Standardised simulation-based emergency and intensive care nursing curriculum to improve nursing students' performance during simulated resuscitation: A quasi-experimental study.

PubMed

Chen, Jie; Yang, Jian; Hu, Fen; Yu, Si-Hong; Yang, Bing-Xiang; Liu, Qian; Zhu, Xiao-Ping

2018-06-01

Simulation-based curriculum has been demonstrated as crucial to nursing education in the development of students' critical thinking and complex clinical skills during a resuscitation simulation. Few studies have comprehensively examined the effectiveness of a standardised simulation-based emergency and intensive care nursing curriculum on the performance of students in a resuscitation simulation. To evaluate the impact of a standardised simulation-based emergency and intensive care nursing curriculum on nursing students' response time in a resuscitation simulation. Two-group, non-randomised quasi-experimental design. A simulation centre in a Chinese University School of Nursing. Third-year nursing students (N = 39) in the Emergency and Intensive Care course were divided into a control group (CG, n = 20) and an experimental group (EG, n = 19). The experimental group participated in a standardised high-technology, simulation-based emergency and intensive care nursing curriculum. The standardised simulation-based curriculum for third-year nursing students consists of three modules: disaster response, emergency care, and intensive care, which include clinical priorities (e.g. triage), basic resuscitation skills, airway/breathing management, circulation management and team work with eighteen lecture hours, six skill-practice hours and twelve simulation hours. The control group took part in the traditional curriculum. This course included the same three modules with thirty-four lecture hours and two skill-practice hours (trauma). Perceived benefits included decreased median (interquartile ranges, IQR) seconds to start compressions [CG 32 (25-75) vs. EG 20 (18-38); p < 0.001] and defibrillation [CG 204 (174-240) vs. EG 167 (162-174); p < 0.001] at the end of the course, compared with compressions [CG 41 (32-49) vs. EG 42 (33-46); p > 0.05] and defibrillation [CG 222 (194-254) vs. EG 221 (214-248); p > 0.05] at the beginning of the course. A

Evidence-Centered Design for Simulation-Based Assessment. CRESST Report 800

ERIC Educational Resources Information Center

Mislevy, Robert J.

2011-01-01

Simulations provide opportunities for individuals to learn and develop skills for situations that may be expensive, time-consuming, or dangerous. Careful design can support a person's learning by tailoring the features of situations to his or her skill level(s), allowing repeated attempts, and by providing timely feedback. Furthermore, simulations…

Implementation of Hydrodynamic Simulation Code in Shock Experiment Design for Alkali Metals

NASA Astrophysics Data System (ADS)

Coleman, A. L.; Briggs, R.; Gorman, M. G.; Ali, S.; Lazicki, A.; Swift, D. C.; Stubley, P. G.; McBride, E. E.; Collins, G.; Wark, J. S.; McMahon, M. I.

2017-10-01

Shock compression techniques enable the investigation of extreme P-T states. In order to probe off-Hugoniot regions of P-T space, target makeup and laser pulse parameters must be carefully designed. HYADES is a hydrodynamic simulation code which has been successfully utilised to simulate shock compression events and refine the experimental parameters required in order to explore new P-T states in alkali metals. Here we describe simulations and experiments on potassium, along with the techniques required to access off-Hugoniot states.

Systems modeling and simulation applications for critical care medicine

PubMed Central

2012-01-01

Critical care delivery is a complex, expensive, error prone, medical specialty and remains the focal point of major improvement efforts in healthcare delivery. Various modeling and simulation techniques offer unique opportunities to better understand the interactions between clinical physiology and care delivery. The novel insights gained from the systems perspective can then be used to develop and test new treatment strategies and make critical care delivery more efficient and effective. However, modeling and simulation applications in critical care remain underutilized. This article provides an overview of major computer-based simulation techniques as applied to critical care medicine. We provide three application examples of different simulation techniques, including a) pathophysiological model of acute lung injury, b) process modeling of critical care delivery, and c) an agent-based model to study interaction between pathophysiology and healthcare delivery. Finally, we identify certain challenges to, and opportunities for, future research in the area. PMID:22703718

Simulation Training in Health Care

DTIC Science & Technology

2015-06-01

Harvey simulates cardiac and lung disease , including blood pressure, breathing, pulses, heart sounds, and murmurs. A significant step toward the...fluoroscopy, cardiovascu- lar and pulmonary disease diagnosis and treatment, anesthesia, patient -centered programs, basic vital signs emergency care, infant...effectiveness. However, in health care, ethical considerations and the quantification of the expenses of clinician “learning” on patients is a challenge to

Developing a Simulation to Study Conflict in Intensive Care Units

PubMed Central

Chiarchiaro, Jared; Schuster, Rachel A.; Ernecoff, Natalie C.; Barnato, Amber E.; Arnold, Robert M.

2015-01-01

Rationale: Although medical simulation is increasingly being used in healthcare education, there are few examples of how to rigorously design a simulation to evaluate and study important communication skills of intensive care unit (ICU) clinicians. Objectives: To use existing best practice recommendations to develop a medical simulation to study conflict management in ICUs, then assess the feasibility, acceptability, and realism of the simulation among ICU clinicians. Methods: The setting was a medical ICU of a tertiary care, university hospital. Participants were 36 physicians who treat critically ill patients: intensivists, palliative medicine specialists, and trainees. Using best-practice guidelines and an iterative, multidisciplinary approach, we developed and refined a simulation involving a critically ill patient, in which the patient had a clear advance directive specifying no use of life support, and a surrogate who was unwilling to follow the patient’s preferences. ICU clinicians participated in the simulation and completed surveys and semistructured interviews to assess the feasibility, acceptability, and realism of the simulation. Measurements and Main Results: All participants successfully completed the simulation, and all perceived conflict with the surrogate (mean conflict score, 4.2 on a 0–10 scale [SD, 2.5; range, 1–10]). Participants reported high realism of the simulation across a range of criteria, with mean ratings of greater than 8 on a 0 to 10 scale for all domains assessed. During semistructured interviews, participants confirmed a high degree of realism and offered several suggestions for improvements. Conclusions: We used existing best practice recommendations to develop a simulation model to study physician–family conflict in ICUs that is feasible, acceptable, and realistic. PMID:25643166

Simulation and curriculum design: a global survey in dental education.

PubMed

Perry, S; Burrow, M F; Leung, W K; Bridges, S M

2017-12-01

Curriculum reforms are being driven by globalization and international standardization. Although new information technologies such as dental haptic virtual reality (VR) simulation systems have provided potential new possibilities for clinical learning in dental curricula, infusion into curricula requires careful planning. This study aimed to identify current patterns in the role and integration of simulation in dental degree curricula internationally. An original internet survey was distributed by invitation to clinical curriculum leaders in dental schools in Asia, Europe, North America, and Oceania (Australia and New Zealand). The results (N = 62) showed Asia, Europe and Oceania tended towards integrated curriculum designs with North America having a higher proportion of traditional curricula. North America had limited implementation of haptic VR simulation technology but reported the highest number of scheduled simulation hours. Australia and New Zealand were the most likely regions to incorporate haptic VR simulation technology. This survey indicated considerable variation in curriculum structure with regionally-specific preferences being evident in terms of curriculum structure, teaching philosophies and motivation for incorporation of VR haptic simulation into curricula. This study illustrates the need for an improved evidence base on dental simulations to inform curriculum designs and psychomotor skill learning in dentistry. © 2017 Australian Dental Association.

Teaching End-of-Life Care Using Interprofessional Simulation.

PubMed

Gannon, Jane; Motycka, Carol; Egelund, Eric; Kraemer, Dale F; Smith, W Thomas; Solomon, Kathleen

2017-04-01

Competency in end-of-life (EOL) care is a growing expectation for health professions students. This study assessed the impact of four EOL care scenarios, using high-fidelity simulation, on the perceived learning needs and attitudes of pharmacy and nursing students. On three campuses, pharmacy students (N = 158) were exposed to standard paper EOL case scenarios, while a fourth campus exposed eight graduate nursing and 37 graduate pharmacy students to simulated versions of the same cases. The paper-based groups produced similar pre-post changes on the End of Life Professional Caregiver Survey. Results were pooled and compared with the simulation-only group, revealing significantly higher changes in pre-post scores for the simulation group. Students participating in the simulation group showed some significant differences in attitudes toward EOL care, compared with students in the classroom setting. [J Nurs Educ. 2017;56(4):205-210.]. Copyright 2017, SLACK Incorporated.

Status of simulation in health care education: an international survey.

PubMed

Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam

2014-01-01

Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages.

Status of simulation in health care education: an international survey

PubMed Central

Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam

2014-01-01

Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254

Simulator design for advanced ISDN satellite design and experiments

NASA Technical Reports Server (NTRS)

Pepin, Gerald R.

1992-01-01

This simulation design task completion report documents the simulation techniques associated with the network models of both the Interim Service ISDN (integrated services digital network) Satellite (ISIS) and the Full Service ISDN Satellite (FSIS) architectures. The ISIS network model design represents satellite systems like the Advanced Communication Technology Satellite (ACTS) orbiting switch. The FSIS architecture, the ultimate aim of this element of the Satellite Communications Applications Research (SCAR) program, moves all control and switching functions on-board the next generation ISDN communication satellite. The technical and operational parameters for the advanced ISDN communications satellite design will be obtained from the simulation of ISIS and FSIS engineering software models for their major subsystems. Discrete events simulation experiments will be performed with these models using various traffic scenarios, design parameters and operational procedures. The data from these simulations will be used to determine the engineering parameters for the advanced ISDN communications satellite.

A high-compression electron gun for C6+ production: concept, simulations and mechanical design

NASA Astrophysics Data System (ADS)

Mertzig, Robert; Breitenfeldt, M.; Mathot, S.; Pitters, J.; Shornikov, A.; Wenander, F.

2017-07-01

In this paper we report on simulations and the mechanical design of a high-compression electron gun for an Electron Beam Ion Source (EBIS) dedicated for production of high intensity and high repetition rate pulses of bare carbon ions for injection into linac-based hadron therapy facilities. The gun is presently under construction at CERN to be retrofitted into the TwinEBIS test bench for experimental studies. We describe the design constraints, show results of numeric simulations and report on the mechanical design featuring several novel ideas. The reported design makes use of combined-function units with reduced number of mechanical joints that were carefully controlled and tuned during the manufacturing phase. The simulations addressed a wide range of topics including the influence of thermal effects, focusing optics, symmetry-breaking misalignments and injection into a full 5 T field.

The Role of Transfer in Designing Games and Simulations for Health: Systematic Review

PubMed Central

Terlouw, Gijs; Wartena, Bard O; van 't Veer, Job TB; Prins, Jelle T; Pierie, Jean Pierre EN

2017-01-01

Background The usefulness and importance of serious games and simulations in learning and behavior change for health and health-related issues are widely recognized. Studies have addressed games and simulations as interventions, mostly in comparison with their analog counterparts. Numerous complex design choices have to be made with serious games and simulations for health, including choices that directly contribute to the effects of the intervention. One of these decisions is the way an intervention is expected to lead to desirable transfer effects. Most designs adopt a first-class transfer rationale, whereas the second class of transfer types seems a rarity in serious games and simulations for health. Objective This study sought to review the literature specifically on the second class of transfer types in the design of serious games and simulations. Focusing on game-like interventions for health and health care, this study aimed to (1) determine whether the second class of transfer is recognized as a road for transfer in game-like interventions, (2) review the application of the second class of transfer type in designing game-like interventions, and (3) assess studies that include second-class transfer types reporting transfer outcomes. Methods A total of 6 Web-based databases were systematically searched by titles, abstracts, and keywords using the search strategy (video games OR game OR games OR gaming OR computer simulation*) AND (software design OR design) AND (fidelity OR fidelities OR transfer* OR behaviour OR behavior). The databases searched were identified as relevant to health, education, and social science. Results A total of 15 relevant studies were included, covering a range of game-like interventions, all more or less mentioning design parameters aimed at transfer. We found 9 studies where first-class transfer was part of the design of the intervention. In total, 8 studies dealt with transfer concepts and fidelity types in game-like intervention

Can Broader Diffusion of Value-Based Insurance Design Increase Benefits from US Health Care without Increasing Costs? Evidence from a Computer Simulation Model

PubMed Central

Scott Braithwaite, R.; Omokaro, Cynthia; Justice, Amy C.; Nucifora, Kimberly; Roberts, Mark S.

2010-01-01

Background Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. Methods and Findings We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (<$100,000 per life-year), would remain unchanged for intermediate- or unknown-value services ($100,000–$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to

Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

PubMed

Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

2010-02-16

Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (<$100,000 per life-year), would remain unchanged for intermediate- or unknown-value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would

Process simulation during the design process makes the difference: process simulations applied to a traditional design.

PubMed

Traversari, Roberto; Goedhart, Rien; Schraagen, Jan Maarten

2013-01-01

The objective is evaluation of a traditionally designed operating room using simulation of various surgical workflows. A literature search showed that there is no evidence for an optimal operating room layout regarding the position and size of an ultraclean ventilation (UCV) canopy with a separate preparation room for laying out instruments and in which patients are induced in the operating room itself. Neither was literature found reporting on process simulation being used for this application. Many technical guidelines and designs have mainly evolved over time, and there is no evidence on whether the proposed measures are also effective for the optimization of the layout for workflows. The study was conducted by applying observational techniques to simulated typical surgical procedures. Process simulations which included complete surgical teams and equipment required for the intervention were carried out for four typical interventions. Four observers used a form to record conflicts with the clean area boundaries and the height of the supply bridge. Preferences for particular layouts were discussed with the surgical team after each simulated procedure. We established that a clean area measuring 3 × 3 m and a supply bridge height of 2.05 m was satisfactory for most situations, provided a movable operation table is used. The only cases in which conflicts with the supply bridge were observed were during the use of a surgical robot (Da Vinci) and a surgical microscope. During multiple trauma interventions, bottlenecks regarding the dimensions of the clean area will probably arise. The process simulation of four typical interventions has led to significantly different operating room layouts than were arrived at through the traditional design process. Evidence-based design, human factors, work environment, operating room, traditional design, process simulation, surgical workflowsPreferred Citation: Traversari, R., Goedhart, R., & Schraagen, J. M. (2013). Process

Virtual Simulated Care Coordination Rounds for Nursing Students.

PubMed

Badowski, Donna M

Implementation of the Affordable Care Act has nursing education reflecting on paradigm shifts in order to prepare nursing students for the evolving health care environment. The traditional focus of nursing education on nursing care in acute care settings does not provide learning experiences in care coordination and transitional care management skills. Virtual simulated care coordination rounds, using the National League for Nursing Advancing Care Excellence resources, offer nursing students an innovative experience in care coordination and transition care management.

Modeling, simulation, and analysis at Sandia National Laboratories for health care systems

NASA Astrophysics Data System (ADS)

Polito, Joseph

1994-12-01

Modeling, Simulation, and Analysis are special competencies of the Department of Energy (DOE) National Laboratories which have been developed and refined through years of national defense work. Today, many of these skills are being applied to the problem of understanding the performance of medical devices and treatments. At Sandia National Laboratories we are developing models at all three levels of health care delivery: (1) phenomenology models for Observation and Test, (2) model-based outcomes simulations for Diagnosis and Prescription, and (3) model-based design and control simulations for the Administration of Treatment. A sampling of specific applications include non-invasive sensors for blood glucose, ultrasonic scanning for development of prosthetics, automated breast cancer diagnosis, laser burn debridement, surgical staple deformation, minimally invasive control for administration of a photodynamic drug, and human-friendly decision support aids for computer-aided diagnosis. These and other projects are being performed at Sandia with support from the DOE and in cooperation with medical research centers and private companies. Our objective is to leverage government engineering, modeling, and simulation skills with the biotechnical expertise of the health care community to create a more knowledge-rich environment for decision making and treatment.

Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

PubMed

Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

2013-02-01

Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high

Simulation training for improving the quality of care for older people: an independent evaluation of an innovative programme for inter-professional education.

PubMed

Ross, Alastair J; Anderson, Janet E; Kodate, Naonori; Thomas, Libby; Thompson, Kellie; Thomas, Beth; Key, Suzie; Jensen, Heidi; Schiff, Rebekah; Jaye, Peter

2013-06-01

This paper describes the evaluation of a 2-day simulation training programme for staff designed to improve teamwork and inpatient care and compassion in an older persons' unit. The programme was designed to improve inpatient care for older people by using mixed modality simulation exercises to enhance teamwork and empathetic and compassionate care. Healthcare professionals took part in: (a) a 1-day human patient simulation course with six scenarios and (b) a 1-day ward-based simulation course involving five 1-h exercises with integrated debriefing. A mixed methods evaluation included observations of the programme, precourse and postcourse confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. Observations showed enjoyment of the course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human patient simulation (t=9; df=56; p<0.001) and ward-based exercises (t=9.3; df=76; p<0.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients. Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons. The study demonstrated that simulation is an effective method for encouraging dignified care and compassion for older persons by teaching team skills and empathetic and sensitive communication with patients and relatives.

Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

PubMed

Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

2012-03-01

To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

Evaluation of cognitive load and emotional states during multidisciplinary critical care simulation sessions.

PubMed

Pawar, Swapnil; Jacques, Theresa; Deshpande, Kush; Pusapati, Raju; Meguerdichian, Michael J

2018-04-01

The simulation in critical care setting involves a heterogeneous group of participants with varied background and experience. Measuring the impacts of simulation on emotional state and cognitive load in this setting is not often performed. The feasibility of such measurement in the critical care setting needs further exploration. Medical and nursing staff with varying levels of experience from a tertiary intensive care unit participated in a standardised clinical simulation scenario. The emotional state of each participant was assessed before and after completion of the scenario using a validated eight-item scale containing bipolar oppositional descriptors of emotion. The cognitive load of each participant was assessed after the completion of the scenario using a validated subjective rating tool. A total of 103 medical and nursing staff participated in the study. The participants felt more relaxed (-0.28±1.15 vs 0.14±1, P<0.005; d=0.39), excited (0.25±0.89 vs 0.55±0.92, P<0.005, d=0.35) and alert (0.85±0.87 vs 1.28±0.73, P<0.00001, d=0.54) following simulation. There was no difference in the mean scores for the remaining five items. The mean cognitive load for all participants was 6.67±1.41. There was no significant difference in the cognitive loads among medical staff versus nursing staff (6.61±2.3 vs 6.62±1.7; P>0.05). A well-designed complex high fidelity critical care simulation scenario can be evaluated to identify the relative cognitive load of the participants' experience and their emotional state. The movement of learners emotionally from a more negative state to a positive state suggests that simulation can be an effective tool for improved knowledge transfer and offers more opportunity for dynamic thinking.

The Role of Transfer in Designing Games and Simulations for Health: Systematic Review.

PubMed

Kuipers, Derek A; Terlouw, Gijs; Wartena, Bard O; van 't Veer, Job Tb; Prins, Jelle T; Pierie, Jean Pierre En

2017-11-24

The usefulness and importance of serious games and simulations in learning and behavior change for health and health-related issues are widely recognized. Studies have addressed games and simulations as interventions, mostly in comparison with their analog counterparts. Numerous complex design choices have to be made with serious games and simulations for health, including choices that directly contribute to the effects of the intervention. One of these decisions is the way an intervention is expected to lead to desirable transfer effects. Most designs adopt a first-class transfer rationale, whereas the second class of transfer types seems a rarity in serious games and simulations for health. This study sought to review the literature specifically on the second class of transfer types in the design of serious games and simulations. Focusing on game-like interventions for health and health care, this study aimed to (1) determine whether the second class of transfer is recognized as a road for transfer in game-like interventions, (2) review the application of the second class of transfer type in designing game-like interventions, and (3) assess studies that include second-class transfer types reporting transfer outcomes. A total of 6 Web-based databases were systematically searched by titles, abstracts, and keywords using the search strategy (video games OR game OR games OR gaming OR computer simulation*) AND (software design OR design) AND (fidelity OR fidelities OR transfer* OR behaviour OR behavior). The databases searched were identified as relevant to health, education, and social science. A total of 15 relevant studies were included, covering a range of game-like interventions, all more or less mentioning design parameters aimed at transfer. We found 9 studies where first-class transfer was part of the design of the intervention. In total, 8 studies dealt with transfer concepts and fidelity types in game-like intervention design in general; 3 studies dealt with

Design and implementation of a virtual world training simulation of ICU first hour handover processes.

PubMed

Brown, Ross; Rasmussen, Rune; Baldwin, Ian; Wyeth, Peta

2012-08-01

Nursing training for an Intensive Care Unit (ICU) is a resource intensive process. High demands are made on staff, students and physical resources. Interactive, 3D computer simulations, known as virtual worlds, are increasingly being used to supplement training regimes in the health sciences; especially in areas such as complex hospital ward processes. Such worlds have been found to be very useful in maximising the utilisation of training resources. Our aim is to design and develop a novel virtual world application for teaching and training Intensive Care nurses in the approach and method for shift handover, to provide an independent, but rigorous approach to teaching these important skills. In this paper we present a virtual world simulator for students to practice key steps in handing over the 24/7 care requirements of intensive care patients during the commencing first hour of a shift. We describe the modelling process to provide a convincing interactive simulation of the handover steps involved. The virtual world provides a practice tool for students to test their analytical skills with scenarios previously provided by simple physical simulations, and live on the job training. Additional educational benefits include facilitation of remote learning, high flexibility in study hours and the automatic recording of a reviewable log from the session. To the best of our knowledge, we believe this is a novel and original application of virtual worlds to an ICU handover process. The major outcome of the work was a virtual world environment for training nurses in the shift handover process, designed and developed for use by postgraduate nurses in training. Copyright © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Linking Six Sigma to simulation: a new roadmap to improve the quality of patient care.

PubMed

Celano, Giovanni; Costa, Antonio; Fichera, Sergio; Tringali, Giuseppe

2012-01-01

Improving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete-event simulation (DES) as a decision-supporting tool in the management of Six Sigma quality improvement projects. A roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define-measure-analyse-design-verify (DMADV) or define-measure-analyse-improve-control (DMAIC) Six Sigma procedures. A case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings. The roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios. The role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete-event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.

Automated Simulation For Analysis And Design

NASA Technical Reports Server (NTRS)

Cantwell, E.; Shenk, Tim; Robinson, Peter; Upadhye, R.

1992-01-01

Design Assistant Workstation (DAWN) software being developed to facilitate simulation of qualitative and quantitative aspects of behavior of life-support system in spacecraft, chemical-processing plant, heating and cooling system of large building, or any of variety of systems including interacting process streams and processes. Used to analyze alternative design scenarios or specific designs of such systems. Expert system will automate part of design analysis: reason independently by simulating design scenarios and return to designer with overall evaluations and recommendations.

Interactive educational simulators in diabetes care.

PubMed

Lehmann, E D

1997-01-01

Since the Diabetes Control and Complications Trial demonstrated the substantial benefits of tight glycaemic control there has been renewed interest in the application of information technology (IT) based techniques for improving the day-to-day care of patients with diabetes mellitus. Computer-based educational approaches have a great deal of potential for patients use, and may offer a means of training more health-care professionals to deliver such improved care. In this article the potential role of IT in diabetes education is reviewed, focusing in particular on the application of compartmental models in both computer-based interactive simulators and educational video games. Close attention is devoted to practical applications-available today-for use by patients, their relatives, students and health-care professionals. The novel features and potential benefits of such methodologies are highlighted and some of the limitations of currently available software are discussed. The need for improved graphical user interfaces, and for further efforts to evaluate such programs and demonstrate an educational benefit from their use are identified as hurdles to their more widespread application. The review concludes with a look to the future and the type of modelling features which should be provided in the next generation of interactive diabetes simulators and educational video games.

Care-givers' reflections on an ethics education immersive simulation care experience: A series of epiphanous events.

PubMed

Gallagher, Ann; Peacock, Matthew; Zasada, Magdalena; Coucke, Trees; Cox, Anna; Janssens, Nele

2017-07-01

There has been little previous scholarship regarding the aims, options and impact of ethics education on residential care-givers. This manuscript details findings from a pragmatic cluster trial evaluating the impact of three different approaches to ethics education. The focus of the article is on one of the interventions, an immersive simulation experience. The simulation experience required residential care-givers to assume the profile of elderly care-recipients for a 24-hr period. The care-givers were student nurses. The project was reviewed favourably by a university ethics committee, and participants provided informed consent. Data from six postsimulation experience focus groups were analysed thematically and three themes were identified: the experience of vulnerability, dignity in care and the organisation of care. Findings suggest that the immersive simulation experience had a powerful immediate impact as participants described epiphanous insights relating to their care experiences. It is suggested that reflecting on and recording epiphanous events has the potential to sustain ethical care practices. Further research is required to evaluate the impact of different ethics education interventions in different cultural contexts. Exploration is also required regarding the meaning and significance of care epiphanies, those "most delicate and evanescent of moments," for the sustainability of ethical care. © 2016 John Wiley & Sons Ltd.

Elective course in acute care using online learning and patient simulation.

PubMed

Seybert, Amy L; Kane-Gill, Sandra L

2011-04-11

To enhance students' knowledge of and critical-thinking skills in the management of acutely ill patients using online independent learning partnered with high-fidelity patient simulation sessions. Students enrolled in the Acute Care Simulation watched 10 weekly Web-based video presentations on various critical care and advanced cardiovascular pharmacotherapy topics. After completing each online module, all students participated in groups in patient-care simulation exercises in which they prepared a pharmacotherapeutic plan for the patient, recommended this plan to the patient's physician, and completed a debriefing session with the facilitator. Students completed a pretest and posttest before and after each simulation exercise, as well as midterm and final evaluations and a satisfaction survey. Pharmacy students significantly improved their scores on 9 of the 10 tests (p ≤ 0.05). Students' performance on the final evaluation improved compared with performance on the midterm evaluation. Overall, students were satisfied with the unique dual approach to learning and enjoyed the realistic patient-care environment that the simulation laboratory provided. Participation in an elective course that combined self-directed Web-based learning and hands-on patient simulation exercises increased pharmacy students' knowledge and critical-thinking skills in acute care.

Continuing Professional Development: Pedagogical Practices of Interprofessional Simulation in Health Care

ERIC Educational Resources Information Center

Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Hult, Håkan; Abrandt Dahlgren, Madeleine

2017-01-01

The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for…

Designing payment for Collaborative Care for Depression in primary care.

PubMed

Bao, Yuhua; Casalino, Lawrence P; Ettner, Susan L; Bruce, Martha L; Solberg, Leif I; Unützer, Jürgen

2011-10-01

To design a bundled case rate for Collaborative Care for Depression (CCD) that aligns incentives with evidence-based depression care in primary care. A clinical information system used by all care managers in a randomized controlled trial of CCD for older primary care patients. We conducted an empirical investigation of factors accounting for variation in CCD resource use over time and across patients. CCD resource use at the patient-episode and patient-month levels was measured by number of care manager contacts and direct patient contact time and analyzed with count data (Poisson or negative binomial) models. Episode-level resource use varies substantially with patient's time in the program. Monthly use declines sharply in the first 6 months regardless of treatment response or remission status, but it remains stable afterwards. An adjusted episode or monthly case rate design better matches payment with variation in resource use compared with a fixed design. Our findings lend support to an episode payment adjusted by number of months receiving CCD and a monthly payment adjusted by the ordinal month. Nonpayment tools including program certification and performance evaluation and reward systems are needed to fully align incentives. © Health Research and Educational Trust.

Instructional design affects the efficacy of simulation-based training in central venous catheterization.

PubMed

Craft, Christopher; Feldon, David F; Brown, Eric A

2014-05-01

Simulation-based learning is a common educational tool in health care training and frequently involves instructional designs based on Experiential Learning Theory (ELT). However, little research explores the effectiveness and efficiency of different instructional design methodologies appropriate for simulations. The aim of this study was to compare 2 instructional design models, ELT and Guided Experiential Learning (GEL), to determine which is more effective for training the central venous catheterization procedure. Using a quasi-experimental randomized block design, nurse anesthetists completed training under 1 of the 2 instructional design models. Performance was assessed using a checklist of central venous catheterization performance, pass rates, and critical action errors. Participants in the GEL condition performed significantly better than those in the ELT condition on the overall checklist score after controlling for individual practice time (F[1, 29] = 4.021, P = .027, Cohen's d = .71), had higher pass rates (P = .006, Cohen's d = 1.15), and had lower rates of failure due to critical action errors (P = .038, Cohen's d = .81). The GEL model of instructional design is significantly more effective than ELT for simulation-based learning of the central venous catheterization procedure, yielding large differences in effect size. Copyright © 2014 Elsevier Inc. All rights reserved.

Patient focused care team design. Critical aspects of a cost-effective design strategy.

PubMed

Leander, W J

1993-01-01

It is the critical, yet largely unknown aspects of Patient Focused care team design--the "how" of a design process--which make LRMC's "Care Pairs" a ground-breaking innovation rather than just a distinctive-sounding name. Unfortunately, many hospital leaders of Patient Focused Care programs know the "what" of LRMC's "Care Pairs" but very little, if anything, about this "how." To create Patient Focused care teams which are "right" for your own institution, you must quantify the Costs of Continuity, Competency and Compartmentalization and their associated benefits. Without these informed trade-offs, you and your hospital will be forced to live with someone else's Patient Focused care team design. In summary, it is what you don't know about LRMC's "Care Pairs," not what you do know, that is important to your Patient Focused Care program. Hospitals just beginning to implement Patient Focused Care must understand this "how" if they are to design effective care teams which optimize the performance of their initial unit(s) within their unique environments. Hospitals like LRMC with established Patient Focused Care units must also periodically draw upon this "how" or they face the very real danger of having their Patient Focused care team design(s) become outdated, less effective and eventually detrimental. Or, said another way: "The man who does not read good books has no advantage over those who cannot." Mark Twain. "An out-of-date Patient Focused hospital has no advantage over those which remain unrestructured." The PFCA. The three critical aspects of Patient Focused care team design explored in this article are just the tip of the iceberg.(ABSTRACT TRUNCATED AT 250 WORDS)

Modeling and Compensation Design for a Power Hardware-in-the-Loop Simulation of an AC Distribution System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ainsworth, Nathan; Hariri, Ali; Prabakar, Kumaraguru

Power hardware-in-the-loop (PHIL) simulation, where actual hardware under text is coupled with a real-time digital model in closed loop, is a powerful tool for analyzing new methods of control for emerging distributed power systems. However, without careful design and compensation of the interface between the simulated and actual systems, PHIL simulations may exhibit instability and modeling inaccuracies. This paper addresses issues that arise in the PHIL simulation of a hardware battery inverter interfaced with a simulated distribution feeder. Both the stability and accuracy issues are modeled and characterized, and a methodology for design of PHIL interface compensation to ensure stabilitymore » and accuracy is presented. The stability and accuracy of the resulting compensated PHIL simulation is then shown by experiment.« less

Role-playing simulation as an educational tool for health care personnel: developing an embedded assessment framework.

PubMed

Libin, Alexander; Lauderdale, Manon; Millo, Yuri; Shamloo, Christine; Spencer, Rachel; Green, Brad; Donnellan, Joyce; Wellesley, Christine; Groah, Suzanne

2010-04-01

Simulation- and video game-based role-playing techniques have been proven effective in changing behavior and enhancing positive decision making in a variety of professional settings, including education, the military, and health care. Although the need for developing assessment frameworks for learning outcomes has been clearly defined, there is a significant gap between the variety of existing multimedia-based instruction and technology-mediated learning systems and the number of reliable assessment algorithms. This study, based on a mixed methodology research design, aims to develop an embedded assessment algorithm, a Knowledge Assessment Module (NOTE), to capture both user interaction with the educational tool and knowledge gained from the training. The study is regarded as the first step in developing an assessment framework for a multimedia educational tool for health care professionals, Anatomy of Care (AOC), that utilizes Virtual Experience Immersive Learning Simulation (VEILS) technology. Ninety health care personnel of various backgrounds took part in online AOC training, choosing from five possible scenarios presenting difficult situations of everyday care. The results suggest that although the simulation-based training tool demonstrated partial effectiveness in improving learners' decision-making capacity, a differential learner-oriented approach might be more effective and capable of synchronizing educational efforts with identifiable relevant individual factors such as sociobehavioral profile and professional background.

Simulation and Spacecraft Design: Engineering Mars Landings.

PubMed

Conway, Erik M

2015-10-01

A key issue in history of technology that has received little attention is the use of simulation in engineering design. This article explores the use of both mechanical and numerical simulation in the design of the Mars atmospheric entry phases of the Viking and Mars Pathfinder missions to argue that engineers used both kinds of simulation to develop knowledge of their designs' likely behavior in the poorly known environment of Mars. Each kind of simulation could be used as a warrant of the other's fidelity, in an iterative process of knowledge construction.

Effects of a Simulation Exercise on Nursing Students' End-of-Life Care Attitudes.

PubMed

Dame, Linda; Hoebeke, Roberta

2016-12-01

Students consider end-of-life care content in their nursing curricula to be inadequate and deficient in promoting the development of the necessary attitudes to care for dying patients. Research identifies simulation as an effective teaching strategy to examine nursing students' attitudes toward end-of-life care. An end-of-life care simulation was developed, implemented, and evaluated. Attitudes toward caring for dying patients were measured pre- and postsimulation on a convenience sample of 57 sophomore nursing students using the Frommelt Attitudes Toward Care of the Dying Scale-Form B. Repeated measures of ANOVA on outcome variables evaluated student attitudes toward end-of-life care. Participation in an end-of-life care simulation resulted in more positive student attitudes toward caring for dying patients (p < .001). Simulation is an active learning strategy to incorporate end-of-life care in nursing curricula and improve student attitudes toward caring for dying patients. [J Nurs Educ. 2016;55(12):701-705.]. Copyright 2016, SLACK Incorporated.

Accessing primary care: a simulated patient study

PubMed Central

Campbell, John L; Carter, Mary; Davey, Antoinette; Roberts, Martin J; Elliott, Marc N; Roland, Martin

2013-01-01

Background Simulated patient, or so-called ‘mystery-shopper’, studies are a controversial, but potentially useful, approach to take when conducting health services research. Aim To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey. Design and setting Observational study in 41 general practices in rural, urban, and inner-city settings in the UK. Method Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey. Results Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients’ reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders’ possible confusion in answering this question. Conclusion Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients’ satisfaction with their practice is not related to practice call handling, but is related to appointment availability. PMID:23561783

Design of object-oriented distributed simulation classes

NASA Technical Reports Server (NTRS)

Schoeffler, James D. (Principal Investigator)

1995-01-01

Distributed simulation of aircraft engines as part of a computer aided design package is being developed by NASA Lewis Research Center for the aircraft industry. The project is called NPSS, an acronym for 'Numerical Propulsion Simulation System'. NPSS is a flexible object-oriented simulation of aircraft engines requiring high computing speed. It is desirable to run the simulation on a distributed computer system with multiple processors executing portions of the simulation in parallel. The purpose of this research was to investigate object-oriented structures such that individual objects could be distributed. The set of classes used in the simulation must be designed to facilitate parallel computation. Since the portions of the simulation carried out in parallel are not independent of one another, there is the need for communication among the parallel executing processors which in turn implies need for their synchronization. Communication and synchronization can lead to decreased throughput as parallel processors wait for data or synchronization signals from other processors. As a result of this research, the following have been accomplished. The design and implementation of a set of simulation classes which result in a distributed simulation control program have been completed. The design is based upon MIT 'Actor' model of a concurrent object and uses 'connectors' to structure dynamic connections between simulation components. Connectors may be dynamically created according to the distribution of objects among machines at execution time without any programming changes. Measurements of the basic performance have been carried out with the result that communication overhead of the distributed design is swamped by the computation time of modules unless modules have very short execution times per iteration or time step. An analytical performance model based upon queuing network theory has been designed and implemented. Its application to realistic configurations has

Design of Object-Oriented Distributed Simulation Classes

NASA Technical Reports Server (NTRS)

Schoeffler, James D.

1995-01-01

Distributed simulation of aircraft engines as part of a computer aided design package being developed by NASA Lewis Research Center for the aircraft industry. The project is called NPSS, an acronym for "Numerical Propulsion Simulation System". NPSS is a flexible object-oriented simulation of aircraft engines requiring high computing speed. It is desirable to run the simulation on a distributed computer system with multiple processors executing portions of the simulation in parallel. The purpose of this research was to investigate object-oriented structures such that individual objects could be distributed. The set of classes used in the simulation must be designed to facilitate parallel computation. Since the portions of the simulation carried out in parallel are not independent of one another, there is the need for communication among the parallel executing processors which in turn implies need for their synchronization. Communication and synchronization can lead to decreased throughput as parallel processors wait for data or synchronization signals from other processors. As a result of this research, the following have been accomplished. The design and implementation of a set of simulation classes which result in a distributed simulation control program have been completed. The design is based upon MIT "Actor" model of a concurrent object and uses "connectors" to structure dynamic connections between simulation components. Connectors may be dynamically created according to the distribution of objects among machines at execution time without any programming changes. Measurements of the basic performance have been carried out with the result that communication overhead of the distributed design is swamped by the computation time of modules unless modules have very short execution times per iteration or time step. An analytical performance model based upon queuing network theory has been designed and implemented. Its application to realistic configurations has not

Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation.

PubMed

Sørensen, Jette Led; Østergaard, Doris; LeBlanc, Vicki; Ottesen, Bent; Konge, Lars; Dieckmann, Peter; Van der Vleuten, Cees

2017-01-21

Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment. Thus, this intentional blend of simulation and real working environments means that in situ simulation brings simulation to the real working environment and provides training where people work. In situ simulation can be either announced or unannounced, the latter also known as a drill. This article presents and discusses the design of SBME and the advantage and disadvantage of the different simulation settings, such as training in simulation-centres, in-house simulations in hospital departments, announced or unannounced in situ simulations. Non-randomised studies argue that in situ simulation is more effective for educational purposes than other types of simulation settings. Conversely, the few comparison studies that exist, either randomised or retrospective, show that choice of setting does not seem to influence individual or team learning. However, hospital department-based simulations, such as in-house simulation and in situ simulation, lead to a gain in organisational learning. To our knowledge no studies have compared announced and unannounced in situ simulation. The literature suggests some improved organisational learning from unannounced in situ simulation; however, unannounced in situ simulation was also found to be challenging to plan and conduct, and more stressful among participants. The importance of

The role of simulation in continuing medical education for acute care physicians: a systematic review.

PubMed

Khanduja, P Kristina; Bould, M Dylan; Naik, Viren N; Hladkowicz, Emily; Boet, Sylvain

2015-01-01

We systematically reviewed the effectiveness of simulation-based education, targeting independently practicing qualified physicians in acute care specialties. We also describe how simulation is used for performance assessment in this population. Data source included: DataMEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL Database of Controlled Trials, and National Health Service Economic Evaluation Database. The last date of search was January 31, 2013. All original research describing simulation-based education for independently practicing physicians in anesthesiology, critical care, and emergency medicine was reviewed. Data analysis was performed in duplicate with further review by a third author in cases of disagreement until consensus was reached. Data extraction was focused on effectiveness according to Kirkpatrick's model. For simulation-based performance assessment, tool characteristics and sources of validity evidence were also collated. Of 39 studies identified, 30 studies focused on the effectiveness of simulation-based education and nine studies evaluated the validity of simulation-based assessment. Thirteen studies (30%) targeted the lower levels of Kirkpatrick's hierarchy with reliance on self-reporting. Simulation was unanimously described as a positive learning experience with perceived impact on clinical practice. Of the 17 remaining studies, 10 used a single group or "no intervention comparison group" design. The majority (n = 17; 44%) were able to demonstrate both immediate and sustained improvements in educational outcomes. Nine studies reported the psychometric properties of simulation-based performance assessment as their sole objective. These predominantly recruited independent practitioners as a convenience sample to establish whether the tool could discriminate between experienced and inexperienced operators and concentrated on a single aspect of validity evidence. Simulation is perceived as a positive learning

Design and Test of Advanced Thermal Simulators for an Alkali Metal-Cooled Reactor Simulator

NASA Technical Reports Server (NTRS)

Garber, Anne E.; Dickens, Ricky E.

2011-01-01

The Early Flight Fission Test Facility (EFF-TF) at NASA Marshall Space Flight Center (MSFC) has as one of its primary missions the development and testing of fission reactor simulators for space applications. A key component in these simulated reactors is the thermal simulator, designed to closely mimic the form and function of a nuclear fuel pin using electric heating. Continuing effort has been made to design simple, robust, inexpensive thermal simulators that closely match the steady-state and transient performance of a nuclear fuel pin. A series of these simulators have been designed, developed, fabricated and tested individually and in a number of simulated reactor systems at the EFF-TF. The purpose of the thermal simulators developed under the Fission Surface Power (FSP) task is to ensure that non-nuclear testing can be performed at sufficiently high fidelity to allow a cost-effective qualification and acceptance strategy to be used. Prototype thermal simulator design is founded on the baseline Fission Surface Power reactor design. Recent efforts have been focused on the design, fabrication and test of a prototype thermal simulator appropriate for use in the Technology Demonstration Unit (TDU). While designing the thermal simulators described in this paper, effort were made to improve the axial power profile matching of the thermal simulators. Simultaneously, a search was conducted for graphite materials with higher resistivities than had been employed in the past. The combination of these two efforts resulted in the creation of thermal simulators with power capacities of 2300-3300 W per unit. Six of these elements were installed in a simulated core and tested in the alkali metal-cooled Fission Surface Power Primary Test Circuit (FSP-PTC) at a variety of liquid metal flow rates and temperatures. This paper documents the design of the thermal simulators, test program, and test results.

Unifying interdisciplinary education: designing and implementing an intern simulation educational curriculum to increase confidence in critical care from PGY1 to PGY2.

PubMed

Bullard, Mark J; Leuck, Jo Anna; Howley, Lisa D

2017-11-06

A longitudinal, multidisciplinary critical care simulation curriculum was developed and implemented within a teaching hospital to address the need for consistent, safe, efficient, and unified critical care training within graduate medical education. Primary goals were to increase learner confidence in critical care topics and procedural skills across all specialties. Secondary goals included improving communication skills and obtaining a high level of learner satisfaction. All interns caring for adult patients within our hospital participated in three 4-h simulation-based sessions scheduled over the second half of their intern year. Pre- and postcurricular surveys evaluated self-confidence in critical care topics, procedures, and communication skills. The Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV) Short Form was used to evaluate facilitator debriefing. Data were compared with Wilcoxon rank sum and signed rank test. Pre- and postcurricular surveys were collected from 51 of 52 interns (98% response rate) in curricular year 1 and 59 of 59 interns (100% response rate) in curricular year 2 in six programs within the hospital. Resident confidence significantly improved in all areas (p < .05). DASH-SV demonstrated overall effective facilitator debriefing and > 75% of interns in both curricular years 1 and 2 expressed a desire for future educational sessions. The implemented curriculum increased learner confidence in select critical care topics, procedures, and communication skills and demonstrated a high level of learner satisfaction. The curriculum has expanded to learners from three other teaching hospitals within our system to unify critical care education for all interns caring for adult patients.

Telecom Link--A Competitive Simulated Design Exercise.

ERIC Educational Resources Information Center

Freeman, J.; Allen, J.

1982-01-01

Telecom link is a structured design exercise concerned with building a telecommunications link between London and Amsterdam. Designed for A-level physics, the simulation requires a minimum of 10 hours. Aims of the exercise, design specifications and technical aspects, and summaries of four possible technologies used in the simulation are…

Competency-based learning in an ambulatory care setting: Implementation of simulation training in the Ambulatory Care Rotation during the final year of the MaReCuM model curriculum.

PubMed

Dusch, Martin; Narciß, Elisabeth; Strohmer, Renate; Schüttpelz-Brauns, Katrin

2018-01-01

Aim: As part of the MaReCuM model curriculum at Medical Faculty Mannheim Heidelberg University, a final year rotation in ambulatory care was implemented and augmented to include ambulatory care simulation. In this paper we describe this ambulatory care simulation, the designated competency-based learning objectives, and evaluate the educational effect of the ambulatory care simulation training. Method: Seventy-five final year medical students participated in the survey (response rate: 83%). The control group completed the ambulatory rotation prior to the implementation of the ambulatory care simulation. The experimental group was required to participate in the simulation at the beginning of the final year rotation in ambulatory care. A survey of both groups was conducted at the beginning and at the end of the rotation. The learning objectives were taken from the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). Results: The ambulatory care simulation had no measurable influence on students' subjectively perceived learning progress, the evaluation of the ambulatory care rotation, or working in an ambulatory care setting. At the end of the rotation participants in both groups reported having gained better insight into treating outpatients. At the beginning of the rotation members of both groups assessed their competencies to be at the same level. The simulated ambulatory scenarios were evaluated by the participating students as being well structured and easy to understand. The scenarios successfully created a sense of time pressure for those confronted with them. The ability to correctly fill out a narcotic prescription form as required was rated significantly higher by those who participated in the simulation. Participation in the ambulatory care simulation had no effect on the other competencies covered by the survey. Discussion: The effect of the four instructional units comprising the ambulatory care simulation

Modeling and Compensation Design for a Power Hardware-in-the-Loop Simulation of an AC Distribution System: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prabakar, Kumaraguru; Ainsworth, Nathan; Pratt, Annabelle

Power hardware-in-the-loop (PHIL) simulation, where actual hardware under text is coupled with a real-time digital model in closed loop, is a powerful tool for analyzing new methods of control for emerging distributed power systems. However, without careful design and compensation of the interface between the simulated and actual systems, PHIL simulations may exhibit instability and modeling inaccuracies. This paper addresses issues that arise in the PHIL simulation of a hardware battery inverter interfaced with a simulated distribution feeder. Both the stability and accuracy issues are modeled and characterized, and a methodology for design of PHIL interface compensation to ensure stabilitymore » and accuracy is presented. The stability and accuracy of the resulting compensated PHIL simulation is then shown by experiment.« less

Simulating care: technology-mediated learning in twenty-first century nursing education.

PubMed

Diener, Elizabeth; Hobbs, Nelda

2012-01-01

The increased reliance on simulation classrooms has proven successful in learning skills. Questions persist concerning the ability of technology-driven robotic devices to form and cultivate caring behaviors, or sufficiently develop interactive nurse-client communication necessary in the context of nursing. This article examines the disconnects created by use of simulation technology in nursing education, raising the question: "Can learning of caring-as-being, be facilitated in simulation classrooms?" We propose that unless time is spent with human beings in the earliest stages of nursing education, transpersonal caring relationships do not have space to develop. Learning, crafting, and maturation of caring behaviors threatens to become a serendipitous event or is no longer perceived as an essential characteristic of nursing. Technology does not negate caring-the isolation it fosters makes transpersonal caring all the more important. We are called to create a new paradigm for nursing education that merges Nightingale's vision with technology's promise. © 2012 Wiley Periodicals, Inc.

Space shuttle visual simulation system design study

NASA Technical Reports Server (NTRS)

1973-01-01

A recommendation and a specification for the visual simulation system design for the space shuttle mission simulator are presented. A recommended visual system is described which most nearly meets the visual design requirements. The cost analysis of the recommended system covering design, development, manufacturing, and installation is reported. Four alternate systems are analyzed.

Nurse students learning acute care by simulation - Focus on observation and debriefing.

PubMed

Abelsson, Anna; Bisholt, Birgitta

2017-05-01

Simulation creates the possibility to experience acute situations during nursing education which cannot easily be achieved in clinical settings. To describe how nursing students learn acute care of patients through simulation exercises, based on observation and debriefing. The study was designed as an observational study inspired by an ethnographic approach. Data was collected through observations and interviews. Data was analyzed using an interpretive qualitative content analysis. Nursing students created space for reflection when needed. There was a positive learning situation when suitable patient scenarios were presented. Observations and discussions with peers gave the students opportunities to identify their own need for knowledge, while also identifying existing knowledge. Reflections could confirm or reject their preparedness for clinical practice. The importance of working in a structured manner in acute care situations became apparent. However, negative feedback to peers was avoided, which led to a loss of learning opportunity. High fidelity simulation training as a method plays an important part in the nursing students' learning. The teacher also plays a key role by asking difficult questions and guiding students towards accurate knowledge. This makes it possible for the students to close knowledge gaps, leading to improved patient safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Design by Dragging: An Interface for Creative Forward and Inverse Design with Simulation Ensembles

PubMed Central

Coffey, Dane; Lin, Chi-Lun; Erdman, Arthur G.; Keefe, Daniel F.

2014-01-01

We present an interface for exploring large design spaces as encountered in simulation-based engineering, design of visual effects, and other tasks that require tuning parameters of computationally-intensive simulations and visually evaluating results. The goal is to enable a style of design with simulations that feels as-direct-as-possible so users can concentrate on creative design tasks. The approach integrates forward design via direct manipulation of simulation inputs (e.g., geometric properties, applied forces) in the same visual space with inverse design via “tugging” and reshaping simulation outputs (e.g., scalar fields from finite element analysis (FEA) or computational fluid dynamics (CFD)). The interface includes algorithms for interpreting the intent of users’ drag operations relative to parameterized models, morphing arbitrary scalar fields output from FEA and CFD simulations, and in-place interactive ensemble visualization. The inverse design strategy can be extended to use multi-touch input in combination with an as-rigid-as-possible shape manipulation to support rich visual queries. The potential of this new design approach is confirmed via two applications: medical device engineering of a vacuum-assisted biopsy device and visual effects design using a physically based flame simulation. PMID:24051845

Design-Based Comparison of Spine Surgery Simulators: Optimizing Educational Features of Surgical Simulators.

PubMed

Ryu, Won Hyung A; Mostafa, Ahmed E; Dharampal, Navjit; Sharlin, Ehud; Kopp, Gail; Jacobs, W Bradley; Hurlbert, R John; Chan, Sonny; Sutherland, Garnette R

2017-10-01

Simulation-based education has made its entry into surgical residency training, particularly as an adjunct to hands-on clinical experience. However, one of the ongoing challenges to wide adoption is the capacity of simulators to incorporate educational features required for effective learning. The aim of this study was to identify strengths and limitations of spine simulators to characterize design elements that are essential in enhancing resident education. We performed a mixed qualitative and quantitative cohort study with a focused survey and interviews of stakeholders in spine surgery pertaining to their experiences on 3 spine simulators. Ten participants were recruited spanning all levels of training and expertise until qualitative analysis reached saturation of themes. Participants were asked to perform lumbar pedicle screw insertion on 3 simulators. Afterward, a 10-item survey was administrated and a focused interview was conducted to explore topics pertaining to the design features of the simulators. Overall impressions of the simulators were positive with regards to their educational benefit, but our qualitative analysis revealed differing strengths and limitations. Main design strengths of the computer-based simulators were incorporation of procedural guidance and provision of performance feedback. The synthetic model excelled in achieving more realistic haptic feedback and incorporating use of actual surgical tools. Stakeholders from trainees to experts acknowledge the growing role of simulation-based education in spine surgery. However, different simulation modalities have varying design elements that augment learning in distinct ways. Characterization of these design characteristics will allow for standardization of simulation curricula in spinal surgery, optimizing educational benefit. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring the Effect of Trauma Care Simulation on Undergraduate Critical Care Nursing Students' Attitude at a College of Nursing, in Jeddah--An Intervention Study

ERIC Educational Resources Information Center

El-Gamal, Seham; de Beer, Jennifer; Sunari, Dalia

2017-01-01

Background: Patient safety has become a priority and prerequisite for the provision for effective quality care. Simulation is seen as one method to ensure patient safety as this method allows for the attainment of skills and promotes the transference of these skills into safe clinical practice. Method: A pretest-posttest research design was used.…

Automated simulation as part of a design workstation

NASA Technical Reports Server (NTRS)

Cantwell, Elizabeth; Shenk, T.; Robinson, P.; Upadhye, R.

1990-01-01

A development project for a design workstation for advanced life-support systems (called the DAWN Project, for Design Assistant Workstation), incorporating qualitative simulation, required the implementation of a useful qualitative simulation capability and the integration of qualitative and quantitative simulation such that simulation capabilities are maximized without duplication. The reason is that to produce design solutions to a system goal, the behavior of the system in both a steady and perturbed state must be represented. The Qualitative Simulation Tool (QST), on an expert-system-like model building and simulation interface toll called ScratchPad (SP), and on the integration of QST and SP with more conventional, commercially available simulation packages now being applied in the evaluation of life-support system processes and components are discussed.

Use of gaming simulation by health care professionals.

PubMed

Smoyak, S A

1977-01-01

Gaming-simulation is being developed foruse in a variety of aspects of health care. A mental health diagnostic and therapeutic application is described for problems in parent-teenager relations; it features gaming, videotaping of interactions, and extensive discussion. Two applications which elucidate the nature of discord between couples and two applications for work-group problems are also described. Gaming-simulation is used in basic and continuing education of health professionals for such issues as problems of dying patients and the aged, and prevention of coronary heart disease. Patients rights issues provide a potential focus for opening dialogues between patients and professionals about all facets of health and illness care.

A channel simulator design study

NASA Technical Reports Server (NTRS)

Devito, D. M.; Goutmann, M. M.; Harper, R. C.

1971-01-01

A propagation path simulator was designed for the channel between a Tracking and Data Relay Satellite in geostationary orbit and a user spacecraft orbiting the earth at an altitude between 200 and 4000 kilometers. The simulator is required to duplicate the time varying parameters of the propagation channel.

Using simulation pedagogy to enhance teamwork and communication in the care of older adults: the ELDER project.

PubMed

Mager, Diana R; Lange, Jean W; Greiner, Philip A; Saracino, Katherine H

2012-08-01

The Expanded Learning and Dedication to Elders in the Region (ELDER) project addressed the needs of under-served older adults by educating health care providers in home health and long-term care facilities. Four agencies in a health professional shortage/medically underserved area participated. Focus groups were held to determine agency-specific educational needs. Curricula from the John A. Hartford Foundation were adapted to design unique curricula for each agency and level of personnel during the first 2 years. The focus of this report is the case-based simulation learning approach used in year 3 to validate application of knowledge and facilitate teamwork and interprofessional communication. Three simulation sessions on varying topics were conducted at each site. Postsimulation surveys and qualitative interviews with hired evaluators showed that participants found simulations helpful to their practice. Tailored on-site education incorporating mid-fidelity simulation was an effective model for translating gerontological knowledge into practice and encouraging communication and teamwork in these settings. Copyright 2012, SLACK Incorporated.

[Simulation in health to improve the delivery of care].

PubMed

Tesnière, Antoine; Fleury, Cynthia

2017-11-01

Simulation in health care is a very effective training tool. Using mannequins, 'standardised patients' or virtual care environments, it encourages participants to reflect on nursing practices while practising in a safe and controlled space. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Design and simulation of a gyroklystron amplifier

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chauhan, M. S., E-mail: mschauhan.rs.ece@iitbhu.ac.in; Swati, M. V.; Jain, P. K.

2015-03-15

In the present paper, a design methodology of the gyroklystron amplifier has been described and subsequently used for the design of a typically selected 200 kW, Ka-band, four-cavity gyroklystron amplifier. This conceptual device design has been validated through the 3D particle-in-cell (PIC) simulation and nonlinear analysis. Commercially available PIC simulation code “MAGIC” has been used for the electromagnetic study at the different location of the device RF interaction structure for the beam-absent case, i.e., eigenmode study as well as for the electron beam and RF wave interaction behaviour study in the beam present case of the gyroklystron. In addition, a practicalmore » problem of misalignment of the RF cavities with drift tubes within the tube has been also investigated and its effect on device performance studied. The analytical and simulation results confirmed the validity of the gyroklystron device design. The PIC simulation results of the present gyroklystron produced a stable RF output power of ∼218 kW for 0% velocity spread at 35 GHz, with ∼45 dB gain, 37% efficiency, and a bandwidth of 0.3% for a 70 kV, 8.2 A gyrating electron beam. The simulated values of RF output power have been found in agreement with the nonlinear analysis results within ∼5%. Further, the PIC simulation has been extended to study a practical problem of misalignment of the cavities axis and drift tube axis of the gyroklystron amplifier and found that the RF output power is more sensitive to misalignments in comparison to the device bandwidth. The present paper, gyroklystron device design, nonlinear analysis, and 3D PIC simulation using commercially available code had been systematically described would be of use to the high-power gyro-amplifier tube designers and research scientists.« less

Zeitgeists and development trends in long-term care facility design.

PubMed

Wang, Chia-Hui; Kuo, Nai-Wen

2006-06-01

Through literature analysis, in-depth interviews, and the application of the Delphi survey, this study explored long-term care resident priorities with regard to long-term care facility design in terms of both physical and psychological needs. This study further clarified changing trends in long-term care concepts; illustrated the impact that such changes are having on long-term care facility design; and summarized zeitgeists related to the architectural design of long-term care facilities. Results of our Delphi survey indicated the following top five priorities in long-term care facility design: (1) creating a home-like feeling; (2) adhering to Universal Design concepts; (3) providing well-defined private sleeping areas; (4) providing adequate social space; and (5) decentralizing residents' rooms into clusters. The three major zeitgeists related to long-term care facility design include: (1) modern long-term care facilities should abandon their traditional "hospital" image and gradually reposition facilities into homelike settings; (2) institution-based care for the elderly should be de-institutionalized under the concept of aging-in-place; and (3) living clusters, rather than traditional hospital-like wards, should be designed into long-term care facilities.

Flexible Multi-Body Spacecraft Simulator: Design, Construction, and Experiments

DTIC Science & Technology

2017-12-01

BODY SPACECRAFT SIMULATOR: DESIGN , CONSTRUCTION, AND EXPERIMENTS by Adam L. Atwood December 2017 Thesis Advisor: Mark Karpenko Second...TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE FLEXIBLE MULTI-BODY SPACECRAFT SIMULATOR: DESIGN , CONSTRUCTION, AND EXPERIMENTS 5...spacecraft simulator for use in testing optimal control-based slew and maneuver designs . The simulator is modified from an earlier prototype, which

Simulator technology as a tool for education in cardiac care.

PubMed

Hravnak, Marilyn; Beach, Michael; Tuite, Patricia

2007-01-01

Assisting nurses in gaining the cognitive and psychomotor skills necessary to safely and effectively care for patients with cardiovascular disease can be challenging for educators. Ideally, nurses would have the opportunity to synthesize and practice these skills in a protected training environment before application in the dynamic clinical setting. Recently, a technology known as high fidelity human simulation was introduced, which permits learners to interact with a simulated patient. The dynamic physiologic parameters and physical assessment capabilities of the simulated patient provide for a realistic learning environment. This article describes the High Fidelity Human Simulation Laboratory at the University of Pittsburgh School of Nursing and presents strategies for using this technology as a tool in teaching complex cardiac nursing care at the basic and advanced practice nursing levels. The advantages and disadvantages of high fidelity human simulation in learning are discussed.

Selecting a dynamic simulation modeling method for health care delivery research-part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force.

PubMed

Marshall, Deborah A; Burgos-Liz, Lina; IJzerman, Maarten J; Crown, William; Padula, William V; Wong, Peter K; Pasupathy, Kalyan S; Higashi, Mitchell K; Osgood, Nathaniel D

2015-03-01

In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling can be used more effectively than other modeling methods. The hierarchical relationship between the health care delivery system, providers, patients, and other stakeholders exhibits a level of complexity that ought to be captured using dynamic simulation modeling methods. As a tool to help researchers decide whether dynamic simulation modeling is an appropriate method for modeling the effects of an intervention on a health care system, we presented the System, Interactions, Multilevel, Understanding, Loops, Agents, Time, Emergence (SIMULATE) checklist consisting of eight elements. This report builds on the previous work, systematically comparing each of the three most commonly used dynamic simulation modeling methods-system dynamics, discrete-event simulation, and agent-based modeling. We review criteria for selecting the most suitable method depending on 1) the purpose-type of problem and research questions being investigated, 2) the object-scope of the model, and 3) the method to model the object to achieve the purpose. Finally, we provide guidance for emerging good practices for dynamic simulation modeling in the health sector, covering all aspects, from the engagement of decision makers in the model design through model maintenance and upkeep. We conclude by providing some recommendations about the application of these methods to add value to informed decision making, with an emphasis on stakeholder engagement, starting with the problem definition. Finally, we identify areas in which further methodological development will likely occur given the growing "volume, velocity and variety" and availability of "big data" to provide empirical evidence and techniques

Interprofessional, simulation-based training in end of life care communication: a pilot study.

PubMed

Efstathiou, Nikolaos; Walker, Wendy Marina

2014-01-01

This paper reports on the process and outcomes of a study, designed to pilot the use of interprofessional, simulation-based training in end of life care communication. Participants comprised 50 final year medicine, nursing, physiotherapy and pharmacy students. Learning methods included observation of role play and facilitated, interactive group discussion. A Likert scale rating questionnaire was used to evaluate the impact of the learning experience. Evaluation data revealed that students were supportive of interprofessional learning and could recognise its benefits. The results indicated self-perceived improvements in knowledge, skills, confidence and competence when dealing with challenging end of life care communication situations. Comparison of pre- and post-intervention scores revealed a statistically significant positive change in the students' perceptions about their level of knowledge (Z = -5.887, p = 0.000). The reported benefits need to be balanced against design and delivery issues that proved labour and resource intensive. Economic evaluation is worthy of further consideration.

Child Care Center Design & the Potential of Architecture.

ERIC Educational Resources Information Center

Abbott, Carl; Abbott, Cooper

This paper discusses the impact of layout and design of child care centers on the education of young children. It asserts that child care facilities must be designed to support and stimulate children's natural developmental processes, providing both direct and indirect educational opportunities. The paper discusses the stages of the design process…

The optical design and simulation of the collimated solar simulator

NASA Astrophysics Data System (ADS)

Zhang, Jun; Ma, Tao

2018-01-01

The solar simulator is a lighting device that can simulate the solar radiation. It has been widely used in the testing of solar cells, satellite space environment simulation and ground experiment, test and calibration precision of solar sensor. The solar simulator mainly consisted of short—arc xenon lamp, ellipsoidal reflectors, a group of optical integrator, field stop, aspheric folding mirror and collimating reflector. In this paper, the solar simulator's optical system basic size are given by calculation. Then the system is optically modeled with the Lighttools software, and the simulation analysis on solar simulator using the Monte Carlo ray -tracing technique is conducted. Finally, the simulation results are given quantitatively by diagrammatic form. The rationality of the design is verified on the basis of theory.

Design principles for simulation games for learning clinical reasoning: A design-based research approach.

PubMed

Koivisto, J-M; Haavisto, E; Niemi, H; Haho, P; Nylund, S; Multisilta, J

2018-01-01

Nurses sometimes lack the competence needed for recognising deterioration in patient conditions and this is often due to poor clinical reasoning. There is a need to develop new possibilities for learning this crucial competence area. In addition, educators need to be future oriented; they need to be able to design and adopt new pedagogical innovations. The purpose of the study is to describe the development process and to generate principles for the design of nursing simulation games. A design-based research methodology is applied in this study. Iterative cycles of analysis, design, development, testing and refinement were conducted via collaboration among researchers, educators, students, and game designers. The study facilitated the generation of reusable design principles for simulation games to guide future designers when designing and developing simulation games for learning clinical reasoning. This study makes a major contribution to research on simulation game development in the field of nursing education. The results of this study provide important insights into the significance of involving nurse educators in the design and development process of educational simulation games for the purpose of nursing education. Copyright © 2017 Elsevier Ltd. All rights reserved.

Designing, Implementing and Evaluating Preclinical Simulation Lab for Maternity Nursing Course

ERIC Educational Resources Information Center

ALFozan, Haya; El Sayed, Yousria; Habib, Farida

2015-01-01

Background: The opportunity for students to deliver care safely in today's, complex health care environment is limited. Simulation allows students to practice skills in a safe environment. Purpose: to assess the students' perception, satisfaction, and learning outcomes after a simulation based maternity course. Method: a quasi experimental design…

[Simulation technologies in anesthesiology, resuscitation and intensive care: state of the problem].

PubMed

Pasechnik, I N; Skobelev, E I; Volkova, N N; Sal'nikov, P S

2014-01-01

The foundation of simulation technologies application in educational process is presented in the article. It is described difficulties during anesthesiologists-resuscitators training and education of physicians of not intensive care specialty in intensive care methods. It was emphasized that new innovative educational stage is formed at present time. It is simulation stage between preclinical and clinical stages. Theoretical foundation and practical evidence of efficiency of simulation training are expressed in detail.

Simulation for the training of human performance and technical skills: the intersection of how we will train health care professionals in the future.

PubMed

Hamman, William R; Beaubien, Jeffrey M; Beaudin-Seiler, Beth M

2009-12-01

The aims of this research are to begin to understand health care teams in their operational environment, establish metrics of performance for these teams, and validate a series of scenarios in simulation that elicit team and technical skills. The focus is on defining the team model that will function in the operational environment in which health care professionals work. Simulations were performed across the United States in 70- to 1000-bed hospitals. Multidisciplinary health care teams analyzed more than 300 hours of videos of health care professionals performing simulations of team-based medical care in several different disciplines. Raters were trained to enhance inter-rater reliability. The study validated event sets that trigger team dynamics and established metrics for team-based care. Team skills were identified and modified using simulation scenarios that employed the event-set-design process. Specific skills (technical and team) were identified by criticality measurement and task analysis methodology. In situ simulation, which includes a purposeful and Socratic Method of debriefing, is a powerful intervention that can overcome inertia found in clinician behavior and latent environmental systems that present a challenge to quality and patient safety. In situ simulation can increase awareness of risks, personalize the risks, and encourage the reflection, effort, and attention needed to make changes to both behaviors and to systems.

NREL: News - Solar Decathlon Design Presentation and Simulation Results

Science.gov Websites

Announced Design Presentation and Simulation Results Announced Monday, September 30, 2002 took first place in the Design Presentation and Simulation Contest at the Solar Village on the National Tech in third. Design Presentation and Simulation is one of ten contests in the Solar Decathlon, which

Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal.

PubMed

Fialho, André S; Oliveira, Mónica D; Sá, Armando B

2011-10-15

Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs) into a new type of organizational unit--family health units (FHUs). This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.

Critical care unit design: a nursing perspective.

PubMed

Williams, M

2001-11-01

The task of designing a new critical care unit is best accomplished with the input of people representing multiple disciplines including architects, engineers, physicians, nurses, and equipment manufacturers. It is imperative that the critical care nursing staff and management take an active role in planning the layout of the unit and patient rooms, as the nurses will be the bedside providers 24 hours a day. The new unit should be designed to offer efficient patient care as well as a healing, comfortable environment for both the patients and their families.

Design and implementation of a simulation exercise for teaching confidentiality of patient information.

PubMed

Snyder, J R

1982-05-01

Allied health students, making the transition from a purely academic to a professional school setting, are suddenly faced with judgment decisions about disclosure of medical information. Obscure guidelines and new interpersonal relationships with other members of the health care team complicate this transition and pose a threat to confidentiality of patient information. This article describes the design and implementation of a simulation exercise to reinforce lecture guidelines specifying disclosure of medical information without risk to the patient or student. The simulation is comprised of 10 critical incidents calling for responses ranging from logical to judgmental. Although written primarily for medical technologists, with emphasis on limitations governing release of patient laboratory data, the simulation approach is presented here as a model for other allied health professions. The use of a latent image format provides learners with positive or negative reinforcement as they learn the consequences of their decisions. The simulation activity described is easily adapted to small group discussion or computer-assisted instruction. While the simulation appears to be an accurate representation of reality, peer and real-life pressures could not be totally simulated.

Nurse training with simulation: an innovative approach to teach complex microsurgery patient care.

PubMed

Flurry, Mitchell; Brooke, Sebastian; Micholetti, Brett; Natoli, Noel; Moyer, Kurtis; Mnich, Stephanie; Potochny, John

2012-10-01

Simulation has become an integral part of education at all levels within the medical field. The ability to allow personnel to practice and learn in a safe and controlled environment makes it a valuable tool for initial training and continued competence verification. An area of specific interest to the reconstructive microsurgeon is assurance that the nursing staff has adequate training and experience to provide optimum care for microsurgery patients. Plastic surgeons in institutions where few microsurgeries are performed face challenges teaching nurses how to care for these complex patients. Because no standard exists to educate microsurgery nurses, learning often happens by chance on-the-job encounters. Outcomes, therefore, may be affected by poor handoffs between inexperienced personnel. Our objective is to create a course that augments such random clinical experience and teaches the knowledge and skills necessary for successful microsurgery through simulated patient scenarios. Quality care reviews at our institution served as the foundation to develop an accredited nursing course providing clinical training for the care of microsurgery patients. The course combined lectures on microsurgery, pharmacology, and flap monitoring as well as simulated operating room, surgical intensive care unit, postanesthesia care unit, Trauma Bay, and Floor scenarios. Evaluation of participants included precourse examination, postcourse examination, and a 6-month follow-up. Average test scores were 72% precourse and 92% postcourse. Educational value, effectiveness of lectures and simulation, and overall course quality was rated very high or high by 86% of respondents; 0% respondents rated it as low. Six-month follow-up test score average was 88%. Learning to care for microsurgery patients should not be left to chance patient encounters on the job. Simulation provides a safe, reproducible, and controlled clinical experience. Our results show that simulation is a highly rated and

Automated simulation as part of a design workstation

NASA Technical Reports Server (NTRS)

Cantwell, E.; Shenk, T.; Robinson, P.; Upadhye, R.

1990-01-01

A development project for a design workstation for advanced life-support systems incorporating qualitative simulation, required the implementation of a useful qualitative simulation capability and the integration of qualitative and quantitative simulations, such that simulation capabilities are maximized without duplication. The reason is that to produce design solutions to a system goal, the behavior of the system in both a steady and perturbed state must be represented. The paper reports on the Qualitative Simulation Tool (QST), on an expert-system-like model building and simulation interface toll called ScratchPad (SP), and on the integration of QST and SP with more conventional, commercially available simulation packages now being applied in the evaluation of life-support system processes and components.

Effects of nursing process-based simulation for maternal child emergency nursing care on knowledge, attitude, and skills in clinical nurses.

PubMed

Kim, Sunghee; Shin, Gisoo

2016-02-01

Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

Forecasting the use of elderly care: a static micro-simulation model.

PubMed

Eggink, Evelien; Woittiez, Isolde; Ras, Michiel

2016-07-01

This paper describes a model suitable for forecasting the use of publicly funded long-term elderly care, taking into account both ageing and changes in the health status of the population. In addition, the impact of socioeconomic factors on care use is included in the forecasts. The model is also suitable for the simulation of possible implications of some specific policy measures. The model is a static micro-simulation model, consisting of an explanatory model and a population model. The explanatory model statistically relates care use to individual characteristics. The population model mimics the composition of the population at future points in time. The forecasts of care use are driven by changes in the composition of the population in terms of relevant characteristics instead of dynamics at the individual level. The results show that a further 37 % increase in the use of elderly care (from 7 to 9 % of the Dutch 30-plus population) between 2008 and 2030 can be expected due to a further ageing of the population. However, the use of care is expected to increase less than if it were based on the increasing number of elderly only (+70 %), due to decreasing disability levels and increasing levels of education. As an application of the model, we simulated the effects of restricting access to residential care to elderly people with severe physical disabilities. The result was a lower growth of residential care use (32 % instead of 57 %), but a somewhat faster growth in the use of home care (35 % instead of 32 %).

The impact of transmural multiprofessional simulation-based obstetric team training on perinatal outcome and quality of care in the Netherlands

PubMed Central

2014-01-01

Background Perinatal mortality and morbidity in the Netherlands is relatively high compared to other European countries. Our country has a unique system with an independent primary care providing care to low-risk pregnancies and a secondary/tertiary care responsible for high-risk pregnancies. About 65% of pregnant women in the Netherlands will be referred from primary to secondary care implicating multiple medical handovers. Dutch audits concluded that in the entire obstetric collaborative network process parameters could be improved. Studies have shown that obstetric team training improves perinatal outcome and that simulation-based obstetric team training implementing crew resource management (CRM) improves team performance. In addition, deliberate practice (DP) improves medical skills. The aim of this study is to analyse whether transmural multiprofessional simulation-based obstetric team training improves perinatal outcome. Methods/Design The study will be implemented in the south-eastern part of the Netherlands with an annual delivery rate of over 9,000. In this area secondary care is provided by four hospitals. Each hospital with referring primary care practices will form a cluster (study group). Within each cluster, teams will be formed of different care providers representing the obstetric collaborative network. CRM and elements of DP will be implemented in the training. To analyse the quality of care as perceived by patients, the Pregnancy and Childbirth Questionnaire (PCQ) will be used. Furthermore, self-reported collaboration between care providers will be assessed. Team performance will be measured by the Clinical Teamwork Scale (CTS). We employ a stepped-wedge trial design with a sequential roll-out of the trainings for the different study groups. Primary outcome will be perinatal mortality and/or admission to a NICU. Secondary outcome will be team performance, quality of care as perceived by patients, and collaboration among care providers. Conclusion

Base Camp Design Simulation Training

DTIC Science & Technology

2011-07-01

States Military Academy undertook a project to bring base camp design and development simulation support into the classrooms of the US Army Engineer...endeavor was to bring simulation support to Army classrooms . Initial discussions between the ORCEN and the Manuever Support Center of Excellence... classrooms . MSCoE acts as TRADOC’s proponent for base camps, subsequently delegated to the Engineer School (one of three branch schools overseen by

Simulation for System Change: Holland Bloorview's Experience Using Simulation to Enhance the Use of Technology at the Point-Of-Care.

PubMed

Hubley, Darlene; Peacocke, Sean; Maxwell, Joanne; Parker, Kathryn

2015-01-01

Simulation has the potential to invigorate teaching practices, facilitate professional development and impact client care. However, there is little literature on using simulation at the level of organizational change in healthcare. In this paper, the authors explore Holland Bloorview Kids Rehabilitation Hospital's experience using simulation to enhance the use of technology at the point-of-care. The simulation event demonstrated documentation using technology in two typical practice environments and allowed learners to discuss the challenges and opportunities. Participant feedback was positive overall, and this article reveals important lessons to support the future use of simulation as an educational tool for organizational change.

Shuttle mission simulator hardware conceptual design report

NASA Technical Reports Server (NTRS)

Burke, J. F.

1973-01-01

The detailed shuttle mission simulator hardware requirements are discussed. The conceptual design methods, or existing technology, whereby those requirements will be fulfilled are described. Information of a general nature on the total design problem plus specific details on how these requirements are to be satisfied are reported. The configuration of the simulator is described and the capabilities for various types of training are identified.

Impact of Hypobarism During Simulated Transport on Critical Care Air Transport Team Performance

DTIC Science & Technology

2017-04-26

AFRL-SA-WP-SR-2017-0008 Impact of Hypobarism During Simulated Transport on Critical Care Air Transport Team Performance Dina...July 2014 – November 2016 4. TITLE AND SUBTITLE Impact of Hypobarism During Simulated Transport on Critical Care Air Transport Team Performance 5a...During Critical Care Air Transport Team Advanced Course validation, three-member teams consisting of a physician, nurse, and respiratory therapist

Simulant Basis for the Standard High Solids Vessel Design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peterson, Reid A.; Fiskum, Sandra K.; Suffield, Sarah R.

The Waste Treatment and Immobilization Plant (WTP) is working to develop a Standard High Solids Vessel Design (SHSVD) process vessel. To support testing of this new design, WTP engineering staff requested that a Newtonian simulant and a non-Newtonian simulant be developed that would represent the Most Adverse Design Conditions (in development) with respect to mixing performance as specified by WTP. The majority of the simulant requirements are specified in 24590-PTF-RPT-PE-16-001, Rev. 0. The first step in this process is to develop the basis for these simulants. This document describes the basis for the properties of these two simulant types. Themore » simulant recipes that meet this basis will be provided in a subsequent document.« less

Biologically-inspired hexapod robot design and simulation

NASA Technical Reports Server (NTRS)

Espenschied, Kenneth S.; Quinn, Roger D.

1994-01-01

The design and construction of a biologically-inspired hexapod robot is presented. A previously developed simulation is modified to include models of the DC drive motors, the motor driver circuits and their transmissions. The application of this simulation to the design and development of the robot is discussed. The mechanisms thought to be responsible for the leg coordination of the walking stick insect were previously applied to control the straight-line locomotion of a robot. We generalized these rules for a robot walking on a plane. This biologically-inspired control strategy is used to control the robot in simulation. Numerical results show that the general body motion and performance of the simulated robot is similar to that of the robot based on our preliminary experimental results.

Simulation for ward processes of surgical care.

PubMed

Pucher, Philip H; Darzi, Ara; Aggarwal, Rajesh

2013-07-01

The role of simulation in surgical education, initially confined to technical skills and procedural tasks, increasingly includes training nontechnical skills including communication, crisis management, and teamwork. Research suggests that many preventable adverse events can be attributed to nontechnical error occurring within a ward context. Ward rounds represent the primary point of interaction between patient and physician but take place without formalized training or assessment. The simulated ward should provide an environment in which processes of perioperative care can be performed safely and realistically, allowing multidisciplinary assessment and training of full ward rounds. We review existing literature and describe our experience in setting up our ward simulator. We examine the facilities, equipment, cost, and personnel required for establishing a surgical ward simulator and consider the scenario development, assessment, and feedback tools necessary to integrate it into a surgical curriculum. Copyright © 2013 Elsevier Inc. All rights reserved.

Engineering design and integration simulation utilization manual

NASA Technical Reports Server (NTRS)

Hirsch, G. N.

1976-01-01

A description of the Engineering Design Integration (EDIN) Simulation System as it exists at Johnson Space Center is provided. A discussion of the EDIN Simulation System capabilities and applications is presented.

Simulation Genres and Student Uptake: The Patient Health Record in Clinical Nursing Simulations

ERIC Educational Resources Information Center

Campbell, Lilly

2017-01-01

Drawing on fieldwork, this article examines nursing students' design and use of a patient health record during clinical simulations, where small teams of students provide nursing care for a robotic patient. The student-designed patient health record provides a compelling example of how simulation genres can both authentically coordinate action…

Design of biped hip simulator using SolidWorks

NASA Astrophysics Data System (ADS)

Zainudin, M. R.; Yahya, A.; Fazli, M. I. M.; Syahrom, A.; Harun, F. K. C.; Nazarudin, M. S.

2017-10-01

The increasing number of people who underwent both hip implant surgery based on World Health Organization (WHO) has received massive attention from researchers lately to develop various types of hip simulators in order to test the hip implant. Various number of hip simulator have been developed with different functions and capabilities. This paper presents the design development of biped hip simulator using SolidWorks software by taking into consideration some improvement and modifications. The finite element method is used to test the design whether it is safe to be used or not. The biped hip simulator has been successfully designed and ready to be fabricated as the endurance testing shown a positive results. The von Mises stress induced in the material is an alloy steel which is 2,975,862.3 N/m2 lower than the yield strength. Thus, the design is safe to be used as it obey the safety criterion.

Lessons Learned from Participatory Design in Dementia Care: Placing Care Partners at the Centre.

PubMed

Hendriks, Niels; Slegers, Karin; Wilkinson, Andrea

2017-01-01

In this paper we analyze the participatory design (PD) process of a health information technology (HIT) project. This project, AToM was situated in dementia care and involved partners from academia, industry and care. The analysis specifically focuses on the role of the care partners in the PD process. We will show that the conditions to enable 'good participatory design' were not fully met and we present a set of actions to prevent this in future HIT projects. Central to our recommended approach is placing the care partners at the centre of the PD project.

Critical Care Performance in a Simulated Military Aircraft Cabin Environment.

PubMed

McNeill, Margaret M

2018-04-01

Critical Care Air Transport Teams care for 5% to 10% of injured patients who are transported on military aircraft to definitive treatment facilities. Little is known about how the aeromedical evacuation environment affects care. To determine the effects of 2 stressors of flight, altitude-induced hypoxia and aircraft noise, and to examine the contributions of fatigue and clinical experience on cognitive and physiological performance of the Critical Care Air Transport Team. This repeated measures 2 × 2 × 4 factorial study included 60 military nurses. The participants completed a simulated patient care scenario under aircraft cabin noise and altitude conditions. Differences in cognitive and physiological performance were analyzed using repeated measures analysis of variance. A multiple regression model was developed to determine the independent contributions of fatigue and clinical experience. Critical care scores ( P = .02) and errors and omissions ( P = .047) were negatively affected by noise. Noise was associated with increased respiratory rate ( P = .02). Critical care scores ( P < .001) and errors and omissions ( P = .002) worsened with altitude-induced hypoxemia. Heart rate and respiratory rate increased with altitude-induced hypoxemia; oxygen saturation decreased ( P < .001 for all 3 variables). In a simulated military aircraft environment, the care of critically ill patients was significantly affected by noise and altitude-induced hypoxemia. The participants did not report much fatigue and experience did not play a role, contrary to most findings in the literature. ©2018 American Association of Critical-Care Nurses.

A computer simulator for development of engineering system design methodologies

NASA Technical Reports Server (NTRS)

Padula, S. L.; Sobieszczanski-Sobieski, J.

1987-01-01

A computer program designed to simulate and improve engineering system design methodology is described. The simulator mimics the qualitative behavior and data couplings occurring among the subsystems of a complex engineering system. It eliminates the engineering analyses in the subsystems by replacing them with judiciously chosen analytical functions. With the cost of analysis eliminated, the simulator is used for experimentation with a large variety of candidate algorithms for multilevel design optimization to choose the best ones for the actual application. Thus, the simulator serves as a development tool for multilevel design optimization strategy. The simulator concept, implementation, and status are described and illustrated with examples.

Overview of the EarthCARE simulator and its applications

NASA Astrophysics Data System (ADS)

van Zadelhoff, G.; Donovan, D. P.; Lajas, D.

2011-12-01

The EarthCARE Simulator (ECSIM) was initially developed in 2004 as a scientific tool to simulate atmospheric scenes, radiative transfer and instrument models for the four instruments of the EarthCARE mission. ECSIM has subsequently been significantly further enhanced and is evolving into a tool for both mission performance assessment and L2 retrieval development. It is an ESA requirement that all L2 retrieval algorithms foreseen for the ground segment will be integrated and tested in ECSIM. It is furthermore envisaged, that the (retrieval part of) ECSIM will be the tool for scientists to work with on updates and new L2 algorithms during the EarthCARE Commissioning phase and beyond. ECSIM is capable of performing 'end to end' simulations of single, or any combination of the EarthCARE instruments. That is, ECSIM starts with an input atmospheric ``scene'', then uses various radiative transfer and instrument models in order to generate synthetic observations which can be subsequently inverted. The results of the inversions may then be compared to the input "truth". ECSIM consists of a modular general framework populated by various models. The models within ECSIM are grouped according to the following scheme: 1) Scene creation models (3D atmospheric scene definition) 2) Orbit models (orbit and orientation of the platform as it overflies the scene) 3) Forward models (calculate the signal impinging on the telescope/antenna of the instrument(s) in question) 4) Instrument models (calculate the instrument response to the signals calculated by the Forward models) 5) Retrieval models (invert the instrument signals to recover relevant geophysical information) Within the default ECSIM models crude instrument specific parameterizations (i.e. empirically based radar reflectivity vs. IWC relationships) are avoided. Instead, the radiative transfer forward models are kept separate (as possible) from the instrument models. In order to accomplish this, the atmospheric scenes are

Insights from molecular dynamics simulations for computational protein design.

PubMed

Childers, Matthew Carter; Daggett, Valerie

2017-02-01

A grand challenge in the field of structural biology is to design and engineer proteins that exhibit targeted functions. Although much success on this front has been achieved, design success rates remain low, an ever-present reminder of our limited understanding of the relationship between amino acid sequences and the structures they adopt. In addition to experimental techniques and rational design strategies, computational methods have been employed to aid in the design and engineering of proteins. Molecular dynamics (MD) is one such method that simulates the motions of proteins according to classical dynamics. Here, we review how insights into protein dynamics derived from MD simulations have influenced the design of proteins. One of the greatest strengths of MD is its capacity to reveal information beyond what is available in the static structures deposited in the Protein Data Bank. In this regard simulations can be used to directly guide protein design by providing atomistic details of the dynamic molecular interactions contributing to protein stability and function. MD simulations can also be used as a virtual screening tool to rank, select, identify, and assess potential designs. MD is uniquely poised to inform protein design efforts where the application requires realistic models of protein dynamics and atomic level descriptions of the relationship between dynamics and function. Here, we review cases where MD simulations was used to modulate protein stability and protein function by providing information regarding the conformation(s), conformational transitions, interactions, and dynamics that govern stability and function. In addition, we discuss cases where conformations from protein folding/unfolding simulations have been exploited for protein design, yielding novel outcomes that could not be obtained from static structures.

Insights from molecular dynamics simulations for computational protein design

PubMed Central

Childers, Matthew Carter; Daggett, Valerie

2017-01-01

A grand challenge in the field of structural biology is to design and engineer proteins that exhibit targeted functions. Although much success on this front has been achieved, design success rates remain low, an ever-present reminder of our limited understanding of the relationship between amino acid sequences and the structures they adopt. In addition to experimental techniques and rational design strategies, computational methods have been employed to aid in the design and engineering of proteins. Molecular dynamics (MD) is one such method that simulates the motions of proteins according to classical dynamics. Here, we review how insights into protein dynamics derived from MD simulations have influenced the design of proteins. One of the greatest strengths of MD is its capacity to reveal information beyond what is available in the static structures deposited in the Protein Data Bank. In this regard simulations can be used to directly guide protein design by providing atomistic details of the dynamic molecular interactions contributing to protein stability and function. MD simulations can also be used as a virtual screening tool to rank, select, identify, and assess potential designs. MD is uniquely poised to inform protein design efforts where the application requires realistic models of protein dynamics and atomic level descriptions of the relationship between dynamics and function. Here, we review cases where MD simulations was used to modulate protein stability and protein function by providing information regarding the conformation(s), conformational transitions, interactions, and dynamics that govern stability and function. In addition, we discuss cases where conformations from protein folding/unfolding simulations have been exploited for protein design, yielding novel outcomes that could not be obtained from static structures. PMID:28239489

Hygrothermal Simulation: A Tool for Building Envelope Design Analysis

Treesearch

Samuel V. Glass; Anton TenWolde; Samuel L. Zelinka

2013-01-01

Is it possible to gauge the risk of moisture problems while designing the building envelope? This article provides a brief introduction to computer-based hygrothermal (heat and moisture) simulation, shows how simulation can be useful as a design tool, and points out a number of im-portant considerations regarding model inputs and limita-tions. Hygrothermal simulation...

Design-based research in designing the model for educating simulation facilitators.

PubMed

Koivisto, Jaana-Maija; Hannula, Leena; Bøje, Rikke Buus; Prescott, Stephen; Bland, Andrew; Rekola, Leena; Haho, Päivi

2018-03-01

The purpose of this article is to introduce the concept of design-based research, its appropriateness in creating education-based models, and to describe the process of developing such a model. The model was designed as part of the Nurse Educator Simulation based learning project, funded by the EU's Lifelong Learning program (2013-1-DK1-LEO05-07053). The project partners were VIA University College, Denmark, the University of Huddersfield, UK and Metropolia University of Applied Sciences, Finland. As an outcome of the development process, "the NESTLED model for educating simulation facilitators" (NESTLED model) was generated. This article also illustrates five design principles that could be applied to other pedagogies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modeling and Simulation for Mission Operations Work System Design

NASA Technical Reports Server (NTRS)

Sierhuis, Maarten; Clancey, William J.; Seah, Chin; Trimble, Jay P.; Sims, Michael H.

2003-01-01

Work System analysis and design is complex and non-deterministic. In this paper we describe Brahms, a multiagent modeling and simulation environment for designing complex interactions in human-machine systems. Brahms was originally conceived as a business process design tool that simulates work practices, including social systems of work. We describe our modeling and simulation method for mission operations work systems design, based on a research case study in which we used Brahms to design mission operations for a proposed discovery mission to the Moon. We then describe the results of an actual method application project-the Brahms Mars Exploration Rover. Space mission operations are similar to operations of traditional organizations; we show that the application of Brahms for space mission operations design is relevant and transferable to other types of business processes in organizations.

Learning Reverse Engineering and Simulation with Design Visualization

NASA Technical Reports Server (NTRS)

Hemsworth, Paul J.

2018-01-01

The Design Visualization (DV) group supports work at the Kennedy Space Center by utilizing metrology data with Computer-Aided Design (CAD) models and simulations to provide accurate visual representations that aid in decision-making. The capability to measure and simulate objects in real time helps to predict and avoid potential problems before they become expensive in addition to facilitating the planning of operations. I had the opportunity to work on existing and new models and simulations in support of DV and NASA’s Exploration Ground Systems (EGS).

Online Simulation of Health Care Reform: Helping Health Educators Learn and Participate

ERIC Educational Resources Information Center

Jecklin, Robert

2010-01-01

Young and healthy undergraduates in health education were not predisposed to learn the complex sprawl of topics in a required course on U.S. Health Care. An online simulation of health care reform was used to encourage student learning about health care and participating in health care reform. Students applied their understanding of high costs,…

A Handy Preterm Infant Incubator for Providing Intensive Care: Simulation, 3D Printed Prototype, and Evaluation.

PubMed

Zaylaa, Amira J; Rashid, Mohamad; Shaib, Mounir; El Majzoub, Imad

2018-01-01

Preterm infants encounter an abrupt delivery before their complete maturity during the third trimester of pregnancy. Polls anticipate an increase in the rates of preterm infants for 2025, especially in middle- and low-income countries. Despite the abundance of intensive care methods for preterm infants, such as, but not limited to, commercial, transport, embrace warmer, radiant warmer, and Kangaroo Mother Care methods, they are either expensive, lack the most essential requirements or specifications, or lack the maternal-preterm bond. This drove us to carry this original research and innovative idea of developing a new 3D printed prototype of a Handy preterm infant incubator. We aim to provide the most indispensable intensive care with the lowest cost, to bestow low-income countries with the Handy incubator's care, preserve the maternal -preterm's bond, and diminish the rate of mortality. Biomedical features, electronics, and biocompatible materials were utilized. The design was simulated, the prototype was 3D printed, and the outcomes were tested and evaluated. Simulation results showed the best fit for the Handy incubator's components. Experimental results showed the 3D-printed prototype and the time elapsed to obtain it. Evaluation results revealed that the overall performance of Kangaroo Mother Care and the embrace warmer was 75 ± 1.4% and 66.7 ± 1.5%, respectively, while the overall performance of our Handy incubator was 91.7 ± 1.6%, thereby our cost-effective Handy incubator surpassed existing intensive care methods. The future step is associating the Handy incubator with more specifications and advancements.

Discrete-event simulation of a wide-area health care network.

PubMed Central

McDaniel, J G

1995-01-01

OBJECTIVE: Predict the behavior and estimate the telecommunication cost of a wide-area message store-and-forward network for health care providers that uses the telephone system. DESIGN: A tool with which to perform large-scale discrete-event simulations was developed. Network models for star and mesh topologies were constructed to analyze the differences in performances and telecommunication costs. The distribution of nodes in the network models approximates the distribution of physicians, hospitals, medical labs, and insurers in the Province of Saskatchewan, Canada. Modeling parameters were based on measurements taken from a prototype telephone network and a survey conducted at two medical clinics. Simulation studies were conducted for both topologies. RESULTS: For either topology, the telecommunication cost of a network in Saskatchewan is projected to be less than $100 (Canadian) per month per node. The estimated telecommunication cost of the star topology is approximately half that of the mesh. Simulations predict that a mean end-to-end message delivery time of two hours or less is achievable at this cost. A doubling of the data volume results in an increase of less than 50% in the mean end-to-end message transfer time. CONCLUSION: The simulation models provided an estimate of network performance and telecommunication cost in a specific Canadian province. At the expected operating point, network performance appeared to be relatively insensitive to increases in data volume. Similar results might be anticipated in other rural states and provinces in North America where a telephone-based network is desired. PMID:7583646

Design and Analysis of Solar Smartflower Simulation by Solidwork Program

NASA Astrophysics Data System (ADS)

Mulyana, Tatang; Sebayang, Darwin; Fajrina, Fildzah; Raihan; Faizal, M.

2018-03-01

The potential of solar energy that is so large in Indonesia can be a driving force for the use of renewable energy as a solution for energy needs. Government with the community can utilize and optimize this technology to increase the electrification ratio up to 100% in all corners of Indonesia. Because of its modular and practical nature, making this technology easy to apply. One of the latest imported products that have started to be offered and sold in Indonesia but not yet widely used for solar power generation is the kind of smartflower. Before using the product, it is of course very important and immediately to undertake an in-depth study of the utilization, use, maintenance, repair, component supply and fabrication. The best way to know the above is through a review of the design and simulation. To meet this need, this paper presents a solar-smartflower design and then simulated using the facilities available in the solidwork program. Solid simulation express is a tool that serves to create power simulation of a design part modelling. With the simulation is very helpful at all to reduce errors in making design. Accurate or not a design created is also influenced by several other factors such as material objects, the silent part of the part, and the load given. The simulation is static simulation and body battery drop test, and based on the results of this simulation is known that the design results have been very satisfactory.

[The Learning Effectiveness of Nurses Participating in a Simulated Radiation Therapy Skin Care Workshop].

PubMed

Lee, Yu-San; Kao, Yu-Hsiu

2016-08-01

The skin reaction rate is 60-95% in cancer patients that receive radiation therapy. This therapy is likely to cause physical and mental discomfort and prolong treatment for patients. The current emphasis on lectures rather than practice to help nurses learn proper skin care practices likely imposes difficulties for nurses to handle various clinical situations. To investigate the learning effectiveness of a simulated radiation therapy skin care workshop for nurses. A total of 34 nurses at a hospital in one health system in northern Taiwan who had never used radiation therapy to provide care to patients were enrolled in this quasi-experimental study. A single group pretest, posttest and post-posttest (6 weeks after intervention) approach was used. At the simulated radiation therapy skin care workshop, we used teaching strategies including Ausubel's direct instruction teaching method and practice on simulated wounds on pig skins. Outcomes were evaluated using "the questionnaire of radiation therapy skin care" and "direct observation of procedural skills checklist". The results from the simulated radiation therapy skin care workshop were analyzed using GEE (generalized estimating equation). The post-posttest and posttest scores increased significantly; knowledge mean score 3.14 (< .001) vs 2.64 (< .001), attitude mean score 2.06 (p < .05) vs 2.24 (p < .001), and skill mean score 2.79 (p < .001) vs 1.68 (p < .001). The simulated radiation therapy skin care workshop demonstrated significant and positive effects on learning outcomes. Therefore, we recommend incorporating this workshop into clinical nursing education and training strategies in the future.

Spinning Rocket Simulator Turntable Design

NASA Technical Reports Server (NTRS)

Miles, Robert W.

2001-01-01

Contained herein is the research and data acquired from the Turntable Design portion of the Spinning Rocket Simulator (SRS) project. The SRS Project studies and eliminates the effect of coning on thrust-propelled spacecraft. This design and construction of the turntable adds a structural support for the SRS model and two degrees of freedom. The two degrees of freedom, radial and circumferential, will help develop a simulated thrust force perpendicular to the plane of the spacecraft model while undergoing an unstable coning motion. The Turntable consists of a ten-foot linear track mounted to a sprocket and press-fit to a thrust bearing. A two-inch high column grounded by a Triangular Baseplate supports this bearing and houses the slip rings and pressurized, air-line swivel. The thrust bearing allows the entire system to rotate under the moment applied through the chain-driven sprocket producing a circumferential degree of freedom. The radial degree of freedom is given to the model through the helically threaded linear track. This track allows the Model Support and Counter Balance to simultaneously reposition according to the coning motion of the Model. Two design factors that hinder the linear track are bending and twist due to torsion. A Standard Aluminum "C" channel significantly reduces these two deflections. Safety considerations dictate the design of all the components involved in this project.

Simulation, Design Abstraction, and SystemC

ERIC Educational Resources Information Center

Harcourt, Ed

2007-01-01

SystemC is a system-level design and simulation language based on C++. We've been using SystemC for computer organization and design projects for the past several years. Because SystemC is embedded in C++ it contains the powerful abstraction mechanisms of C++ not found in traditional hardware description languages, such as support for…

Design of a bounded wave EMP (Electromagnetic Pulse) simulator

NASA Astrophysics Data System (ADS)

Sevat, P. A. A.

1989-06-01

Electromagnetic Pulse (EMP) simulators are used to simulate the EMP generated by a nuclear weapon and to harden equipment against the effects of EMP. At present, DREO has a 1 m EMP simulator for testing computer terminal size equipment. To develop the R and D capability for testing larger objects, such as a helicopter, a much bigger threat level facility is required. This report concerns the design of a bounded wave EMP simulator suitable for testing large size equipment. Different types of simulators are described and their pros and cons are discussed. A bounded wave parallel plate type simulator is chosen for it's efficiency and the least environmental impact. Detailed designs are given for 6 m and 10 m parallel plate type wire grid simulators. Electromagnetic fields inside and outside the simulators are computed. Preliminary specifications for a pulse generator required for the simulator are also given. Finally, the electromagnetic fields radiated from the simulator are computed and discussed.

Traffic signal design and simulation for vulnerable road users safety and bus preemption

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lo, Shih-Ching; Huang, Hsieh-Chu

Mostly, pedestrian car accidents occurred at a signalized interaction is because pedestrians cannot across the intersection safely within the green light. From the viewpoint of pedestrian, there might have two reasons. The first one is pedestrians cannot speed up to across the intersection, such as the elders. The other reason is pedestrians do not sense that the signal phase is going to change and their right-of-way is going to be lost. Developing signal logic to protect pedestrian, who is crossing an intersection is the first purpose of this study. In addition, to improve the reliability and reduce delay of publicmore » transportation service is the second purpose. Therefore, bus preemption is also considered in the designed signal logic. In this study, the traffic data of the intersection of Chong-Qing North Road and Min-Zu West Road, Taipei, Taiwan, is employed to calibrate and validate the signal logic by simulation. VISSIM 5.20, which is a microscopic traffic simulation software, is employed to simulate the signal logic. From the simulated results, the signal logic presented in this study can protect pedestrians crossing the intersection successfully. The design of bus preemption can reduce the average delay. However, the pedestrian safety and bus preemption signal will influence the average delay of cars largely. Thus, whether applying the pedestrian safety and bus preemption signal logic to an intersection or not should be evaluated carefully.« less

In situ pediatric trauma simulation: assessing the impact and feasibility of an interdisciplinary pediatric in situ trauma care quality improvement simulation program.

PubMed

Auerbach, Marc; Roney, Linda; Aysseh, April; Gawel, Marcie; Koziel, Jeannette; Barre, Kimberly; Caty, Michael G; Santucci, Karen

2014-12-01

This study aimed to evaluate the feasibility and measure the impact of an in situ interdisciplinary pediatric trauma quality improvement simulation program. Twenty-two monthly simulations were conducted in a tertiary care pediatric emergency department with the aim of improving the quality of pediatric trauma (February 2010 to November 2012). Each session included 20 minutes of simulated patient care, followed by 30 minutes of debriefing that focused on teamwork, communication, and the identification of gaps in care. A single rater scored the performance of the team in real time using a validated assessment instrument for 6 subcomponents of care (teamwork, airway, intubation, breathing, circulation, and disability). Participants completed a survey and written feedback forms. A trend analysis of the 22 simulations found statistically significant positive trends for overall performance, teamwork, and intubation subcomponents; the strength of the upward trend was the strongest for the teamwork (τ = 0.512), followed by overall performance (τ = 0.488) and intubation (τ = 0.433). Two hundred fifty-one of 398 participants completed the participant feedback form (response rate, 63%), reporting that debriefing was the most valuable aspect of the simulation. An in situ interdisciplinary pediatric trauma simulation quality improvement program resulted in improved validated trauma simulation assessment scores for overall performance, teamwork, and intubation. Participants reported high levels of satisfaction with the program, and debriefing was reported as the most valuable component of the program.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

PubMed

Han, Myong-Ja; Lee, Ju-Ry; Shin, Yu-Jung; Son, Jeong-Suk; Choi, Eun-Joo; Oh, Yun-Hee; Lee, Soon-Haeng; Choi, Hye-Ran

2017-12-21

To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units. A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared. After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations. Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education. © 2017 Japan Academy of Nursing Science.

LSST: Cadence Design and Simulation

NASA Astrophysics Data System (ADS)

Cook, Kem H.; Pinto, P. A.; Delgado, F.; Miller, M.; Petry, C.; Saha, A.; Gee, P. A.; Tyson, J. A.; Ivezic, Z.; Jones, L.; LSST Collaboration

2009-01-01

The LSST Project has developed an operations simulator to investigate how best to observe the sky to achieve its multiple science goals. The simulator has a sophisticated model of the telescope and dome to properly constrain potential observing cadences. This model has also proven useful for investigating various engineering issues ranging from sizing of slew motors, to design of cryogen lines to the camera. The simulator is capable of balancing cadence goals from multiple science programs, and attempts to minimize time spent slewing as it carries out these goals. The operations simulator has been used to demonstrate a 'universal' cadence which delivers the science requirements for a deep cosmology survey, a Near Earth Object Survey and good sampling in the time domain. We will present the results of simulating 10 years of LSST operations using realistic seeing distributions, historical weather data, scheduled engineering downtime and current telescope and camera parameters. These simulations demonstrate the capability of the LSST to deliver a 25,000 square degree survey probing the time domain including 20,000 square degrees for a uniform deep, wide, fast survey, while effectively surveying for NEOs over the same area. We will also present our plans for future development of the simulator--better global minimization of slew time and eventual transition to a scheduler for the real LSST.

Computer Simulation For Design Of TWT's

NASA Technical Reports Server (NTRS)

Bartos, Karen F.; Fite, E. Brian; Shalkhauser, Kurt A.; Sharp, G. Richard

1992-01-01

A three-dimensional finite-element analytical technique facilitates design and fabrication of traveling-wave-tube (TWT) slow-wave structures. Used to perform thermal and mechanical analyses of TWT designed with variety of configurations, geometries, and materials. Using three-dimensional computer analysis, designer able to simulate building and testing of TWT, with consequent substantial saving of time and money. Technique enables detailed look into operation of traveling-wave tubes to help improve performance for future communications systems.

Using simulation to improve the capability of undergraduate nursing students in mental health care.

PubMed

Kunst, Elicia L; Mitchell, Marion; Johnston, Amy N B

2017-03-01

Mental health care is an increasing component of acute patient care and yet mental health care education can be limited in undergraduate nursing programs. The aim of this study was to establish if simulation learning can be an effective method of improving undergraduate nurses' capability in mental health care in an acute care environment. Undergraduate nursing students at an Australian university were exposed to several high-fidelity high-technology simulation activities that incorporated elements of acute emergency nursing practice and acute mental health intervention, scaffolded by theories of learning. This approach provided a safe environment for students to experience clinical practice, and develop their skills for dealing with complex clinical challenges. Using a mixed method approach, the primary domains of interest in this study were student confidence, knowledge and ability. These were self-reported and assessed before and after the simulation activities (intervention) using a pre-validated survey, to gauge the self-rated capacity of students to initiate and complete effective care episodes. Focus group interviews were subsequently held with students who attended placement in the emergency department to explore the impact of the intervention on student performance in this clinical setting. Students who participated in the simulation activity identified and reported significantly increased confidence, knowledge and ability in mental health care post-intervention. They identified key features of the intervention included the impact of its realism on the quality of learning. There is some evidence to suggest that the intervention had an impact on the performance and reflection of students in the clinical setting. This study provides evidence to support the use of simulation to enhance student nurses' clinical capabilities in providing mental health care in acute care environments. Nursing curriculum development should be based on best-evidence to ensure that

Designing simulator-based training: an approach integrating cognitive task analysis and four-component instructional design.

PubMed

Tjiam, Irene M; Schout, Barbara M A; Hendrikx, Ad J M; Scherpbier, Albert J J M; Witjes, J Alfred; van Merriënboer, Jeroen J G

2012-01-01

Most studies of simulator-based surgical skills training have focused on the acquisition of psychomotor skills, but surgical procedures are complex tasks requiring both psychomotor and cognitive skills. As skills training is modelled on expert performance consisting partly of unconscious automatic processes that experts are not always able to explicate, simulator developers should collaborate with educational experts and physicians in developing efficient and effective training programmes. This article presents an approach to designing simulator-based skill training comprising cognitive task analysis integrated with instructional design according to the four-component/instructional design model. This theory-driven approach is illustrated by a description of how it was used in the development of simulator-based training for the nephrostomy procedure.

Nursing Students' Nonverbal Reactions to Malodor in Wound Care Simulation

ERIC Educational Resources Information Center

Baker, Gloria Waters

2012-01-01

Background: Wound care is an essential competency which nursing students are expected to acquire. To foster students' competency, nurse educators use high fidelity simulation to expose nursing students to various wound characteristics. Problem: Little is known about how nursing students react to simulated wound characteristics. Malodor is a…

Housing choices and care home design for people with dementia.

PubMed

Hadjri, Karim; Rooney, Cliona; Faith, Verity

2015-01-01

This article reviews the current state of housing for people with dementia by exploring housing choices available to this group, and identifying potential issues with design of care homes. Older people who wish to age in place are faced with the challenge of adapting their domestic environment to ensure independence, accessibility, and social connectivity. This is even more challenging for people with dementia who continue to live at home, given the risks of self-harm and getting lost. More imaginative and inclusive forms of collective housing are needed. For people with dementia, a move to a new environment is often a stressful experience that causes shock, withdrawal, and anger. Hence, more research is needed to develop more fitting long-term housing options for people with dementia. This article presents a brief review on housing choices and housing design for people with dementia. Interviews with managers of 22 care homes were conducted to explore housing choices and design issues. Results show that the main housing choices available to people with dementia offer different levels of care. The choice of care homes relates to the atmosphere of a home as some occupants favor a homely or relaxing environment and others prefer dynamic settings. A combination of appropriate level of care, a good atmosphere, and design quality within the care home are elements that lead to a more enabling environment. Design of a successful caring environment also requires appropriate care and a positive therapeutic and domestic-looking environment. © The Author(s) 2015.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

PubMed

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

PubMed Central

Verhees, Bart; van Kuijk, Kees

2017-01-01

Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. PMID:29267224

Evolutionary Design and Simulation of a Tube Crawling Inspection Robot

NASA Technical Reports Server (NTRS)

Craft, Michael; Howsman, Tom; ONeil, Daniel; Howell, Joe T. (Technical Monitor)

2002-01-01

The Space Robotics Assembly Team Simulation (SpaceRATS) is an expansive concept that will hopefully lead to a space flight demonstration of a robotic team cooperatively assembling a system from its constitutive parts. A primary objective of the SpaceRATS project is to develop a generalized evolutionary design approach for multiple classes of robots. The portion of the overall SpaceRats program associated with the evolutionary design and simulation of an inspection robot's morphology is the subject of this paper. The vast majority of this effort has concentrated on the use and modification of Darwin2K, a robotic design and simulation software package, to analyze the design of a tube crawling robot. This robot is designed for carrying out inspection duties in relatively inaccessible locations within a liquid rocket engine similar to the SSME. A preliminary design of the tube crawler robot was completed, and the mechanical dynamics of the system were simulated. An evolutionary approach to optimizing a few parameters of the system was utilized, resulting in a more optimum design.

Multi-Agent-Based Simulation of a Complex Ecosystem of Mental Health Care.

PubMed

Kalton, Alan; Falconer, Erin; Docherty, John; Alevras, Dimitris; Brann, David; Johnson, Kyle

2016-02-01

This paper discusses the creation of an Agent-Based Simulation that modeled the introduction of care coordination capabilities into a complex system of care for patients with Serious and Persistent Mental Illness. The model describes the engagement between patients and the medical, social and criminal justice services they interact with in a complex ecosystem of care. We outline the challenges involved in developing the model, including process mapping and the collection and synthesis of data to support parametric estimates, and describe the controls built into the model to support analysis of potential changes to the system. We also describe the approach taken to calibrate the model to an observable level of system performance. Preliminary results from application of the simulation are provided to demonstrate how it can provide insights into potential improvements deriving from introduction of care coordination technology.

An Intensive, Simulation-Based Communication Course for Pediatric Critical Care Medicine Fellows.

PubMed

Johnson, Erin M; Hamilton, Melinda F; Watson, R Scott; Claxton, Rene; Barnett, Michael; Thompson, Ann E; Arnold, Robert

2017-08-01

Effective communication among providers, families, and patients is essential in critical care but is often inadequate in the PICU. To address the lack of communication education pediatric critical care medicine fellows receive, the Children's Hospital of Pittsburgh PICU developed a simulation-based communication course, Pediatric Critical Care Communication course. Pediatric critical care medicine trainees have limited prior training in communication and will have increased confidence in their communication skills after participating in the Pediatric Critical Care Communication course. Pediatric Critical Care Communication is a 3-day course taken once during fellowship featuring simulation with actors portraying family members. Off-site conference space as part of a pediatric critical care medicine educational curriculum. Pediatric Critical Care Medicine Fellows. Didactic sessions and interactive simulation scenarios. Prior to and after the course, fellows complete an anonymous survey asking about 1) prior instruction in communication, 2) preparedness for difficult conversations, 3) attitudes about end-of-life care, and 4) course satisfaction. We compared pre- and postcourse surveys using paired Student t test. Most of the 38 fellows who participated over 4 years had no prior communication training in conducting a care conference (70%), providing bad news (57%), or discussing end-of-life options (75%). Across all four iterations of the course, fellows after the course reported increased confidence across many topics of communication, including giving bad news, conducting a family conference, eliciting both a family's emotional reaction to their child's illness and their concerns at the end of a child's life, discussing a child's code status, and discussing religious issues. Specifically, fellows in 2014 reported significant increases in self-perceived preparedness to provide empathic communication to families regarding many aspects of discussing critical care, end

Training Pediatric Fellows in Palliative Care: A Pilot Comparison of Simulation Training and Didactic Education.

PubMed

Brock, Katharine E; Cohen, Harvey J; Sourkes, Barbara M; Good, Julie J; Halamek, Louis P

2017-10-01

Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution). Intervention group participants participated in a two-day program over three months (three simulations and videotaped PC panel). Control group participants received written education designed to be similar in content and time. (1) Self-assessment questionnaires were completed at baseline, post-intervention and three months; mean between-group differences for each outcome measure were assessed. (2) External reviewers rated simulation-group encounters on nine communication domains. Within-group changes over time were assessed. (3) The simulation-based site's PC consultations were compared in the six months pre- and post-intervention. Compared to the control group, participants in the intervention group improved in self-efficacy (p = 0.003) and perceived adequacy of medical education (p < 0.001), but not knowledge (p = 0.20). Reviewers noted nonsustained improvement in four domains: relationship building (p = 0.01), opening discussion (p = 0.03), gathering information (p = 0.01), and communicating accurate information (p = 0.04). PC consultation rate increased 64%, an improvement when normalized to average daily census (p = 0.04). This simulation-based curriculum is an effective method for improving PC comfort, education, and consults. More frequent practice is likely needed to lead to sustained improvements in communication competence.

Improving the Aircraft Design Process Using Web-Based Modeling and Simulation

NASA Technical Reports Server (NTRS)

Reed, John A.; Follen, Gregory J.; Afjeh, Abdollah A.; Follen, Gregory J. (Technical Monitor)

2000-01-01

Designing and developing new aircraft systems is time-consuming and expensive. Computational simulation is a promising means for reducing design cycle times, but requires a flexible software environment capable of integrating advanced multidisciplinary and multifidelity analysis methods, dynamically managing data across heterogeneous computing platforms, and distributing computationally complex tasks. Web-based simulation, with its emphasis on collaborative composition of simulation models, distributed heterogeneous execution, and dynamic multimedia documentation, has the potential to meet these requirements. This paper outlines the current aircraft design process, highlighting its problems and complexities, and presents our vision of an aircraft design process using Web-based modeling and simulation.

Improving the Aircraft Design Process Using Web-based Modeling and Simulation

NASA Technical Reports Server (NTRS)

Reed, John A.; Follen, Gregory J.; Afjeh, Abdollah A.

2003-01-01

Designing and developing new aircraft systems is time-consuming and expensive. Computational simulation is a promising means for reducing design cycle times, but requires a flexible software environment capable of integrating advanced multidisciplinary and muitifidelity analysis methods, dynamically managing data across heterogeneous computing platforms, and distributing computationally complex tasks. Web-based simulation, with its emphasis on collaborative composition of simulation models, distributed heterogeneous execution, and dynamic multimedia documentation, has the potential to meet these requirements. This paper outlines the current aircraft design process, highlighting its problems and complexities, and presents our vision of an aircraft design process using Web-based modeling and simulation.

Shuttle mission simulator software conceptual design

NASA Technical Reports Server (NTRS)

Burke, J. F.

1973-01-01

Software conceptual designs (SCD) are presented for meeting the simulator requirements for the shuttle missions. The major areas of the SCD discussed include: malfunction insertion, flight software, applications software, systems software, and computer complex.

Maintenance Training Simulator Design and Acquisition.

DTIC Science & Technology

1980-08-01

7 ADA69 149 APPLIED SCIENCE ASSOCIATES INC VALENCIA PA F/6 5/9 MAINTENANCE TRAINING SIMULATOR DESIG AND ACOUISITION.(U) AUG 8O R J HRITZ. 6 R...TRAINING SIMULATOR DESIGN H AND ACQUISIIONII By Rohn J. Htz George R. Purifoy, Jr. M Applied Science Associates, Inc. Box 158A Valencia , Pennsylvania...related thereto. This report was submitted by Applied Science Associates, Inc., Box 158. Valencia . Pennsyvania 10059. under Contract F33015-78-C-409

Using clinical simulation centers to test design interventions: a pilot study of lighting and color modifications.

PubMed

Gray, Whitney Austin; Kesten, Karen S; Hurst, Stephen; Day, Tama Duffy; Anderko, Laura

2012-01-01

The aim of this pilot study was to test design interventions such as lighting, color, and spatial color patterning on nurses' stress, alertness, and satisfaction, and to provide an example of how clinical simulation centers can be used to conduct research. The application of evidence-based design research in healthcare settings requires a transdisciplinary approach. Integrating approaches from multiple fields in real-life settings often proves time consuming and experimentally difficult. However, forums for collaboration such as clinical simulation centers may offer a solution. In these settings, identical operating and patient rooms are used to deliver simulated patient care scenarios using automated mannequins. Two identical rooms were modified in the clinical simulation center. Nurses spent 30 minutes in each room performing simulated cardiac resuscitation. Subjective measures of nurses' stress, alertness, and satisfaction were collected and compared between settings and across time using matched-pair t-test analysis. Nurses reported feeling less stressed after exposure to the experimental room than nurses who were exposed to the control room (2.22, p = .03). Scores post-session indicated a significant reduction in stress and an increase in alertness after exposure to the experimental room as compared to the control room, with significance levels below .10. (Change in stress scores: 3.44, p = .069); (change in alertness scores: 3.6, p = .071). This study reinforces the use of validated survey tools to measure stress, alertness, and satisfaction. Results support human-centered design approaches by evaluating the effect on nurses in an experimental setting.

Helicopter Evacuation Following a Rural Trauma: An Emergency Medicine Simulation Scenario Using Innovative Simulation Technology

PubMed Central

Whalen, Desmond; Harty, Chris; Ravalia, Mohamed; Renouf, Tia; Alani, Sabrina; Brown, Robert

2016-01-01

The relevance of simulation as a teaching tool for medical professionals working in rural and remote contexts is apparent when low-frequency, high-risk situations are considered. Simulation training has been shown to enhance learning and improve patient outcomes in urban settings. However, there are few simulation scenarios designed to teach rural trauma management during complex medical transportation. In this technical report, we present a scenario using a medevac helicopter (Replica of Sikorsky S-92 designed by Virtual Marine Technology, St. John's, NL) at a rural community. This case can be used for training primary care physicians who are working in a rural or remote setting, or as an innovative addition to emergency medicine and pre-hospital care training programs. PMID:27081585

MASTOS: Mammography Simulation Tool for design Optimization Studies.

PubMed

Spyrou, G; Panayiotakis, G; Tzanakos, G

2000-01-01

Mammography is a high quality imaging technique for the detection of breast lesions, which requires dedicated equipment and optimum operation. The design parameters of a mammography unit have to be decided and evaluated before the construction of such a high cost of apparatus. The optimum operational parameters also must be defined well before the real breast examination. MASTOS is a software package, based on Monte Carlo methods, that is designed to be used as a simulation tool in mammography. The input consists of the parameters that have to be specified when using a mammography unit, and also the parameters specifying the shape and composition of the breast phantom. In addition, the input may specify parameters needed in the design of a new mammographic apparatus. The main output of the simulation is a mammographic image and calculations of various factors that describe the image quality. The Monte Carlo simulation code is PC-based and is driven by an outer shell of a graphical user interface. The entire software package is a simulation tool for mammography and can be applied in basic research and/or in training in the fields of medical physics and biomedical engineering as well as in the performance evaluation of new designs of mammography units and in the determination of optimum standards for the operational parameters of a mammography unit.

Memory interface simulator: A computer design aid

NASA Technical Reports Server (NTRS)

Taylor, D. S.; Williams, T.; Weatherbee, J. E.

1972-01-01

Results are presented of a study conducted with a digital simulation model being used in the design of the Automatically Reconfigurable Modular Multiprocessor System (ARMMS), a candidate computer system for future manned and unmanned space missions. The model simulates the activity involved as instructions are fetched from random access memory for execution in one of the system central processing units. A series of model runs measured instruction execution time under various assumptions pertaining to the CPU's and the interface between the CPU's and RAM. Design tradeoffs are presented in the following areas: Bus widths, CPU microprogram read only memory cycle time, multiple instruction fetch, and instruction mix.

Design of penicillin fermentation process simulation system

NASA Astrophysics Data System (ADS)

Qi, Xiaoyu; Yuan, Zhonghu; Qi, Xiaoxuan; Zhang, Wenqi

2011-10-01

Real-time monitoring for batch process attracts increasing attention. It can ensure safety and provide products with consistent quality. The design of simulation system of batch process fault diagnosis is of great significance. In this paper, penicillin fermentation, a typical non-linear, dynamic, multi-stage batch production process, is taken as the research object. A visual human-machine interactive simulation software system based on Windows operation system is developed. The simulation system can provide an effective platform for the research of batch process fault diagnosis.

Using screen-based simulation of inhaled anaesthetic delivery to improve patient care.

PubMed

Philip, J H

2015-12-01

Screen-based simulation can improve patient care by giving novices and experienced clinicians insight into drug behaviour. Gas Man(®) is a screen-based simulation program that depicts pictorially and graphically the anaesthetic gas and vapour tension from the vaporizer to the site of action, namely the brain and spinal cord. The gases and vapours depicted are desflurane, enflurane, ether, halothane, isoflurane, nitrogen, nitrous oxide, sevoflurane, and xenon. Multiple agents can be administered simultaneously or individually and the results shown on an overlay graph. Practice exercises provide in-depth knowledge of the subject matter. Experienced clinicians can simulate anaesthesia occurrences and practices for application to their clinical practice, and publish the results to benefit others to improve patient care. Published studies using this screen-based simulation have led to a number of findings, as follows: changing from isoflurane to desflurane toward the end of anaesthesia does not accelerate recovery in humans; vital capacity induction can produce loss of consciousness in 45 s; simulated context-sensitive decrement times explain recovery profiles; hyperventilation does not dramatically speed emergence; high fresh gas flow is wasteful; fresh gas flow and not the vaporizer setting should be reduced during intubation; re-anaesthetization can occur with severe hypoventilation after extubation; and in re-anaesthetization, the anaesthetic redistributes from skeletal muscle. Researchers using screen-based simulations can study fewer subjects to reach valid conclusions that impact clinical care. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Design and Analysis of Windmill Simulation and Pole by Solidwork Program

NASA Astrophysics Data System (ADS)

Mulyana, Tatang; Sebayang, Darwin; R, Akmal Muamar. D.; A, Jauharah H. D.; Yahya Shomit, M.

2018-03-01

The Indonesian state of archipelago has great wind energy potential. For micro-scale power generation, the energy obtained from the windmill can be connected directly to the electrical load and can be used without problems. However, for macro-scale power generation, problems will arise such as the design of vane shapes, there should be a simulation and an accurate experiment to produce blades with a special shape that can capture wind energy. In addition, daily and yearly wind and wind rate calculations are also required to ensure the best latitude and longitude positions for building windmills. This paper presents a solution to solve the problem of how to produce a windmill which in the builder is very practical and very mobile can be moved its location. Before a windmill prototype is built it should have obtained the best windmill design result. Therefore, the simulation of the designed windmill is of crucial importance. Solid simulation express is a tool that serves to generate simulation of a design. Some factors that can affect a design result include the power part and the rest part of the part, material selection, the load is given, the security of the design power made, and changes in shape due to treat the load given to the design made. In this paper, static and thermal simulations of windmills have been designed. Based on the simulation result on the designed windmill, it shows that the design has been made very satisfactory so that it can be done prototyping fabrication process.

Symplectic molecular dynamics simulations on specially designed parallel computers.

PubMed

Borstnik, Urban; Janezic, Dusanka

2005-01-01

We have developed a computer program for molecular dynamics (MD) simulation that implements the Split Integration Symplectic Method (SISM) and is designed to run on specialized parallel computers. The MD integration is performed by the SISM, which analytically treats high-frequency vibrational motion and thus enables the use of longer simulation time steps. The low-frequency motion is treated numerically on specially designed parallel computers, which decreases the computational time of each simulation time step. The combination of these approaches means that less time is required and fewer steps are needed and so enables fast MD simulations. We study the computational performance of MD simulation of molecular systems on specialized computers and provide a comparison to standard personal computers. The combination of the SISM with two specialized parallel computers is an effective way to increase the speed of MD simulations up to 16-fold over a single PC processor.

Design and evaluation of a wireless electronic health records system for field care in mass casualty settings.

PubMed

Lenert, L A; Kirsh, D; Griswold, W G; Buono, C; Lyon, J; Rao, R; Chan, T C

2011-01-01

There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22). Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.

Evidence-based design in an intensive care unit: end-user perceptions.

PubMed

Ferri, Mauricio; Zygun, David A; Harrison, Alexandra; Stelfox, Henry T

2015-04-25

The objective of this study was to describe end-user impressions and experiences in a new intensive care unit built using evidence-based design. This qualitative study was comprised of early (2-3 months after opening) and late (12-15 months after opening) phase individual interviews with end-users (healthcare providers, support staff, and patient family members) of the newly constructed Foothills Medical Centre intensive care unit in Calgary, Canada. The study unit was the recipient of the Society of Critical Care Medicine Design Citation award in 2012. We conducted interviews with thirty-nine ICU end-users, twenty-four in the early phase and fifteen in the late phase. We identified four themes (eleven sub-themes): atmosphere (abundant natural light and low noise levels), physical spaces (single occupancy rooms, rooms clustered into clinical pods, medication rooms, and tradeoffs of larger spaces), family participation in care (family support areas and social networks), and equipment (usability, storage, and providers connectivity). Abundant natural light was the design feature most frequently associated with a pleasant atmosphere. Participants emphasized the tradeoffs of size and space, and reported that the benefits of additional space (e.g., fewer interruptions due to less noise) out-weighed the disadvantages (e.g., greater distances between patients, families and providers). End-users advised that local patient care policies (e.g., number of visitors allowed at a time) and staffing needed to be updated to reflect the characteristics of the new facility design. End-users identified design elements for creating a pleasant atmosphere, attention to the tradeoffs of space and size, designing family support areas to encourage family participation in care, and updating patient care policies and staffing to reflect the new physical space as important aspects to consider when building intensive care units. Evidence-based design may optimize ICU structure for patients

Design of a breathing mattress based on the respiratory movement of kangaroo mother care for the development of neonates.

PubMed

Schets, M W M; Chen, W; Bambang Oetomo, S

2015-01-01

Kangaroo mother care (KMC) benefits the development of neonates. This paper focuses on the design and implementing the extension of KMC for infants at Neonatal Intensive Care Units (NICU). A breathing mattress is proposed to comfort infants and stimulate them to breathe regularly by mimicking the movement of the parent's chest during KMC. The incubator mattress simulates the breathing of the parent's chest with embedded electronics and pneumatic technology for mattress motion actuating systems. The stakeholders, including the child, parents and NICU staff, were directly involved during the concept development, prototyping and evaluation.

Effects of pre-education combined with a simulation for caring for children with croup on senior nursing students.

PubMed

Lee, Myung-Nam; Kang, Kyung-Ah; Park, Sun-Jung; Kim, Shin-Jeong

2017-06-01

Educational outcomes, such as knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods in caring for children with croup, were compared between groups of students that received education through simulation combined with pre-education, simulation only, and pre-education only. In this quasi-experimental design, the educational intervention for the experimental group was the pre-education modality. Data from a convenience sample of 127 senior nursing students were drawn from three nursing schools in South Korea. There were significant differences in the mean scores of knowledge, confidence in performance, satisfaction with the learning method, and ability in nursing practice between the three groups. Pre-education with simulation significantly enhanced students' knowledge, confidence in performance, ability in nursing practice, and satisfaction with learning methods compared with pre-education or simulation alone. Simulation strategies should focus more on enhancing nursing students' learning outcomes. © 2017 John Wiley & Sons Australia, Ltd.

Simulation-based Education to Ensure Provider Competency Within the Health Care System.

PubMed

Griswold, Sharon; Fralliccardi, Alise; Boulet, John; Moadel, Tiffany; Franzen, Douglas; Auerbach, Marc; Hart, Danielle; Goswami, Varsha; Hui, Joshua; Gordon, James A

2018-02-01

The acquisition and maintenance of individual competency is a critical component of effective emergency care systems. This article summarizes consensus working group deliberations and recommendations focusing on the topic "Simulation-based education to ensure provider competency within the healthcare system." The authors presented this work for discussion and feedback at the 2017 Academic Emergency Medicine Consensus Conference on "Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes," held on May 16, 2017, in Orlando, Florida. Although simulation-based training is a quality and safety imperative in other high-reliability professions such as aviation, nuclear power, and the military, health care professions still lag behind in applying simulation more broadly. This is likely a result of a number of factors, including cost, assessment challenges, and resistance to change. This consensus subgroup focused on identifying current gaps in knowledge and process related to the use of simulation for developing, enhancing, and maintaining individual provider competency. The resulting product is a research agenda informed by expert consensus and literature review. © 2017 by the Society for Academic Emergency Medicine.

Designing a Care Pathway Model - A Case Study of the Outpatient Total Hip Arthroplasty Care Pathway.

PubMed

Oosterholt, Robin I; Simonse, Lianne Wl; Boess, Stella U; Vehmeijer, Stephan Bw

2017-03-09

Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi-structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1) and mobilisation & discharge (4). The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. The design addressed existing problems and is an optimisation of the case hospital's pathway. The network of actors consists of the patient (1), radiologist (1), anaesthetist (1), nurse specialist (1), pharmacist (1), orthopaedic surgeon (1,4), physiotherapist (1,4), nurse (4), doctor (4) and patient application (1,4). The critical value exchanges include patient preparation (mental and practical), patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team.

Purpose and Learning Benefits of Simulations: A Design and Development Perspective.

ERIC Educational Resources Information Center

Goosen, Kenneth R.; Jensen, Ron; Wells, Robert

2001-01-01

Considers the role of the simulation designer in the development of business enterprise simulations used in collegiate business education. Topics include the designer's knowledge domain; conflicting business administration theories in accounting, finance, economics, marketing, production, and income tax; and other designer issues. (LRW)

Holistic Nursing Simulation: A Concept Analysis.

PubMed

Cohen, Bonni S; Boni, Rebecca

2018-03-01

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

A longitudinal interprofessional simulation curriculum for critical care teams: Exploring successes and challenges.

PubMed

Leclair, Laurie W; Dawson, Mary; Howe, Alison; Hale, Sue; Zelman, Eric; Clouser, Ryan; Garrison, Garth; Allen, Gilman

2018-05-01

Interprofessional care teams are the backbone of intensive care units (ICUs) where severity of illness is high and care requires varied skills and experience. Despite this care model, longitudinal educational programmes for such workplace teams rarely include all professions. In this article, we report findings on the initial assessment and evaluation of an ongoing, longitudinal simulation-based curriculum for interprofessional workplace critical care teams. The study had two independent components, quantitative learner assessment and qualitative curricular evaluation. To assess curriculum effectiveness at meeting learning objectives, participant-reported key learning points identified using a self-assessment tool administered immediately following curricular participation were mapped to session learning objectives. To evaluate the curriculum, we conducted a qualitative study using a phenomenology approach involving purposeful sampling of nine curricular participants undergoing recorded semi-structured interviews. Verbatim transcripts were reviewed by two independent readers to derive themes further subdivided into successes and barriers. Learner self-assessment demonstrated that the majority of learners, across all professions, achieved at least one intended learning objective with senior learners more likely to report team-based objectives and junior learners more likely to report knowledge/practice objectives. Successes identified by curricular evaluation included authentic critical care curricular content, safe learning environment, and team comradery from shared experience. Barriers included unfamiliarity with the simulation environment and clinical coverage for curricular participation. This study suggests that a sustainable interprofessional curriculum for workplace ICU critical care teams can achieve the desired educational impact and effectively deliver authentic simulated work experiences if barriers to educational engagement and participation can be

Wet cooling towers: rule-of-thumb design and simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leeper, Stephen A.

1981-07-01

A survey of wet cooling tower literature was performed to develop a simplified method of cooling tower design and simulation for use in power plant cycle optimization. The theory of heat exchange in wet cooling towers is briefly summarized. The Merkel equation (the fundamental equation of heat transfer in wet cooling towers) is presented and discussed. The cooling tower fill constant (Ka) is defined and values derived. A rule-of-thumb method for the optimized design of cooling towers is presented. The rule-of-thumb design method provides information useful in power plant cycle optimization, including tower dimensions, water consumption rate, exit air temperature,more » power requirements and construction cost. In addition, a method for simulation of cooling tower performance at various operating conditions is presented. This information is also useful in power plant cycle evaluation. Using the information presented, it will be possible to incorporate wet cooling tower design and simulation into a procedure to evaluate and optimize power plant cycles.« less

Design of a TEM cell EMP simulator

NASA Astrophysics Data System (ADS)

Sevat, Pete

1991-06-01

Electromagnetic pulse (EMP) simulators are designed to simulate the EMP generated by a nuclear weapon and are used to harden equipment against the effects of EMP. A transverse electromagnetic (TEM) cell is a square or rectangular coaxial transmission line tapered at each end to form a closed cell. The cell is fed at one end with a signal generator, a continuous wave or pulse generator, and terminated at the other end with a resistor equal to the characteristic impedance of the line. An advantage of the TEM cell is that the field is well characterized and reasonably uniform. A small, symmetric, TEM cell EMP simulator is described which is intended for applications such as susceptibility testing of small equipment, calibration of sensors, design and testing of countermeasures, measurement of transfer functions, and research and development. A detailed design is presented for a 50 ohm and 100 ohm TEM cell with an inner volume of 4 m(exp 3) and a test volume of 0.24 m(exp 3). The pulse generator and terminating network are integrated into the cell to form a completely shielded structure. In this way no interference from the inside of the cell to the outside, or vice versa, will occur.

Simulation methods to estimate design power: an overview for applied research.

PubMed

Arnold, Benjamin F; Hogan, Daniel R; Colford, John M; Hubbard, Alan E

2011-06-20

Estimating the required sample size and statistical power for a study is an integral part of study design. For standard designs, power equations provide an efficient solution to the problem, but they are unavailable for many complex study designs that arise in practice. For such complex study designs, computer simulation is a useful alternative for estimating study power. Although this approach is well known among statisticians, in our experience many epidemiologists and social scientists are unfamiliar with the technique. This article aims to address this knowledge gap. We review an approach to estimate study power for individual- or cluster-randomized designs using computer simulation. This flexible approach arises naturally from the model used to derive conventional power equations, but extends those methods to accommodate arbitrarily complex designs. The method is universally applicable to a broad range of designs and outcomes, and we present the material in a way that is approachable for quantitative, applied researchers. We illustrate the method using two examples (one simple, one complex) based on sanitation and nutritional interventions to improve child growth. We first show how simulation reproduces conventional power estimates for simple randomized designs over a broad range of sample scenarios to familiarize the reader with the approach. We then demonstrate how to extend the simulation approach to more complex designs. Finally, we discuss extensions to the examples in the article, and provide computer code to efficiently run the example simulations in both R and Stata. Simulation methods offer a flexible option to estimate statistical power for standard and non-traditional study designs and parameters of interest. The approach we have described is universally applicable for evaluating study designs used in epidemiologic and social science research.

Simulation methods to estimate design power: an overview for applied research

PubMed Central

2011-01-01

Background Estimating the required sample size and statistical power for a study is an integral part of study design. For standard designs, power equations provide an efficient solution to the problem, but they are unavailable for many complex study designs that arise in practice. For such complex study designs, computer simulation is a useful alternative for estimating study power. Although this approach is well known among statisticians, in our experience many epidemiologists and social scientists are unfamiliar with the technique. This article aims to address this knowledge gap. Methods We review an approach to estimate study power for individual- or cluster-randomized designs using computer simulation. This flexible approach arises naturally from the model used to derive conventional power equations, but extends those methods to accommodate arbitrarily complex designs. The method is universally applicable to a broad range of designs and outcomes, and we present the material in a way that is approachable for quantitative, applied researchers. We illustrate the method using two examples (one simple, one complex) based on sanitation and nutritional interventions to improve child growth. Results We first show how simulation reproduces conventional power estimates for simple randomized designs over a broad range of sample scenarios to familiarize the reader with the approach. We then demonstrate how to extend the simulation approach to more complex designs. Finally, we discuss extensions to the examples in the article, and provide computer code to efficiently run the example simulations in both R and Stata. Conclusions Simulation methods offer a flexible option to estimate statistical power for standard and non-traditional study designs and parameters of interest. The approach we have described is universally applicable for evaluating study designs used in epidemiologic and social science research. PMID:21689447

Acoustic Analysis and Design of the E-STA MSA Simulator

NASA Technical Reports Server (NTRS)

Bittinger, Samantha A.

2016-01-01

The Orion European Service Module Structural Test Article (E-STA) Acoustic Test was completed in May 2016 to verify that the European Service Module (ESM) can withstand qualification acoustic environments. The test article required an aft closeout to simulate the Multi-Purpose Crew Vehicle (MPCV) Stage Adapter (MSA) cavity, however, the flight MSA design was too cost-prohibitive to build. NASA Glenn Research Center (GRC) had 6 months to design an MSA Simulator that could recreate the qualification prediction MSA cavity sound pressure level to within a reasonable tolerance. This paper summarizes the design and analysis process to arrive at a design for the MSA Simulator, and then compares its performance to the final prediction models created prior to test.

Little shop of errors: an innovative simulation patient safety workshop for community health care professionals.

PubMed

Tupper, Judith B; Pearson, Karen B; Meinersmann, Krista M; Dvorak, Jean

2013-06-01

Continuing education for health care workers is an important mechanism for maintaining patient safety and high-quality health care. Interdisciplinary continuing education that incorporates simulation can be an effective teaching strategy for improving patient safety. Health care professionals who attended a recent Patient Safety Academy had the opportunity to experience firsthand a simulated situation that included many potential patient safety errors. This high-fidelity activity combined the best practice components of a simulation and a collaborative experience that promoted interdisciplinary communication and learning. Participants were challenged to see, learn, and experience "ah-ha" moments of insight as a basis for error reduction and quality improvement. This innovative interdisciplinary educational training method can be offered in place of traditional lecture or online instruction in any facility, hospital, nursing home, or community care setting. Copyright 2013, SLACK Incorporated.

Effects of Simulation With Problem-Based Learning Program on Metacognition, Team Efficacy, and Learning Attitude in Nursing Students: Nursing Care With Increased Intracranial Pressure Patient.

PubMed

Lee, Myung-Nam; Nam, Kyung-Dong; Kim, Hyeon-Young

2017-03-01

Nursing care for patients with central nervous system problems requires advanced professional knowledge and care skills. Nursing students are more likely to have difficulty in dealing with adult patients who have severe neurological problems in clinical practice. This study investigated the effect on the metacognition, team efficacy, and learning attitude of nursing students after an integrated simulation and problem-based learning program. A real scenario of a patient with increased intracranial pressure was simulated for the students. The results showed that this method was effective in improving the metacognitive ability of the students. Furthermore, we used this comprehensive model of simulation with problem-based learning in order to assess the consequences of student satisfaction with the nursing major, interpersonal relationships, and importance of simulation-based education in relation to the effectiveness of the integrated simulation with problem-based learning. The results can be used to improve the design of clinical practicum and nursing education.

Some Current Problems in Simulator Design, Testing and Use.

ERIC Educational Resources Information Center

Caro, Paul W.

Concerned with the general problem of the effectiveness of simulator training, this report reflects information developed during the conduct of aircraft simulator training research projects sponsored by the Air Force, Army, Navy, and Coast Guard. Problems are identified related to simulator design, testing, and use, all of which impact upon…

Identifying Facilitators and Barriers for Patient Safety in a Medicine Label Design System Using Patient Simulation and Interviews.

PubMed

Dieckmann, Peter; Clemmensen, Marianne Hald; Sørensen, Trine Kart; Kunstek, Pina; Hellebek, Annemarie

2016-12-01

Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. The study design is qualitative and exploratory, with a convenience sample of 10 nurses and 10 physicians from different acute care specialties working in hospitals in the Capital Region of Denmark. In 2 patient simulation scenarios and a sorting task, the participants selected the medicines from a range of ampules, vials, and infusion bags. After each scenario and in the end of the study, the participants were interviewed. Notes were validated with the participants, and content was analyzed. The label design benefited from the standardized construction of the labels, the clear layout and font, and some warning signs. The complexity of the system and some inconsistencies (different meaning of colors) posed challenges, when considered with the actual application context, in which there is little time to get familiar with the design features. For optimizing medicine labels and obtaining the full benefit of label design features on patient safety, it is necessary to consider the context in which they are used.

Visualisation and interaction design solutions to address specific demands in shared home care.

PubMed

Scandurra, Isabella; Hägglund, Maria; Koch, Sabine

2006-01-01

When care professionals from different organisations are involved in patient care, their different views on the care process may not be meaningfully integrated. To use visualisation and interaction design solutions addressing the specific demands of shared care in order to support a collaborative work process. Participatory design, comprising interdisciplinary seminar series with real users and iterative prototyping, was applied. A set of interaction and visualisation design solutions to address care professionals' requirements in shared home care is presented, introducing support for identifying origin of information, holistic presentation of information, user group specific visualisation, avoiding cognitive overload, coordination of work and planning, and quick overviews. The design solutions are implemented in an integrated virtual health record system supporting cooperation and coordination in shared home care for the elderly. The described requirements are, however, generalized to comprise all shared care work. The presented design considerations allow healthcare professionals in different organizations to share patient data on mobile devices. Visualization and interaction design facilitates specific work situations and assists in handling specific demands in shared care. The user interface is adapted to different user groups with similar yet distinct needs. Consequently different views supporting cooperative work and presenting shared information in holistic overviews are developed.

Mechanical design of NASA Ames Research Center vertical motion simulator

NASA Technical Reports Server (NTRS)

Engelbert, D. F.; Bakke, A. P.; Chargin, M. K.; Vallotton, W. C.

1976-01-01

NASA has designed and is constructing a new flight simulator with large vertical travel. Several aspects of the mechanical design of this Vertical Motion Simulator (VMS) are discussed, including the multiple rack and pinion vertical drive, a pneumatic equilibration system, and the friction-damped rigid link catenaries used as cable supports.

Prototype software model for designing intruder detection systems with simulation

NASA Astrophysics Data System (ADS)

Smith, Jeffrey S.; Peters, Brett A.; Curry, James C.; Gupta, Dinesh

1998-08-01

This article explores using discrete-event simulation for the design and control of defence oriented fixed-sensor- based detection system in a facility housing items of significant interest to enemy forces. The key issues discussed include software development, simulation-based optimization within a modeling framework, and the expansion of the framework to create real-time control tools and training simulations. The software discussed in this article is a flexible simulation environment where the data for the simulation are stored in an external database and the simulation logic is being implemented using a commercial simulation package. The simulation assesses the overall security level of a building against various intruder scenarios. A series of simulation runs with different inputs can determine the change in security level with changes in the sensor configuration, building layout, and intruder/guard strategies. In addition, the simulation model developed for the design stage of the project can be modified to produce a control tool for the testing, training, and real-time control of systems with humans and sensor hardware in the loop.

Stress levels during emergency care: A comparison between reality and simulated scenarios.

PubMed

Daglius Dias, Roger; Scalabrini Neto, Augusto

2016-06-01

Medical simulation is fast becoming a standard of health care training throughout undergraduate, postgraduate and continuing medical education. Our aim was to evaluate if simulated scenarios have a high psychological fidelity and induce stress levels similarly to real emergency medical situations. Medical residents had their stress levels measured during emergency care (real-life and simulation) in baseline (T1) and immediately post-emergencies (T2). Parameters measuring acute stress were: heart rate, systolic and diastolic blood pressure, salivary α-amylase, salivary interleukin-1β, and State-Trait Anxiety Inventory score. Twenty-eight internal medicine residents participated in 32 emergency situations (16 real-life and 16 simulated emergencies). In the real-life group, all parameters increased significantly (P < .05) between T1 and T2. In the simulation group, only heart rate and interleukin-1β increased significantly after emergencies. The comparison between groups demonstrates that acute stress response (T2 - T1) and State-Trait Anxiety Inventory score (in T2) did not differ between groups. Acute stress response did not differ between both groups. Our results indicate that emergency medicine simulation may create a high psychological fidelity environment similarly to what is observed in a real emergency room. Copyright © 2016 Elsevier Inc. All rights reserved.

Point-of-care ultrasound education: the increasing role of simulation and multimedia resources.

PubMed

Lewiss, Resa E; Hoffmann, Beatrice; Beaulieu, Yanick; Phelan, Mary Beth

2014-01-01

This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.

Design and evaluation of a wireless electronic health records system for field care in mass casualty settings

PubMed Central

Kirsh, D; Griswold, W G; Buono, C; Lyon, J; Rao, R; Chan, T C

2011-01-01

Background There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). Materials and methods WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. Results WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53–1:05:32 vs 18:55–57:22). Conclusion Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters. PMID:21709162

Application of a nonrandomized stepped wedge design to evaluate an evidence-based quality improvement intervention: a proof of concept using simulated data on patient-centered medical homes.

PubMed

Huynh, Alexis K; Lee, Martin L; Farmer, Melissa M; Rubenstein, Lisa V

2016-10-21

Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations. To test the feasibility of a nonrandomized stepped wedge design, we developed simulated data on patient care experiences and on QII implementation that had the structures and features of the expected data from a planned QII. We then applied the design in anticipation of performing an actual QII evaluation. We used simulated data on 108,000 patients to model nonrandomized stepped wedge results from QII implementation across nine primary care sites over 12 quarters. The outcome we simulated was change in a single self-administered question on access to care used by Veterans Health Administration (VA), based in the United States, as part of its quarterly patient ratings of quality of care. Our main predictors were QII exposure and time. Based on study hypotheses, we assigned values of 4 to 11 % for improvement in access when sites were first exposed to implementation and 1 to 3 % improvement in each ensuing time period thereafter when sites continued with implementation. We included site-level (practice size) and respondent-level (gender, race/ethnicity) characteristics that might account for nonrandomized timing in site implementation of the QII. We analyzed the resulting data as a repeated cross-sectional model using HLM 7 with a three-level hierarchical data structure and an ordinal outcome. Levels in the data structure included patient ratings

Harnessing hospital purchase power to design safe care delivery.

PubMed

Ebben, Steven F; Gieras, Izabella A; Gosbee, Laura Lin

2008-01-01

Since the Institute of Medicine's well-publicized 1999 report To Err is Human, the healthcare patient safety movement has grown at an exponential pace. However, much more can be done to advance patient safety from a care process design vantage point-improving safety through effective care processes and technology integration. While progress is being made, the chasm between technology developers and caregivers remains a profound void. Why hasn't more been done to expand our view of patient safety to include technology design? Healthcare organizations have not consolidated their purchasing power to expect improved designs. This article will (1) provide an assessment of the present state of healthcare technology management and (2) provide recommendations for collaborative design of safe healthcare delivery systems.

Bio-Inspired Multi-Functional Drug Transport Design Concept and Simulations.

PubMed

Pidaparti, Ramana M; Cartin, Charles; Su, Guoguang

2017-04-25

In this study, we developed a microdevice concept for drug/fluidic transport taking an inspiration from supramolecular motor found in biological cells. Specifically, idealized multi-functional design geometry (nozzle/diffuser/nozzle) was developed for (i) fluidic/particle transport; (ii) particle separation; and (iii) droplet generation. Several design simulations were conducted to demonstrate the working principles of the multi-functional device. The design simulations illustrate that the proposed design concept is feasible for multi-functionality. However, further experimentation and optimization studies are needed to fully evaluate the multifunctional device concept for multiple applications.

Towards Application of NASA Standard for Models and Simulations in Aeronautical Design Process

NASA Astrophysics Data System (ADS)

Vincent, Luc; Dunyach, Jean-Claude; Huet, Sandrine; Pelissier, Guillaume; Merlet, Joseph

2012-08-01

Even powerful computational techniques like simulation endure limitations in their validity domain. Consequently using simulation models requires cautions to avoid making biased design decisions for new aeronautical products on the basis of inadequate simulation results. Thus the fidelity, accuracy and validity of simulation models shall be monitored in context all along the design phases to build confidence in achievement of the goals of modelling and simulation.In the CRESCENDO project, we adapt the Credibility Assessment Scale method from NASA standard for models and simulations from space programme to the aircraft design in order to assess the quality of simulations. The proposed eight quality assurance metrics aggregate information to indicate the levels of confidence in results. They are displayed in management dashboard and can secure design trade-off decisions at programme milestones.The application of this technique is illustrated in aircraft design context with specific thermal Finite Elements Analysis. This use case shows how to judge the fitness- for-purpose of simulation as Virtual testing means and then green-light the continuation of Simulation Lifecycle Management (SLM) process.

Using IMPRINT to Guide Experimental Design with Simulated Task Environments

DTIC Science & Technology

2015-06-18

USING IMPRINT TO GUIDE EXPERIMENTAL DESIGN OF SIMULATED TASK ENVIRONMENTS THESIS Gregory...ENG-MS-15-J-052 USING IMPRINT TO GUIDE EXPERIMENTAL DESIGN WITH SIMULATED TASK ENVIRONMENTS THESIS Presented to the Faculty Department...Civilian, USAF June 2015 DISTRIBUTION STATEMENT A. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. AFIT-ENG-MS-15-J-052 USING IMPRINT

Thin-film designs by simulated annealing

NASA Astrophysics Data System (ADS)

Boudet, T.; Chaton, P.; Herault, L.; Gonon, G.; Jouanet, L.; Keller, P.

1996-11-01

With the increasing power of computers, new methods in synthesis of optical multilayer systems have appeared. Among these, the simulated-annealing algorithm has proved its efficiency in several fields of physics. We propose to show its performances in the field of optical multilayer systems through different filter designs.

Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study.

PubMed

Shilkofski, Nicole; Hunt, Elizabeth A

2015-12-01

Eighty percent of the 10 million annual deaths in children aged <5 years in developing countries are estimated to be avoidable, with improvements in education for pediatric emergency management being a key factor. Education must take into account cultural considerations to be effective. Study objectives were: (1) to use simulation to identify factors posing barriers to patient care in limited resource settings (LRS); and (2) to understand how simulations in LRS can affect communication and decision-making processes. A qualitative study was conducted at 17 different sites in 12 developing countries in Asia, Latin America, and Africa. Data from observations of 68 in situ simulated pediatric emergencies were coded for thematic analysis. Sixty-two different "key informants" were interviewed regarding perceived benefit of simulations. Coding of observations and interviews yielded common themes: impact of culture on team hierarchy, impact of communication and language barriers on situational awareness, systematic emergency procedures, role delineation, shared cognition and resource awareness through simulation, logistic barriers to patient care, and use of recognition-primed decision-making by experienced clinicians. Changes in clinical environments were implemented as a result of simulations. Ad hoc teams in LRS face challenges in caring safely for patients; these include language and cultural barriers, as well as environmental and resource constraints. Engaging teams in simulations may promote improved communication, identification of systems issues and latent threats to target for remediation. There may be a role for training novices in use of recognition-primed or algorithmic decision-making strategies to improve rapidity and efficiency of decisions in LRS. Copyright © 2015 by the American Academy of Pediatrics.

Designing a Care Pathway Model – A Case Study of the Outpatient Total Hip Arthroplasty Care Pathway

PubMed Central

Oosterholt, Robin I; Boess, Stella U; Vehmeijer, Stephan BW

2017-01-01

Introduction: Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. Theory: The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. Methods: An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi-structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. Results: The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1) and mobilisation & discharge (4). The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. Conclusion: The design addressed existing problems and is an optimisation of the case hospital’s pathway. The network of actors consists of the patient (1), radiologist (1), anaesthetist (1), nurse specialist (1), pharmacist (1), orthopaedic surgeon (1,4), physiotherapist (1,4), nurse (4), doctor (4) and patient application (1,4). The critical value exchanges include patient preparation (mental and practical), patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team. PMID

An explorative study of experiences of healthcare providers posing as simulated care receivers in a 'care-ethical' lab.

PubMed

Vanlaere, Linus; Timmermann, Madeleine; Stevens, Marleen; Gastmans, Chris

2012-01-01

In recent approaches to ethics, the personal involvement of health care providers and their empathy are perceived as important elements of an overall ethical ability. Experiential working methods are used in ethics education to foster, inter alia, empathy. In 2008, the care-ethics lab 'sTimul' was founded in Flanders, Belgium, to provide training that focuses on improving care providers' ethical abilities through experiential working simulations. The curriculum of sTimul focuses on empathy sessions, aimed at care providers' empathic skills. The present study provides better insight into how experiential learning specifically targets the empathic abilities of care providers. Providing contrasting experiences that affect the care providers' self-reflection seems a crucial element in this study. Further research is needed to provide more insight into how empathy leads to long-term changes in behaviour.

Simulation studies of a wide area health care network.

PubMed Central

McDaniel, J. G.

1994-01-01

There is an increasing number of efforts to install wide area health care networks. Some of these networks are being built to support several applications over a wide user base consisting primarily of medical practices, hospitals, pharmacies, medical laboratories, payors, and suppliers. Although on-line, multi-media telecommunication is desirable for some purposes such as cardiac monitoring, store-and-forward messaging is adequate for many common, high-volume applications. Laboratory test results and payment claims, for example, can be distributed using electronic messaging networks. Several network prototypes have been constructed to determine the technical problems and to assess the effectiveness of electronic messaging in wide area health care networks. Our project, Health Link, developed prototype software that was able to use the public switched telephone network to exchange messages automatically, reliably and securely. The network could be configured to accommodate the many different traffic patterns and cost constraints of its users. Discrete event simulations were performed on several network models. Canonical star and mesh networks, that were composed of nodes operating at steady state under equal loads, were modeled. Both topologies were found to support the throughput of a generic wide area health care network. The mean message delivery time of the mesh network was found to be less than that of the star network. Further simulations were conducted for a realistic large-scale health care network consisting of 1,553 doctors, 26 hospitals, four medical labs, one provincial lab and one insurer. Two network topologies were investigated: one using predominantly peer-to-peer communication, the other using client-server communication.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7949966

Operationalising elaboration theory for simulation instruction design: a Delphi study.

PubMed

Haji, Faizal A; Khan, Rabia; Regehr, Glenn; Ng, Gary; de Ribaupierre, Sandrine; Dubrowski, Adam

2015-06-01

, thereby advancing the agenda of theoretically based instruction design in health care simulation. © 2015 John Wiley & Sons Ltd.

New concept of aging care architecture landscape design based on sustainable development

NASA Astrophysics Data System (ADS)

Xu, Ying

2017-05-01

As the aging problem becoming serious in China, Aging care is now one of the top issuer in front of all of us. Lots of private and public aging care architecture and facilities have been built. At present, we only pay attention to the architecture design and interior design scientific, ecological and sustainable design on aged care architecture landscape. Based on the social economy, population resources, mutual coordination and development of the environment, taking the elderly as the special group, this paper follows the principles of the sustainable development, conducts the comprehensive design planning of aged care landscape architecture and makes a deeper understanding and exploration through changing the form of architectural space, ecological landscape planting, new materials and technology, ecological energy utilization.

Software for simulation of a computed tomography imaging spectrometer using optical design software

NASA Astrophysics Data System (ADS)

Spuhler, Peter T.; Willer, Mark R.; Volin, Curtis E.; Descour, Michael R.; Dereniak, Eustace L.

2000-11-01

Our Imaging Spectrometer Simulation Software known under the name Eikon should improve and speed up the design of a Computed Tomography Imaging Spectrometer (CTIS). Eikon uses existing raytracing software to simulate a virtual instrument. Eikon enables designers to virtually run through the design, calibration and data acquisition, saving significant cost and time when designing an instrument. We anticipate that Eikon simulations will improve future designs of CTIS by allowing engineers to explore more instrument options.

Mixed methods research: a design for emergency care research?

PubMed

Cooper, Simon; Porter, Jo; Endacott, Ruth

2011-08-01

This paper follows previous publications on generic qualitative approaches, qualitative designs and action research in emergency care by this group of authors. Contemporary views on mixed methods approaches are considered, with a particular focus on the design choice and the amalgamation of qualitative and quantitative data emphasising the timing of data collection for each approach, their relative 'weight' and how they will be mixed. Mixed methods studies in emergency care are reviewed before the variety of methodological approaches and best practice considerations are presented. The use of mixed methods in clinical studies is increasing, aiming to answer questions such as 'how many' and 'why' in the same study, and as such are an important and useful approach to many key questions in emergency care.

Long-term care for people with dementia: environmental design guidelines.

PubMed

Fleming, Richard; Purandare, Nitin

2010-11-01

A large and growing number of people with dementia are being cared for in long-term care. The empirical literature on the design of environments for people with dementia contains findings that can be helpful in the design of these environments. A schema developed by Marshall in 2001 provides a means of reviewing the literature against a set of recommendations. The aims of this paper are to assess the strength of the evidence for these recommendations and to identify those recommendations that could be used as the basis for guidelines to assist in the design of long term care facilities for people with dementia. The literature was searched for articles published after 1980, evaluating an intervention utilizing the physical environment, focused on the care of people with dementia and incorporating a control group, pre-test-post-test, cross sectional or survey design. A total of 156 articles were identified as relevant and subjected to an evaluation of their methodological strength. Of these, 57 articles were identified as being sufficiently strong to be reviewed. Designers may confidently use unobtrusive safety measures; vary ambience, size and shape of spaces; provide single rooms; maximize visual access; and control levels of stimulation. There is less agreement on the usefulness of signage, homelikeness, provision for engagement in ordinary activities, small size and the provision of outside space. There is sufficient evidence available to come to a consensus on guiding principles for the design of long term environments for people with dementia.

FEAMAC/CARES Stochastic-Strength-Based Damage Simulation Tool for Ceramic Matrix Composites

NASA Technical Reports Server (NTRS)

Nemeth, Noel; Bednarcyk, Brett; Pineda, Evan; Arnold, Steven; Mital, Subodh; Murthy, Pappu; Bhatt, Ramakrishna

2016-01-01

Reported here is a coupling of two NASA developed codes: CARES (Ceramics Analysis and Reliability Evaluation of Structures) with the MAC/GMC (Micromechanics Analysis Code/ Generalized Method of Cells) composite material analysis code. The resulting code is called FEAMAC/CARES and is constructed as an Abaqus finite element analysis UMAT (user defined material). Here we describe the FEAMAC/CARES code and an example problem (taken from the open literature) of a laminated CMC in off-axis loading is shown. FEAMAC/CARES performs stochastic-strength-based damage simulation response of a CMC under multiaxial loading using elastic stiffness reduction of the failed elements.

Optical design of a high-power LED-based solar simulator

NASA Astrophysics Data System (ADS)

Toro-Betancur, Veronica; Velásquez-López, Alejandro; Velásquez, David; Acevedo-Gómez, David

2016-04-01

The optical design of a High-Power LED based Solar Simulator was made in order to reach the AM1.5G spectrum standards. An optical model of the light emitted by the LEDs was made and used for spectral intensities calculations and the light intensity uniformity was optimized. A class AAA solar simulator was designed using a hexagonal LED distribution.

Design and implementation of a combined influenza immunization and tuberculosis screening campaign with simulation modelling.

PubMed

Heim, Joseph A; Huang, Hao; Zabinsky, Zelda B; Dickerson, Jane; Wellner, Monica; Astion, Michael; Cruz, Doris; Vincent, Jeanne; Jack, Rhona

2015-08-01

Design and implement a concurrent campaign of influenza immunization and tuberculosis (TB) screening for health care workers (HCWs) that can reduce the number of clinic visits for each HCW. A discrete-event simulation model was developed to support issues of resource allocation decisions in planning and operations phases. The campaign was compressed to100 days in 2010 and further compressed to 75 days in 2012 and 2013. With more than 5000 HCW arrivals in 2011, 2012 and 2013, the 14-day goal of TB results was achieved for each year and reduced to about 4 days in 2012 and 2013. Implementing a concurrent campaign allows less number of visiting clinics and the compressing of campaign length allows earlier immunization. The support of simulation modelling can provide useful evaluations of different configurations. © 2015 John Wiley & Sons, Ltd.

Designing Scenarios for Controller-in-the-Loop Air Traffic Simulations

NASA Technical Reports Server (NTRS)

Kupfer, Michael; Mercer, Joey S.; Cabrall, Christopher; Callantine, Todd

2013-01-01

Well prepared traffic scenarios contribute greatly to the success of controller-in-the-loop simulations. This paper describes each stage in the design process of realistic scenarios based on real-world traffic, to be used in the Airspace Operations Laboratory for simulations within the Air Traffic Management Technology Demonstration 1 effort. The steps from the initial analysis of real-world traffic, to the editing of individual aircraft records in the scenario file, until the final testing of the scenarios before the simulation conduct, are all described. The iterative nature of the design process and the various efforts necessary to reach the required fidelity, as well as the applied design strategies, challenges, and tools used during this process are also discussed.

Design of an Indoor Sonic Boom Simulator at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Klos, Jacob; Sullivan, Brenda M.; Shepherd, Kevin P.

2008-01-01

Construction of a simulator to recreate the soundscape inside residential buildings exposed to sonic booms is scheduled to start during the summer of 2008 at NASA Langley Research Center. The new facility should be complete by the end of the year. The design of the simulator allows independent control of several factors that create the indoor soundscape. Variables that will be isolated include such factors as boom duration, overpressure, rise time, spectral shape, level of rattle, level of squeak, source of rattle and squeak, level of vibration and source of vibration. Test subjects inside the simulator will be asked to judge the simulated soundscape, which will represent realistic indoor boom exposure. Ultimately, this simulator will be used to develop a functional relationship between human response and the sound characteristics creating the indoor soundscape. A conceptual design has been developed by NASA personnel, and is currently being vetted through small-scale risk reduction tests that are being performed in-house. The purpose of this document is to introduce the conceptual design, identify how the indoor response will be simulated, briefly outline some of the risk reduction tests that have been completed to vet the design, and discuss the impact of these tests on the simulator design.

Bridging burn care education with modern technology, an integration with high fidelity human patient simulation.

PubMed

Reeves, Patrick T; Borgman, Matthew A; Caldwell, Nicole W; Patel, Leela; Aden, James; Duggan, John P; Serio-Melvin, Maria L; Mann-Salinas, Elizabeth A

2018-08-01

The Advanced Burn Life Support (ABLS) program is a burn-education curriculum nearly 30 years in the making, focusing on the unique challenges of the first 24h of care after burn injury. Our team applied high fidelity human patient simulation (HFHPS) to the established ABLS curriculum. Our hypothesis was that HFHPS would be a feasible, easily replicable, and valuable adjunct to the current curriculum that would enhance learner experience. This prospective, evidenced-based practice project was conducted in a single simulation center employing the American Burn Association's ABLS curriculum using HFHPS. Participants managed 7 separate simulated polytrauma and burn scenarios with resultant clinical complications. After training, participants completed written and practical examinations as well as satisfaction surveys. From 2012 to 2013, 71 students participated in this training. Simulation (ABLS-Sim) participants demonstrated a 2.5% increase in written post-test scores compared to traditional ABLS Provider Course (ABLS Live) (p=0.0016). There was no difference in the practical examination when comparing ABLS-Sim versus ABLS Live. Subjectively, 60 (85%) participants completed surveys. The Educational Practice Questionnaire showed best practices rating of 4.5±0.7; with importance of learning rated at 4.4±0.8. The Simulation Design Scale rating for design was 4.6±0.6 with an importance rating of 4.4±0.8. Overall Satisfaction and Self-Confidence with Learning were 4.4±0.7 and 4.5±0.7, respectfully. Integrating HFHPS with the current ABLS curriculum led to higher written exam scores, high levels of confidence, satisfaction, and active learning, and presented an evidenced-based model for education that is easily employable for other facilities nationwide. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Effects of clinical supervision on resident learning and patient care during simulated ICU scenarios.

PubMed

Piquette, Dominique; Tarshis, Jordan; Regehr, Glenn; Fowler, Robert A; Pinto, Ruxandra; LeBlanc, Vicki R

2013-12-01

Closer supervision of residents' clinical activities has been promoted to improve patient safety, but may additionally affect resident participation in patient care and learning. The objective of this study was to determine the effects of closer supervision on patient care, resident participation, and the development of resident ability to care independently for critically ill patients during simulated scenarios. This quantitative study represents a component of a larger mixed-methods study. Residents were randomized to one of three levels of supervision, defined by the physical proximity of the supervisor (distant, immediately available, and direct). Each resident completed a simulation scenario under the supervision of a critical care fellow, immediately followed by a modified scenario of similar content without supervision. The simulation center of a tertiary, university-affiliated academic center in a large urban city. Fifty-three residents completing a critical care rotation and 24 critical care fellows were recruited between April 2009 and June 2010. None. During the supervised scenarios, lower team performance checklist scores were obtained for distant supervision compared with immediately available and direct supervision (mean [SD], direct: 72% [12%] vs immediately available: 77% [10%] vs distant: 61% [11%]; p = 0.0013). The percentage of checklist items completed by the residents themselves was significantly lower during direct supervision (median [interquartile range], direct: 40% [21%] vs immediately available: 58% [16%] vs distant: 55% [11%]; p = 0.005). During unsupervised scenarios, no significant differences were found on the outcome measures. Care delivered in the presence of senior supervising physicians was more comprehensive than care delivered without access to a bedside supervisor, but was associated with lower resident participation. However, subsequent resident performance during unsupervised scenarios was not adversely affected. Direct

Promoting Collaboration in Health Care Teams through Interprofessional Education: A Simulation Case Study

ERIC Educational Resources Information Center

Ekmekci, Ozgur

2013-01-01

This simulation study explores how the integration of interprofessional components into health care curriculum may impact professional stereotyping and collaborative behavior in care delivery teams comprised of a physician, a registered nurse, a physician's assistant, a physical therapist, and a radiation therapist. As part of the agent-based…

Design characteristics of acute care units in china.

PubMed

Lu, Yi; Wang, Yijia

2014-01-01

To describe the current state of design characteristics of acute care units in China's public hospitals and compare these with characteristics with acute care units in the United States. The healthcare construction industry in China is one of the fastest growing sectors in China and, arguably, in the world. Understanding the physical design of acute care units in China is of great importance because it will influence a large population. Descriptive study was performed of unit configuration, size, patient visibility, distance to nursing station and supplies, and lighting conditions in 25 units in 19 public hospitals built after 2003. Data and information were collected based on spatial and visibility analysis. The study identified major design characteristics of the recently built (from 2003 onward) acute care units in China, comparing them, where appropriate, with those in U.S. It found there are three dominant types of unit layout: single-corridor (52%), triangular (36%), and double-corridor (12%). The number of private rooms is very low (11%), compared with two- or three-bed rooms. Centralized nursing stations are the only type of nurses' working area. China also has a large unit size in terms of number of patient beds. The average number of patient beds in a unit is 40.6 in China (versus 32.9 in U.S.). The care units in China have longer walking distance from nursing station to patient bedside. The percentage of beds visible from a nursing station is lower in China than in the U.S. The access to natural light and direct sunlight in patient rooms is greater in China compared with those in U.S.-100% of patient rooms in China have natural lighting. A majority of them face south or southeast and thus receiving direct sunlight (91.4%). Because of the differences in economies and building codes, there are dramatic differences between the spatial characteristics of acute care units in China and the United States. © 2014 Vendome Group, LLC.

Clinical simulation as a boundary object in design of health IT-systems.

PubMed

Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

2013-01-01

Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work. In this paper we present how clinical simulation additionally holds the potential to function as a boundary object in the design process. The case points out that clinical simulation provides an opportunity for discussions and mutual learning among the various stakeholders involved in design of standardized electronic clinical documentation templates. The paper presents and discusses the use of clinical simulation in the translation, transfer and transformation of knowledge between various stakeholders in a large healthcare organization.

User-Design: A Case Application in Health Care Training.

ERIC Educational Resources Information Center

Carr-Chellman, Alison; Cuyar, Craig; Breman, Jeroen

1998-01-01

Discussion of user-design as a theoretical process for creating training, software, and computer systems focuses on a case study that describes user-design methodology in home health care through the context of diffusing a new laptop patient-record-keeping system with home nurses. Research needs and implications for the design process are…

Simulated human patients and patient-centredness: The uncanny hybridity of nursing education, technology, and learning to care.

PubMed

Ireland, Aileen V

2017-01-01

Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman. © 2016 John Wiley & Sons Ltd.

Accessing primary care: a simulated patient study.

PubMed

Campbell, John L; Carter, Mary; Davey, Antoinette; Roberts, Martin J; Elliott, Marc N; Roland, Martin

2013-03-01

Simulated patient, or so-called 'mystery-shopper', studies are a controversial, but potentially useful, approach to take when conducting health services research. To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey. Observational study in 41 general practices in rural, urban, and inner-city settings in the UK. Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey. Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients' reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders' possible confusion in answering this question. Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients' satisfaction with their practice is not related to practice call handling, but is related to appointment availability.

Effectiveness of simulation with team-based learning in newborn nursing care.

PubMed

Kang, Kyung-Ah; Kim, Shin-Jeong; Oh, Jina; Kim, Sunghee; Lee, Myung-Nam

2016-06-01

This study determines the effect of simulation with team-based learning (TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes, academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (t = 3.445, P = 0.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches. © 2015 Wiley Publishing Asia Pty Ltd.

Design of a high-speed digital processing element for parallel simulation

NASA Technical Reports Server (NTRS)

Milner, E. J.; Cwynar, D. S.

1983-01-01

A prototype of a custom designed computer to be used as a processing element in a multiprocessor based jet engine simulator is described. The purpose of the custom design was to give the computer the speed and versatility required to simulate a jet engine in real time. Real time simulations are needed for closed loop testing of digital electronic engine controls. The prototype computer has a microcycle time of 133 nanoseconds. This speed was achieved by: prefetching the next instruction while the current one is executing, transporting data using high speed data busses, and using state of the art components such as a very large scale integration (VLSI) multiplier. Included are discussions of processing element requirements, design philosophy, the architecture of the custom designed processing element, the comprehensive instruction set, the diagnostic support software, and the development status of the custom design.

Numerical Simulation of the Francis Turbine and CAD used to Optimized the Runner Design (2nd).

NASA Astrophysics Data System (ADS)

Sutikno, Priyono

2010-06-01

Hydro Power is the most important renewable energy source on earth. The water is free of charge and with the generation of electric energy in a Hydroelectric Power station the production of green house gases (mainly CO2) is negligible. Hydro Power Generation Stations are long term installations and can be used for 50 years and more, care must be taken to guarantee a smooth and safe operation over the years. Maintenance is necessary and critical parts of the machines have to be replaced if necessary. Within modern engineering the numerical flow simulation plays an important role in order to optimize the hydraulic turbine in conjunction with connected components of the plant. Especially for rehabilitation and upgrading existing Power Plants important point of concern are to predict the power output of turbine, to achieve maximum hydraulic efficiency, to avoid or to minimize cavitations, to avoid or to minimized vibrations in whole range operation. Flow simulation can help to solve operational problems and to optimize the turbo machinery for hydro electric generating stations or their component through, intuitive optimization, mathematical optimization, parametric design, the reduction of cavitations through design, prediction of draft tube vortex, trouble shooting by using the simulation. The classic design through graphic-analytical method is cumbersome and can't give in evidence the positive or negative aspects of the designing options. So it was obvious to have imposed as necessity the classical design methods to an adequate design method using the CAD software. There are many option chose during design calculus in a specific step of designing may be verified in ensemble and detail form a point of view. The final graphic post processing would be realized only for the optimal solution, through a 3 D representation of the runner as a whole for the final approval geometric shape. In this article it was investigated the redesign of the hydraulic turbine's runner

Simulation as a Tool to Facilitate Practice Changes in Teams Taking Care of Patients Under Investigation for Ebola Virus Disease in Spain.

PubMed

Rojo, Elena; Oruña, Clara; Sierra, Dolores; García, Gema; Del Moral, Ignacio; Maestre, Jose M

2016-04-01

We analyzed the impact of simulation-based training on clinical practice and work processes on teams caring for patients with possible Ebola virus disease (EVD) in Cantabria, Spain. The Government of Spain set up a special committee for the management of EVD, and the Spanish Ministry of Health and foreign health services created an action protocol. Each region is responsible for selecting a reference hospital and an in-house care team to care for patients under investigation. Laboratory-confirmed cases of EVD have to be transferred to the Carlos III Health Institute in Madrid. Predeployment training and follow-up support are required to help personnel work safely and effectively. Simulation-based scenarios were designed to give staff the opportunity to practice before encountering a real-life situation. Lessons learned by each team during debriefings were listed, and a survey administered 3 months later assessed the implementation of practice and system changes. Implemented changes were related to clinical practice (eg, teamwork principles application), protocol implementation (eg, addition of new processes and rewriting of confusing parts), and system and workflow (eg, change of shift schedule and rearrangement of room equipment). Simulation can be used to detect needed changes in protocol or guidelines or can be adapted to meet the needs of a specific team.

Vestibular models for design and evaluation of flight simulator motion

NASA Technical Reports Server (NTRS)

Bussolari, S. R.; Sullivan, R. B.; Young, L. R.

1986-01-01

The use of spatial orientation models in the design and evaluation of control systems for motion-base flight simulators is investigated experimentally. The development of a high-fidelity motion drive controller using an optimal control approach based on human vestibular models is described. The formulation and implementation of the optimal washout system are discussed. The effectiveness of the motion washout system was evaluated by studying the response of six motion washout systems to the NASA/AMES Vertical Motion Simulator for a single dash-quick-stop maneuver. The effects of the motion washout system on pilot performance and simulator acceptability are examined. The data reveal that human spatial orientation models are useful for the design and evaluation of flight simulator motion fidelity.

Designing primary health care teams for developing countries.

PubMed Central

Reisman, A; Duran, L

1983-01-01

A time-honored industrial engineering technique, job evaluation, which was developed to set rates for manual labor, was used in the design of new teams for delivering primary health care in Latin America. The technique was used both in writing job descriptions for new allied health personnel and in designing the curriculums needed to train the personnel. PMID:6856744

Simulation system architecture design for generic communications link

NASA Technical Reports Server (NTRS)

Tsang, Chit-Sang; Ratliff, Jim

1986-01-01

This paper addresses a computer simulation system architecture design for generic digital communications systems. It addresses the issues of an overall system architecture in order to achieve a user-friendly, efficient, and yet easily implementable simulation system. The system block diagram and its individual functional components are described in detail. Software implementation is discussed with the VAX/VMS operating system used as a target environment.

An optimal control approach to the design of moving flight simulators

NASA Technical Reports Server (NTRS)

Sivan, R.; Ish-Shalom, J.; Huang, J.-K.

1982-01-01

An abstract flight simulator design problem is formulated in the form of an optimal control problem, which is solved for the linear-quadratic-Gaussian special case using a mathematical model of the vestibular organs. The optimization criterion used is the mean-square difference between the physiological outputs of the vestibular organs of the pilot in the aircraft and the pilot in the simulator. The dynamical equations are linearized, and the output signal is modeled as a random process with rational power spectral density. The method described yields the optimal structure of the simulator's motion generator, or 'washout filter'. A two-degree-of-freedom flight simulator design, including single output simulations, is presented.

Ideas in Practice (3): A Simulated Laboratory Experience in Digital Design.

ERIC Educational Resources Information Center

Cleaver, Thomas G.

1988-01-01

Gives an example of the use of a simplified logic simulator in a logic design course. Discusses some problems in logic design classes, commercially available software, and software problems. Describes computer-aided engineering (CAE) software. Lists 14 experiments in the simulated laboratory and presents students' evaluation of the course. (YP)

Design of the environment of care for safety of patients and personnel: does form follow function or vice versa in the intensive care unit?

PubMed

Bartley, Judene; Streifel, Andrew J

2010-08-01

We review the context of the environment of care in the intensive care unit setting in relation to patient safety and quality, specifically addressing healthcare-associated infection issues and solutions involving interdisciplinary teams. Issues addressed include current and future architectural design and layout trends, construction trends affecting intensive care units, and prevention of construction-associated healthcare-associated infections related to airborne and waterborne risks and design solutions. Specific elements include single-occupancy, acuity-scalable intensive care unit rooms; environmental aspects of hand hygiene, such as water risks, sink design/location, human waste management, surface selection (floor covering, countertops, furniture, and equipment) and cleaning, antimicrobial-treated or similar materials, ultraviolet germicidal irradiation, specialized rooms (airborne infection isolation and protective environments), and water system design and strategies for safe use of potable water and mitigation of water intrusion. Effective design and operational use of the intensive care unit environment of care must engage critical care personnel from initial planning and design through occupancy of the new/renovated intensive care unit as part of the infection control risk assessment team. The interdisciplinary infection control risk assessment team can address key environment of care design features to enhance the safety of intensive care unit patients, personnel, and visitors. This perspective will ensure the environment of care supports human factors and behavioral aspects of the interaction between the environment of care and its occupants.

Approximate simulation model for analysis and optimization in engineering system design

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, Jaroslaw

1989-01-01

Computational support of the engineering design process routinely requires mathematical models of behavior to inform designers of the system response to external stimuli. However, designers also need to know the effect of the changes in design variable values on the system behavior. For large engineering systems, the conventional way of evaluating these effects by repetitive simulation of behavior for perturbed variables is impractical because of excessive cost and inadequate accuracy. An alternative is described based on recently developed system sensitivity analysis that is combined with extrapolation to form a model of design. This design model is complementary to the model of behavior and capable of direct simulation of the effects of design variable changes.

Incorporating quality and safety education for nurses competencies in simulation scenario design.

PubMed

Jarzemsky, Paula; McCarthy, Jane; Ellis, Nadege

2010-01-01

When planning a simulation scenario, even if adopting prepackaged simulation scenarios, faculty should first conduct a task analysis to guide development of learning objectives and cue critical events. The authors describe a strategy for systematic planning of simulation-based training that incorporates knowledge, skills, and attitudes as defined by the Quality and Safety Education for Nurses (QSEN) initiative. The strategy cues faculty to incorporate activities that target QSEN competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety) before, during, and after simulation scenarios.

Design for dependability: A simulation-based approach. Ph.D. Thesis, 1993

NASA Technical Reports Server (NTRS)

Goswami, Kumar K.

1994-01-01

This research addresses issues in simulation-based system level dependability analysis of fault-tolerant computer systems. The issues and difficulties of providing a general simulation-based approach for system level analysis are discussed and a methodology that address and tackle these issues is presented. The proposed methodology is designed to permit the study of a wide variety of architectures under various fault conditions. It permits detailed functional modeling of architectural features such as sparing policies, repair schemes, routing algorithms as well as other fault-tolerant mechanisms, and it allows the execution of actual application software. One key benefit of this approach is that the behavior of a system under faults does not have to be pre-defined as it is normally done. Instead, a system can be simulated in detail and injected with faults to determine its failure modes. The thesis describes how object-oriented design is used to incorporate this methodology into a general purpose design and fault injection package called DEPEND. A software model is presented that uses abstractions of application programs to study the behavior and effect of software on hardware faults in the early design stage when actual code is not available. Finally, an acceleration technique that combines hierarchical simulation, time acceleration algorithms and hybrid simulation to reduce simulation time is introduced.

Simulations for designing and interpreting intervention trials in infectious diseases.

PubMed

Halloran, M Elizabeth; Auranen, Kari; Baird, Sarah; Basta, Nicole E; Bellan, Steven E; Brookmeyer, Ron; Cooper, Ben S; DeGruttola, Victor; Hughes, James P; Lessler, Justin; Lofgren, Eric T; Longini, Ira M; Onnela, Jukka-Pekka; Özler, Berk; Seage, George R; Smith, Thomas A; Vespignani, Alessandro; Vynnycky, Emilia; Lipsitch, Marc

2017-12-29

Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods. Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. In an increasingly complex world, simulations can explicitly represent transmission dynamics, which are critical for proper trial design and interpretation. Certain ethical aspects of a trial can also be quantified using simulations. Further, after a trial has been conducted, simulations can be used to explore the possible explanations for the observed effects. Much is to be gained through a multidisciplinary approach that builds collaborations among experts in infectious disease dynamics, epidemiology, statistical science, economics, simulation methods, and the conduct of clinical trials.

Transforming care: medical practice design and information technology.

PubMed

Kilo, Charles M

2005-01-01

The transformation of the medical practice is possible today because of the advancement of system design knowledge coupled with innovations in information technology (IT). Examples of such transformed care are present today, and they are creating a roadmap for others. Those efforts are also elucidating critical issues in the use of IT to advance health care quality. Connectivity, electronic integration, and knowledge management are the key functionalities emerging as levers to promote this transformation.

Simulation in the Service of Design - Asking the Right Questions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donn, Michael; Selkowitz, Stephen; Bordass, Bill

2009-03-01

This paper proposes an approach to the creation of design tools that address the real information needs of designers in the early stages of design of nonresidential buildings. Traditional simplified design tools are typically too limited to be of much use, even in conceptual design. The proposal is to provide access to the power of detailed simulation tools, at a stage in design when little is known about the final building, but at a stage also when the freedom to explore options is greatest. The proposed approach to tool design has been derived from consultation with design analysis teams asmore » part of the COMFEN tool development. The paper explores how tools like COMFEN have been shaped by this consultation and how requests from these teams for real-world relevance might shape such tools in the future, drawing into the simulation process the lessons from Post Occupancy Evaluation (POE) of buildings.« less

Simulating clinical trial visits yields patient insights into study design and recruitment.

PubMed

Lim, S Sam; Kivitz, Alan J; McKinnell, Doug; Pierson, M Edward; O'Brien, Faye S

2017-01-01

We elicited patient experiences from clinical trial simulations to aid in future trial development and to improve patient recruitment and retention. Two simulations of draft Phase II and Phase III anifrolumab studies for systemic lupus erythematosus (SLE)/lupus nephritis (LN) were performed involving African-American patients from Grady Hospital, an indigent care hospital in Atlanta, GA, USA, and white patients from Altoona Arthritis and Osteoporosis Center in Altoona, PA, USA. The clinical trial simulation included an informed consent procedure, a mock screening visit, a mock dosing visit, and a debriefing period for patients and staff. Patients and staff were interviewed to obtain sentiments and perceptions related to the simulated visits. The Atlanta study involved 6 African-American patients (5 female) aged 27-60 years with moderate to severe SLE/LN. The Altoona study involved 12 white females aged 32-75 years with mild to moderate SLE/LN. Patient experiences had an impact on four patient-centric care domains: 1) information, communication, and education; 2) responsiveness to needs; 3) access to care; and 4) coordination of care; and continuity and transition. Patients in both studies desired background material, knowledgeable staff, family and friend support, personal results, comfortable settings, shorter wait times, and greater scheduling flexibility. Compared with the Altoona study patients, Atlanta study patients reported greater preferences for information from the Internet, need for strong community and online support, difficulties in discussing SLE, emphasis on transportation and child care help during the visits, and concerns related to financial matters; and they placed greater importance on time commitment, understanding of potential personal benefit, trust, and confidentiality of patient data as factors for participation. Using these results, we present recommendations to improve study procedures to increase retention, recruitment, and compliance

Interactive Graphics Simulator: Design, Development, and Effectiveness/Cost Evaluation. Final Report.

ERIC Educational Resources Information Center

Pieper, William J.; And Others

This study was initiated to design, develop, implement, and evaluate a videodisc-based simulator system, the Interactive Graphics Simulator (IGS) for 6883 Converter Flight Control Test Station training at Lowry Air Force Base, Colorado. The simulator provided a means for performing task analysis online, developing simulations from the task…

Designing the role of the embedded care manager.

PubMed

Hines, Patricia; Mercury, Marge

2013-01-01

: The role of the professional case manager is changing rapidly. Health reform has called upon the industry to ensure that care is delivered in an efficient, effective, and high-quality and low cost manner. As a means to achieve this objective, health plans and health systems are moving the care manager out of a centralized location within their organizations to "embedding" them into physician offices. This move enables the care manager to work alongside the primary care physicians and their high-risk patients. This article discusses the framework for designing and implementing an embedded care manager role into a physician practice. Key elements of the program are discussed. IMPLICATIONS FOR CARE MANAGEMENT:: Historically care management has played a foundational role in improving the quality of care for individuals and populations via the efficient and effective use of resources. Now with the goals of health care reform, a successful transition from a volume-based to value-based reimbursement system requires primary care physicians to welcome care managers into their practices to improve patient care, quality, and costs through care coordination across health care settings and populations. : As patient-centered medical homes and integrated delivery systems formulate their plans for population health management, their efforts have included embedding a care manager in the primary practice setting. Having care managers embedded at the physician offices increases their ability to collaborate with the physician and their staff in the implementation and monitoring care plans for their patients. : Implementing an embedded care manager into an existing physician's practice requires the following:Although the embedded care manager is a highly evolving role, physician groups are beginning to realize the benefits from their care management collaborations. Examples cited include improved outreach and coordination, patient adherence to care plans, and improved quality of life.

[Simulation and Design of Infant Incubator Assembly Line].

PubMed

Ke, Huqi; Hu, Xiaoyong; Ge, Xia; Hu, Yanhai; Chen, Zaihong

2015-11-01

According to current assembly situation of infant incubator in company A, basic industrial engineering means such as time study was used to analyze the actual products assembly production and an assembly line was designed. The assembly line was modeled and simulated with software Flexsim. The problem of the assembly line was found by comparing simulation result and actual data, then through optimization to obtain high efficiency assembly line.

Bio-Inspired Multi-Functional Drug Transport Design Concept and Simulations †

PubMed Central

Pidaparti, Ramana M.; Cartin, Charles; Su, Guoguang

2017-01-01

In this study, we developed a microdevice concept for drug/fluidic transport taking an inspiration from supramolecular motor found in biological cells. Specifically, idealized multi-functional design geometry (nozzle/diffuser/nozzle) was developed for (i) fluidic/particle transport; (ii) particle separation; and (iii) droplet generation. Several design simulations were conducted to demonstrate the working principles of the multi-functional device. The design simulations illustrate that the proposed design concept is feasible for multi-functionality. However, further experimentation and optimization studies are needed to fully evaluate the multifunctional device concept for multiple applications. PMID:28952516

Aviation Human-in-the-Loop Simulation Studies: Experimental Planning, Design, and Data Management

DTIC Science & Technology

2014-01-01

Aviation Human-in-the-Loop Simulation Studies: Experimental Planning, Design , and Data Management Kevin W. Williams1 Bonny Christopher2 Gena...Simulation Studies: Experimental Planning, Design , and Data Management January 2014 6. Performing Organization Code 7. Author(s) 8. Performing...describe the process by which we designed our human-in-the-loop (HITL) simulation study and the methodology used to collect and analyze the results

Simulating Social Networks of Online Communities: Simulation as a Method for Sociability Design

NASA Astrophysics Data System (ADS)

Ang, Chee Siang; Zaphiris, Panayiotis

We propose the use of social simulations to study and support the design of online communities. In this paper, we developed an Agent-Based Model (ABM) to simulate and study the formation of social networks in a Massively Multiplayer Online Role Playing Game (MMORPG) guild community. We first analyzed the activities and the social network (who-interacts-with-whom) of an existing guild community to identify its interaction patterns and characteristics. Then, based on the empirical results, we derived and formalized the interaction rules, which were implemented in our simulation. Using the simulation, we reproduced the observed social network of the guild community as a means of validation. The simulation was then used to examine how various parameters of the community (e.g. the level of activity, the number of neighbors of each agent, etc) could potentially influence the characteristic of the social networks.

Design and characterization of a cough simulator.

PubMed

Zhang, Bo; Zhu, Chao; Ji, Zhiming; Lin, Chao-Hsin

2017-02-23

Expiratory droplets from human coughing have always been considered as potential carriers of pathogens, responsible for respiratory infectious disease transmission. To study the transmission of disease by human coughing, a transient repeatable cough simulator has been designed and built. Cough droplets are generated by different mechanisms, such as the breaking of mucus, condensation and high-speed atomization from different depths of the respiratory tract. These mechanisms in coughing produce droplets of different sizes, represented by a bimodal distribution of 'fine' and 'coarse' droplets. A cough simulator is hence designed to generate transient sprays with such bimodal characteristics. It consists of a pressurized gas tank, a nebulizer and an ejector, connected in series, which are controlled by computerized solenoid valves. The bimodal droplet size distribution is characterized for the coarse droplets and fine droplets, by fibrous collection and laser diffraction, respectively. The measured size distributions of coarse and fine droplets are reasonably represented by the Rosin-Rammler and log-normal distributions in probability density function, which leads to a bimodal distribution. To assess the hydrodynamic consequences of coughing including droplet vaporization and polydispersion, a Lagrangian model of droplet trajectories is established, with its ambient flow field predetermined from a computational fluid dynamics simulation.

Clinical trial design in the neurocritical care unit.

PubMed

Hall, C E; Mirski, M; Palesch, Y Y; Diringer, M N; Qureshi, A I; Robertson, C S; Geocadin, R; Wijman, C A C; Le Roux, P D; Suarez, Jose I

2012-02-01

Clinical trials provide a robust mechanism to advance science and change clinical practice across the widest possible spectrum. Fundamental in the Neurocritical Care Society's mission is to promote Quality Patient Care by identifying and implementing best medical practices for acute neurological disorders that are consistent with the current scientific knowledge. The next logical step will be to foster rapid growth of our scientific body of evidence, to establish and disseminate these best practices. In this manuscript, five invited experts were impaneled to address questions, identified by the conference organizing committee as fundamental issues for the design of clinical trials in the neurological intensive care unit setting.

Functional requirements for design of the Space Ultrareliable Modular Computer (SUMC) system simulator

NASA Technical Reports Server (NTRS)

Curran, R. T.; Hornfeck, W. A.

1972-01-01

The functional requirements for the design of an interpretive simulator for the space ultrareliable modular computer (SUMC) are presented. A review of applicable existing computer simulations is included along with constraints on the SUMC simulator functional design. Input requirements, output requirements, and language requirements for the simulator are discussed in terms of a SUMC configuration which may vary according to the application.

Design and application of star map simulation system for star sensors

NASA Astrophysics Data System (ADS)

Wu, Feng; Shen, Weimin; Zhu, Xifang; Chen, Yuheng; Xu, Qinquan

2013-12-01

Modern star sensors are powerful to measure attitude automatically which assure a perfect performance of spacecrafts. They achieve very accurate attitudes by applying algorithms to process star maps obtained by the star camera mounted on them. Therefore, star maps play an important role in designing star cameras and developing procession algorithms. Furthermore, star maps supply significant supports to exam the performance of star sensors completely before their launch. However, it is not always convenient to supply abundant star maps by taking pictures of the sky. Thus, star map simulation with the aid of computer attracts a lot of interests by virtue of its low price and good convenience. A method to simulate star maps by programming and extending the function of the optical design program ZEMAX is proposed. The star map simulation system is established. Firstly, based on analyzing the working procedures of star sensors to measure attitudes and the basic method to design optical system by ZEMAX, the principle of simulating star sensor imaging is given out in detail. The theory about adding false stars and noises, and outputting maps is discussed and the corresponding approaches are proposed. Then, by external programming, the star map simulation program is designed and produced. Its user interference and operation are introduced. Applications of star map simulation method in evaluating optical system, star image extraction algorithm and star identification algorithm, and calibrating system errors are presented completely. It was proved that the proposed simulation method provides magnificent supports to the study on star sensors, and improves the performance of star sensors efficiently.

High-Alpha Research Vehicle (HARV) longitudinal controller: Design, analyses, and simulation resultss

NASA Technical Reports Server (NTRS)

Ostroff, Aaron J.; Hoffler, Keith D.; Proffitt, Melissa S.; Brown, Philip W.; Phillips, Michael R.; Rivers, Robert A.; Messina, Michael D.; Carzoo, Susan W.; Bacon, Barton J.; Foster, John F.

1994-01-01

This paper describes the design, analysis, and nonlinear simulation results (batch and piloted) for a longitudinal controller which is scheduled to be flight-tested on the High-Alpha Research Vehicle (HARV). The HARV is an F-18 airplane modified for and equipped with multi-axis thrust vectoring. The paper includes a description of the facilities, a detailed review of the feedback controller design, linear analysis results of the feedback controller, a description of the feed-forward controller design, nonlinear batch simulation results, and piloted simulation results. Batch simulation results include maximum pitch stick agility responses, angle of attack alpha captures, and alpha regulation for full lateral stick rolls at several alpha's. Piloted simulation results include task descriptions for several types of maneuvers, task guidelines, the corresponding Cooper-Harper ratings from three test pilots, and some pilot comments. The ratings show that desirable criteria are achieved for almost all of the piloted simulation tasks.

Realization of planning design of mechanical manufacturing system by Petri net simulation model

NASA Astrophysics Data System (ADS)

Wu, Yanfang; Wan, Xin; Shi, Weixiang

1991-09-01

Planning design is to work out a more overall long-term plan. In order to guarantee a mechanical manufacturing system (MMS) designed to obtain maximum economical benefit, it is necessary to carry out a reasonable planning design for the system. First, some principles on planning design for MMS are introduced. Problems of production scheduling and their decision rules for computer simulation are presented. Realizable method of each production scheduling decision rule in Petri net model is discussed. Second, the solution of conflict rules for conflict problems during running Petri net is given. Third, based on the Petri net model of MMS which includes part flow and tool flow, according to the principle of minimum event time advance, a computer dynamic simulation of the Petri net model, that is, a computer dynamic simulation of MMS, is realized. Finally, the simulation program is applied to a simulation exmple, so the scheme of a planning design for MMS can be evaluated effectively.

Emergency nurses' perception of department design as an obstacle to providing end-of-life care.

PubMed

Beckstrand, Renea L; Rasmussen, Ryan J; Luthy, Karlen E; Heaston, Sondra

2012-09-01

Of the 119.2 million visits to the emergency department in 2006, it was estimated that about 249,000 visits resulted in the patient dying or being pronounced dead on arrival. In 2 national studies of emergency nurses' perceptions of end-of-life (EOL) care, ED design was identified as a large and frequent obstacle to providing EOL care. The purpose of this study was to determine the impact of ED design on EOL care as perceived by emergency nurses and to determine how much input emergency nurses have on the design of their emergency department. A 25-item questionnaire regarding ED design as it affects EOL care was sent to a national, geographically dispersed, random sample of 500 members of ENA. Inclusion criteria were nurses who could read English, worked in an emergency department, and had cared for at least one patient at the EOL. Descriptive statistics were calculated for the Likert-type and demographic items. Open-ended questions were analyzed using content analysis. Two mailings yielded 198 usable responses. Nurses did not report that ED design was as large an obstacle to EOL care as previous studies had suggested. Nurses reported that the ED design helped EOL care at a greater rate than it obstructed EOL care. Nurses also believed they had little input into unit design or layout changes. The most common request for design change was private places for family members to grieve. Thirteen nurses also responded with an optional drawing of suggested ED designs. Overall, nurses reported some dissatisfaction with ED design and believed they had little to no input in unit design improvement. Improvements to EOL care might be achieved if ED design suggestions from emergency nurses were considered by committees that oversee remodeling and construction of emergency departments. Further research is needed to determine the impact of ED design on EOL care in the emergency department. Copyright © 2012 Emergency Nurses Association. Published by Mosby, Inc. All rights

Geriatric simulation: practicing management and leadership in care of the older adult.

PubMed

Miller, Sally; Overstreet, Maria

2015-06-01

According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluating sampling designs by computer simulation: A case study with the Missouri bladderpod

USGS Publications Warehouse

Morrison, L.W.; Smith, D.R.; Young, C.; Nichols, D.W.

2008-01-01

To effectively manage rare populations, accurate monitoring data are critical. Yet many monitoring programs are initiated without careful consideration of whether chosen sampling designs will provide accurate estimates of population parameters. Obtaining accurate estimates is especially difficult when natural variability is high, or limited budgets determine that only a small fraction of the population can be sampled. The Missouri bladderpod, Lesquerella filiformis Rollins, is a federally threatened winter annual that has an aggregated distribution pattern and exhibits dramatic interannual population fluctuations. Using the simulation program SAMPLE, we evaluated five candidate sampling designs appropriate for rare populations, based on 4 years of field data: (1) simple random sampling, (2) adaptive simple random sampling, (3) grid-based systematic sampling, (4) adaptive grid-based systematic sampling, and (5) GIS-based adaptive sampling. We compared the designs based on the precision of density estimates for fixed sample size, cost, and distance traveled. Sampling fraction and cost were the most important factors determining precision of density estimates, and relative design performance changed across the range of sampling fractions. Adaptive designs did not provide uniformly more precise estimates than conventional designs, in part because the spatial distribution of L. filiformis was relatively widespread within the study site. Adaptive designs tended to perform better as sampling fraction increased and when sampling costs, particularly distance traveled, were taken into account. The rate that units occupied by L. filiformis were encountered was higher for adaptive than for conventional designs. Overall, grid-based systematic designs were more efficient and practically implemented than the others. ?? 2008 The Society of Population Ecology and Springer.

Xyce parallel electronic simulator design.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thornquist, Heidi K.; Rankin, Eric Lamont; Mei, Ting

2010-09-01

This document is the Xyce Circuit Simulator developer guide. Xyce has been designed from the 'ground up' to be a SPICE-compatible, distributed memory parallel circuit simulator. While it is in many respects a research code, Xyce is intended to be a production simulator. As such, having software quality engineering (SQE) procedures in place to insure a high level of code quality and robustness are essential. Version control, issue tracking customer support, C++ style guildlines and the Xyce release process are all described. The Xyce Parallel Electronic Simulator has been under development at Sandia since 1999. Historically, Xyce has mostly beenmore » funded by ASC, the original focus of Xyce development has primarily been related to circuits for nuclear weapons. However, this has not been the only focus and it is expected that the project will diversify. Like many ASC projects, Xyce is a group development effort, which involves a number of researchers, engineers, scientists, mathmaticians and computer scientists. In addition to diversity of background, it is to be expected on long term projects for there to be a certain amount of staff turnover, as people move on to different projects. As a result, it is very important that the project maintain high software quality standards. The point of this document is to formally document a number of the software quality practices followed by the Xyce team in one place. Also, it is hoped that this document will be a good source of information for new developers.« less

Through the Eyes of the User: Evaluating Neonatal Intensive Care Unit Design.

PubMed

Denham, Megan E; Bushehri, Yousef; Lim, Lisa

2018-01-01

This article presents a pilot study that employed a user-centered methodology for evaluating and quantifying neonatal intensive care unit (NICU) designs based on the needs of the primary users. The design of NICUs has begun to shift from open-bay to single-family rooms. Both designs present unique advantages and challenges that impact babies, families, and caregivers. One NICU design was analyzed using the functional scenario (FS) analysis method. For the FS, users' needs were determined through literature review, interviews with NICU providers and parents, and a review of published design guidelines. Quantitative metrics were developed for each FS, so that characteristics of the NICU design could be analyzed to determine how successful they were in meeting the users' needs. The results were graphically represented to visualize the success and considerations of the design. A total of 23 FSs and 61 spatial metrics were developed. FSs for babies focused on infection prevention, minimizing exposure to environmental stimuli, and supporting enriching care activities. FSs for family members focused on direct access to the baby, and privacy and adequate space for daily activities. FSs for providers and caregivers focused on infection prevention, care activities, care zones, and visibility. Using an FS approach highlights design characteristics in the NICU that need to be addressed during the design process to more successfully meet the needs of the different users. Additionally, using this approach can inform design professionals' decision-making by presenting them with the design characteristics that impact the needs of the user groups.

Designing a SCADA system simulator for fast breeder reactor

NASA Astrophysics Data System (ADS)

Nugraha, E.; Abdullah, A. G.; Hakim, D. L.

2016-04-01

SCADA (Supervisory Control and Data Acquisition) system simulator is a Human Machine Interface-based software that is able to visualize the process of a plant. This study describes the results of the process of designing a SCADA system simulator that aims to facilitate the operator in monitoring, controlling, handling the alarm, accessing historical data and historical trend in Nuclear Power Plant (NPP) type Fast Breeder Reactor (FBR). This research used simulation to simulate NPP type FBR Kalpakkam in India. This simulator was developed using Wonderware Intouch software 10 and is equipped with main menu, plant overview, area graphics, control display, set point display, alarm system, real-time trending, historical trending and security system. This simulator can properly simulate the principle of energy flow and energy conversion process on NPP type FBR. This SCADA system simulator can be used as training media for NPP type FBR prospective operators.

The Numerical Propulsion System Simulation: A Multidisciplinary Design System for Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Lytle, John K.

1999-01-01

Advances in computational technology and in physics-based modeling are making large scale, detailed simulations of complex systems possible within the design environment. For example, the integration of computing, communications, and aerodynamics has reduced the time required to analyze ma or propulsion system components from days and weeks to minutes and hours. This breakthrough has enabled the detailed simulation of major propulsion system components to become a routine part of design process and to provide the designer with critical information about the components early in the design process. This paper describes the development of the Numerical Propulsion System Simulation (NPSS), a multidisciplinary system of analysis tools that is focussed on extending the simulation capability from components to the full system. This will provide the product developer with a "virtual wind tunnel" that will reduce the number of hardware builds and tests required during the development of advanced aerospace propulsion systems.

Designing a Distributed Space Systems Simulation in Accordance with the Simulation Interoperability Standards Organization (SISO)

NASA Technical Reports Server (NTRS)

Cowen, Benjamin

2011-01-01

Simulations are essential for engineering design. These virtual realities provide characteristic data to scientists and engineers in order to understand the details and complications of the desired mission. A standard development simulation package known as Trick is used in developing a source code to model a component (federate in HLA terms). The runtime executive is integrated into an HLA based distributed simulation. TrickHLA is used to extend a Trick simulation for a federation execution, develop a source code for communication between federates, as well as foster data input and output. The project incorporates international cooperation along with team collaboration. Interactions among federates occur throughout the simulation, thereby relying on simulation interoperability. Communication through the semester went on between participants to figure out how to create this data exchange. The NASA intern team is designing a Lunar Rover federate and a Lunar Shuttle federate. The Lunar Rover federate supports transportation across the lunar surface and is essential for fostering interactions with other federates on the lunar surface (Lunar Shuttle, Lunar Base Supply Depot and Mobile ISRU Plant) as well as transporting materials to the desired locations. The Lunar Shuttle federate transports materials to and from lunar orbit. Materials that it takes to the supply depot include fuel and cargo necessary to continue moon-base operations. This project analyzes modeling and simulation technologies as well as simulation interoperability. Each team from participating universities will work on and engineer their own federate(s) to participate in the SISO Spring 2011 Workshop SIW Smackdown in Boston, Massachusetts. This paper will focus on the Lunar Rover federate.

Designing A Mixed Methods Study In Primary Care

PubMed Central

Creswell, John W.; Fetters, Michael D.; Ivankova, Nataliya V.

2004-01-01

BACKGROUND Mixed methods or multimethod research holds potential for rigorous, methodologically sound investigations in primary care. The objective of this study was to use criteria from the literature to evaluate 5 mixed methods studies in primary care and to advance 3 models useful for designing such investigations. METHODS We first identified criteria from the social and behavioral sciences to analyze mixed methods studies in primary care research. We then used the criteria to evaluate 5 mixed methods investigations published in primary care research journals. RESULTS Of the 5 studies analyzed, 3 included a rationale for mixing based on the need to develop a quantitative instrument from qualitative data or to converge information to best understand the research topic. Quantitative data collection involved structured interviews, observational checklists, and chart audits that were analyzed using descriptive and inferential statistical procedures. Qualitative data consisted of semistructured interviews and field observations that were analyzed using coding to develop themes and categories. The studies showed diverse forms of priority: equal priority, qualitative priority, and quantitative priority. Data collection involved quantitative and qualitative data gathered both concurrently and sequentially. The integration of the quantitative and qualitative data in these studies occurred between data analysis from one phase and data collection from a subsequent phase, while analyzing the data, and when reporting the results. DISCUSSION We recommend instrument-building, triangulation, and data transformation models for mixed methods designs as useful frameworks to add rigor to investigations in primary care. We also discuss the limitations of our study and the need for future research. PMID:15053277

Designing a mixed methods study in primary care.

PubMed

Creswell, John W; Fetters, Michael D; Ivankova, Nataliya V

2004-01-01

Mixed methods or multimethod research holds potential for rigorous, methodologically sound investigations in primary care. The objective of this study was to use criteria from the literature to evaluate 5 mixed methods studies in primary care and to advance 3 models useful for designing such investigations. We first identified criteria from the social and behavioral sciences to analyze mixed methods studies in primary care research. We then used the criteria to evaluate 5 mixed methods investigations published in primary care research journals. Of the 5 studies analyzed, 3 included a rationale for mixing based on the need to develop a quantitative instrument from qualitative data or to converge information to best understand the research topic. Quantitative data collection involved structured interviews, observational checklists, and chart audits that were analyzed using descriptive and inferential statistical procedures. Qualitative data consisted of semistructured interviews and field observations that were analyzed using coding to develop themes and categories. The studies showed diverse forms of priority: equal priority, qualitative priority, and quantitative priority. Data collection involved quantitative and qualitative data gathered both concurrently and sequentially. The integration of the quantitative and qualitative data in these studies occurred between data analysis from one phase and data collection from a subsequent phase, while analyzing the data, and when reporting the results. We recommend instrument-building, triangulation, and data transformation models for mixed methods designs as useful frameworks to add rigor to investigations in primary care. We also discuss the limitations of our study and the need for future research.

Effects of Patient Care Unit Design and Technology on Nurse and Patient Care Technician Communication.

PubMed

Beck, Mary S; Doscher, Mindy

2018-04-01

The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.

Simulation models and designs for advanced Fischer-Tropsch technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choi, G.N.; Kramer, S.J.; Tam, S.S.

1995-12-31

Process designs and economics were developed for three grass-roots indirect Fischer-Tropsch coal liquefaction facilities. A baseline and an alternate upgrading design were developed for a mine-mouth plant located in southern Illinois using Illinois No. 6 coal, and one for a mine-mouth plane located in Wyoming using Power River Basin coal. The alternate design used close-coupled ZSM-5 reactors to upgrade the vapor stream leaving the Fischer-Tropsch reactor. ASPEN process simulation models were developed for all three designs. These results have been reported previously. In this study, the ASPEN process simulation model was enhanced to improve the vapor/liquid equilibrium calculations for themore » products leaving the slurry bed Fischer-Tropsch reactors. This significantly improved the predictions for the alternate ZSM-5 upgrading design. Another model was developed for the Wyoming coal case using ZSM-5 upgrading of the Fischer-Tropsch reactor vapors. To date, this is the best indirect coal liquefaction case. Sensitivity studies showed that additional cost reductions are possible.« less

Home Care Nursing via Computer Networks: Justification and Design Specifications

PubMed Central

Brennan, Patricia Flatley

1988-01-01

High-tech home care includes the use of information technologies, such as computer networks, to provide direct care to patients in the home. This paper presents the justification and design of a project using a free, public access computer network to deliver home care nursing. The intervention attempts to reduce isolation and improve problem solving among home care patients and their informal caregivers. Three modules comprise the intervention: a decision module, a communications module, and an information data base. This paper describes the experimental evaluation of the project, and discusses issues in the delivery of nursing care via computers.

Using simulation to design a central sterilization department.

PubMed

Lin, Feng; Lawley, Mark; Spry, Charlie; McCarthy, Kelly; Coyle-Rogers, Patricia G; Yih, Yuehwern

2008-10-01

A simulation project was performed to assist with redesign of the surgery department of a large tertiary hospital and to help administrators make the best decisions about relocating, staffing, and equipping the central sterilization department. A simulation model was created to analyze department configurations, staff schedules, equipment capacities, and cart-washing requirements. Performance measures examined include tray turnaround time, surgery-delay rate, and work-in-process levels. The analysis provides significant insight into how the proposed system will perform, allowing planning for expected patient volume increases. This work illustrates how simulation can facilitate the design of a central sterilization department and improve surgical sterilization operations.

Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.

PubMed

Best, Allyson M; Dixon, Cinnamon A; Kelton, W David; Lindsell, Christopher J; Ward, Michael J

2014-08-01

Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance. Using this modality, our objective was to identify operational interventions that could potentially improve patient throughput of one acute care setting in a developing country. We developed a simulation model of acute care at a district level hospital in Ghana to test the effects of resource-neutral (eg, modified staff start times and roles) and resource-additional (eg, increased staff) operational interventions on patient throughput. Previously captured deidentified time-and-motion data from 487 acute care patients were used to develop and test the model. The primary outcome was the modeled effect of interventions on patient length of stay (LOS). The base-case (no change) scenario had a mean LOS of 292 minutes (95% confidence interval [CI], 291-293). In isolation, adding staffing, changing staff roles, and varying shift times did not affect overall patient LOS. Specifically, adding 2 registration workers, history takers, and physicians resulted in a 23.8-minute (95% CI, 22.3-25.3) LOS decrease. However, when shift start times were coordinated with patient arrival patterns, potential mean LOS was decreased by 96 minutes (95% CI, 94-98), and with the simultaneous combination of staff roles (registration and history taking), there was an overall mean LOS reduction of 152 minutes (95% CI, 150-154). Resource-neutral interventions identified through discrete event simulation modeling have the potential to improve acute care throughput in this Ghanaian municipal hospital. Discrete event simulation offers another approach to identifying potentially effective interventions to improve patient

Design and Performance Frameworks for Constructing Problem-Solving Simulations

ERIC Educational Resources Information Center

Stevens, Rons; Palacio-Cayetano, Joycelin

2003-01-01

Rapid advancements in hardware, software, and connectivity are helping to shorten the times needed to develop computer simulations for science education. These advancements, however, have not been accompanied by corresponding theories of how best to design and use these technologies for teaching, learning, and testing. Such design frameworks…

Incorporating Interprofessional Evidenced-Based Sepsis Simulation Education for Certified Nursing Assistants (CNAs) and Licensed Care Providers Within Long-term Care Settings for Process and Quality Improvement.

PubMed

Mihaljevic, Susan E; Howard, Valerie M

2016-01-01

Improving resident safety and quality of care by maximizing interdisciplinary communication among long-term care providers is essential in meeting the goals of the United States' Federal Health care reform. The new Triple Aim goals focus on improved patient outcomes, increasing patient satisfaction, and decreased health care costs, thus providing consumers with quality, efficient patient-focused care. Within the United States, sepsis is the 10th leading cause of death with a 28.6% mortality rate in the elderly, increasing to 40% to 60% in septic shock. As a result of the Affordable Care Act, the Centers for Medicare & Medicaid services supported the Interventions to Reduce Acute Care Transfers 3.0 program to improve health care quality and prevent avoidable rehospitalization by improving assessment, documentation, and communication among health care providers. The Interventions to Reduce Acute Care Transfers 3.0 tools were incorporated in interprofessional sepsis simulations throughout 19 long-term care facilities to encourage the early recognition of sepsis symptoms and prompt communication of sepsis symptoms among interdisciplinary teams. As a result of this simulation training, many long-term care organizations have adopted the STOP and WATCH and SBAR tools as a venue to communicate resident condition changes.

Stepped Care to Optimize Pain care Effectiveness (SCOPE) trial study design and sample characteristics.

PubMed

Kroenke, Kurt; Krebs, Erin; Wu, Jingwei; Bair, Matthew J; Damush, Teresa; Chumbler, Neale; York, Tish; Weitlauf, Sharon; McCalley, Stephanie; Evans, Erica; Barnd, Jeffrey; Yu, Zhangsheng

2013-03-01

Pain is the most common physical symptom in primary care, accounting for an enormous burden in terms of patient suffering, quality of life, work and social disability, and health care and societal costs. Although collaborative care interventions are well-established for conditions such as depression, fewer systems-based interventions have been tested for chronic pain. This paper describes the study design and baseline characteristics of the enrolled sample for the Stepped Care to Optimize Pain care Effectiveness (SCOPE) study, a randomized clinical effectiveness trial conducted in five primary care clinics. SCOPE has enrolled 250 primary care veterans with persistent (3 months or longer) musculoskeletal pain of moderate severity and randomized them to either the stepped care intervention or usual care control group. Using a telemedicine collaborative care approach, the intervention couples automated symptom monitoring with a telephone-based, nurse care manager/physician pain specialist team to treat pain. The goal is to optimize analgesic management using a stepped care approach to drug selection, symptom monitoring, dose adjustment, and switching or adding medications. All subjects undergo comprehensive outcome assessments at baseline, 1, 3, 6 and 12 months by interviewers blinded to treatment group. The primary outcome is pain severity/disability, and secondary outcomes include pain beliefs and behaviors, psychological functioning, health-related quality of life and treatment satisfaction. Innovations of SCOPE include optimized analgesic management (including a stepped care approach, opioid risk stratification, and criteria-based medication adjustment), automated monitoring, and centralized care management that can cover multiple primary care practices. Published by Elsevier Inc.

Iterative simulated quenching for designing irregular-spot-array generators.

PubMed

Gillet, J N; Sheng, Y

2000-07-10

We propose a novel, to our knowledge, algorithm of iterative simulated quenching with temperature rescaling for designing diffractive optical elements, based on an analogy between simulated annealing and statistical thermodynamics. The temperature is iteratively rescaled at the end of each quenching process according to ensemble statistics to bring the system back from a frozen imperfect state with a local minimum of energy to a dynamic state in a Boltzmann heat bath in thermal equilibrium at the rescaled temperature. The new algorithm achieves much lower cost function and reconstruction error and higher diffraction efficiency than conventional simulated annealing with a fast exponential cooling schedule and is easy to program. The algorithm is used to design binary-phase generators of large irregular spot arrays. The diffractive phase elements have trapezoidal apertures of varying heights, which fit ideal arbitrary-shaped apertures better than do trapezoidal apertures of fixed heights.

Conceptual Design of Simulation Models in an Early Development Phase of Lunar Spacecraft Simulator Using SMP2 Standard

NASA Astrophysics Data System (ADS)

Lee, Hoon Hee; Koo, Cheol Hea; Moon, Sung Tae; Han, Sang Hyuck; Ju, Gwang Hyeok

2013-08-01

The conceptual study for Korean lunar orbiter/lander prototype has been performed in Korea Aerospace Research Institute (KARI). Across diverse space programs around European countries, a variety of simulation application has been developed using SMP2 (Simulation Modelling Platform) standard related to portability and reuse of simulation models by various model users. KARI has not only first-hand experience of a development of SMP compatible simulation environment but also an ongoing study to apply the SMP2 development process of simulation model to a simulator development project for lunar missions. KARI has tried to extend the coverage of the development domain based on SMP2 standard across the whole simulation model life-cycle from software design to its validation through a lunar exploration project. Figure. 1 shows a snapshot from a visualization tool for the simulation of lunar lander motion. In reality, a demonstrator prototype on the right-hand side of image was made and tested in 2012. In an early phase of simulator development prior to a kick-off start in the near future, targeted hardware to be modelled has been investigated and indentified at the end of 2012. The architectural breakdown of the lunar simulator at system level was performed and the architecture with a hierarchical tree of models from the system to parts at lower level has been established. Finally, SMP Documents such as Catalogue, Assembly, Schedule and so on were converted using a XML(eXtensible Mark-up Language) converter. To obtain benefits of the suggested approaches and design mechanisms in SMP2 standard as far as possible, the object-oriented and component-based design concepts were strictly chosen throughout a whole model development process.

High-fidelity, simulation-based, interdisciplinary operating room team training at the point of care.

PubMed

Paige, John T; Kozmenko, Valeriy; Yang, Tong; Paragi Gururaja, Ramnarayan; Hilton, Charles W; Cohn, Isidore; Chauvin, Sheila W

2009-02-01

The operating room (OR) is a dynamic, high risk setting requiring effective teamwork for the safe delivery of care. Teamwork in the modern OR, however, is less than ideal. High fidelity simulation is an attractive approach to training key teamwork competencies. We have developed a portable simulation platform, the mobile mock OR (MMOR) that permits bringing team training over long distances to the point of care. We examined the effectiveness of this innovative, simulation-based interdisciplinary operating room (OR) team training model on its participants. All general surgical OR team members at an academic affiliated medical center underwent scenario-based training using a mobile mock OR. Pre- and post-session mean scores were calculated and analyzed for 15 Likert-type items measuring self-efficacy in teamwork competencies using t test. The mean gain in pre-post item scores for 38 participants averaged 0.4 units on a 6-point Likert scale. The significance was demonstrated in 4 of the items: role clarity (Delta = 0.6 units, P = .02), anticipatory response (Delta = 0.6 units, P = .01), cross monitoring (Delta = 0.6 units, P < .01), and team cohesion and interaction (Delta = 0.7 units, P < .01). High-fidelity, simulation-based OR team training at the point of care positively impacts self-efficacy for effective teamwork performance in everyday practice.

Enhanced avatar design using cognitive map-based simulation.

PubMed

Lee, Kun Chang; Moon, Byung Suk

2007-12-01

With the advent of the Internet era and the maturation of electronic commerce, strategic avatar design has become an important way of keeping up with market changes and customer tastes. In this study, we propose a new approach to an adaptive avatar design that uses cognitive map (CM) as a what-if simulation vehicle. The main virtue of the new design is its ability to change specific avatar design features with objective consideration of the subsequent effects upon other design features, thereby enhancing user satisfaction. Statistical analyses of focus group interview results with a group of experts majoring in avatars and CM showed that our proposed approach could be used to effectively analyze avatar design in an adaptive and practical manner when the market situation is changing.

LEGO - A Class Library for Accelerator Design and Simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cai, Yunhai

1998-11-19

An object-oriented class library of accelerator design and simulation is designed and implemented in a simple and modular fashion. All physics of single-particle dynamics is implemented based on the Hamiltonian in the local frame of the component. Symplectic integrators are used to approximate the integration of the Hamiltonian. A differential algebra class is introduced to extract a Taylor map up to arbitrary order. Analysis of optics is done in the same way both for the linear and non-linear cases. Recently, Monte Carlo simulation of synchrotron radiation has been added into the library. The code is used to design and simulatemore » the lattices of the PEP-II and SPEAR3. And it is also used for the commissioning of the PEP-II. Some examples of how to use the library will be given.« less

Design and feasibility of integrating personalized PRO dashboards into prostate cancer care

PubMed Central

Izard, Jason P; Dalkin, Bruce L; Mikles, Sean P; Gore, John L

2016-01-01

Objective Patient-reported outcomes (PROs) are a valued source of health information, but prior work focuses largely on data capture without guidance on visual displays that promote effective PRO use in patient-centered care. We engaged patients, providers, and design experts in human-centered design of “PRO dashboards” that illustrate trends in health-related quality of life (HRQOL) reported by patients following prostate cancer treatment. Materials and Methods We designed and assessed the feasibility of integrating dashboards into care in 3 steps: (1) capture PRO needs of patients and providers through focus groups and interviews; (2) iteratively build and refine a prototype dashboard; and (3) pilot test dashboards with patients and their provider during follow-up care. Results Focus groups (n = 60 patients) prioritized needs for dashboards that compared longitudinal trends in patients’ HRQOL with “men like me.” Of the candidate dashboard designs, 50 patients and 50 providers rated pictographs less helpful than bar charts, line graphs, or tables (P < .001) and preferred bar charts and line graphs most. Given these needs and the design recommendations from our Patient Advisory Board (n = 7) and design experts (n = 7), we built and refined a prototype that charts patients’ HRQOL compared with age- and treatment-matched patients in personalized dashboards. Pilot testing dashboard use (n = 12 patients) improved compliance with quality indicators for prostate cancer care (P < .01). Conclusion PRO dashboards are a promising approach for integrating patient-generated data into prostate cancer care. Informed by human-centered design principles, this work establishes guidance on dashboard content, tailoring, and clinical use that patients and providers find meaningful. PMID:26260247

Vehicle impact simulation for curb and barrier design : volume 1, impact simulation procedures.

DOT National Transportation Integrated Search

1998-10-01

The objectives of this study were to perform computer simulations of vehicle-curb and vehicle-berm impacts, to characterize : the behavior of a wide range of vehicle types after such impacts, and to produce design and evaluation trajectory data for u...

Task management skills and their deficiencies during care delivery in simulated medical emergency situation: A classification.

PubMed

Morineau, Thierry; Chapelain, Pascal; Quinio, Philippe

2016-06-01

Our objective was to develop the analysis of task management skills by proposing a framework classifying task management stages and deficiencies. Few studies of non-technical skills have detailed the components of task management skills through behavioural markers, despite their central role in care delivery. A post hoc qualitative behavioural analysis was performed of recordings made of professional training sessions based upon simulated scenarios. Four recorded sessions in a high-fidelity simulation setting were observed and recorded. Two scenarios were used (cardiac arrest and respiratory failure), and there were two training sessions per scenario. Four types of task management deficiencies were identified with regards to task constraints: constraint relaxation, unsatisfied constraints, additional constraints and constraint transgression. Both equipment and space constraints were also identified. The lack of prerequisite actions when preparing the environment, corequisite actions for equipment and protocol monitoring, or postrequisite actions to restore the environment were associated with task management deficiencies. Deficiencies in task management behaviours can be identified in simulated as well as actual medical emergency settings. This framework opens perspectives for both training caregivers and designing ergonomic work situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Simulation Tools Model Icing for Aircraft Design

NASA Technical Reports Server (NTRS)

2012-01-01

Here s a simple science experiment to try: Place an unopened bottle of distilled water in your freezer. After 2-3 hours, if the water is pure enough, you will notice that it has not frozen. Carefully pour the water into a bowl with a piece of ice in it. When it strikes the ice, the water will instantly freeze. One of the most basic and commonly known scientific facts is that water freezes at around 32 F. But this is not always the case. Water lacking any impurities for ice crystals to form around can be supercooled to even lower temperatures without freezing. High in the atmosphere, water droplets can achieve this delicate, supercooled state. When a plane flies through clouds containing these droplets, the water can strike the airframe and, like the supercooled water hitting the ice in the experiment above, freeze instantly. The ice buildup alters the aerodynamics of the plane - reducing lift and increasing drag - affecting its performance and presenting a safety issue if the plane can no longer fly effectively. In certain circumstances, ice can form inside aircraft engines, another potential hazard. NASA has long studied ways of detecting and countering atmospheric icing conditions as part of the Agency s efforts to enhance aviation safety. To do this, the Icing Branch at Glenn Research Center utilizes a number of world-class tools, including the Center s Icing Research Tunnel and the NASA 607 icing research aircraft, a "flying laboratory" for studying icing conditions. The branch has also developed a suite of software programs to help aircraft and icing protection system designers understand the behavior of ice accumulation on various surfaces and in various conditions. One of these innovations is the LEWICE ice accretion simulation software. Initially developed in the 1980s (when Glenn was known as Lewis Research Center), LEWICE has become one of the most widely used tools in icing research and aircraft design and certification. LEWICE has been transformed over

Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments.

PubMed

Zhang, Xiao C; Bermudez, Ana M; Reddy, Pranav M; Sarpatwari, Ravi R; Chheng, Darin B; Mezoian, Taylor J; Schwartz, Victoria R; Simmons, Quinneil J; Jay, Gregory D; Kobayashi, Leo

2017-03-01

A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care. We designed and built a novel, open-source, portable, bedside procedural surface through an iterative development process with use testing in simulated and live clinical environments. The procedural surface development project was conducted between October 2014 and June 2016 at an academic referral hospital and its affiliated simulation facility. An interdisciplinary team of emergency physicians, mechanical engineers, medical students, and design students sought to construct a prototype bedside procedural surface out of off-the-shelf hardware during a collaborative university course on health care design. After determination of end-user needs and core design requirements, multiple prototypes were fabricated and iteratively modified, with early variants featuring undermattress stabilizing supports or ratcheting clamp mechanisms. Versions 1 through 4 underwent 2 hands-on usability-testing simulation sessions; version 5 was presented at a design critique held jointly by a panel of clinical and industrial design faculty for expert feedback. Responding to select feedback elements over several surface versions, investigators arrived at a near-final prototype design for fabrication and use testing in a live clinical setting. This experimental procedural surface (version 8) was constructed and then deployed for controlled usability testing against the standard Mayo stands in use at the study site ED. Clinical providers working in the ED who opted to participate in the study were provided with the prototype

A Novel Simulation Technician Laboratory Design: Results of a Survey-Based Study

PubMed Central

Hughes, Patrick G; Friedl, Ed; Ortiz Figueroa, Fabiana; Cepeda Brito, Jose R; Frey, Jennifer; Birmingham, Lauren E; Atkinson, Steven Scott

2016-01-01

Objective  The purpose of this study was to elicit feedback from simulation technicians prior to developing the first simulation technician-specific simulation laboratory in Akron, OH. Background Simulation technicians serve a vital role in simulation centers within hospitals/health centers around the world. The first simulation technician degree program in the US has been approved in Akron, OH. To satisfy the requirements of this program and to meet the needs of this special audience of learners, a customized simulation lab is essential.  Method A web-based survey was circulated to simulation technicians prior to completion of the lab for the new program. The survey consisted of questions aimed at identifying structural and functional design elements of a novel simulation center for the training of simulation technicians. Quantitative methods were utilized to analyze data. Results Over 90% of technicians (n=65) think that a lab designed explicitly for the training of technicians is novel and beneficial. Approximately 75% of respondents think that the space provided appropriate audiovisual (AV) infrastructure and space to evaluate the ability of technicians to be independent. The respondents think that the lab needed more storage space, visualization space for a large number of students, and more space in the technical/repair area. Conclusions  A space designed for the training of simulation technicians was considered to be beneficial. This laboratory requires distinct space for technical repair, adequate bench space for the maintenance and repair of simulators, an appropriate AV infrastructure, and space to evaluate the ability of technicians to be independent. PMID:27096134

A Novel Simulation Technician Laboratory Design: Results of a Survey-Based Study.

PubMed

Ahmed, Rami; Hughes, Patrick G; Friedl, Ed; Ortiz Figueroa, Fabiana; Cepeda Brito, Jose R; Frey, Jennifer; Birmingham, Lauren E; Atkinson, Steven Scott

2016-03-16

OBJECTIVE : The purpose of this study was to elicit feedback from simulation technicians prior to developing the first simulation technician-specific simulation laboratory in Akron, OH. Simulation technicians serve a vital role in simulation centers within hospitals/health centers around the world. The first simulation technician degree program in the US has been approved in Akron, OH. To satisfy the requirements of this program and to meet the needs of this special audience of learners, a customized simulation lab is essential. A web-based survey was circulated to simulation technicians prior to completion of the lab for the new program. The survey consisted of questions aimed at identifying structural and functional design elements of a novel simulation center for the training of simulation technicians. Quantitative methods were utilized to analyze data. Over 90% of technicians (n=65) think that a lab designed explicitly for the training of technicians is novel and beneficial. Approximately 75% of respondents think that the space provided appropriate audiovisual (AV) infrastructure and space to evaluate the ability of technicians to be independent. The respondents think that the lab needed more storage space, visualization space for a large number of students, and more space in the technical/repair area. CONCLUSIONS : A space designed for the training of simulation technicians was considered to be beneficial. This laboratory requires distinct space for technical repair, adequate bench space for the maintenance and repair of simulators, an appropriate AV infrastructure, and space to evaluate the ability of technicians to be independent.

Co-Simulation for Advanced Process Design and Optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephen E. Zitney

2009-01-01

Meeting the increasing demand for clean, affordable, and secure energy is arguably the most important challenge facing the world today. Fossil fuels can play a central role in a portfolio of carbon-neutral energy options provided CO{sub 2} emissions can be dramatically reduced by capturing CO{sub 2} and storing it safely and effectively. Fossil energy industry faces the challenge of meeting aggressive design goals for next-generation power plants with CCS. Process designs will involve large, highly-integrated, and multipurpose systems with advanced equipment items with complex geometries and multiphysics. APECS is enabling software to facilitate effective integration, solution, and analysis of high-fidelitymore » process/equipment (CFD) co-simulations. APECS helps to optimize fluid flow and related phenomena that impact overall power plant performance. APECS offers many advanced capabilities including ROMs, design optimization, parallel execution, stochastic analysis, and virtual plant co-simulations. NETL and its collaborative R&D partners are using APECS to reduce the time, cost, and technical risk of developing high-efficiency, zero-emission power plants with CCS.« less

Design Considerations for Post-Acute Care mHealth: Patient Perspectives.

PubMed

Sanger, Patrick; Hartzler, Andrea; Lober, William B; Evans, Heather L; Pratt, Wanda

2014-01-01

Many current mobile health applications ("apps") and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Post-discharge SSIs are a major source of morbidity and expense, and occur at a critical care transition when patients are physically and emotionally stressed. Through interviews with surgical patients who experienced SSI, we derived design considerations for such a post-acute care app. Key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. We illustrate our application of these guiding design considerations and propose a new framework for mHealth design based on illness duration and intensity.

Designing Online Scaffolds for Interactive Computer Simulation

ERIC Educational Resources Information Center

Chen, Ching-Huei; Wu, I-Chia; Jen, Fen-Lan

2013-01-01

The purpose of this study was to examine the effectiveness of online scaffolds in computer simulation to facilitate students' science learning. We first introduced online scaffolds to assist and model students' science learning and to demonstrate how a system embedded with online scaffolds can be designed and implemented to help high school…

An interprofessional communication training using simulation to enhance safe care for a deteriorating patient.

PubMed

Liaw, Sok Ying; Zhou, Wen Tao; Lau, Tang Ching; Siau, Chiang; Chan, Sally Wai-Chi

2014-02-01

Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. The aim of the study is to describe the development, implementation and evaluation of a simulation-based interprofessional educational (Sim-IPE) program, using a presage-process-product (3P) model, for improving medical and nursing students' communication skills in caring of a patient with physiological deterioration. The program was conducted using full-scale simulation and communication strategies adapted from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). 127 medical and nursing students participated in a 3-hour small group interprofessional learning that incorporated simulation scenarios of deteriorating patients. Pre and post-tests were conducted to assess the students' self-confidence in interprofessional communication and perception in interprofessional learning. After the training, the students completed a satisfaction questionnaire. Both medicine and nursing groups demonstrated a significant improvement on post-test score from pre-test score for self-confidence (p<.0001) and perception (p<.0001) with no significant differences detected between the two groups. The participants were highly satisfied with their simulation learning. The Sim-IPE has better prepared the medical and nursing students in communicating with one another in providing safe care for deteriorating patient. In addition, it has improved their perception towards interprofessional learning. This pre-registration interprofessional education could prepare them for more comprehensive interprofessional team learning at post-registration level. Copyright © 2014 Elsevier Ltd. All rights reserved.

Numerical Simulation and Mechanical Design for TPS Electron Beam Position Monitors

NASA Astrophysics Data System (ADS)

Hsueh, H. P.; Kuan, C. K.; Ueng, T. S.; Hsiung, G. Y.; Chen, J. R.

2007-01-01

Comprehensive study on the mechanical design and numerical simulation for the high resolution electron beam position monitors are key steps to build the newly proposed 3rd generation synchrotron radiation research facility, Taiwan Photon Source (TPS). With more advanced electromagnetic simulation tool like MAFIA tailored specifically for particle accelerator, the design for the high resolution electron beam position monitors can be tested in such environment before they are experimentally tested. The design goal of our high resolution electron beam position monitors is to get the best resolution through sensitivity and signal optimization. The definitions and differences between resolution and sensitivity of electron beam position monitors will be explained. The design consideration is also explained. Prototype deign has been carried out and the related simulations were also carried out with MAFIA. The results are presented here. Sensitivity as high as 200 in x direction has been achieved in x direction at 500 MHz.

Highly efficient simulation environment for HDTV video decoder in VLSI design

NASA Astrophysics Data System (ADS)

Mao, Xun; Wang, Wei; Gong, Huimin; He, Yan L.; Lou, Jian; Yu, Lu; Yao, Qingdong; Pirsch, Peter

2002-01-01

With the increase of the complex of VLSI such as the SoC (System on Chip) of MPEG-2 Video decoder with HDTV scalability especially, simulation and verification of the full design, even as high as the behavior level in HDL, often proves to be very slow, costly and it is difficult to perform full verification until late in the design process. Therefore, they become bottleneck of the procedure of HDTV video decoder design, and influence it's time-to-market mostly. In this paper, the architecture of Hardware/Software Interface of HDTV video decoder is studied, and a Hardware-Software Mixed Simulation (HSMS) platform is proposed to check and correct error in the early design stage, based on the algorithm of MPEG-2 video decoding. The application of HSMS to target system could be achieved by employing several introduced approaches. Those approaches speed up the simulation and verification task without decreasing performance.

Lightning Simulation and Design Program (LSDP)

NASA Astrophysics Data System (ADS)

Smith, D. A.

This computer program simulates a user-defined lighting configuration. It has been developed as a tool to aid in the design of exterior lighting systems. Although this program is used primarily for perimeter security lighting design, it has potential use for any application where the light can be approximated by a point source. A data base of luminaire photometric information is maintained for use with this program. The user defines the surface area to be illuminated with a rectangular grid and specifies luminaire positions. Illumination values are calculated for regularly spaced points in that area and isolux contour plots are generated. The numerical and graphical output for a particular site mode are then available for analysis. The amount of time spent on point-to-point illumination computation with this progress is much less than that required for tedious hand calculations. The ease with which various parameters can be interactively modified with the progress also reduces the time and labor expended. Consequently, the feasibility of design ideas can be examined, modified, and retested more thoroughly, and overall design costs can be substantially lessened by using this progress as an adjunct to the design process.

Optimal Living Environments for the Elderly: A Design Simulation Approach.

ERIC Educational Resources Information Center

Hoffman, Stephanie B.; And Others

PLANNED AGE (Planned Alternatives for Gerontological Environments) is a consumer/advocate-oriented design simulation package that provides: (a) a medium for user-planner interaction in the design of living and service environments for the aged; (b) an educational, planning, design, and evaluation tool that can be used by the elderly, their…

Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: patient gateway for diabetes collaborative care.

PubMed

Grant, Richard W; Wald, Jonathan S; Poon, Eric G; Schnipper, Jeffrey L; Gandhi, Tejal K; Volk, Lynn A; Middleton, Blackford

2006-10-01

Despite the availability of expert guidelines and widespread diabetes quality improvement efforts, care of patients with diabetes remains suboptimal. Two key barriers to care that may be amenable to informatics-based interventions include (1) lack of patient engagement with therapeutic care plans and (2) lack of medication adjustment by physicians ("clinical inertia") during clinical encounters. The authors describe the conceptual framework, design, implementation, and analysis plan for a diabetes patient web-portal linked directly to the electronic health record (EHR) of a large academic medical center via secure Internet access designed to overcome barriers to effective diabetes care. Partners HealthCare System (Boston, MA), a multi-hospital health care network comprising several thousand physicians caring for over 1 million individual patients, has developed a comprehensive patient web-portal called Patient Gateway that allows patients to interact directly with their EHR via secure Internet access. Using this portal, a specific diabetes interface was designed to maximize patient engagement by importing the patient's current clinical data in an educational format, providing patient-tailored decision support, and enabling the patient to author a "Diabetes Care Plan." The physician view of the patient's Diabetes Care Plan was designed to be concise and to fit into typical EHR clinical workflow. We successfully designed and implemented a Diabetes Patient portal that allows direct interaction with our system's EHR. We are assessing the impact of this advanced informatics tool for collaborative diabetes care in a clinic-randomized controlled trial among 14 primary care practices within our integrated health care system.

Design and Simulation of a MEMS Structure for Electrophoretic and Dielectrophoretic Separation of Particles by Contactless Electrodes

NASA Technical Reports Server (NTRS)

Shaw, Harry C.

2007-01-01

Rapid identification of pathogenic bacterial species is an important factor in combating public health problems such as E. coli contamination. Food and waterborne pathogens account for sickness in 76 million people annually (CDC). Diarrheagenic E. coli is a major source of gastrointestinal illness. Severe sepsis and Septicemia within the hospital environment are also major problems. 75 1,000 cases annually with a 30-50% mortality rate (Crit Care Med, July '01, Vol. 29, 1303-10). Patient risks run the continuum from fever to organ failure and death. Misdiagnosis or inappropriate treatment increases mortality. There exists a need for rapid screening of samples for identification of pathogenic species (Certain E. coli strains are essential for health). Critical to the identification process is the ability to isolate analytes of interest rapidly. This poster discusses novel devices for the separation of particles on the basis of the dielectric properties, mass and surface charge characteristics is presented. Existing designs involve contact between electrode surfaces and analyte medium resulting in contamination of the electrode bearing elements Two different device designs using different bulk micromachining MEMS processes (PolyMUMPS and a PyrexBIGold electrode design) are presented. These designs cover a range of particle sizes from small molecules through eucaryotic cells. The application of separation of bacteria is discussed in detail. Simulation data for electrostatic and microfluidic characteristics are provided. Detailed design characteristics and physical features of the as fabricated PolyMUMPS design are provided. Analysis of the simulation data relative to the expected performance of the devices will be provided and subsequent conclusions discussed.

Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model.

PubMed

Schnelle, John F; Schroyer, L Dale; Saraf, Avantika A; Simmons, Sandra F

2016-11-01

Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload

The use of computers for perioperative simulation in anesthesia, critical care, and pain medicine.

PubMed

Lambden, Simon; Martin, Bruce

2011-09-01

Simulation in perioperative anesthesia training is a field of considerable interest, with an urgent need for tools that reliably train and facilitate objective assessment of performance. This article reviews the available simulation technologies, their evolution, and the current evidence base for their use. The future directions for research in the field and potential applications of simulation technology in anesthesia, critical care, and pain medicine are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

CAGE IIIA Distributed Simulation Design Methodology

DTIC Science & Technology

2014-05-01

2 VHF Very High Frequency VLC Video LAN Codec – an Open-source cross-platform multimedia player and framework VM Virtual Machine VOIP Voice Over...Implementing Defence Experimentation (GUIDEx). The key challenges for this methodology are with understanding how to: • design it o define the...operation and to be available in the other nation’s simulations. The challenge for the CAGE campaign of experiments is to continue to build upon this

Design of transient light signal simulator based on FPGA

NASA Astrophysics Data System (ADS)

Kang, Jing; Chen, Rong-li; Wang, Hong

2014-11-01

A design scheme of transient light signal simulator based on Field Programmable gate Array (FPGA) was proposed in this paper. Based on the characteristics of transient light signals and measured feature points of optical intensity signals, a fitted curve was created in MATLAB. And then the wave data was stored in a programmed memory chip AT29C1024 by using SUPERPRO programmer. The control logic was realized inside one EP3C16 FPGA chip. Data readout, data stream cache and a constant current buck regulator for powering high-brightness LEDs were all controlled by FPGA. A 12-Bit multiplying CMOS digital-to-analog converter (DAC) DAC7545 and an amplifier OPA277 were used to convert digital signals to voltage signals. A voltage-controlled current source constituted by a NPN transistor and an operational amplifier controlled LED array diming to achieve simulation of transient light signal. LM3405A, 1A Constant Current Buck Regulator for Powering LEDs, was used to simulate strong background signal in space. Experimental results showed that the scheme as a transient light signal simulator can satisfy the requests of the design stably.

Design, Fabrication, and Testing of a Hopper Spacecraft Simulator

NASA Astrophysics Data System (ADS)

Mucasey, Evan Phillip Krell

A robust test bed is needed to facilitate future development of guidance, navigation, and control software for future vehicles capable of vertical takeoff and landings. Specifically, this work aims to develop both a hardware and software simulator that can be used for future flight software development for extra-planetary vehicles. To achieve the program requirements of a high thrust to weight ratio with large payload capability, the vehicle is designed to have a novel combination of electric motors and a micro jet engine is used to act as the propulsion elements. The spacecraft simulator underwent several iterations of hardware development using different materials and fabrication methods. The final design used a combination of carbon fiber and fiberglass that was cured under vacuum to serve as the frame of the vehicle which provided a strong, lightweight platform for all flight components and future payloads. The vehicle also uses an open source software development platform, Arduino, to serve as the initial flight computer and has onboard accelerometers, gyroscopes, and magnetometers to sense the vehicles attitude. To prevent instability due to noise, a polynomial kalman filter was designed and this fed the sensed angles and rates into a robust attitude controller which autonomously control the vehicle' s yaw, pitch, and roll angles. In addition to the hardware development of the vehicle itself, both a software simulation and a real time data acquisition interface was written in MATLAB/SIMULINK so that real flight data could be taken and then correlated to the simulation to prove the accuracy of the analytical model. In result, the full scale vehicle was designed and own outside of the lab environment and data showed that the software model accurately predicted the flight dynamics of the vehicle.

Rapidly Re-Configurable Flight Simulator Tools for Crew Vehicle Integration Research and Design

NASA Technical Reports Server (NTRS)

Schutte, Paul C.; Trujillo, Anna; Pritchett, Amy R.

2000-01-01

While simulation is a valuable research and design tool, the time and difficulty required to create new simulations (or re-use existing simulations) often limits their application. This report describes the design of the software architecture for the Reconfigurable Flight Simulator (RFS), which provides a robust simulation framework that allows the simulator to fulfill multiple research and development goals. The core of the architecture provides the interface standards for simulation components, registers and initializes components, and handles the communication between simulation components. The simulation components are each a pre-compiled library 'plug-in' module. This modularity allows independent development and sharing of individual simulation components. Additional interfaces can be provided through the use of Object Data/Method Extensions (OD/ME). RFS provides a programmable run-time environment for real-time access and manipulation, and has networking capabilities using the High Level Architecture (HLA).

Rapidly Re-Configurable Flight Simulator Tools for Crew Vehicle Integration Research and Design

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.

2002-01-01

While simulation is a valuable research and design tool, the time and difficulty required to create new simulations (or re-use existing simulations) often limits their application. This report describes the design of the software architecture for the Reconfigurable Flight Simulator (RFS), which provides a robust simulation framework that allows the simulator to fulfill multiple research and development goals. The core of the architecture provides the interface standards for simulation components, registers and initializes components, and handles the communication between simulation components. The simulation components are each a pre-compiled library 'plugin' module. This modularity allows independent development and sharing of individual simulation components. Additional interfaces can be provided through the use of Object Data/Method Extensions (OD/ME). RFS provides a programmable run-time environment for real-time access and manipulation, and has networking capabilities using the High Level Architecture (HLA).

Design of magnetic Circuit Simulation for Curing Device of Anisotropic MRE

NASA Astrophysics Data System (ADS)

Hapipi, N.; Ubaidillah; Mazlan, S. A.; Widodo, P. J.

2018-03-01

The strength of magnetic field during fabrication of magnetorheological elastomer (MRE) plays a crucial role in order to form a pre-structured MRE. So far, gaussmeter were used to determine the magnetic intensity subjected to the MRE during curing. However, the magnetic flux reading through that measurement considered less accurate. Therefore, a simulation should be done to figure out the magnetic flux concentration around the sample. This paper investigates the simulation of magnetic field distribution in a curing device used during curing stage of anisotropic magnetorheological elastomer (MRE). The target in designing the magnetic circuit is to ensure a sufficient and uniform magnetic field to all the MRE surfaces during the curing process. The magnetic circuit design for the curing device was performed using Finite Element Method Magnetic (FEMM) to examine the magnetic flux density distribution in the device. The material selection was first done instantaneously during a magnetic simulation process. Then, the experimental validation of simulation was performed by measuring and comparing the actual flux generated within the specimen type and the one from the FEMM simulation. İt apparent that the data from FEMM simulation shows an agreement with the actual measurement. Furthermore, the FEMM results showed that the magnetic design is able to provide sufficient and uniform magnetic field all over the surfaces of the MRE.

Real-time simulator for designing electron dual scattering foil systems.

PubMed

Carver, Robert L; Hogstrom, Kenneth R; Price, Michael J; LeBlanc, Justin D; Pitcher, Garrett M

2014-11-08

The purpose of this work was to develop a user friendly, accurate, real-time com- puter simulator to facilitate the design of dual foil scattering systems for electron beams on radiotherapy accelerators. The simulator allows for a relatively quick, initial design that can be refined and verified with subsequent Monte Carlo (MC) calculations and measurements. The simulator also is a powerful educational tool. The simulator consists of an analytical algorithm for calculating electron fluence and X-ray dose and a graphical user interface (GUI) C++ program. The algorithm predicts electron fluence using Fermi-Eyges multiple Coulomb scattering theory with the reduced Gaussian formalism for scattering powers. The simulator also estimates central-axis and off-axis X-ray dose arising from the dual foil system. Once the geometry of the accelerator is specified, the simulator allows the user to continuously vary primary scattering foil material and thickness, secondary scat- tering foil material and Gaussian shape (thickness and sigma), and beam energy. The off-axis electron relative fluence or total dose profile and central-axis X-ray dose contamination are computed and displayed in real time. The simulator was validated by comparison of off-axis electron relative fluence and X-ray percent dose profiles with those calculated using EGSnrc MC. Over the energy range 7-20 MeV, using present foils on an Elekta radiotherapy accelerator, the simulator was able to reproduce MC profiles to within 2% out to 20 cm from the central axis. The central-axis X-ray percent dose predictions matched measured data to within 0.5%. The calculation time was approximately 100 ms using a single Intel 2.93 GHz processor, which allows for real-time variation of foil geometrical parameters using slider bars. This work demonstrates how the user-friendly GUI and real-time nature of the simulator make it an effective educational tool for gaining a better understanding of the effects that various system

Peer Mentoring in Long-Term Care: Rational, Design, and Retention

ERIC Educational Resources Information Center

Hegeman, Carol; Hoskinson, Debi; Munro, Heather; Maiden, Patricia; Pillemer, Karl

2007-01-01

This article describes two successful peer-mentoring programs designed to improve the quality of care in nursing homes and retention rates among direct care staff. The first program, "Growing Strong Roots," examined CNA retention rates and the second program, "Peer Mentoring for Long Term Charge Nurses," examined RN and LPN retention rates. These…

Patient‐centred improvements in health‐care built environments: perspectives and design indicators

PubMed Central

Douglas, Calbert H.; Douglas, Mary R.

2005-01-01

Abstract Objective  To explore patients’ perceptions of health‐care built environments, to assess how they perceived health‐care built facilities and designs. To develop a set of patient‐centred indicators by which to appraise future health‐care designs. Design  Qualitative and quantitative methodologies, including futures group conferencing, autophotographic study, novice‐expert exchanges and a questionnaire survey of a representative sample of past patients. Setting and participants  The research was carried out at Salford Royal Hospitals NHS Trust (SRHT), Greater Manchester, UK, selected for the study because of planned comprehensive redevelopment based on the new NHS vision for hospital care and service delivery for the 21st century. Participants included 35 patients who took part in an autophotographic study, eight focus groups engaged in futures conferencing, a sample of past inpatients from the previous 12 months that returned 785 completed postal questionnaires. Results  The futures group provided suggestions for radical improvements which were categorized into transport issues; accessibility and mobility; ground and landscape designs; social and public spaces; homeliness and assurance; cultural diversity; safety and security; personal space and access to outside. Patients’ autophotographic study centred on: the quality of the ward design, human interactions, the state and quality of personal space, and facilities for recreation and leisure. The novices’ suggestions were organized into categories of elemental factors representing patient‐friendly designs. Experts from the architectural and surveying professions and staff at SRHT in turn considered these categories and respective subsets of factors. They agreed with the novices in terms of the headings but differed in prioritizing the elemental factors. The questionnaire survey of past patients provided opinions about ward designs that varied according to where they stayed, single

How architectural design affords experiences of freedom in residential care for older people.

PubMed

Van Steenwinkel, Iris; Dierckx de Casterlé, Bernadette; Heylighen, Ann

2017-04-01

Human values and social issues shape visions on dwelling and care for older people, a growing number of whom live in residential care facilities. These facilities' architectural design is considered to play an important role in realizing care visions. This role, however, has received little attention in research. This article presents a case study of a residential care facility for which the architects made considerable effort to match the design with the care vision. The study offers insights into residents' and caregivers' experiences of, respectively, living and working in this facility, and the role of architectural features therein. A single qualitative case study design was used to provide in-depth, contextual insights. The methods include semi-structured interviews with residents and caregivers, and participant observation. Data concerning design intentions, assumptions and strategies were obtained from design documents, through a semi-structured interview with the architects, and observations on site. Our analysis underlines the importance of freedom (and especially freedom of movement), and the balance between experiencing freedom and being bound to a social and physical framework. It shows the architecture features that can have a role therein: small-scaleness in terms of number of residents per dwelling unit, size and compactness; spatial generosity in terms of surface area, room to maneuver and variety of places; and physical accessibility. Our study challenges the idea of family-like group living. Since we found limited sense of group belonging amongst residents, our findings suggest to rethink residential care facilities in terms of private or collective living in order to address residents' social freedom of movement. Caregivers associated 'hominess' with freedom of movement, action and choice, with favorable social dynamics and with the building's residential character. Being perceived as homey, the facility's architectural design matches caregivers

The Effects of Organization Design and Patient Perceptions of Care on Switching Behavior and Reliance on a Health Care System Across Time.

PubMed

Labonte, Alan J; Benzer, Justin K; Burgess, James F; Cramer, Irene E; Meterko, Mark; Pogoda, Terri K; Charns, Martin P

2016-04-01

Sustaining ongoing relationships with patients is a strategic, clinically relevant goal of health care systems. This study develops and tests a conceptual model that aims to account for the influence of organization design, perceptions of quality of patient care, and other patient-level factors on the extent to which patients sustain reliance on a health care system. We use a longitudinal survey design and structural equation modeling to predict increases or decreases in patient reliance on the Department of Veterans Affairs health care system across a 4-year period for Veterans with Parkinson's Disease. Our findings show that specialized and integrated clinical practices have a positive association with the quality of patient care. Health care systems may be able to foster long-term relations with patients and improve service quality by allocating resources to form integrated, specialized, disease-specific centers of care designed for patients with chronic illnesses. © The Author(s) 2016.

Simulation Research in Gastrointestinal and Urologic Care-Challenges and Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering Workshop.

PubMed

Aggarwal, Rajesh; Brown, Kimberly M; de Groen, Piet C; Gallagher, Anthony G; Henriksen, Kerm; Kavoussi, Louis R; Peng, Grace C Y; Ritter, E Matthew; Silverman, Elliott; Wang, Kenneth K; Andersen, Dana K

2018-01-01

: A workshop on "Simulation Research in Gastrointestinal and Urologic Care: Challenges and Opportunities" was held at the National Institutes of Health in June 2016. The purpose of the workshop was to examine the extent to which simulation approaches have been used by skilled proceduralists (not trainees) caring for patients with gastrointestinal and urologic diseases. The current status of research findings in the use and effectiveness of simulation applications was reviewed, and numerous knowledge gaps and research needs were identified by the faculty and the attendees. The paradigm of "deliberate practice," rather than mere repetition, and the value of coaching by experts was stressed by those who have adopted simulation in music and sports. Models that are most useful for the adoption of simulation by expert clinicians have yet to be fully validated. Initial studies on the impact of simulation on safety and error reduction have demonstrated its value in the training domain, but the role of simulation as a strategy for increased procedural safety remains uncertain in the world of the expert practitioner. Although the basic requirements for experienced physicians to acquire new skills have been explored, the widespread availability of such resources is an unrealized goal, and there is a need for well-designed outcome studies to establish the role of simulation in improving the quality of health care.

Effects of Thinking Style on Design Strategies: Using Bridge Construction Simulation Programs

ERIC Educational Resources Information Center

Sun, Chuen-Tsai; Wang, Dai-Yi; Chang, Yu-Yeh

2013-01-01

Computer simulation users can freely control operational factors and simulation results, repeat processes, make changes, and learn from simulation environment feedback. The focus of this paper is on simulation-based design tools and their effects on student learning processes in a group of 101 Taiwanese senior high school students. Participants…

Opportunities for Breakthroughs in Large-Scale Computational Simulation and Design

NASA Technical Reports Server (NTRS)

Alexandrov, Natalia; Alter, Stephen J.; Atkins, Harold L.; Bey, Kim S.; Bibb, Karen L.; Biedron, Robert T.; Carpenter, Mark H.; Cheatwood, F. McNeil; Drummond, Philip J.; Gnoffo, Peter A.

2002-01-01

Opportunities for breakthroughs in the large-scale computational simulation and design of aerospace vehicles are presented. Computational fluid dynamics tools to be used within multidisciplinary analysis and design methods are emphasized. The opportunities stem from speedups and robustness improvements in the underlying unit operations associated with simulation (geometry modeling, grid generation, physical modeling, analysis, etc.). Further, an improved programming environment can synergistically integrate these unit operations to leverage the gains. The speedups result from reducing the problem setup time through geometry modeling and grid generation operations, and reducing the solution time through the operation counts associated with solving the discretized equations to a sufficient accuracy. The opportunities are addressed only at a general level here, but an extensive list of references containing further details is included. The opportunities discussed are being addressed through the Fast Adaptive Aerospace Tools (FAAST) element of the Advanced Systems Concept to Test (ASCoT) and the third Generation Reusable Launch Vehicles (RLV) projects at NASA Langley Research Center. The overall goal is to enable greater inroads into the design process with large-scale simulations.

Using Blocked Fractional Factorial Designs to Construct Discrete Choice Experiments for Health Care Studies

PubMed Central

Jaynes, Jessica; Wong, Weng Kee; Xu, Hongquan

2016-01-01

Discrete choice experiments (DCEs) are increasingly used for studying and quantifying subjects preferences in a wide variety of health care applications. They provide a rich source of data to assess real-life decision making processes, which involve trade-offs between desirable characteristics pertaining to health and health care, and identification of key attributes affecting health care. The choice of the design for a DCE is critical because it determines which attributes’ effects and their interactions are identifiable. We apply blocked fractional factorial designs to construct DCEs and address some identification issues by utilizing the known structure of blocked fractional factorial designs. Our design techniques can be applied to several situations including DCEs where attributes have different number of levels. We demonstrate our design methodology using two health care studies to evaluate (1) asthma patients’ preferences for symptom-based outcome measures, and (2) patient preference for breast screening services. PMID:26823156

Designing quality of care--contributions from parents: Parents' experiences of care processes in paediatric care and their contribution to improvements of the care process in collaboration with healthcare professionals.

PubMed

Gustavsson, Susanne; Gremyr, Ida; Kenne Sarenmalm, Elisabeth

2016-03-01

The aim of this article was to explore whether current quality dimensions for health care services are sufficient to capture how parents perceive and contribute to quality of health care. New quality improvement initiatives that actively involve patients must be examined with a critical view on established quality dimensions to ensure that these measures support patient involvement. This paper used a qualitative and descriptive design. This paper is based on interviews with parents participating in two experience-based co-design projects in a Swedish hospital that included qualitative content analysis of data from 12 parent interviews in paediatric care. Health care professionals often overemphasize their own significance for value creation in care processes and underappreciate parents' ability to influence and contribute to better quality. However, quality is not based solely on how professionals accomplish their task, but is co-created by health care professionals and parents. Consequently, assessment of quality outcomes also must include parents' ability and context. This paper questions current models of quality dimensions in health care, and suggests additional sub-dimensions, such as family quality and involvement quality. This paper underscores the importance of involving parents in health care improvements with health care professionals to capture as many dimensions of quality as possible. © 2015 John Wiley & Sons Ltd.

Computational Aerodynamic Simulations of a Spacecraft Cabin Ventilation Fan Design

NASA Technical Reports Server (NTRS)

Tweedt, Daniel L.

2010-01-01

Quieter working environments for astronauts are needed if future long-duration space exploration missions are to be safe and productive. Ventilation and payload cooling fans are known to be dominant sources of noise, with the International Space Station being a good case in point. To address this issue cost effectively, early attention to fan design, selection, and installation has been recommended, leading to an effort by NASA to examine the potential for small-fan noise reduction by improving fan aerodynamic design. As a preliminary part of that effort, the aerodynamics of a cabin ventilation fan designed by Hamilton Sundstrand has been simulated using computational fluid dynamics codes, and the computed solutions analyzed to quantify various aspects of the fan aerodynamics and performance. Four simulations were performed at the design rotational speed: two at the design flow rate and two at off-design flow rates. Following a brief discussion of the computational codes, various aerodynamic- and performance-related quantities derived from the computed flow fields are presented along with relevant flow field details. The results show that the computed fan performance is in generally good agreement with stated design goals.

Digital autopilots: Design considerations and simulator evaluations

NASA Technical Reports Server (NTRS)

Osder, S.; Neuman, F.; Foster, J.

1971-01-01

The development of a digital autopilot program for a transport aircraft and the evaluation of that system's performance on a transport aircraft simulator is discussed. The digital autopilot includes three axis attitude stabilization, automatic throttle control and flight path guidance functions with emphasis on the mode progression from descent into the terminal area through automatic landing. The study effort involved a sequence of tasks starting with the definition of detailed system block diagrams of control laws followed by a flow charting and programming phase and concluding with performance verification using the transport aircraft simulation. The autopilot control laws were programmed in FORTRAN 4 in order to isolate the design process from requirements peculiar to an individual computer.

Software Design for Interactive Graphic Radiation Treatment Simulation Systems*

PubMed Central

Kalet, Ira J.; Sweeney, Christine; Jacky, Jonathan

1990-01-01

We examine issues in the design of interactive computer graphic simulation programs for radiation treatment planning (RTP), as well as expert system programs that automate parts of the RTP process, in light of ten years of experience at designing, building and using such programs. An experiment in object-oriented design using standard Pascal shows that while some advantage is gained from the design, it is still difficult to achieve modularity and to integrate expert system components. A new design based on the Common LISP Object System (CLOS) is described. This series of designs for RTP software shows that this application benefits in specific ways from object-oriented design methods and appropriate languages and tools.

Comparative Simulation Study of Glucose Control Methods Designed for Use in the Intensive Care Unit Setting via a Novel Controller Scoring Metric.

PubMed

DeJournett, Jeremy; DeJournett, Leon

2017-11-01

Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance. We proposed a composite metric that combines 5 commonly reported metrics, and we used this composite metric to compare 6 glucose controllers. We evaluated the following controllers: Ideal Medical Technologies (IMT) artificial-intelligence-based controller, Yale protocol, Glucommander, Wintergerst et al PID controller, GRIP, and NICE-SUGAR. We evaluated each controller across 80 simulated patients, 4 clinically relevant exogenous dextrose infusions, and one nonclinical infusion as a test of the controller's ability to handle difficult situations. This gave a total of 2400 5-day simulations, and 585 604 individual glucose values for analysis. We used a random walk sensor error model that gave a 10% MARD. For each controller, we calculated severe hypoglycemia (<40 mg/dL), mild hypoglycemia (40-69 mg/dL), normoglycemia (70-140 mg/dL), hyperglycemia (>140 mg/dL), and coefficient of variation (CV), as well as our novel controller metric. For the controllers tested, we achieved the following median values for our novel controller scoring metric: IMT: 88.1, YALE: 46.7, GLUC: 47.2, PID: 50, GRIP: 48.2, NICE: 46.4. The novel scoring metric employed in this study shows promise as a means for evaluating new and existing ICU-based glucose controllers, and it could be used in the future to compare results of glucose control studies in critical care. The IMT AI-based glucose controller demonstrated the most consistent performance results based on this new metric.

Scaffolding Interprofessional Education: Unfolding Case Studies, Virtual World Simulations, and Patient-Centered Care.

PubMed

Zook, Sharon Strang; Hulton, Linda J; Dudding, Carol C; Stewart, Anne L; Graham, Amy C

Fragmentation of health care negatively impacts quality; one of the contributing factors may be ineffective collaboration among health care professionals. This article describes the implementation of an interprofessional education curriculum for graduate students enrolled in nursing, psychology, and speech-language pathology programs. Over 3 semesters, students engaged in interprofessional collaboration modules, unfolding case studies, virtual simulation, and shared case planning experiences. The curriculum's impact on students' attitudes and values toward interprofessional collaborative practice was measured.

Design and validation of the eyesafe ladar testbed (ELT) using the LadarSIM system simulator

NASA Astrophysics Data System (ADS)

Neilsen, Kevin D.; Budge, Scott E.; Pack, Robert T.; Fullmer, R. Rees; Cook, T. Dean

2009-05-01

The development of an experimental full-waveform LADAR system has been enhanced with the assistance of the LadarSIM system simulation software. The Eyesafe LADAR Test-bed (ELT) was designed as a raster scanning, single-beam, energy-detection LADAR with the capability of digitizing and recording the return pulse waveform at up to 2 GHz for 3D off-line image formation research in the laboratory. To assist in the design phase, the full-waveform LADAR simulation in LadarSIM was used to simulate the expected return waveforms for various system design parameters, target characteristics, and target ranges. Once the design was finalized and the ELT constructed, the measured specifications of the system and experimental data captured from the operational sensor were used to validate the behavior of the system as predicted during the design phase. This paper presents the methodology used, and lessons learned from this "design, build, validate" process. Simulated results from the design phase are presented, and these are compared to simulated results using measured system parameters and operational sensor data. The advantages of this simulation-based process are also presented.

Design and simulation of betavoltaic battery using large-grain polysilicon.

PubMed

Yao, Shulin; Song, Zijun; Wang, Xiang; San, Haisheng; Yu, Yuxi

2012-10-01

In this paper, we present the design and simulation of a p-n junction betavoltaic battery based on large-grain polysilicon. By the Monte Carlo simulation, the average penetration depth were obtained, according to which the optimal depletion region width was designed. The carriers transport model of large-grain polysilicon is used to determine the diffusion length of minority carrier. By optimizing the doping concentration, the maximum power conversion efficiency can be achieved to be 0.90% with a 10 mCi/cm(2) Ni-63 source radiation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Designing a complex intervention for dementia case management in primary care

PubMed Central

2013-01-01

Background Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in ‘real life’ settings. PMID:23865537

Photoacoustic design parameter optimization for deep tissue imaging by numerical simulation

NASA Astrophysics Data System (ADS)

Wang, Zhaohui; Ha, Seunghan; Kim, Kang

2012-02-01

A new design of light illumination scheme for deep tissue photoacoustic (PA) imaging, a light catcher, is proposed and evaluated by in silico simulation. Finite element (FE)-based numerical simulation model was developed for photoacoustic (PA) imaging in soft tissues. In this in silico simulation using a commercially available FE simulation package (COMSOL MultiphysicsTM, COMSOL Inc., USA), a short-pulsed laser point source (pulse length of 5 ns) was placed in water on the tissue surface. Overall, four sets of simulation models were integrated together to describe the physical principles of PA imaging. Light energy transmission through background tissues from the laser source to the target tissue or contrast agent was described by diffusion equation. The absorption of light energy and its conversion to heat by target tissue or contrast agent was modeled using bio-heat equation. The heat then causes the stress and strain change, and the resulting displacement of the target surface produces acoustic pressure. The created wide-band acoustic pressure will propagate through background tissues to the ultrasound detector, which is governed by acoustic wave equation. Both optical and acoustical parameters in soft tissues such as scattering, absorption, and attenuation are incorporated in tissue models. PA imaging performance with different design parameters of the laser source and energy delivery scheme was investigated. The laser light illumination into the deep tissues can be significantly improved by up to 134.8% increase of fluence rate by introducing a designed compact light catcher with highly reflecting inner surface surrounding the light source. The optimized parameters through this simulation will guide the design of PA system for deep tissue imaging, and help to form the base protocols of experimental evaluations in vitro and in vivo.

Technology, design, simulation, and evaluation for SEP-hardened circuits

NASA Technical Reports Server (NTRS)

Adams, J. R.; Allred, D.; Barry, M.; Rudeck, P.; Woodruff, R.; Hoekstra, J.; Gardner, H.

1991-01-01

This paper describes the technology, design, simulation, and evaluation for improvement of the Single Event Phenomena (SEP) hardness of gate-array and SRAM cells. Through the use of design and processing techniques, it is possible to achieve an SEP error rate less than 1.0 x 10(exp -10) errors/bit-day for a 9O percent worst-case geosynchronous orbit environment.

Safer@home-Simulation and training: the study protocol of a qualitative action research design.

PubMed

Wiig, Siri; Guise, Veslemøy; Anderson, Janet; Storm, Marianne; Lunde Husebø, Anne Marie; Testad, Ingelin; Søyland, Elsa; Moltu, Kirsti L

2014-07-29

While it is predicted that telecare and other information and communication technology (ICT)-assisted services will have an increasingly important role in future healthcare services, their implementation in practice is complex. For implementation of telecare to be successful and ensure quality of care, sufficient training for staff (healthcare professionals) and service users (patients) is fundamental. Telecare training has been found to have positive effects on attitudes to, sustained use of, and outcomes associated with telecare. However, the potential contribution of training in the adoption, quality and safety of telecare services is an under-investigated research field. The overall aim of this study is to develop and evaluate simulation-based telecare training programmes to aid the use of videophone technology in elderly home care. Research-based training programmes will be designed for healthcare professionals, service users and next of kin, and the study will explore the impact of training on adoption, quality and safety of new telecare services. The study has a qualitative action research design. The research will be undertaken in close collaboration with a multidisciplinary team consisting of researchers and managers and clinical representatives from healthcare services in two Norwegian municipalities, alongside experts in clinical education and simulation, as well as service user (patient) representatives. The qualitative methods used involve focus group interviews, semistructured interviews, observation and document analysis. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation; in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. The study is approved by the Norwegian Social Science Data Services. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in

Safer@home—Simulation and training: the study protocol of a qualitative action research design

PubMed Central

Wiig, Siri; Guise, Veslemøy; Anderson, Janet; Storm, Marianne; Lunde Husebø, Anne Marie; Testad, Ingelin; Søyland, Elsa; Moltu, Kirsti L

2014-01-01

Introduction While it is predicted that telecare and other information and communication technology (ICT)-assisted services will have an increasingly important role in future healthcare services, their implementation in practice is complex. For implementation of telecare to be successful and ensure quality of care, sufficient training for staff (healthcare professionals) and service users (patients) is fundamental. Telecare training has been found to have positive effects on attitudes to, sustained use of, and outcomes associated with telecare. However, the potential contribution of training in the adoption, quality and safety of telecare services is an under-investigated research field. The overall aim of this study is to develop and evaluate simulation-based telecare training programmes to aid the use of videophone technology in elderly home care. Research-based training programmes will be designed for healthcare professionals, service users and next of kin, and the study will explore the impact of training on adoption, quality and safety of new telecare services. Methods and analysis The study has a qualitative action research design. The research will be undertaken in close collaboration with a multidisciplinary team consisting of researchers and managers and clinical representatives from healthcare services in two Norwegian municipalities, alongside experts in clinical education and simulation, as well as service user (patient) representatives. The qualitative methods used involve focus group interviews, semistructured interviews, observation and document analysis. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation; in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. Ethics and dissemination The study is approved by the Norwegian Social Science Data Services. The study is based on voluntary participation and informed

A design of hardware haptic interface for gastrointestinal endoscopy simulation.

PubMed

Gu, Yunjin; Lee, Doo Yong

2011-01-01

Gastrointestinal endoscopy simulations have been developed to train endoscopic procedures which require hundreds of practices to be competent in the skills. Even though realistic haptic feedback is important to provide realistic sensation to the user, most of previous simulations including commercialized simulation have mainly focused on providing realistic visual feedback. In this paper, we propose a novel design of portable haptic interface, which provides 2DOF force feedback, for the gastrointestinal endoscopy simulation. The haptic interface consists of translational and rotational force feedback mechanism which are completely decoupled, and gripping mechanism for controlling connection between the endoscope and the force feedback mechanism.

Two decades (1993-2012) of adult intensive care unit design: a comparative study of the physical design features of the best practice examples.

PubMed

Rashid, Mahbub

2014-01-01

In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical

Representing the work of medical protocols for organizational simulation.

PubMed Central

Fridsma, D. B.

1998-01-01

Developing and implementing patient care protocols within a specific organizational setting requires knowledge of the protocol, the organization, and the way in which the organization does its work. Computer-based simulation tools have been used in many industries to provide managers with prospective insight into problems of work process and organization design mismatch. Many of these simulation tools are designed for well-understood routine work processes in which there are few contingent tasks. In this paper, we describe theoretic that make it possible to simulate medical protocols using an information-processing theory framework. These simulations will allow medical administrators to test different protocol and organizational designs before actually using them within a particular clinical setting. PMID:9929231

Designing a Technology Enhanced Practice for Home Nursing Care of Patients with Congestive Heart Failure

PubMed Central

Casper, Gail R.; Karsh, Ben-Tzion; K.L., Calvin; Carayon, Pascale; Grenier, Anne-Sophie; Sebern, Margaret; Burke, Laura J.; Brennan, Patricia F.

2005-01-01

This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities. A modified macroergonomic analysis, design work system analysis, and focus groups utilizing participatory design methodology were undertaken to characterize the nursing practice model. Design of the HeartCare website required synthesizing the extant practice model and the agency’s evidence-based heart failure protocols, identifying aspects of practice that could be enhanced by supporting technology, and delineation of functional requirements of the Enhanced HeartCare technology. Validation and refinement of the website and planning for user training activities will be accomplished through a two-stage usability testing strategy. PMID:16779013

Intensive care nursing students' perceptions of simulation for learning confirming communication skills: A descriptive qualitative study.

PubMed

Karlsen, Marte-Marie Wallander; Gabrielsen, Anita Kristin; Falch, Anne Lise; Stubberud, Dag-Gunnar

2017-10-01

The aim of this study was to explore intensive care nursing students experiences with confirming communication skills training in a simulation-based environment. The study has a qualitative, exploratory and descriptive design. The participants were students in a post-graduate program in intensive care nursing, that had attended a one day confirming communication course. Three focus group interviews lasting between 60 and 80min were conducted with 14 participants. The interviews were transcribed verbatim. Thematic analysis was performed, using Braun & Clark's seven steps. The analysis resulted in three main themes: "awareness", "ice-breaker" and "challenging learning environment". The participants felt that it was a challenge to see themselves on the video-recordings afterwards, however receiving feedback resulted in better self-confidence in mastering complex communication. The main finding of the study is that the students reported improved communication skills after the confirming communication course. However; it is uncertain how these skills can be transferred to clinical practice improving patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interoperability and complementarity of simulation tools for beamline design in the OASYS environment

NASA Astrophysics Data System (ADS)

Rebuffi, Luca; Sanchez del Rio, Manuel

2017-08-01

In the next years most of the major synchrotron radiation facilities around the world will upgrade to 4th-generation Diffraction Limited Storage Rings using multi-bend-achromat technology. Moreover, several Free Electron Lasers are ready-to-go or in phase of completion. These events represent a huge challenge for the optics physicists responsible of designing and calculating optical systems capable to exploit the revolutionary characteristics of the new photon beams. Reliable and robust beamline design is nowadays based on sophisticated computer simulations only possible by lumping together different simulation tools. The OASYS (OrAnge SYnchrotron Suite) suite drives several simulation tools providing new mechanisms of interoperability and communication within the same software environment. OASYS has been successfully used during the conceptual design of many beamline and optical designs for the ESRF and Elettra- Sincrotrone Trieste upgrades. Some examples are presented showing comparisons and benchmarking of simulations against calculated and experimental data.

Method and Tool for Design Process Navigation and Automatic Generation of Simulation Models for Manufacturing Systems

NASA Astrophysics Data System (ADS)

Nakano, Masaru; Kubota, Fumiko; Inamori, Yutaka; Mitsuyuki, Keiji

Manufacturing system designers should concentrate on designing and planning manufacturing systems instead of spending their efforts on creating the simulation models to verify the design. This paper proposes a method and its tool to navigate the designers through the engineering process and generate the simulation model automatically from the design results. The design agent also supports collaborative design projects among different companies or divisions with distributed engineering and distributed simulation techniques. The idea was implemented and applied to a factory planning process.

Benefits of full scope simulators during solar thermal power plants design and construction

NASA Astrophysics Data System (ADS)

Gallego, José F.; Gil, Elena; Rey, Pablo

2017-06-01

In order to efficiently develop high-precision dynamic simulators for solar thermal power plants, Tecnatom adapted its simulation technology to consider solar thermal models. This effort and the excellent response of the simulation market have allowed Tecnatom to develop simulators with both parabolic trough and solar power tower technologies, including molten salt energy storage. These simulators may pursue different objectives, giving rise to training or engineering simulators. Solar thermal power market combines the need for the training of the operators with the potential benefits associated to the improvement of the design of the plants. This fact along with the simulation capabilities enabled by the current technology and the broad experience of Tecnatom present the development of an engineering+training simulator as a very advantageous option. This paper describes the challenge of the development and integration of a full scope simulator during the design and construction stages of a solar thermal power plant, showing the added value to the different engineering areas.

A simulation-based probabilistic design method for arctic sea transport systems

NASA Astrophysics Data System (ADS)

Martin, Bergström; Ove, Erikstad Stein; Sören, Ehlers

2016-12-01

When designing an arctic cargo ship, it is necessary to consider multiple stochastic factors. This paper evaluates the merits of a simulation-based probabilistic design method specifically developed to deal with this challenge. The outcome of the paper indicates that the incorporation of simulations and probabilistic design parameters into the design process enables more informed design decisions. For instance, it enables the assessment of the stochastic transport capacity of an arctic ship, as well as of its long-term ice exposure that can be used to determine an appropriate level of ice-strengthening. The outcome of the paper also indicates that significant gains in transport system cost-efficiency can be obtained by extending the boundaries of the design task beyond the individual vessel. In the case of industrial shipping, this allows for instance the consideration of port-based cargo storage facilities allowing for temporary shortages in transport capacity and thus a reduction in the required fleet size / ship capacity.

Predicting Silk Fiber Mechanical Properties through Multiscale Simulation and Protein Design.

PubMed

Rim, Nae-Gyune; Roberts, Erin G; Ebrahimi, Davoud; Dinjaski, Nina; Jacobsen, Matthew M; Martín-Moldes, Zaira; Buehler, Markus J; Kaplan, David L; Wong, Joyce Y

2017-08-14

Silk is a promising material for biomedical applications, and much research is focused on how application-specific, mechanical properties of silk can be designed synthetically through proper amino acid sequences and processing parameters. This protocol describes an iterative process between research disciplines that combines simulation, genetic synthesis, and fiber analysis to better design silk fibers with specific mechanical properties. Computational methods are used to assess the protein polymer structure as it forms an interconnected fiber network through shearing and how this process affects fiber mechanical properties. Model outcomes are validated experimentally with the genetic design of protein polymers that match the simulation structures, fiber fabrication from these polymers, and mechanical testing of these fibers. Through iterative feedback between computation, genetic synthesis, and fiber mechanical testing, this protocol will enable a priori prediction capability of recombinant material mechanical properties via insights from the resulting molecular architecture of the fiber network based entirely on the initial protein monomer composition. This style of protocol may be applied to other fields where a research team seeks to design a biomaterial with biomedical application-specific properties. This protocol highlights when and how the three research groups (simulation, synthesis, and engineering) should be interacting to arrive at the most effective method for predictive design of their material.

The design and development of a triaxial wear-testing joint simulator.

PubMed

Green, A S; O'Connell, M K; Lyons, A S; James, S P

1999-01-01

Most of the existing wear testers created to wear test total hip replacements, specifically the acetabular component, are designed to exert only an axial force and provide rotation in a close approximation of the actual femoral movement. The Rocky Mountain Joint Simulator was designed to exert three orthogonal forces and provide rotations about the X-, Y- and Z-axes to more closely simulate the physiological forces and motions found in the human gait cycle. The RMJS was also designed with adaptability for other joints, such as knees or canine hips, through the use of hydraulics and a computer-programmable control system. Such adaptability and functionality allows the researcher to more closely model a gait cycle, thereby obtaining wear patterns that resemble those found in retrieved implants more closely than existing simulators. Research is ongoing into the tuning and evaluation of the machine and preliminary acetabular component wear test results will be presented at the conference.

Self-reconfigurable ship fluid-network modeling for simulation-based design

NASA Astrophysics Data System (ADS)

Moon, Kyungjin

Our world is filled with large-scale engineering systems, which provide various services and conveniences in our daily life. A distinctive trend in the development of today's large-scale engineering systems is the extensive and aggressive adoption of automation and autonomy that enable the significant improvement of systems' robustness, efficiency, and performance, with considerably reduced manning and maintenance costs, and the U.S. Navy's DD(X), the next-generation destroyer program, is considered as an extreme example of such a trend. This thesis pursues a modeling solution for performing simulation-based analysis in the conceptual or preliminary design stage of an intelligent, self-reconfigurable ship fluid system, which is one of the concepts of DD(X) engineering plant development. Through the investigations on the Navy's approach for designing a more survivable ship system, it is found that the current naval simulation-based analysis environment is limited by the capability gaps in damage modeling, dynamic model reconfiguration, and simulation speed of the domain specific models, especially fluid network models. As enablers of filling these gaps, two essential elements were identified in the formulation of the modeling method. The first one is the graph-based topological modeling method, which will be employed for rapid model reconstruction and damage modeling, and the second one is the recurrent neural network-based, component-level surrogate modeling method, which will be used to improve the affordability and efficiency of the modeling and simulation (M&S) computations. The integration of the two methods can deliver computationally efficient, flexible, and automation-friendly M&S which will create an environment for more rigorous damage analysis and exploration of design alternatives. As a demonstration for evaluating the developed method, a simulation model of a notional ship fluid system was created, and a damage analysis was performed. Next, the models

Integrative health care model for climacteric stage women: design of the intervention

PubMed Central

2011-01-01

Background Climacteric stage women experience significant biological, psychological and social changes. With demographic changes being observed in the growing number of climacteric stage women in Mexico, it is important to improve their knowledge about the climacteric stage and its potential associated problems, encourage their participation in screening programs, and promote the acquisition of healthy lifestyles. At Mexican health care institutions the predominant health care model for climacteric stage women has a biomedical perspective. Medical doctors provide mostly curative services and have limited support from other health professionals. This study aims to design an integrative health care model (IHCM: bio-psycho-social, multidisciplinary and women-centered) applicable in primary care services aimed at climacteric stage women. Methods/Design We present the design, inclusion criteria and detailed description of an IHCM. The IHCM consists of collaborative and coordinated provision of services by a health team, which is involves a family doctor, nurse, psychologist, and the woman herself. The health team promotes the empowerment of women through individual and group counseling on the climacteric stage and health related self-care. The intervention lasts three months followed by a three-month follow-up period to evaluate the effectiveness of the model. The effectiveness of the model will be evaluated through the following aspects: health-related quality of life (HR-QoL), empowerment, self-efficacy and knowledge regarding the climacteric stage and health-related self-care activities, use of screening services, and improvement in lifestyles (regular leisure time physical activity and healthy diet). Discussion Participation in preventive activities should be encouraged among women in Mexico. Designing and evaluating the effectiveness of an integrative health care model for women at the climacteric stage, based on the empowerment approach and focus on health

A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners.

PubMed

Brown, Kristen M; Mudd, Shawna S; Hunt, Elizabeth A; Perretta, Julianne S; Shilkofski, Nicole A; Diddle, J Wesley; Yurasek, Gregory; Bembea, Melania; Duval-Arnould, Jordan; Nelson McMillan, Kristen

2018-06-01

Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Prospective pre/post interventional pilot study. University simulation center. Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation, based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [SD], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p < 0.001). Time to recognize and treat an acute deterioration was evaluated through the use of selected high-fidelity simulation. Median time improved overall "time to task" across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool ("Student Satisfaction and Self-Confidence in Learning"). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.7 ± 0.30) and performance confidence (4.8 ± 0.31) with the simulation experience. Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel

Cognitive load predicts point-of-care ultrasound simulator performance.

PubMed

Aldekhyl, Sara; Cavalcanti, Rodrigo B; Naismith, Laura M

2018-02-01

The ability to maintain good performance with low cognitive load is an important marker of expertise. Incorporating cognitive load measurements in the context of simulation training may help to inform judgements of competence. This exploratory study investigated relationships between demographic markers of expertise, cognitive load measures, and simulator performance in the context of point-of-care ultrasonography. Twenty-nine medical trainees and clinicians at the University of Toronto with a range of clinical ultrasound experience were recruited. Participants answered a demographic questionnaire then used an ultrasound simulator to perform targeted scanning tasks based on clinical vignettes. Participants were scored on their ability to both acquire and interpret ultrasound images. Cognitive load measures included participant self-report, eye-based physiological indices, and behavioural measures. Data were analyzed using a multilevel linear modelling approach, wherein observations were clustered by participants. Experienced participants outperformed novice participants on ultrasound image acquisition. Ultrasound image interpretation was comparable between the two groups. Ultrasound image acquisition performance was predicted by level of training, prior ultrasound training, and cognitive load. There was significant convergence between cognitive load measurement techniques. A marginal model of ultrasound image acquisition performance including prior ultrasound training and cognitive load as fixed effects provided the best overall fit for the observed data. In this proof-of-principle study, the combination of demographic and cognitive load measures provided more sensitive metrics to predict ultrasound simulator performance. Performance assessments which include cognitive load can help differentiate between levels of expertise in simulation environments, and may serve as better predictors of skill transfer to clinical practice.

Design and simulation of permanent magnet synchronous motor control system

NASA Astrophysics Data System (ADS)

Li, Li; Liu, Yongqiu

2018-06-01

In recent years, with the development of power electronics, microelectronics, new motor control theory and rare earth permanent magnet materials, permanent magnet synchronous motors have been rapidly applied. Permanent magnet synchronous motors have the advantages of small size, low loss and high efficiency. Today, energy conservation and environmental protection are increasingly valued. It is very necessary to study them. Permanent magnet synchronous motor control system has a wide range of application prospects in the fields of electric vehicles, ships and other transportation. Using the simulation function of MATLAB/SIMULINK, a modular design structure was used to simulate the whole system model of speed loop adjustment, current PI modulation, SVPWM (Space Vector Pulse Width Module) wave generation and double closed loop. The results show that this control method has good robustness, and this method can improve the design efficiency and shorten the system design time. In this article, the analysis of the control principle of modern permanent magnet synchronous motor and the various processes of MATLAB simulation application will be analyzed in detail. The basic theory, basic method and application technology of the permanent magnet synchronous motor control system are systematically introduced.

Design, modeling, simulation and evaluation of a distributed energy system

NASA Astrophysics Data System (ADS)

Cultura, Ambrosio B., II

This dissertation presents the design, modeling, simulation and evaluation of distributed energy resources (DER) consisting of photovoltaics (PV), wind turbines, batteries, a PEM fuel cell and supercapacitors. The distributed energy resources installed at UMass Lowell consist of the following: 2.5kW PV, 44kWhr lead acid batteries and 1500W, 500W & 300W wind turbines, which were installed before year 2000. Recently added to that are the following: 10.56 kW PV array, 2.4 kW wind turbine, 29 kWhr Lead acid batteries, a 1.2 kW PEM fuel cell and 4-140F supercapacitors. Each newly added energy resource has been designed, modeled, simulated and evaluated before its integration into the existing PV/Wind grid-connected system. The Mathematical and Simulink model of each system was derived and validated by comparing the simulated and experimental results. The Simulated results of energy generated from a 10.56kW PV system are in good agreement with the experimental results. A detailed electrical model of a 2.4kW wind turbine system equipped with a permanent magnet generator, diode rectifier, boost converter and inverter is presented. The analysis of the results demonstrates the effectiveness of the constructed simulink model, and can be used to predict the performance of the wind turbine. It was observed that a PEM fuel cell has a very fast response to load changes. Moreover, the model has validated the actual operation of the PEM fuel cell, showing that the simulated results in Matlab Simulink are consistent with the experimental results. The equivalent mathematical equation, derived from an electrical model of the supercapacitor, is used to simulate its voltage response. The model is completely capable of simulating its voltage behavior, and can predict the charge time and discharge time of voltages on the supercapacitor. The bi-directional dc-dc converter was designed in order to connect the 48V battery bank storage to the 24V battery bank storage. This connection was

Design of Accelerator Online Simulator Server Using Structured Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shen, Guobao; /Brookhaven; Chu, Chungming

2012-07-06

Model based control plays an important role for a modern accelerator during beam commissioning, beam study, and even daily operation. With a realistic model, beam behaviour can be predicted and therefore effectively controlled. The approach used by most current high level application environments is to use a built-in simulation engine and feed a realistic model into that simulation engine. Instead of this traditional monolithic structure, a new approach using a client-server architecture is under development. An on-line simulator server is accessed via network accessible structured data. With this approach, a user can easily access multiple simulation codes. This paper describesmore » the design, implementation, and current status of PVData, which defines the structured data, and PVAccess, which provides network access to the structured data.« less

Physician Communication in Pediatric End-of-Life Care: A Simulation Study.

PubMed

Bateman, Lori Brand; Tofil, Nancy M; White, Marjorie Lee; Dure, Leon S; Clair, Jeffrey Michael; Needham, Belinda L

2016-12-01

The objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life. Thirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent. Fifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely. Findings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units. The findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care. © The Author(s) 2015.

The role of simulation in the design of a neural network chip

NASA Technical Reports Server (NTRS)

Desai, Utpal; Roppel, Thaddeus A.; Padgett, Mary L.

1993-01-01

An iterative, simulation-based design procedure for a neural network chip is introduced. For this design procedure, the goal is to produce a chip layout for a neural network in which the weights are determined by transistor gate width-to-length ratios. In a given iteration, the current layout is simulated using the circuit simulator SPICE, and layout adjustments are made based on conventional gradient-decent methods. After the iteration converges, the chip is fabricated. Monte Carlo analysis is used to predict the effect of statistical fabrication process variations on the overall performance of the neural network chip.

Design and simulation of the surface shape control system for membrane mirror

NASA Astrophysics Data System (ADS)

Zhang, Gengsheng; Tang, Minxue

2009-11-01

The surface shape control is one of the key technologies for the manufacture of membrane mirror. This paper presents a design of membrane mirror's surface shape control system on the basis of fuzzy logic control. The system contains such function modules as surface shape design, surface shape control, surface shape analysis, and etc. The system functions are realized by using hybrid programming technology of Visual C# and MATLAB. The finite element method is adopted to simulate the surface shape control of membrane mirror. The finite element analysis model is established through ANSYS Parametric Design Language (APDL). ANSYS software kernel is called by the system in background running mode when doing the simulation. The controller is designed by means of controlling the sag of the mirror's central crosssection. The surface shape of the membrane mirror and its optical aberration are obtained by applying Zernike polynomial fitting. The analysis of surface shape control and the simulation of disturbance response are performed for a membrane mirror with 300mm aperture and F/2.7. The result of the simulation shows that by using the designed control system, the RMS wavefront error of the mirror can reach to 142λ (λ=632.8nm), which is consistent to the surface accuracy of the membrane mirror obtained by the large deformation theory of membrane under the same condition.

Nanophotonic particle simulation and inverse design using artificial neural networks.

PubMed

Peurifoy, John; Shen, Yichen; Jing, Li; Yang, Yi; Cano-Renteria, Fidel; DeLacy, Brendan G; Joannopoulos, John D; Tegmark, Max; Soljačić, Marin

2018-06-01

We propose a method to use artificial neural networks to approximate light scattering by multilayer nanoparticles. We find that the network needs to be trained on only a small sampling of the data to approximate the simulation to high precision. Once the neural network is trained, it can simulate such optical processes orders of magnitude faster than conventional simulations. Furthermore, the trained neural network can be used to solve nanophotonic inverse design problems by using back propagation, where the gradient is analytical, not numerical.

Nanophotonic particle simulation and inverse design using artificial neural networks

PubMed Central

Peurifoy, John; Shen, Yichen; Jing, Li; Cano-Renteria, Fidel; DeLacy, Brendan G.; Joannopoulos, John D.; Tegmark, Max

2018-01-01

We propose a method to use artificial neural networks to approximate light scattering by multilayer nanoparticles. We find that the network needs to be trained on only a small sampling of the data to approximate the simulation to high precision. Once the neural network is trained, it can simulate such optical processes orders of magnitude faster than conventional simulations. Furthermore, the trained neural network can be used to solve nanophotonic inverse design problems by using back propagation, where the gradient is analytical, not numerical. PMID:29868640

PREFACE: International Conference on Quantum Simulators and Design, Hiroshima, Japan, 3 6 December 2006

NASA Astrophysics Data System (ADS)

Akai, Hisazumi; Oguchi, Tamio

2007-09-01

This special issue of Journal of Physics: Condensed Matter comprises selected papers from the 1st International Conference on Quantum Simulators and Design (QSD2006) held in Hiroshima, Japan, 3-6 December 2006. This conference was organized under the auspices of the Development of New Quantum Simulators and Quantum Design Grant-in-Aid for Scientific Research on Priority Areas, Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT), and Hiroshima University Quantum design is a computational approach to the development of new materials with specified properties and functionalities. The basic ingredient is the use of quantum simulations to design a material that meets a given specification of properties and functionalities. For this to be successful, the quantum simulation should be highly reliable and be applicable to systems of realistic size. A central interest is, therefore, the development of new methods of quantum simulation and quantum design. This includes methods beyond the local density approximation of density functional theory (LDA), order-N methods, methods dealing with excitations and reactions, and so on, as well as the application of these methods to the design of new materials and devices. The field of quantum design has developed rapidly in the past few years and this conference provides an international forum for experimental and theoretical researchers to exchange ideas. A total of 183 delegates from 8 countries participated in the conference. There were 18 invited talks, 16 oral presentations and 100 posters. There were many new ideas and we foresee dramatic progress in the coming years. The 2nd International Conference on Quantum Simulators and Design will be held in Tokyo, Japan, 31 May-3 June 2008.

SINERGIA laparoscopic virtual reality simulator: didactic design and technical development.

PubMed

Lamata, Pablo; Gómez, Enrique J; Sánchez-Margallo, Francisco M; López, Oscar; Monserrat, Carlos; García, Verónica; Alberola, Carlos; Florido, Miguel Angel Rodríguez; Ruiz, Juan; Usón, Jesús

2007-03-01

VR laparoscopic simulators have demonstrated its validity in recent studies, and research should be directed towards a high training effectiveness and efficacy. In this direction, an insight into simulators' didactic design and technical development is provided, by describing the methodology followed in the building of the SINERGIA simulator. It departs from a clear analysis of training needs driven by a surgical training curriculum. Existing solutions and validation studies are an important reference for the definition of specifications, which are described with a suitable use of simulation technologies. Five new didactic exercises are proposed to train some of the basic laparoscopic skills. Simulator construction has required existing algorithms and the development of a particle-based biomechanical model, called PARSYS, and a collision handling solution based in a multi-point strategy. The resulting VR laparoscopic simulator includes new exercises and enhanced simulation technologies, and is finding a very good acceptance among surgeons.

Modeling, simulation, and concept design for hybrid-electric medium-size military trucks

NASA Astrophysics Data System (ADS)

Rizzoni, Giorgio; Josephson, John R.; Soliman, Ahmed; Hubert, Christopher; Cantemir, Codrin-Gruie; Dembski, Nicholas; Pisu, Pierluigi; Mikesell, David; Serrao, Lorenzo; Russell, James; Carroll, Mark

2005-05-01

A large scale design space exploration can provide valuable insight into vehicle design tradeoffs being considered for the U.S. Army"s FMTV (Family of Medium Tactical Vehicles). Through a grant from TACOM (Tank-automotive and Armaments Command), researchers have generated detailed road, surface, and grade conditions representative of the performance criteria of this medium-sized truck and constructed a virtual powertrain simulator for both conventional and hybrid variants. The simulator incorporates the latest technology among vehicle design options, including scalable ultracapacitor and NiMH battery packs as well as a variety of generator and traction motor configurations. An energy management control strategy has also been developed to provide efficiency and performance. A design space exploration for the family of vehicles involves running a large number of simulations with systematically varied vehicle design parameters, where each variant is paced through several different mission profiles and multiple attributes of performance are measured. The resulting designs are filtered to remove dominated designs, exposing the multi-criterial surface of optimality (Pareto optimal designs), and revealing the design tradeoffs as they impact vehicle performance and economy. The results are not yet definitive because ride and drivability measures were not included, and work is not finished on fine-tuning the modeled dynamics of some powertrain components. However, the work so far completed demonstrates the effectiveness of the approach to design space exploration, and the results to date suggest the powertrain configuration best suited to the FMTV mission.

Design of an instrument to measure the quality of care in Physical Therapy.

PubMed

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; Prado, Cristiane do; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

As accessible as a book on a library shelf: the imperative of routine simulation in modern health care.

PubMed

Gordon, James A

2012-01-01

Technology-enhanced patient simulation has emerged as an important new modality for teaching and learning in medicine. In particular, immersive simulation platforms that replicate the clinical environment promise to revolutionize medical education by enabling an enhanced level of safety, standardization, and efficiency across health-care training. Such an experiential approach seems unique in reliably catalyzing a level of emotional engagement that fosters immediate and indelible learning and allows for increasingly reliable levels of performance evaluation-all in a completely risk-free environment. As such, medical simulation is poised to emerge as a critical component of training and certification throughout health care, promising to fundamentally enhance quality and safety across disciplines. To encourage routine simulation-based practice as part of its core quality and safety mission, Massachusetts General Hospital now incorporates simulation resources within its historic medical library (est. 1847), located at the center of the campus. In this new model, learners go to the library not only to read about a patient's illness, but also to take care of their "patient." Such an approach redefines and advances the central role of the library on the campus and ensures that simulation-based practice is centrally available as part of everyday hospital operations. This article describes the reasons for identifying simulation as an institutional priority leading up to the Massachusetts General Hospital Bicentennial Celebration (1811-2011) and for creating a simulation-based learning laboratory within a hospital library.

Improved Pyrolysis Micro reactor Design via Computational Fluid Dynamics Simulations

DTIC Science & Technology

2017-05-23

Dynamics Simulations Ghanshyam L. Vaghjiani Air Force Research Laboratory (AFMC) AFRL/RQRS 1 Ara Drive Edwards AFB, CA 93524-7013 Air Force...Aerospace Systems Directorate Air Force Research Laboratory AFRL/RQRS 1 Ara Road Edwards AFB, CA 93524 *Email: ghanshyam.vaghjiani@us.af.mil IMPROVED...PYROLYSIS MICRO-REACTOR DESIGN VIA COMPUTATIONAL FLUID DYNAMICS SIMULATIONS Ghanshyam L. Vaghjiani* DISTRIBUTION A: Approved for public release

Simulation-based end-of-life care training during surgical clerkship: assessment of skills and perceptions.

PubMed

Parikh, Priti P; Brown, Ronald; White, Mary; Markert, Ronald J; Eustace, Rosemary; Tchorz, Kathryn

2015-06-15

Assessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. Medical students underwent simulation-based end-of-life care OSCE training that involved standardized patients who evaluated students' communication skills and physician trust with the Kalamazoo Essential Elements Communication Checklist and the Wake Forest Physician Trust Scale. Students also completed the Jefferson Scale of Physician Empathy. Pearson correlation was used to examine the relationship between OSCE performance grades and communication, trust, and empathy scores. Student comments were analyzed using the constant comparative method of analysis to identify dominant themes. The 389 students (mean age 26.6 ± 2.8 y; 54.5% female) had OSCE grades that were positively correlated with physician trust scores (r = 0.325, P < 0.01) and communication skills (r = 0.383, P < 0.01). However, OSCE grades and self-reported empathy were not related (r = 0.021, P = 0.68). Time of clerkship differed for OSCE grade and physician trust scores; however, there was no trend identified. No differences were noted between the time of clerkship and communication skills or empathy. Overall, students perceived simulation-based end-of-life care training to be a valuable learning experience and appreciated its placement early in clinical training. We found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative

A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain

PubMed Central

Cherkin, Daniel C.; Sherman, Karen J.; Avins, Andrew L.; Erro, Janet H.; Ichikawa, Laura; Barlow, William E.; Delaney, Kristin; Hawkes, Rene; Hamilton, Luisa; Pressman, Alice; Khalsa, Partap S.; Deyo, Richard A.

2009-01-01

Background Acupuncture is a popular complementary and alternative treatment for chronic back pain. Recent European trials suggest similar short-term benefits from real and sham acupuncture needling. This trial addresses the importance of needle placement and skin penetration in eliciting acupuncture effects for patients with chronic low back pain. Methods 638 adults with chronic mechanical low back pain were randomized to: individualized acupuncture, standardized acupuncture, simulated acupuncture, or usual care. Ten treatments were provided over 7 weeks by experienced acupuncturists. The primary outcomes were back-related dysfunction (Roland Disability score, range: 0 to 23) and symptom bothersomeness (0 to 10 scale). Outcomes were assessed at baseline and after 8, 26 and 52 weeks. Results At 8 weeks, mean dysfunction scores for the individualized, standardized, and simulated acupuncture groups improved by 4.4, 4.5, and 4.4 points, respectively, compared with 2.1 points for those receiving usual care (P<0.001). Participants receiving real or simulated acupuncture were more likely than those receiving usual care to experience clinically meaningful improvements on the dysfunction scale (60% vs. 39%, P<0.0001). Symptoms improved by 1.6 to 1.9 points in the treatment groups compared with 0.7 points in the usual care group (P<0.0001). After one year, participants in the treatment groups were more likely than those receiving usual care group to experience clinically meaningful improvements in dysfunction (59% to 65% versus 50%, respectively, P=0.02) but not in symptoms (P>0.05). Conclusions Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture, or our simulated method of acupuncture, provide physiologically

Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial.

PubMed

Cheng, Adam; Brown, Linda L; Duff, Jonathan P; Davidson, Jennifer; Overly, Frank; Tofil, Nancy M; Peterson, Dawn T; White, Marjorie L; Bhanji, Farhan; Bank, Ilana; Gottesman, Ronald; Adler, Mark; Zhong, John; Grant, Vincent; Grant, David J; Sudikoff, Stephanie N; Marohn, Kimberly; Charnovich, Alex; Hunt, Elizabeth A; Kessler, David O; Wong, Hubert; Robertson, Nicola; Lin, Yiqun; Doan, Quynh; Duval-Arnould, Jordan M; Nadkarni, Vinay M

2015-02-01

The quality of cardiopulmonary resuscitation (CPR) affects hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonary arrest (CPA). Most health care professionals fail to perform CPR within established American Heart Association guidelines. To determine whether "just-in-time" (JIT) CPR training with visual feedback (VisF) before CPA or real-time VisF during CPA improves the quality of chest compressions (CCs) during simulated CPA. Prospective, randomized, 2 × 2 factorial-design trial with explicit methods (July 1, 2012, to April 15, 2014) at 10 International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) institutions running a standardized simulated CPA scenario, including 324 CPR-certified health care professionals assigned to 3-person resuscitation teams (108 teams). Each team was randomized to 1 of 4 permutations, including JIT training vs no JIT training before CPA and real-time VisF vs no real-time VisF during simulated CPA. The proportion of CCs with depth exceeding 50 mm, the proportion of CPR time with a CC rate of 100 to 120 per minute, and CC fraction (percentage CPR time) during simulated CPA. The quality of CPR was poor in the control group, with 12.7% (95% CI, 5.2%-20.1%) mean depth compliance and 27.1% (95% CI, 14.2%-40.1%) mean rate compliance. JIT training compared with no JIT training improved depth compliance by 19.9% (95% CI, 11.1%-28.7%; P < .001) and rate compliance by 12.0% (95% CI, 0.8%-23.2%; P = .037). Visual feedback compared with no VisF improved depth compliance by 15.4% (95% CI, 6.6%-24.2%; P = .001) and rate compliance by 40.1% (95% CI, 28.8%-51.3%; P < .001). Neither intervention had a statistically significant effect on CC fraction, which was excellent (>89.0%) in all groups. Combining both interventions showed the highest compliance with American Heart Association guidelines but was not significantly better than either intervention in isolation. The

[Visitation policy, design and comfort in Spanish intensive care units].

PubMed

Escudero, D; Martín, L; Viña, L; Quindós, B; Espina, M J; Forcelledo, L; López-Amor, L; García-Arias, B; del Busto, C; de Cima, S; Fernández-Rey, E

2015-01-01

To determine the design and comfort in the Intensive Care Units (ICUs), by analysing visiting hours, information, and family participation in patient care. Descriptive, multicentre study. Spanish ICUs. A questionnaire e-mailed to members of the Spanish Society of Intensive Care Medicine, Critical and Coronary Units (SEMICYUC), subscribers of the Electronic Journal Intensive Care Medicine, and disseminated through the blog Proyecto HU-CI. A total of 135 questionnaires from 131 hospitals were analysed. Visiting hours: 3.8% open 24h, 9.8% open daytime, and 67.7% have 2 visits a day. Information: given only by the doctor in 75.2% of the cases, doctor and nurse together in 4.5%, with a frequency of once a day in 79.7%. During weekends, information is given in 95.5% of the cases. Information given over the phone 74.4%. Family participation in patient care: hygiene 11%, feeding 80.5%, physiotherapy 17%. Personal objects allowed: mobile phone 41%, computer 55%, sound system 77%, and television 30%. Architecture and comfort: all individual cubicles 60.2%, natural light 54.9%, television 7.5%, ambient music 12%, clock in the cubicle 15.8%, environmental noise meter 3.8%, and a waiting room near the ICU 68.4%. Visiting policy is restrictive, with a closed ICU being the predominating culture. On average, technological communication devices are not allowed. Family participation in patient care is low. The ICU design does not guarantee privacy or provide a desirable level of comfort. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Fractal Simulations of African Design in Pre-College Computing Education

ERIC Educational Resources Information Center

Eglash, Ron; Krishnamoorthy, Mukkai; Sanchez, Jason; Woodbridge, Andrew

2011-01-01

This article describes the use of fractal simulations of African design in a high school computing class. Fractal patterns--repetitions of shape at multiple scales--are a common feature in many aspects of African design. In African architecture we often see circular houses grouped in circular complexes, or rectangular houses in rectangular…

Design of the HELICS High-Performance Transmission-Distribution-Communication-Market Co-Simulation Framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palmintier, Bryan S; Krishnamurthy, Dheepak; Top, Philip

This paper describes the design rationale for a new cyber-physical-energy co-simulation framework for electric power systems. This new framework will support very large-scale (100,000+ federates) co-simulations with off-the-shelf power-systems, communication, and end-use models. Other key features include cross-platform operating system support, integration of both event-driven (e.g. packetized communication) and time-series (e.g. power flow) simulation, and the ability to co-iterate among federates to ensure model convergence at each time step. After describing requirements, we begin by evaluating existing co-simulation frameworks, including HLA and FMI, and conclude that none provide the required features. Then we describe the design for the new layeredmore » co-simulation architecture.« less

On the design of script languages for neural simulation.

PubMed

Brette, Romain

2012-01-01

In neural network simulators, models are specified according to a language, either specific or based on a general programming language (e.g. Python). There are also ongoing efforts to develop standardized languages, for example NeuroML. When designing these languages, efforts are often focused on expressivity, that is, on maximizing the number of model types than can be described and simulated. I argue that a complementary goal should be to minimize the cognitive effort required on the part of the user to use the language. I try to formalize this notion with the concept of "language entropy", and I propose a few practical guidelines to minimize the entropy of languages for neural simulation.

Numerical simulation of several impact attenuator design for a formula student car

NASA Astrophysics Data System (ADS)

Sinaga, Farlian Rizky; Ubaidillah, Kurniawan, Krishna Eka; Fadhil, Muhamad Ivan; Cahyono, Sukmaji Indro; Idris, Muhamad Hafiz

2018-02-01

In the Formula Society of Automotive Engineer (SAE), safety is a vigorous factor. One of the safety components in the Formula SAE car is the impact attenuator. The purpose of this study is to get the impact attenuator design with the best ability to absorb kinetic energy from several existing designs, through numerical approaches, for estimating conditions against dynamic impacts. Material of impact attenuator use combination of aluminum and Zirconium G350. The simulation was caried out by crashing the impact with the rigid wall, to find the deformation that occurs and the energies are absorbed. The impact attenuator design to be simulated should be optimized to meet some parameters in the SAE Formula. The result of impact attenuator simulation should be able to absorb energy of 7350 joules at move 7 m/s and deformation at bulkhead less than 25.4 mm.

Mission Design and Simulation Considerations for ADReS-A

NASA Astrophysics Data System (ADS)

Peters, S.; Förstner, R.; Fiedler, H.

2016-09-01

Space debris in general has become a major problem for modern space activities. Guidelines to mitigate the threat have been recommended, better prediction models are developed and an advanced observation of objects orbiting Earth is in progress. And still - without the implementation of active debris removal (ADR), the number of debris in space will exponentially increase. To support the ongoing research on ADR-missions, this paper presents the updated mission design of ADReS-A (Autonomous Debris Removal Satellite - #A) - one possible concept for the multiple active removal of large debris in Low Earth orbit, in this case especially of rocket bodies of the SL-8-type. ADReS-A as chaser satellite is supported by at least 5 de-orbit kits, allowing for the same number of targets to be removed. While ADReS-A is conceived for handling of the target, the kit's task is the controlled re-entry of the designated rocket body. The presented mission design forms the basis for the simulation environment in progress. The simulation shall serve as testbed to test multiple scenarios in terms of approach and abort optimization or different tumbling modes of the target. The ultimate goal is the test of autonomous behaviors of the spacecraft in case of unforeseen failures during the approach phase. Considerations to create a simulation for the described mission are presented and discussed. A first visualization of pre-calculated aboard trajectories can be found at the end of this paper.

Simulated Data for High Temperature Composite Design

NASA Technical Reports Server (NTRS)

Chamis, Christos C.; Abumeri, Galib H.

2006-01-01

The paper describes an effective formal method that can be used to simulate design properties for composites that is inclusive of all the effects that influence those properties. This effective simulation method is integrated computer codes that include composite micromechanics, composite macromechanics, laminate theory, structural analysis, and multi-factor interaction model. Demonstration of the method includes sample examples for static, thermal, and fracture reliability for a unidirectional metal matrix composite as well as rupture strength and fatigue strength for a high temperature super alloy. Typical results obtained for a unidirectional composite show that the thermal properties are more sensitive to internal local damage, the longitudinal properties degrade slowly with temperature, the transverse and shear properties degrade rapidly with temperature as do rupture strength and fatigue strength for super alloys.

A new long-term care facilities model in nova scotia, Canada: protocol for a mixed methods study of care by design.

PubMed

Marshall, Emily Gard; Boudreau, Michelle Anne; Jensen, Jan L; Edgecombe, Nancy; Clarke, Barry; Burge, Frederick; Archibald, Greg; Taylor, Anthony; Andrew, Melissa K

2013-11-29

Prior to the implementation of a new model of care in long-term care facilities in the Capital District Health Authority, Halifax, Nova Scotia, residents entering long-term care were responsible for finding their own family physician. As a result, care was provided by many family physicians responsible for a few residents leading to care coordination and continuity challenges. In 2009, Capital District Health Authority (CDHA) implemented a new model of long-term care called "Care by Design" which includes: a dedicated family physician per floor, 24/7 on-call physician coverage, implementation of a standardized geriatric assessment tool, and an interdisciplinary team approach to care. In addition, a new Emergency Health Services program was implemented shortly after, in which specially trained paramedics dedicated to long-term care responses are able to address urgent care needs. These changes were implemented to improve primary and emergency care for vulnerable residents. Here we describe a comprehensive mixed methods research study designed to assess the impact of these programs on care delivery and resident outcomes. The results of this research will be important to guide primary care policy for long-term care. We aim to evaluate the impact of introducing a new model of a dedicated primary care physician and team approach to long-term care facilities in the CDHA using a mixed methods approach. As a mixed methods study, the quantitative and qualitative data findings will inform each other. Quantitatively we will measure a number of indicators of care in CDHA long-term care facilities pre and post-implementation of the new model. In the qualitative phase of the study we will explore the experience under the new model from the perspectives of stakeholders including family doctors, nurses, administration and staff as well as residents and family members. The proposed mixed method study seeks to evaluate and make policy recommendations related to primary care in long

Designing prenatal care messages for low-income Mexican women.

PubMed Central

Alcalay, R; Ghee, A; Scrimshaw, S

1993-01-01

Communication theories and research data were used to design cross-cultural health education messages. A University of California Los Angeles-Universidad Autonoma in Tijuana, Mexico, research team used the methods of ethnographic and survey research to study behaviors, attitudes, and knowledge concerning prenatal care of a sample of pregnant low-income women living in Tijuana. This audience provided information that served as a framework for a series of messages to increase awareness and change prenatal care behaviors. The message design process was guided by persuasion theories that included Petty and Caccioppo's elaboration likelihood model, McGuire's persuasion matrix, and Bandura's social learning theory. The results from the research showed that poor women in Tijuana tend to delay or not seek prenatal care. They were not aware of symptoms that could warn of pregnancy complications. Their responses also revealed pregnant women's culturally specific beliefs and behaviors regarding pregnancy. After examination of these and other results from the study, prenatal care messages about four topics were identified as the most relevant to communicate to this audience: health services use, the mother's weight gain, nutrition and anemia, and symptoms of high-risk complications during pregnancy. A poster, a calendar, a brochure, and two radio songs were produced and pretested in focus groups with low-income women in Tijuana. Each medium included one or more messages addressing informational, attitudinal, or behavioral needs, or all three, of the target population. PMID:8497574

Simulating changes to emergency care resources to compare system effectiveness.

PubMed

Branas, Charles C; Wolff, Catherine S; Williams, Justin; Margolis, Gregg; Carr, Brendan G

2013-08-01

To apply systems optimization methods to simulate and compare the most effective locations for emergency care resources as measured by access to care. This study was an optimization analysis of the locations of trauma centers (TCs), helicopter depots (HDs), and severely injured patients in need of time-critical care in select US states. Access was defined as the percentage of injured patients who could reach a level I/II TC within 45 or 60 minutes. Optimal locations were determined by a search algorithm that considered all candidate sites within a set of existing hospitals and airports in finding the best solutions that maximized access. Across a dozen states, existing access to TCs within 60 minutes ranged from 31.1% to 95.6%, with a mean of 71.5%. Access increased from 0.8% to 35.0% after optimal addition of one or two TCs. Access increased from 1.0% to 15.3% after optimal addition of one or two HDs. Relocation of TCs and HDs (optimal removal followed by optimal addition) produced similar results. Optimal changes to TCs produced greater increases in access to care than optimal changes to HDs although these results varied across states. Systems optimization methods can be used to compare the impacts of different resource configurations and their possible effects on access to care. These methods to determine optimal resource allocation can be applied to many domains, including comparative effectiveness and patient-centered outcomes research. Copyright © 2013 Elsevier Inc. All rights reserved.

77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health... facilities designated as primary medical care, mental health, and dental health professional shortage areas... primary care, dental, or mental health services in these HPSAs. NHSC health [[Page 38839

Design of an instrument to measure the quality of care in Physical Therapy

PubMed Central

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; do Prado, Cristiane; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care. PMID:26154548

A high precision dual feedback discrete control system designed for satellite trajectory simulator

NASA Astrophysics Data System (ADS)

Liu, Ximin; Liu, Liren; Sun, Jianfeng; Xu, Nan

2005-08-01

Cooperating with the free-space laser communication terminals, the satellite trajectory simulator is used to test the acquisition, pointing, tracking and communicating performances of the terminals. So the satellite trajectory simulator plays an important role in terminal ground test and verification. Using the double-prism, Sun etc in our group designed a satellite trajectory simulator. In this paper, a high precision dual feedback discrete control system designed for the simulator is given and a digital fabrication of the simulator is made correspondingly. In the dual feedback discrete control system, Proportional- Integral controller is used in velocity feedback loop and Proportional- Integral- Derivative controller is used in position feedback loop. In the controller design, simplex method is introduced and an improvement to the method is made. According to the transfer function of the control system in Z domain, the digital fabrication of the simulator is given when it is exposed to mechanism error and moment disturbance. Typically, when the mechanism error is 100urad, the residual standard error of pitching angle, azimuth angle, x-coordinate position and y-coordinate position are 0.49urad, 6.12urad, 4.56urad, 4.09urad respectively. When the moment disturbance is 0.1rad, the residual standard error of pitching angle, azimuth angle, x-coordinate position and y-coordinate position are 0.26urad, 0.22urad, 0.16urad, 0.15urad respectively. The digital fabrication results demonstrate that the dual feedback discrete control system designed for the simulator can achieve the anticipated high precision performance.

A Methodology for the Design of Application-Specific Cyber-Physical Social Sensing Co-Simulators.

PubMed

Sánchez, Borja Bordel; Alcarria, Ramón; Sánchez-Picot, Álvaro; Sánchez-de-Rivera, Diego

2017-09-22

Cyber-Physical Social Sensing (CPSS) is a new trend in the context of pervasive sensing. In these new systems, various domains coexist in time, evolve together and influence each other. Thus, application-specific tools are necessary for specifying and validating designs and simulating systems. However, nowadays, different tools are employed to simulate each domain independently. Mainly, the cause of the lack of co-simulation instruments to simulate all domains together is the extreme difficulty of combining and synchronizing various tools. In order to reduce that difficulty, an adequate architecture for the final co-simulator must be selected. Therefore, in this paper the authors investigate and propose a methodology for the design of CPSS co-simulation tools. The paper describes the four steps that software architects should follow in order to design the most adequate co-simulator for a certain application, considering the final users' needs and requirements and various additional factors such as the development team's experience. Moreover, the first practical use case of the proposed methodology is provided. An experimental validation is also included in order to evaluate the performing of the proposed co-simulator and to determine the correctness of the proposal.

A Methodology for the Design of Application-Specific Cyber-Physical Social Sensing Co-Simulators

PubMed Central

Sánchez-Picot, Álvaro

2017-01-01

Cyber-Physical Social Sensing (CPSS) is a new trend in the context of pervasive sensing. In these new systems, various domains coexist in time, evolve together and influence each other. Thus, application-specific tools are necessary for specifying and validating designs and simulating systems. However, nowadays, different tools are employed to simulate each domain independently. Mainly, the cause of the lack of co-simulation instruments to simulate all domains together is the extreme difficulty of combining and synchronizing various tools. In order to reduce that difficulty, an adequate architecture for the final co-simulator must be selected. Therefore, in this paper the authors investigate and propose a methodology for the design of CPSS co-simulation tools. The paper describes the four steps that software architects should follow in order to design the most adequate co-simulator for a certain application, considering the final users’ needs and requirements and various additional factors such as the development team’s experience. Moreover, the first practical use case of the proposed methodology is provided. An experimental validation is also included in order to evaluate the performing of the proposed co-simulator and to determine the correctness of the proposal. PMID:28937610

Standard High Solids Vessel Design De-inventory Simulant Qualification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fiskum, Sandra K.; Burns, Carolyn A.M.; Gauglitz, Phillip A.

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is working to develop a Standard High Solids Vessel Design (SHSVD) process vessel. To support testing of this new design, WTP engineering staff requested that a Newtonian simulant be developed that would represent the de-inventory (residual high-density tank solids cleanout) process. Its basis and target characteristics are defined in 24590-WTP-ES-ENG-16-021 and implemented through PNNL Test Plan TP-WTPSP-132 Rev. 1.0. This document describes the de-inventory Newtonian carrier fluid (DNCF) simulant composition that will satisfy the basis requirement to mimic the density (1.18 g/mL ± 0.1 g/mL) and viscosity (2.8 cP ± 0.5more » cP) of 5 M NaOH at 25 °C.1 The simulant viscosity changes significantly with temperature. Therefore, various solution compositions may be required, dependent on the test stand process temperature range, to meet these requirements. Table ES.1 provides DNCF compositions at selected temperatures that will meet the density and viscosity specifications as well as the temperature range at which the solution will meet the acceptable viscosity tolerance.« less

An automated methodology development. [software design for combat simulation

NASA Technical Reports Server (NTRS)

Hawley, L. R.

1985-01-01

The design methodology employed in testing the applicability of Ada in large-scale combat simulations is described. Ada was considered as a substitute for FORTRAN to lower life cycle costs and ease the program development efforts. An object-oriented approach was taken, which featured definitions of military targets, the capability of manipulating their condition in real-time, and one-to-one correlation between the object states and real world states. The simulation design process was automated by the problem statement language (PSL)/problem statement analyzer (PSA). The PSL/PSA system accessed the problem data base directly to enhance the code efficiency by, e.g., eliminating non-used subroutines, and provided for automated report generation, besides allowing for functional and interface descriptions. The ways in which the methodology satisfied the responsiveness, reliability, transportability, modifiability, timeliness and efficiency goals are discussed.

Design and Simulation of an Electrothermal Actuator Based Rotational Drive

NASA Astrophysics Data System (ADS)

Beeson, Sterling; Dallas, Tim

2008-10-01

As a participant in the Micro and Nano Device Engineering (MANDE) Research Experience for Undergraduates program at Texas Tech University, I learned how MEMS devices operate and the limits of their operation. Using specialized AutoCAD-based design software and the ANSYS simulation program, I learned the MEMS fabrication process used at Sandia National Labs, the design limitations of this process, the abilities and drawbacks of micro devices, and finally, I redesigned a MEMS device called the Chevron Torsional Ratcheting Actuator (CTRA). Motion is achieved through electrothermal actuation. The chevron (bent-beam) actuators cause a ratcheting motion on top of a hub-less gear so that as voltage is applied the CTRA spins. The voltage applied needs to be pulsed and the frequency of the pulses determine the angular frequency of the device. The main objective was to design electromechanical structures capable of transforming the electrical signals into mechanical motion without overheating. The design was optimized using finite element analysis in ANSYS allowing multi-physics simulations of our model system.

Interim Service ISDN Satellite (ISIS) simulator development for advanced satellite designs and experiments

NASA Technical Reports Server (NTRS)

Pepin, Gerard R.

1992-01-01

The simulation development associated with the network models of both the Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) and the Full Service ISDN Satellite (FSIS) architectures is documented. The ISIS Network Model design represents satellite systems like the Advanced Communications Technology Satellite (ACTS) orbiting switch. The FSIS architecture, the ultimate aim of this element of the Satellite Communications Applications Research (SCAR) Program, moves all control and switching functions on-board the next generation ISDN communications satellite. The technical and operational parameters for the advanced ISDN communications satellite design will be obtained from the simulation of ISIS and FSIS engineering software models for their major subsystems. Discrete event simulation experiments will be performed with these models using various traffic scenarios, design parameters, and operational procedures. The data from these simulations will be used to determine the engineering parameters for the advanced ISDN communications satellite.

Solar air heating system: design and dynamic simulation

NASA Astrophysics Data System (ADS)

Bououd, M.; Hachchadi, O.; Janusevicius, K.; Martinaitis, V.; Mechaqrane, A.

2018-05-01

The building sector is one of the big energy consumers in Morocco, accounting for about 23% of the country’s total energy consumption. Regarding the population growth, the modern lifestyle requiring more comfort and the increase of the use rate of electronic devices, the energy consumption will continue to increase in the future. In this context, the introduction of renewable energy systems, along with energy efficiency, is becoming a key factor in reducing the energy bill of buildings. This study focuses on the design and dynamic simulation of an air heating system for the mean categories of the tertiary sector where the area exceeds 750 m3. Heating system has been designed via a dynamic simulation environment (TRNSYS) to estimate the produced temperature and airflow rate by one system consisting of three essential components: vacuum tube solar collector, storage tank and water-to-air finned heat exchanger. The performances estimation of this system allows us to evaluate its capacity to meet the heating requirements in Ifrane city based on the prescriptive approach according to the Moroccan Thermal Regulation. The simulation results show that in order to maintain a comfort temperature of 20°C in a building of 750m3, the places requires a thermal powers of approximately 21 kW, 29 kW and 32 kW, respectively, for hotels, hospitals, administrative and public-school. The heat generation is ensured by a solar collector areas of 5 m², 7 m² and 10 m², respectively, for hotels, hospitals, administrative and public-school spaces, a storage tank of 2 m3 and a finned heat exchanger with 24 tubes. The finned tube bundles have been modelled and integrated into the system design via a Matlab code. The heating temperature is adjusted via two controllers to ensure a constant air temperature of 20°C during the heating periods.

Diversity of nursing student views about simulation design: a q-methodological study.

PubMed

Paige, Jane B; Morin, Karen H

2015-05-01

Education of future nurses benefits from well-designed simulation activities. Skillful teaching with simulation requires educators to be constantly aware of how students experience learning and perceive educators' actions. Because revision of simulation activities considers feedback elicited from students, it is crucial to understand the perspective from which students base their response. In a Q-methodological approach, 45 nursing students rank-ordered 60 opinion statements about simulation design into a distribution grid. Factor analysis revealed that nursing students hold five distinct and uniquely personal perspectives-Let Me Show You, Stand By Me, The Agony of Defeat, Let Me Think It Through, and I'm Engaging and So Should You. Results suggest that nurse educators need to reaffirm that students clearly understand the purpose of each simulation activity. Nurse educators should incorporate presimulation assignments to optimize learning and help allay anxiety. The five perspectives discovered in this study can serve as a tool to discern individual students' learning needs. Copyright 2015, SLACK Incorporated.

Design and evaluation of a prelicensure interprofessional course on improving care transitions.

PubMed

Heflin, Mitchell T; Pinheiro, Sandro O; Konrad, Thomas R; Egerton, Emily O; Thornlow, Deirdre K; White, Heidi K; McConnell, Eleanor J

2014-01-01

Effective management of care transitions for older adults require the coordinated expertise of an interprofessional team. Unfortunately, different health care professions are rarely educated together or trained in teamwork skills. To address this issue, a team of professionally diverse faculty from the Duke University Geriatric Education Center designed an interprofessional course focused on improving transitions of care for older adults. This innovative prelicensure course provided interactive teaching sessions designed to promote critical thinking and foster effective communication among health care professionals, caregivers, and patients. Students were assessed by in-class and online participation, performance on individual assignments, and team-based proposals to improve care transitions for older patients with congestive heart failure. Twenty students representing six professions completed the course; 18 completed all self-efficacy and course evaluation surveys. Students rated their self-efficacy in several domains before and after the course and reported gains in teamwork skills (p < .001), transitions of care (p < .001), quality improvement (p < .001) and cultural competence (p < .001). Learner feedback emphasized the importance of enthusiastic and well-prepared faculty, interactive learning experiences, and engagement in relevant work. This course offers a promising approach to shifting the paradigm of health professions education to empower graduates to promote quality improvement through team-based care.

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

PubMed

Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

2016-09-01

At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries

PubMed Central

BERNHARDT, ANTONIA K.; BERGER, GREGORY; LEE, JAMES A.; REUTER, KEVIN; DAVANZO, JOAN; MONTGOMERY, ANNE; DOBSON, ALLEN

2016-01-01

Policy Points: At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with “activities of daily living.” Available services fail to match frail elders’ needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs.The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long‐term care costs, and declining family caregiver availability portend gaps in badly needed services.The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. Context The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better‐coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. Methods The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. Findings The simulation projected third‐year savings between $269 and $537 per beneficiary per month and

Simulation at the point of care: reduced-cost, in situ training via a mobile cart.

PubMed

Weinstock, Peter H; Kappus, Liana J; Garden, Alexander; Burns, Jeffrey P

2009-03-01

The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams. Descriptive study. A tertiary care pediatric teaching hospital. A self-contained mobile simulation cart was constructed at a cost of $8054 (mannequin not included). The cart is compatible with any mannequin and contains all equipment needed to produce a high quality simulation experience equivalent to that of our on-site center--including didactics and debriefing with videotaped recordings complete with vital sign overlay. Over a 3-year period the cart delivered 57 courses to 425 participants from five pediatric departments. All individuals were trained among their native teams and within their own clinical environment. By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.

Why Health Care Needs Design Research: Broadening the Perspective on Communication in Pediatric Care Through Play.

PubMed

Knutz, Eva; Ammentorp, Jette; Kofoed, Poul-Erik

2015-01-01

Today's pediatric health care lacks methods to tap into the emotional state of hospitalized pediatric patients (age 4-6 years). The most frequently used approaches were developed for adults and fail to acknowledge the importance of imaginary experiences and the notion of play that may appeal to children. The scope of this article is to introduce a new design-oriented method of gathering information about the emotional state of pediatric patients using an experimental computer game called the Child Patient game (CPgame). The CPgame was developed at a Danish hospital, and the results of the preliminary tests show that games could serve as a system in which children are willing to express their emotions through play. The results are based on two comparative analyses of the CPgame through which it is possible to identify three different types of players among the patients playing the game. Furthermore, the data reveal that pediatric patients display a radically different play pattern than children who are not in hospital. The inquiry takes an interdisciplinary approach; it has obvious health care-related objectives and seeks to meet the urgent need for new methods within health care to optimize communication with young children. At the same time, design research (i.e., the development of new knowledge through the development of a new design) heavily impacts the method.

Understanding interdisciplinary health care teams: using simulation design processes from the Air Carrier Advanced Qualification Program to identify and train critical teamwork skills.

PubMed

Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M

2010-09-01

In the report "Five Years After 'To Err is Human' ", it was noted that "the combination of complexity, professional fragmentation, and a tradition of individualism, enhanced by a well-entrenched hierarchical authority structure and diffuse accountability, forms a daunting barrier to creating the habits and beliefs of common purpose, teamwork, and individual accountability for successful interdependence that a safe culture requires". Training physicians, nurses, and other professionals to work in teams is a concept that has been promoted by many patient safety experts. However the model of teamwork in healthcare is diffusely defined, no clear performance metrics have been established, and the use of simulation to train teams has been suboptimal. This paper reports on the first three years of work performed in the Michigan Economic Development Corporation (MEDC) Tri-Corridor life science grant to apply concepts and processes of simulation design that were developed in the air carrier industry to understand and train healthcare teams. This work has been monitored by the American Academy for the Advancement of Science (AAA) and is based on concepts designed in the Advanced Qualification Program (AQP) from the air carrier industry, which trains and assesses teamwork skills in the same manner as technical skills. This grant has formed the foundation for the Center of Excellence for Simulation Education and Research (CESR).

Use of a Virtual Learning Platform for Distance-Based Simulation in an Acute Care Nurse Practitioner Curriculum.

PubMed

Carman, Margaret; Xu, Shu; Rushton, Sharron; Smallheer, Benjamin A; Williams, Denise; Amarasekara, Sathya; Oermann, Marilyn H

Acute care nurse practitioner (ACNP) programs that use high-fidelity simulation as a teaching tool need to consider innovative strategies to provide distance-based students with learning experiences that are comparable to those in a simulation laboratory. The purpose of this article is to describe the use of virtual simulations in a distance-based ACNP program and student performance in the simulations. Virtual simulations using iSimulate were integrated into the ACNP course to promote the translation of content into a clinical context and enable students to develop their knowledge and decision-making skills. With these simulations, students worked as a team, even though they were at different sites from each other and from the faculty, to manage care of an acutely ill patient. The students were assigned to simulation groups of 4 students each. One week before the simulation, they reviewed past medical records. The virtual simulation sessions were recorded and then evaluated. The evaluation tools assessed 8 areas of performance and included key behaviors in each of these areas to be performed by students in the simulation. More than 80% of the student groups performed the key behaviors. Virtual simulations provide a learning platform that allows live interaction between students and faculty, at a distance, and application of content to clinical situations. With simulation, learners have an opportunity to practice assessment and decision-making in emergency and high-risk situations. Simulations not only are valuable for student learning but also provide a nonthreatening environment for staff to practice, receive feedback on their skills, and improve their confidence.

Integrated Simulation Design Challenges to Support TPS Repair Operations

NASA Technical Reports Server (NTRS)

Quiocho, Leslie J.; Crues, Edwin Z.; Huynh, An; Nguyen, Hung T.; MacLean, John

2005-01-01

During the Orbiter Repair Maneuver (ORM) operations planned for Return to Flight (RTF), the Shuttle Remote Manipulator System (SRMS) must grapple the International Space Station (ISS), undock the Orbiter, maneuver it through a long duration trajectory, and orient it to an EVA crewman poised at the end of the Space Station Remote Manipulator System (SSRMS) to facilitate the repair of the Thermal Protection System (TPS). Once repair has been completed and confirmed, then the SRMS proceeds back through the trajectory to dock the Orbiter to the Orbiter Docking System. In order to support analysis of the complex dynamic interactions of the integrated system formed by the Orbiter, ISS, SRMS, and SSRMS during the ORM, simulation tools used for previous 'nominal' mission support required substantial enhancements. These upgrades were necessary to provide analysts with the capabilities needed to study integrated system performance. This paper discusses the simulation design challenges encountered while developing simulation capabilities to mirror the ORM operations. The paper also describes the incremental build approach that was utilized, starting with the subsystem simulation elements and integration into increasing more complex simulations until the resulting ORM worksite dynamics simulation had been assembled. Furthermore, the paper presents an overall integrated simulation V&V methodology based upon a subsystem level testing, integrated comparisons, and phased checkout.