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Results for “Simulation Training”

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At least 397 records · Page 22Linked to original sources

PubMed2004

Interactive haptic modeling of colon and colonoscope.

This paper presents physics-based modeling for colonoscopy training simulator. The colon is modeled as a chain of beam along the medial axis for global bending motions. The Timoshenko's beam theory is applied to the centerline of colon extracted from a medical image. The stiffness matrix of colon is formulated using the finite element method. The colonoscope model consists of rigid elements connected with torsional spring and damper. This modeling allows global bending motions to be simulated in real time.

Colon↗

PubMed2005

Development of a VR therapy application for Iraq war military personnel with PTSD.

Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experiences including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that 1 out of 6 returning Iraq War military personnel are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) exposure therapy has been used in previous treatments of PTSD patients with reports of positive outcomes. The aim of the current paper is to specify the rationale, design and development of an Iraq War PTSD VR application that is being created from the virtual assets that were initially developed for theX-Box game entitled Full Spectrum Warrior which was inspired by a combat tactical training simulation, Full Spectrum Command.

Computer Simulation↗

PubMed2005

Blending clinical and technical skills at the bedside.

The brave new world will find a richer blending of clinical and technical skill development as scenario-based simulation training emerges on the web. The benefits of competency assessment, standards-based education, and just-in-time decision-making support will help organizations serve the patient with greater skill. This is the bridge to crossing the quality chasm that exists today. And, it is the promise for a safer tomorrow.

Clinical Competence↗

PubMed2006

[The use of individual EEG peculiarities for increase of neurofeedback efficiency].

An aim of the study was to demonstrate efficiency of neurofeedback in using individual frequency ranges of electroencephalogram (EEG). The sessions of theta/beta decreasing and alpha simulating trainings were carried out in 2 outpatients: one of them with attention deficit disorder (a schoolboy) and another one with functional pain contraction (a professional musician). The neurofeedback with standard frequency did not result in any improvement of psychometric and EEG characteristics of both patients. The neurofeedback training with individual frequency of maximal peak and alpha band width improved these characteristics that suggest efficiency of the approach used.

Alpha Rhythm↗

PubMed1990

[Statistical studies of student clinical practice. 1. Clinical practice of operative dentistry from 1983 to 1989].

Clinical practice has been assigned as a final and very important aspect of study and practice of dental education. In our university, the students are exposed the clinical practice from the latter term of fifth year. This report investigated the protocols of clinical cases from the first to the seventh class of graduates. The results obtained were as follows: 1) The graduates of first class averaged 9 clinical cases. This decreased with the years and the fourth class averaged 5.5 cases. From the sixth class simulator training and mutual practice among the students was introduced and the total average of seventh class was 5.1 cases. 2) The dental practice centers on restoration and 20 percent of all cases were amalgam fillings from the first to four the class. However this decreased from the fifth class and does not take place at present. Composite resin restorations increased. Cast restorations occupied 20 percent of all cases and the proportion hasn't changed. 3) Clinical cases of graduates of fifth class who were first to include treatment between students averaged 7 cases. Mutual treatment practice is useful because of the increase exposure to clinical practice.

Clinical Clerkship↗

PubMed1989

Massive retroperitoneal hemorrhage from an asymptomatic adrenal cortical adenoma. Report of a case.

A 52-year-old man was admitted to the General Surgical Service, with acute onset of left back and flank pain. Two weeks prior to admission he had been subjected to a 3G to 4G acceleration in an ejection seat training simulator. On the day of admission, he had performed a 100 yard swim in flight gear following a seven foot jump into water. He denied any injury during the above exercises or any other trauma. A falling hematocrit was demonstrated by serial determinations and a computerized tomography scan revealed a left retroperitoneal hematoma with normal bilateral renal function and no obvious renal injury. Continued hemorrhage resulted in laparotomy, which showed an 11 cm left adrenal tumor with massive hemorrhage into the retroperitoneum. Histologically the tumor was a benign non-functioning adrenal cortical adenoma.

Adenoma↗

PubMed1995

Enhancing the participation and independence of students with severe physical and multiple disabilities in performing community activities.

The effectiveness of a multi-element approach derived from factors to increase self-determination of middle- and high-school-age students with physical and multiple disabilities was examined. The approach includes equipment and performance adaptations, brief in-school simulation training, and instruction and support for parents and home assistance providers. The intervention was instituted with 3 students; a multiple baseline design was used. Student participation and independence dramatically increased after the intervention. Results suggest that this approach may be one solution to providing students with both inclusive education and community skill and activity instruction. The impact of the intervention on student self-determination was discussed.

Activities of Daily Living↗

PubMed1994

An evaluation of a time-saving anaesthetic machine checkout procedure.

Although it is generally acknowledged that a pre-use checkout of the anaesthetic machine significantly improves patient safety, an evaluation of such procedures is uncommon. Previous studies have shown that anaesthetic personnel using different check routines are unable to detect the majority of pre-set technical malfunctions. We have shown that it is possible to develop an effective and time-saving check procedure by integrating seven simple steps into one continuous flow procedure, where the settings and results of one step are used in the following step to optimize step interaction. The method is a 'core' procedure adapted to machines sold after 1980 according to the current ISO standard (presently undergoing revision). A user inquiry demonstrated that this pre-use check has been easily adopted in departments of anaesthesia. Moreover, the inquiry showed that most departments would not accept a checkout procedure which required more than 5-6 min. A study on nurse anaesthetists performing this procedure in the operating suite showed an average checking time of approximately 3 min. A performance test was undertaken by activating four different malfunctions in an anaesthetic machine training simulator. Twelve of 17 nurse anaesthetists rapidly identified all faults, whereas five nurses missed one or two faults. Our study suggests that our check procedure (the seven point check) provides a time-saving method for effective pre-use control of the anaesthetic machine.

Anesthesia Department, Hospital↗

PubMed2003

Real-time PC based X-ray simulation for interventional radiology training.

The ability to simulate realistic fluoroscopic images in real-time is a key aspect of any interventional radiology training system. In this paper, we propose a method for rendering X-ray images in real-time on a PC with consumer level graphics hardware, while improving the quality of the images. Although volume rendering techniques form the basis of our algorithm, we studied the characteristics of actual X-ray images to develop a method that can provide a new level of realism. In addition, the integration of the various levels of information contained in a CT scan in the rendering pipeline can be exploited to produce even more realistic, patient-specific X-ray or fluoroscopic images. Although the results presented here are preliminary, the performance of multi-texturing and multi-stage rasterization features available on recent low-cost graphics hardware already allows us to render X-ray images at about 30 frames per second.

Algorithms↗

PubMed2007

Violations and errors during simulation-based driver training.

The effectiveness of virtual driving instruction can increase when techniques that automatically distinguish between violations and errors are available, two behaviours requiring different types of remediation. This study reports the analysis of the objectively measured performance of 520 participants completing a simulation-based training programme. Factor analysis of failure reasons showed that violations and errors were the primary underlying factors. Men committed more violations and women made more errors; the magnitude of sex differences corresponded to the factor loadings. Factor analysis of the mean task completion times yielded a factor that can be described as the extent to which motivation for speed resulted in quicker task execution. Quicker participants completed more tasks, committed more violations, but made fewer errors. Participants reduced errors during forced-paced driving and increased speed during self-paced driving. The authors would recommend exploiting the distinction between violations and errors by developing interfaces and feedback for both types of aberration.

Accidents, Traffic↗

PubMed2000

Training residents using simulation technology: experience with ultrasound for trauma.

BACKGROUND: The need for surgeons to become proficient in performing and interpreting ultrasound examinations has been well recognized in recent years, but providing standardized training remains a significant challenge. The UltraSim (MedSim, Ft. Lauderdale, Fla) ultrasound simulator is a modified ultrasound machine that stores patient data in three-dimensional images. By scanning on the UltraSim mannequin, the student can reconstruct these images in real-time, eliminating the need for finding normal and abnormal models, while providing an objective method of both teaching and testing. The objective of this study was to compare the posttest results between residents trained on a real-time ultrasound simulator versus those trained in a traditional hands-on patient format. We hypothesized that both methods of teaching would yield similar results as judged by performance on the interpretive portion of a standardized posttest. It is designed as a prospective, cohort study from two university trauma centers involving residents at the beginning of their first or second postgraduate year of training. The main outcome measure was performance on a standardized posttest, which included interpretation of ultrasound cases recorded on videotape. METHODS: Students first took a written pretest to evaluate their baseline knowledge of ultrasound physics as well as their ability to interpret basic ultrasound images. The didactic portion of the course used the same teaching materials for all residents and included lectures on ultrasound physics, ultrasound use in trauma/critical care, and a series of instructional videos. This didactic session was followed by 1 hour for each student of hands-on training on medical models/medical patients (group I) or by training on the ultrasound simulator (group II). The pretest was repeated at the completion of the course (posttest). Data were stratified by postgraduate year, i.e., PG1 or PG2. RESULTS: A total of 74 residents were trained and tested in this study (PG1 = 48, PG2 = 26). All residents showed significant improvement in their pretest and posttest scores (p = 0.00) in both their knowledge of ultrasound physics and in their interpretation of ultrasound images. Importantly, we could not demonstrate any significant difference between groups trained on models/patients (group I) versus those trained on the simulator (group II) when comparing their posttest interpretation of ultrasound images presented on videotapes (PG1, group I mean score 6.9 +/- 1.4 vs. PG1, group II mean score 6.5 +/- 1.6, p = 0.32; PG2, group I mean score 7.7 +/- 1.4 vs. PG2, group II mean score 7.9 +/- 1.2, p = 0.70). CONCLUSION: The use of a simulator is a convenient and objective method of introducing ultrasound to surgery residents and compares favorably with the experience gained with traditional hands-on patient models.

Cohort Studies↗

PubMed2004

Full scale computer simulators in anesthesia training and evaluation.

PURPOSE: With the advent of competency-based curriculum, technology such as full scale computer simulators have acquired an increasingly important role in anesthesia both in training and evaluation. This article reviews the current role of full scale computer simulators in teaching and evaluation in anesthesia. SOURCE: This review draws from existing anesthesia and medical education literature in order to examine and assess the current role of full scale computer simulators in anesthesia education today. PRINCIPAL FINDINGS: The last decade has witnessed a major increase in the use of full scale computer simulators in anesthesia. Many applications have been found for these simulators including teaching and training, evaluation and research. Despite the increasing use and application of full scale computers in anesthesia in the area of teaching and training, definitive studies evaluating its cost effectiveness, its efficacy compared to traditional training methods or its impact on patient outcome are still pending. Although there is some preliminary evidence of reliability and validity in using the simulator to evaluate clinical competence, development in this area has not progressed enough to justify its use in formal, summative evaluation of competence in anesthesia at this time. CONCLUSIONS: As technology acquires an increasingly important role in medical education, full scale computer simulators represent an exciting potential in anesthesia. However, the full potential and role of simulators in anesthesia is still in development and will require a dovetailing of clinical theory and practice with current research in medical education.

Anesthesiology↗

PubMed2002

The application of clinical simulation in crisis management training.

Since it was first introduced more than 30 years ago, clinical simulation has become a popular tool for medical training, particularly in crisis management. The modern high-fidelity patient simulator consists of a whole-body mannequin with integrated electronic patient monitoring; it is controlled by computers capable of simulating numerous clinical scenarios and patient characteristics, and reacting to various interventions appropriately. Simulator training is theoretically superior to conventional training in management of rare crisis situations, as it allows unlimited practice in a safe yet familiar environment. Training in clinical skills can be developed, together with competency in crisis management behaviours such as leadership and communication skills. Although there is evidence demonstrating the popularity, reliability, and validity of simulator training, its superiority over conventional training has not been proven, and research in this area is required.

Anesthesiology↗

PubMed2000

The role of simulation in surgical training.

Surgical training has undergone many changes in the last decade. One outcome of these changes is the interest that has been generated in the possibility of training surgical skills outside the operating theatre. Simulation of surgical procedures and human tissue, if perfect, would allow complete transfer of techniques learnt in a skills laboratory directly to the operating theatre. Several techniques of simulation are available including artificial tissues, animal models and virtual reality computer simulation. Each is discussed in this article and their advantages and disadvantages considered.

Computer Simulation↗

PubMed1998

Task and training requirements analysis methodology (TTRAM): an analytic methodology for identifying potential training uses of simulator networks in teamwork-intensive task environments.

A methodology designed to identify potential application areas for use of networked simulations is presented. The technique, known as task and training requirements analysis methodology (TTRAM), has been independently applied to the analysis of numerous US military aircraft simulator networking requirements, and appears to effectively discriminate tasks that are prone to skill decay, that are critical to mission success, that require high levels of internal and external teamwork, and that require additional training support.

Aviation↗

PubMed1992

Simulator sickness in the U.S. Army UH-60A Blackhawk flight simulator.

Realistic training in aviation now includes the use of sophisticated flight simulators which can provide near total perception of aircraft flight. Reports of simulator sickness seem to be increasing in simulators with multi-directional motion, computer-generated imagery, and infinity optics. A voluntary, subjective, symptom-oriented questionnaire was completed by 141 pilots after training in the UH-60A 2B38 Blackhawk flight simulator. Thirty-six percent reported positive symptoms of motion sickness. Pilots may be at risk if they fly too soon after simulator training and a mandatory grounding time is advised.

Computer Simulation↗

PubMed2002

A comparison of the training value of two types of anesthesia simulators: computer screen-based and mannequin-based simulators.

UNLABELLED: In this study, we compared two different training simulators (the computer screen-based simulator versus the full-scale simulator) with respect to training effectiveness in anesthesia residents. Participants were evaluated in the management of a simulated preprogrammed scenario of anaphylactic shock using two variables: treatment score and diagnosis time. Our results showed that simulators can contribute significantly to the improvement of performance but that learning in treating simulated crisis situations such as anaphylactic shock did not significantly vary between full-scale and computer screen-based simulators. Consequently, the initial decision on whether to use a full-scale or computer screen-based training simulator should be made on the basis of cost and learning objectives rather than on the basis of technical or fidelity criteria. Our results support the contention that screen-based simulators are good devices to acquire technical skills of crisis management. Mannequin-based simulators would probably provide better training for behavioral aspects of crisis management, such as communication, leadership, and interpersonal conflicts, but this was not tested in the current study. IMPLICATIONS: We compared two different training simulators (computer screen-based versus full-scale) for training anesthesia residents to better document the effectiveness of such devices as training tools. This is an important issue, given the extensive use and the high cost of mannequin-based simulators in anesthesiology.

Anaphylaxis↗

PubMed2003

Evaluating minimally invasive surgery training using low-cost mechanical simulations.

BACKGROUND: The goal of this study was to develop, test, and validate the efficacy of inexpensive mechanical minimally invasive surgery (MIS) model simulations for training faculty, residents, and medical students. We sought to demonstrate that trained and experienced MIS surgeon raters could reliably rate the MIS skills acquired during these simulations. METHODS: We developed three renewable models that represent difficult or challenging segments of laparoscopic procedures; laparoscopic appendectomy (LA), laparoscopic cholecystectomy (LC), and laparoscopic inguinal hernia (LH). We videotaped 10 students, 12 surgical residents, and 1 surgeon receiving training on each of the models and again during their posttraining evaluation session. Five MIS surgeons then assessed the evaluation session performance. For each simulation, we asked them to rate overall competence (COM) and four skills: clinical judgment (respect for tissue) (CJ), dexterity (economy of movement) (DEX), serial/simultaneous complexity (SSC), and spatial orientation (SO). We computed intraclass correlation (ICC) coefficients to determine the extent of agreement (i.e., reliability) among ratings. RESULTS: We obtained ICC values of 0.74, 0.84, and 0.81 for COM ratings on LH, LC, and LA, respectively. We also obtained the following ICC values for the same three models: CJ, 0.75, 0.83, and 0.89; DEX, 0.88, 0.86, and 0.89; SSC, 0.82, 0.82, and 0.82; and SO, 0.86, 0.86, and 0.87, respectively. CONCLUSIONS: We obtained very high reliability of performance ratings for competence and surgical skills using a mechanical simulator. Typically, faculty evaluations of residents in the operating room are much less reliable. In contrast, when faculty members observe residents in a controlled, standardized environment, their ratings can be very reliable.

Clinical Competence↗