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Biomedical subjects

Mark W Scerbo

Publications and source records attributed to Mark W Scerbo.

13 recordsLinked to original sources
PubMed2006

The efficacy of a medical virtual reality simulator for training phlebotomy.

OBJECTIVE: The present study compared the effectiveness of a virtual reality (VR) simulator for training phlebotomy with that of a more traditional approach using simulated limbs. BACKGROUND: Phlebotomy, or drawing blood, is one of the most common medical procedures; yet, there are no universal standards for training and assessing performance. The absence of any standards can lead to injuries and inaccurate test results if the procedure is improperly performed. METHOD: Twenty 3rd-year medical students were trained under one of the two methods and had their performance assessed with a 28-item checklist. RESULTS: The results showed that performance improvements were limited to those who trained with the simulated limbs, and a detailed comparison of the two systems revealed several functional and physical differences that may explain these findings. CONCLUSION: Participants trained with simulated limbs performed better than those trained with a VR simulator; however, the metrics recorded by the VR system may address some aspects of performance that could eventually prove beneficial. APPLICATION: The present study highlights the potential for medical simulators to improve patient safety by enabling trainees to practice procedures on devices instead of patients. Applications of this research include training, performance assessment, and design of simulator systems.

Adult↗
PubMed2006

A simulation-based training system for surgical wound debridement.

A simulation-based training system for surgical wound debridement was developed and comprises a multimedia introduction, a surgical simulator (tutorial component), and an assessment component. The simulator includes two PCs, a haptic device, and mirrored display. Debridement is performed on a virtual leg model with a shallow laceration wound superimposed. Trainees are instructed to remove debris with forceps, scrub with a brush, and rinse with saline solution to maintain sterility. Research and development issues currently under investigation include tissue deformation models using mass-spring system and finite element methods; tissue cutting using a high-resolution volumetric mesh and dynamic topology; and accurate collision detection, cutting, and soft-body haptic rendering for two devices within the same haptic space.

Computer Simulation↗
PubMed2005

Determining the efficacy of an immersive trainer for arthroscopy skills.

The present study examined the effectiveness of an immersive arthroscopic simulator for training naive participants to identify major anatomical structures and manipulate the arthroscope and probe. Ten psychology graduate students engaged in five consecutive days of practice sessions with the arthroscopic trainer. Following each session, participants were tested to see how quickly and accurately they could identify 10 anatomical landmarks and manipulate the arthroscope and probe. The results demonstrated steady learning on both tasks. For the anatomy task, participants correctly identified an average of 7.7 out of 10 structures correctly in the first session and 9.5 in the last. During the manipulation task, participants collided 53.5 times with simulated tissues in the first session and 13.2 times during the final session. Participants (n=9) also demonstrated minimal performance degradation when tested 4 weeks later. These data suggest that the immersive arthroscopic trainer might be useful as an initial screening or training tool for beginning medical students.

Adult↗
PubMed2005

Teaching intravenous cannulation to medical students: comparative analysis of two simulators and two traditional educational approaches.

This study examines the effectiveness of two virtual reality simulators when compared with traditional methods of teaching intravenous (IV) cannulation to third year medical students. Thirty-four third year medical students were divided into four groups and then trained to perform an IV cannulation using either CathSim, Virtual I.V., a plastic simulated arm or by practicing IV placement on each other. All subjects watched a five minute training video and completed a cannulation pretest and posttest on the simulated arm. The results showed significant improvement from pretest to posttest in each of the four groups. Students trained on the Virtual I.V. showed significantly greater improvement over baseline when compared with the simulated arm group (p<.026). Both simulators provided at least equal training to traditional methods of teaching, a finding with implications for future training of this procedure to novices.

Catheterization↗
PubMed2005

Assessing surgical skill training under hazardous conditions in a virtual environment.

The present study examined the performance of a surgical procedure under simulated combat conditions. Eleven residents performed a cricothyroidotomy on a mannequin-based simulator in a fully immersive virtual environment running a combat simulation with a virtual sniper under both day and night time lighting conditions. The results showed that completion times improved between the first and second attempt and that differences between day and night time conditions were minimal. However, three participants were killed by the virtual sniper before completing the procedure. These results suggest that some participants' ability to allocate attention to the task and their surroundings was inappropriate even under simulated hazardous conditions. Further, this study shows that virtual environments offer the chance to study a wider variety of medical procedures performed under an unlimited number of conditions.

Adult↗
PubMed2004

An evaluation of an adaptive automation system using a cognitive vigilance task.

The performance of an adaptive automation system was evaluated using a cognitive vigilance task. Participants responded to the presence of a green "K" in an array of two, five, or nine distractor stimuli during a 40-min vigil. The array with the target stimulus was presented once each minute. Participants EEG was recorded and an engagement index (EI = 20 x beta/(alpha + theta)) was derived. In the negative feedback condition, increases in the EI caused the number of stimuli in the array to decrease while decreases in the EI caused the number of stimuli to increase. For the positive feedback condition, increases in the index caused an increase in the array size (AS) while decreases caused a decrease in the array size. Each experimental participant had a yoked control partner who received the same pattern of changes in array irrespective of their engagement index. A vigilance decrement was seen only for the positive feedback, experimental group.

Adaptation, Physiological↗
PubMed2004

A comparison of the CathSim system and simulated limbs for teaching intravenous cannulation.

The present study describes a comparison between the CathSim VR simulator and simulated limbs for training IV cannulation. Two groups of physician assistant students underwent 2 hours of training on either method. Performance was assessed before and after training with a standardized assessment form. The results showed that all students improved after training, but the degree of improvement was greater for those trained with the simulated limbs. These findings may be due to differences between the two training methods as well as the methodology adopted in the present study.

Extremities↗
PubMed2002

The effects of communication modes on performance and discourse organization with an adaptive interface.

This paper reports a study of different communication patterns on performance with a simulated adaptive interface that created the impression of a talking and listening computer which would help participants solve problems with a computer. There were four levels of communication modes which differed in the restrictions placed on human-computer communication. Dependent measures included tasks completed per minute as well as participants' utterances, which were assessed for verbosity, disfluencies, and indices of common ground. The largest performance differences were found between the groups that could communicate freely and those where communication was restricted or denied. As restriction increased, performance decreased. Further, as restriction increased, the computer assumed greater control and verbosity decreased. Performance on the simple tasks declined as communication restriction increased, but no differences were observed for complex tasks. The results are discussed with respect to differences between human-human and human-computer communication as well as research on adaptive environments.

Analysis of Variance↗
PubMed2002

Effects of a biocybernetic system on vigilance performance.

The present study was designed to determine whether a biocybernetic, adaptive system could enhance vigilance performance. Participants were asked to monitor the repetitive presentation of white bars on a computer screen for occasional increases in length. An index of task engagement was derived from participants' electroencephalographic (EEG) activity and was used to change the presentation rate of events among 3 values (6, 20, and 60 events/min). Under a negative feedback contingency, event rates increased if the engagement index decreased and, conversely, decreased if the index increased. Under positive feedback, the opposite contingency existed. Each experimental participant had a yoked control partner who received the same pattern of changes in event rates irrespective of his or her EEG activity. The results showed that better vigilance performance was obtained under negative feedback and that the performance of the yoked participants was similar to that of their experimental partners. These findings suggest that it may be possible to improve monitoring performance on critical activities such as air traffic control and radar and sonar operation through a pattern of event rate changes that do not rely on an operator's overt behavior.

Adolescent↗
PubMedDate not supplied

Comparison of a virtual reality simulator and simulated limbs for phlebotomy training.

The current study compared the CathSim virtual reality simulator with simulated limbs for phlebotomy training. In the first experiment, medical students completed two 1-hour training sessions using 1 of the 2 methods. Afterward, the students' performance was assessed with both simulated limbs and genuine patients. The results showed that students trained with the simulated limbs achieved higher scores on both the posttest and the field test with actual patients than those trained on the CathSim system. In the second study, graduate students practiced with the CathSim system for 5 hours. The results showed a significant improvement in scores from pretest to posttest for these students. However, even after extended practice, their final scores did not differ from those of the medical students in the first experiment. Critical differences in design characteristics between the 2 systems may explain these findings. Although the authors observed a clear advantage for simulated limbs over the CathSim system, neither system faithfully represents all of steps needed to perform the procedure. Thus, training decisions may require that the unique advantages afforded by each system be considered.

Adult↗
PubMedDate not supplied

Effects of a psychophysiological system for adaptive automation on performance, workload, and the event-related potential P300 component.

The present study examined the effects of an electroencephalographic- (EEG-) based system for adaptive automation on tracking performance and workload. In addition, event-related potentials (ERPs) to a secondary task were derived to determine whether they would provide an additional degree of workload specificity. Participants were run in an adaptive automation condition, in which the system switched between manual and automatic task modes based on the value of each individual's own EEG engagement index; a yoked control condition; or another control group, in which task mode switches followed a random pattern. Adaptive automation improved performance and resulted in lower levels of workload. Further, the P300 component of the ERP paralleled the sensitivity to task demands of the performance and subjective measures across conditions. These results indicate that it is possible to improve performance with a psychophysiological adaptive automation system and that ERPs may provide an alternative means for distinguishing among levels of cognitive task demand in such systems. Actual or potential applications of this research include improved methods for assessing operator workload and performance.

Adaptation, Psychological↗