PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Simulation Training”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed2003

Computer-assisted training system for pars plana vitrectomy.

PURPOSE: To evaluate whether microsurgical steps in vitreoretinal surgery can be taught by a computer-assisted training system. METHODS: This prospective, randomized experimental study included 14 ophthalmic residents and medical students who were completely inexperienced in microsurgery. They were randomized into two groups. The study group underwent training programmes in a computer-assisted training system for simulation of pars plana vitrectomy. The control group did not participate in any in vitro training. In the second phase of the study, participants of both groups performed a pars plana vitrectomy in three pig eyes, which included picking a metallic foreign body from the retinal surface. RESULTS: The amount of retinal detachment and the number of retinal defects at the end of the vitrectomies were smaller, the time needed to remove the foreign body was shorter, the number of retinal lesions associated with the foreign body removal was lower, and the mark given was better in the trained study group than in the untrained group. The relatively small number of study participants did not allow the differences between the study and control groups to reach the 5% level of error probability. CONCLUSIONS: In an animal model, training by a computer-based medical work station for simulation of pars plana vitrectomy showed better outcome measures for trained study participants compared with untrained study participants. Future studies may show whether further refinements of such training programmes will result in statistically significantly better results in surgical outcome parameters.

Adult↗
PubMed2005

Objective benefit of a 1-day training course in endoscopic hemostasis using the "compactEASIE" endoscopy simulator.

BACKGROUND AND STUDY AIMS: The Erlangen Active Simulator for Interventional Endoscopy (EASIE) was introduced in 1997 as a training model for interventional endoscopy. Objective evidence of the benefits of training with this model has not previously been published. As part of two long-term projects, the benefits of a 1-day training course with the "compactEASIE" simulator were evaluated. MATERIALS AND METHODS: Fourteen American and 18 French gastroenterology fellows were enrolled. These fellows were participants in the intensive groups performing training in endoscopic hemostasis, with a total number of 28 fellows in New York and 36 in France. Gastrointestinal endoscopy faculty members in New York and France evaluated and timed the fellows in four disciplines to establish baseline skills (manual skills; injection and coagulation; Hemoclip application; and variceal ligation) with the compactEASIE simulator. The trainees were reevaluated after an intensive 1-day course (with two or three fellows and one instructor per station), also including preparation and assistance for each procedure. The assessment (overall and parts) was done by expert tutors using an ordinal scale ranging from 1 to 10 (1 = poorest, 10 = best), recording also mistakes and performance time. The compactEASIE simulator, equipped with an upper gastrointestinal organ package and an artificial blood perfusion system, was used as the training tool. RESULTS: A highly significant improvement ( P < or = 0.001) was observed in the performance of all endoscopic techniques. A significant reduction in performance time was also observed with three of the four endoscopic techniques. Successful hemostasis was significantly improved in two out of three techniques. CONCLUSIONS: A 1-day training course on endoscopic hemostasis using the compactEASIE simulator is capable of improving the performance of hemostasis procedures. Long-term effects of repeated training sessions are currently subject of collaborative studies in New York and France.

Clinical Competence↗
PubMed2006

Training in laparoscopic urology.

PURPOSE OF REVIEW: Training in laparoscopy has become an important issue in the current surgical scenario. In this overview we aim to update the current knowledge in the field of laparoscopic urological training and to highlight the potential dangers of using simulation for accreditation and selection purposes at this stage. RECENT FINDINGS: Physical simulators are widely available and seem to be equally efficient as virtual reality simulators. Transfer of training has been proven to be beneficial in randomized controlled trials for virtual reality and cholecystectomy. A model for the vesico-urethral suture has been described and integrated in a skills laboratory program. The program has construct validity and can discriminate at least between beginners and advanced laparoscopists. Efforts have still to be made in defining appropriate tools to assess competence and evidence for reliability, and validity must be obtained before including simulators in accreditation programs. SUMMARY: In spite of the abundant literature there is still little evidence about the learning mechanism involved in acquiring laparoscopic skills. Physical and virtual reality simulators have been proven to be efficient in improving dexterity and some evidence exists of a positive transfer from virtual reality to the operating room in cholecystectomy. Very few models, however, have been described for reconstructive urology, and effective transfer to the operating room has not yet been proven, although validation work is in progress in the field of urology.

Clinical Competence↗
PubMed2001

Use of simulation technology in Australian Defence Force resuscitation training.

Realistic training of health personnel for the resuscitation of military casualties is problematic. There are few opportunities for personnel to obtain the necessary experience unless working in a busy emergency or trauma environment. Even so, the specific nature of military trauma means that many aspects of casualty management may not be adequately covered in the civilian domain. This paper discusses the use of advanced simulation technology in the training of military resuscitation teams. Such training has been available to members of the Australian Defence Force (ADF) for two years.

Australia↗
PubMed1993

Correlates of military tank simulator sickness.

A military tank driving simulator is currently widely used as a training aid for tank drivers. The purpose of this study was to investigate the relationship between possible correlates of simulator sickness and the occurrence of sickness and performance test results among simulator drivers. The average number of motion sickness-like symptoms reported after driving the simulator among subjects with a history of susceptibility to motion sickness was 3.4, significantly higher than the average of 1.6 reported among subjects who did not report previous susceptibility to motion sickness (p < 0.05). Subjects driving the simulator while screen image quality was disturbed had a longer reaction time (42.0 s) than when driving the simulator without screen interferences (18.4 s, p = 0.001). Subjects driving the simulator for a short period had the same number of symptoms as did those driving for a longer period, but had better digit symbol test results. There was no statistically significant association between the development of sickness and tank driving experience. Suggested countermeasures are expected to prevent simulator sickness among some of the simulator trainees and to make simulator training more effective.

Adolescent↗
PubMed2002

The effect of intermittent training in hypobaric hypoxia on sea-level exercise: a cross-over study in humans.

The purpose of this study was to examine the effect of intermittent training in a hypobaric chamber on physical exercise at sea level. Over a 10 day period, 16 male triathletes trained for 2 h each day on a cycle ergometer placed in a hypobaric chamber. Training intensity was at 60%-70% of the heart rate reserve. There were 8 subjects who trained at a simulated altitude of 2,500 m, the other 8 trained at sea level. A year later, a cross-over study took place. Baseline measurements were made on a cycle ergometer at sea level, which included an incremental test until exhaustion and a Wingate Anaerobic Test. Altogether, 12 subjects completed the cross-over study. At 9 days after training in hypoxia, significant increases were seen in maximal power output (.W(max))(5.2%), anaerobic mean power (4.1%), and anaerobic peak power (3.8%). A non-significant increase in maximal oxygen uptake (.VO(2max)) of 1.9% was observed. At 9 days after training at sea level, no significant changes were seen in .W(max)(2.1%), .VO(2max) (2.0%), anaerobic mean power (0.2%) and anaerobic peak power (0.2%). When comparing the results of the two training regimes, the anaerobic mean power was the only variable that showed a significantly larger increase as a result of training at altitude. And, although the differences in percentage change between the two training protocols were not significant, they were substantial for as well as for anaerobic peak power. The results of this study indicate that intermittent hypobaric training can improve the anaerobic energy supplying system, and also, to a lesser extent, the aerobic system. It can be concluded that the overall results of the cross-over study showed predominantly improvements in the anaerobic metabolism at variance with the previous study of our own group, where the relative .VO(2max) and .W(max) increased by 7%.

Altitude↗
PubMed2001

Training physicians in communication skills with adolescents using teenage actors as simulated patients.

Role-play exercises with simulated patients may serve the purpose of training professionals to develop appropriate communication skills with adolescents. Authentic adolescent responses toward the physicians may be achieved by actors who themselves are in their teenage years. We describe our experience in continuing medical education programmes for primary care physicians aimed at improving their skills in communicating with adolescents, using simulation methodology with teenage actors. Eight 16-17-year-old actors from the drama department of a high school for the arts were trained to simulate 20 cases with characteristic adolescent medical problems, as well as confidentiality issues and home and school problems. The actors performed in front of large groups of 20-30 paediatricians, family practitioners, or gynaecologists in continuing medical education. Diagnostic issues as well as therapeutic and management approaches were discussed, while the actors provided feedback to the trainees about their understanding and their feeling regarding the issues raised during the exercises. Normally, smaller learning groups are more suitable for such training purposes; nevertheless the participants could appreciate learning the principles of careful listening, a non-judgmental approach and assuring confidentiality. A collaboration of medical schools and postgraduate programmes with high schools which have drama departments may be fruitful in the teaching of adolescent medicine with special emphasis on communication skills with teenagers.

Adolescent↗
PubMed2005

Virtual reality colonoscopy simulation: a compulsory practice for the future colonoscopist?

BACKGROUND AND STUDY AIM: As for any manual procedure, the learning curves for medical interventions can have undesirable phases, occurring mostly in the early experience of applying a technique. There have been impressive advances in endoscopic procedures during recent years, and there is an emerging trend that the number of procedures is increasing in parallel with these. In addition, the introduction of screening programs for colorectal cancer will also increase the numbers of procedures needed. Recent developments in medical simulation seem promising with regard to the possibility of "training out" undesirable parts of the learning curve outside the operating room. The aim of this study was to investigate whether the use of the AccuTouch flexible endoscopy simulator improves the early part of the learning curve in colonoscopy training. METHOD: 12 endoscopy trainees, 10 surgeons and two medical gastroenterologists, all with experience in gastroscopy but with no specific colonoscopy experience, were randomly assigned to either simulator training or to a control group. They all received the same theoretical study package and the training group practiced with the AccuTouch colonoscopy simulator until a predefined expert level of performance was reached. All trainees performed their first ten individual colonoscopies described in detail in a separate protocol. RESULTS: Trainees in the simulator-trained group performed significantly better (P=0.0011) and managed to reach the cecum in 52% of their cases (vs. 19% in the control group), and were 4.53 times more likely to succeed compared with the controls. Additionally, there was a significantly shorter procedure time and less patient discomfort in the hands of the simulator-trained group. CONCLUSION: Skills acquired using the AccuTouch simulator transfer well into the clinical colonoscopy environment. The results of this trial clearly support the plan to integrate simulator training into endoscopic education curricula.

Adult↗
PubMed2005

Hydrometra simulation for VR-based hysteroscopy training.

During hysteroscopy a hydrometra is maintained, i.e. the uterus is distended with liquid media to access and visualize the uterine cavity. The pressure and flow induced by the liquid are crucial tools for he gynecologists during surgery to obtain a clear view of the operation site. This paper presents two different aspects of hydrometra simulation, namely the distension of the uterine muscle and the liquid flow simulation in the cavity. The deformation of the organ's shape is computed offline based on finite element calculations whereas the flow is approximated on the fly by solving the simplified Navier-Stokes equations. The real-time capabilities of the presented algorithms as well as the level of fidelity achieved by the proposed methods are discussed.

Body Fluids↗
PubMed1977

Strategies and techniques for the reduction of sexual anxiety.

In this paper 14 anxiety-reduction techniques are discussed: use of bibliotherapy, use of audiovisual materials, in vivo desensitization via written, programmed exercises; self-exploration/masturbation training; orgasmic reconditioning; simulated orgasm experiences; implosion techniques; sex word desensitization; sexual assertion training; therapist modeling/self-disclosure; systematic desensitization; and cue-controlled relaxation. The sex therapist can integrate these techniques into the sex therapy contract with individuals or couples and use them either singly or in a sequential multiple technique format to reduce sexual anxiety.

Anxiety↗
PubMed1998

Measuring skill acquisition and retention with an ATM simulator: the need for age-specific training.

The present study focused on the type of information presented during training and its effects on initial and retention performance of older and younger adults interacting with computerized, new technology. The effects of emphasizing concepts versus actions during training on performance immediately after training and after a 1-month retention interval were examined. Younger and older adults completed either action or concept training for operating a virtual automatic teller machine (ATM). Overall, action training was associated with faster and more accurate performance immediately after training and better retention performance for older adults. For older adults, value of type of training interacted with type of task component. These findings are applicable to the development of age-specific training materials for computerized tasks.

Adolescent↗
PubMed2002

Training the novice in laparoscopy. More challenge is better.

BACKGROUND: Virtual reality simulation is effective in training the novice to perform basic laparoscopic skills. METHODS: Using the Minimally Invasive Surgery Training--Virtual Reality (MIST-VR) trainer, 27 honors high school students were tested at the easy level, prospectively randomized to eight training sessions at the easy (group A, n = 14) or medium (group B, n = 13) level, then retested at the easy level. RESULTS: Both groups were statistically similar at baseline. All scores improved significantly (50.1% to 81.3%) over the period of training (p < 0.05). Although the group A scores were significantly better than the group B scores throughout training (p < 0.05), on final testing at the easy level, group B surpassed group A for all the tasks except TransferPlace (p = 0.054). CONCLUSIONS: Virtual simulation is an effective laparoscopic training method for the novice, providing significant improvement in skill levels over a relatively short period. More challenging training seems to predict greater improvement over time and better final skill levels.

Adolescent↗
PubMed2001

MEDNET: a medical simulation network grand challenge.

The need to improve war-fighter training led to significant advancements in simulator technology. Now, simulator technology is ready to be applied to a new challenge: an evolutionary approach to training military medical personnel that will result in improved combat casualty care. With the exception of the introduction of helicopter evacuation support during the Korean War, changes in combat casualty care have not significantly altered the percentage of wounded soldiers lost in combat since World War II. The introduction of battlefield simulator training has improved strategic planning and combat readiness. It is time to apply these same tools to improve medical planning, military medical readiness and execution of casualty care.

Computer Communication Networks↗
PubMed2000

S.P.I.C. pedagogical simulator for gynecologic laparoscopy.

Laparoscopic surgery has numerous advantages, but this technique is difficult and requires specific training. This paper presents a simulator for gynecologic laparoscopic surgery called S.P.I.C. (Pedagogical Simulator for Gynecologic Laparoscopic Surgery), specifically designed for teaching. It includes a rail with 3 trocars already in place, and a computer monitor. Training using the simulator is divided into tasks and steps in order of increasing difficulty. Each step consists of training exercises and evaluations. Learning with the simulator is guided by software that allows instructors to personalize their lessons. This prototype has allowed us to put into place training for spatial localization and manipulation of surgical instruments in the abdominal cavity. An evaluation at a clinical site has allowed us to determine the improvements to be made on this prototype. Training with a simulator is part of a resident's regular curriculum and is not meant to replace on site hospital experience. Some imperfections in imaging still exist, due to inevitable technical limitations. Our initial choice was to emphasize realism and "real time", rather than the "aesthetic quality" of the images. Furthermore, by limiting our graphic expectations, we have been able to create a simulator at a reasonable overall price. The S.P.I.C. training tool remains experimental and is still in the process of being developed.

Computer Simulation↗
PubMed2006

Intelligent inferencing and haptic simulation for Chinese acupuncture learning and training.

This paper presents an intelligent virtual environment for Chinese acupuncture learning and training using state-of-the-art virtual reality technology. It is the first step toward developing a comprehensive virtual human model for studying Chinese medicine. Students can learn and practice acupuncture in the proposed 3-D interactive virtual environment that supports a force feedback interface for needle insertion. Thus, students not only "see" but also "touch" the virtual patient. With high performance computers, highly informative and flexible visualization of acupuncture points of various related meridian and collateral can be highlighted to guide the students during training. A computer-based expert system using our newly proposed intelligent fuzzy petri net is designed and implemented to train the students to treat different diseases using acupuncture. Such an intelligent virtual reality system can provide an interesting and effective learning environment for Chinese acupuncture.

Acupuncture↗
PubMedDate not supplied

Successful automatic external defibrillator operation by people trained only in basic life support in a simulated cardiac arrest situation.

OBJECTIVE: To show whether in an in-hospital cardiac arrest, early defibrillation can also be performed by hospital staff trained only in basic life support. BACKGROUND: The International Liaison Committee on Resuscitation (ILCOR) endorses the concept that in many settings non-medical individuals should be allowed and encouraged to use defibrillators. METHODS: Five different groups of hospital staff were evaluated whether they were able to correctly operate an automatic external defibrillator in a simulated sudden cardiac arrest situation without any prior instruction. The participants were assigned either to the 'basic life support-trained' group (BLS, n = 40, or to the 'advanced life support-trained' group (ALS, n = 40). RESULTS: All persons of the 'only BLS-trained' group delivered the three sequential ('stacked') shocks with the automatic external defibrillator when persistent ventricular fibrillation was simulated. The 'ALS-trained' persons successfully delivered the three shocks with the automatic external defibrillator in 98% of the cases. When this group used a conventional defibrillator, only 88% were able to deliver the three shocks, however they were able to do it significantly more quickly. CONCLUSION: Using an automatic defibrillator without any prior instruction, even persons trained only in BLS were able to deliver three sequential shocks in a simulated persistent ventricular fibrillation cardiac arrest.

Adult↗
PubMed2005

A human factors analysis of technical and team skills among surgical trainees during procedural simulations in a simulated operating theatre.

BACKGROUND: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. METHODS: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. RESULTS: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. CONCLUSIONS: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills.

Attention↗