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At least 19 recordsLinked to original sources
PubMed2006

Interactive simulation training: computer simulated standardized patients for medical diagnosis.

SIMmersion LLC is a software development company that creates human interactive training simulations. SIMmersion produces PC-based simulations of people with whom trainees are able to hold conversations. Trainees communicate with simulated characters in face-to-face conversations, using voice recognition technology. Topics that would match well with SIMmersion's simulation capabilities include diagnosis of depression, alcoholism, or drug use, grievance counseling, marriage counseling, suicide intervention, and first responder training for biological terrorism. SIMmersion's technology could be integrated with modeling technology to create a speech-interactive, mannequin-based patient simulation system for healthcare training and assessment. Systems currently being developed involve early detection of smallpox as a result of a biological attack.

Computer Simulation↗
PubMed2006

The human face of simulation: patient-focused simulation training.

Simulation is firmly established within health care training but often focuses on training for technical tasks and can overlook crucial skills such as professionalism and physician-patient communication. The authors locate this paper within current developments in health care and relate it to the literature on simulation. They make the case for placing real human "patients" (played by actors) within simulation environments, thereby ensuring that the training experience remains rooted in actual practice. By practicing repeatedly within a safe environment, technical skills, communication with patients and team members, decision making, and clinical judgment may all be practiced and mastered while preserving patient safety. In elaborating this concept of patient-focused simulation (PFS), the authors draw on work already published by their group and several recent studies that are in review. These explore PFS in low, medium, and high complexity settings. Important or rare situations can be recreated and practiced, as well as key procedures required across a range of experience levels and clinical specialties. Finally, the case is made for curriculum redesign to ensure that simulator-based technical skills training and assessment take place within an authentic context that reflects the wider elements of clinical practice.

Computer Simulation↗
PubMed2005

[Malfunction simulation by spaceflight training simulator].

OBJECTIVE: To implement malfunction simulation in spaceflight training simulator. METHOD: The principle of malfunction simulation was defined according to spacecraft malfunction predict and its countermeasures. The malfunction patterns were classified, and malfunction type was confirmed. A malfunction simulation model was established, and the malfunction simulation was realized by math simulation. RESULT: According to the requirement of astronaut training, a spacecraft subsystem malfunction simulation model was established and realized, such as environment control and life support, GNC, push, power supply, heat control, data management, measure control and communication, structure and so on. CONCLUSION: The malfunction simulation function implemented in the spaceflight training simulator satisfied the requirements for astronaut training.

Accidents, Aviation↗
PubMed2005

Augmented, pulsating tactile feedback facilitates simulator training of clinical breast examinations.

Haptic training devices can facilitate tactile skill development by providing repeatable exposures to rare stimuli. Extant haptic training simulator research primarily emphasizes realistic stimuli representation; however, the experiments reported herein suggest that providing augmented feedback can improve training effectiveness, even when the feedback is not natural. A novel clinical breast examination training device uses inflated balloons embedded in silicone to simulate breast lumps. Oscillating the balloon water pressure makes the lumps pulsate. The pulsating lumps are easier to detect than the static lumps used in current simulators, and this manipulation seems to effectively introduce trainees to small, deep lumps that are initially difficult to perceive. A study of 48 medical students indicates that training with the dynamic breast model increased the number of lumps detected, F(1, 47) = 9.34, p = .004, decreased the number of false positives, F(1, 47) = 5.78, p = .020, and improved intersimulator skill transfer, F(1, 47) = 26.56, p < .001. The results suggest that at least in this case, augmented, tactile feedback increases training effectiveness, despite the fact that the feedback does not attempt to mimic any physical phenomenon present in the natural stimulus. Applications of this research include training techniques and tools for improved detection of palpable cancers.

Adult↗
PubMed2006

Surgical residents' perception of simulation training.

Laparoscopic surgical simulation is a valuable and validated training tool. We examined its perception and use among general surgery residents at our institution. Questionnaires were sent to all 29 general surgery residents with a 93 per cent response rate. Residents were divided into junior residents (JR; PGY 1-2) and senior residents (SR; PGY 3-5). JR spent more hours in the simulation center and completed their assigned tasks faster than SR (14 vs 52 days). Thirty-three per cent of SR felt that simulation training should be limited to JR in contrast to only 8 per cent of JR. However, 93 per cent of residents agreed that the program improved their laparoscopic skills. Most residents feel that simulation training is essential and mandatory in current surgical residency (75% of JR and 67% of SR) and needs to be extended to open surgery (67% JR and 60% SR). Seventy-five per cent of JR, but only 13 per cent of SR, feel that residents' involvement in procedures should be based on performance in surgical simulation. JR ranked simulation training first in useful ways to learn new skills, whereas SR ranked proctorship highest. JR have a higher use of simulation training and a higher perception of its utility.

Attitude of Health Personnel↗
PubMed2006

Simulation training in video-assisted urologic surgery.

The current system of surgical education is facing many challenges in terms of time efficiency, costs, and patient safety. Training using simulation is an emerging area, mostly based on the experience of other high-risk professions like aviation. The goal of simulation-based training in surgery is to develop not only technical but team skills. This learning environment is stress-free and safe, allows standardization and tailoring of training, and also objectively evaluate performances. The development of simulation training is straightforward in endourology, since these procedures are video-assisted and the low degree of freedom of the instruments is easily replicated. On the other hand, these interventions necessitate a long learning curve, training in the operative room is especially costly and risky. Many models are already in use or under development in all fields of video-assisted urologic surgery: ureteroscopy, percutaneous surgery, transurethral resection of the prostate, and laparoscopy. Although bench models are essential, simulation increasingly benefits from the achievements and development of computer technology. Still in its infancy, virtual reality simulation will certainly belong to tomorrow's teaching tools.

Clinical Competence↗
PubMed2006

Tumor growth models to generate pathologies for surgical training simulators.

Many virtual reality based surgical training simulators have been presented in the last few years. These systems promise to alleviate the lack of realistic training possibilities common to minimally invasive procedures. Virtual reality allows for riskless training on a wide range of findings in a condensed period of time. We investigated different methods for the generation of tumor models suitable for surgical training simulators. The goal of our research is a high fidelity hysteroscopy simulator which provides an individual surgical scene for every training. Emphasis was placed on the modeling of growth processes leading to the generation of macroscopically realistic findings of the most common pathologies in hysteroscopy, namely polyps and myomas found in the uterine cavity. Both a cellular automaton and a particle based tumor growth model are presented and discussed.

Cell Proliferation↗
PubMed2004

Improving resident competency in the management of shoulder dystocia with simulation training.

OBJECTIVE: To determine whether a simulation training scenario improves resident competency in the management of shoulder dystocia. METHODS: Residents from 2 training programs participated in this study. The residents were block-randomized by year-group to a training session on shoulder dystocia management that used an obstetric birthing simulator or to a control group with no specific training. Trained residents and control subjects were subsequently tested on a standardized shoulder dystocia scenario, and the encounters were digitally recorded. A physician grader from an external institution then graded and rated the resident's performance with a standardized evaluation sheet. Statistical analysis included the Student t test, chi(2), and regression analysis, as appropriate. RESULTS: Trained residents had significantly higher scores in all evaluation categories, including timelines of their interventions, performance of maneuvers, and overall performance. They also performed the delivery in a shorter time than control subjects (61 versus 146 seconds, P =.003). CONCLUSION: Training with a simulation-training scenario improved resident performance in the management of shoulder dystocia. LEVEL OF EVIDENCE: I

Clinical Competence↗
PubMed1982

A method for training simulated patients.

The purpose of the study on which this article was based was to examine the effectiveness of training simulated patients with self-instructional materials. A six-hour program consisting of eight videotapes and 10 sets of written materials was administered to 54 trainees. Pretest and posttest score comparisons revealed an increase in knowledge about simulation. Most of the trainees (91 percent) stated that the simulation training program increased their competencies in portraying patients. Most important, simulators with the self-instructional training received higher ratings from trainers on their ability to evaluate students than did simulators in the control group.

Education, Medical↗
PubMed2006

[Ultrasound education by simulator training high acceptance by ultrasound trainees of all qualification levels].

Ultrasound education improves by simulator training, however, the acceptance of ultrasound simulator training has not been investigated. Therefore we evaluated the participants response to simulator education during an ultrasound course of abdominal emergencies at an international ultrasound congress, at a regular ultrasound course and during courses at a regional hospital and an university hospital. Altogether, 62.3% of the participants judged the simulator image quality to be good. 84.3% considered the case selection to be good and 92.7% of the participants viewed the educational benefit to be good. 98.5% whished to have further ultrasound simulator courses to be developed and 95.3% of the participants opted for the integration of simulator training into the conventional ultrasound education.

Attitude of Health Personnel↗
PubMed2005

Does simulator training for medical students change patient opinions and attitudes toward medical student procedures in the emergency department?

OBJECTIVES: To determine how simulator training impacts patients' preferences about medical student procedures in the emergency department. METHODS: A questionnaire was administered to a convenience sample of 151 of 185 patients approached (82% participation) seen in the emergency department of a midwestern teaching hospital. The questionnaire asked how many procedures they would prefer a medical student have performed after mastering the procedure on a simulator before allowing the medical student to perform this procedure on them. The procedures included venipuncture, placement of an intravenous line, suturing the face or arm, performing a lumbar puncture, placement of a central line, placement of a nasogastric tube, intubation, and cardioversion. These results were compared with those of a similar study asking about the same procedures without the stipulation that the skill had been mastered on a simulator. RESULTS: A high of 57% (venipuncture) and a low of 11% (placement of a central line) would agree to be a student's first procedure after simulator training. Except for intubating and suturing, participants were more likely (p < 0.05) to allow a medical student to perform a procedure on them after simulator training than without simulator training. Many patients prefer not to have a medical student perform a procedure no matter how many procedures the student has done (low of 21% for venipuncture, high of 55% for placement of a central line). CONCLUSIONS: Patients are more accepting of medical students performing procedures if the skill has been mastered on a simulator. However, many patients do not want a medical student to perform a procedure on them regardless of the student's level of training.

Adolescent↗
PubMed2003

Validation of medical modeling & simulation training devices and systems.

For almost a decade, research has been conducted in many areas of science to develop medical simulation training devices and even comprehensive training systems. To propel the field, the Telemedicine and Advanced Technology Research Center (TATRC), an agency of the United States Army Medical Research Materiel Command (USAMRMC), has been managing a portfolio of research projects in the area of Medical Modeling and Simulation (MM&S) since 1999. Significant progress has made to identify and harness enabling technologies. Generally, these developments can be categorized in four areas: (1) PC-based interactive multimedia, (2) Digitally Enhanced Mannequins, (3) Virtual Workbench, or "part-task", simulators, and (4) Total Immersion Virtual Reality (TIVR). Many medical simulation-training systems have shown great potential to improve medical training, but the potential shown has been based largely on anecdotal feedback from informal user studies. Formal assessment is needed to determine the degree to which simulator(s) train medical skills and the degree to which skills learned on a simulator transfer to the practice of care. A robust methodology is required as a basis for these assessments. Several scientific workshops sponsored in 2001 focused on algorithm and metrics development in support of surgical simulation. Also in 2001, TATRC chartered a Simulation Working Group (SWG) to develop a robust methodology upon which to base an assessment of the effectiveness of simulation training devices and systems. After the terrorist attacks of September 11, 2001, attention was redirected for a period, and progress was delayed. In the summer of 2002, TATRC chartered a follow-on group called the Validation, Metrics and Simulation (VMAS) Committee. The poster will highlight and summarize the development of the methodology and identify validation studies to be conducted (supported by various funding sources and research programs). The interaction between TATRC and the National Capital Area Medical Simulation Center (NCAMSC) will be noted.

Computer Simulation↗
PubMed2003

[Development of fixed-base full task space flight training simulator].

Fixed-base full task flight training simulator is a very critical and important integrated training facility. It is mostly used in training of integrated skills and tasks, such as running the flight program of manned space flight, dealing with faults, operating and controlling spacecraft flight, communicating information between spacecraft and ground. This simulator was made up of several subentries including spacecraft simulation, simulating cabin, sight image, acoustics, main controlling computer, instructor and assistant support. It has implemented many simulation functions, such as spacecraft environment, spacecraft movement, communicating information between spacecraft and ground, typical faults, manual control and operating training, training control, training monitor, training database management, training data recording, system detecting and so on.

Astronauts↗
PubMed1990

In vivo versus simulation training: an interactional analysis of range and type of training exemplars.

We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives.

Activities of Daily Living↗
PubMed2006

Simulation training and resident performance of singleton vaginal breech delivery.

OBJECTIVE: To determine whether simulation training improves resident competency in the management of a simulated vaginal breech delivery. METHODS: Without advance notice or training, residents from 2 obstetrics and gynecology residency programs participated in a standardized simulation scenario of management of an imminent term vaginal breech delivery. The scenario used an obstetric birth simulator and human actors, with the encounters digitally recorded. Residents then received a training session with the simulator on the proper techniques for vaginal breech delivery. Two weeks later they were retested using a similar simulation scenario. A physician, blinded to training status, graded the residents' performance using a standardized evaluation sheet. Statistical analysis included the Wilcoxon signed rank test, McNemar chi2, regression analysis, and paired t test as appropriate with a P value of less than .05 considered significant. RESULTS: Twenty residents from 2 institutions completed all parts of the study protocol. Trained residents had significantly higher scores in 8 of 12 critical delivery components (P < .05). Overall performance of the delivery and safety in performing the delivery also improved significantly (P = .001 for both). CONCLUSION: Simulation training improved resident performance in the management of a simulated vaginal breech delivery. Performance of a term breech vaginal delivery is well suited for simulation training, because it is uncommon and inevitable, and improper technique may result in significant injury. LEVEL OF EVIDENCE: II-2.

Adult↗
PubMed2006

Viewpoint: power and communication: why simulation training ought to be complemented by experiential and humanist learning.

The authors present an analysis of communication training for medical students using simulation patients, and its possible influence on later doctor-patient relationships. Many empirical studies have shown the various benefits of using simulation patients to teach communication skills, but theoretical sociology and humanistic reflection shed light on some fundamental differences between the student-doctor/actor-patient interactions practiced in simulation encounters and real doctor-patient relationships. In contrast to the usual power dynamics of a doctor-patient relation, those of simulation encounters are inverted and overwritten by an entirely different set of power relations, namely, those of the evaluator-student relationship. Since the power dynamics of real doctor-patient relations are generally overlooked, the altered dynamics of the simulation encounter are not readily perceived, and simulation encounters are thus often mistaken as accurate representations of clinical reality. Exclusive reliance on this pedagogic approach of simulation training may be encouraging students to become "simulation doctors" who act out a good relationship to their patients but have no authentic connection with them. The authors propose that liberal-arts learning and encounters with real patients should be used to cultivate students' abilities to create good doctor-patient relationships, as a compliment to the pedagogic benefits of simulation encounters.

Communication↗
PubMed1998

[SPIC: a training simulator for coelioscopic interventions with gynecologic purpose].

There is much demand for laparoscopy training. We have developed a training simulator for initial training in gynecological laparoscopy. The simulator includes a mannequin with 3 located trocars, a PC and software for managing the graphical part of the training protocol. The objective is to learn how to achieve spatial localization and handle tools within the abdominal cavity. A series of exercises are proposed with increasing degree of difficulty. The simulator can be customized to simulate many different scenarios. The trainer must be present to provide an ultimate assessment of the trainee's experience. This new training tool cannot replace traditional surgical training but can help make it more efficient. The simulator is now being used by residents. Further technical developments are in progress to add further indispensable mechanical interactions (force feed back) to visualize the organ deformations and organ dissections within the abdominal cavity.

Computer Simulation↗
PubMed1993

A training simulator for detecting equipment failure in the anaesthetic machine.

Simulation is often used for training personnel in activities where the consequences of inappropriate actions are serious. We report a realistic training simulator, which can reproduce practically all potential malfunctions in the anaesthetic machine. Using actual standard equipment (Dameca 10750), the interior of the anaesthetic machine has been profoundly modified, whereas the external appearance remains virtually unchanged. The concealed alterations allow 20 different pre-set technical faults to be activated selectively from a mobile control unit. While assisted by an instructor, the trainee performs hands-on interactive experimentation with the simulator, while being exposed to 'unexpected' machine faults, which prompt for interpretation of error symptoms. Alternatively, the trainee can personally activate the simulated symptoms of different component failures, to enhance learning of the functional principles of the apparatus. The latter approach also allows a systematic presentation of defects to be identified by each step in a formal safety checklist for anaesthetic machines.

Anesthesiology↗