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At least 433 records · Page 24Linked to original sources
PubMed2006

Three-dimensional spatial skill training in a simulated space station: random vs. blocked designs.

BACKGROUND: Astronauts floating inside a spacecraft must be able to recall the direction to surrounding visual landmarks, regardless of their viewing perspective. If 3D orientation skills are taught preflight, should perspective sequences be blocked or randomized? Can standard spatial skill tests predict performance? METHODS: Undergraduates (40 men and 40 women; ages 19-24) learned 3D spatial relationships among landmark pictures in a cubic chamber simulating a space station node. Subjects learned to predict picture directions when told one picture's direction (the one behind them) and the subject's simulated roll orientation, which was changed between trials by rotating pictures. The dependent variable was the proportion of correct predictions. A between group (n=40 per group) independent variable was training type (random vs. blocked sequencing of perspectives). Experiment phase (familiarization, training, transfer, and 2 retention phases) was a within group variable. Subjects also took three standard spatial skill tests: Card Rotation, Cube Comparison, and Group Imbedded Figures. RESULTS: As hypothesized, during training, performance for the random group (0.56) was worse than the blocked group (0.83); during transfer, the random group (0.75) was better than the blocked group (0.56); during retention-i, the random group (0.70) was better than the blocked group (0.55); and during retention-2, the random group (0.76) was better than the blocked group (0.65). Spatial skill tests correlated differently across the two groups, indicating that random sequencing elicits different skills. CONCLUSION: Random presentation enhances 3D spatial skill transfer and retention. Standard spatial tests can predict performance and have the potential to customize training.

Adult↗
PubMed2003

Use of simulated clients in training veterinary undergraduates in communication skills.

A course in communication skills has been developed specifically for veterinary students, based on those delivered at many medical schools, and making extensive use of professional actors as simulated clients. Its aim is to raise awareness of the importance of communication among veterinary undergraduates at all stages of the curriculum, and it allows them to role-play in acted-out scenarios. Facilitated small groups provide an environment in which students can receive feedback on their own performance and also give feedback to their colleagues. An independent evaluation suggests that the opportunity to role-play increased the students' confidence in communicating with others. They were able to identify their personal strengths as communicators and gain insights into the aspects of communication they could improve. Feedback and subsequent discussions were highly valued, with the actors playing a crucial role in providing feedback from the client's perspective. Students were able to use the knowledge they acquired when consulting with real clients. Most of the students suggested that the course should continue in its current format, but with more time provided for it in the curriculum.

Communication↗
PubMed1989

A simulator-based approach to training in aeronautical decision making.

The effectiveness of a simulator-based approach to training pilot skills in risk assessment and decision making was evaluated in a sample of pilots enrolled in a university aviation science program. The 16 experimental group subjects received 4 hours (h) of classroom instruction designed to enhance pilot judgment skills, followed by 4 simulated cross-country flights during which several critical inflight events occurred. Subjects in the control group received classroom instruction in basic instrument flying, followed by simulator sessions emphasizing instrument flight. Measures of pilot judgment were obtained on all subjects before and after the training, and subjects in the experimental judgment-trained group performed significantly better on the posttraining simulation than did control group subjects. The findings suggest that significant gains in pilot decision-making skill can be obtained through the use of the judgment training materials along with simulator practice.

Accidents, Aviation↗
PubMed2003

A lay person versus a trained endoscopist: can the preop endoscopy simulator detect a difference?

The purpose of this study was to establish construct validation of a flexible sigmoidoscopy simulator by comparing training-level grouped subjects. These included clerical staff (n = 10), residents (n = 19), and experts (n = 5). Each participant performed 3 scopes. The ANOVA group-based results for trainer-measured variables are shown in Table 1. These results demonstrate that the flexible sigmoidoscopy simulator distinguished the trained from the untrained and the resident from the expert. Although there was no statistically significant differences between the senior residents and the experts, the expert commonly outperformed the residents. Establishing the transferability of simulator training to real life is next. If the transfer of skill can be established, it may give rise to a new skills training approach.

Administrative Personnel↗
PubMed2001

Simulation as a training and assessment tool in the management of failed intubation in obstetrics.

Failed intubation has been a serious problem in obstetric anaesthesia in the UK. The current study was designed to assess the use of the 'ACCESS' simulator (Anaesthetic Computer-Controlled Emergency Situation Simulator) to evaluate our trainees' performance in an obstetric failed intubation setting. Using a scoring system based on our department's failed intubation drill in obstetrics, 13 junior anaesthetists were recruited for the study and all took part in the simulation exercise. Six weeks later they were all tutored as a group or individually on the important points raised from their first simulations. Two weeks after that, 12 of the candidates were re-tested, and 11 scored better than their first time. The results were confidential and the authors ensured all feedback was of a positive nature. The study shows that a simulator may be a useful tool for assessment of performance in a simulated emergency situation when combined with practice and formal teaching.

Journal Article↗
PubMed2004

[Simulator-based modular human factor training in anesthesiology. Concept and results of the module "Communication and Team Cooperation"].

BACKGROUND: Human factors (HF) play a major role in crisis development and management and simulator training can help to train HF aspects. We developed a modular training concept with psychological intensive briefing. The aim of the study was to see whether learning and transfer in the treatment group (TG) with the module "communication and team-cooperation" differed from that in the control group (CG) without psychological briefing ("anaesthesia crisis resource management type course"). METHODS: A total of 34 residents (TG: n=20, CG: n=14) managed 1 out of 3 scenarios and communication patterns and management were evaluated using video recordings. A questionnaire was answered at the end of the course and 2 months later participants were asked for lessons learnt and behavioral changes. RESULTS: Good communication and medical management showed a significant correlation (r=0.57, p=0.001). The TG showed greater initiative ( p=0.001) and came more often in conflict with the surgeon ( p=0.06). The TG also reported more behavioral changes than the CG 2 months later. The reported benefit of the simulation was training for rare events in the CG, whereas in the TG it was issues of communication and cooperation ( p=0.001). CONCLUSIONS: A training concept with psychological intensive briefing may enhance the transfer of HF aspects more than classical ACRM.

Anesthesia↗
PubMed2003

Simulation in surgical training: educational issues and practical implications.

BACKGROUND: Surgical skills are required by a wide range of health care professionals. Tasks range from simple wound closure to highly complex diagnostic and therapeutic procedures. Technical expertise, although essential, is only one component of a complex picture. By emphasising the importance of knowledge and attitudes, this article aims to locate the acquisition of surgical skills within a wider educational framework. SIMULATORS: Simulators can provide safe, realistic learning environments for repeated practice, underpinned by feedback and objective metrics of performance. Using a simple classification of simulators into model-based, computer-based or hybrid, this paper summarises the current state of the art and describes recent technological developments. Advances in computing have led to the establishment of precision placement and simple manipulation simulators within health care education, while complex manipulation and integrated procedure simulators are still in the development phase. EVALUATION: Tension often exists between the design and evaluation of surgical simulations. A lack of high quality published data is compounded by the difficulties of conducting longitudinal studies in such a fast-moving field. The implications of this tension are discussed. THE WIDER CONTEXT: The emphasis is now shifting from the technology of simulation towards partnership with education and clinical practice. This highlights the need for an integrated learning framework, where knowledge can be acquired alongside technical skills and not in isolation from them. Recent work on situated learning underlines the potential for simulation to feed into and enrich everyday clinical practice.

Clinical Competence↗
PubMed1981

Correlations between visual test results and flying performance on the advanced simulator for pilot training (ASPT).

Looking for visual differences in pilots to account for differences in flying performance, we tested five groups of subjects: Air Force primary student jet pilots, graduating (T38 aircraft) students, Air Force pilot instructors, and two control groups made up of experienced nonpilot aircrew and nonflying civilians. This interim report compares 13 different visual test results with low-visibility landing performance on the Air Force Human Resources Laboratory ASPT simulator. Performance was assessed by the number of crashes and by the distance of the aircraft from the runway threshold at the time of the first visual flight correction. Our main finding was that, for student pilots, landing performance correlated with tracking performance for a target that changed size (as if moving in depth) and also with tracking performance for a target that moved sideways. On the other hand, landing performance correlated comparatively weakly with psychophysical thresholds for motion and contrast. For student pilots, several of the visual tests gave results that correlated with flying grades in T37 and T38 jet aircraft. Tracking tests clearly distinguished between the nonflying group and all the flying groups. On the other hand, visual threshold tests did not distinguish between nonflying and flying groups except for grating contrast, which distinguished between the nonflying group and the pilot instructors. The sideways-motion tracking task was sensitive enough to distinguish between the various flying groups.

Adult↗
PubMed2003

A prospective randomized trial comparing a virtual reality simulator to bedside teaching for training in sigmoidoscopy.

BACKGROUND AND STUDY AIMS: Clinical investigation using endoscopy simulators is now possible due to recent advances in virtual reality technology. A prospective randomized trial was conducted to compare the exclusive use of a virtual reality endoscopy simulator with bedside teaching for training in sigmoidoscopy. MATERIALS AND METHODS: Internal medicine residents were randomly assigned to training exclusively using a virtual reality simulator (group 1) or via bedside teaching (group 2). Residents were then observed performing five sigmoidoscopic procedures in asymptomatic patients referred for colorectal cancer screening. Endoscopic examinations were evaluated for procedure duration, completion, ability to perform retroflexion, and level of patient comfort/discomfort. Each examination was scored from 1 (inability to insert the endoscope beyond the rectum) to 5 (able to complete the entire examination independently in less than 20 min). RESULTS: Sixty-six sigmoidoscopic examinations were completed by nine residents in group 1 (simulator-trained group) and seven residents in group 2 (traditional teaching group). Participants in group 1 had more difficulty with initial endoscope insertion and negotiation of the rectosigmoid junction (mean score +/- SEM 2.9 +/- 0.2) than those in group 2 (3.8 +/- 0.2) ( P < 0.001). The splenic flexure was reached independently in 10 of 34 examinations (29 %) in group 1, compared with 23 of 32 examinations (72 %) in group 2 ( P = 0.001). Retroflexion was successfully performed by 19 of 34 (56 %) in group 1 compared to 27 of 32 (84 %) in group 2 ( P = 0.02). The average procedure time, patient satisfaction, and discomfort associated with the procedure did not differ statistically between the two groups. CONCLUSIONS: The use of a state-of-the-art virtual reality-based endoscopy simulator is inferior to traditional bedside teaching techniques when used exclusively for training medical residents to perform sigmoidoscopy.

Adult↗
PubMed1986

Simulation in surgical training using freeze dried material.

The acquisition of manual dexterity and surgical skills is usually achieved in the operating theatre under supervision. We describe an efficient way of learning intestinal anastomosis procedures with the use of gamma irradiated, lyophilized porcine or bovine tissues together with a purpose designed holding jig. Preliminary evaluation of this method with untrained subjects showed that they were able to improve their performance. Because the tissues are sterile, health hazards are avoided and no special laboratory facilities are required. This approach has promise as an aid to evaluation as well as training.

Animals↗
PubMed2005

Real-time synthesis of bleeding for virtual hysteroscopy.

In this paper we present a method for simulating bleeding in a virtual reality hysteroscopic simulator for surgical training. The simulated bleeding is required to be visually appealing while at the same time instantaneously responsive to any feedback that the surgeon may be conducing to the virtual environment. In order to meet these real-time requirements, we have based the simulation on graphical fluid solvers. These solvers primarily work best over a 2D domain. For correct visualization in the hysteroscopic simulator, it is, however, necessary to perform the simulation fully in 3D. Therefore in this paper we also present the design modifications for 3D graphical fluid solving and show how to use parallelization to maintain real-time behavior. We also discuss how the incorporation of massless particles into the simulation can improve the visual quality of the results by limiting numerical dissipation effects.

Blood Flow Velocity↗