

    Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator. Twenty residents and five experts in arthroscopy were included. All participants performed a test including knee -and shoulder arthroscopy tasks on a virtual reality knee- and shoulder arthroscopy simulator. The residents had to complete a competency based training program. Thereafter, the previously completed test was retaken. We evaluated the metric data of the simulator using a z-score and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess training effects in residents and performance levels in experts. The residents significantly improved from pre- to post training in the overall z-score: - 9.82 (range, - 20.35 to - 1.64) to - 2.61 (range, - 6.25 to 1.5); p < 0.001. The overall ASSET score improved from 55 (27 to 84) percent to 75 (48 to 92) percent; p < 0.001. The experts, however, achieved a significantly higher z-score in the shoulder tasks (p < 0.001 and a statistically insignificantly higher z-score in the knee tasks with a p = 0.921. The experts mean overall ASSET score (knee and shoulder) was significantly higher in the therapeutic tasks (p < 0.001) compared to the residents post training result. The use of a competency based simulator training with this specific device for 3-5 h is an effective tool to advance basic arthroscopic skills of resident in training from 0 to 5 years based on simulator measures and simulator based ASSET testing. Therefore, we conclude that this sort of training method appears useful to learn the handling of the camera, basic anatomy and the triangulation with instruments.

  10. Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial.

    Science.gov (United States)

    Grover, Samir C; Garg, Ankit; Scaffidi, Michael A; Yu, Jeffrey J; Plener, Ian S; Yong, Elaine; Cino, Maria; Grantcharov, Teodor P; Walsh, Catharine M

    2015-12-01

    GI endoscopy simulation-based training augments early clinical performance; however, the optimal manner by which to deliver training is unknown. We aimed to validate a simulation-based structured comprehensive curriculum (SCC) designed to teach technical, cognitive, and integrative competencies in colonoscopy. Single-blinded, randomized, controlled trial. Endoscopic simulation course at an academic hospital. Thirty-three novice endoscopists were allocated to an SCC group or self-regulated learning (SRL) group. The SCC group received a curriculum consisting of 6 hours of didactic lectures and 8 hours of virtual reality simulation-based training with expert feedback. The SRL group was provided a list of desired objectives and was instructed to practice on the simulator for an equivalent time (8 hours). Clinical transfer was assessed during 2 patient colonoscopies using the Joint Advisory Group Direct Observation of Procedural Skills (JAG DOPS) scale. Secondary outcome measures included differences in procedural knowledge, immediate post-training simulation performance, and delayed post-training (4-6 weeks) performance during an integrated scenario test on the JAG DOPS communication and integrated scenario global rating scales. There was no significant difference in baseline or post-training performance on the simulator task. The SCC group performed superiorly during their first and second clinical colonoscopies. Additionally, the SCC group demonstrated significantly better knowledge and colonoscopy-specific performance, communication, and global performance during the integrated scenario. We were unable to measure SRL participants' effort outside of mandatory training. In addition, feedback metrics and number of available simulation cases are limited. These results support integration of endoscopy simulation into a structured curriculum incorporating instructional feedback and complementary didactic knowledge as a means to augment technical, cognitive, and

  11. Cloud radiative effects and changes simulated by the Coupled Model Intercomparison Project Phase 5 models

    Science.gov (United States)

    Shin, Sun-Hee; Kim, Ok-Yeon; Kim, Dongmin; Lee, Myong-In

    2017-07-01

    Using 32 CMIP5 (Coupled Model Intercomparison Project Phase 5) models, this study examines the veracity in the simulation of cloud amount and their radiative effects (CREs) in the historical run driven by observed external radiative forcing for 1850-2005, and their future changes in the RCP (Representative Concentration Pathway) 4.5 scenario runs for 2006-2100. Validation metrics for the historical run are designed to examine the accuracy in the representation of spatial patterns for climatological mean, and annual and interannual variations of clouds and CREs. The models show large spread in the simulation of cloud amounts, specifically in the low cloud amount. The observed relationship between cloud amount and the controlling large-scale environment are also reproduced diversely by various models. Based on the validation metrics, four models—ACCESS1.0, ACCESS1.3, HadGEM2-CC, and HadGEM2-ES—are selected as best models, and the average of the four models performs more skillfully than the multimodel ensemble average. All models project global-mean SST warming at the increase of the greenhouse gases, but the magnitude varies across the simulations between 1 and 2 K, which is largely attributable to the difference in the change of cloud amount and distribution. The models that simulate more SST warming show a greater increase in the net CRE due to reduced low cloud and increased incoming shortwave radiation, particularly over the regions of marine boundary layer in the subtropics. Selected best-performing models project a significant reduction in global-mean cloud amount of about -0.99% K-1 and net radiative warming of 0.46 W m-2 K-1, suggesting a role of positive feedback to global warming.

  12. Cognitive Load in Mastoidectomy Skills Training

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars

    2016-01-01

    OBJECTIVE: The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study...... aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. DESIGN: A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary...... surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired...

  13. Construct and criterion validity testing of the Non-Technical Skills for Surgeons (NOTSS) behaviour assessment tool using videos of simulated operations.

    Science.gov (United States)

    Yule, S; Gupta, A; Gazarian, D; Geraghty, A; Smink, D S; Beard, J; Sundt, T; Youngson, G; McIlhenny, C; Paterson-Brown, S

    2018-05-01

    Surgeons' non-technical skills are an important part of surgical performance and surgical education. The most widely adopted assessment tool is the Non-Technical Skills for Surgeons (NOTSS) behaviour rating system. Psychometric analysis of this tool to date has focused on inter-rater reliability and feasibility rather than validation. NOTSS assessments were collected from two groups of consultant/attending surgeons in the UK and USA, who rated behaviours of the lead surgeon during a video-based simulated crisis scenario after either online or classroom instruction. The process of validation consisted of assessing construct validity, scale reliability and concurrent criterion validity, and undertaking a sensitivity analysis. Central to this was confirmatory factor analysis to evaluate the structure of the NOTSS taxonomy. Some 255 consultant surgeons participated in the study. The four-category NOTSS model was found to have robust construct validity evidence, and a superior fit compared with alternative models. Logistic regression and sensitivity analysis revealed that, after adjusting for technical skills, for every 1-point increase in NOTSS score of the lead surgeon, the odds of having a higher versus lower patient safety score was 2·29 times. The same pattern of results was obtained for a broad mix of surgical specialties (UK) as well as a single discipline (cardiothoracic, USA). The NOTSS tool can be applied in research and education settings to measure non-technical skills in a valid and efficient manner. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  14. Training Self-Regulated Learning Skills with Video Modeling Examples: Do Task-Selection Skills Transfer?

    Science.gov (United States)

    Raaijmakers, Steven F.; Baars, Martine; Schaap, Lydia; Paas, Fred; van Merriënboer, Jeroen; van Gog, Tamara

    2018-01-01

    Self-assessment and task-selection skills are crucial in self-regulated learning situations in which students can choose their own tasks. Prior research suggested that training with video modeling examples, in which another person (the model) demonstrates and explains the cyclical process of problem-solving task performance, self-assessment, and…

  15. Assessment of laparoscopic psychomotor skills in interns using the MIST Virtual Reality Simulator: a prerequisite for those considering surgical training?

    Science.gov (United States)

    Cope, Daron H; Fenton-Lee, Douglas

    2008-04-01

    Selection for surgical training in Australia is currently based on assessment of a structured curriculum vitae, referral reports from selected clinicians and an interview. The formal assessment of laparoscopic psychomotor skill and ability to attain skills is not currently a prerequisite for selection. The aim of this study was to assess the innate psychomotor skills of interns and also to compare interns with an interest in pursuing a surgical career to interns with those with no interest in pursuing a surgical career. Twenty-two interns were given the opportunity to carry out tasks on the Minimal Invasive Surgical Trainer, Virtual Reality (Mentice, Gothenburg, Sweden) Simulator. The candidates were required to complete six tasks, repeated six times each. Scores for each task were calculated objectively by the simulator software. Demographic data were similar between the two groups. Although some candidates who were interested in pursuing a surgical career performed poorly on the simulator, there was no significant difference when comparing the two groups. The Minimal Invasive Surgical Trainer, Virtual Reality (Mentice) Simulator provides an objective and comparable assessment of laparoscopic psychomotor skills. We can conclude that interns have varying inherent ability as judged by the simulator and this does not seem to have an influence on their career selection. There was no significant difference in the scores between the two groups. Interns with and without inherent abilities have aspirations to pursue surgical careers and their aptitude does not seem to influence this decision. Surgical colleges could use psychomotor ability assessments to recruit candidates to pursue a career in surgery. Trainees needing closer monitoring and additional training could be identified early and guided to achieve competency.

  16. Decadal prediction skill in the ocean with surface nudging in the IPSL-CM5A-LR climate model

    Science.gov (United States)

    Mignot, Juliette; García-Serrano, Javier; Swingedouw, Didier; Germe, Agathe; Nguyen, Sébastien; Ortega, Pablo; Guilyardi, Eric; Ray, Sulagna

    2016-08-01

    Two decadal prediction ensembles, based on the same climate model (IPSL-CM5A-LR) and the same surface nudging initialization strategy are analyzed and compared with a focus on upper-ocean variables in different regions of the globe. One ensemble consists of 3-member hindcasts launched every year since 1961 while the other ensemble benefits from 9 members but with start dates only every 5 years. Analysis includes anomaly correlation coefficients and root mean square errors computed against several reanalysis and gridded observational fields, as well as against the nudged simulation used to produce the hindcasts initial conditions. The last skill measure gives an upper limit of the predictability horizon one can expect in the forecast system, while the comparison with different datasets highlights uncertainty when assessing the actual skill. Results provide a potential prediction skill (verification against the nudged simulation) beyond the linear trend of the order of 10 years ahead at the global scale, but essentially associated with non-linear radiative forcings, in particular from volcanoes. At regional scale, we obtain 1 year in the tropical band, 10 years at midlatitudes in the North Atlantic and North Pacific, and 5 years at tropical latitudes in the North Atlantic, for both sea surface temperature (SST) and upper-ocean heat content. Actual prediction skill (verified against observational or reanalysis data) is overall more limited and less robust. Even so, large actual skill is found in the extratropical North Atlantic for SST and in the tropical to subtropical North Pacific for upper-ocean heat content. Results are analyzed with respect to the specific dynamics of the model and the way it is influenced by the nudging. The interplay between initialization and internal modes of variability is also analyzed for sea surface salinity. The study illustrates the importance of two key ingredients both necessary for the success of future coordinated decadal

  17. Arthroscopic skills assessment and use of box model for training in arthroscopic surgery using Sawbones – “FAST” workstation

    Directory of Open Access Journals (Sweden)

    Goyal Saumitra

    2016-01-01

    Full Text Available Purpose: Arthroscopic skills training outside the operative room may decrease risks and errors by trainee surgeons. There is a need of simple objective method for evaluating proficiency and skill of arthroscopy trainees using simple bench model of arthroscopic simulator. The aim of this study is to correlate motor task performance to level of prior arthroscopic experience and establish benchmarks for training modules. Methods: Twenty orthopaedic surgeons performed a set of tasks to assess a arthroscopic triangulation, b navigation, c object handling and d meniscus trimming using SAWBONES “FAST” arthroscopy skills workstation. Time to completion and the errors were computed. The subjects were divided into four levels; “Novice”, “Beginner”, “Intermediate” and “Advanced” based on previous arthroscopy experience, for analyses of performance. Results: The task performance under transparent dome was not related to experience of the surgeon unlike opaque dome, highlighting the importance of hand-eye co-ordination required in arthroscopy. Median time to completion for each task improved as the level of experience increased and this was found to be statistically significant (p 85% of subjects across all the levels reported improvement in performance with sequential tasks. Conclusion: Use of the arthroscope requires visuo-spatial coordination which is a skill that develops with practice. This simple box model can reliably differentiate the arthroscopic skills based on experience and can be used to monitor progression of skills of trainees in institutions.

  18. Skills development programme: The UNISA/CSIR model

    CSIR Research Space (South Africa)

    Sparrow, RW

    2010-09-01

    Full Text Available development programmes and industry. A key component will be the use of Information Learning Technology. The skills development programmes are vocational and centred on research and industrial requirements. This programme is modelled on vocational...

  19. 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....

  20. Learning Leadership Skills in a Simulated Business Environment

    Science.gov (United States)

    Siewiorek, Anna; Saarinen, Eeli; Lainema, Timo; Lehtinen, Erno

    2012-01-01

    In today's unstable market economy, individuals have to be skilled to work efficiently in constantly changing and complex situations. Thus, graduate students have to be trained to cope with unpredictable situations before they enter the workforce. They need to exercise occupational skills, such as leadership skills, during higher education.…

  1. [Simulation-based training and OR apprenticeship for medical students : A prospective, randomized, single-blind study of clinical skills].

    Science.gov (United States)

    Ott, T; Schmidtmann, I; Limbach, T; Gottschling, P F; Buggenhagen, H; Kurz, S; Pestel, G

    2016-11-01

    Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site. Whether SBT has an effect on medical students' skills in anesthesiology in the clinical setting is controversial. To explore this issue, we designed a prospective, randomized, single-blind trial that was integrated into the undergraduate anesthesiology curriculum of our department during the second year of the clinical phase of medical school. This study intended to explore the effect of SBT on medical students within the mandatory undergraduate anesthesiology curriculum of our department in the operating room with respect to basic skills in anesthesiology. After obtaining ethical approval, the participating students of the third clinical semester were randomized into two groups: the SIM-OR group was trained by a 225 min long SBT in basic skills in anesthesiology before attending the operating room (OR) apprenticeship. The OR-SIM group was trained after the operating room apprenticeship by SBT. During SBT the students were trained in five clinical skills detailed below. Further, two clinical scenarios were simulated using a full-scale simulator. The students had to prepare the patient and perform induction of anesthesia, including bag-mask ventilation after induction in scenario 1 and rapid sequence induction in scenario 2. Using the five-point Likert scale, five defined skills were evaluated at defined time points during the study period. 1) application of the safety checklist, 2) application of

  2. PENGEMBANGAN MODEL PELATIHAN SOFT-SKILLS PADA SISWA SEKOLAH MENENGAH PERTAMA NEGERI (SMPN DI KOTA MATARAM

    Directory of Open Access Journals (Sweden)

    Anik Darmiany

    2016-06-01

    Full Text Available Abstrak : Penelitian dan pengembangan ini bertujuan menghasilkan model pelatihan soft-skill khususnya keterampilan komunikasi dan kendali emosi siswa sekolah menengah pertama negeri (SMPN di kota Mataram. Metode penelitian dan pengembangan dilakukan melalui tiga tahap dari sepuluh langkah Borg & Gall yaitu, (1 penelitian awal (analisis kebutuhan, (2 pengembangan model pelatihan, (3 uji coba dan evaluasi model. Hasil penelitian menunjukkan bahwa pengembangan model pelatihan soft-skill menghasilkan pedoman pelatihan untuk konselor dan siswa, serta materi pelatihan soft-skill yang memenuhi kriteria akseptabel dari kegunaan, kemanfaatan, dan kelayakan. Disamping itu hasil penelitian menunjukkan pula bahwa terdapat perbedaan skor antara pre-test dan post-test keterampilan mengelola emosi dari tidak terampil menjadi sangat trampil, dan keterampilan komunikasi dari tidak terampil menjadi cukup terampil.   Abstract: Research and development is aimed to produce soft-skills training models especially in communication skills and emotional control student junior high school (SMP in Mataram city. Research and development method is carried out through three stages from the ten steps of Borg & Gall, they are; (1 the preliminary research (needs analysis, (2 the development of training model, (3 Model evaluation and try out. The results show that the development of soft-skills training model develop training manual for counselors and students, as well as soft-skills training materials that meet acceptable criteria of usability, usefulness and feasibility. Besides, the results showed also that there is a difference in scores between pre-test and post-test in skills at managing emotions from unskilled to be very skilled, and communication skills from unskilled become quite skilled.

  3. 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 study longer. The e-module appeared to be very effective, while the high-fidelity 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.

  4. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training.

    Science.gov (United States)

    Gallagher, Anthony G; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P; Moses, Gerald; Smith, C Daniel; Satava, Richard M

    2005-02-01

    To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills.

  5. Basic visual observation skills training course: Appendix B. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the in-class exercises in the five skill areas; pre- and post-course exercises in closure, hidden figures, map memory, and mental rotations; the final examination; a training evaluation form; and the integrating exercise.

  6. Basic visual observation skills training course: Appendix B. Final report

    International Nuclear Information System (INIS)

    Toquam, J.L.; Morris, F.A.; Griggs, J.R.

    1995-06-01

    The purpose of the basic visual observation skills course is to help safeguards inspectors evaluate and improve their skills in making observations during inspections and in evaluating and interpreting this information. The first 12 hours of the course provide training in five skill areas: perception and recognition; attention to detail; memory; mental imaging, mapping, and modeling skills; and judgment and decision making. Following this training is an integrating exercise involving a simulated safeguards inspection. This report contains the in-class exercises in the five skill areas; pre- and post-course exercises in closure, hidden figures, map memory, and mental rotations; the final examination; a training evaluation form; and the integrating exercise

  7. Comparing video games and laparoscopic simulators in the development of laparoscopic skills in surgical residents.

    Science.gov (United States)

    Adams, Barbara J; Margaron, Franklin; Kaplan, Brian J

    2012-01-01

    The video game industry has become increasingly popular over recent years, offering photorealistic simulations of various scenarios while requiring motor, visual, and cognitive coordination. Video game players outperform nonplayers on different visual tasks and are faster and more accurate on laparoscopic simulators. The same qualities found in video game players are highly desired in surgeons. Our investigation aims to evaluate the effect of video game play on the development of fine motor and visual skills. Specifically, we plan to examine if handheld video devices offer the same improvement in laparoscopic skill as traditional simulators, with less cost and more accessibility. We performed an Institutional Review Board-approved study, including categorical surgical residents and preliminary interns at our institution. The residents were randomly assigned to 1 of 3 study arms, including a traditional laparoscopic simulator, XBOX 360 gaming console, or Nintendo DS handheld gaming system. After an introduction survey and baseline timed test using a laparoscopic surgery box trainer, residents were given 6 weeks to practice on their respective consoles. At the conclusion of the study, the residents were tested again on the simulator and completed a final survey. A total of 31 residents were included in the study, representing equal distribution of each class level. The XBOX 360 group spent more time on their console weekly (6 hours per week) compared with the simulator (2 hours per week), and Nintendo groups (3 hours per week). There was a significant difference in the improvement of the tested time among the 3 groups, with the XBOX 360 group showing the greatest improvement (p = 0.052). The residents in the laparoscopic simulator arm (n = 11) improved 4.6 seconds, the XBOX group (n = 10) improved 17.7 seconds, and the Nintendo DS group (n = 10) improved 11.8 seconds. Residents who played more than 10 hours of video games weekly had the fastest times on the simulator

  8. Objective evaluation of minimally invasive surgical skills for transplantation. Surgeons using a virtual reality simulator.

    Science.gov (United States)

    Dănilă, R; Gerdes, B; Ulrike, H; Domínguez Fernández, E; Hassan, I

    2009-01-01

    The learning curve in laparoscopic surgery may be associated with higher patient risk, which is unacceptable in the setting of kidney donation. Virtual reality simulators may increase the safety and efficiency of training in laparoscopic surgery. The aim of this study was to investigate if the results of a training session reflect the actual skill level of transplantation surgeons and whether the simulator could differentiate laparoscopic experienced transplantation surgeon from advanced trainees. 16 subjects were assigned to one of two groups: 5 experienced transplantation surgeon and 11 advanced residents, with only assistant role during transplantation. The level of performance was measured by a relative scoring system that combines single parameters assessed by the computer. The higher the level of transplantation experience of a participant, the higher the laparoscopic performance. Experienced transplantation surgeons showed statistically significant better scores than the advanced group for time and precision parameters. Our results show that performance of the various tasks on the simulator corresponds to the respective level of experience in transplantation surgery in our research groups. This study confirms construct validity for the LapSim. It thus measures relevant skills and can be integrated in an endoscopic training and assessment curriculum for transplantations surgeons.

  9. Objective psychomotor skills assessment of experienced and novice flexible endoscopists with a virtual reality simulator.

    Science.gov (United States)

    Ritter, E Matt; McClusky, David A; Lederman, Andrew B; Gallagher, Anthony G; Smith, C Daniel

    2003-11-01

    The objective of this study was to determine whether the GI Mentor II virtual reality simulator can distinguish the psychomotor skills of intermediately experienced endoscopists from those of novices, and do so with a high level of consistency and reliability. A total of five intermediate and nine novice endoscopists were evaluated using the EndoBubble abstract psychomotor task. Each subject performed three repetitions of the task. Performance and error data were recorded for each trial. The intermediate group performed better than the novice group in each trial. The differences were significant in trial 1 for balloons popped (P=.001), completion time (P=.04), and errors (P=.03). Trial 2 showed significance only for balloons popped (P=.002). Trial 3 showed significance for balloons popped (P=.004) and errors (P=.008). The novice group showed significant improvement between trials 1 and 3 (P<0.05). No improvement was noted in the intermediate group. Measures of consistency and reliability were greater than 0.8 in both groups with the exception of novice completion time where test-retest reliability was 0.74. The GI Mentor II simulator can distinguish between novice and intermediate endoscopists. The simulator assesses skills with levels of consistency and reliability required for high-stakes assessment.

  10. 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.

  11. Simulation and debriefing in neonatology 2016: Mission incomplete.

    Science.gov (United States)

    Halamek, Louis P

    2016-11-01

    Simulation can be an effective tool to facilitate the acquisition and maintenance of the cognitive, technical and behavioral skills necessary to carry out our mission in neonatology: the delivery of safe, effective and efficient care to our patients. Prominent examples of successful implementation of simulation within neonatology include the Neonatal Resuscitation Program, the International Pediatric Simulation Society, and the International Network for Simulation-Based Pediatric Innovation, Research and Education. Despite these successes much remains to be accomplished. Expanding simulation beyond technical skill acquisition, using simulated environments to conduct research into human and system performance, incorporating simulation into high-stakes skill assessments, embracing the expertise of the more extensive modeling and simulation community and, in general, applying simulation to healthcare with the same degree of gravitas with which it is deployed in other high-risk industries are all tasks that must be completed in order to achieve our mission. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. An Evaluation of the Role of Simulation Training for Teaching Surgical Skills in Sub-Saharan Africa.

    Science.gov (United States)

    Campain, Nicholas J; Kailavasan, Mithun; Chalwe, Mumba; Gobeze, Aberra A; Teferi, Getaneh; Lane, Robert; Biyani, Chandra Shekhar

    2018-04-01

    An estimated 5 billion people worldwide lack access to any surgical care, whilst surgical conditions account for 11-30% of the global burden of disease. Maximizing the effectiveness of surgical training is imperative to improve access to safe and essential surgical care on a global scale. Innovative methods of surgical training have been used in sub-Saharan Africa to attempt to improve the efficiency of training healthcare workers in surgery. Simulation training may have an important role in up-scaling and improving the efficiency of surgical training and has been widely used in SSA. Though not intended to be a systematic review, the role of simulation for teaching surgical skills in Sub-Saharan Africa was reviewed to assess the evidence for use and outcomes. A systematic search strategy was used to retrieve relevant studies from electronic databases PubMed, Ovid, Medline for pertinent articles published until August 2016. Studies that reported the use of simulation-based training for surgery in Africa were included. In all, 19 articles were included. A variety of innovative surgical training methods using simulation techniques were identified. Few studies reported any outcome data. Compared to the volume of surgical training initiatives that are known to take place in SSA, there is very limited good quality published evidence for the use of simulation training in this context. Simulation training presents an excellent modality to enhance and improve both volume and access to high quality surgical skills training, alongside other learning domains. There is a desperate need to meticulously evaluate the appropriateness and effectiveness of simulation training in SSA, where simulation training could have a large potential beneficial impact. Training programs should attempt to assess and report learner outcomes.

  13. Use of human patient simulation and the situation awareness global assessment technique in practical trauma skills assessment.

    Science.gov (United States)

    Hogan, Michael P; Pace, David E; Hapgood, Joanne; Boone, Darrell C

    2006-11-01

    Situation awareness (SA) is defined as the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future. This construct is vital to decision making in intense, dynamic environments. It has been used in aviation as it relates to pilot performance, but has not been applied to medical education. The most widely used objective tool for measuring trainee SA is the Situation Awareness Global Assessment Technique (SAGAT). The purpose of this study was to design and validate SAGAT for assessment of practical trauma skills, and to compare SAGAT results to traditional checklist style scoring. Using the Human Patient Simulator, we designed SAGAT for practical trauma skills assessment based on Advanced Trauma Life Support objectives. Sixteen subjects (four staff surgeons, four senior residents, four junior residents, and four medical students) participated in three scenarios each. They were assessed using SAGAT and traditional checklist assessment. A questionnaire was used to assess possible confounding factors in attaining SA and overall trainee satisfaction. SAGAT was found to show significant difference (analysis of variance; p level of training lending statistical support to construct validity. SAGAT was likewise found to display reliability (Cronbach's alpha 0.767), and significant scoring correlation with traditional checklist performance measures (Pearson's coefficient 0.806). The questionnaire revealed no confounding factors and universal satisfaction with the human patient simulator and SAGAT. SAGAT is a valid, reliable assessment tool for trauma trainees in the dynamic clinical environment created by human patient simulation. Information provided by SAGAT could provide specific feedback, direct individualized teaching, and support curriculum change. Introduction of SAGAT could improve the current assessment model for practical trauma education.

  14. Simulation modeling and arena

    CERN Document Server

    Rossetti, Manuel D

    2015-01-01

    Emphasizes a hands-on approach to learning statistical analysis and model building through the use of comprehensive examples, problems sets, and software applications With a unique blend of theory and applications, Simulation Modeling and Arena®, Second Edition integrates coverage of statistical analysis and model building to emphasize the importance of both topics in simulation. Featuring introductory coverage on how simulation works and why it matters, the Second Edition expands coverage on static simulation and the applications of spreadsheets to perform simulation. The new edition als

  15. Short- and long-term transfer of urethral catheterization skills from simulation training to performance on patients

    DEFF Research Database (Denmark)

    Todsen, Tobias; Henriksen, Mikael V.; Kromann, Charles B.

    2013-01-01

    Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Although training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC...

  16. Progress Towards Achieving the Challenge of Indian Summer Monsoon Climate Simulation in a Coupled Ocean-Atmosphere Model

    Science.gov (United States)

    Hazra, Anupam; Chaudhari, Hemantkumar S.; Saha, Subodh Kumar; Pokhrel, Samir; Goswami, B. N.

    2017-10-01

    Simulation of the spatial and temporal structure of the monsoon intraseasonal oscillations (MISOs), which have effects on the seasonal mean and annual cycle of Indian summer monsoon (ISM) rainfall, remains a grand challenge for the state-of-the-art global coupled models. Biases in simulation of the amplitude and northward propagation of MISOs and related dry rainfall bias over ISM region in climate models are limiting the current skill of monsoon prediction. Recent observations indicate that the convective microphysics of clouds may be critical in simulating the observed MISOs. The hypothesis is strongly supported by high fidelity in simulation of the amplitude and space-time spectra of MISO by a coupled climate model, when our physically based modified cloud microphysics scheme is implemented in conjunction with a modified new Simple Arakawa Schubert (nSAS) convective parameterization scheme. Improved simulation of MISOs appears to have been aided by much improved simulation of the observed high cloud fraction and convective to stratiform rain fractions and resulted into a much improved simulation of the ISM rainfall, monsoon onset, and the annual cycle.

  17. Simulation-based Education for Endoscopic Third Ventriculostomy: A Comparison Between Virtual and Physical Training Models.

    Science.gov (United States)

    Breimer, Gerben E; Haji, Faizal A; Bodani, Vivek; Cunningham, Melissa S; Lopez-Rios, Adriana-Lucia; Okrainec, Allan; Drake, James M

    2017-02-01

    The relative educational benefits of virtual reality (VR) and physical simulation models for endoscopic third ventriculostomy (ETV) have not been evaluated "head to head." To compare and identify the relative utility of a physical and VR ETV simulation model for use in neurosurgical training. Twenty-three neurosurgical residents and 3 fellows performed an ETV on both a physical and VR simulation model. Trainees rated the models using 5-point Likert scales evaluating the domains of anatomy, instrument handling, procedural content, and the overall fidelity of the simulation. Paired t tests were performed for each domain's mean overall score and individual items. The VR model has relative benefits compared with the physical model with respect to realistic representation of intraventricular anatomy at the foramen of Monro (4.5, standard deviation [SD] = 0.7 vs 4.1, SD = 0.6; P = .04) and the third ventricle floor (4.4, SD = 0.6 vs 4.0, SD = 0.9; P = .03), although the overall anatomy score was similar (4.2, SD = 0.6 vs 4.0, SD = 0.6; P = .11). For overall instrument handling and procedural content, the physical simulator outperformed the VR model (3.7, SD = 0.8 vs 4.5; SD = 0.5, P educational objectives. Training focused on learning anatomy or decision-making for anatomic cues may be aided with the VR simulation model. A focus on developing manual dexterity and technical skills using endoscopic equipment in the operating room may be better learned on the physical simulation model. Copyright © 2016 by the Congress of Neurological Surgeons

  18. A Vascular Anastomosis Simulation Can Provide a Safe and Effective Environment for Resident Skills Development.

    Science.gov (United States)

    Heelan Gladden, Alicia A; Conzen, Kendra D; Benge, Michael J; Gralla, Jane; Kennealey, Peter T

    2018-04-09

    Vascular anastomoses are complex surgical procedures, performed in time-sensitive circumstances, making intraoperative teaching more challenging. We sought to evaluate whether a vascular anastomosis simulation was effective in developing resident skills. General surgery residents participated in a vascular anastomosis simulation for 1 to 2hours during their transplant rotation. An attending transplant surgeon at the University of Colorado guided the resident through end-to-end and end-to-side anastomoses using bovine carotid artery (Artegraft). The residents completed a presimulation and postsimulation survey which quantitated their confidence. They also completed the MiSSES scale, which assessed the validity of the simulation. Twenty residents participated in the simulation and completed the surveys. The residents reported increased understanding in how to set up an end-to-end anastomosis and an end-to-side anastomosis (p = 0.001 and p = 0.009, respectively). They reported increased ability to suture, forehand and backhand with a Castro-Viejo needle driver (both p < 0.001). The residents reported increased ability to manipulate the needle (p = 0.006), and increased ability to manipulate tissue without causing trauma (p = 0.021). They reported increased confidence in tying a surgical knot with 6-0 Prolene and in operating while wearing loupes (p = 0.002, and p < 0.001, respectively). Overall, the residents reported increased confidence when asked to perform part of a vascular anastomosis in the operating room (p < 0.001). Seventeen residents completed the MiSSES scale with median scores of "somewhat agree" to "strongly agree" on all domains of the scale. The use of a simple, inexpensive vascular anastomosis simulation is an effective and safe environment to improve residents' surgical skills and the residents felt that the simulation was valid. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Surgical simulation training in orthopedics: current insights.

    Science.gov (United States)

    Kalun, Portia; Wagner, Natalie; Yan, James; Nousiainen, Markku T; Sonnadara, Ranil R

    2018-01-01

    While the knowledge required of residents training in orthopedic surgery continues to increase, various factors, including reductions in work hours, have resulted in decreased clinical learning opportunities. Recent work suggests residents graduate from their training programs without sufficient exposure to key procedures. In response, simulation is increasingly being incorporated into training programs to supplement clinical learning. This paper reviews the literature to explore whether skills learned in simulation-based settings results in improved clinical performance in orthopedic surgery trainees. A scoping review of the literature was conducted to identify papers discussing simulation training in orthopedic surgery. We focused on exploring whether skills learned in simulation transferred effectively to a clinical setting. Experimental studies, systematic reviews, and narrative reviews were included. A total of 15 studies were included, with 11 review papers and four experimental studies. The review articles reported little evidence regarding the transfer of skills from simulation to the clinical setting, strong evidence that simulator models discriminate among different levels of experience, varied outcome measures among studies, and a need to define competent performance in both simulated and clinical settings. Furthermore, while three out of the four experimental studies demonstrated transfer between the simulated and clinical environments, methodological study design issues were identified. Our review identifies weak evidence as to whether skills learned in simulation transfer effectively to clinical practice for orthopedic surgery trainees. Given the increased reliance on simulation, there is an immediate need for comprehensive studies that focus on skill transfer, which will allow simulation to be incorporated effectively into orthopedic surgery training programs.

  20. Use of simulated patients to assess the clinical and communication skills of community pharmacists.

    Science.gov (United States)

    Weiss, Marjorie C; Booth, Anneka; Jones, Bethan; Ramjeet, Sarah; Wong, Eva

    2010-06-01

    To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Community pharmacies in the southwest of England during 2007. Two simulated patient ('mystery shopper') scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John's Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.

  1. Leadership Development Through Peer-Facilitated Simulation in Nursing Education.

    Science.gov (United States)

    Brown, Karen M; Rode, Jennifer L

    2018-01-01

    Baccalaureate nursing graduates must possess leadership skills, yet few opportunities exist to cultivate leadership abilities in a clinical environment. Peer-facilitated learning may increase the leadership skills of competence, self-confidence, self-reflection, and role modeling. Facilitating human patient simulation provides opportunities to develop leadership skills. With faculty supervision, senior baccalaureate students led small-group simulation experiences with sophomore and junior peers and then conducted subsequent debriefings. Quantitative and qualitative descriptive data allowed evaluation of students' satisfaction with this teaching innovation and whether the experience affected students' desire to take on leadership roles. Students expressed satisfaction with the peer-facilitated simulation experience and confidence in mastering the content while developing necessary skills for practice. Peer-facilitated simulation provides an opportunity for leadership development and learning. Study results can inform the development of nursing curricula to best develop the leadership skills of nursing students. [J Nurs Educ. 2018;57(1):53-57.]. Copyright 2018, SLACK Incorporated.

  2. Virtual reality bronchoscopy simulation: a revolution in procedural training.

    Science.gov (United States)

    Colt, H G; Crawford, S W; Galbraith, O

    2001-10-01

    In the airline industry, training is costly and operator error must be avoided. Therefore, virtual reality (VR) is routinely used to learn manual and technical skills through simulation before pilots assume flight responsibilities. In the field of medicine, manual and technical skills must also be acquired to competently perform invasive procedures such as flexible fiberoptic bronchoscopy (FFB). Until recently, training in FFB and other endoscopic procedures has occurred on the job in real patients. We hypothesized that novice trainees using a VR skill center could rapidly acquire basic skills, and that results would compare favorably with those of senior trainees trained in the conventional manner. We prospectively studied five novice bronchoscopists entering a pulmonary and critical care medicine training program. They were taught to perform inspection flexible bronchoscopy using a VR bronchoscopy skill center; dexterity, speed, and accuracy were tested using the skill center and an inanimate airway model before and after 4 h of group instruction and 4 h of individual unsupervised practice. Results were compared to those of a control group of four skilled physicians who had performed at least 200 bronchoscopies during 2 years of training. Student's t tests were used to compare mean scores of study and control groups for the inanimate model and VR bronchoscopy simulator. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired two-sample t tests were used. Novices significantly improved their dexterity and accuracy in both models. They missed fewer segments after training than before training, and had fewer contacts with the bronchial wall. There was no statistically significant improvement in speed or total time spent not visualizing airway anatomy. After training, novice performance equaled or surpassed that of the skilled physicians. Novices performed

  3. Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists' Acquisition of Ultrasound-Guided Regional Anesthesia Skills.

    Science.gov (United States)

    Udani, Ankeet Deepak; Harrison, T Kyle; Mariano, Edward R; Derby, Ryan; Kan, Jack; Ganaway, Toni; Shum, Cynthia; Gaba, David M; Tanaka, Pedro; Kou, Alex; Howard, Steven K

    2016-01-01

    Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control). Participants were recorded and assessed while performing simulated peripheral nerve blocks at baseline, immediately after the experimental condition, and 3 months after enrollment. Subject performance was scored from video by 2 blinded reviewers using a composite tool. The amount of time each participant spent in deliberate or self-guided practice was recorded. Twenty-eight participants completed the study. Both groups showed within-group improvement from baseline scores immediately after the curriculum and 3 months following study enrollment. There was no difference between groups in changed composite scores immediately after the curriculum (P = 0.461) and 3 months following study enrollment (P = 0.927) from baseline. The average time in minutes that subjects spent in simulation practice was 6.8 minutes for the control group compared with 48.5 minutes for the intervention group (P < 0.001). In this comparative effectiveness study, there was no difference in acquisition and retention of skills in UGRA for novice residents taught by either simulation-based deliberate practice or self-guided practice. Both methods increased skill from baseline; however, self-guided practice required less time and faculty resources.

  4. MJO prediction skill of the subseasonal-to-seasonal (S2S) prediction models

    Science.gov (United States)

    Son, S. W.; Lim, Y.; Kim, D.

    2017-12-01

    The Madden-Julian Oscillation (MJO), the dominant mode of tropical intraseasonal variability, provides the primary source of tropical and extratropical predictability on subseasonal to seasonal timescales. To better understand its predictability, this study conducts quantitative evaluation of MJO prediction skill in the state-of-the-art operational models participating in the subseasonal-to-seasonal (S2S) prediction project. Based on bivariate correlation coefficient of 0.5, the S2S models exhibit MJO prediction skill ranging from 12 to 36 days. These prediction skills are affected by both the MJO amplitude and phase errors, the latter becoming more important with forecast lead times. Consistent with previous studies, the MJO events with stronger initial amplitude are typically better predicted. However, essentially no sensitivity to the initial MJO phase is observed. Overall MJO prediction skill and its inter-model spread are further related with the model mean biases in moisture fields and longwave cloud-radiation feedbacks. In most models, a dry bias quickly builds up in the deep tropics, especially across the Maritime Continent, weakening horizontal moisture gradient. This likely dampens the organization and propagation of MJO. Most S2S models also underestimate the longwave cloud-radiation feedbacks in the tropics, which may affect the maintenance of the MJO convective envelop. In general, the models with a smaller bias in horizontal moisture gradient and longwave cloud-radiation feedbacks show a higher MJO prediction skill, suggesting that improving those processes would enhance MJO prediction skill.

  5. [Effect of Debriefing Based on the Clinical Judgment Model on Simulation Based Learning Outcomes of End-of-Life Care for Nursing Students: A Non-Randomized Controlled Trial].

    Science.gov (United States)

    Jeong, Kyung In; Choi, Ja Yun

    2017-12-01

    This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, psatisfaction (t=-0.38, p=.704) between the experimental and control groups. This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC. © 2017 Korean Society of Nursing Science

  6. Teaching effective problem solving skills to radiation protection students

    International Nuclear Information System (INIS)

    Waller, Edward

    2008-01-01

    Full text: Problem solving skills are essential for all radiation protection personnel. Although some students have more natural problem solving skills than others, all students require practice to become comfortable using these skills. At the University of Ontario Institute of Technology (UOIT), a unique one-semester course was developed as part of the core curriculum to teach students problem solving skills and elements of modelling and simulation. The underlying emphasis of the course was to allow students to develop their own problem solving strategies, both individually and in groups. Direction was provided on how to examine problems from different perspectives, and how to determine the proper root problem statement. A five-point problem solving strategy was presented as: 1) Problem definition; 2) Solution generation; 3) Decision; 4) Implementation; 5) Evaluation. Within the strategy, problem solving techniques were integrated from diverse areas such as: De Bono 's six thinking hats, Kepner-Tregoe decision analysis, Covey's seven habits of highly effective people, Reason's swiss cheese theory of complex failure, and Howlett's common failure modes. As part of the evaluation step, students critically explore areas such as ethics and environmental responsibility. In addition to exploring problem solving methods, students learn the usefulness of simulation methods, and how to model and simulate complex phenomena of relevance to radiation protection. Computational aspects of problem solving are explored using the commercially available MATLAB computer code. A number of case studies are presented as both examples and problems to the students. Emphasis was placed on solutions to problems of interest to radiation protection, health physics and nuclear engineering. A group project, pertaining to an accident or event related to the nuclear industry is a course requirement. Students learn to utilize common time and project management tools such as flowcharting, Pareto

  7. Video modeling by experts with video feedback to enhance gymnastics skills.

    Science.gov (United States)

    Boyer, Eva; Miltenberger, Raymond G; Batsche, Catherine; Fogel, Victoria

    2009-01-01

    The effects of combining video modeling by experts with video feedback were analyzed with 4 female competitive gymnasts (7 to 10 years old) in a multiple baseline design across behaviors. During the intervention, after the gymnast performed a specific gymnastics skill, she viewed a video segment showing an expert gymnast performing the same skill and then viewed a video replay of her own performance of the skill. The results showed that all gymnasts demonstrated improved performance across three gymnastics skills following exposure to the intervention.

  8. [Learning together for working together: interprofessionalism in simulation training for collaborative skills development].

    Science.gov (United States)

    Policard, Florence

    2014-06-01

    The use of simulation as an educational tool is becoming more widespread in healthcare. Such training gathers doctors and nurses together, which is a rare opportunity in such a sector. The present research focuses on the contribution of inter-professional training to the development of collaborative skills when managing an emergency situation in the context of anesthesia or intensive care. From direct observations of post-simulation debriefing sessions and interviews held with learners in post graduate or in-service training, either in single or multi-professional groups, this study shows that these sessions, based on experiential learning and reflective practice, help to build a shared vision of the problem and of common operative patterns, supporting better communication and the "ability to work in a team".

  9. Performance goals on simulators boost resident motivation and skills laboratory attendance.

    Science.gov (United States)

    Stefanidis, Dimitrios; Acker, Christina E; Greene, Frederick L

    2010-01-01

    To assess the impact of setting simulator training goals on resident motivation and skills laboratory attendance. Residents followed a proficiency-based laparoscopic curriculum on the 5 Fundamentals of Laparoscopic Surgery and 9 virtual reality tasks. Training goals consisted of the average expert performance on each task + 2 SD (mandatory) and best expert performance (optional). Residents rated the impact of the training goals on their motivation on a 20-point visual analog scale. Performance and attendance data were analyzed and correlated (Spearman's). Data are reported as medians (range). General Surgery residency program at a regional referral Academic Medical Center. General surgery residents (n = 15). During the first 5 months of the curriculum, weekly attendance rate was 51% (range, 8-96). After 153 (range, 21-412) repetitions, resident speed improved by 97% (range, 18-230), errors improved by 17% (range, 0-24), and motion efficiency by 59% (range, 26-114) compared with their baseline. Nine (60%) residents achieved proficiency in 7 (range, 3-14) and the best goals in 3.5 (range, 1-9) tasks; the other 6 residents had attendance rates motivation as 15 (range, 1-18) and setting a best goal as 13 (range, 1-18). Motivation ratings correlated positively with attendance rates, number of repetitions, performance improvement, and achievement of proficiency and best goals (r = 0.59-0.75; p motivation to participate in a simulator curriculum. While more stringent goals may potentiate this effect, they have a limited impact on senior residents. Further research is needed to investigate ways to improve skills laboratory attendance. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Validating the Learning Cycle Models of Business Simulation Games via Student Perceived Gains in Skills and Knowledge

    Science.gov (United States)

    Tao, Yu-Hui; Yeh, C. Rosa; Hung, Kung Chin

    2015-01-01

    Several theoretical models have been constructed to determine the effects of buisness simulation games (BSGs) on learning performance. Although these models agree on the concept of learning-cycle effect, no empirical evidence supports the claim that the use of learning cycle activities with BSGs produces an effect on incremental gains in knowledge…

  11. How valid are commercially available medical simulators?

    Science.gov (United States)

    Stunt, JJ; Wulms, PH; Kerkhoffs, GM; Dankelman, J; van Dijk, CN; Tuijthof, GJM

    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 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 insufficient, it is advisable for medical professionals, trainees, medical educators, and companies who manufacture medical simulators to critically judge the available medical simulators for proper validation. This way adequate, safe, and affordable medical psychomotor skills training can be achieved. PMID:25342926

  12. Simulation Exploration Experience 2018 Overview

    Science.gov (United States)

    Paglialonga, Stephen; Elfrey, Priscilla; Crues, Edwin Z.

    2018-01-01

    The Simulation Exploration Experience (SEE) joins students, industry, professional associations, and faculty together for an annual modeling and simulation (M&S) challenge. SEE champions collaborative collegiate-level modeling and simulation by providing a venue for students to work in highly dispersed inter-university teams to design, develop, test, and execute simulated missions associated with space exploration. Participating teams gain valuable knowledge, skills, and increased employability by working closely with industry professionals, NASA, and faculty advisors. This presentation gives and overview of the SEE and the upcoming 2018 SEE event.

  13. An information-motivation-behavioral skills model of adherence to antiretroviral therapy.

    Science.gov (United States)

    Fisher, Jeffrey D; Fisher, William A; Amico, K Rivet; Harman, Jennifer J

    2006-07-01

    HIV-positive persons who do not maintain consistently high levels of adherence to often complex and toxic highly active antiretroviral therapy (HAART) regimens may experience therapeutic failure and deterioration of health status and may develop multidrug-resistant HIV that can be transmitted to uninfected others. The current analysis conceptualizes social and psychological determinants of adherence to HAART among HIV-positive individuals. The authors propose an information-motivation-behavioral skills (IMB) model of HAART adherence that assumes that adherence-related information, motivation, and behavioral skills are fundamental determinants of adherence to HAART. According to the model, adherence-related information and motivation work through adherence-related behavioral skills to affect adherence to HAART. Empirical support for the IMB model of adherence is presented, and its application in adherence-promotion intervention efforts is discussed.

  14. Aviation Safety Simulation Model

    Science.gov (United States)

    Houser, Scott; Yackovetsky, Robert (Technical Monitor)

    2001-01-01

    The Aviation Safety Simulation Model is a software tool that enables users to configure a terrain, a flight path, and an aircraft and simulate the aircraft's flight along the path. The simulation monitors the aircraft's proximity to terrain obstructions, and reports when the aircraft violates accepted minimum distances from an obstruction. This model design facilitates future enhancements to address other flight safety issues, particularly air and runway traffic scenarios. This report shows the user how to build a simulation scenario and run it. It also explains the model's output.

  15. Effectiveness of Video Modeling Provided by Mothers in Teaching Play Skills to Children with Autism

    Science.gov (United States)

    Besler, Fatma; Kurt, Onur

    2016-01-01

    Video modeling is an evidence-based practice that can be used to provide instruction to individuals with autism. Studies show that this instructional practice is effective in teaching many types of skills such as self-help skills, social skills, and academic skills. However, in previous studies, videos used in the video modeling process were…

  16. Cognitive models embedded in system simulation models

    International Nuclear Information System (INIS)

    Siegel, A.I.; Wolf, J.J.

    1982-01-01

    If we are to discuss and consider cognitive models, we must first come to grips with two questions: (1) What is cognition; (2) What is a model. Presumably, the answers to these questions can provide a basis for defining a cognitive model. Accordingly, this paper first places these two questions into perspective. Then, cognitive models are set within the context of computer simulation models and a number of computer simulations of cognitive processes are described. Finally, pervasive issues are discussed vis-a-vis cognitive modeling in the computer simulation context

  17. Training and Assessment of Hysteroscopic Skills: A Systematic Review.

    Science.gov (United States)

    Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars; Tolsgaard, Martin G; Bjerrum, Flemming

    2016-01-01

    The aim of this systematic review was to identify studies on hysteroscopic training and assessment. PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. A total of 25 studies on hysteroscopy training were identified, of which 23 were performed in simulated settings. Overall, 10 studies used virtual-reality simulators and reported effect sizes for technical skills ranging from 0.31 to 2.65; 12 used inanimate models and reported effect sizes for technical skills ranging from 0.35 to 3.19. One study involved live animal models; 2 studies were performed in clinical settings. The validity evidence supporting the assessment tools used was low. Consensus between the 2 raters on the reported validity evidence was high (94%). This systematic review demonstrated large variations in the effect of different tools for hysteroscopy training. The validity evidence supporting the assessment of hysteroscopic skills was limited. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Simulation-based medical education: time for a pedagogical shift.

    Science.gov (United States)

    Kalaniti, Kaarthigeyan; Campbell, Douglas M

    2015-01-01

    The purpose of medical education at all levels is to prepare physicians with the knowledge and comprehensive skills, required to deliver safe and effective patient care. The traditional 'apprentice' learning model in medical education is undergoing a pedagogical shift to a 'simulation-based' learning model. Experiential learning, deliberate practice and the ability to provide immediate feedback are the primary advantages of simulation-based medical education. It is an effective way to develop new skills, identify knowledge gaps, reduce medical errors, and maintain infrequently used clinical skills even among experienced clinical teams, with the overall goal of improving patient care. Although simulation cannot replace clinical exposure as a form of experiential learning, it promotes learning without compromising patient safety. This new paradigm shift is revolutionizing medical education in the Western world. It is time that the developing countries embrace this new pedagogical shift.

  19. A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine.

    Science.gov (United States)

    Suslu, Husnu

    2012-01-01

    Laboratory training models are essential for developing and refining treatment skills before the clinical application of surgical and invasive procedures. A simple simulation model is needed for young trainees to learn how to handle instruments, and to perform safe lumbar transforaminal epidural injections. Our aim is to present a model of a fresh cadaveric sheep lumbar spine that simulates the lumbar transforaminal epidural injection. The material consists of a 2-year-old fresh cadaveric sheep spine. A 4-step approach was designed for lumbar transforaminal epidural injection under C-arm scopy. For the lumbar transforaminal epidural injection, the fluoroscope was adjusted to get a proper oblique view while the material was stabilized in a prone position. The procedure then begin, using the C-arm guidance scopy. The model simulates well the steps of standard lumbar transforaminal epidural injections in the human spine. The cadaveric sheep spine represents a good method for training and it simulates fluoroscopic lumbar transforaminal epidural steroid injection procedures performed in the human spine.

  20. Comparison of the education effect in simulated environment with educational film on acquiring midwifery students\\' episiotomy skill

    Directory of Open Access Journals (Sweden)

    Z Kalani

    2016-07-01

    Full Text Available Introduction: In clinical education, it is essential to prevent patients from injuries  by using the new educational approaches. Therefore, the students must be ready before involving in any procedures. This study aimed to determine the effect of education in simulated environment and instructional videos on the skills of the episiotomy among midwifery students. Methods: In this interventional study, at the beginning of the sixth term, all of the midwifery students, 30 students, were divided randomly into 3 groups. The education was taken place in simulated environment and using educational films without intervention. The training was performed on training mannequin. The film was prepared from this training and presented to each of the students in film group. A practical test done and the results recorded in check list. The data were analyzed by SPSS software. Results: The mean scores of students in performing an episiotomy based on all of the cases in 3 groups was statistically significant difference (p<0.001. But in comparing 3 groups of two, it was not found any statistically significant difference in all cases between the educational groups in simulated environment and educational film (p=0.975. Overall skill level of students on the basis of all the cases in the group without interference was lower than the other two groups. Conclusion: The educational film, which was designed, based on the scientific principles can be effective in gaining skills as a self-taught. Therefore, using the mentioned methods is recommended in clinical education planning.

  1. An experimental study on the effects of a simulation game on students’ clinical cognitive skills and motivation

    NARCIS (Netherlands)

    M. Dankbaar (Mary); J. Alsma (Jelmer); E.E.H. Jansen (Els E. H.); J.J.G. van Merriënboer (Jeroen); J.L.C.M. van Saase (Jan); S.C.E. Schuit (Stephanie)

    2016-01-01

    textabstractSimulation 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

  2. Aiming for excellence - A simulation-based study on adapting and testing an instrument for developing non-technical skills in Norwegian student nurse anaesthetists.

    Science.gov (United States)

    Flynn, Fiona M; Sandaker, Kjersti; Ballangrud, Randi

    2017-01-01

    There is increasing focus on building safety into anaesthesia practice, with excellence in anaesthesia as an aspirational goal. Non-technical skills are an important factor in excellence and improved patient safety, though there have been few systematic attempts at integrating them into anaesthesia nursing education. This study aimed to test the reliability of NANTS-no, a specially adapted behavioural marker system for nurse anaesthetists in Norway, and explore the development of non-technical skills in student nurse anaesthetists. The pre-test post-test design incorporated a 10-week simulation-based programme, where non-technical skills in 14 student nurse anaesthetists were rated on three different occasions during high-fidelity simulation, before and after taking part in a training course. NANTS-no demonstrated high overall inter-rater reliability (ICC = 0.91), high test-retest reliability (ICC = 0.94) and good internal consistency (Cronbach's α of 0.85-0.92). A significant improvement was demonstrated across all categories of non-technical skills, with greatest improvements between the first and third and second and third sessions. There was also a significant improvement in two categories between the first and second sessions. NANTS-no is therefore suitable for assessing non-technical skills during simulation training in anaesthesia nursing education. More research is needed to validate its use in clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Modeling and simulation of complex systems a framework for efficient agent-based modeling and simulation

    CERN Document Server

    Siegfried, Robert

    2014-01-01

    Robert Siegfried presents a framework for efficient agent-based modeling and simulation of complex systems. He compares different approaches for describing structure and dynamics of agent-based models in detail. Based on this evaluation the author introduces the "General Reference Model for Agent-based Modeling and Simulation" (GRAMS). Furthermore he presents parallel and distributed simulation approaches for execution of agent-based models -from small scale to very large scale. The author shows how agent-based models may be executed by different simulation engines that utilize underlying hard

  4. Teaching Communication Skills to Radiology Residents.

    Science.gov (United States)

    Itri, Jason N; Yacob, Sammy; Mithqal, Ayman

    The transition of health care in the United States from volume to value requires a systems-based approach aligning clinical services across the continuum of care. The ability to communicate effectively and resolve conflict is a critical skill within the systems-based model. Recognizing the essential role of communication in medicine, the Accreditation Council of Graduate Medical Education has designated interpersonal and communication skills a core competency for all residents regardless of specialty. Yet, communication skills are often developed through on-the-job training or not at all. Traditional educational curricula use a predominantly didactic approach without opportunities for trainees to observe, actively experiment, or reflect on what is learned as a part of the learning process. In this article, we describe a 1-day experiential communication skills workshop customized for radiology residents that consists of Myers-Briggs Type Indicator and conflict management sessions designed to develop interpersonal, communication, and conflict management skills through group discussion, role-play, and simulation. The purpose of this educational initiative was to determine the perceived value of an experiential communication skills workshop designed for radiology trainees. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Objective Assessment of Laparoscopic Force and Psychomotor Skills in a Novel Virtual Reality-Based Haptic Simulator.

    Science.gov (United States)

    Prasad, M S Raghu; Manivannan, Muniyandi; Manoharan, Govindan; Chandramohan, S M

    2016-01-01

    Most of the commercially available virtual reality-based laparoscopic simulators do not effectively evaluate combined psychomotor and force-based laparoscopic skills. Consequently, the lack of training on these critical skills leads to intraoperative errors. To assess the effectiveness of the novel virtual reality-based simulator, this study analyzed the combined psychomotor (i.e., motion or movement) and force skills of residents and expert surgeons. The study also examined the effectiveness of real-time visual force feedback and tool motion during training. Bimanual fundamental (i.e., probing, pulling, sweeping, grasping, and twisting) and complex tasks (i.e., tissue dissection) were evaluated. In both tasks, visual feedback on applied force and tool motion were provided. The skills of the participants while performing the early tasks were assessed with and without visual feedback. Participants performed 5 repetitions of fundamental and complex tasks. Reaction force and instrument acceleration were used as metrics. Surgical Gastroenterology, Government Stanley Medical College and Hospital; Institute of Surgical Gastroenterology, Madras Medical College and Rajiv Gandhi Government General Hospital. Residents (N = 25; postgraduates and surgeons with 4 and ≤10 years of laparoscopic surgery). Residents applied large forces compared with expert surgeons and performed abrupt tool movements (p < 0.001). However, visual + haptic feedback improved the performance of residents (p < 0.001). In complex tasks, visual + haptic feedback did not influence the applied force of expert surgeons, but influenced their tool motion (p < 0.001). Furthermore, in complex tissue sweeping task, expert surgeons applied more force, but were within the tissue damage limits. In both groups, exertion of large forces and abrupt tool motion were observed during grasping, probing or pulling, and tissue sweeping maneuvers (p < 0.001). Modern day curriculum-based training should evaluate the skills

  6. Development of Reliable and Validated Tools to Evaluate Technical Resuscitation Skills in a Pediatric Simulation Setting: Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics.

    Science.gov (United States)

    Faudeux, Camille; Tran, Antoine; Dupont, Audrey; Desmontils, Jonathan; Montaudié, Isabelle; Bréaud, Jean; Braun, Marc; Fournier, Jean-Paul; Bérard, Etienne; Berlengi, Noémie; Schweitzer, Cyril; Haas, Hervé; Caci, Hervé; Gatin, Amélie; Giovannini-Chami, Lisa

    2017-09-01

    To develop a reliable and validated tool to evaluate technical resuscitation skills in a pediatric simulation setting. Four Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics (RESCAPE) evaluation tools were created, following international guidelines: intraosseous needle insertion, bag mask ventilation, endotracheal intubation, and cardiac massage. We applied a modified Delphi methodology evaluation to binary rating items. Reliability was assessed comparing the ratings of 2 observers (1 in real time and 1 after a video-recorded review). The tools were assessed for content, construct, and criterion validity, and for sensitivity to change. Inter-rater reliability, evaluated with Cohen kappa coefficients, was perfect or near-perfect (>0.8) for 92.5% of items and each Cronbach alpha coefficient was ≥0.91. Principal component analyses showed that all 4 tools were unidimensional. Significant increases in median scores with increasing levels of medical expertise were demonstrated for RESCAPE-intraosseous needle insertion (P = .0002), RESCAPE-bag mask ventilation (P = .0002), RESCAPE-endotracheal intubation (P = .0001), and RESCAPE-cardiac massage (P = .0037). Significantly increased median scores over time were also demonstrated during a simulation-based educational program. RESCAPE tools are reliable and validated tools for the evaluation of technical resuscitation skills in pediatric settings during simulation-based educational programs. They might also be used for medical practice performance evaluations. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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

  8. Understanding interdisciplinary health care teams: using simulation design processes from the Air Carrier Advanced Qualification Program to identify and train critical teamwork skills.

    Science.gov (United States)

    Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M

    2010-09-01

    In the report "Five Years After 'To Err is Human' ", it was noted that "the combination of complexity, professional fragmentation, and a tradition of individualism, enhanced by a well-entrenched hierarchical authority structure and diffuse accountability, forms a daunting barrier to creating the habits and beliefs of common purpose, teamwork, and individual accountability for successful interdependence that a safe culture requires". Training physicians, nurses, and other professionals to work in teams is a concept that has been promoted by many patient safety experts. However the model of teamwork in healthcare is diffusely defined, no clear performance metrics have been established, and the use of simulation to train teams has been suboptimal. This paper reports on the first three years of work performed in the Michigan Economic Development Corporation (MEDC) Tri-Corridor life science grant to apply concepts and processes of simulation design that were developed in the air carrier industry to understand and train healthcare teams. This work has been monitored by the American Academy for the Advancement of Science (AAA) and is based on concepts designed in the Advanced Qualification Program (AQP) from the air carrier industry, which trains and assesses teamwork skills in the same manner as technical skills. This grant has formed the foundation for the Center of Excellence for Simulation Education and Research (CESR).

  9. Comparison of the didactic lecture with the simulation/model approach for the teaching of a novel perioperative ultrasound curriculum to anesthesiology residents.

    Science.gov (United States)

    Ramsingh, Davinder; Alexander, Brenton; Le, Khanhvan; Williams, Wendell; Canales, Cecilia; Cannesson, Maxime

    2014-09-01

    To expose residents to two methods of education for point-of-care ultrasound, a traditional didactic lecture and a model/simulation-based lecture, which focus on concepts of cardiopulmonary function, volume status, and evaluation of severe thoracic/abdominal injuries; and to assess which method is more effective. Single-center, prospective, blinded trial. University hospital. Anesthesiology residents who were assigned to an educational day during the two-month research study period. Residents were allocated to two groups to receive either a 90-minute, one-on-one didactic lecture or a 90-minute lecture in a simulation center, during which they practiced on a human model and simulation mannequin (normal pathology). Data points included a pre-lecture multiple-choice test, post-lecture multiple-choice test, and post-lecture, human model-based examination. Post-lecture tests were performed within three weeks of the lecture. An experienced sonographer who was blinded to the education modality graded the model-based skill assessment examinations. Participants completed a follow-up survey to assess the perceptions of the quality of their instruction between the two groups. 20 residents completed the study. No differences were noted between the two groups in pre-lecture test scores (P = 0.97), but significantly higher scores for the model/simulation group occurred on both the post-lecture multiple choice (P = 0.038) and post-lecture model (P = 0.041) examinations. Follow-up resident surveys showed significantly higher scores in the model/simulation group regarding overall interest in perioperative ultrasound (P = 0.047) as well understanding of the physiologic concepts (P = 0.021). A model/simulation-based based lecture series may be more effective in teaching the skills needed to perform a point-of-care ultrasound examination to anesthesiology residents. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Model Forecast Skill and Sensitivity to Initial Conditions in the Seasonal Sea Ice Outlook

    Science.gov (United States)

    Blanchard-Wrigglesworth, E.; Cullather, R. I.; Wang, W.; Zhang, J.; Bitz, C. M.

    2015-01-01

    We explore the skill of predictions of September Arctic sea ice extent from dynamical models participating in the Sea Ice Outlook (SIO). Forecasts submitted in August, at roughly 2 month lead times, are skillful. However, skill is lower in forecasts submitted to SIO, which began in 2008, than in hindcasts (retrospective forecasts) of the last few decades. The multimodel mean SIO predictions offer slightly higher skill than the single-model SIO predictions, but neither beats a damped persistence forecast at longer than 2 month lead times. The models are largely unsuccessful at predicting each other, indicating a large difference in model physics and/or initial conditions. Motivated by this, we perform an initial condition sensitivity experiment with four SIO models, applying a fixed -1 m perturbation to the initial sea ice thickness. The significant range of the response among the models suggests that different model physics make a significant contribution to forecast uncertainty.

  11. Development of modelling method selection tool for health services management: from problem structuring methods to modelling and simulation methods.

    Science.gov (United States)

    Jun, Gyuchan T; Morris, Zoe; Eldabi, Tillal; Harper, Paul; Naseer, Aisha; Patel, Brijesh; Clarkson, John P

    2011-05-19

    There is an increasing recognition that modelling and simulation can assist in the process of designing health care policies, strategies and operations. However, the current use is limited and answers to questions such as what methods to use and when remain somewhat underdeveloped. The aim of this study is to provide a mechanism for decision makers in health services planning and management to compare a broad range of modelling and simulation methods so that they can better select and use them or better commission relevant modelling and simulation work. This paper proposes a modelling and simulation method comparison and selection tool developed from a comprehensive literature review, the research team's extensive expertise and inputs from potential users. Twenty-eight different methods were identified, characterised by their relevance to different application areas, project life cycle stages, types of output and levels of insight, and four input resources required (time, money, knowledge and data). The characterisation is presented in matrix forms to allow quick comparison and selection. This paper also highlights significant knowledge gaps in the existing literature when assessing the applicability of particular approaches to health services management, where modelling and simulation skills are scarce let alone money and time. A modelling and simulation method comparison and selection tool is developed to assist with the selection of methods appropriate to supporting specific decision making processes. In particular it addresses the issue of which method is most appropriate to which specific health services management problem, what the user might expect to be obtained from the method, and what is required to use the method. In summary, we believe the tool adds value to the scarce existing literature on methods comparison and selection.

  12. Improving Junior High Schools’ Critical Thinking Skills Based on Test Three Different Models of Learning

    Directory of Open Access Journals (Sweden)

    Nur Miftahul Fuad

    2017-01-01

    Full Text Available The aims of this study were (1 to find out the differences in critical thinking skills among students who were given three different learning models: differentiated science inquiry combined with mind map, differentiated science inquiry model, and conventional model, (2 to find out the differences of critical thinking skills among male and female students. This study is a quasi-experimental research with pretest-posttest nonequivalent control group design. The population in this research is the seventh grade students of junior high schools in Kediri, Indonesia. The sample of the research is in the number of 96 students distributed in three classes at different schools. The data of critical thinking skills are gained from test scores and then analyzed using descriptive and inferential statistics through ANCOVA. The results of research revealed that there are different skills in critical thinking in different models. The highest skills in critical thinking are reached by students who were given differentiated science inquiry model combined with mind map in their learning. There are also differences in critical thinking skills between male and female students.

  13. Development of a Behavioural Marker System for Rating Cadet’s Non-Technical Skills

    Directory of Open Access Journals (Sweden)

    Victor Fernando PlÁcido da ConceiçÌo

    2017-06-01

    Full Text Available Despite the adoption of crew resource management training for bridge teams over the last decades, the training is still heavily focussed on technical achievements. In an educational context, the situation is more problematical, since with requirement of developing the technical skills, there is a need to build and evaluate the non-technical skills of cadets with little experience in bridge team management. In parallel with the application of team leadership models, the Portuguese Naval Academy conducted a research to improve the development and assessment of non-technical skills in bridge simulators. This paper describes the method used to identify the key non-technical skills required for naval cadets and to develop a behavioural marker system for their measurement. A literature review of behavioural marker systems was supplemented with an analysis of interviews conducted with students and simulator instructors. Additionally, further analysis of Portuguese Navy accidents reports was made, applying the HFACS framework to identify the relevant non-technical skills involved in the accidents. The resulting rating system covers five skill categories (leadership, situational awareness, communication, team work and decision making, each one with three rating elements. The framework is currently under evaluation tests in bridge simulators sessions, within an educational context.

  14. Simulation in Complex Modelling

    DEFF Research Database (Denmark)

    Nicholas, Paul; Ramsgaard Thomsen, Mette; Tamke, Martin

    2017-01-01

    This paper will discuss the role of simulation in extended architectural design modelling. As a framing paper, the aim is to present and discuss the role of integrated design simulation and feedback between design and simulation in a series of projects under the Complex Modelling framework. Complex...... performance, engage with high degrees of interdependency and allow the emergence of design agency and feedback between the multiple scales of architectural construction. This paper presents examples for integrated design simulation from a series of projects including Lace Wall, A Bridge Too Far and Inflated...... Restraint developed for the research exhibition Complex Modelling, Meldahls Smedie Gallery, Copenhagen in 2016. Where the direct project aims and outcomes have been reported elsewhere, the aim for this paper is to discuss overarching strategies for working with design integrated simulation....

  15. Impact of a Vascular Neurosurgery Simulation-Based Course on Cognitive Knowledge and Technical Skills in European Neurosurgical Trainees.

    Science.gov (United States)

    Zammar, Samer G; El Tecle, Najib E; El Ahmadieh, Tarek Y; Adelson, P David; Veznedaroglu, Erol; Surdell, Daniel L; Harrop, James S; Benes, Vladimir; Rezai, Ali R; Resnick, Daniel K; Bendok, Bernard R

    2015-08-01

    To assess microsurgical and diagnostic cerebral angiography modules and their corresponding objective assessment scales as educational tools for European neurosurgical residents at the European Association of Neurosurgical Societies Resident Vascular Neurosurgery course, which was held in Prague, Czech Republic, on September 2013. Microsurgical skills and cerebral angiography are fundamental skills in vascular neurosurgery. There is a need to develop a simulation-based curriculum focusing on these skills for neurosurgical trainees worldwide. The course consisted of 2 modules: microanastomosis and diagnostic cerebral angiography. In addition to an initial screening survey, each module was divided into 3 components: 1) a before didactic cognitive knowledge and technical skills testing, 2) a didactic lecture, and 3) an after didactic cognitive knowledge and technical skills testing. We compared the trainees' cognitive and technical scores from the before and after testing phases. Wilcoxon sum rank test was used to test statistical significance. The knowledge test median scores increased from 63% and 68% to 80% and 88% (P technical proficiency. Copyright © 2015. Published by Elsevier Inc.

  16. Model of practical skill performance as an instrument for supervision and formative assessment

    DEFF Research Database (Denmark)

    Nielsen, Carsten; Sommer, Irene; Larsen, Karin

    2012-01-01

    as during practice, performance and formative assessment of practical skills learning. It provided a common language about practical skills and enhanced the participants’ understanding of professionalism in practical nursing skill. In conclusion, the model helped to highlight the complexity in mastering......There are still weaknesses in the practical skills of newly graduated nurses. There is also an escalating pressure on existing clinical placements due to increasing student numbers and structural changes in health services. Innovative educational practices and the use of tools that might support...... learning are sparsely researched in the field of clinical education for nursing students. This paper reports on an action research study that promoted and investigated use of The Model of Practical Skill Performance as a learning tool during nursing students’ clinical placement. Clinical supervisors...

  17. 3D Printed Surgical Simulation Models as educational tool by maxillofacial surgeons.

    Science.gov (United States)

    Werz, S M; Zeichner, S J; Berg, B-I; Zeilhofer, H-F; Thieringer, F

    2018-02-26

    The aim of this study was to evaluate whether inexpensive 3D models can be suitable to train surgical skills to dental students or oral and maxillofacial surgery residents. Furthermore, we wanted to know which of the most common filament materials, acrylonitrile butadiene styrene (ABS) or polylactic acid (PLA), can better simulate human bone according to surgeons' subjective perceptions. Upper and lower jaw models were produced with common 3D desktop printers, ABS and PLA filament and silicon rubber for soft tissue simulation. Those models were given to 10 blinded, experienced maxillofacial surgeons to perform sinus lift and wisdom teeth extraction. Evaluation was made using a questionnaire. Because of slightly different density and filament prices, each silicon-covered model costs between 1.40-1.60 USD (ABS) and 1.80-2.00 USD (PLA) based on 2017 material costs. Ten experienced raters took part in the study. All raters deemed the models suitable for surgical education. No significant differences between ABS and PLA were found, with both having distinct advantages. The study demonstrated that 3D printing with inexpensive printing filaments is a promising method for training oral and maxillofacial surgery residents or dental students in selected surgical procedures. With a simple and cost-efficient manufacturing process, models of actual patient cases can be produced on a small scale, simulating many kinds of surgical procedures. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Simulated training in colonoscopic stenting of colonic strictures: validation of a cadaver model.

    Science.gov (United States)

    Iordache, F; Bucobo, J C; Devlin, D; You, K; Bergamaschi, R

    2015-07-01

    There are currently no available simulation models for training in colonoscopic stent deployment. The aim of this study was to validate a cadaver model for simulation training in colonoscopy with stent deployment for colonic strictures. This was a prospective study enrolling surgeons at a single institution. Participants performed colonoscopic stenting on a cadaver model. Their performance was assessed by two independent observers. Measurements were performed for quantitative analysis (time to identify stenosis, time for deployment, accuracy) and a weighted score was devised for assessment. The Mann-Whitney U-test and Student's t-test were used for nonparametric and parametric data, respectively. Cohen's kappa coefficient was used for reliability. Twenty participants performed a colonoscopy with deployment of a self-expandable metallic stent in two cadavers (groups A and B) with 20 strictures overall. The median time was 206 s. The model was able to differentiate between experts and novices (P = 0. 013). The results showed a good consensus estimate of reliability, with kappa = 0.571 (P cadaver model described in this study has content, construct and concurrent validity for simulation training in colonoscopic deployment of self-expandable stents for colonic strictures. Further studies are needed to evaluate the predictive validity of this model in terms of skill transfer to clinical practice. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  19. Transfer of cysto-urethroscopy skills from a virtual-reality simulator to the operating room : a randomized controlled trial

    NARCIS (Netherlands)

    Schout, Barbara M. A.; Ananias, Hildo J. K.; Bemelmans, Bart L. H.; d'Ancona, Frank C. H.; Muijtjens, Arno M. M.; Dolmans, Valerie E. M. G.; Scherpbier, Albert J. J. A.; Hendrikx, Ad J. M.

    OBJECTIVE To assess whether real-time cysto-urethroscopy (CUS) performance improves by simulator-based training (criterion or predictive validity), addressing the research question 'Does practical skills training on the URO Mentor (UM, Simbionix USA Corp., Cleveland, OH, USA) virtual-reality

  20. RBMK full scope simulator gets virtual refuelling machine

    International Nuclear Information System (INIS)

    Khoudiakov, M.; Slonimsky, V.; Mitrofanov, S.

    2006-01-01

    The paper describes a continuation of efforts of an international Russian-Norwegian joint team to drastically increase operational safety during the refuelling process of an RBMK-type reactor by implementing a training simulator based on an innovative Virtual Reality (VR) approach. During the preceding stage of the project a display-based simulator was extended with VR models of the real Refueling Machine (RM) and its environment in order to improve both the learning process and operation's effectiveness. The simulator's challenge is to support the performance (operational activity) of RM operational staff firstly and to take major part in developing basic knowledge and skills as well as to keep skilled staff in close touch with the complex machinery of the Refueling Machine. At the given 2nd stage the functional scope of the VR-simulator was greatly enhanced - firstly, by connecting to the RBMK-unit full-scope simulator, and, secondly, by a training program and simulator model upgrade. (author)

  1. Otologic Skills Training

    DEFF Research Database (Denmark)

    Wiet, Gregory J; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

    2017-01-01

    This article presents a summary of the current simulation training for otologic skills. There is a wide variety of educational approaches, assessment tools, and simulators in use, including simple low-cost task trainers to complex computer-based virtual reality systems. A systematic approach...

  2. Simulated lumbar minimally invasive surgery educational model with didactic and technical components.

    Science.gov (United States)

    Chitale, Rohan; Ghobrial, George M; Lobel, Darlene; Harrop, James

    2013-10-01

    The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement with simultaneous didactic and technical components. A 2-hour educational curriculum was created to educate neurosurgical residents on anatomy, pathophysiology, and technical aspects associated with image-guided pedicle screw placement. Predidactic and postdidactic practical and written scores were analyzed and compared. Scores were calculated for each participant on the basis of the optimal pedicle screw starting point and trajectory for both fluoroscopy and computed tomographic navigation. Eight trainees participated in this module. Average mean scores on the written didactic test improved from 78% to 100%. The technical component scores for fluoroscopic guidance improved from 58.8 to 52.9. Technical score for computed tomography-navigated guidance also improved from 28.3 to 26.6. Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.

  3. Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

    Science.gov (United States)

    2010-01-01

    Background The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School. Methods In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test. Results At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training. Conclusions Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training. PMID:20082701

  4. Measurement Model of Reasoning Skills among Science Students Based on Socio Scientific Issues (SSI

    Directory of Open Access Journals (Sweden)

    MOHD AFIFI BAHURUDIN SETAMBAH

    2018-05-01

    Full Text Available The lack of reasoning skills has been recognized as one of the contributing factors to the declined achievement in the Trends in Mathematics and Science Studies (TIMSS and Programme for International Student Assessment (PISA assessments in Malaysia. The use of socio-scientific issues (SSI as a learning strategy offers the potential of improving the level of students' reasoning skills and consequently improves students’ achievement in science subjects. This study examined the development of a measurement model of reasoning skills among science students based on SSI using the analysis of moment structure (AMOS approach before going to second level to full structured equation modelling (SEM. A total of 450 respondents were selected using a stratified random sampling. Results showed a modified measurement model of reasoning skills consisting of the View Knowledge (VK was as a main construct. The items that measure the level of pre-reflection of students fulfilled the elements of unidimensionality, validity, and reliability. Although the level of student reasoning skills was still low but this development of measurement model could be identified and proposed teaching methods that could be adopted to improve students’ reasoning skills.

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with quality, comprehensive education. The standardized interactive program has been ...

  6. Review of simulation in paediatrics: The evolution of a revolution

    Directory of Open Access Journals (Sweden)

    Rahul eOjha

    2015-11-01

    Full Text Available Recent changes in medical education have highlighted the importance of experiential learning. Simulation is one model that has gained significant attention in the last decade and has been widely adopted as a training and assessment tool in medical education. Paediatric simulation has been utilized to teach various skills including resuscitation and trauma management, procedural skills and team training. It is also a valuable tool for health care educators, as it allows learners to achieve competence without putting patients at risk. Recent literature demonstrates increased retention of knowledge and skills after simulation based training. Further research is required to improve current simulation curriculums, develop validated assessment tools and to demonstrate improved clinical outcomes after simulation based training. We conducted an online search of original and review articles related to simulation and paediatric medical education and provide an overview of the role and utility of simulation in paediatrics.

  7. A Co-Creation Blended KM Model for Cultivating Critical-Thinking Skills

    Science.gov (United States)

    Yeh, Yu-chu

    2012-01-01

    Both critical thinking (CT) and knowledge management (KM) skills are necessary elements for a university student's success. Therefore, this study developed a co-creation blended KM model to cultivate university students' CT skills and to explore the underlying mechanisms for achieving success. Thirty-one university students participated in this…

  8. Potential predictability and forecast skill in ensemble climate forecast: a skill-persistence rule

    Science.gov (United States)

    Jin, Yishuai; Rong, Xinyao; Liu, Zhengyu

    2017-12-01

    This study investigates the factors relationship between the forecast skills for the real world (actual skill) and perfect model (perfect skill) in ensemble climate model forecast with a series of fully coupled general circulation model forecast experiments. It is found that the actual skill for sea surface temperature (SST) in seasonal forecast is substantially higher than the perfect skill on a large part of the tropical oceans, especially the tropical Indian Ocean and the central-eastern Pacific Ocean. The higher actual skill is found to be related to the higher observational SST persistence, suggesting a skill-persistence rule: a higher SST persistence in the real world than in the model could overwhelm the model bias to produce a higher forecast skill for the real world than for the perfect model. The relation between forecast skill and persistence is further proved using a first-order autoregressive model (AR1) analytically for theoretical solutions and numerically for analogue experiments. The AR1 model study shows that the skill-persistence rule is strictly valid in the case of infinite ensemble size, but could be distorted by sampling errors and non-AR1 processes. This study suggests that the so called "perfect skill" is model dependent and cannot serve as an accurate estimate of the true upper limit of real world prediction skill, unless the model can capture at least the persistence property of the observation.

  9. The comparison the effect of training by means of simulation and oral method on midwives’ skill in management of shoulder dystocia

    Science.gov (United States)

    Kordi, Masoumeh; Erfanian, Fatemeh; Fakari, Farzaneh Rashidi; Dastfan, Fatemeh; Nejad, Keivan Shariati

    2017-01-01

    INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012. METHODS: The current research is a double-group clinical trial that was conducted on 51 members of the employed midwives in the obstetric clinic at Mashhad city in 2012. The questionnaire of personal specification and awareness about shoulder dystocia and practical examination (objective-structured clinical examination) were employed as tools for data collection. The learners were divided into two groups by randomized allocation. Training was done by the presentation of lecture in the oral content group and a short movie was displayed at the end of it. The shoulder dystocia management technique was simulated in another group and through role-playing of instructor application of moulage (station) training was conducted. The period of the training course (4 h) and content of the educational workshop was identical for both groups. The practical examination was held for the learners before and immediately after training course. The given data were analyzed by means of statistical descriptive tests including Mann–Whitney U-test and Wilcoxon test via SPSS software (version 16). The significance level was considered as (P dystocia management skill after intervention in both groups (P dystocia management skill after the intervention was significantly greater in simulation group than in an oral group (P = 0.040). CONCLUSION: Training in simulated delivery room by means of role-playing is an efficient method for training shoulder dystocia management skill, so it is

  10. Improving the interview skills of college students using behavioral skills training.

    Science.gov (United States)

    Stocco, Corey S; Thompson, Rachel H; Hart, John M; Soriano, Heidi L

    2017-07-01

    Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants. © 2017 Society for the Experimental Analysis of Behavior.

  11. Virtual reality simulators: valuable surgical skills trainers or video games?

    Science.gov (United States)

    Willis, Ross E; Gomez, Pedro Pablo; Ivatury, Srinivas J; Mitra, Hari S; Van Sickle, Kent R

    2014-01-01

    Virtual reality (VR) and physical model (PM) simulators differ in terms of whether the trainee is manipulating actual 3-dimensional objects (PM) or computer-generated 3-dimensional objects (VR). Much like video games (VG), VR simulators utilize computer-generated graphics. These differences may have profound effects on the utility of VR and PM training platforms. In this study, we aimed to determine whether a relationship exists between VR, PM, and VG platforms. VR and PM simulators for laparoscopic camera navigation ([LCN], experiment 1) and flexible endoscopy ([FE] experiment 2) were used in this study. In experiment 1, 20 laparoscopic novices played VG and performed 0° and 30° LCN exercises on VR and PM simulators. In experiment 2, 20 FE novices played VG and performed colonoscopy exercises on VR and PM simulators. In both experiments, VG performance was correlated with VR performance but not with PM performance. Performance on VR simulators did not correlate with performance on respective PM models. VR environments may be more like VG than previously thought. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  12. An observational study investigating the impact of simulated patients in teaching communication skills in preclinical dietetic students.

    Science.gov (United States)

    Gibson, S J; Davidson, Z E

    2016-08-01

    Simulated patients (SPs) are often used in dietetics for the teaching and assessment of communication skills. The present study aimed to determine the impact of a SP encounter on communication skills in undergraduate preclinical dietetic students in the context of the resources required for delivering this educational strategy. This observational study collected assessment data from four cohorts of third-year dietetic students to examine the effect of participation in SP-embedded Objective Structured Clinical Exams. Students completed two SP interviews, 2 weeks apart, and communication skills were measured on both occasions. A subgroup of students received a video of their SP encounter. Differences between the two SP interview scores were compared to assess the impact of the SP encounter on communication skills. The required staff and resources were described. Data were collected involving 215 students. Out of 30 marks, there was a modest mean (SD) improvement in communication skills from the first to the second SP interview of 2.5 (4.2) (P skills, with failing students demonstrating the greatest improvement between SP encounters. There were no observed benefits for the subset of students who received videos. Providing repeat SP interview opportunities results in only modest improvement in communication skills for most students. The use of SPs needs to be considered in context of the substantial costs and resources involved and tailored to student ability. © 2015 The British Dietetic Association Ltd.

  13. Imaging skills for transthoracic echocardiography in cardiology fellows: The value of motion metrics

    Science.gov (United States)

    Montealegre-Gallegos, Mario; Mahmood, Feroze; Kim, Han; Bergman, Remco; Mitchell, John D.; Bose, Ruma; Hawthorne, Katie M.; O’Halloran, T. David; Wong, Vanessa; Hess, Philip E.; Matyal, Robina

    2016-01-01

    Background: Proficiency in transthoracic echocardiography (TTE) requires an integration of cognitive knowledge and psychomotor skills. Whereas cognitive knowledge can be quantified, psychomotor skills are implied after repetitive task performance. We applied motion analyses to evaluate psychomotor skill acquisition during simulator-based TTE training. Methods and Results: During the first month of their fellowship training, 16 cardiology fellows underwent a multimodal TTE training program for 4 weeks (8 sessions). The program consisted of online and live didactics as well as simulator training. Kinematic metrics (path length, time, probe accelerations) were obtained at the start and end of the course for 8 standard TTE views using a simulator. At the end of the course TTE image acquisition skills were tested on human models. After completion of the training program the trainees reported improved self-perceived comfort with TTE imaging. There was also an increase of 8.7% in post-test knowledge scores. There was a reduction in the number of probe accelerations [median decrease 49.5, 95% CI = 29-73, adjusted P < 0.01], total time [median decrease 10.6 s, 95% CI = 6.6-15.5, adjusted P < 0.01] and path length [median decrease 8.8 cm, 95% CI = 2.2-17.7, adjusted P < 0.01] from the start to the end of the course. During evaluation on human models, the trainees were able to obtain all the required TTE views without instructor assistance. Conclusion: Simulator-derived motion analyses can be used to objectively quantify acquisition of psychomotor skills during TTE training. Such an approach could be used to assess readiness for clinical practice of TTE. PMID:27052064

  14. Imaging skills for transthoracic echocardiography in cardiology fellows: The value of motion metrics

    Directory of Open Access Journals (Sweden)

    Mario Montealegre-Gallegos

    2016-01-01

    Full Text Available Background: Proficiency in transthoracic echocardiography (TTE requires an integration of cognitive knowledge and psychomotor skills. Whereas cognitive knowledge can be quantified, psychomotor skills are implied after repetitive task performance. We applied motion analyses to evaluate psychomotor skill acquisition during simulator-based TTE training. Methods and Results: During the first month of their fellowship training, 16 cardiology fellows underwent a multimodal TTE training program for 4 weeks (8 sessions. The program consisted of online and live didactics as well as simulator training. Kinematic metrics (path length, time, probe accelerations were obtained at the start and end of the course for 8 standard TTE views using a simulator. At the end of the course TTE image acquisition skills were tested on human models. After completion of the training program the trainees reported improved self-perceived comfort with TTE imaging. There was also an increase of 8.7% in post-test knowledge scores. There was a reduction in the number of probe accelerations [median decrease 49.5, 95% CI = 29-73, adjusted P < 0.01], total time [median decrease 10.6 s, 95% CI = 6.6-15.5, adjusted P < 0.01] and path length [median decrease 8.8 cm, 95% CI = 2.2-17.7, adjusted P < 0.01] from the start to the end of the course. During evaluation on human models, the trainees were able to obtain all the required TTE views without instructor assistance. Conclusion: Simulator-derived motion analyses can be used to objectively quantify acquisition of psychomotor skills during TTE training. Such an approach could be used to assess readiness for clinical practice of TTE.

  15. Computer Simulation and Digital Resources for Plastic Surgery Psychomotor Education.

    Science.gov (United States)

    Diaz-Siso, J Rodrigo; Plana, Natalie M; Stranix, John T; Cutting, Court B; McCarthy, Joseph G; Flores, Roberto L

    2016-10-01

    Contemporary plastic surgery residents are increasingly challenged to learn a greater number of complex surgical techniques within a limited period. Surgical simulation and digital education resources have the potential to address some limitations of the traditional training model, and have been shown to accelerate knowledge and skills acquisition. Although animal, cadaver, and bench models are widely used for skills and procedure-specific training, digital simulation has not been fully embraced within plastic surgery. Digital educational resources may play a future role in a multistage strategy for skills and procedures training. The authors present two virtual surgical simulators addressing procedural cognition for cleft repair and craniofacial surgery. Furthermore, the authors describe how partnerships among surgical educators, industry, and philanthropy can be a successful strategy for the development and maintenance of digital simulators and educational resources relevant to plastic surgery training. It is our responsibility as surgical educators not only to create these resources, but to demonstrate their utility for enhanced trainee knowledge and technical skills development. Currently available digital resources should be evaluated in partnership with plastic surgery educational societies to guide trainees and practitioners toward effective digital content.

  16. Simulation-based ureteroscopy training: a systematic review.

    Science.gov (United States)

    Brunckhorst, Oliver; Aydin, Abdullatif; Abboudi, Hamid; Sahai, Arun; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2015-01-01

    Simulation is a common adjunct to operative training and various modalities exist for ureteroscopy. This systematic review aims the following: (1) to identify available ureteroscopy simulators, (2) to explore evidence for their effectiveness using characteristic criterion, and (3) to provide recommendations for simulation-based ureteroscopy training. The preferred reporting items for systematic reviews and meta-analysis statement guidelines were used. A literature search was performed using the PubMed, EMBASE, and Cochrane Library databases. In total, 20 articles concerning ureteroscopy simulators were included. Overall, 3 high-fidelity bench models are available. The Uro-Scopic Trainer has demonstrated face, construct, and concurrent validity, whereas the Scope Trainer has undergone content, construct, and predictive validation. The adult ureteroscopy trainer has demonstrated face, content, and construct validity. The URO Mentor is the only available ureteroscopy virtual-reality system; 10 studies were identified demonstrating its face, content, construct, concurrent, and predictive validity. The Uro-Scopic Trainer, the Scope Trainer, and the URO Mentor have demonstrated high educational impact. A noncommercially available, low-fidelity model has demonstrated effectiveness comparable to its high-fidelity counterpart at 185 times lesser than the price of the Uro-Scopic Trainer. The use of porcine models has also been described in 3 studies but require further study. Valid models are available for simulation-based ureteroscopy training. However, there is a lack of many high-level studies conducted, and further investigation is required in this area. Furthermore, current research focuses on the technical skills acquisition with little research conducted on nontechnical skills acquisition within ureteroscopy. The next step for ureteroscopy training is a formalized and validated curriculum, incorporating simulation, training models, development of nontechnical skills

  17. Potential predictability and forecast skill in ensemble climate forecast: the skill-persistence rule

    Science.gov (United States)

    Jin, Y.; Rong, X.; Liu, Z.

    2017-12-01

    This study investigates the factors that impact the forecast skill for the real world (actual skill) and perfect model (perfect skill) in ensemble climate model forecast with a series of fully coupled general circulation model forecast experiments. It is found that the actual skill of sea surface temperature (SST) in seasonal forecast is substantially higher than the perfect skill on a large part of the tropical oceans, especially the tropical Indian Ocean and the central-eastern Pacific Ocean. The higher actual skill is found to be related to the higher observational SST persistence, suggesting a skill-persistence rule: a higher SST persistence in the real world than in the model could overwhelm the model bias to produce a higher forecast skill for the real world than for the perfect model. The relation between forecast skill and persistence is further examined using a first-order autoregressive model (AR1) analytically for theoretical solutions and numerically for analogue experiments. The AR1 model study shows that the skill-persistence rule is strictly valid in the case of infinite ensemble size, but can be distorted by the sampling error and non-AR1 processes.

  18. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

    Science.gov (United States)

    Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

    2015-08-01

    Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

  19. Empowering Critical Thinking Skills with Computerized Patient Simulators

    Science.gov (United States)

    Farrar, Francisca Cisneros; Suggs, Leslie

    2010-01-01

    Students struggle with the mastery of critical thinking skills which are essential to their academic success. University faculty are challenged to create teaching strategies to help students build critical thinking skills. Nursing faculty at Austin Peay State University in Clarksville, Tennessee looked to research and technology for ways to…

  20. Deficits in fine motor skills in a genetic animal model of ADHD

    Directory of Open Access Journals (Sweden)

    Qian Yu

    2010-09-01

    Full Text Available Abstract Background In an attempt to model some behavioral aspects of Attention Deficit/Hyperactivity Disorder (ADHD, we examined whether an existing genetic animal model of ADHD is valid for investigating not only locomotor hyperactivity, but also more complex motor coordination problems displayed by the majority of children with ADHD. Methods We subjected young adolescent Spontaneously Hypertensive Rats (SHRs, the most commonly used genetic animal model of ADHD, to a battery of tests for motor activity, gross motor coordination, and skilled reaching. Wistar (WIS rats were used as controls. Results Similar to children with ADHD, young adolescent SHRs displayed locomotor hyperactivity in a familiar, but not in a novel environment. They also had lower performance scores in a complex skilled reaching task when compared to WIS rats, especially in the most sensitive measure of skilled performance (i.e., single attempt success. In contrast, their gross motor performance on a Rota-Rod test was similar to that of WIS rats. Conclusion The results support the notion that the SHR strain is a useful animal model system to investigate potential molecular mechanisms underlying fine motor skill problems in children with ADHD.

  1. A review of the available urology skills training curricula and their validation.

    Science.gov (United States)

    Shepherd, William; Arora, Karan Singh; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

    2014-01-01

    The transforming field of urological surgery continues to demand development of novel training devices and curricula for its trainees. Contemporary trainees have to balance workplace demands while overcoming the cognitive barriers of acquiring skills in rapidly multiplying and advancing surgical techniques. This article provides a brief review of the process involved in developing a surgical curriculum and the current status of real and simulation-based curricula in the 4 subgroups of urological surgical practice: open, laparoscopic, endoscopic, and robotic. An informal literature review was conducted to provide a snapshot into the variety of simulation training tools available for technical and nontechnical urological surgical skills within all subgroups of urological surgery using the following keywords: "urology, surgery, training, curriculum, validation, non-technical skills, technical skills, LESS, robotic, laparoscopy, animal models." Validated training tools explored in research were tabulated and summarized. A total of 20 studies exploring validated training tools were identified. Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery. The following key recommendations emerge from the review: adoption of simulation-based curricula in training; better integration of dedicated training time in simulated environments within a trainee's working hours; better incentivization for educators and assessors to improvise, research, and deliver teaching using the technologies available; and continued emphasis on developing nontechnical skills in tandem with technical operative skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  2. Performance of the general circulation models in simulating temperature and precipitation over Iran

    Science.gov (United States)

    Abbasian, Mohammadsadegh; Moghim, Sanaz; Abrishamchi, Ahmad

    2018-03-01

    General Circulation Models (GCMs) are advanced tools for impact assessment and climate change studies. Previous studies show that the performance of the GCMs in simulating climate variables varies significantly over different regions. This study intends to evaluate the performance of the Coupled Model Intercomparison Project phase 5 (CMIP5) GCMs in simulating temperature and precipitation over Iran. Simulations from 37 GCMs and observations from the Climatic Research Unit (CRU) were obtained for the period of 1901-2005. Six measures of performance including mean bias, root mean square error (RMSE), Nash-Sutcliffe efficiency (NSE), linear correlation coefficient (r), Kolmogorov-Smirnov statistic (KS), Sen's slope estimator, and the Taylor diagram are used for the evaluation. GCMs are ranked based on each statistic at seasonal and annual time scales. Results show that most GCMs perform reasonably well in simulating the annual and seasonal temperature over Iran. The majority of the GCMs have a poor skill to simulate precipitation, particularly at seasonal scale. Based on the results, the best GCMs to represent temperature and precipitation simulations over Iran are the CMCC-CMS (Euro-Mediterranean Center on Climate Change) and the MRI-CGCM3 (Meteorological Research Institute), respectively. The results are valuable for climate and hydrometeorological studies and can help water resources planners and managers to choose the proper GCM based on their criteria.

  3. A theory-based curriculum design for remediation of residents' communication skills.

    Science.gov (United States)

    Leung, Fok-Han; Martin, Dawn; Batty, Helen

    2009-12-01

    Residents requiring remediation are often deficient in communication skills, namely clinical interviewing skills. Residents have to digest large amounts of knowledge, and then apply it in a clinical interview. The patient-centered approach, as demonstrated in the Calgary-Cambridge model and Martin's Map, can be difficult to teach. Before implementing a remediation curriculum, the theoretical educational underpinnings must be sound; curriculum evaluation is often expensive. Before establishing metrics for curriculum evaluation, a starting point is to perform a mental experiment to test theoretical adherence. This article describes an experiential remedial curriculum for communication skills. Educational theories of Kolb, Knowles, Bandura, and Bloom are used to design the curriculum into theory-based design components. Kolb's experiential cycle models the natural sequence of experiencing, teaching, and learning interviewing skills. A curriculum structured around this cycle has multiple intercalations with the above educational theories. The design is strengthened by appropriately timed use of education strategies such as learning contracts, taped interviews, simulations, structured reflection, and teacher role modeling. Importantly, it also models the form of the clinical interview format desired. Through understanding and application of contemporary educational theories, a program to remediate interviewing skills can increase its potential for success.

  4. Identifying a key physical factor sensitive to the performance of Madden-Julian oscillation simulation in climate models

    Science.gov (United States)

    Kim, Go-Un; Seo, Kyong-Hwan

    2018-01-01

    A key physical factor in regulating the performance of Madden-Julian oscillation (MJO) simulation is examined by using 26 climate model simulations from the World Meteorological Organization's Working Group for Numerical Experimentation/Global Energy and Water Cycle Experiment Atmospheric System Study (WGNE and MJO-Task Force/GASS) global model comparison project. For this, intraseasonal moisture budget equation is analyzed and a simple, efficient physical quantity is developed. The result shows that MJO skill is most sensitive to vertically integrated intraseasonal zonal wind convergence (ZC). In particular, a specific threshold value of the strength of the ZC can be used as distinguishing between good and poor models. An additional finding is that good models exhibit the correct simultaneous convection and large-scale circulation phase relationship. In poor models, however, the peak circulation response appears 3 days after peak rainfall, suggesting unfavorable coupling between convection and circulation. For an improving simulation of the MJO in climate models, we propose that this delay of circulation in response to convection needs to be corrected in the cumulus parameterization scheme.

  5. Video-recorded simulated patient interactions: can they help develop clinical and communication skills in today's learning environment?

    Science.gov (United States)

    Seif, Gretchen A; Brown, Debora

    2013-01-01

    It is difficult to provide real-world learning experiences for students to master clinical and communication skills. The purpose of this paper is to describe a novel instructional method using self- and peer-assessment, reflection, and technology to help students develop effective interpersonal and clinical skills. The teaching method is described by the constructivist learning theory and incorporates the use of educational technology. The learning activities were incorporated into the pre-clinical didactic curriculum. The students participated in two video-recording assignments and performed self-assessments on each and had a peer-assessment on the second video-recording. The learning activity was evaluated through the self- and peer-assessments and an instructor-designed survey. This evaluation identified several themes related to the assignment, student performance, clinical behaviors and establishing rapport. Overall the students perceived that the learning activities assisted in the development of clinical and communication skills prior to direct patient care. The use of video recordings of a simulated history and examination is a unique learning activity for preclinical PT students in the development of clinical and communication skills.

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  7. The 21st century skills with model eliciting activities on linear program

    Science.gov (United States)

    Handajani, Septriana; Pratiwi, Hasih; Mardiyana

    2018-04-01

    Human resources in the 21st century are required to master various forms of skills, including critical thinking skills and problem solving. The teaching of the 21st century is a teaching that integrates literacy skills, knowledge, skills, attitudes, and mastery of ICT. This study aims to determine whether there are differences in the effect of applying Model Elliciting Activities (MEAs) that integrates 21st century skills, namely 4C and conventional learning to learning outcomes. This research was conducted at Vocational High School in the odd semester of 2017 and uses the experimental method. The experimental class is treated MEAs that integrates 4C skills and the control class is given conventional learning. Methods of data collection in this study using the method of documentation and test methods. The data analysis uses Z-test. Data obtained from experiment class and control class. The result of this study showed there are differences in the effect of applying MEAs that integrates 4C skills and conventional learning to learning outcomes. Classes with MEAs that integrates 4C skills give better learning outcomes than the ones in conventional learning classes. This happens because MEAs that integrates 4C skills can improved creativity skills, communication skills, collaboration skills, and problem-solving skills.

  8. Development of Foundational Movement Skills: A Conceptual Model for Physical Activity Across the Lifespan.

    Science.gov (United States)

    Hulteen, Ryan M; Morgan, Philip J; Barnett, Lisa M; Stodden, David F; Lubans, David R

    2018-03-09

    Evidence supports a positive association between competence in fundamental movement skills (e.g., kicking, jumping) and physical activity in young people. Whilst important, fundamental movement skills do not reflect the broad diversity of skills utilized in physical activity pursuits across the lifespan. Debate surrounds the question of what are the most salient skills to be learned which facilitate physical activity participation across the lifespan. In this paper, it is proposed that the term 'fundamental movement skills' be replaced with 'foundational movement skills'. The term 'foundational movement skills' better reflects the broad range of movement forms that increase in complexity and specificity and can be applied in a variety of settings. Thus, 'foundational movement skills' includes both traditionally conceptualized 'fundamental' movement skills and other skills (e.g., bodyweight squat, cycling, swimming strokes) that support physical activity engagement across the lifespan. A proposed conceptual model outlines how foundational movement skill competency can provide a direct or indirect pathway, via specialized movement skills, to a lifetime of physical activity. Foundational movement skill development is hypothesized to vary according to culture and/or geographical location. Further, skill development may be hindered or enhanced by physical (i.e., fitness, weight status) and psychological (i.e., perceived competence, self-efficacy) attributes. This conceptual model may advance the application of motor development principles within the public health domain. Additionally, it promotes the continued development of human movement in the context of how it leads to skillful performance and how movement skill development supports and maintains a lifetime of physical activity engagement.

  9. Uncovering the Best Skill Multimap by Constraining the Error Probabilities of the Gain-Loss Model

    Science.gov (United States)

    Anselmi, Pasquale; Robusto, Egidio; Stefanutti, Luca

    2012-01-01

    The Gain-Loss model is a probabilistic skill multimap model for assessing learning processes. In practical applications, more than one skill multimap could be plausible, while none corresponds to the true one. The article investigates whether constraining the error probabilities is a way of uncovering the best skill assignment among a number of…

  10. Designing simulator-based training: An approach integrating cognitive task analysis and four-component instructional design

    NARCIS (Netherlands)

    Tjiam, I.M.; Schout, B.M.; Hendrikx, A.J.M.; Scherpbier, A.J.J.A.; Witjes, J.A.; Van Merrienboer, J.J.

    2012-01-01

    Most studies of simulator-based surgical skills training have focused on the acquisition of psychomotor skills, but surgical procedures are complex tasks requiring both psychomotor and cognitive skills. As skills training is modelled on expert performance consisting partly of unconscious automatic

  11. Nintendo Wii video-gaming ability predicts laparoscopic skill.

    Science.gov (United States)

    Badurdeen, Shiraz; Abdul-Samad, Omar; Story, Giles; Wilson, Clare; Down, Sue; Harris, Adrian

    2010-08-01

    Studies using conventional consoles have suggested a possible link between video-gaming and laparoscopic skill. The authors hypothesized that the Nintendo Wii, with its motion-sensing interface, would provide a better model for laparoscopic tasks. This study investigated the relationship between Nintendo Wii skill, prior gaming experience, and laparoscopic skill. In this study, 20 participants who had minimal experience with either laparoscopic surgery or Nintendo Wii performed three tasks on a Webcam-based laparoscopic simulator and were assessed on three games on the Wii. The participants completed a questionnaire assessing prior gaming experience. The score for each of the three Wii games correlated positively with the laparoscopic score (r = 0.78, 0.63, 0.77; P skill overlap between the Nintendo Wii and basic laparoscopic tasks. Surgical candidates with advanced Nintendo Wii ability may possess higher baseline laparoscopic ability.

  12. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling

    Science.gov (United States)

    Feraco, Angela M.; Brand, Sarah R.; Mack, Jennifer W.; Kesselheim, Jennifer C.; Block, Susan D.; Wolfe, Joanne

    2018-01-01

    Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. PMID:26822066

  13. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling.

    Science.gov (United States)

    Feraco, Angela M; Brand, Sarah R; Mack, Jennifer W; Kesselheim, Jennifer C; Block, Susan D; Wolfe, Joanne

    2016-06-01

    Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. © 2016 Wiley Periodicals, Inc.

  14. Computer Modeling and Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Pronskikh, V. S. [Fermilab

    2014-05-09

    Verification and validation of computer codes and models used in simulation are two aspects of the scientific practice of high importance and have recently been discussed by philosophers of science. While verification is predominantly associated with the correctness of the way a model is represented by a computer code or algorithm, validation more often refers to model’s relation to the real world and its intended use. It has been argued that because complex simulations are generally not transparent to a practitioner, the Duhem problem can arise for verification and validation due to their entanglement; such an entanglement makes it impossible to distinguish whether a coding error or model’s general inadequacy to its target should be blamed in the case of the model failure. I argue that in order to disentangle verification and validation, a clear distinction between computer modeling (construction of mathematical computer models of elementary processes) and simulation (construction of models of composite objects and processes by means of numerical experimenting with them) needs to be made. Holding on to that distinction, I propose to relate verification (based on theoretical strategies such as inferences) to modeling and validation, which shares the common epistemology with experimentation, to simulation. To explain reasons of their intermittent entanglement I propose a weberian ideal-typical model of modeling and simulation as roles in practice. I suggest an approach to alleviate the Duhem problem for verification and validation generally applicable in practice and based on differences in epistemic strategies and scopes

  15. A model of cardiopulmonary bypass staged training integrating technical and non-technical skills dedicated to cardiac trainees.

    Science.gov (United States)

    Fouilloux, V; Doguet, F; Kotsakis, A; Dubrowski, A; Berdah, S

    2015-03-01

    To develop a standardized simulation-based curriculum to teach medical knowledge and technical, communication and critical thinking skills necessary to initiate and wean from cardiopulmonary bypass (CPB) to junior cardiac trainees (CTs) in France. Performance on post-curricular tests was compared between CTs who participated in the new curriculum to those who did not. The simulation-based curriculum was developed by content and education experts. Simulations sequentially taught the skills necessary for initiating and weaning from CPB as well as managing crises by adding fidelity and complexity to scenarios. Nine CTs were randomly assigned to the new curriculum (n=5) or the traditional curriculum (n=4). Skills were assessed using tests of medical knowledge and technical, communication (GRS) and critical thinking (SCT) skills. A two-sample Wilcoxon rank-sum test compared average scores between the two groups. Alpha of 0.05 was set to indicate statistically significant differences. The resutls revealed that CTs in the new curriculum significantly outperformed CTs in the traditional curriculum on technical (18.2 vs 14.8, p=0.05) and communication (3.5 vs 2.2, p=0.013) skills. There was no significant difference between CTs in the new curriculum in the Script Concordance Test (16.5 vs 14.8, p=0.141) and knowledge tests (26.9 vs 24.6, p=0.14) compared to CTs in the traditional curriculum. Our new curriculum teaches communication and technical skills necessary for CPB. The results of this pilot study are encouraging and relevant. They give grounds for future research with a larger panel of trainees. Based on the current distribution of scores, a sample size of 12 CTs per group should yield significant results for all tests. © The Author(s) 2014.

  16. Assessors for communication skills: SPs or healthcare professionals?

    Science.gov (United States)

    Liew, Siaw-Cheok; Dutta, Susmita; Sidhu, Jagmohni Kaur; De-Alwis, Ranjit; Chen, Nicole; Sow, Chew-Fei; Barua, Ankur

    2014-07-01

    The complexity of modern medicine creates more challenges for teaching and assessment of communication skills in undergraduate medical programme. This research was conducted to study the level of communication skills among undergraduate medical students and to determine the difference between simulated patients and clinical instructors' assessment of communication skills. This comparative study was conducted for three months at the Clinical Skills and Simulation Centre of the International Medical University in Malaysia. The modified Calgary-Cambridge checklist was used to assess the communication skills of 50 first year and 50 second year medical students (five-minutes pre-recorded interview videos on the scenario of sore throat). These videos were reviewed and scored by simulated patients (SPs), communication skills instructors (CSIs) and non-communication skills instructors (non-CSIs). Better performance was observed among the undergraduate medical students, who had formal training in communication skills with a significant difference in overall scores detected among the first and second year medical students (p = 0.0008). A non-significant difference existed between the scores of SPs and CSIs for Year 1 (p = 0.151). The SPs could be trained and involved in assessment of communication skills. Formal training in communication skills is necessary in the undergraduate medical programme.

  17. Analysis mathematical literacy skills in terms of the students’ metacognition on PISA-CPS model

    Science.gov (United States)

    Ovan; Waluya, S. B.; Nugroho, S. E.

    2018-03-01

    This research was aimed to know the effectiveness of PISA-CPS model and desceibe the mathematical literacy skills (KLM) in terms of the students’ metacognition. This study used Mixed Methods approaches with the concurrent embedded desaign. The technique of data analysis on quantitative research done analysis of lesson plan, prerequisite test, test hypotesis 1 and hypotesis test. While qualitative research done data reduction, data presentation, and drawing conclution and data verification. The subject of this study was the students of Grade Eight (VIII) of SMP Islam Sultan Agung 4 Semarang, Central Java. The writer analyzed the data with quantitative and qualitative approaches based on the metacognition of the students in low, medium and high groups. Subsequently, taken the mathematical literacy skills (KLM) from students’ metacognition in low, medium, and high . The results of the study showed that the PISA-CPS model was complete and the students’ mathematical literacy skills in terms of the students’ metacognition taught by the PISA-CPS model was higher than the expository learning. metacognitions’ students classified low hadmathematical literacy skills (KLM) less good, metacognitions’ students classified medium had mathematical literacy skills (KLM) good enough, metacognitions’ students classified high had mathematical literacy skills (KLM) very good. Based onresult analysis got conclusion that the PISA-CPS model was effective toward the students’ mathematical literacy skills (KLM). To increase the students’ mathematical literacy skills (KLM), the teachers need to provide reinforcements in the form of the exercises so that the student’s mathematical literacy was achieved at level 5 and level 6.

  18. Understanding the modeling skill shift in engineering: the impact of self-efficacy, epistemology, and metacognition

    Science.gov (United States)

    Yildirim, Tuba Pinar

    A focus of engineering education is to prepare future engineers with problem solving, design and modeling skills. In engineering education, the former two skill areas have received copious attention making their way into the ABET criteria. Modeling, a representation containing the essential structure of an event in the real world, is a fundamental function of engineering, and an important academic skill that students develop during their undergraduate education. Yet the modeling process remains under-investigated, particularly in engineering, even though there is an increasing emphasis on modeling in engineering schools (Frey 2003). Research on modeling requires a deep understanding of multiple perspectives, that of cognition, affect, and knowledge expansion. In this dissertation, the relationship between engineering modeling skills and students' cognitive backgrounds including self-efficacy, epistemic beliefs and metacognition is investigated using model-eliciting activities (MEAs). Data were collected from sophomore students at two time periods, as well as senior engineering students. The impact of each cognitive construct on change in modeling skills was measured using a growth curve model at the sophomore level, and ordinary least squares regression at the senior level. Findings of this dissertation suggest that self-efficacy, through its direct and indirect (moderation or interaction term with time) impact, influences the growth of modeling abilities of an engineering student. When sophomore and senior modeling abilities are compared, the difference can be explained by varying self-efficacy levels. Epistemology influences modeling skill development such that the more sophisticated the student beliefs are, the higher the level of modeling ability students can attain, after controlling for the effects of conceptual learning, gender and GPA. This suggests that development of modeling ability may be constrained by the naivete of one's personal epistemology

  19. Simulation training: a systematic review of simulation in arthroscopy and proposal of a new competency-based training framework.

    Science.gov (United States)

    Tay, Charison; Khajuria, Ankur; Gupte, Chinmay

    2014-01-01

    Traditional orthopaedic training has followed an apprenticeship model whereby trainees enhance their skills by operating under guidance. However the introduction of limitations on training hours and shorter training programmes mean that alternative training strategies are required. To perform a literature review on simulation training in arthroscopy and devise a framework that structures different simulation techniques that could be used in arthroscopic training. A systematic search of Medline, Embase, Google Scholar and the Cochrane Databases were performed. Search terms included "virtual reality OR simulator OR simulation" and "arthroscopy OR arthroscopic". 14 studies evaluating simulators in knee, shoulder and hip arthroplasty were included. The majority of the studies demonstrated construct and transference validity but only one showed concurrent validity. More studies are required to assess its potential as a training and assessment tool, skills transference between simulators and to determine the extent of skills decay from prolonged delays in training. We also devised a "ladder of arthroscopic simulation" that provides a competency-based framework to implement different simulation strategies. The incorporation of simulation into an orthopaedic curriculum will depend on a coordinated approach between many bodies. But the successful integration of simulators in other areas of surgery supports a possible role for simulation in advancing orthopaedic education. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of effectiveness of a paediatric simulation course in procedural skills for paediatric residents - A pilot study.

    Science.gov (United States)

    AlShammari, Abdullah; Inayah, Aman; Afsar, Nasir Ali; Nurhussen, Akram; Siddiqui, Amna; Anwer, Muhammad Lucman; Obeidat, Sadek; Bakro, Mohammed Khaled; Abu Assale, Tawfik Samer; Almidani, Eyad; Alsonbul, Abdullah; Alhaider, Sami; Hussain, Ibrahim Bin; Khadawardi, Emad; Zafar, Muhammad

    2018-02-01

    To explore the effects of simulation training on paediatric residents' confidence and skills in managing advanced skills in critical care. The study was conducted at Alfaisal University, Riyadh, Saudi Arabia, from March to June 2016, and comprised junior residents in paediatrics. All paediatric residents (years 1 and 2) were recruited into two workshops, held one week apart. The first workshop covered lumbar puncture/ cerebrospinal fluid interpretation, oral intubation, bone marrow aspiration, and critical airway management. The second workshop covered chest tube insertion, pleural tap, insertion of central line, and arthrocentesis. The participants were surveyed using a 5-point Likert scale survey pre- and post-course, assessing their confidence. Their practical skills were assessed using a pre-objective structured clinical examination on the same day and post-course objective structured clinical examination a week later on selected skills. The outcome measures were: (1) pre-/post-course confidence rating, and (2) pre-/post-course objective structured clinical examination results. Data was analysed using SPSS 20. Of the 16 participants, 8(50%) were boys and 8(50%) girls. Besides, 13(81%) residents were in year-1 and 3(19%) in year-2. Median post-course confidence level ranks for all the skills were higher (pskills and confidence in performing critical tasks.

  1. Does skill retention benefit from retentivity and symbolic rehearsal? - two studies with a simulated process control task.

    Science.gov (United States)

    Kluge, Annette; Frank, Barbara; Maafi, Sanaz; Kuzmanovska, Aleksandra

    2016-05-01

    Two experiments were designed to compare two symbolic rehearsal refresher interventions (imaginary practice, a hidden introspective process) and investigate the role of retentivity in skill retention. Retentivity is investigated as the ability to memorise and reproduce information and associations that were learned a short time ago. Both experiments comprised initial training (week 1), a symbolic rehearsal for the experimental group (week 2) and a retention assessment (week 3). In the first study, the experimental group received a symbolic rehearsal, while the control group received no rehearsal. In the second study, the experimental group received the same symbolic rehearsal used in study 1, enhanced with rehearsal tasks addressing human-computer interaction. The results showed that both symbolic rehearsal interventions were equally likely to mitigate skill decay. The retentivity showed medium to high correlations with skill retention in both studies, and the results suggest that subjects high in retentivity benefit more from a symbolic rehearsal refresher intervention. Practitioner Summary: Skill decay becomes a problem in situations in which jobs require the correct mastery of non-routine situations. Two experimental studies with simulated process control tasks showed that symbolic rehearsal and retentivity can significantly mitigate skill decay and that subjects higher in retentivity benefit more from refresher interventions.

  2. Mentoring Model for Lecturers' Research Skills Development: Case ...

    African Journals Online (AJOL)

    The informal group mentoring model for research skills development begins with desk research for qualities of a publishable paper. Five dummy papers were reviewed by participants for quality. Participants conducted new studies and wrote research articles. These articles were peer reviewed by participants and submitted ...

  3. Probabilistic evaluation of decadal prediction skill regarding Northern Hemisphere winter storms

    Directory of Open Access Journals (Sweden)

    Tim Kruschke

    2016-12-01

    Full Text Available Winter wind storms related to intense extra-tropical cyclones are meteorological extreme events, often with major impacts on economy and human life, especially for Europe and the mid-latitudes. Hence, skillful decadal predictions regarding the frequency of their occurrence would be of great socio-economic value. The present paper extends the study of Kruschke et al. (2014 in several aspects. First, this study is situated in a more impact oriented context by analyzing the frequency of potentially damaging wind storm events instead of targeting at cyclones as general meteorological features which was done by Kruschke et al. (2014. Second, this study incorporates more data sets by analyzing five decadal hindcast experiments – 41 annual (1961–2001 initializations integrated for ten years each – set up with different initialization strategies. However, all experiments are based on the Max-Planck-Institute Earth System Model in a low-resolution configuration (MPI-ESM-LR. Differing combinations of these five experiments allow for more robust estimates of predictive skill (due to considerably larger ensemble size and systematic comparisons of the underlying initialization strategies. Third, the hindcast experiments are corrected for model bias and potential drifts over lead time by means of a novel parametric approach, accounting for non-stationary model drifts. We analyze whether skillful probabilistic three-category forecasts (enhanced, normal or decreased can be provided regarding winter (ONDJFM wind storm frequencies over the Northern Hemisphere (NH. Skill is assessed by using climatological probabilities and uninitialized transient simulations as reference forecasts. It is shown that forecasts of average winter wind storm frequencies for winters 2–5 and winters 2–9 are skillful over large parts of the NH. However, most of this skill is associated with external forcing from transient greenhouse gas and aerosol concentrations

  4. ENHANCING STUDENTS’ COMMUNICATION SKILLS THROUGH TREFFINGER TEACHING MODEL

    Directory of Open Access Journals (Sweden)

    Idrus Alhaddad

    2015-01-01

    Full Text Available This research aims to  investigate, compare, and describe the achievement and enhancement of students’ mathematical communication skills (MCS.  It based on the prior mathematical knowledge (PMK category (high, medium and low by using Treffinger models (TM and conventional learning (CL. This research is an experimental study with the population of all students of Mathematics Education Department who took Discrete Mathematics subject matter of one university in the city of Ternate. The results show that (1 the achievement and enhancement of MCS  students that used  TM are higher than the students learning using CL; (2 Based on the categories of PMK, the achievement and enhancement of MCS of students using TM are also higher than those learning with CL; and  (3 There was no interaction effect between learning (TM and CL and PMK to the achievement and enhancement of MCS of the students.Keyword: Communication Skills, Prior Mathematical Knowledge, Treffinger Model DOI: dx.doi.org/10.22342/jme.61.31

  5. Transformative Learning Model for Youth Life Skills Entrepreneurs in Poor Weavers Songket Palembang

    Directory of Open Access Journals (Sweden)

    Ayi Olim

    2015-05-01

    Full Text Available Non-formal education serves to develop the potential of students with an emphasis on the mastery of knowledge and functional skills and professional attitude and personality development, is now understood as an alternative approach to the future education with an emphasis on the mastery of skills. transformative learning, life skills and entrepreneurship as a modality of model development. learner/ prospective participants learn from the lower-middle group (in the shadow of the transmission of learning should be the owner of the learning process and should be able to identify the capabilities and environmental problems, reflect and take action in developing entrepreneurial abilities. The model requires changing patterns of transformative learning and utilization participants life skills learning, facilitation and management support from stakeholders

  6. PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TIPE PAIR CHECKS PEMECAHAN MASALAH UNTUK MENINGKATKAN SOCIAL SKILL SISWA

    Directory of Open Access Journals (Sweden)

    R. Lestari

    2012-07-01

    Full Text Available Tujuan penelitian tindakan kelas ini untuk mengetahui pengaruh proses pembelajaran dengan menggunakan model pembelajaran kooperatif tipe Pair Checks pemecahan masalah terhadap peningkatan social skill siswa. Pada proses penerapan model pembelajaran kooperatif tipe Pair Checks pemecahan masalah siswa dibagi dalam kelompok-kelompok dan satu kelompok terdiri dari dua orang. Setiap kelompok berdiskusi untuk menyelesaikan suatu masalah, kemudian hasil diskusi kelompok akan dicek oleh pasangan dari kelompok lain. Metode Penelitian yang digunakan adalah penelitian tindakan kelas yang dilaksanakan dua siklus. Metode pengumpulan data menggunakan tes dan angket skala sikap, sedangkan teknik analisis data menggunakan teknik analisis data kuantitatif. Social Skill siswa dari siklus I ke siklus II mengalami peningkatan. Hal ini didapatkan dari data angket skala sikap siklus I ke siklus II ketuntasan klasikalnya meningkat dan sebagian besar siswa sudah memiliki social skill yang baik. Hasil belajar kognitif siswa juga mengalami peningkatan. Model pembelajaran kooperatif tipe Pair Checks pemecahan masalah dapat meningkatkan social skill siswa.This two cycles-action research aimed to know learning process applying cooperative learning model-pair checks problem solving type and improvement of student’s social skills. The process of the model was as follows: deviding students into some groups consisting of two students, solving problem by each group and checking result of the discussion by other groups. Data collection method used was test and the use of attitude scale questionnaire, while technique of data analysis used was quantitative data analysis technique. The data analysis result showed that there was an increase of student’s social skill and students’ achievement from cycle one to two. It is concluded that cooperative learning model-pair checks problem solving type can enhance student’s social skills

  7. IMPLEMENTASI TQM BERORIENTASI HARD SKILL DAN SOFT SKILL DALAM PEMBELAJARAN SEJARAH SMA DI KOTA SEMARANG

    Directory of Open Access Journals (Sweden)

    Cahyo Budi Utomo

    2011-10-01

    Full Text Available This study aims to introduce the implementation of hardskill and softskill oriented TQM in teacher’s learning of history in Senior High School in Semarang. The research model are structural fit model and significance of relationship between TQM implementation model, PDSA cycle, the model analysis of fish bone, continuous improvement , hard skills and soft skills and qualified history learning is the main target of research. Data was obtained from field studies using Likert scale questionnaire developed from the constructs and theoretical construct indicator. Analysis performed using software models SmartPLS. Implementation of PDSA cycle correlated 0879 to the implementation of fish bone analysis, correlates 0830 PDSA cycle to continuously improvement , while continuously improvement  correlated 0441 and 0749 against the hard skills to soft skills. Soft skills to hard skills correlate of 0329, while the correlation of hard skills to qualified history learning is at 0673. The developed qualityfied history learning need support from  the realization of the continuous (continuously improvement and optimal orientation of hard skills. Keywords: model, TQM, PDSA, the analysis of fish bone, hard skills, soft skills, learning the history of quality  Kajian ini bertujuan mengenalkan model implementasi TQM yang berorientasi pada hardskill dan softskill dalam pembelajaran sejarah di sekolah atas Semarang pada para guru. Sebagai model penelitian, model struktural fit dan signifikasi  dari korelasi antara model implementasi TQM, siklus PDSA, model analisis tulang ikan, perbaikan terus-menerus, hard skill dan soft skill, dan pembelajaran sejarah bermutu (PSB menjadi target utama penelitian. Data didapatkan dari studi lapangan menggunakan angket skala Likert yang dikembangkan dari konstruk dan indicator konstruk teoretis. Analisis menggunakan program SmartPLS. Implementasi siklus PDSA berkorelasi 0879 terhadap implementasi model analisis

  8. Advances in Intelligent Modelling and Simulation Simulation Tools and Applications

    CERN Document Server

    Oplatková, Zuzana; Carvalho, Marco; Kisiel-Dorohinicki, Marek

    2012-01-01

    The human capacity to abstract complex systems and phenomena into simplified models has played a critical role in the rapid evolution of our modern industrial processes and scientific research. As a science and an art, Modelling and Simulation have been one of the core enablers of this remarkable human trace, and have become a topic of great importance for researchers and practitioners. This book was created to compile some of the most recent concepts, advances, challenges and ideas associated with Intelligent Modelling and Simulation frameworks, tools and applications. The first chapter discusses the important aspects of a human interaction and the correct interpretation of results during simulations. The second chapter gets to the heart of the analysis of entrepreneurship by means of agent-based modelling and simulations. The following three chapters bring together the central theme of simulation frameworks, first describing an agent-based simulation framework, then a simulator for electrical machines, and...

  9. An Investigation of the Potential of Interactive Simulations for Developing System Thinking Skills in Elementary School: A Case Study with Fifth-Graders and Sixth-Graders

    Science.gov (United States)

    Evagorou, Maria; Korfiatis, Kostas; Nicolaou, Christiana; Constantinou, Costas

    2009-01-01

    The purpose of this study was to investigate the impact of a simulation-based learning environment on elementary school students' (11-12 years old) development of system thinking skills. The learning environment included interactive simulations using the Stagecast Creator software to simulate the ecosystem of a marsh. Simulations are an important…

  10. 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.

    2016-01-01

    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…

  11. Enhancing Students' Communication Skills through Treffinger Teaching Model

    Science.gov (United States)

    Alhaddad, Idrus; Kusumah, Yaya S.; Sabandar, Jozua; Dahlan, Jarnawi A.

    2015-01-01

    This research aims to investigate, compare, and describe the achievement and enhancement of students' mathematical communication skills (MCS). It based on the prior mathematical knowledge (PMK) category (high, medium and low) by using Treffinger models (TM) and conventional learning (CL). This research is an experimental study with the population…

  12. Generic skills requirements (KSA model) towards future mechanical ...

    African Journals Online (AJOL)

    ... Statistics and Discriminant Analysis (DA) as required to achieve the objective of the study. This study will guide all future engineers, especially in the field of Mechanical Engineering in Malaysia to penetrate the job market according to the current market needs. Keywords: generic skills; KSA model; mechanical engineers; ...

  13. Notes on modeling and simulation

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, Antonio [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-03-10

    These notes present a high-level overview of how modeling and simulation are carried out by practitioners. The discussion is of a general nature; no specific techniques are examined but the activities associated with all modeling and simulation approaches are briefly addressed. There is also a discussion of validation and verification and, at the end, a section on why modeling and simulation are useful.

  14. 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 (psimulator in increasing the knowledge scores of students on thorax-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.

  15. Workplace Skills Taught in a Simulated Analytical Department

    Science.gov (United States)

    Sonchik Marine, Susan

    2001-11-01

    Integration of workplace skills into the academic setting is paramount for any chemical technology program. In addition to the expected chemistry content, courses must build proficiency in oral and written communication skills, computer skills, laboratory safety, and logical troubleshooting. Miami University's Chemical Technology II course is set up as a contract analytical laboratory. Students apply the advanced sampling techniques, quality assurance, standard methods, and statistical analyses they have studied. For further integration of workplace skills, weekly "department meetings" are held where the student, as members of the department, report on their work in process, present completed projects, and share what they have learned and what problems they have encountered. Information is shared between the experienced members of the department and those encountering problems or starting a new project. The instructor as department manager makes announcements, reviews company and department status, and assigns work for the coming week. The department members report results to clients in formal reports or in short memos. Factors affecting the success of the "department meeting" approach include the formality of the meeting room, use of an official agenda, the frequency, time, and duration of the meeting, and accountability of the students.

  16. Thermal unit availability modeling in a regional simulation model

    International Nuclear Information System (INIS)

    Yamayee, Z.A.; Port, J.; Robinett, W.

    1983-01-01

    The System Analysis Model (SAM) developed under the umbrella of PNUCC's System Analysis Committee is capable of simulating the operation of a given load/resource scenario. This model employs a Monte-Carlo simulation to incorporate uncertainties. Among uncertainties modeled is thermal unit availability both for energy simulation (seasonal) and capacity simulations (hourly). This paper presents the availability modeling in the capacity and energy models. The use of regional and national data in deriving the two availability models, the interaction between the two and modifications made to the capacity model in order to reflect regional practices is presented. A sample problem is presented to show the modification process. Results for modeling a nuclear unit using NERC-GADS is presented

  17. A survey of simulators for palpation training.

    Science.gov (United States)

    Zhang, Yan; Phillips, Roger; Ward, James; Pisharody, Sandhya

    2009-01-01

    Palpation is a widely used diagnostic method in medical practice. The sensitivity of palpation is highly dependent upon the skill of clinicians, which is often difficult to master. There is a need of simulators in palpation training. This paper summarizes important work and the latest achievements in simulation for palpation training. Three types of simulators; physical models, Virtual Reality (VR) based simulations, and hybrid (computerized and physical) simulators, are surveyed. Comparisons among different kinds of simulators are presented.

  18. Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists.

    Science.gov (United States)

    Mathews, Shyama; Brodman, Michael; D'Angelo, Debra; Chudnoff, Scott; McGovern, Peter; Kolev, Tamara; Bensinger, Giti; Mudiraj, Santosh; Nemes, Andreea; Feldman, David; Kischak, Patricia; Ascher-Walsh, Charles

    2017-11-01

    While simulation training has been established as an effective method for improving laparoscopic surgical performance in surgical residents, few studies have focused on its use for attending surgeons, particularly in obstetrics and gynecology. Surgical simulation may have a role in improving and maintaining proficiency in the operating room for practicing obstetrician gynecologists. We sought to determine if parameters of performance for validated laparoscopic virtual simulation tasks correlate with surgical volume and characteristics of practicing obstetricians and gynecologists. All gynecologists with laparoscopic privileges (n = 347) from 5 academic medical centers in New York City were required to complete a laparoscopic surgery simulation assessment. The physicians took a presimulation survey gathering physician self-reported characteristics and then performed 3 basic skills tasks (enforced peg transfer, lifting/grasping, and cutting) on the LapSim virtual reality laparoscopic simulator (Surgical Science Ltd, Gothenburg, Sweden). The association between simulation outcome scores (time, efficiency, and errors) and self-rated clinical skills measures (self-rated laparoscopic skill score or surgical volume category) were examined with regression models. The average number of laparoscopic procedures per month was a significant predictor of total time on all 3 tasks (P = .001 for peg transfer; P = .041 for lifting and grasping; P simulation performance as it correlates to active physician practice, further studies may help assess skill and individualize training to maintain skill levels as case volumes fluctuate. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Enhancing Systems-Thinking Skills with Modelling

    Science.gov (United States)

    Hung, Woei

    2008-01-01

    Systems thinking is an essential cognitive skill that enables individuals to develop an integrative understanding of a given subject at the conceptual and systemic level. Yet, systems thinking is not usually an innate skill. Helping students develop systems-thinking skills warrants attention from educators. This paper describes a study examining…

  20. General introduction to simulation models

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Boklund, Anette

    2012-01-01

    trials. However, if simulation models would be used, good quality input data must be available. To model FMD, several disease spread models are available. For this project, we chose three simulation model; Davis Animal Disease Spread (DADS), that has been upgraded to DTU-DADS, InterSpread Plus (ISP......Monte Carlo simulation can be defined as a representation of real life systems to gain insight into their functions and to investigate the effects of alternative conditions or actions on the modeled system. Models are a simplification of a system. Most often, it is best to use experiments and field...... trials to investigate the effect of alternative conditions or actions on a specific system. Nonetheless, field trials are expensive and sometimes not possible to conduct, as in case of foot-and-mouth disease (FMD). Instead, simulation models can be a good and cheap substitute for experiments and field...

  1. THE EFFECT MODEL INQUIRY TRAINING MEDIA AND LOGICAL THINKING ABILITY TO STUDENT’S SCIENCE PROCESS SKILL

    Directory of Open Access Journals (Sweden)

    Dahrim Pohan

    2017-06-01

    Full Text Available The aim of the research is to analyz : student’s science process skill using inquiry training learning model is better than konvesional learning.Student’s science process skill who have logical thinking ability above average are better than under average,and the interaction between inquiry training media and logical thinking ability to increase student’s science process skill.The experiment was conducted in SMP 6 Medan as population and class VII-K and VII-J were chosen as sample through cluster random sampling.Science prosess skill used essay test and logical thinking used multiple choice as instrument.Result of the data was analyzed by using two ways ANAVA.Result show that : student’s science process skill using inquiry training learning model is better than konvesional learning,student’s science process skill who logical thinking ability above average are better than under average and the interaction between inquiry training learning model media and logical thinking ability to increase student’s science process skill.

  2. Testing a Model of Undergraduate Competence in Employability Skills and Its Implications for Stakeholders

    Science.gov (United States)

    Jackson, Denise

    2014-01-01

    Despite the development of employability skills being firmly entrenched in higher education's strategic agenda worldwide; recent graduates' standards in certain skills are not meeting industry expectations. This paper presents and tests a model of undergraduate competence in employability skills. It highlights those factors which impact on…

  3. High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

    Science.gov (United States)

    de Vries, Anna H; Schout, Barbara M A; van Merriënboer, Jeroen J G; Pelger, Rob C M; Koldewijn, Evert L; Muijtjens, Arno M M; Wagner, Cordula

    2017-02-01

    Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants. Educational impact was assessed by means of qualitative individual module-specific feedback and a quantitative cross-sectional survey among residents and supervisors. Twenty out of 26 Dutch teaching hospitals participated. The survey focussed on practical aspects, the D-UPS curriculum in general, and the impact of the D-UPS curriculum on the development of technical and non-technical skills. A considerable survey response of 95 % for residents and 76 % for supervisors was obtained. Modules were attended by junior and senior residents, supervised by a urologist, and peer teaching was used. Ninety percent of supervisors versus 67 % of residents judged the D-UPS curriculum as an important addition to current residency training (p = 0.007). Participants' aggregated general judgement of the modules showed a substantial percentage favorable score (M ± SE: 57 ± 4 %). The impact of training on, e.g., knowledge of materials/equipment and ability to anticipate on complications was high, especially for junior residents (77 ± 5 and 71 ± 7 %, respectively). Focus points for improvement of the D-UPS curriculum according to the participants include adaptation of the training level to residents' level of experience and focus on logistics. The simulation-based D-UPS curriculum has a high educational impact. Residents and supervisors consider the curriculum to be an important addition to current residency

  4. Intensive care nursing students' perceptions of simulation for learning confirming communication skills: A descriptive qualitative study.

    Science.gov (United States)

    Karlsen, Marte-Marie Wallander; Gabrielsen, Anita Kristin; Falch, Anne Lise; Stubberud, Dag-Gunnar

    2017-10-01

    The aim of this study was to explore intensive care nursing students experiences with confirming communication skills training in a simulation-based environment. The study has a qualitative, exploratory and descriptive design. The participants were students in a post-graduate program in intensive care nursing, that had attended a one day confirming communication course. Three focus group interviews lasting between 60 and 80min were conducted with 14 participants. The interviews were transcribed verbatim. Thematic analysis was performed, using Braun & Clark's seven steps. The analysis resulted in three main themes: "awareness", "ice-breaker" and "challenging learning environment". The participants felt that it was a challenge to see themselves on the video-recordings afterwards, however receiving feedback resulted in better self-confidence in mastering complex communication. The main finding of the study is that the students reported improved communication skills after the confirming communication course. However; it is uncertain how these skills can be transferred to clinical practice improving patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Mesoscale model simulation of low level equatorial winds over Borneo during the haze episode of September 1997

    Science.gov (United States)

    Mahmud, Mastura

    2009-08-01

    The large-scale vegetation fires instigated by the local farmers during the dry period of the major El Niño event in 1997 can be considered as one of the worst environmental disasters that have occurred in southeast Asia in recent history. This study investigated the local meteorology characteristics of an equatorial environment within a domain that includes the northwestern part of Borneo from the 17 to 27 September 1997 during the height of the haze episode by utilizing a limited area three-dimensional meteorological and dispersion model, The Air Pollution Model (TAPM). Daily land and sea breeze conditions near the northwestern coast of Borneo in the state of Sarawak, Malaysia were predicted with moderate success by the index of agreement of less than one between the observed and simulated values for wind speed and a slight overprediction of 2.3 of the skill indicator that evaluates the standard deviation to the observed values. The innermost domain of study comprises an area of 24,193 km2, from approximately 109°E to 111°E, and from 1°N to 2.3°N, which includes a part of the South China Sea. Tracer analysis of air particles that were sourced in the state of Sarawak on the island of Borneo verified the existence of the landward and shoreward movements of the air during the simulation of the low level wind field. Polluted air particles were transported seawards during night-time, and landwards during daytime, highlighting the recirculation features of aged and newer air particles during the length of eleven days throughout the model simulation. Near calm conditions at low levels were simulated by the trajectory analysis from midnight to mid-day on the 22 of September 1997. Low-level turbulence within the planetary boundary layer in terms of the total kinetic energy was weak, congruent with the weak strength of low level winds that reduced the ability of the air to transport the pollutants. Statistical evaluation showed that parameters such as the systematic

  6. Instrument Motion Metrics for Laparoscopic Skills Assessment in Virtual Reality and Augmented Reality.

    Science.gov (United States)

    Fransson, Boel A; Chen, Chi-Ya; Noyes, Julie A; Ragle, Claude A

    2016-11-01

    To determine the construct and concurrent validity of instrument motion metrics for laparoscopic skills assessment in virtual reality and augmented reality simulators. Evaluation study. Veterinarian students (novice, n = 14) and veterinarians (experienced, n = 11) with no or variable laparoscopic experience. Participants' minimally invasive surgery (MIS) experience was determined by hospital records of MIS procedures performed in the Teaching Hospital. Basic laparoscopic skills were assessed by 5 tasks using a physical box trainer. Each participant completed 2 tasks for assessments in each type of simulator (virtual reality: bowel handling and cutting; augmented reality: object positioning and a pericardial window model). Motion metrics such as instrument path length, angle or drift, and economy of motion of each simulator were recorded. None of the motion metrics in a virtual reality simulator showed correlation with experience, or to the basic laparoscopic skills score. All metrics in augmented reality were significantly correlated with experience (time, instrument path, and economy of movement), except for the hand dominance metric. The basic laparoscopic skills score was correlated to all performance metrics in augmented reality. The augmented reality motion metrics differed between American College of Veterinary Surgeons diplomates and residents, whereas basic laparoscopic skills score and virtual reality metrics did not. Our results provide construct validity and concurrent validity for motion analysis metrics for an augmented reality system, whereas a virtual reality system was validated only for the time score. © Copyright 2016 by The American College of Veterinary Surgeons.

  7. Development and validation of a laparoscopic hysterectomy cuff closure simulation model for surgical training.

    Science.gov (United States)

    Tunitsky-Bitton, Elena; Propst, Katie; Muffly, Tyler

    2016-03-01

    The number of robotically assisted hysterectomies is increasing, and therefore, the opportunities for trainees to become competent in performing traditional laparoscopic hysterectomy are decreasing. Simulation-based training is ideal for filling this gap in training. The objective of the study was to design a surgical model for training in laparoscopic vaginal cuff closure and to present evidence of its validity and reliability as an assessment and training tool. Participants included gynecology staff and trainees at 2 tertiary care centers. Experienced surgeons were also recruited at the combined International Urogynecologic Association and American Urogynecologic Society scientific meeting. Participants included 19 experts and 21 trainees. All participants were recorded using the laparoscopic hysterectomy cuff closure simulation model. The model was constructed using the an advanced uterine manipulation system with a sacrocolopexy tip/vaginal stent, a vaginal cuff constructed from neoprene material and lined with a swimsuit material (nylon and spandex) secured to the vaginal stent with a plastic cable tie. The uterine manipulation system was attached to the fundamentals of laparoscopic surgery laparoscopic training box trainer using a metal bracket. Performance was evaluated using the Global Operative Assessment of Laparoscopic Skills scale. In addition, needle handling, knot tying, and incorporation of epithelial edge were also evaluated. The Student t test was used to compare the scores and the operating times between the groups. Intrarater reliability between the scores by the 2 masked experts was measured using the interclass correlation coefficient. Total and annual experience with laparoscopic suturing and specifically vaginal cuff closure varied greatly among the participants. For the construct validity, the participants in the expert group received significantly higher scores in each of the domains of the Global Operative Assessment of Laparoscopic Skills

  8. Simulations, Imaging, and Modeling: A Unique Theme for an Undergraduate Research Program in Biomechanics.

    Science.gov (United States)

    George, Stephanie M; Domire, Zachary J

    2017-07-01

    As the reliance on computational models to inform experiments and evaluate medical devices grows, the demand for students with modeling experience will grow. In this paper, we report on the 3-yr experience of a National Science Foundation (NSF) funded Research Experiences for Undergraduates (REU) based on the theme simulations, imaging, and modeling in biomechanics. While directly applicable to REU sites, our findings also apply to those creating other types of summer undergraduate research programs. The objective of the paper is to examine if a theme of simulations, imaging, and modeling will improve students' understanding of the important topic of modeling, provide an overall positive research experience, and provide an interdisciplinary experience. The structure of the program and the evaluation plan are described. We report on the results from 25 students over three summers from 2014 to 2016. Overall, students reported significant gains in the knowledge of modeling, research process, and graduate school based on self-reported mastery levels and open-ended qualitative responses. This theme provides students with a skill set that is adaptable to other applications illustrating the interdisciplinary nature of modeling in biomechanics. Another advantage is that students may also be able to continue working on their project following the summer experience through network connections. In conclusion, we have described the successful implementation of the theme simulation, imaging, and modeling for an REU site and the overall positive response of the student participants.

  9. The Role of Work-Related Skills and Career Role Models in Adolescent Career Maturity.

    Science.gov (United States)

    Flouri, Eirini; Buchanan, Ann

    2002-01-01

    Using data for 2,722 British adolescents explores whether work-related skills and career role models are associated with career maturity when sociodemographic characteristics, family support, and personal characteristics are controlled. Having work-related skills and having a career role model were positively associated with career maturity.…

  10. ECONOMIC MODELING STOCKS CONTROL SYSTEM: SIMULATION MODEL

    OpenAIRE

    Климак, М.С.; Войтко, С.В.

    2016-01-01

    Considered theoretical and applied aspects of the development of simulation models to predictthe optimal development and production systems that create tangible products andservices. It isproved that theprocessof inventory control needs of economicandmathematical modeling in viewof thecomplexity of theoretical studies. A simulation model of stocks control that allows make managementdecisions with production logistics

  11. Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting.

    Science.gov (United States)

    George, Katie L; Quatrara, Beth

    The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A

  12. Cryogenic process simulation

    International Nuclear Information System (INIS)

    Panek, J.; Johnson, S.

    1994-01-01

    Combining accurate fluid property databases with a commercial equation-solving software package running on a desktop computer allows simulation of cryogenic processes without extensive computer programming. Computer simulation can be a powerful tool for process development or optimization. Most engineering simulations to date have required extensive programming skills in languages such as Fortran, Pascal, etc. Authors of simulation code have also usually been responsible for choosing and writing the particular solution algorithm. This paper describes a method of simulating cryogenic processes with a commercial software package on a desktop personal computer that does not require these traditional programming tasks. Applications include modeling of cryogenic refrigerators, heat exchangers, vapor-cooled power leads, vapor pressure thermometers, and various other engineering problems

  13. Improving Critical Thinking Skills of College Students through RMS Model for Learning Basic Concepts in Science

    Science.gov (United States)

    Muhlisin, Ahmad; Susilo, Herawati; Amin, Mohamad; Rohman, Fatchur

    2016-01-01

    The purposes of this study were to: 1) Examine the effect of RMS learning model towards critical thinking skills. 2) Examine the effect of different academic abilities against critical thinking skills. 3) Examine the effect of the interaction between RMS learning model and different academic abilities against critical thinking skills. The research…

  14. Prerequisite Skills That Support Learning through Video Modeling

    Science.gov (United States)

    MacDonald, Rebecca P. F.; Dickson, Chata A.; Martineau, Meaghan; Ahearn, William H.

    2015-01-01

    The purpose of this study was to evaluate the relationship between tasks that require delayed discriminations such as delayed imitation and delayed matching to sample on acquisition of skills using video modeling. Twenty-nine participants with an ASD diagnosis were assessed on a battery of tasks including both immediate and delayed imitation and…

  15. PENGEMBANGAN MODEL PENDIDIKAN SOFT SKILL MELALUI PEMBELAJARAN PADA PROGRAM STUDI PENDIDIKAN TEKNIK MESIN FT UM

    Directory of Open Access Journals (Sweden)

    Dwi Agus Sudjimat

    2012-08-01

    Full Text Available The purpose of this research was to develop the soft skill education model at the Mechanical Engineering Education Study Program, State University of Malang included the curriculum and its implementation on the instructional activities. The research found that: (1 the soft skill curriculum needed by the Mechanical Engi­neering Education Study Program consists of fundamental skill, personal skill, and social skill; and (2 for implementing the soft skill curriculum entire the instructional activities strive for each lecture to take one or more soft skills statement for development, using the various strategies/methods of teaching refer to student-centered, giving tasks, and introducing the HES (Health and Environment Safety particularly in the practicum activities. Tujuan penelitian ini adalah untuk mengembangkan model pendidikan soft skill pada Program Studi Teknik Mesin Universitas Negeri Malang termasuk kuriku­lum dan implementasinya dalam kegiatan pembelajaran. Temuan penelitian ini adalah: (1 kurikulum soft skill yang diperlukan oleh Program Studi Teknik Mesin terdiri dari keterampilan dasar, keterampilan pribadi, dan keterampilan sosial, dan (2 menerap­kan kurikulum soft skill dalam pembelajaran pada masing-masing dasar, mengambil satu atau lebih soft skill untuk dikembangkan, menggunakan berbagai strategi/metode pengajaran berpusat pada mahasiswa, memberikan tugas, dan memperkenalkan K3 (Kesehatan dan Keselamatan Kerja, terutama dalam kegiatan praktikum.

  16. The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students.

    Science.gov (United States)

    Errante, Margaret R; Gill, Gurjinder S; Rodriguez, Tobias E

    2018-01-01

    The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students. This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills. The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time. Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students.

  17. The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students

    Science.gov (United States)

    Errante, Margaret R; Gill, Gurjinder S; Rodriguez, Tobias E

    2018-01-01

    Purpose The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students. Methods This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills. Results The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time. Conclusion Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students. PMID:29720884

  18. Whole-building Hygrothermal Simulation Model

    DEFF Research Database (Denmark)

    Rode, Carsten; Grau, Karl

    2003-01-01

    An existing integrated simulation tool for dynamic thermal simulation of building was extended with a transient model for moisture release and uptake in building materials. Validation of the new model was begun with comparison against measurements in an outdoor test cell furnished with single...... materials. Almost quasi-steady, cyclic experiments were used to compare the indoor humidity variation and the numerical results of the integrated simulation tool with the new moisture model. Except for the case with chipboard as furnishing, the predictions of indoor humidity with the detailed model were...

  19. Improving MJO Prediction and Simulation Using AGCM Coupled Ocean Model with Refined Vertical Resolution

    Science.gov (United States)

    Tu, Chia-Ying; Tseng, Wan-Ling; Kuo, Pei-Hsuan; Lan, Yung-Yao; Tsuang, Ben-Jei; Hsu, Huang-Hsiung

    2017-04-01

    Precipitation in Taiwan area is significantly influenced by MJO (Madden-Julian Oscillation) in the boreal winter. This study is therefore conducted by toggling the MJO prediction and simulation with a unique model structure. The one-dimensional TKE (Turbulence Kinetic Energy) type ocean model SIT (Snow, Ice, Thermocline) with refined vertical resolution near surface is able to resolve cool skin, as well as diurnal warm layer. SIT can simulate accurate SST and hence give precise air-sea interaction. By coupling SIT with ECHAM5 (MPI-Meteorology), CAM5 (NCAR) and HiRAM (GFDL), the MJO simulations in 20-yrs climate integrations conducted by three SIT-coupled AGCMs are significant improved comparing to those driven by prescribed SST. The horizontal resolutions in ECHAM5, CAM5 and HiRAM are 2-deg., 1-deg and 0.5-deg., respectively. This suggests that the improvement of MJO simulation by coupling SIT is AGCM-resolution independent. This study further utilizes HiRAM coupled SIT to evaluate its MJO forecast skill. HiRAM has been recognized as one of the best model for seasonal forecasts of hurricane/typhoon activity (Zhao et al., 2009; Chen & Lin, 2011; 2013), but was not as successful in MJO forecast. The preliminary result of the HiRAM-SIT experiment during DYNAMO period shows improved success in MJO forecast. These improvements of MJO prediction and simulation in both hindcast experiments and climate integrations are mainly from better-simulated SST diurnal cycle and diurnal amplitude, which is contributed by the refined vertical resolution near ocean surface in SIT. Keywords: MJO Predictability, DYNAMO

  20. Performances on simulator and da Vinci robot on subjects with and without surgical background.

    Science.gov (United States)

    Moglia, Andrea; Ferrari, Vincenzo; Melfi, Franca; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred; Morelli, Luca

    2017-08-17

    To assess whether previous training in surgery influences performance on da Vinci Skills Simulator and da Vinci robot. In this prospective study, thirty-seven participants (11 medical students, 17 residents, and 9 attending surgeons) without previous experience in laparoscopy and robotic surgery performed 26 exercises at da Vinci Skills Simulator. Thirty-five then executed a suture using a da Vinci robot. The overall scores on the exercises at the da Vinci Skills Simulator show a similar performance among the groups with no statistically significant pair-wise differences (p poor for the untrained groups (5 (3.5, 9)), without statistically significant difference (p < .05). This study showed, for subjects new to laparoscopy and robotic surgery, insignificant differences in the scores at the da Vinci Skills Simulator and at the da Vinci robot on inanimate models.

  1. PERBEDAAN SOFT SKILL SISWA ANTARA PENERAPAN MODEL PEMBELAJARAN GROUP INVESTIGATION DAN KONVENSIONAL PADA KEAHLIAN TEKNIK PEMESINAN SMK

    Directory of Open Access Journals (Sweden)

    Heru Darmawan

    2015-02-01

    Full Text Available Soft Skill Differences between the Application of Student Learning Group In­vestigation and Conventional Mo­­­­del at Mechanical Engineering Program in Vo­ca­tio­­­­­nal High School. The purpose of this study was to describe: (1 the students soft skills level before and after the implementation of the student learning using group in­vestigation (GI and conventional, and (2 the students soft skill differences using the GI learning and con­­­­ventional model.The research was a quantitative research. This re­search used a quasi-experimental  de­­­sign, and the research design used the Non-Equi­valent Groups pretest-posttest de­sign. The re­­­sults showed that: (1 the level of soft skills using the application of the GI model on average ​​increased by 6.14, and (2 the level of soft skills using the ap­pli­ca­­­tion of conventional models on average de­creased by 1.11. As a conclusion, there was a significant difference between the stu­dents soft skills using the ap­­plication of theGI and conventional model, and the soft skills for the in­tro­duc­ti­on of GI mo­­dels was better than the conventional model.   Tujuan penelitian untuk mendeskripsikan: (1 soft skill siswa sebelum dan sesudah menerapkan pembelajaran group investigation  ( dan konvensional, dan (2 Je­­nis pe­ne­­­litian merupakan penelitian kuantitatif, rancangan penelitian eks­pe­ri­men semu, se­­­dangkan desain penelitian Non-Equivalent Groups Pretest-Posttest De­­sign. Ha­sil penelitian menunjukkan bahwa: (1 tingkat keterampilan soft skill de­ngan pe­ne­rap­an model GI mengalami peningkatan margin nilai sebesar 6,14, dan (2 ting­­­kat ke­te­ram­­pilan soft skill dengan penerapan model konvensional tidak meng­alami kenaikan ni­lai, tetapi mengalami penurunan margin nilai sebesar 1,11. Ada per­be­­­daan yang sig­ni­fikan soft skill siswa antara penerapan model GI dan konvensional, un­­­tuk pengantar soft

  2. Progress in modeling and simulation.

    Science.gov (United States)

    Kindler, E

    1998-01-01

    For the modeling of systems, the computers are more and more used while the other "media" (including the human intellect) carrying the models are abandoned. For the modeling of knowledges, i.e. of more or less general concepts (possibly used to model systems composed of instances of such concepts), the object-oriented programming is nowadays widely used. For the modeling of processes existing and developing in the time, computer simulation is used, the results of which are often presented by means of animation (graphical pictures moving and changing in time). Unfortunately, the object-oriented programming tools are commonly not designed to be of a great use for simulation while the programming tools for simulation do not enable their users to apply the advantages of the object-oriented programming. Nevertheless, there are exclusions enabling to use general concepts represented at a computer, for constructing simulation models and for their easy modification. They are described in the present paper, together with true definitions of modeling, simulation and object-oriented programming (including cases that do not satisfy the definitions but are dangerous to introduce misunderstanding), an outline of their applications and of their further development. In relation to the fact that computing systems are being introduced to be control components into a large spectrum of (technological, social and biological) systems, the attention is oriented to models of systems containing modeling components.

  3. Training Inference Making Skills Using a Situation Model Approach Improves Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Lisanne eBos

    2016-02-01

    Full Text Available This study aimed to enhance third and fourth graders’ text comprehension at the situation model level. Therefore, we tested a reading strategy training developed to target inference making skills, which are widely considered to be pivotal to situation model construction. The training was grounded in contemporary literature on situation model-based inference making and addressed the source (text-based versus knowledge-based, type (necessary versus unnecessary for (re-establishing coherence, and depth of an inference (making single lexical inferences versus combining multiple lexical inferences, as well as the type of searching strategy (forward versus backward. Results indicated that, compared to a control group (n = 51, children who followed the experimental training (n = 67 improved their inference making skills supportive to situation model construction. Importantly, our training also resulted in increased levels of general reading comprehension and motivation. In sum, this study showed that a ‘level of text representation’-approach can provide a useful framework to teach inference making skills to third and fourth graders.

  4. Simulation modelling of fynbos ecosystems: Systems analysis and conceptual models

    CSIR Research Space (South Africa)

    Kruger, FJ

    1985-03-01

    Full Text Available -animal interactions. An additional two models, which expand aspects of the FYNBOS model, are described: a model for simulating canopy processes; and a Fire Recovery Simulator. The canopy process model will simulate ecophysiological processes in more detail than FYNBOS...

  5. Standardized patient simulation versus didactic teaching alone for improving residents' communication skills when discussing goals of care and resuscitation: A randomized controlled trial.

    Science.gov (United States)

    Downar, James; McNaughton, Nancy; Abdelhalim, Tarek; Wong, Natalie; Lapointe-Shaw, Lauren; Seccareccia, Dori; Miller, Kim; Dev, Shelly; Ridley, Julia; Lee, Christie; Richardson, Lisa; McDonald-Blumer, Heather; Knickle, Kerry

    2017-02-01

    Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care. Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone. First-year internal medicine residents. Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure. We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop ( p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores. Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.

  6. Solving a mixed-integer linear programming model for a multi-skilled project scheduling problem by simulated annealing

    Directory of Open Access Journals (Sweden)

    H Kazemipoor

    2012-04-01

    Full Text Available A multi-skilled project scheduling problem (MSPSP has been generally presented to schedule a project with staff members as resources. Each activity in project network requires different skills and also staff members have different skills, too. This causes the MSPSP becomes a special type of a multi-mode resource-constrained project scheduling problem (MM-RCPSP with a huge number of modes. Given the importance of this issue, in this paper, a mixed integer linear programming for the MSPSP is presented. Due to the complexity of the problem, a meta-heuristic algorithm is proposed in order to find near optimal solutions. To validate performance of the algorithm, results are compared against exact solutions solved by the LINGO solver. The results are promising and show that optimal or near-optimal solutions are derived for small instances and good solutions for larger instances in reasonable time.

  7. Improving Junior High Schools' Critical Thinking Skills Based on Test Three Different Models of Learning

    Science.gov (United States)

    Fuad, Nur Miftahul; Zubaidah, Siti; Mahanal, Susriyati; Suarsini, Endang

    2017-01-01

    The aims of this study were (1) to find out the differences in critical thinking skills among students who were given three different learning models: differentiated science inquiry combined with mind map, differentiated science inquiry model, and conventional model, (2) to find out the differences of critical thinking skills among male and female…

  8. Optimizing the Timing of Expert Feedback During Simulation-Based Spaced Practice of Endourologic Skills.

    Science.gov (United States)

    Lee, Jason Young; McDougall, Elspeth M; Lineberry, Matthew; Tekian, Ara

    2016-08-01

    Provision of expert feedback is widely acknowledged to be an essential component of simulation-based training. However, little is known about the most effective and efficient ways to provide feedback to novices. Optimizing the timing of expert feedback may improve outcomes while reducing resource requirements. The main objective of this study was to determine the impact of providing early versus late expert feedback to novice learners engaged in a flexible ureteroscopy (fURS) training curriculum. Senior medical students were recruited to participate in this study. Each student participated in a comprehensive fURS training curriculum that included 3 deliberate, independent practice sessions. Baseline and postcourse fURS skill was assessed for each student using a standardized fURS test task. Each student was randomized to either an early feedback group (EFG) or late feedback group (LFG). The EFG participants were provided expert feedback immediately after the baseline skill test, whereas LFG participants were given feedback before their final deliberate, independent practice session. Eighteen senior medical students completed the study (9 EFG and 9 LFG participants). There were no discernible demographic differences between the groups at baseline. When controlling for pretest performance, early rather than late feedback was associated with both shorter postcourse time to completion of the task (19.2 vs. 21.5 minutes, P feedback when learning a novel skill. Further study is required.

  9. Development of a novel ex vivo porcine laparoscopic Heller myotomy and Nissen fundoplication training model (Toronto lap-Nissen simulator).

    Science.gov (United States)

    Ujiie, Hideki; Kato, Tatsuya; Hu, Hsin-Pei; Bauer, Patrycja; Patel, Priya; Wada, Hironobu; Lee, Daiyoon; Fujino, Kosuke; Schieman, Colin; Pierre, Andrew; Waddell, Thomas K; Keshavjee, Shaf; Darling, Gail E; Yasufuku, Kazuhiro

    2017-06-01

    Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. An ex vivo , anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen. The Toronto lap-Nissen simulator was contained in a laparoscopic box-trainer and included an arch system to simulate the normal radial shape and tension of the diaphragm. We integrated the use of this training model as a part of our laparoscopic skills laboratory-training curriculum. Afterwards, we surveyed trainees to evaluate the observed benefit of the learning session. Twenty-five trainees and five faculty members completed a survey regarding the use of this model. Among the trainees, only 4 (16%) had experience with laparoscopic Heller myotomy and Nissen fundoplication. They reported that practicing with the model was a valuable use of their limited time, repeating the exercise would be of additional benefit, and that the exercise improved their ability to perform or assist in an actual case in the operating room. Significant improvements were found in the following subjective measures comparing pre- vs. post-training: (I) knowledge level (5.6 vs. 8.0, Pmyotomy and fundoplication.

  10. 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

    2017-11-01

    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.

  11. Crowd-sourced assessment of technical skills: an adjunct to urology resident surgical simulation training.

    Science.gov (United States)

    Holst, Daniel; Kowalewski, Timothy M; White, Lee W; Brand, Timothy C; Harper, Jonathan D; Sorenson, Mathew D; Kirsch, Sarah; Lendvay, Thomas S

    2015-05-01

    Crowdsourcing is the practice of obtaining services from a large group of people, typically an online community. Validated methods of evaluating surgical video are time-intensive, expensive, and involve participation of multiple expert surgeons. We sought to obtain valid performance scores of urologic trainees and faculty on a dry-laboratory robotic surgery task module by using crowdsourcing through a web-based grading tool called Crowd Sourced Assessment of Technical Skill (CSATS). IRB approval was granted to test the technical skills grading accuracy of Amazon.com Mechanical Turk™ crowd-workers compared to three expert faculty surgeon graders. The two groups assessed dry-laboratory robotic surgical suturing performances of three urology residents (PGY-2, -4, -5) and two faculty using three performance domains from the validated Global Evaluative Assessment of Robotic Skills assessment tool. After an average of 2 hours 50 minutes, each of the five videos received 50 crowd-worker assessments. The inter-rater reliability (IRR) between the surgeons and crowd was 0.91 using Cronbach's alpha statistic (confidence intervals=0.20-0.92), indicating an agreement level between the two groups of "excellent." The crowds were able to discriminate the surgical level, and both the crowds and the expert faculty surgeon graders scored one senior trainee's performance above a faculty's performance. Surgery-naive crowd-workers can rapidly assess varying levels of surgical skill accurately relative to a panel of faculty raters. The crowds provided rapid feedback and were inexpensive. CSATS may be a valuable adjunct to surgical simulation training as requirements for more granular and iterative performance tracking of trainees become mandated and commonplace.

  12. Simulation modeling and analysis with Arena

    CERN Document Server

    Altiok, Tayfur

    2007-01-01

    Simulation Modeling and Analysis with Arena is a highly readable textbook which treats the essentials of the Monte Carlo discrete-event simulation methodology, and does so in the context of a popular Arena simulation environment.” It treats simulation modeling as an in-vitro laboratory that facilitates the understanding of complex systems and experimentation with what-if scenarios in order to estimate their performance metrics. The book contains chapters on the simulation modeling methodology and the underpinnings of discrete-event systems, as well as the relevant underlying probability, statistics, stochastic processes, input analysis, model validation and output analysis. All simulation-related concepts are illustrated in numerous Arena examples, encompassing production lines, manufacturing and inventory systems, transportation systems, and computer information systems in networked settings.· Introduces the concept of discrete event Monte Carlo simulation, the most commonly used methodology for modeli...

  13. Analysis of precipitation teleconnections in CMIP models as a measure of model fidelity in simulating precipitation

    Science.gov (United States)

    Langenbrunner, B.; Neelin, J.; Meyerson, J.

    2011-12-01

    The accurate representation of precipitation is a recurring issue in global climate models, especially in the tropics. Poor skill in modeling the variability and climate teleconnections associated with El Niño/Southern Oscillation (ENSO) also persisted in the latest Climate Model Intercomparison Project (CMIP) campaigns. Observed ENSO precipitation teleconnections provide a standard by which we can judge a given model's ability to reproduce precipitation and dynamic feedback processes originating in the tropical Pacific. Using CMIP3 Atmospheric Model Intercomparison Project (AMIP) runs as a baseline, we compare precipitation teleconnections between models and observations, and we evaluate these results against available CMIP5 historical and AMIP runs. Using AMIP simulations restricts evaluation to the atmospheric response, as sea surface temperatures (SSTs) in AMIP are prescribed by observations. We use a rank correlation between ENSO SST indices and precipitation to define teleconnections, since this method is robust to outliers and appropriate for non-Gaussian data. Spatial correlations of the modeled and observed teleconnections are then evaluated. We look at these correlations in regions of strong precipitation teleconnections, including equatorial S. America, the "horseshoe" region in the western tropical Pacific, and southern N. America. For each region and season, we create a "normalized projection" of a given model's teleconnection pattern onto that of the observations, a metric that assesses the quality of regional pattern simulations while rewarding signals of correct sign over the region. Comparing this to an area-averaged (i.e., more generous) metric suggests models do better when restrictions on exact spatial dependence are loosened and conservation constraints apply. Model fidelity in regional measures remains far from perfect, suggesting intrinsic issues with the models' regional sensitivities in moist processes.

  14. The effect of different training exercises on the performance outcome on the da Vinci Skills Simulator.

    Science.gov (United States)

    Walliczek-Dworschak, U; Schmitt, M; Dworschak, P; Diogo, I; Ecke, A; Mandapathil, M; Teymoortash, A; Güldner, C

    2017-06-01

    Increasing usage of robotic surgery presents surgeons with the question of how to acquire the special skills required. This study aimed to analyze the effect of different exercises on their performance outcomes. This prospective study was conducted on the da Vinci Skills Simulator from December 2014 till August 2015. Sixty robotic novices were included and randomized to three groups of 20 participants each. Each group performed three different exercises with comparable difficulty levels. The exercises were performed three times in a row within two training sessions, with an interval of 1 week in between. On the final training day, two new exercises were added and a questionnaire was completed. Technical metrics of performance (overall score, time to complete, economy of motion, instrument collisions, excessive instrument force, instruments out of view, master work space range, drops, missed targets, misapplied energy time, blood loss and broken vessels) were recorded by the simulator software for further analysis. Training with different exercises led to comparable results in performance metrics for the final exercises among the three groups. A significant skills gain was recorded between the first and last exercises, with improved performance in overall score, time to complete and economy of motion for all exercises in all three groups. As training with different exercises led to comparable results in robotic training, the type of exercise seems to play a minor role in the outcome. For a robotic training curriculum, it might be important to choose exercises with comparable difficulty levels. In addition, it seems to be advantageous to limit the duration of the training to maintain the concentration throughout the entire session.

  15. Indicators of Simulated Driving Skills in Adolescents with Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    Sherrilene Classen PhD, MPH, OTR/L, FAOTA

    2014-01-01

    Full Text Available Adolescents with attention deficit hyperactivity disorder (ADHD have an increased risk for committing traffic violations, and they are four times more likely than neurotypical peers to be crash involved, making them a potentially high risk group for driving. We used a two-group design to measure differences in demographics, clinical off-road tests, and fitness to drive abilities in a driving simulator with nine adolescents with ADHD (mean age = 15.00, SD ± 1.00 compared to 22 healthy controls (HC (mean age = 14.32, SD ±..716, as evaluated by an Occupational Therapist Certified Driving Rehabilitation Specialist (OT-CDRS. Despite few demographic differences, the adolescents with ADHD performed worse than the HC on tests of right visual acuity (F = 5.92, p = .036, right peripheral field (F = 6.85, p = .019, selective attention (U = 53.00, p = .046, and motor coordination (U = 53.00, p = .046. The ADHD group made more visual scanning (U = 52.50, p = .041, speed regulation (U = 28.00, p = .001, and total driving errors (U = 32.50, p = .003 on the simulator. Adolescents with ADHD performed worse on tests measuring visual, cognitive, motor, and pre-driving skills, and on a driving simulator. They may require the services of an OT-CDRS to determine their fitness to drive abilities prior to referring them for driver’s education.

  16. Holistic Nursing Simulation: A Concept Analysis.

    Science.gov (United States)

    Cohen, Bonni S; Boni, Rebecca

    2018-03-01

    Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

  17. Educating the delivery of bad news in medicine: Preceptorship versus simulation.

    Science.gov (United States)

    Jacques, Andrew P; Adkins, Eric J; Knepel, Sheri; Boulger, Creagh; Miller, Jessica; Bahner, David P

    2011-07-01

    Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice.

  18. Helping Mothers Survive Bleeding After Birth: retention of knowledge, skills, and confidence nine months after obstetric simulation-based training

    NARCIS (Netherlands)

    Nelissen, E.J.T.; Ersdal, H.; Mduma, E.; Evjen-Olsen, B.; Broerse, J.E.W.; van Roosmalen, J.; Stekelenburg, J.

    2015-01-01

    Background: It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of

  19. Helping Mothers Survive Bleeding After Birth : retention of knowledge, skills, and confidence nine months after obstetric simulation-based training

    NARCIS (Netherlands)

    Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjorg; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle

    2015-01-01

    Background: It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of

  20. Development of the Transport Class Model (TCM) Aircraft Simulation From a Sub-Scale Generic Transport Model (GTM) Simulation

    Science.gov (United States)

    Hueschen, Richard M.

    2011-01-01

    A six degree-of-freedom, flat-earth dynamics, non-linear, and non-proprietary aircraft simulation was developed that is representative of a generic mid-sized twin-jet transport aircraft. The simulation was developed from a non-proprietary, publicly available, subscale twin-jet transport aircraft simulation using scaling relationships and a modified aerodynamic database. The simulation has an extended aerodynamics database with aero data outside the normal transport-operating envelope (large angle-of-attack and sideslip values). The simulation has representative transport aircraft surface actuator models with variable rate-limits and generally fixed position limits. The simulation contains a generic 40,000 lb sea level thrust engine model. The engine model is a first order dynamic model with a variable time constant that changes according to simulation conditions. The simulation provides a means for interfacing a flight control system to use the simulation sensor variables and to command the surface actuators and throttle position of the engine model.

  1. Helicopter training simulators: Key market factors

    Science.gov (United States)

    Mcintosh, John

    1992-01-01

    Simulators will gain an increasingly important role in training helicopter pilots only if the simulators are of sufficient fidelity to provide positive transfer of skills to the aircraft. This must be done within an economic model of return on investment. Although rotor pilot demand is still only a small percentage of overall pilot requirements, it will grow in significance. This presentation described the salient factors influencing the use of helicopter training simulators.

  2. Using the Dynamic Model to Identify Stages of Teacher Skills in Assessment

    Science.gov (United States)

    Christoforidou, Margarita; Xirafidou, Elisavet

    2014-01-01

    The article presents the results of two cross-sectional studies that investigate teachers' skills in using various techniques of assessment in mathematics by taking into account the four phases of assessment. The five dimensions of the dynamic model are also taken into account in proposing a framework for measuring teacher skills in assessment.…

  3. Coping modeling problem solving versus mastery modeling: effects on adherence, in-session process, and skill acquisition in a residential parent-training program.

    Science.gov (United States)

    Cunningham, C E; Davis, J R; Bremner, R; Dunn, K W; Rzasa, T

    1993-10-01

    This trial compared two approaches used to introduce parenting skills in a residential staff training program. Fifty staff were randomly assigned to: mastery modelling in which videotaped models demonstrated new skills, coping modelling problem solving (CMPS) in which participants formulated their own solutions to the errors depicted by videotaped models, or a waiting-list control group. In both, leaders used modelling, role playing, and homework projects to promote mastery and transfer of new skills. The skills of all groups improved, but CMPS participants attended more sessions, were late to fewer sessions, completed more homework, engaged in more cooperative in-session interaction, rated the program more positively, and reported higher job accomplishment scores. These data suggest that CMPS allowing participants to formulate their own solutions may enhance adherence and reduce the resistance observed in more didactic programs.

  4. Fine and gross motor skills: The effects on skill-focused dual-tasks.

    Science.gov (United States)

    Raisbeck, Louisa D; Diekfuss, Jed A

    2015-10-01

    Dual-task methodology often directs participants' attention towards a gross motor skill involved in the execution of a skill, but researchers have not investigated the comparative effects of attention on fine motor skill tasks. Furthermore, there is limited information about participants' subjective perception of workload with respect to task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. The task required participants to stand 15 feet from a projector screen which depicted virtual targets and fire a modified Glock 17 handgun equipped with an infrared laser. Participants performed the primary shooting task alone (control), or were also instructed to focus their attention on a gross motor skill relevant to task execution (gross skill-focused) and a fine motor skill relevant to task execution (fine skill-focused). Results revealed that workload was significantly greater during the fine skill-focused task for both skill levels, but performance was only affected for the lesser-skilled participants. Shooting performance for the lesser-skilled participants was greater during the gross skill-focused condition compared to the fine skill-focused condition. Correlational analyses also demonstrated a significant negative relationship between shooting performance and workload during the gross skill-focused task for the higher-skilled participants. A discussion of the relationship between skill type, workload, skill level, and performance in dual-task paradigms is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Using Video-Based Modeling to Promote Acquisition of Fundamental Motor Skills

    Science.gov (United States)

    Obrusnikova, Iva; Rattigan, Peter J.

    2016-01-01

    Video-based modeling is becoming increasingly popular for teaching fundamental motor skills to children in physical education. Two frequently used video-based instructional strategies that incorporate modeling are video prompting (VP) and video modeling (VM). Both strategies have been used across multiple disciplines and populations to teach a…

  6. Innovative learning model for improving students’ argumentation skill and concept understanding on science

    Science.gov (United States)

    Nafsiati Astuti, Rini

    2018-04-01

    Argumentation skill is the ability to compose and maintain arguments consisting of claims, supports for evidence, and strengthened-reasons. Argumentation is an important skill student needs to face the challenges of globalization in the 21st century. It is not an ability that can be developed by itself along with the physical development of human, but it must be developed under nerve like process, giving stimulus so as to require a person to be able to argue. Therefore, teachers should develop students’ skill of arguing in science learning in the classroom. The purpose of this study is to obtain an innovative learning model that are valid in terms of content and construct in improving the skills of argumentation and concept understanding of junior high school students. The assessment of content validity and construct validity was done through Focus Group Discussion (FGD), using the content and construct validation sheet, book model, learning video, and a set of learning aids for one meeting. Assessment results from 3 (three) experts showed that the learning model developed in the category was valid. The validity itself shows that the developed learning model has met the content requirement, the student needs, state of the art, strong theoretical and empirical foundation and construct validity, which has a connection of syntax stages and components of learning model so that it can be applied in the classroom activities

  7. PENGEMBANGAN MODEL PELATIHAN SOFT-SKILLS PADA SISWA SEKOLAH MENENGAH PERTAMA NEGERI (SMPN) DI KOTA MATARAM

    OpenAIRE

    Anik Darmiany

    2016-01-01

    Abstrak : Penelitian dan pengembangan ini bertujuan menghasilkan model pelatihan soft-skill khususnya keterampilan komunikasi dan kendali emosi siswa sekolah menengah pertama negeri (SMPN) di kota Mataram. Metode penelitian dan pengembangan dilakukan melalui tiga tahap dari sepuluh langkah Borg & Gall yaitu, (1) penelitian awal (analisis kebutuhan), (2) pengembangan model pelatihan, (3) uji coba dan evaluasi model. Hasil penelitian menunjukkan bahwa pengembangan model pelatihan soft-skill men...

  8. Skill of ship-following large-eddy simulations in reproducing MAGIC observations across the northeast Pacific stratocumulus to cumulus transition region

    Science.gov (United States)

    McGibbon, J.; Bretherton, C. S.

    2017-06-01

    During the Marine ARM GPCI Investigation of Clouds (MAGIC) in October 2011 to September 2012, a container ship making periodic cruises between Los Angeles, CA, and Honolulu, HI, was instrumented with surface meteorological, aerosol and radiation instruments, a cloud radar and ceilometer, and radiosondes. Here large-eddy simulation (LES) is performed in a ship-following frame of reference for 13 four day transects from the MAGIC field campaign. The goal is to assess if LES can skillfully simulate the broad range of observed cloud characteristics and boundary layer structure across the subtropical stratocumulus to cumulus transition region sampled during different seasons and meteorological conditions. Results from Leg 15A, which sampled a particularly well-defined stratocumulus to cumulus transition, demonstrate the approach. The LES reproduces the observed timing of decoupling and transition from stratocumulus to cumulus and matches the observed evolution of boundary layer structure, cloud fraction, liquid water path, and precipitation statistics remarkably well. Considering the simulations of all 13 cruises, the LES skillfully simulates the mean diurnal variation of key measured quantities, including liquid water path (LWP), cloud fraction, measures of decoupling, and cloud radar-derived precipitation. The daily mean quantities are well represented, and daily mean LWP and cloud fraction show the expected correlation with estimated inversion strength. There is a -0.6 K low bias in LES near-surface air temperature that results in a high bias of 5.6 W m-2 in sensible heat flux (SHF). Overall, these results build confidence in the ability of LES to represent the northeast Pacific stratocumulus to trade cumulus transition region.Plain Language SummaryDuring the Marine ARM GPCI Investigation of Clouds (MAGIC) field campaign in October 2011 to September 2012, a cargo container ship making regular cruises between Los Angeles, CA, and Honolulu, HI, was fitted with tools to

  9. Comprehensive simulation-enhanced training curriculum for an advanced minimally invasive procedure: a randomized controlled trial.

    Science.gov (United States)

    Zevin, Boris; Dedy, Nicolas J; Bonrath, Esther M; Grantcharov, Teodor P

    2017-05-01

    There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure. 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group. University. This prospective single-blinded, randomized, controlled trial allocated 20 intermediate-level surgery residents to receive either conventional training (control) or SET curriculum training (intervention). The SET curriculum consisted of cognitive, psychomotor, and nontechnical training modules. Psychomotor skills in a live anesthetized porcine model in the OR was the primary outcome. Knowledge of advanced minimally invasive and bariatric surgery and nontechnical skills in a simulated OR crisis scenario were the secondary outcomes. Residents in the SET curriculum group went on to perform a laparoscopic jejunojejunostomy in the OR. Cognitive, psychomotor, and nontechnical skills of SET curriculum group were also compared to a group of 12 chief surgery residents. SET curriculum group demonstrated superior psychomotor skills in a live porcine model (56 [47-62] versus 44 [38-53], Ppsychomotor skills in the live porcine model and in the OR in a human patient (56 [47-62] versus 63 [61-68]; P = .21). SET curriculum group demonstrated inferior knowledge (13 [11-15] versus 16 [14-16]; P<.05), equivalent psychomotor skill (63 [61-68] versus 68 [62-74]; P = .50), and superior nontechnical skills (41 [38-45] versus 34 [27-35], P<.01) compared with chief resident group. Completion of the SET curriculum resulted in superior training outcomes, compared with conventional surgery training. Implementation of the SET curriculum can standardize training

  10. Comparing Video Modeling and Graduated Guidance Together and Video Modeling Alone for Teaching Role Playing Skills to Children with Autism

    Science.gov (United States)

    Akmanoglu, Nurgul; Yanardag, Mehmet; Batu, E. Sema

    2014-01-01

    Teaching play skills is important for children with autism. The purpose of the present study was to compare effectiveness and efficiency of providing video modeling and graduated guidance together and video modeling alone for teaching role playing skills to children with autism. The study was conducted with four students. The study was conducted…

  11. Predicting Condom Use Using the Information-Motivation-Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis

    Science.gov (United States)

    Senn, Theresa E.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Michael P.

    2011-01-01

    Background The Information-Motivation-Behavioral Skills (IMB) model often guides sexual risk reduction programs even though no studies have examined covariation in the theory’s constructs in a dynamic fashion with longitudinal data. Purpose Using new developments in latent growth modeling, we explore how changes in information, motivation, and behavioral skills over 9 months relate to changes in condom use among STD clinic patients. Methods Participants (N = 1281, 50% female, 66% African American) completed measures of IMB constructs at three time points. We used parallel process latent growth modeling to examine associations among intercepts and slopes of IMB constructs. Results Initial levels of motivation, behavioral skills, and condom use were all positively associated, with behavioral skills partially mediating associations between motivation and condom use. Changes over time in behavioral skills positively related to changes in condom use. Conclusions Results support the key role of behavioral skills in sexual risk reduction, suggesting these skills should be targeted in HIV prevention interventions. PMID:21638196

  12. Encouraging IS developers to learn business skills: an examination of the MARS model

    OpenAIRE

    Tsay, Han-Huei (Crystal)

    2016-01-01

    Though prior research has recognized business skills as one of the keys to successful information system development, few studies have investigated the determinants of an IS developer’s behavioral intention to learn such skills. Based on the Motivation–Ability–Role Perception–Situational factors (i.e., the MARS model), this study argues that the intention of IS developers to acquire business skills is influenced by learning motivation (M), learning self-efficacy (A), change agent role percept...

  13. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  14. Simulation for transthoracic echocardiography of aortic valve

    Science.gov (United States)

    Nanda, Navin C.; Kapur, K. K.; Kapoor, Poonam Malhotra

    2016-01-01

    Simulation allows interactive transthoracic echocardiography (TTE) learning using a virtual three-dimensional model of the heart and may aid in the acquisition of the cognitive and technical skills needed to perform TTE. The ability to link probe manipulation, cardiac anatomy, and echocardiographic images using a simulator has been shown to be an effective model for training anesthesiology residents in transesophageal echocardiography. A proposed alternative to real-time reality patient-based learning is simulation-based training that allows anesthesiologists to learn complex concepts and procedures, especially for specific structures such as aortic valve. PMID:27397455

  15. Open surgical simulation--a review.

    Science.gov (United States)

    Davies, Jennifer; Khatib, Manaf; Bello, Fernando

    2013-01-01

    Surgical simulation has benefited from a surge in interest over the last decade as a result of the increasing need for a change in the traditional apprentice model of teaching surgery. However, despite the recent interest in surgical simulation as an adjunct to surgical training, most of the literature focuses on laparoscopic, endovascular, and endoscopic surgical simulation with very few studies scrutinizing open surgical simulation and its benefit to surgical trainees. The aim of this review is to summarize the current standard of available open surgical simulators and to review the literature on the benefits of open surgical simulation. Open surgical simulators currently used include live animals, cadavers, bench models, virtual reality, and software-based computer simulators. In the current literature, there are 18 different studies (including 6 randomized controlled trials and 12 cohort studies) investigating the efficacy of open surgical simulation using live animal, bench, and cadaveric models in many surgical specialties including general, cardiac, trauma, vascular, urologic, and gynecologic surgery. The current open surgical simulation studies show, in general, a significant benefit of open surgical simulation in developing the surgical skills of surgical trainees. However, these studies have their limitations including a low number of participants, variable assessment standards, and a focus on short-term results often with no follow-up assessment. The skills needed for open surgical procedures are the essential basis that a surgical trainee needs to grasp before attempting more technical procedures such as laparoscopic procedures. In this current climate of medical practice with reduced hours of surgical exposure for trainees and where the patient's safety and outcome is key, open surgical simulation is a promising adjunct to modern surgical training, filling the void between surgeons being trained in a technique and a surgeon achieving fluency in that

  16. Effect of training frequency on the learning curve on the da Vinci Skills Simulator.

    Science.gov (United States)

    Walliczek, Ute; Förtsch, Arne; Dworschak, Philipp; Teymoortash, Afshin; Mandapathil, Magis; Werner, Jochen; Güldner, Christian

    2016-04-01

    The purpose of this study was to evaluate the effect of training on the performance outcome with the da Vinci Skills Simulator. Forty novices were enrolled in a prospective training curriculum. Participants were separated into 2 groups. Group 1 performed 4 training sessions and group 2 had 2 training sessions over a 4-week period. Five exercises were performed 3 times consecutively. On the last training day, a new exercise was added. A significant skills gain from the first to the final practice day in overall performance, time to complete, and economy of motion was seen for both groups. Group 1 had a significantly better outcome in overall performance, time to complete, and economy of motion in all exercises. There was no significant difference found regarding the new exercise in group 1 versus group 2 in nearly all parameters. Longer time distances between training sessions are assumed to play a secondary role, whereas total repetition frequency is crucial for improvement of technical performance. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1762-E1769, 2016. © 2015 Wiley Periodicals, Inc.

  17. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  18. AEGIS geologic simulation model

    International Nuclear Information System (INIS)

    Foley, M.G.

    1982-01-01

    The Geologic Simulation Model (GSM) is used by the AEGIS (Assessment of Effectiveness of Geologic Isolation Systems) program at the Pacific Northwest Laboratory to simulate the dynamic geology and hydrology of a geologic nuclear waste repository site over a million-year period following repository closure. The GSM helps to organize geologic/hydrologic data; to focus attention on active natural processes by requiring their simulation; and, through interactive simulation and calibration, to reduce subjective evaluations of the geologic system. During each computer run, the GSM produces a million-year geologic history that is possible for the region and the repository site. In addition, the GSM records in permanent history files everything that occurred during that time span. Statistical analyses of data in the history files of several hundred simulations are used to classify typical evolutionary paths, to establish the probabilities associated with deviations from the typical paths, and to determine which types of perturbations of the geologic/hydrologic system, if any, are most likely to occur. These simulations will be evaluated by geologists familiar with the repository region to determine validity of the results. Perturbed systems that are determined to be the most realistic, within whatever probability limits are established, will be used for the analyses that involve radionuclide transport and dose models. The GSM is designed to be continuously refined and updated. Simulation models are site specific, and, although the submodels may have limited general applicability, the input data equirements necessitate detailed characterization of each site before application

  19. Validation of a global assessment of arthroscopic skills in a cadaveric knee model.

    Science.gov (United States)

    Slade Shantz, Jesse A; Leiter, Jeff R; Collins, John B; MacDonald, Peter B

    2013-01-01

    employed to measure the impact of skills curricula, including but not limited to simulation. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. Mock ECHO: A Simulation-Based Medical Education Method.

    Science.gov (United States)

    Fowler, Rebecca C; Katzman, Joanna G; Comerci, George D; Shelley, Brian M; Duhigg, Daniel; Olivas, Cynthia; Arnold, Thomas; Kalishman, Summers; Monnette, Rebecca; Arora, Sanjeev

    2018-04-16

    This study was designed to develop a deeper understanding of the learning and social processes that take place during the simulation-based medical education for practicing providers as part of the Project ECHO® model, known as Mock ECHO training. The ECHO model is utilized to expand access to care of common and complex diseases by supporting the education of primary care providers with an interprofessional team of specialists via videoconferencing networks. Mock ECHO trainings are conducted through a train the trainer model targeted at leaders replicating the ECHO model at their organizations. Trainers conduct simulated teleECHO clinics while participants gain skills to improve communication and self-efficacy. Three focus groups, conducted between May 2015 and January 2016 with a total of 26 participants, were deductively analyzed to identify common themes related to simulation-based medical education and interdisciplinary education. Principal themes generated from the analysis included (a) the role of empathy in community development, (b) the value of training tools as guides for learning, (c) Mock ECHO design components to optimize learning, (d) the role of interdisciplinary education to build community and improve care delivery, (e) improving care integration through collaboration, and (f) development of soft skills to facilitate learning. Mock ECHO trainings offer clinicians the freedom to learn in a noncritical environment while emphasizing real-time multidirectional feedback and encouraging knowledge and skill transfer. The success of the ECHO model depends on training interprofessional healthcare providers in behaviors needed to lead a teleECHO clinic and to collaborate in the educational process. While building a community of practice, Mock ECHO provides a safe opportunity for a diverse group of clinician experts to practice learned skills and receive feedback from coparticipants and facilitators.