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At least 235 records · Page 13Linked to original sources
PubMed2006

Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills.

OBJECTIVE: To determine whether full-scale simulation (SIM) is superior to interactive problem-based learning (PBL) for teaching medical students acute care assessment and management skills. DESIGN: Randomized controlled trial. SETTING: Simulation center at a U.S. medical school. SUBJECTS: Thirty-one fourth-year medical students in a week-long acute care course. INTERVENTIONS: After institutional review board approval and informed consent, eligible students were randomized to either the SIM or PBL group. On day 1, all subjects underwent a simulator-based initial assessment designed to evaluate their critical care skills. Two blinded investigators assessed each student using a standardized checklist. Subsequently, the PBL group learned about dyspnea in a standard PBL format. The SIM group learned about dyspnea using the simulator. To equalize simulator education time, the PBL group learned about acute abdominal pain on the simulator, whereas the SIM group used the PBL format. On day 5, each student was tested on a unique dyspnea scenario. MEASUREMENTS AND MAIN RESULTS: Mean initial assessment and final assessment checklist scores and their change for the SIM and PBL groups were compared using the Student's t-test. A p < .05 was considered significant. The SIM and PBL groups had similar mean (PBL 0.44, SIM 0.47, p = .64) initial assessment scores (earned score divided by maximum score) and were deemed equivalent. The SIM group performed better than the PBL group on the final assessment (mean, PBL 0.53, SIM 0.72, p < .0001). When each student's change in score (percent correct on final assessment minus percent correct on the initial assessment) was compared, SIM group students performed better (mean improvement, SIM 25 percentage points vs. PBL 8 percentage points, p < .04) CONCLUSIONS: For fourth-year medical students, simulation-based learning was superior to problem-based learning for the acquisition of critical assessment and management skills.

Adult↗
PubMed2006

Haptic rendering for VR laparoscopic surgery simulation.

This project concerns the application of haptic feedback to a VR laparoscopic surgery simulator. Haptic attributes such as mass, friction, elasticity, roughness and viscosity are individually modeled, validated and applied to the existing visual simulation created by researchers at Monash University. Haptic feedback is an essential element in an immersive and realistic virtual reality laparoscopic training simulator. The haptic system must display stable, continuous and realistic multi-dimensional force feedback, and its inclusion should enhance the simulators training capability. Stability is a recurring concern throughout haptic history, and will be tackled with the implementation of a stable control algorithm and a passive environment model. Haptic force feedback modeling, systems implementation and validation studies form the principal areas of new work associated with this project.

Computer Graphics↗
PubMed1995

Teaching self-administration of nasogastric tube insertion to an adolescent with Crohn disease.

We examined the effectiveness of simulation training to teach an adolescent male with Crohn disease to self-administer nasogastric tube insertion. Nasogastric tube insertion was taught using simulation training, after which self-insertion skills were assessed. Results across skill components indicated that this subject was able to self-administer insertion of the nasogastric tube.

Adolescent↗
PubMedDate not supplied

Work simulation: putting training to work.

As awareness of the efficacy of using work for rehabilitation has expanded, a growing number of physicians have recognized the value of using work conditioning in early intervention for the injured worker and other patients. Work simulation therapy and its benefits are discussed.

Exercise Therapy↗
PubMed2026

Structured Visualization for Laparoscopic Skill Acquisition:A Randomized Controlled Study.

OBJECTIVE: To evaluate whether structured visualization can support acquisition of basic laparoscopic skills during simulation training and whether this approach can achieve outcomes comparable to repeated physical practice. DESIGN: Prospective randomized comparative study. SETTING: Simulation-based laparoscopic skills training at a university-affiliated teaching center. PARTICIPANTS: Fifty laparoscopy-naive medical students were randomly assigned to a laparoscopic practice group or a visualization group. The laparoscopic practice group performed a validated Gynecological Endoscopic Surgical Education and Assessment (GESEA) Laparoscopic Skills Training and Testing (LASTT) hand-eye coordination task 7 consecutive times. The visualization group performed the same task physically on attempts 1, 4, and 7, while attempts 2, 3, 5, and 6 consisted of guided visualization. Each attempt lasted up to 2 minutes, and performance was scored as the number of correctly placed rings (range 0-12). RESULTS: Baseline performance was comparable between groups (2.92&#x202f;&#xb1;&#x202f;2.14&#x202f;vs 2.88&#x202f;&#xb1;&#x202f;1.72; p&#x202f;=&#x202f;0.94). Both groups improved significantly over time (p&#x202f;<&#x202f;0.001). No statistically significant between-group differences were found on the 4th attempt (6.52&#x202f;&#xb1;&#x202f;3.25&#x202f;vs 5.76&#x202f;&#xb1;&#x202f;2.57; p&#x202f;=&#x202f;0.48) or 7th attempt (8.24&#x202f;&#xb1;&#x202f;2.86&#x202f;vs 7.44&#x202f;&#xb1;&#x202f;2.99; p&#x202f;=&#x202f;0.39). The final physical performance of the visualization group was significantly better than the 3rd physical attempt of the laparoscopic practice group (p&#x202f;=&#x202f;0.025). CONCLUSIONS: Structured visualization may support early laparoscopic skill acquisition and achieve short-term outcomes comparable to repeated hands-on simulator training. Visualization should be considered an adjunct, rather than a replacement, for physical practice in simulation-based laparoscopic education.

Laparoscopy↗
PubMed1989

Accident simulation as a new therapy technique for post-traumatic stress disorder. A case study.

Data are presented from clinical interviews and psychological tests of a helicopter pilot who had survived a helicopter crash. Within a week, the pilot developed severe stress reactions after the crash, dominated by guilt feelings, nightmares and fear of not being able to fly. Helicopter-accident training simulating a helicopter crashing into the water was used as part of the treatment. The therapeutic value and limitations of this type of treatment are discussed. The main benefit seemed to be the extinction of traumatic helplessness and the reestablishment of a positive response-outcome expectancy. Existential conflicts were not covered by the simulator training.

Accidents, Aviation↗
PubMed2000

Augmented reality simulator for training in two-dimensional echocardiography.

In two-dimensional echocardiography the sonographer must synthesize multiple tomographic slices into a mental three-dimensional (3D) model of the heart. Computer graphics and virtual reality environments are ideal to visualize complex 3D spatial relationships. In augmented reality (AR) applications, real and virtual image data are linked, to increase the information content. In the presented AR simulator a 3D surface model of the human heart is linked with echocardiographic volume data sets. The 3D echocardiographic data sets are registered with the heart model to establish spatial and temporal congruence. The heart model, together with an animated ultrasound sector represents a reference scenario, which displays the currently selected two-dimensional echocardiographic cutting plane calculated from the volume data set. Modifications of the cutting plane within the echocardiographic data are transferred and visualized simultaneously and in real time within the reference scenario. The trainee can interactively explore the 3D heart model and the registered 3D echocardiographic data sets by an animated ultrasound probe, whose position is controlled by an electromagnetic tracking system. The tracking system is attached to a dummy transducer and placed on a plastic puppet to give a realistic impression of a two-dimensional echocardiographic examination.

Computer Graphics↗
PubMed2006

Working memory and image guided surgical simulation.

We report on a study that investigates the relationship between visual working memory and verbal working memory and a performance measure in endoscopic instrument navigation in MIST and GI Mentor II (a simulator for gastroendoscopy). Integrated cognitive neuroscience in state-of-the-art simulator training curriculum will take safety science in health care one step ahead. Current simulator validation focuses on how to train. In the light of recent research it is now prime time to ask why in search of mechanisms rather than to repeatedly show that training has effect. This will help tailor training to maximize individual output in procedures that require a high level of dexterity. WM training is a unique learning aid in simulator training and should be used alongside clinical practice in order to improve the quality of complex clinical intervention in the field of image guided surgical simulation.

Computer Simulation↗
PubMed2006

Intensive continuing medical education course training on simulators results in proficiency for laparoscopic suturing.

BACKGROUND: The purpose of this study was to determine the feasibility and effectiveness of implementing a validated suturing curriculum as a free-standing continuing medical education (CME) course. METHODS: Eighteen participants (9 practicing surgeons, 9 surgery residents) attended a 4-hour laparoscopic suturing CME course. After viewing an instructional videotape all participants had their baseline performance measured on a fundamentals of laparoscopic surgery-type videotrainer suture model. Participants then practiced on the model with active instruction from 6 proctors until a previously reported proficiency level was achieved or until the course ended. Performance was scored objectively based on time and errors. Precourse and postcourse questionnaires were collected. RESULTS: Participants trained for 2.6 +/- .8 hours and performed 37 +/- 11 repetitions. Although no participant was proficient at baseline, 72% achieved the proficiency level by the end of the course. Participants showed 44% improvement in objective scores and 34% improvement according to subjective self-rating. CONCLUSIONS: Although 4 hours may be insufficient for some trainees, an intensive half-day CME course is feasible and effective in significantly improving performance and allowing the majority of participants to achieve proficiency.

Adult↗
PubMed2006

Simulation for training with the Autosuture Endo Stitch device.

The rapid development and deployment of novel laparoscopic instruments present the surgical educator and trainee with a significant challenge. Several useful instruments have been particularly difficult to teach the novice. We have developed a platform that allows the combination of the actual instrument handle with a virtual re-creation of the instrument tip. We chose the Autosuture Endo Stitch device as the prototypical instrument because it satisfies our subjective experience of "useful, but hard to teach." A software package was developed to support the re-creation of the needle and suture that accompany the device. The apparatus has haptic capabilities and collision detection so that the needle driver is "aware" of suture and instrument contact. The developed virtual environment allows re-creation of the necessary motion to simulate the instrument, the trainee can use the actual instrument handle, and the system can be altered to accommodate other instruments.

Algorithms↗
PubMed1978

Effects of simulated altitude training on aerobic and anaerobic power.

Five trained males aged 20-23 years undertook successive phases (2-5 weeks duration) of daily training in normoxia or hypoxia. Weekly exhaustive tests alternately in normoxia or hypoxia, throughout, assessed the comparative efficacy of the training. The relative contribution to endurance, aerobic (peak VO2) and anaerobic (deltaLa) power made by exercise or hypoxia separately was studied. In a stepwise increasing work test to exhaustion relative bradycardia developed during the first minute of exhaustive work at 1800 kgm/min in all subjects and aerobic power increased both in normoxia and hypoxia significantly by the end of the first phase hypoxic training. Endurance for exhaustive work increased in both environments as did aerobic and anaerobic power.

Acclimatization↗