Tube thoracostomy training with a medical simulator is associated with faster, more successful performance of the procedure

PubMed Central

Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Chung, Hyun Soo

2016-01-01

Objective Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator. Methods This is a simulation study. Eligible participants were emergency medicine residents with very few (≤3 times) TT experience. Participants were randomized to two groups: the conventional training group, and the simulator training group. While the simulator training group used the simulator to train TT, the conventional training group watched the instructor performing TT on a cadaver. After training, all participants performed a TT on a cadaver. The performance quality was measured as correct placement and time delay. Subjects were graded if they had difficulty on process. Results Estimated median procedure time was 228 seconds in the conventional training group and 75 seconds in the simulator training group, with statistical significance (P=0.040). The difficulty grading did not show any significant difference among groups (overall performance scale, 2 vs. 3; P=0.094). Conclusion Tube thoracostomy training with a medical simulator, when compared to no simulator training, is associated with a significantly faster procedure, when performed on a human cadaver. PMID:27752610

The German VR Simulation Realism Scale--psychometric construction for virtual reality applications with virtual humans.

PubMed

Poeschl, Sandra; Doering, Nicola

2013-01-01

Virtual training applications with high levels of immersion or fidelity (for example for social phobia treatment) produce high levels of presence and therefore belong to the most successful Virtual Reality developments. Whereas display and interaction fidelity (as sub-dimensions of immersion) and their influence on presence are well researched, realism of the displayed simulation depends on the specific application and is therefore difficult to measure. We propose to measure simulation realism by using a self-report questionnaire. The German VR Simulation Realism Scale for VR training applications was developed based on a translation of scene realism items from the Witmer-Singer-Presence Questionnaire. Items for realism of virtual humans (for example for social phobia training applications) were supplemented. A sample of N = 151 students rated simulation realism of a Fear of Public Speaking application. Four factors were derived by item- and principle component analysis (Varimax rotation), representing Scene Realism, Audience Behavior, Audience Appearance and Sound Realism. The scale developed can be used as a starting point for future research and measurement of simulation realism for applications including virtual humans.

Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery.

PubMed

Ribeiro de Oliveira, Marcelo Magaldi; Nicolato, Arthur; Santos, Marcilea; Godinho, Joao Victor; Brito, Rafael; Alvarenga, Alexandre; Martins, Ana Luiza Valle; Prosdocimi, André; Trivelato, Felipe Padovani; Sabbagh, Abdulrahman J; Reis, Augusto Barbosa; Maestro, Rolando Del

2016-05-01

OBJECT The development of neurointerventional treatments of central nervous system disorders has resulted in the need for adequate training environments for novice interventionalists. Virtual simulators offer anatomical definition but lack adequate tactile feedback. Animal models, which provide more lifelike training, require an appropriate infrastructure base. The authors describe a training model for neurointerventional procedures using the human placenta (HP), which affords haptic training with significantly fewer resource requirements, and discuss its validation. METHODS Twelve HPs were prepared for simulated endovascular procedures. Training exercises performed by interventional neuroradiologists and novice fellows were placental angiography, stent placement, aneurysm coiling, and intravascular liquid embolic agent injection. RESULTS The endovascular training exercises proposed can be easily reproduced in the HP. Face, content, and construct validity were assessed by 6 neurointerventional radiologists and 6 novice fellows in interventional radiology. CONCLUSIONS The use of HP provides an inexpensive training model for the training of neurointerventionalists. Preliminary validation results show that this simulation model has face and content validity and has demonstrated construct validity for the interventions assessed in this study.

Computer-Based Simulations for Maintenance Training: Current ARI Research. Technical Report 544.

ERIC Educational Resources Information Center

Knerr, Bruce W.; And Others

Three research efforts that used computer-based simulations for maintenance training were in progress when this report was written: Game-Based Learning, which investigated the use of computer-based games to train electronics diagnostic skills; Human Performance in Fault Diagnosis Tasks, which evaluated the use of context-free tasks to train…

A haptic interface for virtual simulation of endoscopic surgery.

PubMed

Rosenberg, L B; Stredney, D

1996-01-01

Virtual reality can be described as a convincingly realistic and naturally interactive simulation in which the user is given a first person illusion of being immersed within a computer generated environment While virtual reality systems offer great potential to reduce the cost and increase the quality of medical training, many technical challenges must be overcome before such simulation platforms offer effective alternatives to more traditional training means. A primary challenge in developing effective virtual reality systems is designing the human interface hardware which allows rich sensory information to be presented to users in natural ways. When simulating a given manual procedure, task specific human interface requirements dictate task specific human interface hardware. The following paper explores the design of human interface hardware that satisfies the task specific requirements of virtual reality simulation of Endoscopic surgical procedures. Design parameters were derived through direct cadaver studies and interviews with surgeons. Final hardware design is presented.

Study of Physiological Responses to Acute Carbon Monoxide Exposure with a Human Patient Simulator

ERIC Educational Resources Information Center

Cesari, Whitney A.; Caruso, Dominique M.; Zyka, Enela L.; Schroff, Stuart T.; Evans, Charles H., Jr.; Hyatt, Jon-Philippe K.

2006-01-01

Human patient simulators are widely used to train health professionals and students in a clinical setting, but they also can be used to enhance physiology education in a laboratory setting. Our course incorporates the human patient simulator for experiential learning in which undergraduate university juniors and seniors are instructed to design,…

Creating virtual humans for simulation-based training and planning

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

Stansfield, S.; Sobel, A.

1998-05-12

Sandia National Laboratories has developed a distributed, high fidelity simulation system for training and planning small team Operations. The system provides an immersive environment populated by virtual objects and humans capable of displaying complex behaviors. The work has focused on developing the behaviors required to carry out complex tasks and decision making under stress. Central to this work are techniques for creating behaviors for virtual humans and for dynamically assigning behaviors to CGF to allow scenarios without fixed outcomes. Two prototype systems have been developed that illustrate these capabilities: MediSim, a trainer for battlefield medics and VRaptor, a system formore » planning, rehearsing and training assault operations.« less

Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings.

PubMed

Reedy, Gabriel B; Lavelle, Mary; Simpson, Thomas; Anderson, Janet E

2017-10-01

A central feature of clinical simulation training is human factors skills, providing staff with the social and cognitive skills to cope with demanding clinical situations. Although these skills are critical to safe patient care, assessing their learning is challenging. This study aimed to develop, pilot and evaluate a valid and reliable structured instrument to assess human factors skills, which can be used pre- and post-simulation training, and is relevant across a range of healthcare professions. Through consultation with a multi-professional expert group, we developed and piloted a 39-item survey with 272 healthcare professionals attending training courses across two large simulation centres in London, one specialising in acute care and one in mental health, both serving healthcare professionals working across acute and community settings. Following psychometric evaluation, the final 12-item instrument was evaluated with a second sample of 711 trainees. Exploratory factor analysis revealed a 12-item, one-factor solution with good internal consistency (α=0.92). The instrument had discriminant validity, with newly qualified trainees scoring significantly lower than experienced trainees ( t (98)=4.88, p<0.001) and was sensitive to change following training in acute and mental health settings, across professional groups (p<0.001). Confirmatory factor analysis revealed an adequate model fit (RMSEA=0.066). The Human Factors Skills for Healthcare Instrument provides a reliable and valid method of assessing trainees' human factors skills self-efficacy across acute and mental health settings. This instrument has the potential to improve the assessment and evaluation of human factors skills learning in both uniprofessional and interprofessional clinical simulation training.

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

PubMed

Wright, Melanie C; Taekman, Jeffrey M; Barber, Linda; Hobbs, Gene; Newman, Mark F; Stafford-Smith, Mark

2005-12-01

Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection tools. High-fidelity patient simulation centers provide an ideal environment to apply human-centered design to clinical trial development. A draft of a complex clinical protocol was designed, evaluated and modified using a high-fidelity human patient simulator in the Duke University Human Simulation and Patient Safety Center. The process included walk-throughs, detailed modifications of the protocol and development of procedural aids. Training of monitors and coordinators provided an opportunity for observation of performance that was used to identify further improvements to the protocol. Evaluative steps were used to design the research protocol and procedures. Iterative modifications were made to the protocol and data collection tools. The success in use of human simulation in the preparation of a complex clinical drug trial suggests the benefits of human patient simulation extend beyond training and medical equipment evaluation. Human patient simulation can provide a context for informal expert evaluation of clinical protocol design and for formal "rehearsal" to evaluate the efficacy of procedures and support tools.

Evaluation of Medical Students' Attitudes and Performance of Basic Surgery Skills in a Training Program Using Fresh Human skin, Excised During Body Contouring Surgeries.

PubMed

Rothenberger, Jens; Seyed Jafari, Seyed Morteza; Schnabel, Kai P; Tschumi, Christian; Angermeier, Sarina; Shafighi, Maziar

2015-01-01

Learning surgical skills in the operating room may be a challenge for medical students. Therefore, more approaches using simulation to enable students to develop their practical skills are required. We hypothesized that (1) there would be a need for additional surgical training for medical students in the pre-final year, and (2) our basic surgery skills training program using fresh human skin would improve medical students' surgical skills. We conducted a preliminary survey of medical students to clarify the need for further training in basic surgery procedures. A new approach using simulation to teach surgical skills on human skin was set up. The procedural skills of 15 randomly selected students were assessed in the operating room before and after participation in the simulation, using Objective Structured Assessment of Technical Skills. Furthermore, subjective assessment was performed based on students' self-evaluation. The data were analyzed using SPSS, version 21 (SPSS, Inc., Chicago, IL). The study took place at the Inselspital, Bern University Hospital. A total of 186 pre-final-year medical students were enrolled into the preliminary survey; 15 randomly selected medical students participated in the basic surgical skills training course on the fresh human skin operating room. The preliminary survey revealed the need for a surgical skills curriculum. The simulation approach we developed showed significant (p < 0.001) improvement for all 12 surgical skills, with mean cumulative precourse and postcourse values of 31.25 ± 5.013 and 45.38 ± 3.557, respectively. The self-evaluation contained positive feedback as well. Simulation of surgery using human tissue samples could help medical students become more proficient in handling surgical instruments before stepping into a real surgical situation. We suggest further studies evaluating our proposed teaching method and the possibility of integrating this simulation approach into the medical school curriculum. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Cost considerations in using simulations for medical training.

PubMed

Fletcher, J D; Wind, Alexander P

2013-10-01

This article reviews simulation used for medical training, techniques for assessing simulation-based training, and cost analyses that can be included in such assessments. Simulation in medical training appears to take four general forms: human actors who are taught to simulate illnesses and ailments in standardized ways; virtual patients who are generally presented via computer-controlled, multimedia displays; full-body manikins that simulate patients using electronic sensors, responders, and controls; and part-task anatomical simulations of various body parts and systems. Techniques for assessing costs include benefit-cost analysis, return on investment, and cost-effectiveness analysis. Techniques for assessing the effectiveness of simulation-based medical training include the use of transfer effectiveness ratios and incremental transfer effectiveness ratios to measure transfer of knowledge and skill provided by simulation to the performance of medical procedures. Assessment of costs and simulation effectiveness can be combined with measures of transfer using techniques such as isoperformance analysis to identify ways of minimizing costs without reducing performance effectiveness or maximizing performance without increasing costs. In sum, economic analysis must be considered in training assessments if training budgets are to compete successfully with other requirements for funding. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Human Factors in Training - Space Flight Resource Management Training

NASA Technical Reports Server (NTRS)

Bryne, Vicky; Connell, Erin; Barshi, Immanuel; Arsintescu, L.

2009-01-01

Accidents and incidents show that high workload-induced stress and poor teamwork skills lead to performance decrements and errors. Research on teamwork shows that effective teams are able to adapt to stressful situations, and to reduce workload by using successful strategies for communication and decision making, and through dynamic redistribution of tasks among team members. Furthermore, superior teams are able to recognize signs and symptoms of workload-induced stress early, and to adapt their coordination and communication strategies to the high workload, or stress conditions. Mission Control Center (MCC) teams often face demanding situations in which they must operate as an effective team to solve problems with crew and vehicle during onorbit operations. To be successful as a team, flight controllers (FCers) must learn effective teamwork strategies. Such strategies are the focus of Space Flight Resource Management (SFRM) training. SFRM training in MOD has been structured to include some classroom presentations of basic concepts and case studies, with the assumption that skill development happens in mission simulation. Integrated mission simulations do provide excellent opportunities for FCers to practice teamwork, but also require extensive technical knowledge of vehicle systems, mission operations, and crew actions. Such technical knowledge requires lengthy training. When SFRM training is relegated to integrated simulations, FCers can only practice SFRM after they have already mastered the technical knowledge necessary for these simulations. Given the centrality of teamwork to the success of MCC, holding SFRM training till late in the flow is inefficient. But to be able to train SFRM earlier in the flow, the training cannot rely on extensive mission-specific technical knowledge. Hence, the need for a generic SFRM training framework that would allow FCers to develop basic teamwork skills which are mission relevant, but without the required mission knowledge. Work on SFRM training has been conducted in collaboration with the Expedition Vehicle Division at the Mission Operations Directorate (MOD) and with United Space Alliance (USA) which provides training to Flight Controllers. The space flight resource management training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at the Ames Research Center have been investigating team work and distributed decision making processes to develop a generic SFRM training framework for flight controllers. The work proposed for FY10 continues to build on this strong collaboration with MOD and the USA Training Group as well as previous research in relevant domains such as aviation. In FY10, the work focuses on documenting and analyzing problem solving strategies and decision making processes used in MCC by experienced FCers.

STEPS: A Simulated, Tutorable Physics Student.

ERIC Educational Resources Information Center

Ur, Sigalit; VanLehn, Kurt

1995-01-01

Describes a simulated student that learns by interacting with a human tutor. Tests suggest that simulated students, when developed past the prototype stage, could be valuable for training human tutors. Provides a computational cognitive task analysis of the skill of learning from a tutor that is useful for designing intelligent tutoring systems.…

Teaching basic lung isolation skills on human anatomy simulator: attainment and retention of lung isolation skills.

PubMed

Latif, Rana K; VanHorne, Edgar M; Kandadai, Sunitha Kanchi; Bautista, Alexander F; Neamtu, Aurel; Wadhwa, Anupama; Carter, Mary B; Ziegler, Craig H; Memon, Mohammed Faisal; Akça, Ozan

2016-01-20

Lung isolation skills, such as correct insertion of double lumen endobronchial tube and bronchial blocker, are essential in anesthesia training; however, how to teach novices these skills is underexplored. Our aims were to determine (1) if novices can be trained to a basic proficiency level of lung isolation skills, (2) whether video-didactic and simulation-based trainings are comparable in teaching lung isolation basic skills, and (3) whether novice learners' lung isolation skills decay over time without practice. First, five board certified anesthesiologist with experience of more than 100 successful lung isolations were tested on Human Airway Anatomy Simulator (HAAS) to establish Expert proficiency skill level. Thirty senior medical students, who were naive to bronchoscopy and lung isolation techniques (Novice) were randomized to video-didactic and simulation-based trainings to learn lung isolation skills. Before and after training, Novices' performances were scored for correct placement using pass/fail scoring and a 5-point Global Rating Scale (GRS); and time of insertion was recorded. Fourteen novices were retested 2 months later to assess skill decay. Experts' and novices' double lumen endobronchial tube and bronchial blocker passing rates showed similar success rates after training (P >0.99). There were no differences between the video-didactic and simulation-based methods. Novices' time of insertion decayed within 2 months without practice. Novices could be trained to basic skill proficiency level of lung isolation. Video-didactic and simulation-based methods we utilized were found equally successful in training novices for lung isolation skills. Acquired skills partially decayed without practice.

Simulation training and resident performance of singleton vaginal breech delivery.

PubMed

Deering, Shad; Brown, Jill; Hodor, Jonathon; Satin, Andrew J

2006-01-01

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

Graduate Education and Simulation Training for CBRNE Disasters Using a Multimodal Approach to Learning. Part 1: Education and Training from a Human-Performance Perspective

DTIC Science & Technology

2013-08-01

Learning Styles . Available at http://www2.umist.ac.uk.staff/talsc/TaLSC/VARK/default.htm; accessed Aug 9, 2010. 14. Joels M, Pu Z, Wiegert O, Oitzl M...and Simulation Training   for CBRNE Disasters Using a Multimodal  Approach to  Learning   Part 1: Education and Training from a Human‐ Performance...Graduate Education and Simulation Training for CBRNE Disasters Using a Multimodal 5a. CONTRACT NUMBER Approach to Learning . Part 1: Education and

Teaching and assessing procedural skills using simulation: metrics and methodology.

PubMed

Lammers, Richard L; Davenport, Moira; Korley, Frederick; Griswold-Theodorson, Sharon; Fitch, Michael T; Narang, Aneesh T; Evans, Leigh V; Gross, Amy; Rodriguez, Elliot; Dodge, Kelly L; Hamann, Cara J; Robey, Walter C

2008-11-01

Simulation allows educators to develop learner-focused training and outcomes-based assessments. However, the effectiveness and validity of simulation-based training in emergency medicine (EM) requires further investigation. Teaching and testing technical skills require methods and assessment instruments that are somewhat different than those used for cognitive or team skills. Drawing from work published by other medical disciplines as well as educational, behavioral, and human factors research, the authors developed six research themes: measurement of procedural skills; development of performance standards; assessment and validation of training methods, simulator models, and assessment tools; optimization of training methods; transfer of skills learned on simulator models to patients; and prevention of skill decay over time. The article reviews relevant and established educational research methodologies and identifies gaps in our knowledge of how physicians learn procedures. The authors present questions requiring further research that, once answered, will advance understanding of simulation-based procedural training and assessment in EM.

A review of the design and development processes of simulation for training in healthcare - A technology-centered versus a human-centered perspective.

PubMed

Persson, Johanna

2017-01-01

This article reviews literature about simulation systems for training in healthcare regarding the prevalence of human-centered approaches in the design and development of these systems, motivated by a tradition in this field of working technology-centered. The results show that the focus on human needs and context of use is limited. It is argued that a reduction of the focus on technical advancements in favor of the needs of the users and the healthcare community, underpinned by human factors and ergonomics theory, is favorable. Due to the low number of identified articles describing or discussing human-centered approaches it is furthermore concluded that the publication culture promotes technical descriptions and summative evaluations rather than descriptions and reflections regarding the design and development processes. Shifting the focus from a technology-centered approach to a human-centered one can aid in the process of creating simulation systems for training in healthcare that are: 1) relevant to the learning objectives, 2) adapted to the needs of users, context and task, and 3) not selected based on technical or fidelity criteria. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improving Patient Safety through Simulation Training in Anesthesiology: Where Are We?

PubMed Central

2016-01-01

There have been colossal technological advances in the use of simulation in anesthesiology in the past 2 decades. Over the years, the use of simulation has gone from low fidelity to high fidelity models that mimic human responses in a startlingly realistic manner, extremely life-like mannequin that breathes, generates E.K.G, and has pulses, heart sounds, and an airway that can be programmed for different degrees of obstruction. Simulation in anesthesiology is no longer a research fascination but an integral part of resident education and one of ACGME requirements for resident graduation. Simulation training has been objectively shown to increase the skill-set of anesthesiologists. Anesthesiology is leading the movement in patient safety. It is rational to assume a relationship between simulation training and patient safety. Nevertheless there has not been a demonstrable improvement in patient outcomes with simulation training. Larger prospective studies that evaluate the improvement in patient outcomes are needed to justify the integration of simulation training in resident education but ample number of studies in the past 5 years do show a definite benefit of using simulation in anesthesiology training. This paper gives a brief overview of the history and evolution of use of simulation in anesthesiology and highlights some of the more recent studies that have advanced simulation-based training. PMID:26949389

Simulator Sickness During Emergency Procedures Training in a Helicopter Simulator: Age, Flight Experience, and Amount Learned

DTIC Science & Technology

2007-09-01

Aircrew Training Research Division, Human Resources Directorate. Smart, L. J ., Stoffregen, T. A ., & Bardy , B. G. (2002). Visually induced motion sickness...Aviation, Space, and Environmental Medicine, 60, 1043-1048. Benson, A . J . (1978). Motion sickness. In G. Dhenin & J . Ernsting (Eds.), Aviation Medicine...pp. 468-493). London: Tri-Med Books. Benson, A . J . (1988). Aetiological factors in simulator sickness. In AGARD, Motion cues in flight simulation and

The role of simulation in surgical training.

PubMed Central

Torkington, J.; Smith, S. G.; Rees, B. I.; Darzi, A.

2000-01-01

Surgical training has undergone many changes in the last decade. One outcome of these changes is the interest that has been generated in the possibility of training surgical skills outside the operating theatre. Simulation of surgical procedures and human tissue, if perfect, would allow complete transfer of techniques learnt in a skills laboratory directly to the operating theatre. Several techniques of simulation are available including artificial tissues, animal models and virtual reality computer simulation. Each is discussed in this article and their advantages and disadvantages considered. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:10743423

Judicious use of simulation technology in continuing medical education.

PubMed

Curtis, Michael T; DiazGranados, Deborah; Feldman, Moshe

2012-01-01

Use of simulation-based training is fast becoming a vital source of experiential learning in medical education. Although simulation is a common tool for undergraduate and graduate medical education curricula, the utilization of simulation in continuing medical education (CME) is still an area of growth. As more CME programs turn to simulation to address their training needs, it is important to highlight concepts of simulation technology that can help to optimize learning outcomes. This article discusses the role of fidelity in medical simulation. It provides support from a cross section of simulation training domains for determining the appropriate levels of fidelity, and it offers guidelines for creating an optimal balance of skill practice and realism for efficient training outcomes. After defining fidelity, 3 dimensions of fidelity, drawn from the human factors literature, are discussed in terms of their relevance to medical simulation. From this, research-based guidelines are provided to inform CME providers regarding the use of simulation in CME training. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Training Knowledge Bots for Physics-Based Simulations Using Artificial Neural Networks

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.; Wong, Jay Ming

2014-01-01

Millions of complex physics-based simulations are required for design of an aerospace vehicle. These simulations are usually performed by highly trained and skilled analysts, who execute, monitor, and steer each simulation. Analysts rely heavily on their broad experience that may have taken 20-30 years to accumulate. In addition, the simulation software is complex in nature, requiring significant computational resources. Simulations of system of systems become even more complex and are beyond human capacity to effectively learn their behavior. IBM has developed machines that can learn and compete successfully with a chess grandmaster and most successful jeopardy contestants. These machines are capable of learning some complex problems much faster than humans can learn. In this paper, we propose using artificial neural network to train knowledge bots to identify the idiosyncrasies of simulation software and recognize patterns that can lead to successful simulations. We examine the use of knowledge bots for applications of computational fluid dynamics (CFD), trajectory analysis, commercial finite-element analysis software, and slosh propellant dynamics. We will show that machine learning algorithms can be used to learn the idiosyncrasies of computational simulations and identify regions of instability without including any additional information about their mathematical form or applied discretization approaches.

[The importance of simulation in team training on obstetric emergencies: results of the first phase of the national plan for continuous medical training].

PubMed

Maio Matos, Francisco; Sousa Gomes, Andrea; Costa, Fernando Jorge; Santos Silva, Isabel; Carvalhas, Joana

2012-01-01

Obstetric emergencies are unexpected and random. The traditional model for medical training of these acute events has included lectures combined with sporadic clinical experiences, but this educational method has inherent limitations. Given the variety of manual skills that must be learned and high-risk environment, Obstetrics is uniquely suited for simulation. New technological educational tools provide an opportunity to learn and master technical skills needed in emergent situations as well as the opportunity to rehearse and learn from mistakes without risks to patients. The goals of this study are to assess which are the factors that trainees associate to human fallibility before and after clinical simulation based training; to compare the confidence level to solve emergent obstetric situations between interns and experts with up to 5 years of experience before and after training, and to determine the value that trainees give to simulation as a teaching tool on emergent events. 31 physicians participated at this course sessions. After the course, we verified changes in the factores that trainees associate to human fallibility, an increase in confidence level to solve emergent obstetric and an increase in the value that trainees give to simulation as a teaching tool.

Virtual reality simulator training of laparoscopic cholecystectomies - a systematic review.

PubMed

Ikonen, T S; Antikainen, T; Silvennoinen, M; Isojärvi, J; Mäkinen, E; Scheinin, T M

2012-01-01

Simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. Surgical procedures can be simulated by increasingly complex and expensive techniques. This review gives an update on computer-based virtual reality (VR) simulators in training for laparoscopic cholecystectomies. From leading databases (Medline, Cochrane, Embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. Twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. Furthermore, seven studies comparing black boxes and simulators were included. The results indicated any kind of simulator training (black box, VR) to be beneficial at novice level. After VR training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. No clinical follow-up data were found. Optimal learning requires skills training to be conducted as part of a systematic training program. No data on the cost-benefit of simulators were found, the price of a VR simulator begins at EUR 60 000. Theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. The cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. In order to achieve optimal learning a validated training program is needed.

SYMPTEK homemade foam models for client education and emergency obstetric care skills training in low-resource settings.

PubMed

Deganus, Sylvia A

2009-10-01

Clinical training for health care workers using anatomical models and simulation has become an established norm. A major requirement for this approach is the availability of lifelike training models or simulators for skills practice. Manufactured sophisticated human models such as the resuscitation neonatal dolls, the Zoë gynaecologic simulator, and other pelvic models are very expensive, and are beyond the budgets of many training programs or activities in low-resource countries. Clinical training programs in many low-resource countries suffer greatly because of this cost limitation. Yet it is also in these same poor countries that the need for skilled human resources in reproductive health is greatest. The SYMPTEK homemade models were developed in response to the need for cheaper, more readily available humanistic models for training in emergency obstetric skills and also for client education. With minimal training, a variety of cheap SYMPTEK models can easily be made, by both trainees and facilitators, from high-density latex foam material commonly used for furnishings. The models are reusable, durable, portable, and easily maintained. The uses, advantages, disadvantages, and development of the SYMPTEK foam models are described in this article.

Pilot Task Profiles, Human Factors, And Image Realism

NASA Astrophysics Data System (ADS)

McCormick, Dennis

1982-06-01

Computer Image Generation (CIG) visual systems provide real time scenes for state-of-the-art flight training simulators. The visual system reauires a greater understanding of training tasks, human factors, and the concept of image realism to produce an effective and efficient training scene than is required by other types of visual systems. Image realism must be defined in terms of pilot visual information reauirements. Human factors analysis of training and perception is necessary to determine the pilot's information requirements. System analysis then determines how the CIG and display device can best provide essential information to the pilot. This analysis procedure ensures optimum training effectiveness and system performance.

Managing human error in aviation.

PubMed

Helmreich, R L

1997-05-01

Crew resource management (CRM) programs were developed to address team and leadership aspects of piloting modern airplanes. The goal is to reduce errors through team work. Human factors research and social, cognitive, and organizational psychology are used to develop programs tailored for individual airlines. Flight crews study accident case histories, group dynamics, and human error. Simulators provide pilots with the opportunity to solve complex flight problems. CRM in the simulator is called line-oriented flight training (LOFT). In automated cockpits CRM promotes the idea of automation as a crew member. Cultural aspects of aviation include professional, business, and national culture. The aviation CRM model has been adapted for training surgeons and operating room staff in human factors.

The efficacy of virtual reality simulation training in laparoscopy: a systematic review of randomized trials.

PubMed

Larsen, Christian Rifbjerg; Oestergaard, Jeanett; Ottesen, Bent S; Soerensen, Jette Led

2012-09-01

Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Controlled trials. All randomized controlled trials investigating the effect of VR training in laparoscopy, with outcome measured as surgical performance. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training. © 2012 The Authors  Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Training Research Program and Plans: Advanced Simulation in Undergraduate Pilot Training.

ERIC Educational Resources Information Center

Matheny, W. G.

The study reports the work done by a panel of experts in training research toward defining priority research investigations to be undertaken through the Human Resources Laboratory, Flying Training Division (HRL/FT). A list of recommended investigations judged to be important for increasing the effectiveness of beginning pilot training was…

Simulation-based training for prostate surgery.

PubMed

Khan, Raheej; Aydin, Abdullatif; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

2015-10-01

To identify and review the currently available simulators for prostate surgery and to explore the evidence supporting their validity for training purposes. A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the American Urological Association, European Association of Urology, British Association of Urological Surgeons and World Congress of Endourology meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included; studies regarding other urological simulators were excluded. A total of 22 studies that carried out a validation study were identified. Five validated models and/or simulators were identified for TURP, one for photoselective vaporisation of the prostate, two for holmium enucleation of the prostate, three for laparoscopic radical prostatectomy (LRP) and four for robot-assisted surgery. Of the TURP simulators, all five have demonstrated content validity, three face validity and four construct validity. The GreenLight laser simulator has demonstrated face, content and construct validities. The Kansai HoLEP Simulator has demonstrated face and content validity whilst the UroSim HoLEP Simulator has demonstrated face, content and construct validity. All three animal models for LRP have been shown to have construct validity whilst the chicken skin model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy, both of which demonstrated construct validity. A wide range of different simulators are available for prostate surgery, including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators can be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, to determine which simulators have greater efficacy than others and to assess the cost-effectiveness of the simulators and the transferability of skills learnt. With surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers great scope for implementation alongside traditional methods of training. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

Training Effectiveness of Visual and Motion Simulation

DTIC Science & Technology

1981-01-01

and checkride scores. No statistical differeLes between the two groups were found. Creelman (1959) reported that students trained in theSNJ Link with...simulated and aircraft hvurs or sorsies (Dricisom a Burger, 1976; Brown. Matheny, & Fleaman. 1951; Creelman , 1959; Gray et al., 1969- Payne at al., 1976...reirtionohip between flight simulator motion and trainiag requirmumenia. Human Factors. 1979. 2). 493-50)1. Creelman , J.A. Evaluation of approach

Telehealth innovations in health education and training.

PubMed

Conde, José G; De, Suvranu; Hall, Richard W; Johansen, Edward; Meglan, Dwight; Peng, Grace C Y

2010-01-01

Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences.

Physical environment virtualization for human activities recognition

NASA Astrophysics Data System (ADS)

Poshtkar, Azin; Elangovan, Vinayak; Shirkhodaie, Amir; Chan, Alex; Hu, Shuowen

2015-05-01

Human activity recognition research relies heavily on extensive datasets to verify and validate performance of activity recognition algorithms. However, obtaining real datasets are expensive and highly time consuming. A physics-based virtual simulation can accelerate the development of context based human activity recognition algorithms and techniques by generating relevant training and testing videos simulating diverse operational scenarios. In this paper, we discuss in detail the requisite capabilities of a virtual environment to aid as a test bed for evaluating and enhancing activity recognition algorithms. To demonstrate the numerous advantages of virtual environment development, a newly developed virtual environment simulation modeling (VESM) environment is presented here to generate calibrated multisource imagery datasets suitable for development and testing of recognition algorithms for context-based human activities. The VESM environment serves as a versatile test bed to generate a vast amount of realistic data for training and testing of sensor processing algorithms. To demonstrate the effectiveness of VESM environment, we present various simulated scenarios and processed results to infer proper semantic annotations from the high fidelity imagery data for human-vehicle activity recognition under different operational contexts.

The development and implementation of cockpit resource management in UAL recurrent training

NASA Technical Reports Server (NTRS)

Shroyer, David H.

1987-01-01

Line Oriented Flight Training (LOFT) for United Airlines started in 1976. At that time it was basically no more than a line-simulated training function conducted in a full-mission simulator with no attention or stress on its human factor content. Very soon after the implementation of the LOFT program concerns were voiced about certain crew behavioral situations they were observing in the flight crew's execution of cockpit duties. These duties involved emergency procedures as well as irregular and normal procedures and situations. It was evident that new information was surfacing concerning crew interaction, or its lack thereof, in the cockpit and its effect on satisfactory performance. These observations naturally raised the question of how this information translated into the safety of aircraft operations. A training system had to be repetitive, the crew interactive, and the training had to be conducted under the crew concept. The foundation had to have two other factors: (1) it was necessary to have adequate human factor content, and (2) an advanced state-of-the-art simulator and appropriate electronic devices were required. These concepts are further discussed.

Minimal Access Surgery Educational Needs of Trainees from Africa: Perspectives from an Asian Training Institution.

PubMed

Ahmad, J I; Mishra, R K

2015-01-01

The establishment of minimal access surgery (MAS) in the last three decades brought new dimensions to surgical training. The sole role of traditional apprenticeship training model was challenged and adjunctive surgical simulation models were introduced. Knowledge of the trainees' educational needs is important in designing MAS training curriculum. To study the MAS educational needs of trainees from Africa, review MAS training models and offer recommendations for MAS training. Data was obtained from questionnaires filled by trainees from Africa who attended the monthly MAS training at the World Laparoscopy Hospital, India from October 2013 to May 2014 about their MAS educational needs. There were 38 trainees from different parts of Africa (Central, East, North, South and West Africa) with average age of 41.92 ± 8.67 years (minimum-28 years and maximum 63 years) and majority were males (92%). General surgeons constituted 57% while Gynaecologists were 41%. Only a quarter have MAS training integrated in their training curriculum. Box trainers, Animal models, live human surgeries and virtual reality simulation were the commonest models used in previous trainings and favoured in the educational needs for MAS training. Using cadaveric models and self sponsorship were deemphasised. Widespread application of MAS, globalisation and trainees educational needs call for establishing training programmes. Box trainers, animal models, live human surgeries and virtual reality simulators should be adopted and a synergy between Postgraduate surgical programmes, biomedical industry, universities and trainees will facilitate the setting of MAS skills laboratories and programmes.

[Simulation training in the management of obstetric emergencies. A review of the literature].

PubMed

Bogne, V; Kirkpatrick, C; Englert, Y

2014-01-01

To assess the value of simulation based training in the management of obstetric emergencies. A search by keywords: obstetrics, gynecology, simulation, drills, emergency training restricted to randomized trials led to a selection of eight articles. Shoulder dystocia simulation unmasked deficiencies in performing Mc Robert maneuver in nearly 20% of doctors in training as well as ineffective and potentially harmful maneuver such as pressure on the uterine fundus. Delivery of the impacted shoulder improved from 42.9% to 83.3% after simulation training leading to a shorter head to body delivery interval. In postpartum haemorrhage simulation, lack of knowledge on prostaglandins and alkaloids of ergot, delay to transfer the patient to the operating room (82% of cases) and a poor communication between different professionals were identified. Post simulation improvement was seen in knowledge, technical skills, team spirit and structured communication. In severe preeclampsia simulation, mistakes such as injection of undiluted magnesium sulphate, caesarean section on an unstable patient were identified and reduced by 75%. Management of magnesium sulphate toxicity was also improved after simulation training. This review confirms the potential of simulation in training health professionals on management of obstetrics emergencies. Although the integration of this training modality into the curriculum of health care professionals in obstetrics and gynaecology seems beneficial, questions on the cost, the minimum standard of facilities, type of mannequins, human resources and frequency of drills required to achieve the learning objectives remain unanswered.

Human Factors Topics in Flight Simulation: An Annotated Bibliography

DTIC Science & Technology

1976-01-01

and technical information; - Continuously stimulating advances in the aerospace sciences relevant to strengthening the common defence posture...Topics treated under cost effectiveness are effectiveness as a function of training procedures, physical stimulation versus psychological stimulation ...fidelity of physical stimulation . HUDDLESTON. H.F. and ROLFE, J.M. Behaviouralfactors influencing aircrew response in training and research simulators

Human Factors Tools for Improving Simulation Activities in Continuing Medical Education

ERIC Educational Resources Information Center

Seagull, F. Jacob

2012-01-01

Human factors (HF) is a discipline often drawn upon when there is a need to train people to perform complex, high-stakes tasks and effectively assess their performance. Complex tasks often present unique challenges for training and assessment. HF has developed specialized techniques that have been effective in overcoming several of these…

Integrating team training strategies into obstetrical emergency simulation training.

PubMed

Daniel, Linda T; Simpson, Ellen K

2009-01-01

Successful management of obstetrical emergencies such as shoulder dystocia requires the coordinated efforts of a multidisciplinary team of professionals. Simulation education provides an opportunity to learn and master simple as well as complex technical skills needed in emergent situations. Team training has been shown to improve the quality of communication among team members and consequently has an enormous impact on human performance. In the healthcare environment, especially obstetrics where the stakes are high, integrating team training into simulation education can advance efforts to create and sustain a culture of safety. With over 7,100 deliveries annually, our 1,100-bed, two-hospital regional healthcare system embarked on this journey to advance the culture of safety.

A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine.

PubMed

Suslu, Husnu

2012-01-01

Laboratory training models are essential for developing and refining treatment skills before the clinical application of surgical and invasive procedures. A simple simulation model is needed for young trainees to learn how to handle instruments, and to perform safe lumbar transforaminal epidural injections. Our aim is to present a model of a fresh cadaveric sheep lumbar spine that simulates the lumbar transforaminal epidural injection. The material consists of a 2-year-old fresh cadaveric sheep spine. A 4-step approach was designed for lumbar transforaminal epidural injection under C-arm scopy. For the lumbar transforaminal epidural injection, the fluoroscope was adjusted to get a proper oblique view while the material was stabilized in a prone position. The procedure then begin, using the C-arm guidance scopy. The model simulates well the steps of standard lumbar transforaminal epidural injections in the human spine. The cadaveric sheep spine represents a good method for training and it simulates fluoroscopic lumbar transforaminal epidural steroid injection procedures performed in the human spine.

Telehealth Innovations in Health Education and Training

PubMed Central

De, Suvranu; Hall, Richard W.; Johansen, Edward; Meglan, Dwight; Peng, Grace C.Y.

2010-01-01

Abstract Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

The Umbra Simulation and Integration Framework Applied to Emergency Response Training

NASA Technical Reports Server (NTRS)

Hamilton, Paul Lawrence; Britain, Robert

2010-01-01

The Mine Emergency Response Interactive Training Simulation (MERITS) is intended to prepare personnel to manage an emergency in an underground coal mine. The creation of an effective training environment required realistic emergent behavior in response to simulation events and trainee interventions, exploratory modification of miner behavior rules, realistic physics, and incorporation of legacy code. It also required the ability to add rich media to the simulation without conflicting with normal desktop security settings. Our Umbra Simulation and Integration Framework facilitated agent-based modeling of miners and rescuers and made it possible to work with subject matter experts to quickly adjust behavior through script editing, rather than through lengthy programming and recompilation. Integration of Umbra code with the WebKit browser engine allowed the use of JavaScript-enabled local web pages for media support. This project greatly extended the capabilities of Umbra in support of training simulations and has implications for simulations that combine human behavior, physics, and rich media.

Issues related to line-oriented flight training

NASA Technical Reports Server (NTRS)

Lauber, J. K.

1981-01-01

The use of a training simulator along with carefully structured, detailed, line trip scenarios was envisioned by NASA as a means of providing a controllable, repeatable way to observe line crews in a highly realistic simulation of their working environment and obtain better understanding operationally significant human factors problems and issues. Relevant research done by the agency and the results of full-mission simulation scenarios revealed potential implications for flight training. Aspects to be considered in creating training programs closely related to the actual line environment with a total crew application in real world incident experiences include: (1) operational, environmental, equipment, and crew problems in scenario design; (2) real time line oriented flight training operation; (3) performance assessment and debriefing; (4) instructor qualification and training; and (5) other issues such as ub un initial, transition, and upgrade training; procedures developent and evaluation, and equipment evaluation.

First experiences of high-fidelity simulation training in junior nursing students in Korea.

PubMed

Lee, Suk Jeong; Kim, Sang Suk; Park, Young-Mi

2015-07-01

This study was conducted to explore first experiences of high-fidelity simulation training in Korean nursing students, in order to develop and establish more effective guidelines for future simulation training in Korea. Thirty-three junior nursing students participated in high-fidelity simulation training for the first time. Using both qualitative and quantitative methods, data were collected from reflective journals and questionnaires of simulation effectiveness after simulation training. Descriptive statistics were used to analyze simulation effectiveness and content analysis was performed with the reflective journal data. Five dimensions and 31 domains, both positive and negative experiences, emerged from qualitative analysis: (i) machine-human interaction in a safe environment; (ii) perceived learning capability; (iii) observational learning; (iv) reconciling practice with theory; and (v) follow-up debriefing effect. More than 70% of students scored high on increased ability to identify changes in the patient's condition, critical thinking, decision-making, effectiveness of peer observation, and debriefing in effectiveness of simulation. This study reported both positive and negative experiences of simulation. The results of this study could be used to set the level of task difficulty in simulation. Future simulation programs can be designed by reinforcing the positive experiences and modifying the negative results. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

Virtual reality simulation for construction safety promotion.

PubMed

Zhao, Dong; Lucas, Jason

2015-01-01

Safety is a critical issue for the construction industry. Literature argues that human error contributes to more than half of occupational incidents and could be directly impacted by effective training programs. This paper reviews the current safety training status in the US construction industry. Results from the review evidence the gap between the status and industry expectation on safety. To narrow this gap, this paper demonstrates the development and utilisation of a training program that is based on virtual reality (VR) simulation. The VR-based safety training program can offer a safe working environment where users can effectively rehearse tasks with electrical hazards and ultimately promote their abilities for electrical hazard cognition and intervention. Its visualisation and simulation can also remove the training barriers caused by electricity's features of invisibility and dangerousness.

Human-simulation-based learning to prevent medication error: A systematic review.

PubMed

Sarfati, Laura; Ranchon, Florence; Vantard, Nicolas; Schwiertz, Vérane; Larbre, Virginie; Parat, Stéphanie; Faudel, Amélie; Rioufol, Catherine

2018-01-31

In the past 2 decades, there has been an increasing interest in simulation-based learning programs to prevent medication error (ME). To improve knowledge, skills, and attitudes in prescribers, nurses, and pharmaceutical staff, these methods enable training without directly involving patients. However, best practices for simulation for healthcare providers are as yet undefined. By analysing the current state of experience in the field, the present review aims to assess whether human simulation in healthcare helps to reduce ME. A systematic review was conducted on Medline from 2000 to June 2015, associating the terms "Patient Simulation," "Medication Errors," and "Simulation Healthcare." Reports of technology-based simulation were excluded, to focus exclusively on human simulation in nontechnical skills learning. Twenty-one studies assessing simulation-based learning programs were selected, focusing on pharmacy, medicine or nursing students, or concerning programs aimed at reducing administration or preparation errors, managing crises, or learning communication skills for healthcare professionals. The studies varied in design, methodology, and assessment criteria. Few demonstrated that simulation was more effective than didactic learning in reducing ME. This review highlights a lack of long-term assessment and real-life extrapolation, with limited scenarios and participant samples. These various experiences, however, help in identifying the key elements required for an effective human simulation-based learning program for ME prevention: ie, scenario design, debriefing, and perception assessment. The performance of these programs depends on their ability to reflect reality and on professional guidance. Properly regulated simulation is a good way to train staff in events that happen only exceptionally, as well as in standard daily activities. By integrating human factors, simulation seems to be effective in preventing iatrogenic risk related to ME, if the program is well designed. © 2018 John Wiley & Sons, Ltd.

Method matters: impact of in-scenario instruction on simulation-based teamwork training.

PubMed

Escher, Cecilia; Rystedt, Hans; Creutzfeldt, Johan; Meurling, Lisbet; Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Nordahl Amorøe, Torben; Hult, Håkan; Felländer-Tsai, Li; Abrandt-Dahlgren, Madeleine

2017-01-01

The rationale for introducing full-scale patient simulators in training to improve patient safety is to recreate clinical situations in a realistic setting. Although high-fidelity simulators mimic a wide range of human features, simulators differ from the body of a sick patient. The gap between the simulator and the human body implies a need for facilitators to provide information to help participants understand scenarios. The authors aimed at describing different methods that facilitators in our dataset used to provide such extra scenario information and how the different methods to convey information affected how scenarios played out. A descriptive qualitative study was conducted to examine the variation of methods to deliver extra scenario information to participants. A multistage approach was employed. The authors selected film clips from a shared database of 31 scenarios from three participating simulation centers. A multidisciplinary research team performed a collaborative analysis of representative film clips focusing on the interplay between participants, facilitators, and the physical environment. After that, the entire material was revisited to further examine and elaborate the initial findings. The material displayed four distinct methods for facilitators to convey information to participants in simulation-based teamwork training. The choice of method had impact on the participating teams regarding flow of work, pace, and team communication. Facilitators' close access to the teams' activities when present in the simulation suite, either embodied or disembodied in the simulation, facilitated the timing for providing information, which was critical for maintaining the flow of activities in the scenario. The mediation of information by a loudspeaker or an earpiece from the adjacent operator room could be disturbing for team communication. In-scenario instruction is an essential component of simulation-based teamwork training that has been largely overlooked in previous research. The ways in which facilitators convey information about the simulated patient have the potential to shape the simulation activities and thereby serve different learning goals. Although immediate timing to maintain an adequate pace is necessary for professionals to engage in training of medical emergencies, novices may gain from a slower tempo to train complex clinical team tasks systematically.

SIMULATION EXERCISES IN AREA TRAINING. PAPER PRESENTED IN A SYMPOSIUM AT THE 1965 ARMY HUMAN FACTORS RESEARCH AND DEVELOPMENT CONFERENCE.

ERIC Educational Resources Information Center

STEWART, EDWARD C.

SPECIAL TECHNIQUES AND CONTENT ARE BEING DEVELOPED TO SUPPLEMENT CURRENT AREA TRAINING PROGRAMS. SIMULATION WAS CHOSEN AS THE TECHNIQUE, AND EXERCISES WERE DEVELOPED WHOSE CONTENT EMPHASIZED THE AMERICAN CULTURE AND THE FOREIGN, HOST CULTURE. THESE EVOLVED AS A CONFRONTATION BETWEEN AMERICAN CULTURAL ASSUMPTIONS AND VALUES AND A CONTRASTING SET,…

Virtual reality: emerging role of simulation training in vascular access.

PubMed

Davidson, Ingemar J A; Lok, Charmaine; Dolmatch, Bart; Gallieni, Maurizio; Nolen, Billy; Pittiruti, Mauro; Ross, John; Slakey, Douglas

2012-11-01

Evolving new technologies in vascular access mandate increased attention to patient safety; an often overlooked yet valuable training tool is simulation. For the end-stage renal disease patient, simulation tools are effective for all aspects of creating access for peritoneal dialysis and hemodialysis. Based on aviation principles, known as crew resource management, we place equal emphasis on team training as individual training to improve interactions between team members and systems, cumulating in improved safety. Simulation allows for environmental control and standardized procedures, letting the trainee practice and correct mistakes without harm to patients, compared with traditional patient-based training. Vascular access simulators range from suture devices, to pressurized tunneled conduits for needle cannulation, to computer-based interventional simulators. Simulation training includes simulated case learning, root cause analysis of adverse outcomes, and continual update and refinement of concepts. Implementation of effective human to complex systems interaction in end-stage renal disease patients involves a change in institutional culture. Three concepts discussed in this article are as follows: (1) the need for user-friendly systems and technology to enhance performance, (2) the necessity for members to both train and work together as a team, and (3) the team assigned to use the system must test and practice it to a proficient level before safely using the system on patients. Copyright © 2012 Elsevier Inc. All rights reserved.

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.

Development of a novel ex vivo porcine laparoscopic Heller myotomy and Nissen fundoplication training model (Toronto lap-Nissen simulator).

PubMed

Ujiie, Hideki; Kato, Tatsuya; Hu, Hsin-Pei; Bauer, Patrycja; Patel, Priya; Wada, Hironobu; Lee, Daiyoon; Fujino, Kosuke; Schieman, Colin; Pierre, Andrew; Waddell, Thomas K; Keshavjee, Shaf; Darling, Gail E; Yasufuku, Kazuhiro

2017-06-01

Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. An ex vivo , anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen. The Toronto lap-Nissen simulator was contained in a laparoscopic box-trainer and included an arch system to simulate the normal radial shape and tension of the diaphragm. We integrated the use of this training model as a part of our laparoscopic skills laboratory-training curriculum. Afterwards, we surveyed trainees to evaluate the observed benefit of the learning session. Twenty-five trainees and five faculty members completed a survey regarding the use of this model. Among the trainees, only 4 (16%) had experience with laparoscopic Heller myotomy and Nissen fundoplication. They reported that practicing with the model was a valuable use of their limited time, repeating the exercise would be of additional benefit, and that the exercise improved their ability to perform or assist in an actual case in the operating room. Significant improvements were found in the following subjective measures comparing pre- vs. post-training: (I) knowledge level (5.6 vs. 8.0, P<0.001); (II) comfort level in assisting (6.3 vs. 7.6, P<0.001); and (III) comfort level in performing as the primary surgeon (4.9 vs. 7.1, P<0.001). The trainees and faculty members agreed that this model was of adequate fidelity and was a representative simulation of actual human anatomy. We developed an easily reproducible training model for laparoscopic procedures. This simulator reproduces human anatomy and increases the trainees' comfort level in performing and assisting with myotomy and fundoplication.

Development of a novel ex vivo porcine laparoscopic Heller myotomy and Nissen fundoplication training model (Toronto lap-Nissen simulator)

PubMed Central

Ujiie, Hideki; Kato, Tatsuya; Hu, Hsin-Pei; Bauer, Patrycja; Patel, Priya; Wada, Hironobu; Lee, Daiyoon; Fujino, Kosuke; Schieman, Colin; Pierre, Andrew; Waddell, Thomas K.; Keshavjee, Shaf; Darling, Gail E.

2017-01-01

Background Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. Methods An ex vivo, anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen. The Toronto lap-Nissen simulator was contained in a laparoscopic box-trainer and included an arch system to simulate the normal radial shape and tension of the diaphragm. We integrated the use of this training model as a part of our laparoscopic skills laboratory-training curriculum. Afterwards, we surveyed trainees to evaluate the observed benefit of the learning session. Results Twenty-five trainees and five faculty members completed a survey regarding the use of this model. Among the trainees, only 4 (16%) had experience with laparoscopic Heller myotomy and Nissen fundoplication. They reported that practicing with the model was a valuable use of their limited time, repeating the exercise would be of additional benefit, and that the exercise improved their ability to perform or assist in an actual case in the operating room. Significant improvements were found in the following subjective measures comparing pre- vs. post-training: (I) knowledge level (5.6 vs. 8.0, P<0.001); (II) comfort level in assisting (6.3 vs. 7.6, P<0.001); and (III) comfort level in performing as the primary surgeon (4.9 vs. 7.1, P<0.001). The trainees and faculty members agreed that this model was of adequate fidelity and was a representative simulation of actual human anatomy. Conclusions We developed an easily reproducible training model for laparoscopic procedures. This simulator reproduces human anatomy and increases the trainees’ comfort level in performing and assisting with myotomy and fundoplication. PMID:28740664

The nature of reality represented in high fidelity human patient simulation: philosophical perspectives and implications for nursing education.

PubMed

Dunnington, Renee M

2014-01-01

Simulation technology is increasingly being used in nursing education. Previously used primarily for teaching procedural, instrumental, or critical incident types of skills, simulation is now being applied to training related to more dynamic, complex, and interpersonal human contexts. While high fidelity human patient simulators have significantly increased in authenticity, human responses have greater complexity and are qualitatively different than current technology represents. This paper examines the texture of representation by simulation. Through a tracing of historical and contemporary philosophical perspectives on simulation, the nature and limits of the reality of human health responses represented by high fidelity human patient simulation (HF-HPS) are explored. Issues concerning nursing education are raised around the nature of reality represented in HF-HPS. Drawing on Waks, a framework for guiding pedagogical considerations around simulation in nursing education is presented for the ultimate purpose of promoting an educative experience with simulation. © 2013 John Wiley & Sons Ltd.

The impact of social context on learning and cognitive demands for interactive virtual human simulations

PubMed Central

Lyons, Rebecca; Johnson, Teresa R.; Khalil, Mohammed K.

2014-01-01

Interactive virtual human (IVH) simulations offer a novel method for training skills involving person-to-person interactions. This article examines the effectiveness of an IVH simulation for teaching medical students to assess rare cranial nerve abnormalities in both individual and small-group learning contexts. Individual (n = 26) and small-group (n = 30) interaction with the IVH system was manipulated to examine the influence on learning, learner engagement, perceived cognitive demands of the learning task, and instructional efficiency. Results suggested the IVH activity was an equally effective and engaging instructional tool in both learning structures, despite learners in the group learning contexts having to share hands-on access to the simulation interface. Participants in both conditions demonstrated a significant increase in declarative knowledge post-training. Operation of the IVH simulation technology imposed moderate cognitive demand but did not exceed the demands of the task content or appear to impede learning. PMID:24883241

Comparison of a multimedia simulator to a human model for teaching FAST exam image interpretation and image acquisition.

PubMed

Damewood, Sara; Jeanmonod, Donald; Cadigan, Beth

2011-04-01

This study compared the effectiveness of a multimedia ultrasound (US) simulator to normal human models during the practical portion of a course designed to teach the skills of both image acquisition and image interpretation for the Focused Assessment with Sonography for Trauma (FAST) exam. This was a prospective, blinded, controlled education study using medical students as an US-naïve population. After a standardized didactic lecture on the FAST exam, trainees were separated into two groups to practice image acquisition on either a multimedia simulator or a normal human model. Four outcome measures were then assessed: image interpretation of prerecorded FAST exams, adequacy of image acquisition on a standardized normal patient, perceived confidence of image adequacy, and time to image acquisition. Ninety-two students were enrolled and separated into two groups, a multimedia simulator group (n = 44), and a human model group (n = 48). Bonferroni adjustment factor determined the level of significance to be p = 0.0125. There was no difference between those trained on the multimedia simulator and those trained on a human model in image interpretation (median 80 of 100 points, interquartile range [IQR] 71-87, vs. median 78, IQR 62-86; p = 0.16), image acquisition (median 18 of 24 points, IQR 12-18 points, vs. median 16, IQR 14-20; p = 0.95), trainee's confidence in obtaining images on a 1-10 visual analog scale (median 5, IQR 4.1-6.5, vs. median 5, IQR 3.7-6.0; p = 0.36), or time to acquire images (median 3.8 minutes, IQR 2.7-5.4 minutes, vs. median = 4.5 minutes, IQR = 3.4-5.9 minutes; p = 0.044). There was no difference in teaching the skills of image acquisition and interpretation to novice FAST examiners using the multimedia simulator or normal human models. These data suggest that practical image acquisition skills learned during simulated training can be directly applied to human models. © 2011 by the Society for Academic Emergency Medicine.

Virtual reality simulators for gastrointestinal endoscopy training

PubMed Central

Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

2014-01-01

The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees’ learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application. PMID:24527175

UltraPulse--simulating a human arterial pulse with focussed airborne ultrasound.

PubMed

Hung, G M Y; John, N W; Hancock, C; Gould, D A; Hoshi, T

2013-01-01

Medical simulators provide a risk-free environment for trainee doctors to practice and improve their skills. UltraPulse is a new tactile system designed to utilise focussed airborne ultrasound to mimic a pulsation effect such as that of a human arterial pulse. In this paper, we focus on the construction of the haptics component, which can later be integrated into a variety of medical procedure training simulators.

Development of an E-Prime Based Computer Simulation of an Interactive Human Rights Violation Negotiation Script (Developpement d’un Programme de Simulation par Ordinateur Fonde sur le Logiciel E Prime pour la Negociation Interactive en cas de Violation des Droits de la Personne)

DTIC Science & Technology

2010-12-01

Base ( CFB ) Kingston. The computer simulation developed in this project is intended to be used for future research and as a possible training platform...DRDC Toronto No. CR 2010-055 Development of an E-Prime based computer simulation of an interactive Human Rights Violation negotiation script...Abstract This report describes the method of developing an E-Prime computer simulation of an interactive Human Rights Violation (HRV) negotiation. An

Objective Fidelity Evaluation in Multisensory Virtual Environments: Auditory Cue Fidelity in Flight Simulation

PubMed Central

Meyer, Georg F.; Wong, Li Ting; Timson, Emma; Perfect, Philip; White, Mark D.

2012-01-01

We argue that objective fidelity evaluation of virtual environments, such as flight simulation, should be human-performance-centred and task-specific rather than measure the match between simulation and physical reality. We show how principled experimental paradigms and behavioural models to quantify human performance in simulated environments that have emerged from research in multisensory perception provide a framework for the objective evaluation of the contribution of individual cues to human performance measures of fidelity. We present three examples in a flight simulation environment as a case study: Experiment 1: Detection and categorisation of auditory and kinematic motion cues; Experiment 2: Performance evaluation in a target-tracking task; Experiment 3: Transferrable learning of auditory motion cues. We show how the contribution of individual cues to human performance can be robustly evaluated for each task and that the contribution is highly task dependent. The same auditory cues that can be discriminated and are optimally integrated in experiment 1, do not contribute to target-tracking performance in an in-flight refuelling simulation without training, experiment 2. In experiment 3, however, we demonstrate that the auditory cue leads to significant, transferrable, performance improvements with training. We conclude that objective fidelity evaluation requires a task-specific analysis of the contribution of individual cues. PMID:22957068

Trauma Resuscitation Evaluation Times and Correlating Human Patient Simulation Training Differences-What is the Standard?

PubMed

Bonjour, Timothy J; Charny, Grigory; Thaxton, Robert E

2016-11-01

Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center. This was a prospective observational study measuring incremental step times by trauma teams during trauma and simulation patient resuscitations. Trauma and simulation patient arms had 60 patients for statistical significance. Participants included Emergency Medicine residents and Physician Assistant residents as the trauma team leader. The trauma patient arm revealed a mean evaluation time of 10:33 and simulation arm 10:23. Comparable time characteristics in the airway, intravenous access, blood sample collection, and blood pressure data subsets were seen. TR mean times were similar to the HPS arm subsets demonstrating simulation as an effective educational tool. Effective stepwise approaches, incremental time goals, and superior HPS training can improve patient survivability and improved departmental productivity using TR teams. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

[Human-robot global Simulink modeling and analysis for an end-effector upper limb rehabilitation robot].

PubMed

Liu, Yali; Ji, Linhong

2018-02-01

Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant's functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists' experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients' movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.

Design Evaluation for Personnel, Training and Human Factors (DEPTH) Final Report.

DTIC Science & Technology

1998-01-17

human activity was primarily intended to facilitate man-machine design analyses of complex systems. By importing computer aided design (CAD) data, the human figure models and analysis algorithms can help to ensure components can be seen, reached, lifted and removed by most maintainers. These simulations are also useful for logistics data capture, training, and task analysis. DEPTH was also found to be useful in obtaining task descriptions for technical

Using in situ simulation to identify and resolve latent environmental threats to patient safety: case study involving operational changes in a labor and delivery ward.

PubMed

Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M; Gullickson, Amy M; Orizondo-Korotko, Krystyna; Gross, Amy C; Fuqua, Wayne; Lammers, Richard

2010-01-01

Since the publication of "To Err Is Human" in 1999, health care professionals have looked to high-reliability industries such as aviation for guidance on improving system safety. One of the most widely adopted aviation-derived approaches is simulation-based team training, also known as crew resource management training. In the health care domain, crew resource management training often takes place in custom-built simulation laboratories that are designed to replicate operating rooms or labor and delivery rooms. Unlike these traditional crew resource management training programs, "in situ simulation" occurs on actual patient care units, involves actual health care team members, and uses actual organization processes to train and assess team performance. During the past 24 months, our research team has conducted nearly 40 in situ simulations. In this article, we present the results from 1 such simulation: a patient who experienced a difficult labor that resulted in an emergency caesarian section and hysterectomy. During the simulation, a number of latent environmental threats to safety were identified. This article presents the latent threats and the steps that the hospital has taken to remedy them.

An Annotated Bibliography of Objective Pilot Performance Measures

DTIC Science & Technology

1982-01-01

realism . (Author) 224 NAVTRAEQUIPCEN IH-330 t 667. PROPHET, Wallace W., and Caro, Paul W., Simulation and Aircrew Training and Performance, Human... cinematic simulation and air training appears to be the most promising cost-effective method of developing NOE visual perception skills. Of other...flight and control dynamics. Informal trials were run with research staff and carrier-qualified pilots to evaluate realism of the displays; amount of

Airline Crew Training

NASA Technical Reports Server (NTRS)

1989-01-01

The discovery that human error has caused many more airline crashes than mechanical malfunctions led to an increased emphasis on teamwork and coordination in airline flight training programs. Human factors research at Ames Research Center has produced two crew training programs directed toward more effective operations. Cockpit Resource Management (CRM) defines areas like decision making, workload distribution, communication skills, etc. as essential in addressing human error problems. In 1979, a workshop led to the implementation of the CRM program by United Airlines, and later other airlines. In Line Oriented Flight Training (LOFT), crews fly missions in realistic simulators while instructors induce emergency situations requiring crew coordination. This is followed by a self critique. Ames Research Center continues its involvement with these programs.

Ready or Not: Preparation through Simulation

ERIC Educational Resources Information Center

Spellman, Joy

2008-01-01

Immediately after 9/11, Burlington County College (BCC) realized that the focus of emergency preparedness must change. BCC responded by identifying community needs, developing customized simulation training using high-fidelity human patient simulators and laptop/desktop technology; developing partnerships, and securing outside funding. Over 8,500…

Automated social skills training with audiovisual information.

PubMed

Tanaka, Hiroki; Sakti, Sakriani; Neubig, Graham; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

2016-08-01

People with social communication difficulties tend to have superior skills using computers, and as a result computer-based social skills training systems are flourishing. Social skills training, performed by human trainers, is a well-established method to obtain appropriate skills in social interaction. Previous works have attempted to automate one or several parts of social skills training through human-computer interaction. However, while previous work on simulating social skills training considered only acoustic and linguistic features, human social skills trainers take into account visual features (e.g. facial expression, posture). In this paper, we create and evaluate a social skills training system that closes this gap by considering audiovisual features regarding ratio of smiling, yaw, and pitch. An experimental evaluation measures the difference in effectiveness of social skill training when using audio features and audiovisual features. Results showed that the visual features were effective to improve users' social skills.

[Team training and assessment in mixed reality-based simulated operating room : Current state of research in the field of simulation in spine surgery exemplified by the ATMEOS project].

PubMed

Stefan, P; Pfandler, M; Wucherer, P; Habert, S; Fürmetz, J; Weidert, S; Euler, E; Eck, U; Lazarovici, M; Weigl, M; Navab, N

2018-04-01

Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions. Using a mixed reality approach, a synthetic patient model, real surgical instruments and radiation-free virtual X‑ray imaging are combined into a simulation of spinal surgery. In previous research studies, the concept was evaluated in terms of realism, plausibility and immersiveness. In the current research, assessment measurements for technical and non-technical skills are developed and evaluated. The aim is to observe multidisciplinary surgical teams in the simulated operating room during minimally invasive spinal surgery and objectively assess the performance of the individual team members and the entire team. Moreover, the effectiveness of training methods and surgical techniques or success critical factors, e. g. management of crisis situations, can be captured and objectively assessed in the controlled environment.

Striving for Better Medical Education: the Simulation Approach.

PubMed

Sakakushev, Boris E; Marinov, Blagoi I; Stefanova, Penka P; Kostianev, Stefan St; Georgiou, Evangelos K

2017-06-01

Medical simulation is a rapidly expanding area within medical education due to advances in technology, significant reduction in training hours and increased procedural complexity. Simulation training aims to enhance patient safety through improved technical competency and eliminating human factors in a risk free environment. It is particularly applicable to a practical, procedure-orientated specialties. Simulation can be useful for novice trainees, experienced clinicians (e.g. for revalidation) and team building. It has become a cornerstone in the delivery of medical education, being a paradigm shift in how doctors are educated and trained. Simulation must take a proactive position in the development of metric-based simulation curriculum, adoption of proficiency benchmarking definitions, and should not depend on the simulation platforms used. Conversely, ingraining of poor practice may occur in the absence of adequate supervision, and equipment malfunction during the simulation can break the immersion and disrupt any learning that has occurred. Despite the presence of high technology, there is a substantial learning curve for both learners and facilitators. The technology of simulation continues to advance, offering devices capable of improved fidelity in virtual reality simulation, more sophisticated procedural practice and advanced patient simulators. Simulation-based training has also brought about paradigm shifts in the medical and surgical education arenas and ensured that the scope and impact of simulation will continue to broaden.

Simulation: Moving from Technology Challenge to Human Factors Success

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

Gould, Derek A., E-mail: dgould@liv.ac.uk; Chalmers, Nicholas; Johnson, Sheena J.

2012-06-15

Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable performance assessments. Human factors research is central to simulator model development that is relevant to real-world imaging-guided interventional tasks and to the credentialing programs in which it would be used.

Transfer of training for aerospace operations: How to measure, validate, and improve it

NASA Technical Reports Server (NTRS)

Cohen, Malcolm M.

1993-01-01

It has been a commonly accepted practice to train pilots and astronauts in expensive, extremely sophisticated, high fidelity simulators, with as much of the real-world feel and response as possible. High fidelity and high validity have often been assumed to be inextricably interwoven, although this assumption may not be warranted. The Project Mercury rate-damping task on the Naval Air Warfare Center's Human Centrifuge Dynamic Flight Simulator, the shuttle landing task on the NASA-ARC Vertical Motion Simulator, and the almost complete acceptance by the airline industry of full-up Boeing 767 flight simulators, are just a few examples of this approach. For obvious reasons, the classical models of transfer of training have never been adequately evaluated in aerospace operations, and there have been few, if any, scientifically valid replacements for the classical models. This paper reviews some of the earlier work involving transfer of training in aerospace operations, and discusses some of the methods by which appropriate criteria for assessing the validity of training may be established.

Modeling and simulation for space medicine operations: preliminary requirements considered

NASA Technical Reports Server (NTRS)

Dawson, D. L.; Billica, R. D.; McDonald, P. V.

2001-01-01

The NASA Space Medicine program is now developing plans for more extensive use of high-fidelity medical simulation systems. The use of simulation is seen as means to more effectively use the limited time available for astronaut medical training. Training systems should be adaptable for use in a variety of training environments, including classrooms or laboratories, space vehicle mockups, analog environments, and in microgravity. Modeling and simulation can also provide the space medicine development program a mechanism for evaluation of other medical technologies under operationally realistic conditions. Systems and procedures need preflight verification with ground-based testing. Traditionally, component testing has been accomplished, but practical means for "human in the loop" verification of patient care systems have been lacking. Medical modeling and simulation technology offer potential means to accomplish such validation work. Initial considerations in the development of functional requirements and design standards for simulation systems for space medicine are discussed.

Requirements for Modeling and Simulation for Space Medicine Operations: Preliminary Considerations

NASA Technical Reports Server (NTRS)

Dawson, David L.; Billica, Roger D.; Logan, James; McDonald, P. Vernon

2001-01-01

The NASA Space Medicine program is now developing plans for more extensive use of high-fidelity medical Simulation systems. The use of simulation is seen as means to more effectively use the limited time available for astronaut medical training. Training systems should be adaptable for use in a variety of training environments, including classrooms or laboratories, space vehicle mockups, analog environments, and in microgravity. Modeling and simulation can also provide the space medicine development program a mechanism for evaluation of other medical technologies under operationally realistic conditions. Systems and procedures need preflight verification with ground-based testing. Traditionally, component testing has been accomplished, but practical means for "human in the loop" verification of patient care systems have been lacking. Medical modeling and simulation technology offer potential means to accomplish such validation work. Initial considerations in the development of functional requirements and design standards for simulation systems for space medicine are discussed.

A Comparison of Robotic Simulation Performance on Basic Virtual Reality Skills: Simulator Subjective Versus Objective Assessment Tools.

PubMed

Dubin, Ariel K; Smith, Roger; Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia

To answer the question of whether there is a difference between robotic virtual reality simulator performance assessment and validated human reviewers. Current surgical education relies heavily on simulation. Several assessment tools are available to the trainee, including the actual robotic simulator assessment metrics and the Global Evaluative Assessment of Robotic Skills (GEARS) metrics, both of which have been independently validated. GEARS is a rating scale through which human evaluators can score trainees' performances on 6 domains: depth perception, bimanual dexterity, efficiency, force sensitivity, autonomy, and robotic control. Each domain is scored on a 5-point Likert scale with anchors. We used 2 common robotic simulators, the dV-Trainer (dVT; Mimic Technologies Inc., Seattle, WA) and the da Vinci Skills Simulator (dVSS; Intuitive Surgical, Sunnyvale, CA), to compare the performance metrics of robotic surgical simulators with the GEARS for a basic robotic task on each simulator. A prospective single-blinded randomized study. A surgical education and training center. Surgeons and surgeons in training. Demographic information was collected including sex, age, level of training, specialty, and previous surgical and simulator experience. Subjects performed 2 trials of ring and rail 1 (RR1) on each of the 2 simulators (dVSS and dVT) after undergoing randomization and warm-up exercises. The second RR1 trial simulator performance was recorded, and the deidentified videos were sent to human reviewers using GEARS. Eight different simulator assessment metrics were identified and paired with a similar performance metric in the GEARS tool. The GEARS evaluation scores and simulator assessment scores were paired and a Spearman rho calculated for their level of correlation. Seventy-four subjects were enrolled in this randomized study with 9 subjects excluded for missing or incomplete data. There was a strong correlation between the GEARS score and the simulator metric score for time to complete versus efficiency, time to complete versus total score, economy of motion versus depth perception, and overall score versus total score with rho coefficients greater than or equal to 0.70; these were significant (p < .0001). Those with weak correlation (rho ≥0.30) were bimanual dexterity versus economy of motion, efficiency versus master workspace range, bimanual dexterity versus master workspace range, and robotic control versus instrument collisions. On basic VR tasks, several simulator metrics are well matched with GEARS scores assigned by human reviewers, but others are not. Identifying these matches/mismatches can improve the training and assessment process when using robotic surgical simulators. Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

The Development of Dispatcher Training Simulator in a Thermal Energy Generation System

NASA Astrophysics Data System (ADS)

Hakim, D. L.; Abdullah, A. G.; Mulyadi, Y.; Hasan, B.

2018-01-01

A dispatcher training simulator (DTS) is a real-time Human Machine Interface (HMI)-based control tool that is able to visualize industrial control system processes. The present study was aimed at developing a simulator tool for boilers in a thermal power station. The DTS prototype was designed using technical data of thermal power station boilers in Indonesia. It was then designed and implemented in Wonderware Intouch 10. The resulting simulator came with component drawing, animation, control display, alarm system, real-time trend, historical trend. This application used 26 tagnames and was equipped with a security system. The test showed that the principles of real-time control worked well. It is expected that this research could significantly contribute to the development of thermal power station, particularly in terms of its application as a training simulator for beginning dispatchers.

Simulation of the human-telerobot interface

NASA Technical Reports Server (NTRS)

Stuart, Mark A.; Smith, Randy L.

1988-01-01

A part of NASA's Space Station will be a Flight Telerobotic Servicer (FTS) used to help assemble, service, and maintain the Space Station. Since the human operator will be required to control the FTS, the design of the human-telerobot interface must be optimized from a human factors perspective. Simulation has been used as an aid in the development of complex systems. Simulation has been especially useful when it has been applied to the development of complex systems. Simulation should ensure that the hardware and software components of the human-telerobot interface have been designed and selected so that the operator's capabilities and limitations have been accommodated for since this is a complex system where few direct comparisons to existent systems can be made. Three broad areas of the human-telerobot interface where simulation can be of assistance are described. The use of simulation not only can result in a well-designed human-telerobot interface, but also can be used to ensure that components have been selected to best meet system's goals, and for operator training.

Review-Research on the physical training model of human body based on HQ.

PubMed

Junjie, Liu

2016-11-01

Health quotient (HQ) is the newest health culture and concept in the 21st century, and the analysis of the human body sports model is not enough mature at present, what's more, the purpose of this paper is to study the integration of the two subjects the health quotient and the sport model. This paper draws the conclusion that physical training and education in colleges and universities can improve the health quotient, and it will make students possess a more healthy body and mind. Then through a new rigid body model of sports to simulate the human physical exercise. After that this paper has an in-depth study on the dynamic model of the human body movement on the basis of establishing the matrix and equation. The simulation results of the human body bicycle riding and pole throwing show that the human body joint movement simulation can be realized and it has a certain operability as well. By means of such simulated calculation, we can come to a conclusion that the movement of the ankle joint, knee joint and hip joint's motion law and real motion are basically the same. So it further verify the accuracy of the motion model, which lay the foundation of other research movement model, also, the study of the movement model is an important method in the study of human health in the future.

Virtual reality in ophthalmology training.

PubMed

Khalifa, Yousuf M; Bogorad, David; Gibson, Vincent; Peifer, John; Nussbaum, Julian

2006-01-01

Current training models are limited by an unstructured curriculum, financial costs, human costs, and time constraints. With the newly mandated resident surgical competency, training programs are struggling to find viable methods of assessing and documenting the surgical skills of trainees. Virtual-reality technologies have been used for decades in flight simulation to train and assess competency, and there has been a recent push in surgical specialties to incorporate virtual-reality simulation into residency programs. These efforts have culminated in an FDA-approved carotid stenting simulator. What role virtual reality will play in the evolution of ophthalmology surgical curriculum is uncertain. The current apprentice system has served the art of surgery for over 100 years, and we foresee virtual reality working synergistically with our current curriculum modalities to streamline and enhance the resident's learning experience.

A 3D virtual reality simulator for training of minimally invasive surgery.

PubMed

Mi, Shao-Hua; Hou, Zeng-Gunag; Yang, Fan; Xie, Xiao-Liang; Bian, Gui-Bin

2014-01-01

For the last decade, remarkable progress has been made in the field of cardiovascular disease treatment. However, these complex medical procedures require a combination of rich experience and technical skills. In this paper, a 3D virtual reality simulator for core skills training in minimally invasive surgery is presented. The system can generate realistic 3D vascular models segmented from patient datasets, including a beating heart, and provide a real-time computation of force and force feedback module for surgical simulation. Instruments, such as a catheter or guide wire, are represented by a multi-body mass-spring model. In addition, a realistic user interface with multiple windows and real-time 3D views are developed. Moreover, the simulator is also provided with a human-machine interaction module that gives doctors the sense of touch during the surgery training, enables them to control the motion of a virtual catheter/guide wire inside a complex vascular model. Experimental results show that the simulator is suitable for minimally invasive surgery training.

Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation.

PubMed

McLeod, Helen; Cox, Ben F; Robertson, James; Duncan, Robyn; Matthew, Shona; Bhat, Raj; Barclay, Avril; Anwar, J; Wilkinson, Tracey; Melzer, Andreas; Houston, J Graeme

2017-09-01

The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

A biologically inspired neural model for visual and proprioceptive integration including sensory training.

PubMed

Saidi, Maryam; Towhidkhah, Farzad; Gharibzadeh, Shahriar; Lari, Abdolaziz Azizi

2013-12-01

Humans perceive the surrounding world by integration of information through different sensory modalities. Earlier models of multisensory integration rely mainly on traditional Bayesian and causal Bayesian inferences for single causal (source) and two causal (for two senses such as visual and auditory systems), respectively. In this paper a new recurrent neural model is presented for integration of visual and proprioceptive information. This model is based on population coding which is able to mimic multisensory integration of neural centers in the human brain. The simulation results agree with those achieved by casual Bayesian inference. The model can also simulate the sensory training process of visual and proprioceptive information in human. Training process in multisensory integration is a point with less attention in the literature before. The effect of proprioceptive training on multisensory perception was investigated through a set of experiments in our previous study. The current study, evaluates the effect of both modalities, i.e., visual and proprioceptive training and compares them with each other through a set of new experiments. In these experiments, the subject was asked to move his/her hand in a circle and estimate its position. The experiments were performed on eight subjects with proprioception training and eight subjects with visual training. Results of the experiments show three important points: (1) visual learning rate is significantly more than that of proprioception; (2) means of visual and proprioceptive errors are decreased by training but statistical analysis shows that this decrement is significant for proprioceptive error and non-significant for visual error, and (3) visual errors in training phase even in the beginning of it, is much less than errors of the main test stage because in the main test, the subject has to focus on two senses. The results of the experiments in this paper is in agreement with the results of the neural model simulation.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

PubMed

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training (4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program. Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.

Simulation-based training and assessment of non-technical skills in the Norwegian Helicopter Emergency Medical Services: a cross-sectional survey

PubMed Central

Abrahamsen, Håkon B; Sollid, Stephen J M; Öhlund, Lennart S; Røislien, Jo; Bondevik, Gunnar Tschudi

2015-01-01

Background Human error and deficient non-technical skills (NTSs) among providers of ALS in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment. Objective To document the current level of simulation-based training and assessment of seven generic NTSs in crew members in the Norwegian HEMS. Methods A cross-sectional survey, either electronic or paper-based, of all 207 physicians, HEMS crew members (HCMs) and pilots working in the civilian Norwegian HEMS (11 bases), between 8 May and 25 July 2012. Results The response rate was 82% (n=193). A large proportion of each of the professional groups lacked simulation-based training and assessment of their NTSs. Compared with pilots and HCMs, physicians undergo statistically significantly less frequent simulation-based training and assessment of their NTSs. Fifty out of 82 (61%) physicians were on call for more than 72 consecutive hours on a regular basis. Of these, 79% did not have any training in coping with fatigue. In contrast, 72 out of 73 (99%) pilots and HCMs were on call for more than 3 days in a row. Of these, 54% did not have any training in coping with fatigue. Conclusions Our study indicates a lack of simulation-based training and assessment. Pilots and HCMs train and are assessed more frequently than physicians. All professional groups are on call for extended hours, but receive limited training in how to cope with fatigue. PMID:25344577

Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair.

PubMed

Nishihara, Yuichi; Isobe, Yoh; Kitagawa, Yuko

2017-12-01

A realistic simulator for transabdominal preperitoneal (TAPP) inguinal hernia repair would enhance surgeons' training experience before they enter the operating theater. The purpose of this study was to create a novel physical simulator for TAPP inguinal hernia repair and obtain surgeons' opinions regarding its efficacy. Our novel TAPP inguinal hernia repair simulator consists of a physical laparoscopy simulator and a handmade organ replica model. The physical laparoscopy simulator was created by three-dimensional (3D) printing technology, and it represents the trunk of the human body and the bendability of the abdominal wall under pneumoperitoneal pressure. The organ replica model was manually created by assembling materials. The TAPP inguinal hernia repair simulator allows for the performance of all procedures required in TAPP inguinal hernia repair. Fifteen general surgeons performed TAPP inguinal hernia repair using our simulator. Their opinions were scored on a 5-point Likert scale. All participants strongly agreed that the 3D-printed physical simulator and organ replica model were highly useful for TAPP inguinal hernia repair training (median, 5 points) and TAPP inguinal hernia repair education (median, 5 points). They felt that the simulator would be effective for TAPP inguinal hernia repair training before entering the operating theater. All surgeons considered that this simulator should be introduced in the residency curriculum. We successfully created a physical simulator for TAPP inguinal hernia repair training using 3D printing technology and a handmade organ replica model created with inexpensive, readily accessible materials. Preoperative TAPP inguinal hernia repair training using this simulator and organ replica model may be of benefit in the training of all surgeons. All general surgeons involved in the present study felt that this simulator and organ replica model should be used in their residency curriculum.

Simulation of RIRS in soft cadavers: a novel training model by the Cadaveric Research On Endourology Training (CRET) Study Group.

PubMed

Huri, Emre; Skolarikos, Andreas; Tatar, İlkan; Binbay, Murat; Sofikerim, Mustafa; Yuruk, Emrah; Karakan, Tolga; Sargon, Mustafa; Demiryurek, Deniz; Miano, Roberto; Bagcioglu, Murat; Ezer, Mehmet; Cracco, Cecilia Maria; Scoffone, Cesare Marco

2016-05-01

The aim of the current study was to evaluate the use of fresh-frozen concurrently with embalmed cadavers as initial training models for flexible ureteroscopy (fURS) in a group of urologists who were inexperienced in retrograde intrarenal surgery (RIRS). Twelve urologists involved in a cadaveric fURS training course were enrolled into this prospective study. All the participants were inexperienced in fURS. Theoretical lectures and step-by-step tips and tricks video presentations on fURS were used to incorporate the technical background of the procedure to the hands-on-training course and to standardize the operating steps of the procedure. An 8-item survey was administered to the participants upon initiation and at the end of the course. Pre- and post-training scores were similar for each question. All the participants successfully completed the hands-on-training tasks. Mean pre-training duration [3.56 ± 2.0 min (range 1.21-7.46)] was significantly higher than mean post-training duration [1.76 ± 1.54 min (range 1.00-6.34)] (p = 0.008). At the end of the day, the trainers checked the integrity of the collecting system both by endoscopy and by fluoroscopy and could not detect any injury of the upper ureteral wall or pelvicalyceal structures. The functionality of the scopes was also checked, and no scope injury (including a reduction in the deflection capacity) was noted. The fURS simulation training model using soft human cadavers has the unique advantage of perfectly mimicking the living human tissues. This similarity makes this model one of the best if not the perfect simulator for an effective endourologic training.

Development and validation of a virtual reality simulator: human factors input to interventional radiology training.

PubMed

Johnson, Sheena Joanne; Guediri, Sara M; Kilkenny, Caroline; Clough, Peter J

2011-12-01

This study developed and validated a virtual reality (VR) simulator for use by interventional radiologists. Research in the area of skill acquisition reports practice as essential to become a task expert. Studies on simulation show skills learned in VR can be successfully transferred to a real-world task. Recently, with improvements in technology, VR simulators have been developed to allow complex medical procedures to be practiced without risking the patient. Three studies are reported. In Study I, 35 consultant interventional radiologists took part in a cognitive task analysis to empirically establish the key competencies of the Seldinger procedure. In Study 2, 62 participants performed one simulated procedure, and their performance was compared by expertise. In Study 3, the transferability of simulator training to a real-world procedure was assessed with 14 trainees. Study I produced 23 key competencies that were implemented as performance measures in the simulator. Study 2 showed the simulator had both face and construct validity, although some issues were identified. Study 3 showed the group that had undergone simulator training received significantly higher mean performance ratings on a subsequent patient procedure. The findings of this study support the centrality of validation in the successful design of simulators and show the utility of simulators as a training device. The studies show the key elements of a validation program for a simulator. In addition to task analysis and face and construct validities, the authors highlight the importance of transfer of training in validation studies.

Using Human Patient Simulation to Improve Emergency Airway Management Safety in Post Anesthesia Nursing: A Pilot Project

DTIC Science & Technology

2010-08-04

airway management practices in the PACU has been deemed successful by KMC anesthesia management 15. SUBJECT TERMS Human Patient Simulation; Emergency...of South Alabama and KMC Clinical Research Laboratory (CRL) were received. The training sessions were planned for two 4-hour sessions in the HPS...assistance ofthe KMC CRL research statistician. Findings Results of the NLN Simulation Design Scale surveys showed seven of eight nurses in the

Flight Simulation for the Study of Skill Transfer.

ERIC Educational Resources Information Center

Lintern, Gavan

1992-01-01

Discusses skill transfer as a human performance issue based on experiences with computerized flight simulators. Highlights include the issue of similarity; simulation and the design of training devices; an information theory of transfer; invariants for flight control; and experiments involving the transfer of flight skills. (21 references) (LRW)

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

PubMed

St Pierre, M; Hofinger, G; Buerschaper, C; Grapengeter, M; Harms, H; Breuer, G; Schüttler, J

2004-02-01

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

COMPUTERIZED TRAINING OF CRYOSURGERY – A SYSTEM APPROACH

PubMed Central

Keelan, Robert; Yamakawa, Soji; Shimada, Kenji; Rabin, Yoed

2014-01-01

The objective of the current study is to provide the foundation for a computerized training platform for cryosurgery. Consistent with clinical practice, the training process targets the correlation of the frozen region contour with the target region shape, using medical imaging and accepted criteria for clinical success. The current study focuses on system design considerations, including a bioheat transfer model, simulation techniques, optimal cryoprobe layout strategy, and a simulation core framework. Two fundamentally different approaches were considered for the development of a cryosurgery simulator, based on a finite-elements (FE) commercial code (ANSYS) and a proprietary finite-difference (FD) code. Results of this study demonstrate that the FE simulator is superior in terms of geometric modeling, while the FD simulator is superior in terms of runtime. Benchmarking results further indicate that the FD simulator is superior in terms of usage of memory resources, pre-processing, parallel processing, and post-processing. It is envisioned that future integration of a human-interface module and clinical data into the proposed computer framework will make computerized training of cryosurgery a practical reality. PMID:23995400

Innovative real CSF leak simulation model for rhinology training: human cadaveric design.

PubMed

AlQahtani, Abdulaziz A; Albathi, Abeer A; Alhammad, Othman M; Alrabie, Abdulkarim S

2018-04-01

To study the feasibility of designing a human cadaveric simulation model of real CSF leak for rhinology training. The laboratory investigation took place at the surgical academic center of Prince Sultan Military Medical City between 2016 and 2017. Five heads of human cadaveric specimens were cannulated into the intradural space through two frontal bone holes. Fluorescein-dyed fluid was injected intracranialy, then endoscopic endonasal iatrogenic skull base defect was created with observation of fluid leak, followed by skull base reconstruction. The outcome measures included subjective assessment of integrity of the design, the ability of creating real CSF leak in multiple site of skull base and the possibility of watertight closure by various surgical techniques. The fluid filled the intradural space in all specimens without spontaneous leak from skull base or extra sinus areas. Successfully, we demonstrated fluid leak from all areas after iatrogenic defect in the cribriform plate, fovea ethmoidalis, planum sphenoidale sellar and clival regions. Watertight closure was achieved in all defects using different reconstruction techniques (overly, underlay and gasket seal closure). The design is simulating the real patient with CSF leak. It has potential in the learning process of acquiring and maintaining the surgical skills of skull base reconstruction before direct involvement of the patient. This model needs further evaluation and competence measurement as training tools in rhinology training.

Retention of colonoscopy skills after virtual reality simulator training by independent and proctored methods.

PubMed

Snyder, Christopher W; Vandromme, Marianne J; Tyra, Sharon L; Hawn, Mary T

2010-07-01

Virtual reality (VR) simulators may enhance surgical resident colonoscopy skills, but the duration of skill retention and the effects of different simulator training methods are unknown. Medical students participating in a randomized trial of independent (automated simulator feedback only) versus proctored (human expert feedback plus simulator feedback) simulator training performed a standardized VR colonoscopy scenario at baseline, at the end of training (posttraining), and after a median 4.5 months without practice (retention). Performances were scored on a 10-point scale based on expert proficiency criteria and compared for the independent and proctored groups. Thirteen trainees (8 proctored, 5 independent) were included. Performance at retention testing was significantly better than baseline (median score 10 vs. 5, P < 0.0001), and no different from posttraining (median score 10 vs. 10, P = 0.19). Score changes from baseline to retention and from posttraining to retention were no different for the proctored and independent groups. Overinsufflation and excessive force were the most common reasons for nonproficiency at retention. After proficiency-based VR simulator training, colonoscopy skills are retained for several months, regardless of whether an independent or proctored approach is used. Error avoidance skills may not be retained as well as speed and efficiency skills.

Analysis of Semiotic Principles in a Constructivist Learning Environment.

ERIC Educational Resources Information Center

Williams, Paul

To advance nuclear plant simulator training, the industry must focus on a more detailed and theoretical approach to conduct of this training. The use of semiotics is one method of refining the existing training and examining ways to diversify and blend it with new theoretical methods. Semiotics is the study of signs and how humans interpret them.…

Virtual Learning. A Revolutionary Approach to Building a Highly Skilled Workforce.

ERIC Educational Resources Information Center

Schank, Roger

This book offers trainers and human resource managers an alternative approach to train people more effectively and capitalize on multimedia-based tools. The approach is based on computer-based training and virtual learning theory. Chapter 1 discusses how to remedy problems caused by bad training. Chapter 2 focuses on simulating work and creating…

Simulation training tools for nonlethal weapons using gaming environments

NASA Astrophysics Data System (ADS)

Donne, Alexsana; Eagan, Justin; Tse, Gabriel; Vanderslice, Tom; Woods, Jerry

2006-05-01

Modern simulation techniques have a growing role for evaluating new technologies and for developing cost-effective training programs. A mission simulator facilitates the productive exchange of ideas by demonstration of concepts through compellingly realistic computer simulation. Revolutionary advances in 3D simulation technology have made it possible for desktop computers to process strikingly realistic and complex interactions with results depicted in real-time. Computer games now allow for multiple real human players and "artificially intelligent" (AI) simulated robots to play together. Advances in computer processing power have compensated for the inherent intensive calculations required for complex simulation scenarios. The main components of the leading game-engines have been released for user modifications, enabling game enthusiasts and amateur programmers to advance the state-of-the-art in AI and computer simulation technologies. It is now possible to simulate sophisticated and realistic conflict situations in order to evaluate the impact of non-lethal devices as well as conflict resolution procedures using such devices. Simulations can reduce training costs as end users: learn what a device does and doesn't do prior to use, understand responses to the device prior to deployment, determine if the device is appropriate for their situational responses, and train with new devices and techniques before purchasing hardware. This paper will present the status of SARA's mission simulation development activities, based on the Half-Life gameengine, for the purpose of evaluating the latest non-lethal weapon devices, and for developing training tools for such devices.

Human-simulated intelligent control of train braking response of bridge with MRB

NASA Astrophysics Data System (ADS)

Li, Rui; Zhou, Hongli; Wu, Yueyuan; Wang, Xiaojie

2016-04-01

The urgent train braking could bring structural response menace to the bridge under passive control. Based on the analysis of breaking dynamics of a train-bridge vibration system, a magnetorheological elastomeric bearing (MRB) whose mechanical parameters are adjustable is designed, tested and modeled. A finite element method (FEM) is carried out to model and optimize a full scale vibration isolation system for railway bridge based on MRB. According to the model above, we also consider the effect of different braking stop positions on the vibration isolation system and classify the bridge longitudinal vibration characteristics into several cases. Because the train-bridge vibration isolation system has multiple vibration states and strongly coupling with nonlinear characteristics, a human-simulated intelligent control (HSIC) algorithm for isolating the bridge vibration under the impact of train braking is proposed, in which the peak shear force of pier top, the displacement of beam and the acceleration of beam are chosen as control goals. The simulation of longitudinal vibration control system under the condition of train braking is achieved by MATLAB. The results indicate that different braking stop positions significantly affect the vibration isolation system and the structural response is the most drastic when the train stops at the third cross-span. With the proposed HSIC smart isolation system, the displacement of bridge beam and peak shear force of pier top is reduced by 53.8% and 34.4%, respectively. Moreover, the acceleration of bridge beam is effectively controlled within limited range.

Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise; part II: control development and testing.

PubMed

Hall, Kara L; Phillips, Chandler A; Reynolds, David B; Mohler, Stanley R; Rogers, Dana B; Neidhard-Doll, Amy T

2015-01-01

Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. The controller, based on an inverse three-element phenomenological model and adaptive nonlinear control, allows the system to operate as a type of haptic device. A human quadriceps dynamic simulator was developed (as described in Part I of this work) so that control effectiveness and accommodation could be tested prior to human implementation. Tracking error results indicate that the control system is effective at producing PMA displacement and resistance necessary for a scaled, simulated neuromuscular actuator to maintain low-velocity isokinetic movement during simulated concentric and eccentric knee extension.

Developing Collective Training for Small Unmanned Aerial Systems Employment

NASA Technical Reports Server (NTRS)

Durlach, Paula J.; Priest, Heather; Martin, Glenn A.; Saffold, Jay

2010-01-01

The projected use of small unmanned aerial systems (SUAS) in military operations will produce training requirements which go beyond current capabilities. The paper describes the development of prototype training procedures and accompanying research simulations to address this need. We initially constructed a testbed to develop simulation-based training for an SUAS operator equipped with a simulated vertical-lift and land SUAS. However, the required training will go beyond merely training an operator how to pilot an SUAS. In addition to tactics, techniques, and procedures for employment of SUASs, collective training methods must be trained. Moreover, the leader of a unit equipped with SUAS will need to learn how to plan missions which incorporate the SUAS, and take into account air space and frequency management considerations. The demands of the task require the leader to allocate personnel to the SUAS mission, communicate and coordinate with those personnel during the mission, and make use of the information provided. To help address these training issues, we expanded our research testbed to include a command and control node (C2 node), to enable communications between a leader and the SUAS operator. In addition, we added a virtual environment in which dismounted infantry missions can be conducted. This virtual environment provides the opportunity for interactions among human-controlled avatars and non-player characters (NPCs), plus authoring tools to construct scenarios. Using these NPCs, a collective exercise involving friendly, enemy, and civilian personnel can be conducted without the need for a human role-player for every entity. We will describe the results of our first experiment, which examined the ability of players to negotiate use of the C2 node and the virtual environment at the same time, in order to see if this is a feasible combination of tools for training development.

The (human) science of medical virtual learning environments.

PubMed

Stone, Robert J

2011-01-27

The uptake of virtual simulation technologies in both military and civilian surgical contexts has been both slow and patchy. The failure of the virtual reality community in the 1990s and early 2000s to deliver affordable and accessible training systems stems not only from an obsessive quest to develop the 'ultimate' in so-called 'immersive' hardware solutions, from head-mounted displays to large-scale projection theatres, but also from a comprehensive lack of attention to the needs of the end users. While many still perceive the science of simulation to be defined by technological advances, such as computing power, specialized graphics hardware, advanced interactive controllers, displays and so on, the true science underpinning simulation--the science that helps to guarantee the transfer of skills from the simulated to the real--is that of human factors, a well-established discipline that focuses on the abilities and limitations of the end user when designing interactive systems, as opposed to the more commercially explicit components of technology. Based on three surgical simulation case studies, the importance of a human factors approach to the design of appropriate simulation content and interactive hardware for medical simulation is illustrated. The studies demonstrate that it is unnecessary to pursue real-world fidelity in all instances in order to achieve psychological fidelity--the degree to which the simulated tasks reproduce and foster knowledge, skills and behaviours that can be reliably transferred to real-world training applications.

Surgical Crisis Management Skills Training and Assessment

PubMed Central

Moorthy, Krishna; Munz, Yaron; Forrest, Damien; Pandey, Vikas; Undre, Shabnam; Vincent, Charles; Darzi, Ara

2006-01-01

Background: Intraoperative surgical crisis management is learned in an unstructured manner. In aviation, simulation training allows aircrews to coordinate and standardize recovery strategies. Our aim was to develop a surgical crisis simulation and evaluate its feasibility, realism, and validity of the measures used to assess performance. Methods: Surgical trainees were exposed to a bleeding crisis in a simulated operating theater. Assessment of performance consisted of a trainee’s technical ability to control the bleeding and of their team/human factors skills. This assessment was performed in a blinded manner by 2 surgeons and one human factors expert. Other measures consisted of time measures such as time to diagnose the bleeding (TD), inform team members (TT), achieve control (TC), and close the laceration (TL). Blood loss was used as a surrogate outcome measures. Results: There were considerable variations within both senior (n = 10) and junior (n = 10) trainees for technical and team skills. However, while the senior trainees scored higher than the juniors for technical skills (P = 0.001), there were no differences in human factors skills. There were also significant differences between the 2 groups for TD (P = 0.01), TC (P = 0.001), and TL (0.001). The blood loss was higher in the junior group. Conclusions: We have described the development of a novel simulated setting for the training of crisis management skills and the variability in performance both in between and within the 2 groups. PMID:16794399

Human factors in aviation maintenance, phase two : progress report.

DOT National Transportation Integrated Search

1993-04-01

In this second phase of research on Human Factors in Aviation Maintenance, the emphasis has evolved from problem definition to development of demonstrations and prototypes. These demonstrations include a computer-based training simulation for trouble...

Virtual reality: Avatars in human spaceflight training

NASA Astrophysics Data System (ADS)

Osterlund, Jeffrey; Lawrence, Brad

2012-02-01

With the advancements in high spatial and temporal resolution graphics, along with advancements in 3D display capabilities to model, simulate, and analyze human-to-machine interfaces and interactions, the world of virtual environments is being used to develop everything from gaming, movie special affects and animations to the design of automobiles. The use of multiple object motion capture technology and digital human tools in aerospace has demonstrated to be a more cost effective alternative to the cost of physical prototypes, provides a more efficient, flexible and responsive environment to changes in the design and training, and provides early human factors considerations concerning the operation of a complex launch vehicle or spacecraft. United Space Alliance (USA) has deployed this technique and tool under Research and Development (R&D) activities on both spacecraft assembly and ground processing operations design and training on the Orion Crew Module. USA utilizes specialized products that were chosen based on functionality, including software and fixed based hardware (e.g., infrared and visible red cameras), along with cyber gloves to ensure fine motor dexterity of the hands. The key findings of the R&D were: mock-ups should be built to not obstruct cameras from markers being tracked; a mock-up toolkit be assembled to facilitate dynamic design changes; markers should be placed in accurate positions on humans and flight hardware to help with tracking; 3D models used in the virtual environment be striped of non-essential data; high computational capable workstations are required to handle the large model data sets; and Technology Interchange Meetings with vendors and other industries also utilizing virtual reality applications need to occur on a continual basis enabling USA to maintain its leading edge within this technology. Parameters of interest and benefit in human spaceflight simulation training that utilizes virtual reality technologies are to familiarize and assess operational processes, allow the ability to train virtually, experiment with "what if" scenarios, and expedite immediate changes to validate the design implementation are all parameters of interest in human spaceflight. Training benefits encompass providing 3D animation for post-training assessment, placement of avatars within 3D replicated work environments in assembling or processing hardware, offering various viewpoints of processes viewed and assessed giving the evaluators the ability to assess task feasibility and identify potential support equipment needs; and provide human factors determinations, such as reach, visibility, and accessibility. Multiple object motion capture technology provides an effective tool to train and assess ergonomic risks, simulations for determination of negative interactions between technicians and their proposed workspaces, and evaluation of spaceflight systems prior to, and as part of, the design process to contain costs and reduce schedule delays.

Simulation-based training and assessment of non-technical skills in the Norwegian Helicopter Emergency Medical Services: a cross-sectional survey.

PubMed

Abrahamsen, Håkon B; Sollid, Stephen J M; Öhlund, Lennart S; Røislien, Jo; Bondevik, Gunnar Tschudi

2015-08-01

Human error and deficient non-technical skills (NTSs) among providers of ALS in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-based training and assessment. To document the current level of simulation-based training and assessment of seven generic NTSs in crew members in the Norwegian HEMS. A cross-sectional survey, either electronic or paper-based, of all 207 physicians, HEMS crew members (HCMs) and pilots working in the civilian Norwegian HEMS (11 bases), between 8 May and 25 July 2012. The response rate was 82% (n=193). A large proportion of each of the professional groups lacked simulation-based training and assessment of their NTSs. Compared with pilots and HCMs, physicians undergo statistically significantly less frequent simulation-based training and assessment of their NTSs. Fifty out of 82 (61%) physicians were on call for more than 72 consecutive hours on a regular basis. Of these, 79% did not have any training in coping with fatigue. In contrast, 72 out of 73 (99%) pilots and HCMs were on call for more than 3 days in a row. Of these, 54% did not have any training in coping with fatigue. Our study indicates a lack of simulation-based training and assessment. Pilots and HCMs train and are assessed more frequently than physicians. All professional groups are on call for extended hours, but receive limited training in how to cope with fatigue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Realistic Radio Communications in Pilot Simulator Training

NASA Technical Reports Server (NTRS)

Burki-Cohen, Judith; Kendra, Andrew J.; Kanki, Barbara G.; Lee, Alfred T.

2000-01-01

Simulators used for total training and evaluation of airline pilots must satisfy stringent criteria in order to assure their adequacy for training and checking maneuvers. Air traffic control and company radio communications simulation, however, may still be left to role-play by the already taxed instructor/evaluators in spite of their central importance in every aspect of the flight environment. The underlying premise of this research is that providing a realistic radio communications environment would increase safety by enhancing pilot training and evaluation. This report summarizes the first-year efforts of assessing the requirement and feasibility of simulating radio communications automatically. A review of the training and crew resource/task management literature showed both practical and theoretical support for the need for realistic radio communications simulation. A survey of 29 instructor/evaluators from 14 airlines revealed that radio communications are mainly role-played by the instructor/evaluators. This increases instructor/evaluators' own workload while unrealistically lowering pilot communications load compared to actual operations, with a concomitant loss in training/evaluation effectiveness. A technology review searching for an automated means of providing radio communications to and from aircraft with minimal human effort showed that while promising, the technology is still immature. Further research and the need for establishing a proof-of-concept are also discussed.

The Effectiveness of Simulator Motion in the Transfer of Performance on a Tracking Task Is Influenced by Vision and Motion Disturbance Cues.

PubMed

Grundy, John G; Nazar, Stefan; O'Malley, Shannon; Mohrenshildt, Martin V; Shedden, Judith M

2016-06-01

To examine the importance of platform motion to the transfer of performance in motion simulators. The importance of platform motion in simulators for pilot training is strongly debated. We hypothesized that the type of motion (e.g., disturbance) contributes significantly to performance differences. Participants used a joystick to perform a target tracking task in a pod on top of a MOOG Stewart motion platform. Five conditions compared training without motion, with correlated motion, with disturbance motion, with disturbance motion isolated to the visual display, and with both correlated and disturbance motion. The test condition involved the full motion model with both correlated and disturbance motion. We analyzed speed and accuracy across training and test as well as strategic differences in joystick control. Training with disturbance cues produced critical behavioral differences compared to training without disturbance; motion itself was less important. Incorporation of disturbance cues is a potentially important source of variance between studies that do or do not show a benefit of motion platforms in the transfer of performance in simulators. Potential applications of this research include the assessment of the importance of motion platforms in flight simulators, with a focus on the efficacy of incorporating disturbance cues during training. © 2016, Human Factors and Ergonomics Society.

Simulations in Cyber-Security: A Review of Cognitive Modeling of Network Attackers, Defenders, and Users.

PubMed

Veksler, Vladislav D; Buchler, Norbou; Hoffman, Blaine E; Cassenti, Daniel N; Sample, Char; Sugrim, Shridat

2018-01-01

Computational models of cognitive processes may be employed in cyber-security tools, experiments, and simulations to address human agency and effective decision-making in keeping computational networks secure. Cognitive modeling can addresses multi-disciplinary cyber-security challenges requiring cross-cutting approaches over the human and computational sciences such as the following: (a) adversarial reasoning and behavioral game theory to predict attacker subjective utilities and decision likelihood distributions, (b) human factors of cyber tools to address human system integration challenges, estimation of defender cognitive states, and opportunities for automation, (c) dynamic simulations involving attacker, defender, and user models to enhance studies of cyber epidemiology and cyber hygiene, and (d) training effectiveness research and training scenarios to address human cyber-security performance, maturation of cyber-security skill sets, and effective decision-making. Models may be initially constructed at the group-level based on mean tendencies of each subject's subgroup, based on known statistics such as specific skill proficiencies, demographic characteristics, and cultural factors. For more precise and accurate predictions, cognitive models may be fine-tuned to each individual attacker, defender, or user profile, and updated over time (based on recorded behavior) via techniques such as model tracing and dynamic parameter fitting.

Association of a Surgical Task During Training With Team Skill Acquisition Among Surgical Residents: The Missing Piece in Multidisciplinary Team Training.

PubMed

Sparks, Jessica L; Crouch, Dustin L; Sobba, Kathryn; Evans, Douglas; Zhang, Jing; Johnson, James E; Saunders, Ian; Thomas, John; Bodin, Sarah; Tonidandel, Ashley; Carter, Jeff; Westcott, Carl; Martin, R Shayn; Hildreth, Amy

2017-09-01

The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers. This pre-post educational intervention pilot study compared the gains in teamwork skills for midlevel surgical residents at Wake Forest Baptist Medical Center after they participated in a standardized multidisciplinary team training scenario with 3 possible levels of surgical realism: (1) SimMan (Laerdal) (control group, no surgical anatomy); (2) "synthetic anatomy for surgical tasks" mannequin (medium-fidelity anatomy), and (3) a patient simulated by a deceased donor (high-fidelity anatomy). Participation in the simulation scenario and the subsequent debriefing. Teamwork competency was assessed using several instruments with extensive validity evidence, including the Nontechnical Skills assessment, the Trauma Management Skills scoring system, the Crisis Resource Management checklist, and a self-efficacy survey instrument. Participant satisfaction was assessed with a Likert-scale questionnaire. Scenario participants included midlevel surgical residents, anesthesia providers, scrub nurses, and circulating nurses. Statistical models showed that surgical residents exposed to medium-fidelity simulation (synthetic anatomy for surgical tasks) team training scenarios demonstrated greater gains in teamwork skills compared with control groups (SimMan) (Nontechnical Skills video score: 95% CI, 1.06-16.41; Trauma Management Skills video score: 95% CI, 0.61-2.90) and equivalent gains in teamwork skills compared with high-fidelity simulations (deceased donor) (Nontechnical Skills video score: 95% CI, -8.51 to 6.71; Trauma Management Skills video score: 95% CI, -1.70 to 0.49). Including a surgical task in operating room team training significantly enhanced the acquisition of teamwork skills among midlevel surgical residents. Incorporating relatively inexpensive, medium-fidelity synthetic anatomy in human patient simulators was as effective as using high-fidelity anatomies from deceased donors for promoting teamwork skills in this learning group.

Collaboration between human and nonhuman players in Night Vision Tactical Trainer-Shadow

NASA Astrophysics Data System (ADS)

Berglie, Stephen T.; Gallogly, James J.

2016-05-01

The Night Vision Tactical Trainer - Shadow (NVTT-S) is a U.S. Army-developed training tool designed to improve critical Manned-Unmanned Teaming (MUMT) communication skills for payload operators in Unmanned Aerial Sensor (UAS) crews. The trainer is composed of several Government Off-The-Shelf (GOTS) simulation components and takes the trainee through a series of escalating engagements using tactically relevant, realistically complex, scenarios involving a variety of manned, unmanned, aerial, and ground-based assets. The trainee is the only human player in the game and he must collaborate, from his web-based mock operating station, with various non-human players via spoken natural language over simulated radio in order to execute the training missions successfully. Non-human players are modeled in two complementary layers - OneSAF provides basic background behaviors for entities while NVTT provides higher level models that control entity actions based on intent extracted from the trainee's spoken natural dialog with game entities. Dialog structure is modeled based on Army standards for communication and verbal protocols. This paper presents an architecture that integrates the U.S. Army's Night Vision Image Generator (NVIG), One Semi- Automated Forces (OneSAF), a flight dynamics model, as well as Commercial Off The Shelf (COTS) speech recognition and text to speech products to effect an environment with sufficient entity counts and fidelity to enable meaningful teaching and reinforcement of critical communication skills. It further demonstrates the model dynamics and synchronization mechanisms employed to execute purpose-built training scenarios, and to achieve ad-hoc collaboration on-the-fly between human and non-human players in the simulated environment.

Using a human patient simulation mannequin to teach interdisciplinary team skills to pharmacy students.

PubMed

Fernandez, Rosemarie; Parker, Dennis; Kalus, James S; Miller, Douglas; Compton, Scott

2007-06-15

To determine the effectiveness and student acceptance of using a human patient simulation (HPS) training module focused on interdisciplinary teamwork skills. During their second-professional year, all pharmacy students were in enrolled in Principles of Pharmacotherapy 4: Cardiovascular Diseases and Patient Care Lab IV, a problem-based learning course. As part of the patient care laboratory, students participated in a simulated case of an acutely ill patient with a hypertensive emergency. During the simulation, students performed a history and physical examination. They then worked as a team to make treatment recommendations to the nursing and physician staff members. Following the exercise, a facilitated debriefing session was conducted. Students completed satisfaction surveys to assess the quality and effectiveness of the session. Over 98% of students agreed or strongly agreed that they learned material relevant to their current studies. When compared to student lectures, 90% of students felt that they learned clinical patient care better when using a HPS mannequin in simulated patient scenarios. HPS-based learning offers a realistic training experience through which clinical knowledge and interpersonal teamwork skills can be taught. Students enjoy the experience and find it relevant to their future practice. Simulation-based training may teach certain topics better than traditional lecture formats and as such could help to fill gaps in the current pharmacy curriculum.

Medical Holography for Basic Anatomy Training

DTIC Science & Technology

2013-12-01

Interservicel!ndustry Training, Simulation, and Education Conference (l/ITSEC) 2013 Medical Holography for Basic Anatomy Training Matthew Hackett...to the complex 3D structures inherent in human anatomy . One potential solution to this problem is to present medical content in three dimensions...traditional format via textbook handouts or through holography. Cognitive load analysis was performed to determine if a difference in cognitive effort was

A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre

PubMed Central

Moorthy, Krishna; Munz, Yaron; Adams, Sally; Pandey, Vikas; Darzi, Ara

2005-01-01

Background: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. Methods: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. Results: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. Conclusions: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills. PMID:16244534

[Simulation-based learning and internal medicine: Opportunities and current perspectives for a national harmonized program].

PubMed

Galland, J; Abbara, S; Terrier, B; Samson, M; Tesnières, A; Fournier, J P; Braun, M

2018-06-01

Simulation-based learning (SBL) is developing rapidly in France and the question of its use in the teaching of internal medicine (IM) is essential. While HAS encourages its integration into medical education, French Young Internists (AJI) set up a working group to reflect on the added-value of this tool in our specialty. Different sorts of SBL exist: human, synthetic and electronic. It enables student to acquire and evaluate technical skills (strengths, invasive procedures, etc.) and non-technical skills (relational, reasoning…). The debriefing that follows the simulation session is an essential time in pedagogical terms. It enables the acquisition of knowledge by encouraging the students' reflection to reshape their reasoning patterns by self-correcting. IM interns are supportive of its use. The simulation would allow young internists to acquire skills specific to our specialty such as certain gestures, complex consulting management, the synthesis of difficult clinical cases. SBL remains confronted with human and financial cost issues. The budgets allocated to the development and maintenance of simulation centres are uneven, making the supply of training unequal on the territory. Simulation sessions are time-consuming and require teacher training. Are faculties ready to train and invest their time in simulation, even though the studies do not allow us to conclude on its pedagogical validity? Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Assessment of skills using a virtual reality temporal bone surgery simulator.

PubMed

Linke, R; Leichtle, A; Sheikh, F; Schmidt, C; Frenzel, H; Graefe, H; Wollenberg, B; Meyer, J E

2013-08-01

Surgery on the temporal bone is technically challenging due to its complex anatomy. Precise anatomical dissection of the human temporal bone is essential and is fundamental for middle ear surgery. We assessed the possible application of a virtual reality temporal bone surgery simulator to the education of ear surgeons. Seventeen ENT physicians with different levels of surgical training and 20 medical students performed an antrotomy with a computer-based virtual temporal bone surgery simulator. The ease, accuracy and timing of the simulated temporal bone surgery were assessed using the automatic assessment software provided by the simulator device and additionally with a modified Final Product Analysis Scale. Trained ENT surgeons, physicians without temporal bone surgical training and medical students were all able to perform the antrotomy. However, the highly trained ENT surgeons were able to complete the surgery in approximately half the time, with better handling and accuracy as assessed by the significant reduction in injury to important middle ear structures. Trained ENT surgeons achieved significantly higher scores using both dissection analysis methods. Surprisingly, there were no significant differences in the results between medical students and physicians without experience in ear surgery. The virtual temporal bone training system can stratify users of known levels of experience. This system can be used not only to improve the surgical skills of trained ENT surgeons for more successful and injury-free surgeries, but also to train inexperienced physicians/medical students in developing their surgical skills for the ear.

Imaging skills for transthoracic echocardiography in cardiology fellows: The value of motion metrics

PubMed Central

Montealegre-Gallegos, Mario; Mahmood, Feroze; Kim, Han; Bergman, Remco; Mitchell, John D.; Bose, Ruma; Hawthorne, Katie M.; O’Halloran, T. David; Wong, Vanessa; Hess, Philip E.; Matyal, Robina

2016-01-01

Background: Proficiency in transthoracic echocardiography (TTE) requires an integration of cognitive knowledge and psychomotor skills. Whereas cognitive knowledge can be quantified, psychomotor skills are implied after repetitive task performance. We applied motion analyses to evaluate psychomotor skill acquisition during simulator-based TTE training. Methods and Results: During the first month of their fellowship training, 16 cardiology fellows underwent a multimodal TTE training program for 4 weeks (8 sessions). The program consisted of online and live didactics as well as simulator training. Kinematic metrics (path length, time, probe accelerations) were obtained at the start and end of the course for 8 standard TTE views using a simulator. At the end of the course TTE image acquisition skills were tested on human models. After completion of the training program the trainees reported improved self-perceived comfort with TTE imaging. There was also an increase of 8.7% in post-test knowledge scores. There was a reduction in the number of probe accelerations [median decrease 49.5, 95% CI = 29-73, adjusted P < 0.01], total time [median decrease 10.6 s, 95% CI = 6.6-15.5, adjusted P < 0.01] and path length [median decrease 8.8 cm, 95% CI = 2.2-17.7, adjusted P < 0.01] from the start to the end of the course. During evaluation on human models, the trainees were able to obtain all the required TTE views without instructor assistance. Conclusion: Simulator-derived motion analyses can be used to objectively quantify acquisition of psychomotor skills during TTE training. Such an approach could be used to assess readiness for clinical practice of TTE. PMID:27052064

Interprofessional teamwork among students in simulated codes: a quasi-experimental study.

PubMed

Garbee, Deborah D; Paige, John; Barrier, Kendra; Kozmenko, Valeriy; Kozmenko, Lyubov; Zamjahn, John; Bonanno, Laura; Cefalu, Jean

2013-01-01

The purpose of this study was to evaluate the efficacy of using crisis resource management (CRM) principles and high-fidelity human patient simulation (HFHPS) for interprofessional (IP) team training of students from undergraduate nursing, nurse anesthesia, medical, and respiratory therapy. IP education using simulation-based training has the potential to transform education by improving teamwork and communication and breaking down silos in education. This one-year study used a quasi-experimental design to evaluate students' acquisition and retention of teamwork and communication skills. A convenience sample consisted of 52 students in the fall semester, with 40 students returning in the spring. Mean scores increased after training, and skills were retained fairly well. Any loss was regained with repeat training in the spring. The results suggest that using CRM and HFHPS is an effective pedagogy for teaching communication and teamwork skills to IP student teams.

Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

PubMed

Kron, Frederick W; Fetters, Michael D; Scerbo, Mark W; White, Casey B; Lypson, Monica L; Padilla, Miguel A; Gliva-McConvey, Gayle A; Belfore, Lee A; West, Temple; Wallace, Amelia M; Guetterman, Timothy C; Schleicher, Lauren S; Kennedy, Rebecca A; Mangrulkar, Rajesh S; Cleary, James F; Marsella, Stacy C; Becker, Daniel M

2017-04-01

To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

PubMed Central

Kron, Frederick W.; Fetters, Michael D.; Scerbo, Mark W.; White, Casey B.; Lypson, Monica L.; Padilla, Miguel A.; Gliva-McConvey, Gayle A.; Belfore, Lee A.; West, Temple; Wallace, Amelia M.; Guetterman, Timothy C.; Schleicher, Lauren S.; Kennedy, Rebecca A.; Mangrulkar, Rajesh S.; Cleary, James F.; Marsella, Stacy C.; Becker, Daniel M.

2016-01-01

Objectives To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group’s experiences and learning preferences. Methods A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR’s intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. Secondary outcomes: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. Results MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. Conclusions MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. Practice Implications MPathic-VR’s virtual human simulation offers an effective and engaging means of advanced communication training. PMID:27939846

Biological Visualization, Imaging and Simulation(Bio-VIS) at NASA Ames Research Center: Developing New Software and Technology for Astronaut Training and Biology Research in Space

NASA Technical Reports Server (NTRS)

Smith, Jeffrey

2003-01-01

The Bio- Visualization, Imaging and Simulation (BioVIS) Technology Center at NASA's Ames Research Center is dedicated to developing and applying advanced visualization, computation and simulation technologies to support NASA Space Life Sciences research and the objectives of the Fundamental Biology Program. Research ranges from high resolution 3D cell imaging and structure analysis, virtual environment simulation of fine sensory-motor tasks, computational neuroscience and biophysics to biomedical/clinical applications. Computer simulation research focuses on the development of advanced computational tools for astronaut training and education. Virtual Reality (VR) and Virtual Environment (VE) simulation systems have become important training tools in many fields from flight simulation to, more recently, surgical simulation. The type and quality of training provided by these computer-based tools ranges widely, but the value of real-time VE computer simulation as a method of preparing individuals for real-world tasks is well established. Astronauts routinely use VE systems for various training tasks, including Space Shuttle landings, robot arm manipulations and extravehicular activities (space walks). Currently, there are no VE systems to train astronauts for basic and applied research experiments which are an important part of many missions. The Virtual Glovebox (VGX) is a prototype VE system for real-time physically-based simulation of the Life Sciences Glovebox where astronauts will perform many complex tasks supporting research experiments aboard the International Space Station. The VGX consists of a physical display system utilizing duel LCD projectors and circular polarization to produce a desktop-sized 3D virtual workspace. Physically-based modeling tools (Arachi Inc.) provide real-time collision detection, rigid body dynamics, physical properties and force-based controls for objects. The human-computer interface consists of two magnetic tracking devices (Ascention Inc.) attached to instrumented gloves (Immersion Inc.) which co-locate the user's hands with hand/forearm representations in the virtual workspace. Force-feedback is possible in a work volume defined by a Phantom Desktop device (SensAble inc.). Graphics are written in OpenGL. The system runs on a 2.2 GHz Pentium 4 PC. The prototype VGX provides astronauts and support personnel with a real-time physically-based VE system to simulate basic research tasks both on Earth and in the microgravity of Space. The immersive virtual environment of the VGX also makes it a useful tool for virtual engineering applications including CAD development, procedure design and simulation of human-system systems in a desktop-sized work volume.

Low-Fidelity Haptic Simulation Versus Mental Imagery Training for Epidural Anesthesia Technical Achievement in Novice Anesthesiology Residents: A Randomized Comparative Study.

PubMed

Lim, Grace; Krohner, Robert G; Metro, David G; Rosario, Bedda L; Jeong, Jong-Hyeon; Sakai, Tetsuro

2016-05-01

There are many teaching methods for epidural anesthesia skill acquisition. Previous work suggests that there is no difference in skill acquisition whether novice learners engage in low-fidelity (LF) versus high-fidelity haptic simulation for epidural anesthesia. No study, however, has compared the effect of LF haptic simulation for epidural anesthesia versus mental imagery (MI) training in which no physical practice is attempted. We tested the hypothesis that MI training is superior to LF haptic simulation training for epidural anesthesia skill acquisition. Twenty Post-Graduate Year 2 (PGY-2) anesthesiology residents were tested at the beginning of the training year. After a didactic lecture on epidural anesthesia, they were randomized into 2 groups. Group LF had LF simulation training for epidural anesthesia using a previously described banana simulation technique. Group MI had guided, scripted MI training in which they initially were oriented to the epidural kit components and epidural anesthesia was described stepwise in detail, followed by individual mental rehearsal; no physical practice was undertaken. Each resident then individually performed epidural anesthesia on a partial-human task trainer on 3 consecutive occasions under the direct observation of skilled evaluators who were blinded to group assignment. Technical achievement was assessed with the use of a modified validated skills checklist. Scores (0-21) and duration to task completion (minutes) were recorded. A linear mixed-effects model analysis was performed to determine the differences in scores and duration between groups and over time. There was no statistical difference between the 2 groups for scores and duration to task completion. Both groups showed similarly significant increases (P = 0.0015) in scores over time (estimated mean score [SE]: group MI, 15.9 [0.55] to 17.4 [0.55] to 18.6 [0.55]; group LF, 16.2 [0.55] to 17.7 [0.55] to 18.9 [0.55]). Time to complete the procedure decreased similarly and significantly (P = 0.032) for both groups after the first attempt (estimated mean time [SE]: group MI, 16.0 [1.04] minutes to 13.7 [1.04] minutes to 13.3 [1.04] minutes; group LF: 15.8 [1.04] minutes to 13.4 [1.04] minutes to 13.1 [1.04] minutes). MI is not different from LF simulation training for epidural anesthesia skill acquisition. Education in epidural anesthesia with structured didactics and continual MI training may suffice to prepare novice learners before an attempt on human subjects.

The Right Stuff: A Look Back at Three Decades of Flight Controller Training for Space Shuttle Mission Operations

NASA Technical Reports Server (NTRS)

Dittemore, Gary D.

2011-01-01

Operations of human spaceflight systems is extremely complex, therefore the training and certification of operations personnel is a critical piece of ensuring mission success. Mission Control Center (MCC-H), at the Lyndon B. Johnson Space Center, in Houston, Texas manages mission operations for the Space Shuttle Program, including the training and certification of the astronauts and flight control teams. This paper will give an overview of a flight control team s makeup and responsibilities during a flight, and details on how those teams are trained and certified. The training methodology for developing flight controllers has evolved significantly over the last thirty years, while the core goals and competencies have remained the same. In addition, the facilities and tools used in the control center have evolved. These changes have been driven by many factors including lessons learned, technology, shuttle accidents, shifts in risk posture, and generational differences. Flight controllers will share their experiences in training and operating the Space Shuttle throughout the Program s history. A primary method used for training Space Shuttle flight control teams is by running mission simulations of the orbit, ascent, and entry phases, to truly "train like you fly." The reader will learn what it is like to perform a simulation as a shuttle flight controller. Finally, the paper will reflect on the lessons learned in training for the shuttle program, and how those could be applied to future human spaceflight endeavors. These endeavors could range from going to the moon or to Mars. The lessons learned from operating the space shuttle for over thirty years will help the space industry build the next human transport space vehicle and inspire the next generation of space explorers.

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.

PAL Boot Camp: Preparing Cognitive Assistants for Deployment

DTIC Science & Technology

2007-06-01

to program it. Another technique used in the military for training humans is simulation. Officers moving to a joint staff tour are taught crisis...a PAL, it may be easier to have it learn from experiencing the military domain within a training setting rather than having an engineer decide how

Exploiting Motion Capture to Enhance Avoidance Behaviour in Games

NASA Astrophysics Data System (ADS)

van Basten, Ben J. H.; Jansen, Sander E. M.; Karamouzas, Ioannis

Realistic simulation of interacting virtual characters is essential in computer games, training and simulation applications. The problem is very challenging since people are accustomed to real-world situations and thus, they can easily detect inconsistencies and artifacts in the simulations. Over the past twenty years several models have been proposed for simulating individuals, groups and crowds of characters. However, little effort has been made to actually understand how humans solve interactions and avoid inter-collisions in real-life. In this paper, we exploit motion capture data to gain more insights into human-human interactions. We propose four measures to describe the collision-avoidance behavior. Based on these measures, we extract simple rules that can be applied on top of existing agent and force based approaches, increasing the realism of the resulting simulations.

A Survey of Immersive Technology For Maintenance Evaluations

DTIC Science & Technology

1998-04-01

image display system. Based on original work performed at the German National Computer Science and Mathematics Research Institute (GMD), and further...simulations, architectural walk- throughs, medical simulations, general research , entertainment applications and location based entertainment use...simulations. This study was conducted as part of a logistics research and development program Design Evaluation for Personnel, Training, and Human Factors

Fabrication of cerebral aneurysm simulator with a desktop 3D printer

NASA Astrophysics Data System (ADS)

Liu, Yu; Gao, Qing; Du, Song; Chen, Zichen; Fu, Jianzhong; Chen, Bing; Liu, Zhenjie; He, Yong

2017-05-01

Now, more and more patients are suffering cerebral aneurysm. However, long training time limits the rapid growth of cerebrovascular neurosurgeons. Here we developed a novel cerebral aneurysm simulator which can be better represented the dynamic bulging process of cerebral aneurysm The proposed simulator features the integration of a hollow elastic vascular model, a skull model and a brain model, which can be affordably fabricated at the clinic (Fab@Clinic), under $25.00 each with the help of a low-cost desktop 3D printer. Moreover, the clinical blood flow and pulsation pressure similar to the human can be well simulated, which can be used to train the neurosurgical residents how to clip aneurysms more effectively.

Real-time "x-ray vision" for healthcare simulation: an interactive projective overlay system to enhance intubation training and other procedural training.

PubMed

Samosky, Joseph T; Baillargeon, Emma; Bregman, Russell; Brown, Andrew; Chaya, Amy; Enders, Leah; Nelson, Douglas A; Robinson, Evan; Sukits, Alison L; Weaver, Robert A

2011-01-01

We have developed a prototype of a real-time, interactive projective overlay (IPO) system that creates augmented reality display of a medical procedure directly on the surface of a full-body mannequin human simulator. These images approximate the appearance of both anatomic structures and instrument activity occurring within the body. The key innovation of the current work is sensing the position and motion of an actual device (such as an endotracheal tube) inserted into the mannequin and using the sensed position to control projected video images portraying the internal appearance of the same devices and relevant anatomic structures. The images are projected in correct registration onto the surface of the simulated body. As an initial practical prototype to test this technique we have developed a system permitting real-time visualization of the intra-airway position of an endotracheal tube during simulated intubation training.

PubMed Central

LINKE, R.; LEICHTLE, A.; SHEIKH, F.; SCHMIDT, C.; FRENZEL, H.; GRAEFE, H.; WOLLENBERG, B.; MEYER, J.E.

2013-01-01

SUMMARY Surgery on the temporal bone is technically challenging due to its complex anatomy. Precise anatomical dissection of the human temporal bone is essential and is fundamental for middle ear surgery. We assessed the possible application of a virtual reality temporal bone surgery simulator to the education of ear surgeons. Seventeen ENT physicians with different levels of surgical training and 20 medical students performed an antrotomy with a computer-based virtual temporal bone surgery simulator. The ease, accuracy and timing of the simulated temporal bone surgery were assessed using the automatic assessment software provided by the simulator device and additionally with a modified Final Product Analysis Scale. Trained ENT surgeons, physicians without temporal bone surgical training and medical students were all able to perform the antrotomy. However, the highly trained ENT surgeons were able to complete the surgery in approximately half the time, with better handling and accuracy as assessed by the significant reduction in injury to important middle ear structures. Trained ENT surgeons achieved significantly higher scores using both dissection analysis methods. Surprisingly, there were no significant differences in the results between medical students and physicians without experience in ear surgery. The virtual temporal bone training system can stratify users of known levels of experience. This system can be used not only to improve the surgical skills of trained ENT surgeons for more successful and injury-free surgeries, but also to train inexperienced physicians/medical students in developing their surgical skills for the ear. PMID:24043916

Augmented reality intravenous injection simulator based 3D medical imaging for veterinary medicine.

PubMed

Lee, S; Lee, J; Lee, A; Park, N; Lee, S; Song, S; Seo, A; Lee, H; Kim, J-I; Eom, K

2013-05-01

Augmented reality (AR) is a technology which enables users to see the real world, with virtual objects superimposed upon or composited with it. AR simulators have been developed and used in human medicine, but not in veterinary medicine. The aim of this study was to develop an AR intravenous (IV) injection simulator to train veterinary and pre-veterinary students to perform canine venipuncture. Computed tomographic (CT) images of a beagle dog were scanned using a 64-channel multidetector. The CT images were transformed into volumetric data sets using an image segmentation method and were converted into a stereolithography format for creating 3D models. An AR-based interface was developed for an AR simulator for IV injection. Veterinary and pre-veterinary student volunteers were randomly assigned to an AR-trained group or a control group trained using more traditional methods (n = 20/group; n = 8 pre-veterinary students and n = 12 veterinary students in each group) and their proficiency at IV injection technique in live dogs was assessed after training was completed. Students were also asked to complete a questionnaire which was administered after using the simulator. The group that was trained using an AR simulator were more proficient at IV injection technique using real dogs than the control group (P ≤ 0.01). The students agreed that they learned the IV injection technique through the AR simulator. Although the system used in this study needs to be modified before it can be adopted for veterinary educational use, AR simulation has been shown to be a very effective tool for training medical personnel. Using the technology reported here, veterinary AR simulators could be developed for future use in veterinary education. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Machine-learning model observer for detection and localization tasks in clinical SPECT-MPI

NASA Astrophysics Data System (ADS)

Parages, Felipe M.; O'Connor, J. Michael; Pretorius, P. Hendrik; Brankov, Jovan G.

2016-03-01

In this work we propose a machine-learning MO based on Naive-Bayes classification (NB-MO) for the diagnostic tasks of detection, localization and assessment of perfusion defects in clinical SPECT Myocardial Perfusion Imaging (MPI), with the goal of evaluating several image reconstruction methods used in clinical practice. NB-MO uses image features extracted from polar-maps in order to predict lesion detection, localization and severity scores given by human readers in a series of 3D SPECT-MPI. The population used to tune (i.e. train) the NB-MO consisted of simulated SPECT-MPI cases - divided into normals or with lesions in variable sizes and locations - reconstructed using filtered backprojection (FBP) method. An ensemble of five human specialists (physicians) read a subset of simulated reconstructed images, and assigned a perfusion score for each region of the left-ventricle (LV). Polar-maps generated from the simulated volumes along with their corresponding human scores were used to train five NB-MOs (one per human reader), which are subsequently applied (i.e. tested) on three sets of clinical SPECT-MPI polar maps, in order to predict human detection and localization scores. The clinical "testing" population comprises healthy individuals and patients suffering from coronary artery disease (CAD) in three possible regions, namely: LAD, LcX and RCA. Each clinical case was reconstructed using three reconstruction strategies, namely: FBP with no SC (i.e. scatter compensation), OSEM with Triple Energy Window (TEW) SC method, and OSEM with Effective Source Scatter Estimation (ESSE) SC. Alternative Free-Response (AFROC) analysis of perfusion scores shows that NB-MO predicts a higher human performance for scatter-compensated reconstructions, in agreement with what has been reported in published literature. These results suggest that NB-MO has good potential to generalize well to reconstruction methods not used during training, even for reasonably dissimilar datasets (i.e. simulated vs. clinical).

U.S. Marine Corps Training Modeling and Simulation Master Plan

DTIC Science & Technology

2007-01-18

is needed that is not restricted by line of sight (LOS) and is transportable/ deployable. • The LVC-TE must have the ability to have Human Anatomy Motion... Human Anatomy Motion-Tracking and Display HEAT.............................HMMWV Egress Assistance Trainer HLA

Effect of body weight support variation on muscle activities during robot assisted gait: a dynamic simulation study.

PubMed

Hussain, Shahid; Jamwal, Prashant K; Ghayesh, Mergen H

2017-05-01

While body weight support (BWS) intonation is vital during conventional gait training of neurologically challenged subjects, it is important to evaluate its effect during robot assisted gait training. In the present research we have studied the effect of BWS intonation on muscle activities during robotic gait training using dynamic simulations. Two dimensional (2-D) musculoskeletal model of human gait was developed conjointly with another 2-D model of a robotic orthosis capable of actuating hip, knee and ankle joints simultaneously. The musculoskeletal model consists of eight major muscle groups namely; soleus (SOL), gastrocnemius (GAS), tibialis anterior (TA), hamstrings (HAM), vasti (VAS), gluteus maximus (GLU), uniarticular hip flexors (iliopsoas, IP), and Rectus Femoris (RF). BWS was provided at levels of 0, 20, 40 and 60% during the simulations. In order to obtain a feasible set of muscle activities during subsequent gait cycles, an inverse dynamics algorithm along with a quadratic minimization algorithm was implemented. The dynamic parameters of the robot assisted human gait such as joint angle trajectories, ground contact force (GCF), human limb joint torques and robot induced torques at different levels of BWS were derived. The patterns of muscle activities at variable BWS were derived and analysed. For most part of the gait cycle (GC) the muscle activation patterns are quite similar for all levels of BWS as is apparent from the mean of muscle activities for the complete GC. Effect of BWS variation during robot assisted gait on muscle activities was studied by developing dynamic simulation. It is expected that the proposed dynamic simulation approach will provide important inferences and information about the muscle function variations consequent upon a change in BWS during robot assisted gait. This information shall be quite important while investigating the influence of BWS intonation on neuromuscular parameters of interest during robotic gait training.

Research on metallic material defect detection based on bionic sensing of human visual properties

NASA Astrophysics Data System (ADS)

Zhang, Pei Jiang; Cheng, Tao

2018-05-01

Due to the fact that human visual system can quickly lock the areas of interest in complex natural environment and focus on it, this paper proposes an eye-based visual attention mechanism by simulating human visual imaging features based on human visual attention mechanism Bionic Sensing Visual Inspection Model Method to Detect Defects of Metallic Materials in the Mechanical Field. First of all, according to the biologically visually significant low-level features, the mark of defect experience marking is used as the intermediate feature of simulated visual perception. Afterwards, SVM method was used to train the advanced features of visual defects of metal material. According to the weight of each party, the biometrics detection model of metal material defect, which simulates human visual characteristics, is obtained.

NASA Virtual Glovebox (VBX): Emerging Simulation Technology for Space Station Experiment Design, Development, Training and Troubleshooting

NASA Technical Reports Server (NTRS)

Smith, Jeffrey D.; Twombly, I. Alexander; Maese, A. Christopher; Cagle, Yvonne; Boyle, Richard

2003-01-01

The International Space Station demonstrates the greatest capabilities of human ingenuity, international cooperation and technology development. The complexity of this space structure is unprecedented; and training astronaut crews to maintain all its systems, as well as perform a multitude of research experiments, requires the most advanced training tools and techniques. Computer simulation and virtual environments are currently used by astronauts to train for robotic arm manipulations and extravehicular activities; but now, with the latest computer technologies and recent successes in areas of medical simulation, the capability exists to train astronauts for more hands-on research tasks using immersive virtual environments. We have developed a new technology, the Virtual Glovebox (VGX), for simulation of experimental tasks that astronauts will perform aboard the Space Station. The VGX may also be used by crew support teams for design of experiments, testing equipment integration capability and optimizing the procedures astronauts will use. This is done through the 3D, desk-top sized, reach-in virtual environment that can simulate the microgravity environment in space. Additional features of the VGX allow for networking multiple users over the internet and operation of tele-robotic devices through an intuitive user interface. Although the system was developed for astronaut training and assisting support crews, Earth-bound applications, many emphasizing homeland security, have also been identified. Examples include training experts to handle hazardous biological and/or chemical agents in a safe simulation, operation of tele-robotic systems for assessing and diffusing threats such as bombs, and providing remote medical assistance to field personnel through a collaborative virtual environment. Thus, the emerging VGX simulation technology, while developed for space- based applications, can serve a dual use facilitating homeland security here on Earth.

Simulation and Analysis of Launch Teams (SALT)

NASA Technical Reports Server (NTRS)

2008-01-01

A SALT effort was initiated in late 2005 with seed funding from the Office of Safety and Mission Assurance Human Factors organization. Its objectives included demonstrating human behavior and performance modeling and simulation technologies for launch team analysis, training, and evaluation. The goal of the research is to improve future NASA operations and training. The project employed an iterative approach, with the first iteration focusing on the last 70 minutes of a nominal-case Space Shuttle countdown, the second iteration focusing on aborts and launch commit criteria violations, the third iteration focusing on Ares I-X communications, and the fourth iteration focusing on Ares I-X Firing Room configurations. SALT applied new commercial off-the-shelf technologies from industry and the Department of Defense in the spaceport domain.

A Holistic Approach to Systems Development

NASA Technical Reports Server (NTRS)

Wong, Douglas T.

2008-01-01

Introduces a Holistic and Iterative Design Process. Continuous process but can be loosely divided into four stages. More effort spent early on in the design. Human-centered and Multidisciplinary. Emphasis on Life-Cycle Cost. Extensive use of modeling, simulation, mockups, human subjects, and proven technologies. Human-centered design doesn t mean the human factors discipline is the most important Disciplines should be involved in the design: Subsystem vendors, configuration management, operations research, manufacturing engineering, simulation/modeling, cost engineering, hardware engineering, software engineering, test and evaluation, human factors, electromagnetic compatibility, integrated logistics support, reliability/maintainability/availability, safety engineering, test equipment, training systems, design-to-cost, life cycle cost, application engineering etc. 9

[Investigation and analysis of status in simulation education of anesthesiology of China].

PubMed

Wang, Tian-long; Xue, Ji-xiu; Xiao, Wei; Wu, Xin-min

2010-03-09

To investigate the status of simulation education of anesthesiology in China. Five hundreds questionnaires were mailed to chairmen of department of anesthesiology in teaching hospitals in 29 provinces and autonomous regions in China. The retrieved questionnaires and data were processed and analyzed with statistics. Sixty one questionnaires were retrieved, and retrieved rate is 12.2%. The result indicated that the theory and knowledge of anesthesiology was adopted for the training of medical students and residents in 2% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion in 52% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion and simulation training in 46% teaching hospitals. The order of simulation devices possessed was as follows: Basic Life Support (BLS) (79.6%), training model for clinical anesthesia techniques (53.1%) and Advances Life Support (ALS) (51.0%). There were only six teaching hospitals utilized Human Patient Simulator for anesthesia training. The result of evaluation of simulation education showed that 91.2% anesthesiologists recognized it as applicable, 90.1% anesthesiologists recognized it as medical ethic requirement and 86.0% anesthesiologists recognized it as partly close to clinical situation. The degree of cognition of anesthesiologists to simulation education was ordered as follows: manipulation correcting ability (92.6%), procedure controllability (87.0%), training adjustability (76.0%) and patients safety (68.5%). The simulation education of anesthesiology in China is still in the preliminary period. The executive departments of education should enhance supports to the simulation education in both hard ware and in soft ware.

Perceptual control models of pursuit manual tracking demonstrate individual specificity and parameter consistency.

PubMed

Parker, Maximilian G; Tyson, Sarah F; Weightman, Andrew P; Abbott, Bruce; Emsley, Richard; Mansell, Warren

2017-11-01

Computational models that simulate individuals' movements in pursuit-tracking tasks have been used to elucidate mechanisms of human motor control. Whilst there is evidence that individuals demonstrate idiosyncratic control-tracking strategies, it remains unclear whether models can be sensitive to these idiosyncrasies. Perceptual control theory (PCT) provides a unique model architecture with an internally set reference value parameter, and can be optimized to fit an individual's tracking behavior. The current study investigated whether PCT models could show temporal stability and individual specificity over time. Twenty adults completed three blocks of 15 1-min, pursuit-tracking trials. Two blocks (training and post-training) were completed in one session and the third was completed after 1 week (follow-up). The target moved in a one-dimensional, pseudorandom pattern. PCT models were optimized to the training data using a least-mean-squares algorithm, and validated with data from post-training and follow-up. We found significant inter-individual variability (partial η 2 : .464-.697) and intra-individual consistency (Cronbach's α: .880-.976) in parameter estimates. Polynomial regression revealed that all model parameters, including the reference value parameter, contribute to simulation accuracy. Participants' tracking performances were significantly more accurately simulated by models developed from their own tracking data than by models developed from other participants' data. We conclude that PCT models can be optimized to simulate the performance of an individual and that the test-retest reliability of individual models is a necessary criterion for evaluating computational models of human performance.

Prediction of Cognitive States During Flight Simulation Using Multimodal Psychophysiological Sensing

NASA Technical Reports Server (NTRS)

Harrivel, Angela R.; Stephens, Chad L.; Milletich, Robert J.; Heinich, Christina M.; Last, Mary Carolyn; Napoli, Nicholas J.; Abraham, Nijo A.; Prinzel, Lawrence J.; Motter, Mark A.; Pope, Alan T.

2017-01-01

The Commercial Aviation Safety Team found the majority of recent international commercial aviation accidents attributable to loss of control inflight involved flight crew loss of airplane state awareness (ASA), and distraction was involved in all of them. Research on attention-related human performance limiting states (AHPLS) such as channelized attention, diverted attention, startle/surprise, and confirmation bias, has been recommended in a Safety Enhancement (SE) entitled "Training for Attention Management." To accomplish the detection of such cognitive and psychophysiological states, a broad suite of sensors was implemented to simultaneously measure their physiological markers during a high fidelity flight simulation human subject study. Twenty-four pilot participants were asked to wear the sensors while they performed benchmark tasks and motion-based flight scenarios designed to induce AHPLS. Pattern classification was employed to predict the occurrence of AHPLS during flight simulation also designed to induce those states. Classifier training data were collected during performance of the benchmark tasks. Multimodal classification was performed, using pre-processed electroencephalography, galvanic skin response, electrocardiogram, and respiration signals as input features. A combination of one, some or all modalities were used. Extreme gradient boosting, random forest and two support vector machine classifiers were implemented. The best accuracy for each modality-classifier combination is reported. Results using a select set of features and using the full set of available features are presented. Further, results are presented for training one classifier with the combined features and for training multiple classifiers with features from each modality separately. Using the select set of features and combined training, multistate prediction accuracy averaged 0.64 +/- 0.14 across thirteen participants and was significantly higher than that for the separate training case. These results support the goal of demonstrating simultaneous real-time classification of multiple states using multiple sensing modalities in high fidelity flight simulators. This detection is intended to support and inform training methods under development to mitigate the loss of ASA and thus reduce accidents and incidents.

Simulations in Cyber-Security: A Review of Cognitive Modeling of Network Attackers, Defenders, and Users

PubMed Central

Veksler, Vladislav D.; Buchler, Norbou; Hoffman, Blaine E.; Cassenti, Daniel N.; Sample, Char; Sugrim, Shridat

2018-01-01

Computational models of cognitive processes may be employed in cyber-security tools, experiments, and simulations to address human agency and effective decision-making in keeping computational networks secure. Cognitive modeling can addresses multi-disciplinary cyber-security challenges requiring cross-cutting approaches over the human and computational sciences such as the following: (a) adversarial reasoning and behavioral game theory to predict attacker subjective utilities and decision likelihood distributions, (b) human factors of cyber tools to address human system integration challenges, estimation of defender cognitive states, and opportunities for automation, (c) dynamic simulations involving attacker, defender, and user models to enhance studies of cyber epidemiology and cyber hygiene, and (d) training effectiveness research and training scenarios to address human cyber-security performance, maturation of cyber-security skill sets, and effective decision-making. Models may be initially constructed at the group-level based on mean tendencies of each subject's subgroup, based on known statistics such as specific skill proficiencies, demographic characteristics, and cultural factors. For more precise and accurate predictions, cognitive models may be fine-tuned to each individual attacker, defender, or user profile, and updated over time (based on recorded behavior) via techniques such as model tracing and dynamic parameter fitting. PMID:29867661

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program.

PubMed

Denadai, Rafael; Saad-Hossne, Rogério; Martinhão Souto, Luís Ricardo

2013-05-01

Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

Multi-material 3D Models for Temporal Bone Surgical Simulation.

PubMed

Rose, Austin S; Kimbell, Julia S; Webster, Caroline E; Harrysson, Ola L A; Formeister, Eric J; Buchman, Craig A

2015-07-01

A simulated, multicolor, multi-material temporal bone model can be created using 3-dimensional (3D) printing that will prove both safe and beneficial in training for actual temporal bone surgical cases. As the process of additive manufacturing, or 3D printing, has become more practical and affordable, a number of applications for the technology in the field of Otolaryngology-Head and Neck Surgery have been considered. One area of promise is temporal bone surgical simulation. Three-dimensional representations of human temporal bones were created from temporal bone computed tomography (CT) scans using biomedical image processing software. Multi-material models were then printed and dissected in a temporal bone laboratory by attending and resident otolaryngologists. A 5-point Likert scale was used to grade the models for their anatomical accuracy and suitability as a simulation of cadaveric and operative temporal bone drilling. The models produced for this study demonstrate significant anatomic detail and a likeness to human cadaver specimens for drilling and dissection. Simulated temporal bones created by this process have potential benefit in surgical training, preoperative simulation for challenging otologic cases, and the standardized testing of temporal bone surgical skills. © The Author(s) 2015.

Evaluating and Enhancing Driving Ability Among Teens with Autism Spectrum Disorder (ASD)

DTIC Science & Technology

2014-10-01

able to engage in the driving training, and none have experienced simulation adaptation syndrome. 15. SUBJECT TERMS Autism, Driving Safety , Driving...routine driving training (RT) required by the DMV, VRDS training + RT (VRDS-T) would lead to greater improvement in driving safety and less driving...improved driving safety above and beyond RT. We hypothesized that computer-generated feedback would be more palatable than human-generated feedback to

The (human) science of medical virtual learning environments

PubMed Central

Stone, Robert J.

2011-01-01

The uptake of virtual simulation technologies in both military and civilian surgical contexts has been both slow and patchy. The failure of the virtual reality community in the 1990s and early 2000s to deliver affordable and accessible training systems stems not only from an obsessive quest to develop the ‘ultimate’ in so-called ‘immersive’ hardware solutions, from head-mounted displays to large-scale projection theatres, but also from a comprehensive lack of attention to the needs of the end users. While many still perceive the science of simulation to be defined by technological advances, such as computing power, specialized graphics hardware, advanced interactive controllers, displays and so on, the true science underpinning simulation—the science that helps to guarantee the transfer of skills from the simulated to the real—is that of human factors, a well-established discipline that focuses on the abilities and limitations of the end user when designing interactive systems, as opposed to the more commercially explicit components of technology. Based on three surgical simulation case studies, the importance of a human factors approach to the design of appropriate simulation content and interactive hardware for medical simulation is illustrated. The studies demonstrate that it is unnecessary to pursue real-world fidelity in all instances in order to achieve psychological fidelity—the degree to which the simulated tasks reproduce and foster knowledge, skills and behaviours that can be reliably transferred to real-world training applications. PMID:21149363

Evaluation of Complex Human Performance: The Promise of Computer-Based Simulation

ERIC Educational Resources Information Center

Newsom, Robert S.; And Others

1978-01-01

For the training and placement of professional workers, multiple-choice instruments are the norm for wide-scale measurement and evaluation efforts. These instruments contain fundamental problems. Computer-based management simulations may provide solutions to these problems, appear scoreable and reliable, offer increased validity, and are better…

Simulation and New Learning Technologies.

ERIC Educational Resources Information Center

Issenberg, S. Barry; Gordon, Michael S.; Gordon, David Lee; Safford, Robert E.; Hart, Ian R.

2001-01-01

In the future, virtual reality technology based initially on data from Visible Human Data sets will provide the majority of simulation-based training. Indicates that evidence-based outcomes must show these systems to be effective instruments for teaching and assessment, and medical educators must be willing to effect change in medical education to…

Computer Simulation of Human Behavior: Assessment of Creativity.

ERIC Educational Resources Information Center

Greene, John F.

The major purpose of this study is to further the development of procedures which minimize current limitations of creativity instruments, thus yielding a reliable and functional means for assessing creativity. Computerized content analysis and multiple regression are employed to simulate the creativity ratings of trained judges. The computerized…

Procedural wound geometry and blood flow generation for medical training simulators

NASA Astrophysics Data System (ADS)

Aras, Rifat; Shen, Yuzhong; Li, Jiang

2012-02-01

Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.

Beyond crisis resource management: new frontiers in human factors training for acute care medicine.

PubMed

Petrosoniak, Andrew; Hicks, Christopher M

2013-12-01

Error is ubiquitous in medicine, particularly during critical events and resuscitation. A significant proportion of adverse events can be attributed to inadequate team-based skills such as communication, leadership, situation awareness and resource utilization. Aviation-based crisis resource management (CRM) training using high-fidelity simulation has been proposed as a strategy to improve team behaviours. This review will address key considerations in CRM training and outline recommendations for the future of human factors education in healthcare. A critical examination of the current literature yields several important considerations to guide the development and implementation of effective simulation-based CRM training. These include defining a priori domain-specific objectives, creating an immersive environment that encourages deliberate practice and transfer-appropriate processing, and the importance of effective team debriefing. Building on research from high-risk industry, we suggest that traditional CRM training may be augmented with new training techniques that promote the development of shared mental models for team and task processes, address the effect of acute stress on team performance, and integrate strategies to improve clinical reasoning and the detection of cognitive errors. The evolution of CRM training involves a 'Triple Threat' approach that integrates mental model theory for team and task processes, training for stressful situations and metacognition and error theory towards a more comprehensive training paradigm, with roots in high-risk industry and cognitive psychology. Further research is required to evaluate the impact of this approach on patient-oriented outcomes.

[Innovative training for enhancing patient safety. Safety culture and integrated concepts].

PubMed

Rall, M; Schaedle, B; Zieger, J; Naef, W; Weinlich, M

2002-11-01

Patient safety is determined by the performance safety of the medical team. Errors in medicine are amongst the leading causes of death of hospitalized patients. These numbers call for action. Backgrounds, methods and new forms of training are introduced in this article. Concepts from safety research are transformed to the field of emergency medical treatment. Strategies from realistic patient simulator training sessions and innovative training concepts are discussed. The reasons for the high numbers of errors in medicine are not due to a lack of medical knowledge, but due to human factors and organisational circumstances. A first step towards an improved patient safety is to accept this. We always need to be prepared that errors will occur. A next step would be to separate "error" from guilt (culture of blame) allowing for a real analysis of accidents and establishment of meaningful incident reporting systems. Concepts with a good success record from aviation like "crew resource management" (CRM) training have been adapted my medicine and are ready to use. These concepts require theoretical education as well as practical training. Innovative team training sessions using realistic patient simulator systems with video taping (for self reflexion) and interactive debriefing following the sessions are very promising. As the need to reduce error rates in medicine is very high and the reasons, methods and training concepts are known, we are urged to implement these new training concepts widely and consequently. To err is human - not to counteract it is not.

Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy.

PubMed

Walsh, Catharine M; Sherlock, Mary E; Ling, Simon C; Carnahan, Heather

2012-06-13

Traditionally, training in gastrointestinal endoscopy has been based upon an apprenticeship model, with novice endoscopists learning basic skills under the supervision of experienced preceptors in the clinical setting. Over the last two decades, however, the growing awareness of the need for patient safety has brought the issue of simulation-based training to the forefront. While the use of simulation-based training may have important educational and societal advantages, the effectiveness of virtual reality gastrointestinal endoscopy simulators has yet to be clearly demonstrated. To determine whether virtual reality simulation training can supplement and/or replace early conventional endoscopy training (apprenticeship model) in diagnostic oesophagogastroduodenoscopy, colonoscopy and/or sigmoidoscopy for health professions trainees with limited or no prior endoscopic experience. Health professions, educational and computer databases were searched until November 2011 including The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, Web of Science, Biosis Previews, CINAHL, Allied and Complementary Medicine Database, ERIC, Education Full Text, CBCA Education, Career and Technical Education @ Scholars Portal, Education Abstracts @ Scholars Portal, Expanded Academic ASAP @ Scholars Portal, ACM Digital Library, IEEE Xplore, Abstracts in New Technologies and Engineering and Computer & Information Systems Abstracts. The grey literature until November 2011 was also searched. Randomised and quasi-randomised clinical trials comparing virtual reality endoscopy (oesophagogastroduodenoscopy, colonoscopy and sigmoidoscopy) simulation training versus any other method of endoscopy training including conventional patient-based training, in-job training, training using another form of endoscopy simulation (e.g. low-fidelity simulator), or no training (however defined by authors) were included.  Trials comparing one method of virtual reality training versus another method of virtual reality training (e.g. comparison of two different virtual reality simulators) were also included. Only trials measuring outcomes on humans in the clinical setting (as opposed to animals or simulators) were included. Two authors (CMS, MES) independently assessed the eligibility and methodological quality of trials, and extracted data on the trial characteristics and outcomes. Due to significant clinical and methodological heterogeneity it was not possible to pool study data in order to perform a meta-analysis. Where data were available for each continuous outcome we calculated standardized mean difference with 95% confidence intervals based on intention-to-treat analysis. Where data were available for dichotomous outcomes we calculated relative risk with 95% confidence intervals based on intention-to-treat-analysis. Thirteen trials, with 278 participants, met the inclusion criteria. Four trials compared simulation-based training with conventional patient-based endoscopy training (apprenticeship model) whereas nine trials compared simulation-based training with no training. Only three trials were at low risk of bias. Simulation-based training, as compared with no training, generally appears to provide participants with some advantage over their untrained peers as measured by composite score of competency, independent procedure completion, performance time, independent insertion depth, overall rating of performance or competency error rate and mucosal visualization. Alternatively, there was no conclusive evidence that simulation-based training was superior to conventional patient-based training, although data were limited. The results of this systematic review indicate that virtual reality endoscopy training can be used to effectively supplement early conventional endoscopy training (apprenticeship model) in diagnostic oesophagogastroduodenoscopy, colonoscopy and/or sigmoidoscopy for health professions trainees with limited or no prior endoscopic experience. However, there remains insufficient evidence to advise for or against the use of virtual reality simulation-based training as a replacement for early conventional endoscopy training (apprenticeship model) for health professions trainees with limited or no prior endoscopic experience. There is a great need for the development of a reliable and valid measure of endoscopic performance prior to the completion of further randomised clinical trials with high methodological quality.

Clinical Space Medicine Products as Developed by the Medical Operations Support Team (MOST)

NASA Technical Reports Server (NTRS)

Polk, James D.; Doerr, Harold K.; Hurst, Victor W., IV; Schmid, Josef

2007-01-01

Medical Operations Support Team (MOST) is introducing/integrating teaching practices associated with high fidelity human patient simulation into the NASA culture, in particular, into medical training sessions and medical procedure evaluations. Current/Future Products iclude: a) Development of Sub-optimal Airway Protocols for the International Space Station (ISS) using the ILMA; b) Clinical Core Competency Training for NASA Flight Surgeons (FS); c) Post-Soyuz Landing Clinical Training for NASA FS; d) Experimental Integrated Training for Astronaut Crew Medical Officers and NASA FS; and e) Private Clinical Refresher Training.

[Non-biological 3D printed simulator for training in percutaneous nephro- lithotripsy].

PubMed

Alyaev, Yu G; Sirota, E S; Bezrukov, E A; Ali, S Kh; Bukatov, M D; Letunovskiy, A V; Byadretdinov, I Sh

2018-03-01

To develop a non-biological 3D printed simulator for training and preoperative planning in percutaneous nephrolithotripsy (PCNL), which allows doctors to master and perform all stages of the operation under ultrasound and fluoroscopy guidance. The 3D model was constructed using multislice spiral computed tomography (MSCT) images of a patient with staghorn urolithiasis. The MSCT data were processed and used to print the model. The simulator consisted of two parts: a non-biological 3D printed soft model of a kidney with reproduced intra-renal vascular and collecting systems and a printed 3D model of a human body. Using this 3D printed simulator, PCNL was performed in the interventional radiology operating room under ultrasound and fluoroscopy guidance. The designed 3D printed model of the kidney completely reproduces the individual features of the intra-renal structures of the particular patient. During the training, all the main stages of PCNL were performed successfully: the puncture, dilation of the nephrostomy tract, endoscopic examination, intra-renal lithotripsy. Our proprietary 3D-printed simulator is a promising development in the field of endourologic training and preoperative planning in the treatment of complicated forms of urolithiasis.

Virtual Glovebox (VGX) Aids Astronauts in Pre-Flight Training

NASA Technical Reports Server (NTRS)

2003-01-01

NASA's Virtual Glovebox (VGX) was developed to allow astronauts on Earth to train for complex biology research tasks in space. The astronauts may reach into the virtual environment, naturally manipulating specimens, tools, equipment, and accessories in a simulated microgravity environment as they would do in space. Such virtual reality technology also provides engineers and space operations staff with rapid prototyping, planning, and human performance modeling capabilities. Other Earth based applications being explored for this technology include biomedical procedural training and training for disarming bio-terrorism weapons.

Using immersive simulation for training first responders for mass casualty incidents.

PubMed

Wilkerson, William; Avstreih, Dan; Gruppen, Larry; Beier, Klaus-Peter; Woolliscroft, James

2008-11-01

A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event. Utilizing a virtual reality cave automatic virtual environment (CAVE) and high-fidelity human patient simulator (HPS), a group of experts modeled a football stadium that experienced a terrorist explosion during a football game. Avatars (virtual patients) were developed by expert consensus that demonstrated a spectrum of injuries ranging from death to minor lacerations. A group of paramedics was assessed by observation for decisions made and action taken. A critical action checklist was created and used for direct observation and viewing videotaped recordings. Of the 12 participants, only 35.7% identified the type of incident they encountered. None identified a secondary device that was easily visible. All participants were enthusiastic about the simulation and provided valuable comments and insights. Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack.

Fabrication of cerebral aneurysm simulator with a desktop 3D printer

PubMed Central

Liu, Yu; Gao, Qing; Du, Song; Chen, ZiChen; Fu, JianZhong; Chen, Bing; Liu, ZhenJie; He, Yong

2017-01-01

Now, more and more patients are suffering cerebral aneurysm. However, long training time limits the rapid growth of cerebrovascular neurosurgeons. Here we developed a novel cerebral aneurysm simulator which can be better represented the dynamic bulging process of cerebral aneurysm The proposed simulator features the integration of a hollow elastic vascular model, a skull model and a brain model, which can be affordably fabricated at the clinic (Fab@Clinic), under $25.00 each with the help of a low-cost desktop 3D printer. Moreover, the clinical blood flow and pulsation pressure similar to the human can be well simulated, which can be used to train the neurosurgical residents how to clip aneurysms more effectively. PMID:28513626

Clinical Core Competency Training for NASA Flight Surgeons

NASA Technical Reports Server (NTRS)

Polk, J. D.; Schmid, Josef; Hurst, Victor, IV; Doerr, Harold K.; Doerr, Harold K.

2007-01-01

Introduction: The cohort of NASA flight surgeons (FS) is a very accomplished group with varied clinical backgrounds; however, the NASA Flight Surgeon Office has identified that the extremely demanding schedule of this cohort prevents many of these physicians from practicing clinical medicine on a regular basis. In an effort to improve clinical competency, the NASA FS Office has dedicated one day a week for the FS to receive clinical training. Each week, an FS is assigned to one of five clinical settings, one being medical patient simulation. The Medical Operations Support Team (MOST) was tasked to develop curricula using medical patient simulation that would meet the clinical and operational needs of the NASA FS Office. Methods: The MOST met with the Lead FS and Training Lead FS to identify those core competencies most important to the FS cohort. The MOST presented core competency standards from the American Colleges of Emergency Medicine and Internal Medicine as a basis for developing the training. Results: The MOST identified those clinical areas that could be best demonstrated and taught using medical patient simulation, in particular, using high fidelity human patient simulators. Curricula are currently being developed and additional classes will be implemented to instruct the FS cohort. The curricula will incorporate several environments for instruction, including lab-based and simulated microgravity-based environments. Discussion: The response from the NASA FS cohort to the initial introductory class has been positive. As a result of this effort, the MOST has identified three types of training to meet the clinical needs of the FS Office; clinical core competency training, individual clinical refresher training, and just-in-time training (specific for post-ISS Expedition landings). The MOST is continuing to work with the FS Office to augment the clinical training for the FS cohort, including the integration of Web-based learning.

Soft 3D-Printed Phantom of the Human Kidney with Collecting System.

PubMed

Adams, Fabian; Qiu, Tian; Mark, Andrew; Fritz, Benjamin; Kramer, Lena; Schlager, Daniel; Wetterauer, Ulrich; Miernik, Arkadiusz; Fischer, Peer

2017-04-01

Organ models are used for planning and simulation of operations, developing new surgical instruments, and training purposes. There is a substantial demand for in vitro organ phantoms, especially in urological surgery. Animal models and existing simulator systems poorly mimic the detailed morphology and the physical properties of human organs. In this paper, we report a novel fabrication process to make a human kidney phantom with realistic anatomical structures and physical properties. The detailed anatomical structure was directly acquired from high resolution CT data sets of human cadaveric kidneys. The soft phantoms were constructed using a novel technique that combines 3D wax printing and polymer molding. Anatomical details and material properties of the phantoms were validated in detail by CT scan, ultrasound, and endoscopy. CT reconstruction, ultrasound examination, and endoscopy showed that the designed phantom mimics a real kidney's detailed anatomy and correctly corresponds to the targeted human cadaver's upper urinary tract. Soft materials with a tensile modulus of 0.8-1.5 MPa as well as biocompatible hydrogels were used to mimic human kidney tissues. We developed a method of constructing 3D organ models from medical imaging data using a 3D wax printing and molding process. This method is cost-effective means for obtaining a reproducible and robust model suitable for surgical simulation and training purposes.

Virtual Reality Simulation for the Operating Room

PubMed Central

Gallagher, Anthony G.; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P.; Moses, Gerald; Smith, C Daniel; Satava, Richard M.

2005-01-01

Summary Background Data: To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision Methods: A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. Results: VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. Conclusions: VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills. PMID:15650649

Virtual reality: teaching tool of the twenty-first century?

PubMed

Hoffman, H; Vu, D

1997-12-01

Virtual reality (VR) is gaining recognition for its enormous educational potential. While not yet in the mainstream of academic medical training, many prototype and first-generation VR applications are emerging, with target audiences ranging from first- and second-year medical students to residents in advanced clinical training. Visualization tools that take advantage of VR technologies are being designed to provide engaging and intuitive environments for learning visually and spatially complex topics such as human anatomy, biochemistry, and molecular biology. These applications present dynamic, three-dimensional views of structures and their spatial relationships, enabling users to move beyond "real-world" experiences by interacting with or altering virtual objects in ways that would otherwise be difficult or impossible. VR-based procedural and surgical simulations, often compared with flight simulators in aviation, hold significant promise for revolutionizing medical training. Already a wide range of simulations, representing diverse content areas and utilizing a variety of implementation strategies, are either under development or in their early implementation stages. These new systems promise to make broad-based training experiences available for students at all levels, without the risks and ethical concerns typically associated with using animal and human subjects. Medical students could acquire proficiency and gain confidence in the ability to perform a wide variety of techniques long before they need to use them clinically. Surgical residents could rehearse and refine operative procedures, using an unlimited pool of virtual patients manifesting a wide range of anatomic variations, traumatic wounds, and disease states. Those simulated encounters, in combination with existing opportunities to work with real patients, could increase the depth and breadth of learners' exposure to medical problems, ensure uniformity of training experiences, and enhance the acquisition of clinical skills.

Evaluation of Wearable Simulation Interface for Military Training

DTIC Science & Technology

2012-01-01

Lampton, 2005). This assumption was based on support from the identi- cal elements theory (Holding, 1965; Thorndike & Woodworth, 1901), which states that...Annual Meeting of the Human Fac- tors and Ergonomics Society (pp. 2014–2018). Santa Monica, CA: Human Factors and Ergonomics Society. Thorndike , E. L

Simulation of minimally invasive vascular interventions for training purposes.

PubMed

Alderliesten, Tanja; Konings, Maurits K; Niessen, Wiro J

2004-01-01

To master the skills required to perform minimally invasive vascular interventions, proper training is essential. A computer simulation environment has been developed to provide such training. The simulation is based on an algorithm specifically developed to simulate the motion of a guide wire--the main instrument used during these interventions--in the human vasculature. In this paper, the design and model of the computer simulation environment is described and first results obtained with phantom and patient data are presented. To simulate minimally invasive vascular interventions, a discrete representation of a guide wire is used which allows modeling of guide wires with different physical properties. An algorithm for simulating the propagation of a guide wire within a vascular system, on the basis of the principle of minimization of energy, has been developed. Both longitudinal translation and rotation are incorporated as possibilities for manipulating the guide wire. The simulation is based on quasi-static mechanics. Two types of energy are introduced: internal energy related to the bending of the guide wire, and external energy resulting from the elastic deformation of the vessel wall. A series of experiments were performed on phantom and patient data. Simulation results are qualitatively compared with 3D rotational angiography data. The results indicate plausible behavior of the simulation.

[Human factors and crisis resource management: improving patient safety].

PubMed

Rall, M; Oberfrank, S

2013-10-01

A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.

Computer-generated forces in distributed interactive simulation

NASA Astrophysics Data System (ADS)

Petty, Mikel D.

1995-04-01

Distributed Interactive Simulation (DIS) is an architecture for building large-scale simulation models from a set of independent simulator nodes communicating via a common network protocol. DIS is most often used to create a simulated battlefield for military training. Computer Generated Forces (CGF) systems control large numbers of autonomous battlefield entities in a DIS simulation using computer equipment and software rather than humans in simulators. CGF entities serve as both enemy forces and supplemental friendly forces in a DIS exercise. Research into various aspects of CGF systems is ongoing. Several CGF systems have been implemented.

The criteria of optimization of training specialists for the nuclear power industry and its implementation in the educational process

NASA Astrophysics Data System (ADS)

Lavrinenko, S. V.; Polikarpov, P. I.

2017-11-01

The nuclear industry is one of the most important and high-tech spheres of human activity in Russia. The main cause of accidents in the nuclear industry is the human factor. In this connection, the need to constantly analyze the system of training of specialists and its optimization in order to improve safety at nuclear industry enterprises. To do this, you must analyze the international experience in the field of training in the field of nuclear energy leading countries. Based on the analysis criteria have been formulated to optimize the educational process of training specialists for the nuclear power industry and test their effectiveness. The most effective and promising is the introduction of modern information technologies of training of students, such as real-time simulators, electronic educational resources, etc.

Human Emotion and Response in Surgery (HEARS): a simulation-based curriculum for communication skills, systems-based practice, and professionalism in surgical residency training.

PubMed

Larkin, Anne C; Cahan, Mitchell A; Whalen, Giles; Hatem, David; Starr, Susan; Haley, Heather-Lyn; Litwin, Demetrius; Sullivan, Kate; Quirk, Mark

2010-08-01

This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques. Members of the Department of Surgery and the Center for Clinical Communication and Performance Outcomes jointly constructed a curriculum for PGY1 and PGY2 residents on topics ranging from challenging communication to time and stress management. Video demonstrations, triggers, and simulated scenarios involving acting patients were created by surgeons and medical educators. Pre- and postintervention measures were obtained for communication skills, perceived stress level, and teamwork. Communication skills were evaluated using a series of video vignettes. The validated Perceived Stress Scale and Teamwork and Patient Safety Attitudes survey were used. Residents' perceptions of the program were also measured. Twenty-seven PGY1 residents and 15 PGY2 residents participated during 2 years. Analyses of video vignette tests indicated significant improvement in empathic communication for PGY1 (t = 3.62, p = 0.001) and PGY2 (t = 5.00, p = 0.004). There were no significant changes to teamwork attitudes. Perceived levels of stress became considerably higher. PGY1 residents reported trying 1 to 3 strategies taught in the time management session, with 60% to 75% reporting improvement post-training. This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Applied Behavior Analysis in Flying Training Research. Interim Report for Period June 1978-August 1978.

ERIC Educational Resources Information Center

Bailey, Jon S.; Hughes, Ronald G.

Research developments in learning theory over the past fifty years have led to principles of behavior which have been shown in innumerable applied settings to be valuable in analyzing and modifying human behavior. When applied to flying training using simulators, these principles suggest that a significant contribution could be made in improving…

A Forecast of Army Aviation Training Research and Development Requirements for the Period 1985 to 2000. Volume 1

DTIC Science & Technology

1981-08-01

cinematic simulation, and interactive computer- 97 control display devices have been reviewed by Roscoe. [35] Developments on some of these training...R. S., Study and Analysis of Requirements for Head-Up Display (HUD), NASA CR-6612, March 1970. 6. Burnette, K. T., "The Status of Human Perceptual

Evaluating the Effect of Virtual Reality Temporal Bone Simulation on Mastoidectomy Performance: A Meta-analysis.

PubMed

Lui, Justin T; Hoy, Monica Y

2017-06-01

Background The increasing prevalence of virtual reality simulation in temporal bone surgery warrants an investigation to assess training effectiveness. Objectives To determine if temporal bone simulator use improves mastoidectomy performance. Data Sources Ovid Medline, Embase, and PubMed databases were systematically searched per the PRISMA guidelines. Review Methods Inclusion criteria were peer-reviewed publications that utilized quantitative data of mastoidectomy performance following the use of a temporal bone simulator. The search was restricted to human studies published in English. Studies were excluded if they were in non-peer-reviewed format, were descriptive in nature, or failed to provide surgical performance outcomes. Meta-analysis calculations were then performed. Results A meta-analysis based on the random-effects model revealed an improvement in overall mastoidectomy performance following training on the temporal bone simulator. A standardized mean difference of 0.87 (95% CI, 0.38-1.35) was generated in the setting of a heterogeneous study population ( I 2 = 64.3%, P < .006). Conclusion In the context of a diverse population of virtual reality simulation temporal bone surgery studies, meta-analysis calculations demonstrate an improvement in trainee mastoidectomy performance with virtual simulation training.

The Right Stuff: A Look Back at Three Decades of Flight Controller Training for Space Shuttle Mission Operations

NASA Technical Reports Server (NTRS)

Dittemore, Gary D.; Bertels, Christie

2010-01-01

This paper will summarize the thirty-year history of Space Shuttle operations from the perspective of training in NASA Johnson Space Center's Mission Control Center. It will focus on training and development of flight controllers and instructors, and how training practices have evolved over the years as flight experience was gained, new technologies developed, and programmatic needs changed. Operations of human spaceflight systems is extremely complex, therefore the training and certification of operations personnel is a critical piece of ensuring mission success. Mission Control Center (MCC-H), at the Lyndon B. Johnson Space Center, in Houston, Texas manages mission operations for the Space Shuttle Program, including the training and certification of the astronauts and flight control teams. This paper will give an overview of a flight control team s makeup and responsibilities during a flight, and details on how those teams are trained and certified. The training methodology for developing flight controllers has evolved significantly over the last thirty years, while the core goals and competencies have remained the same. In addition, the facilities and tools used in the control center have evolved. These changes have been driven by many factors including lessons learned, technology, shuttle accidents, shifts in risk posture, and generational differences. Flight controllers will share their experiences in training and operating the Space Shuttle throughout the Program s history. A primary method used for training Space Shuttle flight control teams is by running mission simulations of the orbit, ascent, and entry phases, to truly "train like you fly." The audience will learn what it is like to perform a simulation as a shuttle flight controller. Finally, we will reflect on the lessons learned in training for the shuttle program, and how those could be applied to future human spaceflight endeavors.

High-Fidelity Simulation for Neonatal Nursing Education: An Integrative Review of the Literature.

PubMed

Cooper, Allyson

2015-01-01

The lack of safe avenues to develop neonatal nursing competencies using human subjects leads to the notion that simulation education for neonatal nurses might be an ideal form of education. This integrative literature review compares traditional, teacher-centered education with high-fidelity simulation education for neonatal nurses. It examines the theoretical frameworks used in neonatal nursing education and outlines the advantages of this type of training, including improving communication and teamwork; providing an innovative pedagogical approach; and aiding in skill acquisition, confidence, and participant satisfaction. The importance of debriefing is also examined. High-fidelity simulation is not without disadvantages, including its significant cost, the time associated with training, the need for very complex technical equipment, and increased faculty resource requirements. Innovative uses of high-fidelity simulation in neonatal nursing education are suggested. High-fidelity simulation has great potential but requires additional research to fully prove its efficacy.

Human Performance Modeling and Simulation for Launch Team Applications

NASA Technical Reports Server (NTRS)

Peaden, Cary J.; Payne, Stephen J.; Hoblitzell, Richard M., Jr.; Chandler, Faith T.; LaVine, Nils D.; Bagnall, Timothy M.

2006-01-01

This paper describes ongoing research into modeling and simulation of humans for launch team analysis, training, and evaluation. The initial research is sponsored by the National Aeronautics and Space Administration's (NASA)'s Office of Safety and Mission Assurance (OSMA) and NASA's Exploration Program and is focused on current and future launch team operations at Kennedy Space Center (KSC). The paper begins with a description of existing KSC launch team environments and procedures. It then describes the goals of new Simulation and Analysis of Launch Teams (SALT) research. The majority of this paper describes products from the SALT team's initial proof-of-concept effort. These products include a nominal case task analysis and a discrete event model and simulation of launch team performance during the final phase of a shuttle countdown; and a first proof-of-concept training demonstration of launch team communications in which the computer plays most roles, and the trainee plays a role of the trainee's choice. This paper then describes possible next steps for the research team and provides conclusions. This research is expected to have significant value to NASA's Exploration Program.

Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) simulation.

PubMed

Keller, Benjamin A; Salcedo, Edgardo S; Williams, Timothy K; Neff, Lucas P; Carden, Anthony J; Li, Yiran; Gotlib, Oren; Tran, Nam K; Galante, Joseph M

2016-09-01

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct technique for salvaging patients with noncompressible torso hemorrhage. Current REBOA training paradigms require large animals, virtual reality simulators, or human cadavers for acquisition of skills. These training strategies are expensive and resource intensive, which may prevent widespread dissemination of REBOA. We have developed a low-cost, near-physiologic, pulsatile REBOA simulator by connecting an anatomic vascular circuit constructed out of latex and polyvinyl chloride tubing to a commercially available pump. This pulsatile simulator is capable of generating cardiac outputs ranging from 1.7 to 6.8 L/min with corresponding arterial blood pressures of 54 to 226/14 to 121 mmHg. The simulator accommodates a 12 French introducer sheath and a CODA balloon catheter. Upon balloon inflation, the arterial waveform distal to the occlusion flattens, distal pulsation within the simulator is lost, and systolic blood pressures proximal to the balloon catheter increase by up to 62 mmHg. Further development and validation of this simulator will allow for refinement, reduction, and replacement of large animal models, costly virtual reality simulators, and perfused cadavers for training purposes. This will ultimately facilitate the low-cost, high-fidelity REBOA simulation needed for the widespread dissemination of this life-saving technique.

Adding tactile realism to a virtual reality laparoscopic surgical simulator with a cost-effective human interface device

NASA Astrophysics Data System (ADS)

Mack, Ian W.; Potts, Stephen; McMenemy, Karen R.; Ferguson, R. S.

2006-02-01

The laparoscopic technique for performing abdominal surgery requires a very high degree of skill in the medical practitioner. Much interest has been focused on using computer graphics to provide simulators for training surgeons. Unfortunately, these tend to be complex and have a very high cost, which limits availability and restricts the length of time over which individuals can practice their skills. With computer game technology able to provide the graphics required for a surgical simulator, the cost does not have to be high. However, graphics alone cannot serve as a training simulator. Human interface hardware, the equivalent of the force feedback joystick for a flight simulator game, is required to complete the system. This paper presents a design for a very low cost device to address this vital issue. The design encompasses: the mechanical construction, the electronic interfaces and the software protocols to mimic a laparoscopic surgical set-up. Thus the surgeon has the capability of practicing two-handed procedures with the possibility of force feedback. The force feedback and collision detection algorithms allow surgeons to practice realistic operating theatre procedures with a good degree of authenticity.

Modeling and simulating human teamwork behaviors using intelligent agents

NASA Astrophysics Data System (ADS)

Fan, Xiaocong; Yen, John

2004-12-01

Among researchers in multi-agent systems there has been growing interest in using intelligent agents to model and simulate human teamwork behaviors. Teamwork modeling is important for training humans in gaining collaborative skills, for supporting humans in making critical decisions by proactively gathering, fusing, and sharing information, and for building coherent teams with both humans and agents working effectively on intelligence-intensive problems. Teamwork modeling is also challenging because the research has spanned diverse disciplines from business management to cognitive science, human discourse, and distributed artificial intelligence. This article presents an extensive, but not exhaustive, list of work in the field, where the taxonomy is organized along two main dimensions: team social structure and social behaviors. Along the dimension of social structure, we consider agent-only teams and mixed human-agent teams. Along the dimension of social behaviors, we consider collaborative behaviors, communicative behaviors, helping behaviors, and the underpinning of effective teamwork-shared mental models. The contribution of this article is that it presents an organizational framework for analyzing a variety of teamwork simulation systems and for further studying simulated teamwork behaviors.

Simple simulation training system for short-wave radio station

NASA Astrophysics Data System (ADS)

Tan, Xianglin; Shao, Zhichao; Tu, Jianhua; Qu, Fuqi

2018-04-01

The short-wave radio station is a most important transmission equipment of our signal corps, but in the actual teaching process, which exist the phenomenon of fewer equipment and more students, making the students' short-wave radio operation and practice time is very limited. In order to solve the above problems, to carry out shortwave radio simple simulation training system development is very necessary. This project is developed by combining hardware and software to simulate the voice communication operation and signal principle of shortwave radio station, and can test the signal flow of shortwave radio station. The test results indicate that this system is simple operation, human-machine interface friendly and can improve teaching more efficiency.

Catheter Insertion Reference Trajectory Construction Method Using Photoelastic Stress Analysis for Quantification of Respect for Tissue During Endovascular Surgery Simulation

NASA Astrophysics Data System (ADS)

Tercero, Carlos; Ikeda, Seiichi; Fukuda, Toshio; Arai, Fumihito; Negoro, Makoto; Takahashi, Ikuo

2011-10-01

There is a need to develop quantitative evaluation for simulator based training in medicine. Photoelastic stress analysis can be used in human tissue modeling materials; this enables the development of simulators that measure respect for tissue. For applying this to endovascular surgery, first we present a model of saccular aneurism where stress variation during micro-coils deployment is measured, and then relying on a bi-planar vision system we measure a catheter trajectory and compare it to a reference trajectory considering respect for tissue. New photoelastic tissue modeling materials will expand the applications of this technology to other medical training domains.

Analyzing Robotic Kinematics Via Computed Simulations

NASA Technical Reports Server (NTRS)

Carnahan, Timothy M.

1992-01-01

Computing system assists in evaluation of kinematics of conceptual robot. Displays positions and motions of robotic manipulator within work cell. Also displays interactions between robotic manipulator and other objects. Results of simulation displayed on graphical computer workstation. System includes both off-the-shelf software originally developed for automotive industry and specially developed software. Simulation system also used to design human-equivalent hand, to model optical train in infrared system, and to develop graphical interface for teleoperator simulation system.

Simulation-Based Cutaneous Surgical-Skill Training on a Chicken-Skin Bench Model in a Medical Undergraduate Program

PubMed Central

Denadai, Rafael; Saad-Hossne, Rogério; Martinhão Souto, Luís Ricardo

2013-01-01

Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described. PMID:23723471

Virtual reality for dermatologic surgery: virtually a reality in the 21st century.

PubMed

Gladstone, H B; Raugi, G J; Berg, D; Berkley, J; Weghorst, S; Ganter, M

2000-01-01

In the 20th century, virtual reality has predominantly played a role in training pilots and in the entertainment industry. Despite much publicity, virtual reality did not live up to its perceived potential. During the past decade, it has also been applied for medical uses, particularly as training simulators, for minimally invasive surgery. Because of advances in computer technology, virtual reality is on the cusp of becoming an effective medical educational tool. At the University of Washington, we are developing a virtual reality soft tissue surgery simulator. Based on fast finite element modeling and using a personal computer, this device can simulate three-dimensional human skin deformations with real-time tactile feedback. Although there are many cutaneous biomechanical challenges to solve, it will eventually provide more realistic dermatologic surgery training for medical students and residents than the currently used models.

Man-Vehicle Systems Research Facility - Design and operating characteristics

NASA Technical Reports Server (NTRS)

Shiner, Robert J.; Sullivan, Barry T.

1992-01-01

This paper describes the full-mission flight simulation facility at the NASA Ames Research Center. The Man-Vehicle Systems Research Facility (MVSRF) supports aeronautical human factors research and consists of two full-mission flight simulators and an air-traffic-control simulator. The facility is used for a broad range of human factors research in both conventional and advanced aviation systems. The objectives of the research are to improve the understanding of the causes and effects of human errors in aviation operations, and to limit their occurrence. The facility is used to: (1) develop fundamental analytical expressions of the functional performance characteristics of aircraft flight crews; (2) formulate principles and design criteria for aviation environments; (3) evaluate the integration of subsystems in contemporary flight and air traffic control scenarios; and (4) develop training and simulation technologies.

Tactical Action Officer Intelligent Tutoring System (TAO ITS)

DTIC Science & Technology

2006-01-01

scenario. As well as the intrinsic feedback that free - play simulations naturally provide a student, the TAO ITS provides detailed, useful extrinsic feedback...incorporate use of free - play simulators into their curriculum, affordably. This is a major shortcoming of conventional CBT as student manipulation of...tutoring systems are ideal for incorporating desktop free - play simulators into computer-based training since the software can stand in for a human

Piloted aircraft simulation concepts and overview

NASA Technical Reports Server (NTRS)

Sinacori, J. B.

1978-01-01

An overview of piloted aircraft simulation is presented that reflects the viewpoint of an aeronautical technologist. The intent is to acquaint potential users with some of the basic concepts and issues that characterize piloted simulation. Application to the development of aircraft are highlighted, but some aspects of training simulators are covered. A historical review is given together with a description of some current simulators. Simulator usages, advantages, and limitations are discussed and human perception qualities important to simulation are related. An assessment of current simulation is presented that addresses validity, fidelity, and deficiencies. Future prospects are discussed and technology projections are made.

A Simulation-Based Program to Train Medical Residents to Lead and Perform Advanced Cardiovascular Life Support

PubMed Central

Stefan, Mihaela S.; Belforti, Raquel K.; Langlois, Gerard; Rothberg, Michael B.

2014-01-01

Background Medical residents are often responsible for leading and performing cardiopulmonary resuscitation; however, their levels of expertise and comfort as leaders of advanced cardiovascular life support (ACLS) teams vary widely. While the current American Heart Association ACLS course provides education in recommended resuscitative protocols, training in leadership skills is insufficient. In this article, we describe the design and implementation in our institution of a formative curriculum aimed at improving residents’ readiness for being leaders of ACLS teams using human patient simulation. Human patient simulation refers to a variety of technologies using mannequins with realistic features, which allows learners to practice through scenarios without putting patients at risk. We discuss the limitations of the program and the challenges encountered in implementation. We also provide a description of the initiation and organization of the program. Case scenarios and assessment tools are provided. Description of the Institutional Training Program Our simulation-based training curriculum consists of 8 simulated patient scenarios during four 1-hour sessions. Postgraduate year–2 and 3 internal medicine residents participate in this program in teams of 4. Assessment tools are utilized only for formative evaluation. Debriefing is used as a teaching strategy for the individual resident leader of the ACLS team to facilitate learning and improve performance. To evaluate the impact of the curriculum, we administered a survey before and after the intervention. The survey consisted of 10 questions answered on a 5-point Likert scale, which addressed residents’ confidence in leading ACLS teams, management of the equipment, and management of cardiac rhythms. Respondents’ mean presimulation (ie, baseline) and postsimulation (outcome) scores were compared using a 2-sample t test. Residents’ overall confidence score improved from 2.8 to 3.9 (P < 0.001; mean improvement, 1.1; 95% confidence interval, 0.7–1.6). The average score for performing and leading ACLS teams improved from 2.8 to 4 (P < 0.001; mean difference, 1.2; 95% confidence interval, 0.7–1.7). There was a uniform increase in the residents’ self-confidence in their role as effective leaders of ACLS teams, and residents valued this simulation-based training program. PMID:22056824

Exploring the simulation requirements for virtual regional anesthesia training

NASA Astrophysics Data System (ADS)

Charissis, V.; Zimmer, C. R.; Sakellariou, S.; Chan, W.

2010-01-01

This paper presents an investigation towards the simulation requirements for virtual regional anaesthesia training. To this end we have developed a prototype human-computer interface designed to facilitate Virtual Reality (VR) augmenting educational tactics for regional anaesthesia training. The proposed interface system, aims to compliment nerve blocking techniques methods. The system is designed to operate in real-time 3D environment presenting anatomical information and enabling the user to explore the spatial relation of different human parts without any physical constrains. Furthermore the proposed system aims to assist the trainee anaesthetists so as to build a mental, three-dimensional map of the anatomical elements and their depictive relationship to the Ultra-Sound imaging which is used for navigation of the anaesthetic needle. Opting for a sophisticated approach of interaction, the interface elements are based on simplified visual representation of real objects, and can be operated through haptic devices and surround auditory cues. This paper discusses the challenges involved in the HCI design, introduces the visual components of the interface and presents a tentative plan of future work which involves the development of realistic haptic feedback and various regional anaesthesia training scenarios.

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.

[Initial results with the Munich knee simulator].

PubMed

Frey, M; Riener, R; Burgkart, R; Pröll, T

2002-01-01

In orthopaedics more than 50 different clinical knee joint evaluation tests exist that have to be trained in orthopaedic education. Often it is not possible to obtain sufficient practical training in a clinical environment. The training can be improved by Virtual Reality technology. In the frame of the Munich Knee Joint Simulation project an artificial leg with anatomical properties is attached by a force-torque sensor to an industrial robot. The recorded forces and torques are the input for a simple biomechanical model of the human knee joint. The robot is controlled in such way that the user gets the feeling he moves a real leg. The leg is embedded in a realistic environment with a couch and a patient on it.

Tutoring electronic troubleshooting in a simulated maintenance work environment

NASA Technical Reports Server (NTRS)

Gott, Sherrie P.

1987-01-01

A series of intelligent tutoring systems, or intelligent maintenance simulators, is being developed based on expert and novice problem solving data. A graded series of authentic troubleshooting problems provides the curriculum, and adaptive instructional treatments foster active learning in trainees who engage in extensive fault isolation practice and thus in conditionalizing what they know. A proof of concept training study involving human tutoring was conducted as a precursor to the computer tutors to assess this integrated, problem based approach to task analysis and instruction. Statistically significant improvements in apprentice technicians' troubleshooting efficiency were achieved after approximately six hours of training.

The Final Count Down: A Review of Three Decades of Flight Controller Training Methods for Space Shuttle Mission Operations

NASA Technical Reports Server (NTRS)

Dittemore, Gary D.; Bertels, Christie

2011-01-01

Operations of human spaceflight systems is extremely complex, therefore the training and certification of operations personnel is a critical piece of ensuring mission success. Mission Control Center (MCC-H), at the Lyndon B. Johnson Space Center, in Houston, Texas manages mission operations for the Space Shuttle Program, including the training and certification of the astronauts and flight control teams. As the space shuttle program ends in 2011, a review of how training for STS-1 was conducted compared to STS-134 will show multiple changes in training of shuttle flight controller over a thirty year period. This paper will additionally give an overview of a flight control team s makeup and responsibilities during a flight, and details on how those teams have been trained certified over the life span of the space shuttle. The training methods for developing flight controllers have evolved significantly over the last thirty years, while the core goals and competencies have remained the same. In addition, the facilities and tools used in the control center have evolved. These changes have been driven by many factors including lessons learned, technology, shuttle accidents, shifts in risk posture, and generational differences. A primary method used for training Space Shuttle flight control teams is by running mission simulations of the orbit, ascent, and entry phases, to truly "train like you fly." The reader will learn what it is like to perform a simulation as a shuttle flight controller. Finally, the paper will reflect on the lessons learned in training for the shuttle program, and how those could be applied to future human spaceflight endeavors.

OB/GYN boot cAMP using high-fidelity human simulators: enhancing residents' perceived competency, confidence in taking a leadership role, and stress hardiness.

PubMed

Pliego, Jose F; Wehbe-Janek, Hania; Rajab, M Hasan; Browning, Jeff L; Fothergill, Russell E

2008-01-01

To evaluate the effectiveness of an obstetrical and gynecologic (Ob/Gyn) Boot Camp simulation training on perceived technical competency, confidence in a leadership role, and stress hardiness of resident training. We conducted a prospective pilot study on the effectiveness of an Ob/Gyn Boot Camp on resident training. Residents participated in an intensive immersion in clinical simulation of common obstetrical emergencies including shoulder dystocia, neonatal resuscitation, postpartum hemorrhage, and ruptured ectopic pregnancy. After the training, residents completed a Web-based survey on their perceptions of how the Ob/Gyn Boot Camp affected their 1) technical competency in the assessment and management of their patients, 2) confidence in taking a leadership role, and 3) stress hardiness. Residents rated their perceptions on a Likert scale of 1 to 5, 1 = poor to 5 = excellent. Twenty-three (14 Ob/Gyn and 9 family medicine) residents participated in this pilot study. Eighteen (78%) residents completed the online survey; 4 Ob/Gyn and 1 family medicine resident did not complete the survey. The residents reported that the simulation training stimulated an interest in learning key skills for obstetrical and gynecologic emergencies. Ob/Gyn residents reported significant improvement in their perceived technical competence and stress hardiness after the Boot Camp. However both Ob/Gyn and family medicine residents reported no significant improvement of confidence in their leadership abilities during obstetrical emergencies after the Boot Camp. Boot Camp simulation training early in the curriculum has the potential for enhancing residents' self-assessments of confidence, competency, and stress hardiness in managing obstetrical emergencies.

Multidisciplinary crisis simulations: the way forward for training surgical teams.

PubMed

Undre, Shabnam; Koutantji, Maria; Sevdalis, Nick; Gautama, Sanjay; Selvapatt, Nowlan; Williams, Samantha; Sains, Parvinderpal; McCulloch, Peter; Darzi, Ara; Vincent, Charles

2007-09-01

High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.

Reverse engineering the human: artificial intelligence and acting theory

NASA Astrophysics Data System (ADS)

Soto-Morettini, Donna

2017-01-01

In two separate papers, Artificial Intelligence (AI)/Robotics researcher Guy Hoffman takes as a starting point that actors have been in the business of reverse engineering human behaviour for centuries. In this paper, I follow the similar trajectories of AI and acting theory (AT), looking at three primary questions, in the hope of framing a response to Hoffman's papers: (1) How are the problems of training a human to simulate a fictional human both similar to and different from training a machine to simulate a human? (2) How are the larger questions of AI design and architecture similar to the larger questions that still remain within the area of AT? (3) Is there anything in the work of AI design that might advance the work of acting theorists and practitioners? The paper explores the use of "swarm intelligence" in recent models of both AT and AI, and considers the issues of embodied cognition, and the kinds of intelligence that enhances or inhibits imaginative immersion for the actor, and concludes with a consideration of the ontological questions raised by the trend towards intersubjective, dynamic systems of generative thought in both AT and AI.

Space Science

NASA Image and Video Library

2003-06-01

NASA’s Virtual Glovebox (VGX) was developed to allow astronauts on Earth to train for complex biology research tasks in space. The astronauts may reach into the virtual environment, naturally manipulating specimens, tools, equipment, and accessories in a simulated microgravity environment as they would do in space. Such virtual reality technology also provides engineers and space operations staff with rapid prototyping, planning, and human performance modeling capabilities. Other Earth based applications being explored for this technology include biomedical procedural training and training for disarming bio-terrorism weapons.

Eight critical factors in creating and implementing a successful simulation program.

PubMed

Lazzara, Elizabeth H; Benishek, Lauren E; Dietz, Aaron S; Salas, Eduardo; Adriansen, David J

2014-01-01

Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians' knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and "memorable" heuristic of the important facets of simulation program creation and implementation, as represented by eight critical "S" factors-science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies. SYSTEMS: One of the eight critical factors-systems-refers to the need to match fidelity requirements to training needs and ensure that technological infrastructure is in place. The type of learning objectives that the training is intended to address should determine these requirements. For example, some simulators emphasize physical fidelity to enable clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures. The eight factors-science, staff, supplies, space, support, systems, success, and sustainability-represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors' relative importance may change as the program evolves.

Pediatric laryngeal simulator using 3D printed models: A novel technique.

PubMed

Kavanagh, Katherine R; Cote, Valerie; Tsui, Yvonne; Kudernatsch, Simon; Peterson, Donald R; Valdez, Tulio A

2017-04-01

Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible. Pediatric laryngeal models were developed using two manufacturing methods: direct three-dimensional (3D) printing of anatomical models and casted anatomical models using 3D-printed molds. Polylactic acid, acrylonitrile butadiene styrene, and high-impact polystyrene (HIPS) were used for the directly printed models, whereas a silicone elastomer (SE) was used for the casted models. The models were evaluated for anatomic quality, ease of manipulation, hardness, and cost of production. A tissue likeness scale was created to validate the simulation model. Fleiss' Kappa rating was performed to evaluate interrater agreement, and analysis of variance was performed to evaluate differences among the materials. The SE provided the most anatomically accurate models, with the tactile properties allowing for surgical manipulation of the larynx. Direct 3D printing was more cost-effective than the SE casting method but did not possess the material properties and tissue likeness necessary for surgical simulation. The SE models of the pediatric larynx created from a casting method demonstrated high quality anatomy, tactile properties comparable to human tissue, and easy manipulation with standard surgical instruments. Their use in a reliable, low-cost, accessible, modular simulation system provides a valuable training resource for otolaryngology residents. N/A. Laryngoscope, 127:E132-E137, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

A robotic voice simulator and the interactive training for hearing-impaired people.

PubMed

Sawada, Hideyuki; Kitani, Mitsuki; Hayashi, Yasumori

2008-01-01

A talking and singing robot which adaptively learns the vocalization skill by means of an auditory feedback learning algorithm is being developed. The robot consists of motor-controlled vocal organs such as vocal cords, a vocal tract and a nasal cavity to generate a natural voice imitating a human vocalization. In this study, the robot is applied to the training system of speech articulation for the hearing-impaired, because the robot is able to reproduce their vocalization and to teach them how it is to be improved to generate clear speech. The paper briefly introduces the mechanical construction of the robot and how it autonomously acquires the vocalization skill in the auditory feedback learning by listening to human speech. Then the training system is described, together with the evaluation of the speech training by auditory impaired people.

Embodied conversational agents for multimodal automated social skills training in people with autism spectrum disorders.

PubMed

Tanaka, Hiroki; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

2017-01-01

Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social communication skills through interaction with a computer avatar. Even though previous work that simulated social skills training only considered acoustic and linguistic information, human social skills trainers take into account visual and other non-verbal features. In this paper, we create and evaluate a social skills training system that closes this gap by considering the audiovisual features of the smiling ratio and the head pose (yaw and pitch). In addition, the previous system was only tested with graduate students; in this paper, we applied our system to children or young adults with autism spectrum disorders. For our experimental evaluation, we recruited 18 members from the general population and 10 people with autism spectrum disorders and gave them our proposed multimodal system to use. An experienced human social skills trainer rated the social skills of the users. We evaluated the system's effectiveness by comparing pre- and post-training scores and identified significant improvement in their social skills using our proposed multimodal system. Computer-based social skills training is useful for people who experience social difficulties. Such a system can be used by teachers, therapists, and social skills trainers for rehabilitation and the supplemental use of human-based training anywhere and anytime.

Embodied conversational agents for multimodal automated social skills training in people with autism spectrum disorders

PubMed Central

Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

2017-01-01

Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social communication skills through interaction with a computer avatar. Even though previous work that simulated social skills training only considered acoustic and linguistic information, human social skills trainers take into account visual and other non-verbal features. In this paper, we create and evaluate a social skills training system that closes this gap by considering the audiovisual features of the smiling ratio and the head pose (yaw and pitch). In addition, the previous system was only tested with graduate students; in this paper, we applied our system to children or young adults with autism spectrum disorders. For our experimental evaluation, we recruited 18 members from the general population and 10 people with autism spectrum disorders and gave them our proposed multimodal system to use. An experienced human social skills trainer rated the social skills of the users. We evaluated the system’s effectiveness by comparing pre- and post-training scores and identified significant improvement in their social skills using our proposed multimodal system. Computer-based social skills training is useful for people who experience social difficulties. Such a system can be used by teachers, therapists, and social skills trainers for rehabilitation and the supplemental use of human-based training anywhere and anytime. PMID:28796781

Increasing combat realism: the effectiveness of stun belt use on soldiers for the enhancement of live training and testing exercises

NASA Astrophysics Data System (ADS)

Schricker, Bradley C.; Antalek, Christopher

2006-05-01

The ability to make correct decisions while operating in a combat zone enables American and Coalition warfighters to better respond to any threats they may encounter due to the minimization of negative training the warfighter encountered during their live, virtual, and constructive (LVC) training exercises. By increasing the physical effects encountered by one's senses during combat scenarios, combat realism is able to be increased, which is a key component in the reduction in negative training. The use of LVC simulations for training and testing augmentation purposes depends on a number of factors, not the least of which is the accurate representation of the training environment. This is particularly true in the realm of tactical engagement training through the use of Tactical Engagement Simulation Systems (TESS). The training environment is perceived through human senses, most notably sight and hearing. As with other haptic devices, the sense of touch is gaining traction as a viable medium through which to express the effects of combat battle damage from the synthetic training environment to participants within a simulated training exercise. New developments in this field are promoting the safe use of an electronic stun device to indicate to a trainee that they have been hit by a projectile, from either direct or indirect fire, through the course of simulated combat. A growing number of examples suggest that this added output medium can greatly enhance the realism of a training exercise and, thus, improve the training value. This paper serves as a literature survey of this concept, beginning with an explanation of TESS. It will then focus on how the electronic stun effect may be employed within a TESS and then detail some of the noted pros and cons of such an approach. The paper will conclude with a description of potential directions and work.

Virtual reality in surgical training.

PubMed

Lange, T; Indelicato, D J; Rosen, J M

2000-01-01

Virtual reality in surgery and, more specifically, in surgical training, faces a number of challenges in the future. These challenges are building realistic models of the human body, creating interface tools to view, hear, touch, feel, and manipulate these human body models, and integrating virtual reality systems into medical education and treatment. A final system would encompass simulators specifically for surgery, performance machines, telemedicine, and telesurgery. Each of these areas will need significant improvement for virtual reality to impact medicine successfully in the next century. This article gives an overview of, and the challenges faced by, current systems in the fast-changing field of virtual reality technology, and provides a set of specific milestones for a truly realistic virtual human body.

Flight simulator requirements for airline transport pilot training - An evaluation of motion system design alternatives

NASA Technical Reports Server (NTRS)

Lee, A. T.; Bussolari, S. R.

1986-01-01

The effect of motion platform systems on pilot behavior is considered with emphasis placed on civil aviation applications. A dynamic model for human spatial orientation based on the physiological structure and function of the human vestibular system is presented. Motion platform alternatives were evaluated on the basis of the following motion platform conditions: motion with six degrees-of-freedom required for Phase II simulators and two limited motion conditions. Consideration was given to engine flameout, airwork, and approach and landing scenarios.

A self-paced brain-computer interface for controlling a robot simulator: an online event labelling paradigm and an extended Kalman filter based algorithm for online training.

PubMed

Tsui, Chun Sing Louis; Gan, John Q; Roberts, Stephen J

2009-03-01

Due to the non-stationarity of EEG signals, online training and adaptation are essential to EEG based brain-computer interface (BCI) systems. Self-paced BCIs offer more natural human-machine interaction than synchronous BCIs, but it is a great challenge to train and adapt a self-paced BCI online because the user's control intention and timing are usually unknown. This paper proposes a novel motor imagery based self-paced BCI paradigm for controlling a simulated robot in a specifically designed environment which is able to provide user's control intention and timing during online experiments, so that online training and adaptation of the motor imagery based self-paced BCI can be effectively investigated. We demonstrate the usefulness of the proposed paradigm with an extended Kalman filter based method to adapt the BCI classifier parameters, with experimental results of online self-paced BCI training with four subjects.

Team Training for Dynamic Cross-Functional Teams in Aviation: Behavioral, Cognitive, and Performance Outcomes.

PubMed

Littlepage, Glenn E; Hein, Michael B; Moffett, Richard G; Craig, Paul A; Georgiou, Andrea M

2016-12-01

This study evaluates the effectiveness of a training program designed to improve cross-functional coordination in airline operations. Teamwork across professional specializations is essential for safe and efficient airline operations, but aviation education primarily emphasizes positional knowledge and skill. Although crew resource management training is commonly used to provide some degree of teamwork training, it is generally focused on specific specializations, and little training is provided in coordination across specializations. The current study describes and evaluates a multifaceted training program designed to enhance teamwork and team performance of cross-functional teams within a simulated airline flight operations center. The training included a variety of components: orientation training, position-specific declarative knowledge training, position-specific procedural knowledge training, a series of high-fidelity team simulations, and a series of after-action reviews. Following training, participants demonstrated more effective teamwork, development of transactive memory, and more effective team performance. Multifaceted team training that incorporates positional training and team interaction in complex realistic situations and followed by after-action reviews can facilitate teamwork and team performance. Team training programs, such as the one described here, have potential to improve the training of aviation professionals. These techniques can be applied to other contexts where multidisciplinary teams and multiteam systems work to perform highly interdependent activities. © 2016, Human Factors and Ergonomics Society.

A new training model for robot-assisted urethrovesical anastomosis and posterior muscle-fascial reconstruction: the Verona training technique.

PubMed

Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W

2017-06-01

A training model is usually needed to teach robotic surgical technique successfully. In this way, an ideal training model should mimic as much as possible the "in vivo" procedure and allow several consecutive surgical simulations. The goal of this study was to create a "wet lab" model suitable for RARP training programs, providing the simulation of the posterior fascial reconstruction. The second aim was to compare the original "Venezuelan" chicken model described by Sotelo to our training model. Our training model consists of performing an anastomosis, reproducing the surgical procedure in "vivo" as in RARP, between proventriculus and the proximal portion of the esophagus. A posterior fascial reconstruction simulating Rocco's stitch is performed between the tissues located under the posterior surface of the esophagus and the tissue represented by the serosa of the proventriculus. From 2014 to 2015, during 6 different full-immersion training courses, thirty-four surgeons performed the urethrovesical anastomosis using our model and the Sotelo's one. After the training period, each surgeon was asked to fill out a non-validated questionnaire to perform an evaluation of the differences between the two training models. Our model was judged the best model, in terms of similarity with urethral tissue and similarity with the anatomic unit urethra-pelvic wall. Our training model as reported by all trainees is easily reproducible and anatomically comparable with the urethrovesical anastomosis as performed during radical prostatectomy in humans. It is suitable for performing posterior fascial reconstruction reported by Rocco. In this context, our surgical training model could be routinely proposed in all robotic training courses to develop specific expertise in urethrovesical anastomosis with the reproducibility of the Rocco stitch.

Cockpit Resource Management (CRM) training in the 1550th combat crew training wing

NASA Technical Reports Server (NTRS)

Fiedler, Michael T.

1987-01-01

The training program the 1550th Combat Crew Training Wing at Kirtland Air Force Base, New Mexico, implemented in September 1985 is discussed. The program is called Aircrew Coordination Training (ACT), and it is designed specifically to help aircrew members work more effectively as a team in their respective aircraft and hopefully to reduce human factors-related accidents. The scope of the 1550th CCTW's training responsibilities is described, the structure of the program, along with a brief look at the content of the academic part of the course. Then the Mission-Oriented Simulator Training (MOST) program is discussed; a program similar to the Line Oriented Flight Training (LOFT) programs. Finally, the future plans for the Aircrew Coordination Training Program at the 1550th is discussed.

Interpersonal Biocybernetics: Connecting Through Social Psychophysiology

NASA Technical Reports Server (NTRS)

Pope, Alan T.; Stephens, Chad L.

2012-01-01

One embodiment of biocybernetic adaptation is a human-computer interaction system designed such that physiological signals modulate the effect that control of a task by other means, usually manual control, has on performance of the task. Such a modulation system enables a variety of human-human interactions based upon physiological self-regulation performance. These interpersonal interactions may be mixes of competition and cooperation for simulation training and/or videogame entertainment

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).

The impact of leadership and team behavior on standard of care delivered during human patient simulation: a pilot study for undergraduate medical students.

PubMed

Carlson, Jim; Min, Elana; Bridges, Diane

2009-01-01

Methodology to train team behavior during simulation has received increased attention, but standard performance measures are lacking, especially at the undergraduate level. Our purposes were to develop a reliable team behavior measurement tool and explore the relationship between team behavior and the delivery of an appropriate standard of care specific to the simulated case. Authors developed a unique team measurement tool based on previous work. Trainees participated in a simulated event involving the presentation of acute dyspnea. Performance was rated by separate raters using the team behavior measurement tool. Interrater reliability was assessed. The relationship between team behavior and the standard of care delivered was explored. The instrument proved to be reliable for this case and group of raters. Team behaviors had a positive relationship with the standard of medical care delivered specific to the simulated case. The methods used provide a possible method for training and assessing team performance during simulation.

Perceptually Guided Photo Retargeting.

PubMed

Xia, Yingjie; Zhang, Luming; Hong, Richang; Nie, Liqiang; Yan, Yan; Shao, Ling

2016-04-22

We propose perceptually guided photo retargeting, which shrinks a photo by simulating a human's process of sequentially perceiving visually/semantically important regions in a photo. In particular, we first project the local features (graphlets in this paper) onto a semantic space, wherein visual cues such as global spatial layout and rough geometric context are exploited. Thereafter, a sparsity-constrained learning algorithm is derived to select semantically representative graphlets of a photo, and the selecting process can be interpreted by a path which simulates how a human actively perceives semantics in a photo. Furthermore, we learn the prior distribution of such active graphlet paths (AGPs) from training photos that are marked as esthetically pleasing by multiple users. The learned priors enforce the corresponding AGP of a retargeted photo to be maximally similar to those from the training photos. On top of the retargeting model, we further design an online learning scheme to incrementally update the model with new photos that are esthetically pleasing. The online update module makes the algorithm less dependent on the number and contents of the initial training data. Experimental results show that: 1) the proposed AGP is over 90% consistent with human gaze shifting path, as verified by the eye-tracking data, and 2) the retargeting algorithm outperforms its competitors significantly, as AGP is more indicative of photo esthetics than conventional saliency maps.

Development of a human cadaver model for training in laparoscopic donor nephrectomy.

PubMed

Sutton, Erica R H; Billeter, Adrian; Druen, Devin; Roberts, Henry; Rice, Jonathan

2017-06-01

The organ procurement network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies (LDN) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress, and efficiency in each of the major steps involved in LDN. Phase I of model development focused on the modifications necessary to maintain visualization for laparoscopic surgery in a human cadaver. Phase II tested proposed learner-based metrics of procedural competency for multiport LDN by timing procedural steps of LDN in a novice learner. Phases I and II required 12 and nine cadavers, with a total of 35 kidneys utilized. The following metrics improved with trial number for multiport LDN: time taken for dissection of the gonadal vein, ureter, renal hilum, adrenal and lumbrical veins, simulated warm ischemic time (WIT), and operative time. Human cadavers can be used for training in LDN as evidenced by improvements in timed learner-based metrics. This simulation-based model fills a gap in available training options for surgeons. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development of a neural net paradigm that predicts simulator sickness

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

Allgood, G.O.

1993-03-01

A disease exists that affects pilots and aircrew members who use Navy Operational Flight Training Systems. This malady, commonly referred to as simulator sickness and whose symptomatology closely aligns with that of motion sickness, can compromise the use of these systems because of a reduced utilization factor, negative transfer of training, and reduction in combat readiness. A report is submitted that develops an artificial neural network (ANN) and behavioral model that predicts the onset and level of simulator sickness in the pilots and aircrews who sue these systems. It is proposed that the paradigm could be implemented in real timemore » as a biofeedback monitor to reduce the risk to users of these systems. The model captures the neurophysiological impact of use (human-machine interaction) by developing a structure that maps the associative and nonassociative behavioral patterns (learned expectations) and vestibular (otolith and semicircular canals of the inner ear) and tactile interaction, derived from system acceleration profiles, onto an abstract space that predicts simulator sickness for a given training flight.« less

Human factors considerations for training astronauts to function effectively in multiple environments

NASA Technical Reports Server (NTRS)

Cohen, Malcolm M.

1991-01-01

This paper reviews some of the basic issues involved in training individuals to function appropriately under the several conditions that comprise the aerospace environment. The topic of transfer of training is examined in some detail, and the use of high-fidelity simulators in various training programs is discussed. Both current and classical techniques used to train astronauts are noted, and some relatively new and innovative training techniques and methods are described. Particularly, the paper discusses an important aspect of functioning appropriately in a given environment that is based on how well the operator calibrates his motor activity for that specific environment. The role of motor-sensory feedback for the acquisition of motor skills is discussed in the context of training.

Technical tips and advancements in pediatric minimally invasive surgical training on porcine based simulations.

PubMed

Narayanan, Sarath Kumar; Cohen, Ralph Clinton; Shun, Albert

2014-06-01

Minimal access techniques have transformed the way pediatric surgery is practiced. Due to various constraints, surgical residency programs have not been able to tutor adequate training skills in the routine setting. The advent of new technology and methods in minimally invasive surgery (MIS), has similarly contributed to the need for systematic skills' training in a safe, simulated environment. To enable the training of the proper technique among pediatric surgery trainees, we have advanced a porcine non-survival model for endoscopic surgery. The technical advancements over the past 3 years and a subjective validation of the porcine model from 114 participating trainees using a standard questionnaire and a 5-point Likert scale have been described here. Mean attitude scores and analysis of variance (ANOVA) were used for statistical analysis of the data. Almost all trainees agreed or strongly agreed that the animal-based model was appropriate (98.35%) and also acknowledged that such workshops provided adequate practical experience before attempting on human subjects (96.6%). Mean attitude score for respondents was 19.08 (SD 3.4, range 4-20). Attitude scores showed no statistical association with years of experience or the level of seniority, indicating a positive attitude among all groups of respondents. Structured porcine-based MIS training should be an integral part of skill acquisition for pediatric surgery trainees and the experience gained can be transferred into clinical practice. We advocate that laparoscopic training should begin in a controlled workshop setting before procedures are attempted on human patients.

Establishment of Next-Generation Neurosurgery Research and Training Laboratory with Integrated Human Performance Monitoring.

PubMed

Bernardo, Antonio

2017-10-01

Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. Until recently, few means have allowed surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory designed to recreate the setting of a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Virtual reality as a tool for cross-cultural communication: an example from military team training

NASA Astrophysics Data System (ADS)

Downes-Martin, Stephen; Long, Mark; Alexander, Joanna R.

1992-06-01

A major problem with communication across cultures, whether professional or national, is that simple language translation if often insufficient to communicate the concepts. This is especially true when the communicators come from highly specialized fields of knowledge or from national cultures with long histories of divergence. This problem becomes critical when the goal of the communication is national negotiation dealing with such high risk items as arms negotiation or trade wars. Virtual Reality technology has considerable potential for facilitating communication across cultures, by immersing the communicators within multiple visual representations of the concepts, and providing control over those representations. Military distributed team training provides a model for virtual reality suitable for cross cultural communication such as negotiation. In both team training and negotiation, the participants must cooperate, agree on a set of goals, and achieve mastery over the concepts being negotiated. Team training technologies suitable for supporting cross cultural negotiation exist (branch wargaming, computer image generation and visualization, distributed simulation), and have developed along different lines than traditional virtual reality technology. Team training de-emphasizes the realism of physiological interfaces between the human and the virtual reality, and emphasizes the interaction of humans with each other and with intelligent simulated agents within the virtual reality. This approach to virtual reality is suggested as being more fruitful for future work.

Modeling and Simulation for Safeguards and Nonproliferation Workshop

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

Gilligan, Kimberly V.; Kirk, Bernadette Lugue

2015-01-01

The Modeling and Simulation for Safeguards and Nonproliferation Workshop was held December 15–18, 2014, at Oak Ridge National Laboratory. This workshop was made possible by the Next Generation Safeguards Initiative Human Capital Development (NGSI HCD) Program. The idea of the workshop was to move beyond the tried-and-true boot camp training of nonproliferation concepts to spend several days on the unique perspective of applying modeling and simulation (M&S) solutions to safeguards challenges.

Verification and validation of a patient simulator for test and evaluation of a laser doppler vibrometer

NASA Astrophysics Data System (ADS)

Byrd, Kenneth A.; Yauger, Sunny

2012-06-01

In the medical community, patient simulators are used to educate and train nurses, medics and doctors in rendering dierent levels of treatment and care to various patient populations. Students have the opportunity to perform real-world medical procedures without putting any patients at risk. A new thrust for the U.S. Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD), is the use of remote sensing technologies to detect human vital signs at stando distances. This capability will provide medics with the ability to diagnose while under re in addition to helping them to prioritize the care and evacuation of battleeld casualties. A potential alternative (or precursor) to human subject testing is the use of patient simulators. This substitution (or augmenting) provides a safe and cost eective means to develop, test, and evaluate sensors without putting any human subjects at risk. In this paper, we present a generalized framework that can be used to accredit patient simulator technologies as human simulants for remote physiological monitoring (RPM). Results indicate that we were successful in using a commercial Laser Doppler Vibrometer (LDV) to exploit pulse and respiration signals from a SimMan 3G patient simulator at stando (8 meters).

A learning-based autonomous driver: emulate human driver's intelligence in low-speed car following

NASA Astrophysics Data System (ADS)

Wei, Junqing; Dolan, John M.; Litkouhi, Bakhtiar

2010-04-01

In this paper, an offline learning mechanism based on the genetic algorithm is proposed for autonomous vehicles to emulate human driver behaviors. The autonomous driving ability is implemented based on a Prediction- and Cost function-Based algorithm (PCB). PCB is designed to emulate a human driver's decision process, which is modeled as traffic scenario prediction and evaluation. This paper focuses on using a learning algorithm to optimize PCB with very limited training data, so that PCB can have the ability to predict and evaluate traffic scenarios similarly to human drivers. 80 seconds of human driving data was collected in low-speed (< 30miles/h) car-following scenarios. In the low-speed car-following tests, PCB was able to perform more human-like carfollowing after learning. A more general 120 kilometer-long simulation showed that PCB performs robustly even in scenarios that are not part of the training set.

Development of a low-cost virtual reality workstation for training and education

NASA Technical Reports Server (NTRS)

Phillips, James A.

1996-01-01

Virtual Reality (VR) is a set of breakthrough technologies that allow a human being to enter and fully experience a 3-dimensional, computer simulated environment. A true virtual reality experience meets three criteria: (1) it involves 3-dimensional computer graphics; (2) it includes real-time feedback and response to user actions; and (3) it must provide a sense of immersion. Good examples of a virtual reality simulator are the flight simulators used by all branches of the military to train pilots for combat in high performance jet fighters. The fidelity of such simulators is extremely high -- but so is the price tag, typically millions of dollars. Virtual reality teaching and training methods are manifestly effective, but the high cost of VR technology has limited its practical application to fields with big budgets, such as military combat simulation, commercial pilot training, and certain projects within the space program. However, in the last year there has been a revolution in the cost of VR technology. The speed of inexpensive personal computers has increased dramatically, especially with the introduction of the Pentium processor and the PCI bus for IBM-compatibles, and the cost of high-quality virtual reality peripherals has plummeted. The result is that many public schools, colleges, and universities can afford a PC-based workstation capable of running immersive virtual reality applications. My goal this summer was to assemble and evaluate such a system.

A virtual reality based simulator for learning nasogastric tube placement.

PubMed

Choi, Kup-Sze; He, Xuejian; Chiang, Vico Chung-Lim; Deng, Zhaohong

2015-02-01

Nasogastric tube (NGT) placement is a common clinical procedure where a plastic tube is inserted into the stomach through the nostril for feeding or drainage. However, the placement is a blind process in which the tube may be mistakenly inserted into other locations, leading to unexpected complications or fatal incidents. The placement techniques are conventionally acquired by practising on unrealistic rubber mannequins or on humans. In this paper, a virtual reality based training simulation system is proposed to facilitate the training of NGT placement. It focuses on the simulation of tube insertion and the rendering of the feedback forces with a haptic device. A hybrid force model is developed to compute the forces analytically or numerically under different conditions, including the situations when the patient is swallowing or when the tube is buckled at the nostril. To ensure real-time interactive simulations, an offline simulation approach is adopted to obtain the relationship between the insertion depth and insertion force using a non-linear finite element method. The offline dataset is then used to generate real-time feedback forces by interpolation. The virtual training process is logged quantitatively with metrics that can be used for assessing objective performance and tracking progress. The system has been evaluated by nursing professionals. They found that the haptic feeling produced by the simulated forces is similar to their experience during real NGT insertion. The proposed system provides a new educational tool to enhance conventional training in NGT placement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development of an educational simulator system, ECCSIM-Lite, for the acquisition of basic perfusion techniques and evaluation.

PubMed

Ninomiya, Shinji; Tokumine, Asako; Yasuda, Toru; Tomizawa, Yasuko

2007-01-01

A training system with quantitative evaluation of performance for training perfusionists is valuable for preparation for rare but critical situations. A simulator system, ECCSIM-Lite, for extracorporeal circulation (ECC) training of perfusionists was developed. This system consists of a computer system containing a simulation program of the hemodynamic conditions and the training scenario with instructions, a flow sensor unit, a reservoir with a built-in water level sensor, and an ECC circuit with a soft bag representing the human body. This system is relatively simple, easy to handle, compact, and reasonably inexpensive. Quantitative information is recorded, including the changes in arterial flow by the manipulation of a knob, the changes in venous drainage by handling a clamp, and the change in reservoir level; the time courses of the above parameters are presented graphically. To increase the realism of the training, a numerical-hydraulic circulatory model was applied. Following the instruction and explanation of the scenario in the form of audio and video captions, it is possible for a trainee to undertake self-study without an instructor or a computer operator. To validate the system, a training session was given to three beginners using a simple training scenario; it was possible to record the performance of the perfusion sessions quantitatively. In conclusion, the ECCSIM-Lite system is expected to be useful for perfusion training, since quantitative information about the trainee's performance is recorded and it is possible to use the data for assessment and comparison.

Anthropogenic and technogenic factors of operational risk at hazardous industrial objects of fuel-power complex

NASA Astrophysics Data System (ADS)

Magid, S. I.; Arkhipova, E. N.; Kulichikhin, V. V.; Zagretdinov, I. Sh.

2016-12-01

Technogenic and anthropogenic accidence at hazardous industrial objects (HIO) in the Russian Federation has been considered. The accidence level at HIO, including power plants and network enterprises, is determined by anthropogenic reasons, so-called "human factor", in 70% of all cases. The analysis of incidents caused by personnel has shown that errors occur most often during accidental situations, launches, holdups, routine switches, and other effects on equipment controls. It has been demonstrated that skills needed to perform type and routine switches can be learned, to certain limits, on real operating equipment, while combating emergency and accidental situations can be learned only with the help of modern training simulators developed based on information technologies. Problems arising during the following processes have been considered: development of mathematical and software support of modern training equipment associated, in one way or another, with adequate power-generating object modeling in accordance with human operator specifics; modeling and/or simulation of the corresponding control and management systems; organization of the education system (functional supply of the instructor, education and methodological resources (EMR)); organization of the program-technical, scalable and adaptable, platform for modeling of the main and secondary functions of the training simulator. It has been concluded that the systemic approach principle on the necessity and sufficiency in the applied methodology allows to reproduce all technological characteristics of the equipment, its topological completeness, as well as to achieve the acceptable counting rate. The initial "rough" models of processes in the equipment are based on the normative techniques and equation coefficients taken from the normative materials as well. Then, the synthesis of "fine" models has been carried out following the global practice in modeling and training simulator building, i.e., verification of "rough" models based on experimental data available to the developer. Finally, the last stage of modeling is adaptation (validation) of "fine" models to the prototype object using experimental data on the power-generating object and tests of these models with operating and maintaining personnel. These stages determine adequacy of the used mathematical model for a particular training simulator and, thus, its compliance with such modern scientific criteria as objectivity and experimental verifiability.

The role of simulation in the development of technical competence during surgical training: a literature review

PubMed Central

2013-01-01

Objectives To establish the current state of knowledge on the effect of surgical simulation on the development of technical competence during surgical training. Methods Using a defined search strategy, the medical and educational literature was searched to identify empirical research that uses simulation as an educational intervention with surgical trainees. Included studies were analysed according to guidelines adapted from a Best Evidence in Medical Education review. Results A total of 32 studies were analysed, across 5 main categories of surgical simulation technique - use of bench models and box trainers (9 studies); Virtual Reality (14 studies); human cadavers (4 studies); animal models (2 studies) and robotics (3 studies). An improvement in technical skill was seen within the simulated environment across all five categories. This improvement was seen to transfer to the real patient in the operating room in all categories except the use of animals. Conclusions Based on current evidence, surgical trainees should be confident in the effects of using simulation, and should have access to formal, structured simulation as part of their training. Surgical simulation should incorporate the use of bench models and box trainers, with the use of Virtual Reality where resources allow. Alternatives to cadaveric and animal models should be considered due to the ethical and moral issues surrounding their use, and due to their equivalency with other simulation techniques. However, any use of surgical simulation must be tailored to the individual needs of trainees, and should be accompanied by feedback from expert tutors.

Simulation training for geriatric medicine.

PubMed

Mehdi, Zehra; Ross, Alastair; Reedy, Gabriel; Roots, Angela; Ernst, Thomas; Jaye, Peter; Birns, Jonathan

2014-08-01

Geriatric medicine encompasses a diverse nature of medical, social and ethical challenges, and requires a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of the elderly, and it is therefore vital that specialist trainees in geriatric medicine are afforded opportunities to develop their skills in managing this complex patient population. Simulation has been widely adopted as a teaching tool in medicine; however, its use in geriatric medicine to date has involved primarily role-play or discrete clinical skills training. This article outlines the development of a bespoke, multimodal, simulation course for specialist trainees in geriatric medicine. A 1-day multimodal and interprofessional simulation course was created specifically for specialist trainees in geriatric medicine, using six curriculum-mapped scenarios in which the patient perspective was central to the teaching objectives. Various simulation techniques were used, including high-fidelity human patient manikins, patient actors, with integrated clinical skills using part-task trainers, and role-play exercises. Debriefs by trained faculty members were completed after each scenario. Twenty-six candidates attended four similar courses in 2012. Quantitative analysis of pre- and post-course questionnaires revealed an improvement of self-reported confidence in managing geriatric scenarios (Z = 4.1; p < 0.001), and thematic analysis of candidate feedback was supportive of simulation as a useful teaching tool, with reported benefits for both technical and non-technical skills. Simulation is an exciting and novel method of delivering teaching for specialist trainees in geriatric medicine. This teaching modality could be integrated into the training curriculum for geriatric medicine, to allow a wider application. © 2014 John Wiley & Sons Ltd.

Broadening the interface bandwidth in simulation based training

NASA Technical Reports Server (NTRS)

Somers, Larry E.

1989-01-01

Currently most computer based simulations rely exclusively on computer generated graphics to create the simulation. When training is involved, the method almost exclusively used to display information to the learner is text displayed on the cathode ray tube. MICROEXPERT Systems is concentrating on broadening the communications bandwidth between the computer and user by employing a novel approach to video image storage combined with sound and voice output. An expert system is used to combine and control the presentation of analog video, sound, and voice output with computer based graphics and text. Researchers are currently involved in the development of several graphics based user interfaces for NASA, the U.S. Army, and the U.S. Navy. Here, the focus is on the human factors considerations, software modules, and hardware components being used to develop these interfaces.

NY TBO Research: Integrated Demand Management (IDM): IDM Concept, Tools, and Training Package

NASA Technical Reports Server (NTRS)

Smith, Nancy

2016-01-01

A series of human-in-the-loop simulation sessions were conducted in the Airspace Operations Laboratory (AOL) to evaluate a new traffic management concept called Integrated Demand Management (IDM). The simulation explored how to address chronic equity, throughput and delay issues associated with New Yorks high-volume airports by operationally integrating three current and NextGen capabilities the Collaborative Trajectory Options Program (CTOP), Time-Based Flow Management (TBFM) and Required Time of Arrival (RTA) in order to better manage traffic demand within the National Air Traffic System. A package of presentation slides was developed to describe the concept, tools, and training materials used in the simulation sessions. The package will be used to outbrief our stakeholders by both presenting orally and disseminating of the materials via email.

In-vehicle group activity modeling and simulation in sensor-based virtual environment

NASA Astrophysics Data System (ADS)

Shirkhodaie, Amir; Telagamsetti, Durga; Poshtyar, Azin; Chan, Alex; Hu, Shuowen

2016-05-01

Human group activity recognition is a very complex and challenging task, especially for Partially Observable Group Activities (POGA) that occur in confined spaces with limited visual observability and often under severe occultation. In this paper, we present IRIS Virtual Environment Simulation Model (VESM) for the modeling and simulation of dynamic POGA. More specifically, we address sensor-based modeling and simulation of a specific category of POGA, called In-Vehicle Group Activities (IVGA). In VESM, human-alike animated characters, called humanoids, are employed to simulate complex in-vehicle group activities within the confined space of a modeled vehicle. Each articulated humanoid is kinematically modeled with comparable physical attributes and appearances that are linkable to its human counterpart. Each humanoid exhibits harmonious full-body motion - simulating human-like gestures and postures, facial impressions, and hands motions for coordinated dexterity. VESM facilitates the creation of interactive scenarios consisting of multiple humanoids with different personalities and intentions, which are capable of performing complicated human activities within the confined space inside a typical vehicle. In this paper, we demonstrate the efficiency and effectiveness of VESM in terms of its capabilities to seamlessly generate time-synchronized, multi-source, and correlated imagery datasets of IVGA, which are useful for the training and testing of multi-source full-motion video processing and annotation. Furthermore, we demonstrate full-motion video processing of such simulated scenarios under different operational contextual constraints.

An Interprofessional Course Using Human Patient Simulation to Teach Patient Safety and Teamwork Skills

PubMed Central

McCulloh, Russell; Dyer, Carla; Gregory, Gretchen; Higbee, Dena

2012-01-01

Objectives. To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students. Design. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards. Assessment. Pharmacy students’ scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students’ scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication. Conclusions. Simulation training provided an opportunity to improve pharmacy students’ ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills. PMID:22611280

Air Force Research Laboratory Warfighter Readiness Research Division Participation in the 2008 IITSEC

DTIC Science & Technology

2008-12-15

of the underlying behaviors that led to each element being cited. The AFSC Human Factors Database listed all human factors cited in the Life...situations of increased pressure. Through an understanding of the causal factors of human behavior , and by analysis of one’s own behavioral patterns...JTAC training and overall lessons learned from modeling and simulation of the JTAC environment to include behavior scripting, artillery models

Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized educational trial.

PubMed

Oestergaard, Jeanett; Bjerrum, Flemming; Maagaard, Mathilde; Winkel, Per; Larsen, Christian Rifbjerg; Ringsted, Charlotte; Gluud, Christian; Grantcharov, Teodor; Ottesen, Bent; Soerensen, Jette Led

2012-02-28

Several studies have found a positive effect on the learning curve as well as the improvement of basic psychomotor skills in the operating room after virtual reality training. Despite this, the majority of surgical and gynecological departments encounter hurdles when implementing this form of training. This is mainly due to lack of knowledge concerning the time and human resources needed to train novice surgeons to an adequate level. The purpose of this trial is to investigate the impact of instructor feedback regarding time, repetitions and self-perception when training complex operational tasks on a virtual reality simulator. The study population consists of medical students on their 4th to 6th year without prior laparoscopic experience. The study is conducted in a skills laboratory at a centralized university hospital. Based on a sample size estimation 98 participants will be randomized to an intervention group or a control group. Both groups have to achieve a predefined proficiency level when conducting a laparoscopic salpingectomy using a surgical virtual reality simulator. The intervention group receives standardized instructor feedback of 10 to 12 min a maximum of three times. The control group receives no instructor feedback. Both groups receive the automated feedback generated by the virtual reality simulator. The study follows the CONSORT Statement for randomized trials. Main outcome measures are time and repetitions to reach the predefined proficiency level on the simulator. We include focus on potential sex differences, computer gaming experience and self-perception. The findings will contribute to a better understanding of optimal training methods in surgical education. NCT01497782.

Virtual physiological human: training challenges.

PubMed

Lawford, Patricia V; Narracott, Andrew V; McCormack, Keith; Bisbal, Jesus; Martin, Carlos; Bijnens, Bart; Brook, Bindi; Zachariou, Margarita; Freixa, Jordi Villà I; Kohl, Peter; Fletcher, Katherine; Diaz-Zuccarini, Vanessa

2010-06-28

The virtual physiological human (VPH) initiative encompasses a wide range of activities, including structural and functional imaging, data mining, knowledge discovery tool and database development, biomedical modelling, simulation and visualization. The VPH community is developing from a multitude of relatively focused, but disparate, research endeavours into an integrated effort to bring together, develop and translate emerging technologies for application, from academia to industry and medicine. This process initially builds on the evolution of multi-disciplinary interactions and abilities, but addressing the challenges associated with the implementation of the VPH will require, in the very near future, a translation of quantitative changes into a new quality of highly trained multi-disciplinary personnel. Current strategies for undergraduate and on-the-job training may soon prove insufficient for this. The European Commission seventh framework VPH network of excellence is exploring this emerging need, and is developing a framework of novel training initiatives to address the predicted shortfall in suitably skilled VPH-aware professionals. This paper reports first steps in the implementation of a coherent VPH training portfolio.

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.

A comparative analysis and guide to virtual reality robotic surgical simulators.

PubMed

Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia; Truong, Mireille; Perez, Manuela; Smith, Roger

2018-02-01

Since the US Food and Drug Administration approved robotically assisted surgical devices for human surgery in 2000, the number of surgeries utilizing this innovative technology has risen. In 2015, approximately 650 000 robot-assisted procedures were performed worldwide. Surgeons must be properly trained to safely transition to using such innovative technology. Multiple virtual reality robotic simulators are now commercially available for educational and training purposes. There is a need for comparative evaluations of these simulators to aid users in selecting an appropriate device for their purposes. We conducted a comparison of the design and capabilities of all dedicated simulators of the da Vinci robot - the da Vinci Skills Simulator (dVSS), dV-Trainer (dVT), Robotic Skills Simulators (RoSS) and the RobotiX Mentor. This paper provides the base specifications of the hardware and software, with an emphasis on the training capabilities of each system. Each simulator contains a large number of training exercises for skills development: dVSS n = 40, dVT n = 65, RoSS n = 52, RobotiX Mentor n = 31. All four offer 3D visual images but use different display technologies. The dVSS leverages the real robotic surgical console to provide visualization, hand controls and foot pedals. The dVT, RoSS and RobotiX Mentor created simulated versions of all of these control systems. Each includes systems management services that allow instructors to collect, export and analyze the scores of students using the simulators. This study provides comparative information on the four simulators' functional capabilities. Each device offers unique advantages and capabilities for training robotic surgeons. Each has been the subject of validation experiments, which have been published in the literature. But those do not provide specific details on the capabilities of the simulators, which are necessary for an understanding sufficient to select the one best suited for an organization's needs. This article provides comparative information to assist with that type of selection. Copyright © 2017 John Wiley & Sons, Ltd.

Emergency manual implementation: can brief simulation-based or staff trainings increase familiarity and planned clinical use?

PubMed

Goldhaber-Fiebert, Sara N; Lei, Vivian; Nandagopal, Kiruthiga; Bereknyei, Sylvia

2015-05-01

Emergency manuals (EMs)-context-relevant sets of cognitive aids such as crisis checklists-are useful tools to enhance perioperative patient care. Studies in high-hazard industries demonstrate that humans, regardless of expertise, do not optimally retrieve or deploy key knowledge under stress. EM use has been shown in both health care simulation studies and other industries to help expert teams effectively manage critical events. However, clinical adoption and use are still nascent in health care. Recognizing that training with, access to, and cultural acceptance of EMs can be vital elements for successful implementation, this study assessed the impact of a brief in situ operating room (OR) staff training program on familiarity with EMs and intention to use them during critical events. Nine 50-minute training sessions were held with OR staff as part of a broader perioperative EM implementation. Participants primarily included OR nurses and surgical technologists. The simulation-based in situ trainings included why and how to use EMs, familiarization with format, simulated scenarios of critical events, and debriefings. A retrospective pre-post survey was conducted to determine participants' levels of EM familiarity and intentions to use EMs clinically. The 126 trained OR staff self-reported increases in awareness of the EM (p < .01), familiarity with EM (p < .01), willingness to use for educational review (p < .01), and intention to use during critical events (p < .01). Participants rated the sessions highly and expressed interest in more opportunities to practice using EMs. Implementing institutions should not only provide EMs in accessible places in ORs but also incorporate training mechanisms to increase clinicians' familiarity, cultural acceptance, and planned clinical use.

[Thinking on the Training of Uniportal Video-assisted Thoracic Surgery].

PubMed

Zhu, Yuming; Jiang, Gening

2018-04-20

Recently, uniportal video-assisted thoracic surgery (VATS) has developed rapidly and has become the main theme of global surgical development. The specific, standardized and systematic training of this technology has become an important topic. Specific training in the uniportal VATS approach is crucial to ensure safety and radical treatment. Such training approach, including a direct interaction with experienced surgeons in high-volume centers, is crucial and represents an indispensable step. Another form of training that usually occurs after preceptorship is proctorship: an experienced mentor can be invited to a trainee's own center to provide specific on-site tutelage. Videos published online are commonly used as training material. Technology has allowed the use of different models of simulators for training. The most common model is the use of animal wet laboratory training. Other models, however, have been used mostrecently, such as the use of 3D and VR Technology, virtual reality simulators, and completely artificial models of the human thorax with synthetic lung, vessel, airway, and nodal tissues. A short-duration, high-volume, clinical immersion training, and a long term systematic training in high-volume centers are getting more and more attention. According to the evaluation of students' grading, a diversified training mode is adopted and the targeted training in accordance with different students helps to improve the training effect. We have done some work in systematic and standardized training of uniportal VATS in single center. We believe such training is feasible and absolutely necessary.

The Final Count Down: A Review of Three Decades of Flight Controller Training Methods for Space Shuttle Mission Operations

NASA Technical Reports Server (NTRS)

Dittermore, Gary; Bertels, Christie

2011-01-01

Operations of human spaceflight systems is extremely complex; therefore, the training and certification of operations personnel is a critical piece of ensuring mission success. Mission Control Center (MCC-H), at the Lyndon B. Johnson Space Center in Houston, Texas, manages mission operations for the Space Shuttle Program, including the training and certification of the astronauts and flight control teams. An overview of a flight control team s makeup and responsibilities during a flight, and details on how those teams are trained and certified, reveals that while the training methodology for developing flight controllers has evolved significantly over the last thirty years the core goals and competencies have remained the same. In addition, the facilities and tools used in the control center have evolved. Changes in methodology and tools have been driven by many factors, including lessons learned, technology, shuttle accidents, shifts in risk posture, and generational differences. Flight controllers share their experiences in training and operating the space shuttle. The primary training method throughout the program has been mission simulations of the orbit, ascent, and entry phases, to truly train like you fly. A review of lessons learned from flight controller training suggests how they could be applied to future human spaceflight endeavors, including missions to the moon or to Mars. The lessons learned from operating the space shuttle for over thirty years will help the space industry build the next human transport space vehicle.

Clinical Outcome Metrics for Optimization of Robust Training

NASA Technical Reports Server (NTRS)

Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M.; Reyes, D.; Young, M.

2016-01-01

Introduction: The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capability's (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-Flight Medical Capabilities." Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes. Methods: Medical simulations will systematically compare success of individual diagnostic and therapeutic procedure simulations performed by physician and non-physician crew medical officer (CMO) analogs using clearly defined short-term (individual procedure) outcome metrics. In the subsequent step of the project, the procedure simulation outcomes will be used as input to a modified version of the NASA Integrated Medical Model (IMM) to analyze the effect of the outcome (degree of success) of individual procedures (including successful, imperfectly performed, and failed procedures) on overall long-term clinical outcomes and the consequent mission impacts. The procedures to be simulated are endotracheal intubation, fundoscopic examination, kidney/urinary ultrasound, ultrasound-guided intravenous catheter insertion, and a differential diagnosis exercise. Multiple assessment techniques will be used, centered on medical procedure simulation studies occurring at 3, 6, and 12 months after initial training (as depicted in the following flow diagram of the experiment design). Discussion: Analysis of procedure outcomes in the physician and non-physician groups and their subsets (tested at different elapsed times post training) will allow the team to 1) define differences between physician and non-physician CMOs in terms of both procedure performance (pre-IMM analysis) and overall mitigation of the mission medical impact (IMM analysis); 2) refine the procedure outcome and clinical outcome metrics themselves; 3) refine or develop innovative medical training products and solutions to maximize CMO performance; and 4) validate the methods and products of this experiment for operational use in the planning, execution, and quality assurance of the CMO training process The team has finalized training protocols and developed a software training/testing tool in collaboration with Butler Graphics (Detroit, MI). In addition to the "hands on" medical procedure modules, the software includes a differential diagnosis exercise (limited clinical decision support tool) to evaluate the diagnostic skills of participants. Human subject testing will occur over the next year.

Preview information in cab displays for high-speed locomotives.

DOT National Transportation Integrated Search

2005-07-31

This research examined the usefulness of preview information in the control of high-speed trains. Experiments were run on a human-in-the-loop locomotive simulator. The primary goal was to examine whether the proposed information-aiding displays impro...

Preview information in cab displays for high-speed locomotives

DOT National Transportation Integrated Search

2005-07-01

This research examined the usefulness of preview information in the control of high-speed trains. Experiments were run on a : human-in-the-loop locomotive simulator. The primary goal was to examine whether the proposed information-aiding displays : i...

Virtual Laparoscopic Training System Based on VCH Model.

PubMed

Tang, Jiangzhou; Xu, Lang; He, Longjun; Guan, Songluan; Ming, Xing; Liu, Qian

2017-04-01

Laparoscopy has been widely used to perform abdominal surgeries, as it is advantageous in that the patients experience lower post-surgical trauma, shorter convalescence, and less pain as compared to traditional surgery. Laparoscopic surgeries require precision; therefore, it is imperative to train surgeons to reduce the risk of operation. Laparoscopic simulators offer a highly realistic surgical environment by using virtual reality technology, and it can improve the training efficiency of laparoscopic surgery. This paper presents a virtual Laparoscopic surgery system. The proposed system utilizes the Visible Chinese Human (VCH) to construct the virtual models and simulates real-time deformation with both improved special mass-spring model and morph target animation. Meanwhile, an external device that integrates two five-degrees-of-freedom (5-DOF) manipulators was designed and made to interact with the virtual system. In addition, the proposed system provides a modular tool based on Unity3D to define the functions and features of instruments and organs, which could help users to build surgical training scenarios quickly. The proposed virtual laparoscopic training system offers two kinds of training mode, skills training and surgery training. In the skills training mode, the surgeons are mainly trained for basic operations, such as laparoscopic camera, needle, grasp, electric coagulation, and suturing. In the surgery-training mode, the surgeons can practice cholecystectomy and removal of hepatic cysts by guided or non-guided teaching.

C-STARS Baltimore Simulation Center Military Trauma Training Program: Training for High Performance Trauma Teams

DTIC Science & Technology

2013-09-19

for October 2010 to September 2013 Air Force Research Laboratory 711th Human Performance Wing School of Aerospace Medicine Air Force...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) USAF School of Aerospace Medicine Air Force Expeditionary Medical Skills...Patient denies any performance enhancers or herbal use. BP – 110/68, P 124, R –28 shallow, and sweating from exercise. Patient states he never

Comprehensive simulation-enhanced training curriculum for an advanced minimally invasive procedure: a randomized controlled trial.

PubMed

Zevin, Boris; Dedy, Nicolas J; Bonrath, Esther M; Grantcharov, Teodor P

2017-05-01

There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure. 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group. University. This prospective single-blinded, randomized, controlled trial allocated 20 intermediate-level surgery residents to receive either conventional training (control) or SET curriculum training (intervention). The SET curriculum consisted of cognitive, psychomotor, and nontechnical training modules. Psychomotor skills in a live anesthetized porcine model in the OR was the primary outcome. Knowledge of advanced minimally invasive and bariatric surgery and nontechnical skills in a simulated OR crisis scenario were the secondary outcomes. Residents in the SET curriculum group went on to perform a laparoscopic jejunojejunostomy in the OR. Cognitive, psychomotor, and nontechnical skills of SET curriculum group were also compared to a group of 12 chief surgery residents. SET curriculum group demonstrated superior psychomotor skills in a live porcine model (56 [47-62] versus 44 [38-53], P<.05) and superior nontechnical skills (41 [38-45] versus 31 [24-40], P<.01) compared with conventional training group. SET curriculum group and conventional training group demonstrated equivalent knowledge (14 [12-15] versus 13 [11-15], P = 0.47). SET curriculum group demonstrated equivalent psychomotor skills in the live porcine model and in the OR in a human patient (56 [47-62] versus 63 [61-68]; P = .21). SET curriculum group demonstrated inferior knowledge (13 [11-15] versus 16 [14-16]; P<.05), equivalent psychomotor skill (63 [61-68] versus 68 [62-74]; P = .50), and superior nontechnical skills (41 [38-45] versus 34 [27-35], P<.01) compared with chief resident group. Completion of the SET curriculum resulted in superior training outcomes, compared with conventional surgery training. Implementation of the SET curriculum can standardize training for an advanced minimally invasive procedure and can ensure that comprehensive proficiency milestones are met before exposure to patient care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Human Machine Interfaces for Teleoperators and Virtual Environments Conference

NASA Technical Reports Server (NTRS)

1990-01-01

In a teleoperator system the human operator senses, moves within, and operates upon a remote or hazardous environment by means of a slave mechanism (a mechanism often referred to as a teleoperator). In a virtual environment system the interactive human machine interface is retained but the slave mechanism and its environment are replaced by a computer simulation. Video is replaced by computer graphics. The auditory and force sensations imparted to the human operator are similarly computer generated. In contrast to a teleoperator system, where the purpose is to extend the operator's sensorimotor system in a manner that facilitates exploration and manipulation of the physical environment, in a virtual environment system, the purpose is to train, inform, alter, or study the human operator to modify the state of the computer and the information environment. A major application in which the human operator is the target is that of flight simulation. Although flight simulators have been around for more than a decade, they had little impact outside aviation presumably because the application was so specialized and so expensive.

SimLife a new model of simulation using a pulsated revascularized and reventilated cadaver for surgical education.

PubMed

Delpech, P O; Danion, J; Oriot, D; Richer, J P; Breque, C; Faure, J P

2017-02-01

Alike becoming a pilot requires competences, acquisition of technical skills is essential to become a surgeon. Halsted's theory on surgical education "See one, do one, and teach one" is not currently compatible with the reality of socio-economic constraints of the operating room, the patient's safety demand and the reduction of residents' work hours. In all countries, this brings mandatory to simulation education for surgery resident's training. Many models are available: video trainers or pelvi-trainers, computed simulator, animal models or human cadaver… Human cadaveric dissection has long been used to teach surgical anatomy. Surgery on human cadaveric model brings greatest accuracy to the haptic characteristics of surgical procedures. Learning in an appropriate and realistic simulation context increases the level of acquisition of the residents' skills and reduces stress and anxiety when performing real procedures. We present a technique of perfusion and ventilation of a fresh human cadaver that restores pulsatile circulation and respiratory movements of the model. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A low-cost, durable, combined ultrasound and fluoroscopic phantom for cervical transforaminal injections.

PubMed

Lerman, Imanuel R; Souzdalnitski, Dmitri; Narouze, Samer

2012-01-01

This technical report describes a durable, low-cost, anatomically accurate, and easy-to-prepare combined ultrasound (US) and fluoroscopic phantom of the cervical spine. This phantom is meant to augment training in US- and fluoroscopic-guided pain medicine procedures. The combined US and fluoroscopic phantom (CUF-P) is prepared from commercially available liquid plastic that is ordinarily used to prepare synthetic fishing lures. The liquid plastic is heated and then poured into a metal canister that houses an anatomical cervical spine model. Drops of dark purple dye are added to make the phantom opaque. After cooling, tubing is attached to the CUF-P to simulate blood vessels. The CUF-P accurately simulates human tissue by imitating both the tactile texture of skin and the haptic resistance of human tissue as the needle is advanced. This phantom contains simulated fluid-filled vertebral arteries that exhibit pulsed flow under color Doppler US. Under fluoroscopic examination, the CUF-P-simulated vertebral arteries also exhibit uptake of contrast dye if mistakenly injected. The creation of a training phantom allows the pain physician to practice needle positioning technique while simultaneously visualizing both targeted and avoidable vascular structures under US and fluoroscopic guidance. This low-cost CUF-P is easy to prepare and is reusable, making it an attractive alternative to current homemade and commercially available phantom simulators.

Human-machine interface issues in the use of helmet-mounted displays in short conjugate simulators

NASA Astrophysics Data System (ADS)

Melzer, James E.

2011-06-01

With the introduction of helmet-mounted displays (HMD) into modern aircraft, there is a desire on the part of pilot trainees to achieve a "look and feel" for the simulation environment similar to the real flight hardware. Given this requirement for high fidelity, it may be necessary to configure - or to perhaps re-configure - the HMD for a short conjugate viewing distance and to do so without causing eye strain or other adverse physiological effects. This paper will survey the human factors literature and provide an analysis on the visual construct issues of focus and vergence which - if not properly configured for the short conjugate simulator - could cause adverse effects, which can negatively affect training.

Study of physiological responses to acute carbon monoxide exposure with a human patient simulator.

PubMed

Cesari, Whitney A; Caruso, Dominique M; Zyka, Enela L; Schroff, Stuart T; Evans, Charles H; Hyatt, Jon-Philippe K

2006-12-01

Human patient simulators are widely used to train health professionals and students in a clinical setting, but they also can be used to enhance physiology education in a laboratory setting. Our course incorporates the human patient simulator for experiential learning in which undergraduate university juniors and seniors are instructed to design, conduct, and present (orally and in written form) their project testing physiological adaptation to an extreme environment. This article is a student report on the physiological response to acute carbon monoxide exposure in a simulated healthy adult male and a coal miner and represents how 1) human patient simulators can be used in a nonclinical way for experiential hypothesis testing; 2) students can transition from traditional textbook learning to practical application of their knowledge; and 3) student-initiated group investigation drives critical thought. While the course instructors remain available for consultation throughout the project, the relatively unstructured framework of the assignment drives the students to create an experiment independently, troubleshoot problems, and interpret the results. The only stipulation of the project is that the students must generate an experiment that is physiologically realistic and that requires them to search out and incorporate appropriate data from primary scientific literature. In this context, the human patient simulator is a viable educational tool for teaching integrative physiology in a laboratory environment by bridging textual information with experiential investigation.

3D force/torque characterization of emergency cricothyroidotomy procedure using an instrumented scalpel.

PubMed

Ryason, Adam; Sankaranarayanan, Ganesh; Butler, Kathryn L; DeMoya, Marc; De, Suvranu

2016-08-01

Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface. We then group individual surgical cuts based on style of cut and cut medium and perform a regression analysis to create two models that allow us to predict the style of cut performed and the cut medium.

Testing and evaluation for astronaut extravehicular activity (EVA) operability.

PubMed

Shields, N; King, L C

1998-09-01

Because it is the human component that defines space mission success, careful planning is required to ensure that hardware can be operated and maintained by crews on-orbit. Several methods exist to allow researchers and designers to better predict how hardware designs will behave under the harsh environment of low Earth orbit, and whether designs incorporate the necessary features for Extra Vehicular Activity (EVA) operability. Testing under conditions of simulated microgravity can occur during the design concept phase when verifying design operability, during mission training, or concurrently with on-orbit mission operations. The bulk of testing is focused on normal operations, but also includes evaluation of credible mission contingencies or "what would happen if" planning. The astronauts and cosmonauts who fly these space missions are well prepared and trained to survive and be productive in Earth's orbit. The engineers, designers, and training crews involved in space missions subject themselves to Earth based simulation techniques that also expose them to extreme environments. Aircraft falling ten thousand feet, alternating g-loads, underwater testing at 45 foot depth, enclosure in a vacuum chamber and subject to thermal extremes, each carries with it inherent risks to the humans preparing for space missions.

Human voluntary activity integration in the control of a standing-up rehabilitation robot: a simulation study.

PubMed

Kamnik, Roman; Bajd, Tadej

2007-11-01

The paper presents a novel control approach for the robot-assisted motion augmentation of disabled subjects during the standing-up manoeuvre. The main goal of the proposal is to integrate the voluntary activity of a person in the control scheme of the rehabilitation robot. The algorithm determines the supportive force to be tracked by a robot force controller. The basic idea behind the calculation of supportive force is to quantify the deficit in the dynamic equilibrium of the trunk. The proposed algorithm was implemented as a Kalman filter procedure and evaluated in a simulation environment. The simulation results proved the adequate and robust performance of "patient-driven" robot-assisted standing-up training. In addition, the possibility of varying the training conditions with different degrees of the subject's initiative is demonstrated.

Neural Network Development Tool (NETS)

NASA Technical Reports Server (NTRS)

Baffes, Paul T.

1990-01-01

Artificial neural networks formed from hundreds or thousands of simulated neurons, connected in manner similar to that in human brain. Such network models learning behavior. Using NETS involves translating problem to be solved into input/output pairs, designing network configuration, and training network. Written in C.

Current concepts in simulation-based trauma education.

PubMed

Cherry, Robert A; Ali, Jameel

2008-11-01

The use of simulation-based technology in trauma education has focused on providing a safe and effective alternative to the more traditional methods that are used to teach technical skills and critical concepts in trauma resuscitation. Trauma team training using simulation-based technology is also being used to develop skills in leadership, team-information sharing, communication, and decision-making. The integration of simulators into medical student curriculum, residency training, and continuing medical education has been strongly recommended by the American College of Surgeons as an innovative means of enhancing patient safety, reducing medical errors, and performing a systematic evaluation of various competencies. Advanced human patient simulators are increasingly being used in trauma as an evaluation tool to assess clinical performance and to teach and reinforce essential knowledge, skills, and abilities. A number of specialty simulators in trauma and critical care have also been designed to meet these educational objectives. Ongoing educational research is still needed to validate long-term retention of knowledge and skills, provide reliable methods to evaluate teaching effectiveness and performance, and to demonstrate improvement in patient safety and overall quality of care.

The effects of mobile applications in cardiopulmonary assessment education.

PubMed

Yoo, In-Young; Lee, Young-Mi

2015-02-01

Mobile applications can be used as effective simulations for nursing education. However, little is known regarding the effects of mobile application-mediated training on nursing. The aim of this study was to determine the effectiveness of mobile applications by comparing the effectiveness of a high-fidelity human patient simulator to that of a mobile application on student learning. Following lectures on the lungs and the heart, twenty-two students were separated into two groups to perform a simulation exercise. Then, the students' education effects were evaluated based on their knowledge of lung and heart assessments, their clinical assessment skill, and satisfaction with their education. After four weeks, the mobile application group maintained their knowledge, whereas the high-fidelity human patient simulator group exhibited significantly decreased knowledge of the lung assessment. Knowledge of the heart assessment was significantly increased in both groups. There was no significant difference in clinical assessment skill or educational satisfaction between the groups. We found that mobile applications provide educational tools similarly effective to a high-fidelity human patient simulator to maintain memory and to teach cardiopulmonary assessment skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

How learning might strengthen existing visual object representations in human object-selective cortex.

PubMed

Brants, Marijke; Bulthé, Jessica; Daniels, Nicky; Wagemans, Johan; Op de Beeck, Hans P

2016-02-15

Visual object perception is an important function in primates which can be fine-tuned by experience, even in adults. Which factors determine the regions and the neurons that are modified by learning is still unclear. Recently, it was proposed that the exact cortical focus and distribution of learning effects might depend upon the pre-learning mapping of relevant functional properties and how this mapping determines the informativeness of neural units for the stimuli and the task to be learned. From this hypothesis we would expect that visual experience would strengthen the pre-learning distributed functional map of the relevant distinctive object properties. Here we present a first test of this prediction in twelve human subjects who were trained in object categorization and differentiation, preceded and followed by a functional magnetic resonance imaging session. Specifically, training increased the distributed multi-voxel pattern information for trained object distinctions in object-selective cortex, resulting in a generalization from pre-training multi-voxel activity patterns to after-training activity patterns. Simulations show that the increased selectivity combined with the inter-session generalization is consistent with a training-induced strengthening of a pre-existing selectivity map. No training-related neural changes were detected in other regions. In sum, training to categorize or individuate objects strengthened pre-existing representations in human object-selective cortex, providing a first indication that the neuroanatomical distribution of learning effects depends upon the pre-learning mapping of visual object properties. Copyright © 2015 Elsevier Inc. All rights reserved.

Reinforcement Learning with Autonomous Small Unmanned Aerial Vehicles in Cluttered Environments

NASA Technical Reports Server (NTRS)

Tran, Loc; Cross, Charles; Montague, Gilbert; Motter, Mark; Neilan, James; Qualls, Garry; Rothhaar, Paul; Trujillo, Anna; Allen, B. Danette

2015-01-01

We present ongoing work in the Autonomy Incubator at NASA Langley Research Center (LaRC) exploring the efficacy of a data set aggregation approach to reinforcement learning for small unmanned aerial vehicle (sUAV) flight in dense and cluttered environments with reactive obstacle avoidance. The goal is to learn an autonomous flight model using training experiences from a human piloting a sUAV around static obstacles. The training approach uses video data from a forward-facing camera that records the human pilot's flight. Various computer vision based features are extracted from the video relating to edge and gradient information. The recorded human-controlled inputs are used to train an autonomous control model that correlates the extracted feature vector to a yaw command. As part of the reinforcement learning approach, the autonomous control model is iteratively updated with feedback from a human agent who corrects undesired model output. This data driven approach to autonomous obstacle avoidance is explored for simulated forest environments furthering autonomous flight under the tree canopy research. This enables flight in previously inaccessible environments which are of interest to NASA researchers in Earth and Atmospheric sciences.

Ultrasound-Guided Vascular Access Simulator for Medical Training: Proposal of a Simple, Economic and Effective Model.

PubMed

Fürst, Rafael Vilhena de Carvalho; Polimanti, Afonso César; Galego, Sidnei José; Bicudo, Maria Claudia; Montagna, Erik; Corrêa, João Antônio

2017-03-01

To present a simple and affordable model able to properly simulate an ultrasound-guided venous access. The simulation was made using a latex balloon tube filled with water and dye solution implanted in a thawed chicken breast with bones. The presented model allows the simulation of all implant stages of a central catheter. The obtained echogenicity is similar to that observed in human tissue, and the ultrasound identification of the tissues, balloon, needle, wire guide and catheter is feasible and reproducible. The proposed model is simple, economical, easy to manufacture and capable of realistically and effectively simulating an ultrasound-guided venous access.

Effects of auditory radio interference on a fine, continuous, open motor skill.

PubMed

Lazar, J M; Koceja, D M; Morris, H H

1995-06-01

The effects of human speech on a fine, continuous, and open motor skill were examined. A tape of auditory human radio traffic was injected into a tank gunnery simulator during each training session for 4 wk. of training for 3 hr. a week. The dependent variables were identification time, fire time, kill time, systems errors, and acquisition errors. These were measured by the Unit Conduct Of Fire Trainer (UCOFT). The interference was interjected into the UCOFT Tank Table VIII gunnery test. A Solomon four-group design was used. A 2 x 2 analysis of variance was used to assess whether interference gunnery training resulted in improvements in interference posttest scores. During the first three weeks of training, the interference group committed 106% more systems errors and 75% more acquisition errors than the standard group. The interference training condition was associated with a significant improvement from pre- to posttest of 44% in over-all UCOFT scores; however, when examined on the posttest the standard training did not improve performance significantly over the same period. It was concluded that auditory radio interference degrades performance of this fine, continuous, open motor skill, and interference training appears to abate the effects of this degradation.

Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized educational trial

PubMed Central

2012-01-01

Abstract Background Several studies have found a positive effect on the learning curve as well as the improvement of basic psychomotor skills in the operating room after virtual reality training. Despite this, the majority of surgical and gynecological departments encounter hurdles when implementing this form of training. This is mainly due to lack of knowledge concerning the time and human resources needed to train novice surgeons to an adequate level. The purpose of this trial is to investigate the impact of instructor feedback regarding time, repetitions and self-perception when training complex operational tasks on a virtual reality simulator. Methods/Design The study population consists of medical students on their 4th to 6th year without prior laparoscopic experience. The study is conducted in a skills laboratory at a centralized university hospital. Based on a sample size estimation 98 participants will be randomized to an intervention group or a control group. Both groups have to achieve a predefined proficiency level when conducting a laparoscopic salpingectomy using a surgical virtual reality simulator. The intervention group receives standardized instructor feedback of 10 to 12 min a maximum of three times. The control group receives no instructor feedback. Both groups receive the automated feedback generated by the virtual reality simulator. The study follows the CONSORT Statement for randomized trials. Main outcome measures are time and repetitions to reach the predefined proficiency level on the simulator. We include focus on potential sex differences, computer gaming experience and self-perception. Discussion The findings will contribute to a better understanding of optimal training methods in surgical education. Trial Registration NCT01497782 PMID:22373062

Could simulated emergency procedures practised in a static environment improve the clinical performance of a Critical Care Air Support Team (CCAST)? A literature review.

PubMed

Lamb, Di

2007-02-01

The Royal Air Force Critical Care Air Support Teams (CCASTs) have a philosophy to undertake transfers of critically ill patients from anywhere in the world back to a UK medical facility in a stable or improved clinical condition. The training they receive is primarily taught by traditional didactic methods, with no standardisation of education between teams that are expected to deliver care to the same standard. Notwithstanding there being no current compromise to patient care during air transfer, it was important to consider the benefits of an alternative experiential teaching modality. Experiential learning utilised in the static environment could potentially improve the current CCAST training curriculum and, therefore, improve clinical performance during air transfer. In the absence of primary research evidence investigating beneficial teaching modalities for medical flight crews, a review of recent literature was undertaken to observe any potential relevance to the aeromedical specialty. This critical review examined recent quantitative research on various modalities of experiential learning and their influence on the critical thinking, higher cognitive and psychomotor skill acquisition by healthcare professionals in a static hospital environment. The main databases were interrogated using the following inclusion criteria: patient simulation, clinical competence, aeromedical, education, computer simulation, critical thinking and problem-based learning. The number of articles obtained was 13; these were coded on methodological strength to reduce the potential for inclusion bias. Nine studies were finally selected for review. Many small studies have been undertaken, primarily observing benefits of experiential learning to medical students and doctors. No studies show conclusively that simulated learning improves patient outcome, but the body of evidence suggests human patient simulators to be advantageous over other modalities because of their realistic recreation of critical events. They have proven to be at least as effective as traditional teaching by didactic methods. For CCASTs to have a standardised training curriculum, they should undertake real-time missions in a flight simulator, supported by a human patient simulator programmed to respond to the physiological changes associated with altitude. Real scenarios could then be practised, on demand, in a safe environment as an augmentation to the current training programme. Consequently, those acquired skills could then be carried out with improved proficiency during real missions with a concomitant potential for improvement in the standard of patient care.

Transfer of training and simulator qualification or myth and folklore in helicopter simulation

NASA Technical Reports Server (NTRS)

Dohme, Jack

1992-01-01

Transfer of training studies at Fort Rucker using the backward-transfer paradigm have shown that existing flight simulators are not entirely adequate for meeting training requirements. Using an ab initio training research simulator, a simulation of the UH-1, training effectiveness ratios were developed. The data demonstrate it to be a cost-effective primary trainer. A simulator qualification method was suggested in which a combination of these transfer-of-training paradigms is used to determine overall simulator fidelity and training effectiveness.

Actively learning human gaze shifting paths for semantics-aware photo cropping.

PubMed

Zhang, Luming; Gao, Yue; Ji, Rongrong; Xia, Yingjie; Dai, Qionghai; Li, Xuelong

2014-05-01

Photo cropping is a widely used tool in printing industry, photography, and cinematography. Conventional cropping models suffer from the following three challenges. First, the deemphasized role of semantic contents that are many times more important than low-level features in photo aesthetics. Second, the absence of a sequential ordering in the existing models. In contrast, humans look at semantically important regions sequentially when viewing a photo. Third, the difficulty of leveraging inputs from multiple users. Experience from multiple users is particularly critical in cropping as photo assessment is quite a subjective task. To address these challenges, this paper proposes semantics-aware photo cropping, which crops a photo by simulating the process of humans sequentially perceiving semantically important regions of a photo. We first project the local features (graphlets in this paper) onto the semantic space, which is constructed based on the category information of the training photos. An efficient learning algorithm is then derived to sequentially select semantically representative graphlets of a photo, and the selecting process can be interpreted by a path, which simulates humans actively perceiving semantics in a photo. Furthermore, we learn a prior distribution of such active graphlet paths from training photos that are marked as aesthetically pleasing by multiple users. The learned priors enforce the corresponding active graphlet path of a test photo to be maximally similar to those from the training photos. Experimental results show that: 1) the active graphlet path accurately predicts human gaze shifting, and thus is more indicative for photo aesthetics than conventional saliency maps and 2) the cropped photos produced by our approach outperform its competitors in both qualitative and quantitative comparisons.

Cardiovascular correlates of emotional state, cognitive workload and time-on-task effect during a realistic flight simulation.

PubMed

Hidalgo-Muñoz, Antonio R; Mouratille, Damien; Matton, Nadine; Causse, Mickaël; Rouillard, Yves; El-Yagoubi, Radouane

2018-04-05

In aviation, emotion and cognitive workload can considerably increase the probability of human error. An accurate online physiological monitoring of pilot's mental state could prevent accidents. The heart rate (HR) and heart rate variability (HRV) of 21 private pilots were analysed during two realistic flight simulator scenarios. Emotion was manipulated by a social stressor and cognitive workload with the difficulty of a secondary task. Our results confirmed the sensitivity of the HR to cognitive demand and training effects, with increased HR when the task was more difficult and decreased HR with training (time-on-task). Training was also associated with an increased HRV, with increased values along the flight scenario time course. Finally, the social stressor seemed to provoke an emotional reaction that enhanced motivation and performance on the secondary task. However, this was not reflected by the cardiovascular activity. Copyright © 2018 Elsevier B.V. All rights reserved.

Error Detection-Based Model to Assess Educational Outcomes in Crisis Resource Management Training: A Pilot Study.

PubMed

Bouhabel, Sarah; Kay-Rivest, Emily; Nhan, Carol; Bank, Ilana; Nugus, Peter; Fisher, Rachel; Nguyen, Lily Hp

2017-06-01

Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors. Some examples of CRM principles include cultivating situational awareness; promoting proper use of available resources; and improving rapid decision making, particularly in high-acuity, low-frequency clinical situations. Our pilot project sought to integrate CRM principles into an airway simulation course for OTL-HNS residents, but most important, it evaluated whether learning objectives were met, through use of a novel error identification model.

Remarks to Eighth Annual State of Modeling and Simulation

DTIC Science & Technology

1999-06-04

organization, training as well as materiel Discovery vice Verification Tolerance for Surprise Free play Red Team Iterative Process Push to failure...Account for responsive & innovative future adversaries – free play , adaptive strategies and tactics by professional red teams • Address C2 issues & human

Human Factors Research in Aircrew Performance and Training

DTIC Science & Technology

1986-11-01

enable performance elements to be introduced at random times. More complex decision rules were needed to provide the necessary degree of realism in... cinematic simulation in which the students experience the practical application of the principles they are taught. The exercises begin with a preflight

Cognitive/emotional models for human behavior representation in 3D avatar simulations

NASA Astrophysics Data System (ADS)

Peterson, James K.

2004-08-01

Simplified models of human cognition and emotional response are presented which are based on models of auditory/ visual polymodal fusion. At the core of these models is a computational model of Area 37 of the temporal cortex which is based on new isocortex models presented recently by Grossberg. These models are trained using carefully chosen auditory (musical sequences), visual (paintings) and higher level abstract (meta level) data obtained from studies of how optimization strategies are chosen in response to outside managerial inputs. The software modules developed are then used as inputs to character generation codes in standard 3D virtual world simulations. The auditory and visual training data also enable the development of simple music and painting composition generators which significantly enhance one's ability to validate the cognitive model. The cognitive models are handled as interacting software agents implemented as CORBA objects to allow the use of multiple language coding choices (C++, Java, Python etc) and efficient use of legacy code.

Emerging CAE technologies and their role in Future Ambient Intelligence Environments

NASA Astrophysics Data System (ADS)

Noor, Ahmed K.

2011-03-01

Dramatic improvements are on the horizon in Computer Aided Engineering (CAE) and various simulation technologies. The improvements are due, in part, to the developments in a number of leading-edge technologies and their synergistic combinations/convergence. The technologies include ubiquitous, cloud, and petascale computing; ultra high-bandwidth networks, pervasive wireless communication; knowledge based engineering; networked immersive virtual environments and virtual worlds; novel human-computer interfaces; and powerful game engines and facilities. This paper describes the frontiers and emerging simulation technologies, and their role in the future virtual product creation and learning/training environments. The environments will be ambient intelligence environments, incorporating a synergistic combination of novel agent-supported visual simulations (with cognitive learning and understanding abilities); immersive 3D virtual world facilities; development chain management systems and facilities (incorporating a synergistic combination of intelligent engineering and management tools); nontraditional methods; intelligent, multimodal and human-like interfaces; and mobile wireless devices. The Virtual product creation environment will significantly enhance the productivity and will stimulate creativity and innovation in future global virtual collaborative enterprises. The facilities in the learning/training environment will provide timely, engaging, personalized/collaborative and tailored visual learning.

A new beating-heart off-pump coronary artery bypass grafting training model.

PubMed

Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E; Koene, Bart M; Erasmus, Michiel E; Natour, Ehsan; Mariani, Massimo A

2015-01-01

Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. Human cadavers were embalmed according to the 'Thiel method' which allows their long-term and repeated use. The training model was constructed by bilateral ligation of the pulmonary veins, cross-clamping of the aorta, positioning of an intra-aortic balloon pump (IABP) in the left ventricle (LV) through the apex (tightened with pledget-reinforced purse strings) and finally placing of a fluid line in the LV through the left atrial appendage (tightened with a pledget-reinforced purse string). The LV was filled with saline to the desired pressure through the fluid line and the IABP was switched on and set to a desired frequency [usually 60-80 beats per minute (bpm)]. A high-fidelity simulation has known limitations, but a more complex, realistic training environment with an actual beating (human) heart strengthens the entire training exercise and is of incremental value. All types of coronary artery anastomosis can be trained with this model. Training should be performed under the supervision of an experienced OPCAB surgeon and training progress is best evaluated with serial Objective Structured Assessment of Technical Skills (OSATS). A score of at least 48 points on the final OSATS ('good' on all components) is recommended before trainees can start their training on patients. The entire set-up provides a versatile training model to help develop and improve the skills required to safely perform beating heart OPCAB anastomoses. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Computer-automated opponent for manned air-to-air combat simulations

NASA Technical Reports Server (NTRS)

Hankins, W. W., III

1979-01-01

Two versions of a real-time digital-computer program that operates a fighter airplane interactively against a human pilot in simulated air combat were evaluated. They function by replacing one of two pilots in the Langley differential maneuvering simulator. Both versions make maneuvering decisions from identical information and logic; they differ essentially in the aerodynamic models that they control. One is very complete, but the other is much simpler, primarily characterizing the airplane's performance (lift, drag, and thrust). Both models competed extremely well against highly trained U.S. fighter pilots.

A university teaching simulation facility

NASA Technical Reports Server (NTRS)

Stark, Lawrence; Kim, Won-Soo; Tendick, Frank; Tyler, Mitchell; Hannaford, Blake; Barakat, Wissam; Bergengruen, Olaf; Braddi, Louis; Eisenberg, Joseph; Ellis, Stephen

1987-01-01

An experimental telerobotics (TR) simulation is described suitable for studying human operator (HO) performance. Simple manipulator pick-and-place and tracking tasks allowed quantitative comparison of a number of calligraphic display viewing conditions. A number of control modes could be compared in this TR simulation, including displacement, rate, and acceleratory control using position and force joysticks. A homeomorphic controller turned out to be no better than joysticks; the adaptive properties of the HO can apparently permit quite good control over a variety of controller configurations and control modes. Training by optimal control example seemed helpful in preliminary experiments.

Flight Simulator and Training Human Factors Validation

NASA Technical Reports Server (NTRS)

Glaser, Scott T.; Leland, Richard

2009-01-01

Loss of control has been identified as the leading cause of aircraft accidents in recent years. Efforts have been made to better equip pilots to deal with these types of events, commonly referred to as upsets. A major challenge in these endeavors has been recreating the motion environments found in flight as the majority of upsets take place well beyond the normal operating envelope of large aircraft. The Environmental Tectonics Corporation has developed a simulator motion base, called GYROLAB, that is capable of recreating the sustained accelerations, or G-forces, and motions of flight. A two part research study was accomplished that coupled NASA's Generic Transport Model with a GYROLAB device. The goal of the study was to characterize physiological effects of the upset environment and to demonstrate that a sustained motion based simulator can be an effective means for upset recovery training. Two groups of 25 Air Transport Pilots participated in the study. The results showed reliable signs of pilot arousal at specific stages of similar upsets. Further validation also demonstrated that sustained motion technology was successful in improving pilot performance during recovery following an extensive training program using GYROLAB technology.

A perspective on the role and utility of haptic feedback in laparoscopic skills training.

PubMed

Singapogu, Ravikiran; Burg, Timothy; Burg, Karen J L; Smith, Dane E; Eckenrode, Amanda H

2014-01-01

Laparoscopic surgery is a minimally invasive surgical technique with significant potential benefits to the patient, including shorter recovery time, less scarring, and decreased costs. There is a growing need to teach surgical trainees this emerging surgical technique. Simulators, ranging from simple "box" trainers to complex virtual reality (VR) trainers, have emerged as the most promising method for teaching basic laparoscopic surgical skills. Current box trainers require oversight from an expert surgeon for both training and assessing skills. VR trainers decrease the dependence on expert teachers during training by providing objective, real-time feedback and automatic skills evaluation. However, current VR trainers generally have limited credibility as a means to prepare new surgeons and have often fallen short of educators' expectations. Several researchers have speculated that the missing component in modern VR trainers is haptic feedback, which refers to the range of touch sensations encountered during surgery. These force types and ranges need to be adequately rendered by simulators for a more complete training experience. This article presents a perspective of the role and utility of haptic feedback during laparoscopic surgery and laparoscopic skills training by detailing the ranges and types of haptic sensations felt by the operating surgeon, along with quantitative studies of how this feedback is used. Further, a number of research studies that have documented human performance effects as a result of the presence of haptic feedback are critically reviewed. Finally, key research directions in using haptic feedback for laparoscopy training simulators are identified.

Human Factors in Aviation Maintenance. Phase 3. Volume 2. Progress Report

DTIC Science & Technology

1994-07-01

computer-simulated NDI eddy-current task developed by Dr. Colin G. Drury and his colleagues at the State University of New York (SUNY) at Buffalo. The task...to lower cost and increase performance ............... 28 Figure 3.2 Comparison of development and delivery costs for CBT and traditional training...Active Female Aircraft Mechanics. . 110 Figure 5.1 NDI Inspection Task Simulation ( Drury et al., 1992) ............... 147 Figure 5.2 Mean Misses and

Human Behavior Representation in Constructive Simulation (La representation du comportement humain dans la simulation constructive)

DTIC Science & Technology

2009-09-01

Environmental Medicine USN United States Navy VAE Virtual Air Environment VACP Visual, Auditory, Cognitive, Psychomotor (demand) VR Virtual Reality ...0 .5 m/s. Another useful approach to capturing leg, trunk, whole body, or movement tasks comes from virtual reality - based training research and...referred to as semi-automated forces (SAF). From: http://www.sedris.org/glossary.htm#C_grp. Constructive Models Abstractions from the reality to

A review of flight simulation techniques

NASA Astrophysics Data System (ADS)

Baarspul, Max

After a brief historical review of the evolution of flight simulation techniques, this paper first deals with the main areas of flight simulator applications. Next, it describes the main components of a piloted flight simulator. Because of the presence of the pilot-in-the-loop, the digital computer driving the simulator must solve the aircraft equations of motion in ‘real-time’. Solutions to meet the high required computer power of todays modern flight simulator are elaborated. The physical similarity between aircraft and simulator in cockpit layout, flight instruments, flying controls etc., is discussed, based on the equipment and environmental cue fidelity required for training and research simulators. Visual systems play an increasingly important role in piloted flight simulation. The visual systems now available and most widely used are described, where image generators and display devices will be distinguished. The characteristics of out-of-the-window visual simulation systems pertaining to the perceptual capabilities of human vision are discussed. Faithful reproduction of aircraft motion requires large travel, velocity and acceleration capabilities of the motion system. Different types and applications of motion systems in e.g. airline training and research are described. The principles of motion cue generation, based on the characteristics of the non-visual human motion sensors, are described. The complete motion system, consisting of the hardware and the motion drive software, is discussed. The principles of mathematical modelling of the aerodynamic, flight control, propulsion, landing gear and environmental characteristics of the aircraft are reviewed. An example of the identification of an aircraft mathematical model, based on flight and taxi tests, is presented. Finally, the paper deals with the hardware and software integration of the flight simulator components and the testing and acceptance of the complete flight simulator. Examples of the so-called ‘Computer Generated Checkout’ and ‘Proof of Match’ are presented. The concluding remarks briefly summarize the status of flight simulator technology and consider possibilities for future research.

Classification of EMG signals using artificial neural networks for virtual hand prosthesis control.

PubMed

Mattioli, Fernando E R; Lamounier, Edgard A; Cardoso, Alexandre; Soares, Alcimar B; Andrade, Adriano O

2011-01-01

Computer-based training systems have been widely studied in the field of human rehabilitation. In health applications, Virtual Reality presents itself as an appropriate tool to simulate training environments without exposing the patients to risks. In particular, virtual prosthetic devices have been used to reduce the great mental effort needed by patients fitted with myoelectric prosthesis, during the training stage. In this paper, the application of Virtual Reality in a hand prosthesis training system is presented. To achieve this, the possibility of exploring Neural Networks in a real-time classification system is discussed. The classification technique used in this work resulted in a 95% success rate when discriminating 4 different hand movements.

Human Behaviour in Long-Term Missions

NASA Technical Reports Server (NTRS)

1997-01-01

In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

Confrontation (A Human Relations Training Unit and Simulation Game for Teacher and Administrators in a Multi-Ethnic Elementary and High School). Description of Teacher Inservice Education Materials.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Project on Utilization of Inservice Education R & D Outcomes.

The inservice teacher and administrator education program described here is intended to make teachers aware of the problems they may encounter in a multicultural, multiethnic school setting. The inservice topic is human relations, with the subject of black/white confrontation the main focus. This descriptive report provides additional information…

Laparoscopic skills acquisition: a study of simulation and traditional training.

PubMed

Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy J

2014-12-01

Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment. A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared. A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used. The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills. © 2013 Royal Australasian College of Surgeons.

Training model for control of an internal carotid artery injury during transsphenoidal surgery.

PubMed

Muto, Jun; Carrau, Ricardo L; Oyama, Kenichi; Otto, Brad A; Prevedello, Daniel M

2017-01-01

As the adoption of endoscopic endonasal approaches (EEA) continues to proliferate, increasing numbers of internal carotid artery (ICA) injuries are reported. The objective of this study was to develop a synthetic ICA injury-training model that could mimic this clinical scenario and be portable, repeatable, reproducible, and without risk of biological contamination. Based on computed tomography of a human head, we constructed a synthetic model using selective laser sintering with polyamide nylon and glass beads. Subsequently, the model was connected to a pulsatile pump using 6-mm silicon tubing. The pump maintains a pulsatile flow of an artificial blood-like fluid at a variable pressure to simulate heart beats. Volunteer surgeons with different levels of training and experience were provided simulation training sessions with the models. Pre- and posttraining questionnaires were completed by each of the participants. Pre- and posttraining questionnaires suggest that repeated simulation sessions improve the surgical skills and self-confidence of trainees. This ICA injury model is portable; reproducible; and avoids ethical, biohazard, religious, and legal problems associated with cadaveric models. A synthetic ICA injury model for EEA allows recurring training that may improve the surgeon's ability to maintain endoscopic visualization, control catastrophic bleeding, decrease psychomotor stress, and develop effective team strategies to achieve hemostasis. NA Laryngoscope, 127:38-43, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Technology and medicine: the evolution of virtual reality simulation in laparoscopic training.

PubMed

Bashir, Gareth

2010-01-01

Virtual reality (VR) simulation for laparoscopic surgical training is now a reality. There is increasing evidence that the use of VR simulation is a powerful adjunct to traditional surgical apprenticeship in the current climate of reduced time spent in training. This article reviews the early evidence supporting the case for VR simulation training in laparoscopic surgery. A standard literature search was conducted using the following phrases--'virtual reality in surgical training', 'surgical training', 'laparoscopic training' and 'simulation in surgical training'. This article outlines the early evidence which supports the use of VR simulation in laparoscopic training and the need for further research into this new training technique.

Echo simulator with novel training and competency testing tools.

PubMed

Sheehan, Florence H; Otto, Catherine M; Freeman, Rosario V

2013-01-01

We developed and validated an echo simulator with three novel tools that facilitate training and enable quantitative and objective measurement of psychomotor as well as cognitive skill. First, the trainee can see original patient images - not synthetic or simulated images - that morph in real time as the mock transducer is manipulated on the mannequin. Second, augmented reality is used for Visual Guidance, a tool that assists the trainee in scanning by displaying the target organ in 3-dimensions (3D) together with the location of the current view plane and the plane of the anatomically correct view. Third, we introduce Image Matching, a tool that leverages the aptitude of the human brain for recognizing similarities and differences to help trainees learn to perform visual assessment of ultrasound images. Psychomotor competence is measured in terms of the view plane angle error. The construct validity of the simulator for competency testing was established by demonstrating its ability to discriminate novices vs. experts.

Basic models modeling resistance training: an update for basic scientists interested in study skeletal muscle hypertrophy.

PubMed

Cholewa, Jason; Guimarães-Ferreira, Lucas; da Silva Teixeira, Tamiris; Naimo, Marshall Alan; Zhi, Xia; de Sá, Rafaele Bis Dal Ponte; Lodetti, Alice; Cardozo, Mayara Quadros; Zanchi, Nelo Eidy

2014-09-01

Human muscle hypertrophy brought about by voluntary exercise in laboratorial conditions is the most common way to study resistance exercise training, especially because of its reliability, stimulus control and easy application to resistance training exercise sessions at fitness centers. However, because of the complexity of blood factors and organs involved, invasive data is difficult to obtain in human exercise training studies due to the integration of several organs, including adipose tissue, liver, brain and skeletal muscle. In contrast, studying skeletal muscle remodeling in animal models are easier to perform as the organs can be easily obtained after euthanasia; however, not all models of resistance training in animals displays a robust capacity to hypertrophy the desired muscle. Moreover, some models of resistance training rely on voluntary effort, which complicates the results observed when animal models are employed since voluntary capacity is something theoretically impossible to measure in rodents. With this information in mind, we will review the modalities used to simulate resistance training in animals in order to present to investigators the benefits and risks of different animal models capable to provoke skeletal muscle hypertrophy. Our second objective is to help investigators analyze and select the experimental resistance training model that best promotes the research question and desired endpoints. © 2013 Wiley Periodicals, Inc.

Objective measures of situation awareness in a simulated medical environment

PubMed Central

Wright, M; Taekman, J; Endsley, M

2004-01-01

One major limitation in the use of human patient simulators is a lack of objective, validated measures of human performance. Objective measures are necessary if simulators are to be used to evaluate the skills and training of medical practitioners and teams or to evaluate the impact of new processes or equipment design on overall system performance. Situation awareness (SA) refers to a person's perception and understanding of their dynamic environment. This awareness and comprehension is critical in making correct decisions that ultimately lead to correct actions in medical care settings. An objective measure of SA may be more sensitive and diagnostic than traditional performance measures. This paper reviews a theory of SA and discusses the methods required for developing an objective measure of SA within the context of a simulated medical environment. Analysis and interpretation of SA data for both individual and team performance in health care are also presented. PMID:15465958

Toward a definition of teamwork in emergency medicine.

PubMed

Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

2008-11-01

The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.

Wall Shear Stress Distribution in a Patient-Specific Cerebral Aneurysm Model using Reduced Order Modeling

NASA Astrophysics Data System (ADS)

Han, Suyue; Chang, Gary Han; Schirmer, Clemens; Modarres-Sadeghi, Yahya

2016-11-01

We construct a reduced-order model (ROM) to study the Wall Shear Stress (WSS) distributions in image-based patient-specific aneurysms models. The magnitude of WSS has been shown to be a critical factor in growth and rupture of human aneurysms. We start the process by running a training case using Computational Fluid Dynamics (CFD) simulation with time-varying flow parameters, such that these parameters cover the range of parameters of interest. The method of snapshot Proper Orthogonal Decomposition (POD) is utilized to construct the reduced-order bases using the training CFD simulation. The resulting ROM enables us to study the flow patterns and the WSS distributions over a range of system parameters computationally very efficiently with a relatively small number of modes. This enables comprehensive analysis of the model system across a range of physiological conditions without the need to re-compute the simulation for small changes in the system parameters.

Using virtual reality technology for aircraft visual inspection training: presence and comparison studies.

PubMed

Vora, Jeenal; Nair, Santosh; Gramopadhye, Anand K; Duchowski, Andrew T; Melloy, Brian J; Kanki, Barbara

2002-11-01

The aircraft maintenance industry is a complex system consisting of several interrelated human and machine components. Recognizing this, the Federal Aviation Administration (FAA) has pursued human factors related research. In the maintenance arena the research has focused on the aircraft inspection process and the aircraft inspector. Training has been identified as the primary intervention strategy to improve the quality and reliability of aircraft inspection. If training is to be successful, it is critical that we provide aircraft inspectors with appropriate training tools and environment. In response to this need, the paper outlines the development of a virtual reality (VR) system for aircraft inspection training. VR has generated much excitement but little formal proof that it is useful. However, since VR interfaces are difficult and expensive to build, the computer graphics community needs to be able to predict which applications will benefit from VR. To address this important issue, this research measured the degree of immersion and presence felt by subjects in a virtual environment simulator. Specifically, it conducted two controlled studies using the VR system developed for visual inspection task of an aft-cargo bay at the VR Lab of Clemson University. Beyond assembling the visual inspection virtual environment, a significant goal of this project was to explore subjective presence as it affects task performance. The results of this study indicated that the system scored high on the issues related to the degree of presence felt by the subjects. As a next logical step, this study, then, compared VR to an existing PC-based aircraft inspection simulator. The results showed that the VR system was better and preferred over the PC-based training tool.

The effect of self-directed virtual reality simulation on dissection training performance in mastoidectomy.

PubMed

Andersen, Steven Arild Wuyts; Foghsgaard, Søren; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

2016-08-01

To establish the effect of self-directed virtual reality (VR) simulation training on cadaveric dissection training performance in mastoidectomy and the transferability of skills acquired in VR simulation training to the cadaveric dissection training setting. Prospective study. Two cohorts of 20 novice otorhinolaryngology residents received either self-directed VR simulation training before cadaveric dissection training or vice versa. Cadaveric and VR simulation performances were assessed using final-product analysis with three blinded expert raters. The group receiving VR simulation training before cadaveric dissection had a mean final-product score of 14.9 (95 % confidence interval [CI] [12.9-16.9]) compared with 9.8 (95% CI [8.4-11.1]) in the group not receiving VR simulation training before cadaveric dissection. This 52% increase in performance was statistically significantly (P < 0.0001). A single dissection mastoidectomy did not increase VR simulation performance (P = 0.22). Two hours of self-directed VR simulation training was effective in increasing cadaveric dissection mastoidectomy performance and suggests that mastoidectomy skills are transferable from VR simulation to the traditional dissection setting. Virtual reality simulation training can therefore be employed to optimize training, and can spare the use of donated material and instructional resources for more advanced training after basic competencies have been acquired in the VR simulation environment. NA. Laryngoscope, 126:1883-1888, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

14 CFR 121.409 - Training courses using airplane simulators and other training devices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Training courses using airplane simulators... Program § 121.409 Training courses using airplane simulators and other training devices. (a) Training courses utilizing airplane simulators and other training devices may be included in the certificate holder...

14 CFR 121.409 - Training courses using airplane simulators and other training devices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Training courses using airplane simulators... Program § 121.409 Training courses using airplane simulators and other training devices. (a) Training courses utilizing airplane simulators and other training devices may be included in the certificate holder...

14 CFR 121.409 - Training courses using airplane simulators and other training devices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Training courses using airplane simulators... Program § 121.409 Training courses using airplane simulators and other training devices. (a) Training courses utilizing airplane simulators and other training devices may be included in the certificate holder...

14 CFR 121.409 - Training courses using airplane simulators and other training devices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training courses using airplane simulators... Program § 121.409 Training courses using airplane simulators and other training devices. (a) Training courses utilizing airplane simulators and other training devices may be included in the certificate holder...

Astronaut Training in the Neutral Buoyancy Simulator

NASA Technical Reports Server (NTRS)

1993-01-01

This photograph shows an STS-61 astronaut training for the Hubble Space Telescope (HST) servicing mission (STS-61) in the Marshall Space Flight Center's (MSFC's) Neutral Buoyancy Simulator (NBS). Two months after its deployment in space, scientists detected a 2-micron spherical aberration in the primary mirror of the HST that affected the telescope's ability to focus faint light sources into a precise point. This imperfection was very slight, one-fiftieth of the width of a human hair. A scheduled Space Service servicing mission (STS-61) in 1993 permitted scientists to correct the problem. The MSFC NBS provided an excellent environment for testing hardware to examine how it would operate in space and for evaluating techniques for space construction and spacecraft servicing.

Crisis Resources for Emergency Workers (CREW II): results of a pilot study and simulation-based crisis resource management course for emergency medicine residents.

PubMed

Hicks, Christopher M; Kiss, Alex; Bandiera, Glen W; Denny, Christopher J

2012-11-01

Emergency department resuscitation requires the coordinated efforts of an interdisciplinary team. Aviation-based crisis resource management (CRM) training can improve safety and performance during complex events. We describe the development, piloting, and multilevel evaluation of "Crisis Resources for Emergency Workers" (CREW), a simulation-based CRM curriculum for emergency medicine (EM) residents. Curriculum development was informed by an a priori needs assessment survey. We constructed a 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Attitudinal shifts regarding team behaviours were assessed using the Human Factors Attitude Survey (HFAS). A subset of 10 residents participated in standardized pre- and postcourse simulated resuscitation scenarios to quantify the effect of CREW training on our primary outcome of CRM performance. Pre/post scenarios were videotaped and scored by two blinded reviewers using a validated behavioural rating scale, the Ottawa CRM Global Rating Scale (GRS). Postcourse survey responses were highly favourable, with the majority of participants reporting that CREW training can reduce errors and improve patient safety. There was a nonsignificant trend toward improved team-based attitudes as assessed by the HFAS (p  =  0.210). Postcourse performance demonstrated a similar trend toward improved scores in all categories on the Ottawa GRS (p  =  0.16). EM residents find simulation-based CRM instruction to be useful, effective, and highly relevant to their practice. Trends toward improved performance and attitudes may have arisen because our study was underpowered to detect a difference. Future efforts should focus on interdisciplinary training and recruiting a larger sample size.

Hypoxia and training-induced adaptation of hormonal responses to exercise in humans.

PubMed

Engfred, K; Kjaer, M; Secher, N H; Friedman, D B; Hanel, B; Nielsen, O J; Bach, F W; Galbo, H; Levine, B D

1994-01-01

To establish whether or not hypoxia influences the training-induced adaptation of hormonal responses to exercise, 21 healthy, untrained subjects (2) years, mean (SE)] were studied in three groups before and after 5 weeks' training (cycle ergometer, 45 min.day-1, 5 days.week-1). Group 1 trained at sea level at 70% maximal oxygen uptake (VO2max), group 2 in a hypobaric chamber at a simulated altitude of 2500 m at 70% of altitude VO2max, and group 3 at a simulated altitude of 2500 m at the same absolute work rate as group 1. Arterial blood was sampled before, during and at the end of exhaustive cycling at sea level (85% of pretraining VO2max). VO2max increased by 12 (2)% with no significant difference between groups, whereas endurance improved most in group 1 (P < 0.05). Training-induced changes in response to exercise of noradrenaline, adrenaline, growth hormone, beta-endorphin, glucagon, and insulin were similar in the three groups. Concentrations of erythropoietin and 2,3-diphosphoglycerate at rest did not change over the training period. In conclusion, within 5 weeks of training, no further adaptation of hormonal exercise responses takes place if intensity is increased above 70% VO2max. Furthermore, hypoxia per se does not add to the training-induced hormonal responses to exercise.

Individual Markers of Resilience in Train Traffic Control: The Role of Operators' Goals and Strategic Mental Models and Implications for Variation, Expertise, and Performance.

PubMed

Lo, Julia C; Pluyter, Kari R; Meijer, Sebastiaan A

2016-02-01

The aim of this study was to examine individual markers of resilience and obtain quantitative insights into the understanding and the implications of variation and expertise levels in train traffic operators' goals and strategic mental models and their impact on performance. The Dutch railways are one of the world's most heavy utilized railway networks and have been identified to be weak in system and organizational resilience. Twenty-two train traffic controllers enacted two scenarios in a human-in-the-loop simulator. Their experience, goals, strategic mental models, and performance were assessed through questionnaires and simulator logs. Goals were operationalized through performance indicators and strategic mental models through train completion strategies. A variation was found between operators for both self-reported primary performance indicators and completion strategies. Further, the primary goal of only 14% of the operators reflected the primary organizational goal (i.e., arrival punctuality). An incongruence was also found between train traffic controllers' self-reported performance indicators and objective performance in a more disrupted condition. The level of experience tends to affect performance differently. There is a gap between primary organizational goals and preferred individual goals. Further, the relative strong diversity in primary operator goals and strategic mental models indicates weak resilience at the individual level. With recent and upcoming large-scale changes throughout the sociotechnical space of the railway infrastructure organization, the findings are useful to facilitate future railway traffic control and the development of a resilient system. © 2015, Human Factors and Ergonomics Society.

[Study on an Exoskeleton Hand Function Training Device].

PubMed

Hu, Xin; Zhang, Ying; Li, Jicai; Yi, Jinhua; Yu, Hongliu; He, Rongrong

2016-02-01

Based on the structure and motion bionic principle of the normal adult fingers, biological characteristics of human hands were analyzed, and a wearable exoskeleton hand function training device for the rehabilitation of stroke patients or patients with hand trauma was designed. This device includes the exoskeleton mechanical structure and the electromyography (EMG) control system. With adjustable mechanism, the device was capable to fit different finger lengths, and by capturing the EMG of the users' contralateral limb, the motion state of the exoskeleton hand was controlled. Then driven by the device, the user's fingers conducting adduction/abduction rehabilitation training was carried out. Finally, the mechanical properties and training effect of the exoskeleton hand were verified through mechanism simulation and the experiments on the experimental prototype of the wearable exoskeleton hand function training device.

Virtual reality simulators and training in laparoscopic surgery.

PubMed

Yiannakopoulou, Eugenia; Nikiteas, Nikolaos; Perrea, Despina; Tsigris, Christos

2015-01-01

Virtual reality simulators provide basic skills training without supervision in a controlled environment, free of pressure of operating on patients. Skills obtained through virtual reality simulation training can be transferred on the operating room. However, relative evidence is limited with data available only for basic surgical skills and for laparoscopic cholecystectomy. No data exist on the effect of virtual reality simulation on performance on advanced surgical procedures. Evidence suggests that performance on virtual reality simulators reliably distinguishes experienced from novice surgeons Limited available data suggest that independent approach on virtual reality simulation training is not different from proctored approach. The effect of virtual reality simulators training on acquisition of basic surgical skills does not seem to be different from the effect the physical simulators. Limited data exist on the effect of virtual reality simulation training on the acquisition of visual spatial perception and stress coping skills. Undoubtedly, virtual reality simulation training provides an alternative means of improving performance in laparoscopic surgery. However, future research efforts should focus on the effect of virtual reality simulation on performance in the context of advanced surgical procedure, on standardization of training, on the possibility of synergistic effect of virtual reality simulation training combined with mental training, on personalized training. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Modified Levenberg-Marquardt Method for RÖSSLER Chaotic System Fuzzy Modeling Training

NASA Astrophysics Data System (ADS)

Wang, Yu-Hui; Wu, Qing-Xian; Jiang, Chang-Sheng; Xue, Ya-Li; Fang, Wei

Generally, fuzzy approximation models require some human knowledge and experience. Operator's experience is involved in the mathematics of fuzzy theory as a collection of heuristic rules. The main goal of this paper is to present a new method for identifying unknown nonlinear dynamics such as Rössler system without any human knowledge. Instead of heuristic rules, the presented method uses the input-output data pairs to identify the Rössler chaotic system. The training algorithm is a modified Levenberg-Marquardt (L-M) method, which can adjust the parameters of each linear polynomial and fuzzy membership functions on line, and do not rely on experts' experience excessively. Finally, it is applied to training Rössler chaotic system fuzzy identification. Comparing this method with the standard L-M method, the convergence speed is accelerated. The simulation results demonstrate the effectiveness of the proposed method.

Simulation-Based Training Platforms for Arthroscopy: A Randomized Comparison of Virtual Reality Learning to Benchtop Learning.

PubMed

Middleton, Robert M; Alvand, Abtin; Garfjeld Roberts, Patrick; Hargrove, Caroline; Kirby, Georgina; Rees, Jonathan L

2017-05-01

To determine whether a virtual reality (VR) arthroscopy simulator or benchtop (BT) arthroscopy simulator showed superiority as a training tool. Arthroscopic novices were randomized to a training program on a BT or a VR knee arthroscopy simulator. The VR simulator provided user performance feedback. Individuals performed a diagnostic arthroscopy on both simulators before and after the training program. Performance was assessed using wireless objective motion analysis and a global rating scale. The groups (8 in the VR group, 9 in the BT group) were well matched at baseline across all parameters (P > .05). Training on each simulator resulted in significant performance improvements across all parameters (P < .05). BT training conferred a significant improvement in all parameters when trainees were reassessed on the VR simulator (P < .05). In contrast, VR training did not confer improvement in performance when trainees were reassessed on the BT simulator (P > .05). BT-trained subjects outperformed VR-trained subjects in all parameters during final assessments on the BT simulator (P < .05). There was no difference in objective performance between VR-trained and BT-trained subjects on final VR simulator wireless objective motion analysis assessment (P > .05). Both simulators delivered improvements in arthroscopic skills. BT training led to skills that readily transferred to the VR simulator. Skills acquired after VR training did not transfer as readily to the BT simulator. Despite trainees receiving automated metric feedback from the VR simulator, the results suggest a greater gain in psychomotor skills for BT training. Further work is required to determine if this finding persists in the operating room. This study suggests that there are differences in skills acquired on different simulators and skills learnt on some simulators may be more transferable. Further work in identifying user feedback metrics that enhance learning is also required. Copyright © 2016 Arthroscopy Association of North America. All rights reserved.

Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters

DTIC Science & Technology

2014-10-01

test with the removal of one wooden foreign body from a turkey breast that simulated the tissue of a human with documentation of procedural omissions...subjects practicing removal of both wooden and metal foreign bodies from a turkey breast while the trainers taught them ways to improve their...Part 2 was an educational efficacy research project. The physicians were trained with a turkey breast simulator. They were evaluated and measured on

[Malfunction simulation by spaceflight training simulator].

PubMed

Chang, Tian-chun; Zhang, Lian-hua; Xue, Liang; Lian, Shun-guo

2005-04-01

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

Teaching Negotiation Skills through Practice and Reflection with Virtual Humans

DTIC Science & Technology

2006-11-01

the 16th Conference on Innovative Applications of Artificial Intelligence (IAAI-04), San Jose , CA. pp. 900–7. [11] Morrison, J. E., and L. L. Meliza...in an automated socratic tutor. In Proceedings of the Inter- service/Industry Training, Simulation, and Education Conference (I/ITSEC), Orlando, FL

Virtual Reality: A Dream Come True or a Nightmare.

ERIC Educational Resources Information Center

Cornell, Richard; Bailey, Dan

Virtual Reality (VR) is a new medium which allows total stimulation of one's senses through human/computer interfaces. VR has applications in training simulators, nano-science, medicine, entertainment, electronic technology, and manufacturing. This paper focuses on some current and potential problems of virtual reality and virtual environments…

An Approach to Embedded Training for Future Leaders and Staff

DTIC Science & Technology

2009-10-01

13. SUPPLEMENTARY NOTES See also ADA562526. RTO-MP-HFM-169 Human Dimensions in Embedded Virtual Simulation (Les dimensions humaines dans la...order to better capitalize on follow-on operations. 4.10 Theme 7: Sustain Unit Operations Theme 7 is defined as the ability of Soldiers and

Human Factors Affecting Pilot Performance in Vertical and Translational Instrument Flight

DTIC Science & Technology

1981-12-01

Creelman , 1955) involving rudimentary visual simulators that provided the student pilot not much more than a crude dynamic perspective view of the runwey he...to find a better terminal procedure. Creelman , J. A. Evaluation of approach training procedures. Pensacola, FL: U.S. Naval School of Aviation Medicine

Models and Methods for Adaptive Management of Individual and Team-Based Training Using a Simulator

NASA Astrophysics Data System (ADS)

Lisitsyna, L. S.; Smetyuh, N. P.; Golikov, S. P.

2017-05-01

Research of adaptive individual and team-based training has been analyzed and helped find out that both in Russia and abroad, individual and team-based training and retraining of AASTM operators usually includes: production training, training of general computer and office equipment skills, simulator training including virtual simulators which use computers to simulate real-world manufacturing situation, and, as a rule, the evaluation of AASTM operators’ knowledge determined by completeness and adequacy of their actions under the simulated conditions. Such approach to training and re-training of AASTM operators stipulates only technical training of operators and testing their knowledge based on assessing their actions in a simulated environment.

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

PubMed

Xue, Liang; Chen, Shan-quang; Chang, Tian-chun; Yang, Hong; Chao, Jian-gang; Li, Zhi-peng

2003-01-01

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

Current status of robotic simulators in acquisition of robotic surgical skills.

PubMed

Kumar, Anup; Smith, Roger; Patel, Vipul R

2015-03-01

This article provides an overview of the current status of simulator systems in robotic surgery training curriculum, focusing on available simulators for training, their comparison, new technologies introduced in simulation focusing on concepts of training along with existing challenges and future perspectives of simulator training in robotic surgery. The different virtual reality simulators available in the market like dVSS, dVT, RoSS, ProMIS and SEP have shown face, content and construct validity in robotic skills training for novices outside the operating room. Recently, augmented reality simulators like HoST, Maestro AR and RobotiX Mentor have been introduced in robotic training providing a more realistic operating environment, emphasizing more on procedure-specific robotic training . Further, the Xperience Team Trainer, which provides training to console surgeon and bed-side assistant simultaneously, has been recently introduced to emphasize the importance of teamwork and proper coordination. Simulator training holds an important place in current robotic training curriculum of future robotic surgeons. There is a need for more procedure-specific augmented reality simulator training, utilizing advancements in computing and graphical capabilities for new innovations in simulator technology. Further studies are required to establish its cost-benefit ratio along with concurrent and predictive validity.

A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy.

PubMed

Dawe, Susan R; Windsor, John A; Broeders, Joris A J L; Cregan, Patrick C; Hewett, Peter J; Maddern, Guy J

2014-02-01

A systematic review to determine whether skills acquired through simulation-based training transfer to the operating room for the procedures of laparoscopic cholecystectomy and endoscopy. Simulation-based training assumes that skills are directly transferable to the operation room, but only a few studies have investigated the effect of simulation-based training on surgical performance. A systematic search strategy that was used in 2006 was updated to retrieve relevant studies. Inclusion of articles was determined using a predetermined protocol, independent assessment by 2 reviewers, and a final consensus decision. Seventeen randomized controlled trials and 3 nonrandomized comparative studies were included in this review. In most cases, simulation-based training was in addition to patient-based training programs. Only 2 studies directly compared simulation-based training in isolation with patient-based training. For laparoscopic cholecystectomy (n = 10 studies) and endoscopy (n = 10 studies), participants who reached simulation-based skills proficiency before undergoing patient-based assessment performed with higher global assessment scores and fewer errors in the operating room than their counterparts who did not receive simulation training. Not all parameters measured were improved. Two of the endoscopic studies compared simulation-based training in isolation with patient-based training with different results: for sigmoidoscopy, patient-based training was more effective, whereas for colonoscopy, simulation-based training was equally effective. Skills acquired by simulation-based training seem to be transferable to the operative setting for laparoscopic cholecystectomy and endoscopy. Future research will strengthen these conclusions by evaluating predetermined competency levels on the same simulators and using objective validated global rating scales to measure operative performance.

Operative and diagnostic hysteroscopy: A novel learning model combining new animal models and virtual reality simulation.

PubMed

Bassil, Alfred; Rubod, Chrystèle; Borghesi, Yves; Kerbage, Yohan; Schreiber, Elie Servan; Azaïs, Henri; Garabedian, Charles

2017-04-01

Hysteroscopy is one of the most common gynaecological procedure. Training for diagnostic and operative hysteroscopy can be achieved through numerous previously described models like animal models or virtual reality simulation. We present our novel combined model associating virtual reality and bovine uteruses and bladders. End year residents in obstetrics and gynaecology attended a full day workshop. The workshop was divided in theoretical courses from senior surgeons and hands-on training in operative hysteroscopy and virtual reality Essure ® procedures using the EssureSim™ and Pelvicsim™ simulators with multiple scenarios. Theoretical and operative knowledge was evaluated before and after the workshop and General Points Averages (GPAs) were calculated and compared using a Student's T test. GPAs were significantly higher after the workshop was completed. The biggest difference was observed in operative knowledge (0,28 GPA before workshop versus 0,55 after workshop, p<0,05). All of the 25 residents having completed the workshop applauded the realism an efficiency of this type of training. The force feedback allowed by the cattle uteruses gives the residents the possibility to manage thickness of resection as in real time surgery. Furthermore, the two-horned bovine uteruses allowed to reproduce septa resection in conditions close to human surgery CONCLUSION: Teaching operative and diagnostic hysteroscopy is essential. Managing this training through a full day workshop using a combined animal model and virtual reality simulation is an efficient model not described before. Copyright © 2017 Elsevier B.V. All rights reserved.

In vivo porcine training model for laparoscopic Roux-en-Y choledochojejunostomy.

PubMed

Lee, Jun Suh; Hong, Tae Ho

2015-06-01

The purpose of this study was to develop a porcine training model for laparoscopic choledochojejunostomy (CJ) that can act as a bridge between simulation models and actual surgery for novice surgeons. The feasibility of this model was evaluated. Laparoscopic CJ using intracorporeal sutures was performed on ten animals by a surgical fellow with no experience in human laparoscopic CJ. A single layer of running sutures was placed in the posterior and anterior layers. Jejunojejunostomy was performed using a linear stapler, and the jejunal opening was closed using absorbable unidirectional sutures (V-Loc 180). The average operation time was 131.3 ± 36.4 minutes, and the CJ time was 57.5 ± 18.4 minutes. Both the operation time and CJ time showed a steady decrease with an increasing number of cases. The average diameter of the CBD was 6.4 ± 0.8 mm. Of a total of ten animals, eight were sacrificed after the procedure. In two animals, a survival model was evaluated. Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed. None of the animals exhibited any signs of bile leakage or anastomosis site stricture. The porcine training model introduced in this paper is an adequate model for practicing laparoscopic CJ. Human tissue simulation is excellent.

14 CFR 121.409 - Training courses using airplane simulators and other training devices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Training courses using airplane simulators... Program § 121.409 Training courses using airplane simulators and other training devices. Link to an amendment published at 78 FR 67837, Nov. 12, 2013. (a) Training courses utilizing airplane simulators and...

Virtual humans and formative assessment to train diagnostic skills in bulimia nervosa.

PubMed

Gutiérrez-Maldonado, José; Ferrer-Garcia, Marta; Pla, Joana; Andrés-Pueyo, Antonio

2014-01-01

Carrying out a diagnostic interview requires skills that need to be taught in a controlled environment. Virtual Reality (VR) environments are increasingly used in the training of professionals, as they offer the most realistic alternative while not requiring students to face situations for which they are yet unprepared. The results of the training of diagnostic skills can also be generalized to any other situation in which effective communication skills play a major role. Our aim with this study has been to develop a procedure of formative assessment in order to increment the effectiveness of virtual learning simulation systems and then to assess their efficacy.

[Simulation training in surgical education - application of virtual reality laparoscopic simulators in a surgical skills course].

PubMed

Lehmann, K S; Gröne, J; Lauscher, J C; Ritz, J-P; Holmer, C; Pohlen, U; Buhr, H-J

2012-04-01

Training and simulation are gaining importance in surgical education. Today, virtual reality surgery simulators provide sophisticated laparoscopic training scenarios and offer detailed assessment methods. This also makes simulators interesting for the application in surgical skills courses. The aim of the current study was to assess the suitability of a virtual surgery simulator for training and assessment in an established surgical training course. The study was conducted during the annual "Practical Course for Visceral Surgery" (Warnemuende, Germany). 36 of 108 course participants were assigned at random for the study. Training was conducted in 15 sessions over 5 days with 4 identical virtual surgery simulators (LapSim) and 2 standardised training tasks. The simulator measured 16 individual parameters and calculated 2 scores. Questionnaires were used to assess the test persons' laparoscopic experience, their training situation and the acceptance of the simulator training. Data were analysed with non-parametric tests. A subgroup analysis for laparoscopic experience was conducted in order to assess the simulator's construct validity and assessment capabilities. Median age was 32 (27 - 41) years; median professional experience was 3 (1 - 11) years. Typical laparoscopic learning curves with initial significant improvements and a subsequent plateau phase were measured over 5 days. The individual training sessions exhibited a rhythmic variability in the training results. A shorter night's sleep led to a marked drop in performance. The participants' different experience levels could clearly be discriminated ( ≤ 20 vs. > 20 laparoscopic operations; p ≤ 0.001). The questionnaire showed that the majority of the participants had limited training opportunities in their hospitals. The simulator training was very well accepted. However, the participants severely misjudged the real costs of the simulators that were used. The learning curve on the simulator was successfully mastered during the course. Construct validity could be demonstrated within the course setting. The simulator's assessment system can be of value for the assessment of laparoscopic training performance within surgical skills courses. Acceptance of the simulator training is high. However, simulators are currently too expensive to be used within a large training course. © Georg Thieme Verlag KG Stuttgart · New York.

Simulation in bronchoscopy: current and future perspectives.

PubMed

Nilsson, Philip Mørkeberg; Naur, Therese Maria Henriette; Clementsen, Paul Frost; Konge, Lars

2017-01-01

To provide an overview of current literature that informs how to approach simulation practice of bronchoscopy and discuss how findings from other simulation research can help inform the use of simulation in bronchoscopy training. We conducted a literature search on simulation training of bronchoscopy and divided relevant studies in three categories: 1) structuring simulation training in bronchoscopy, 2) assessment of competence in bronchoscopy training, and 3) development of cheap alternatives for bronchoscopy simulation. Bronchoscopy simulation is effective, and the training should be structured as distributed practice with mastery learning criteria (ie, training until a certain level of competence is achieved). Dyad practice (training in pairs) is possible and may increase utility of available simulators. Trainee performance should be assessed with assessment tools with established validity. Three-dimensional printing is a promising new technology opening possibilities for developing cheap simulators with innovative features.

Payload training methodology study

NASA Technical Reports Server (NTRS)

1990-01-01

The results of the Payload Training Methodology Study (PTMS) are documented. Methods and procedures are defined for the development of payload training programs to be conducted at the Marshall Space Flight Center Payload Training Complex (PCT) for the Space Station Freedom program. The study outlines the overall training program concept as well as the six methodologies associated with the program implementation. The program concept outlines the entire payload training program from initial identification of training requirements to the development of detailed design specifications for simulators and instructional material. The following six methodologies are defined: (1) The Training and Simulation Needs Assessment Methodology; (2) The Simulation Approach Methodology; (3) The Simulation Definition Analysis Methodology; (4) The Simulator Requirements Standardization Methodology; (5) The Simulator Development Verification Methodology; and (6) The Simulator Validation Methodology.

Central venous catheterization training: current perspectives on the role of simulation

PubMed Central

Soffler, Morgan I; Hayes, Margaret M; Smith, C Christopher

2018-01-01

Simulation is a popular and effective training modality in medical education across a variety of domains. Central venous catheterization (CVC) is commonly undertaken by trainees, and carries significant risk for patient harm when carried out incorrectly. Multiple studies have evaluated the efficacy of simulation-based training programs, in comparison with traditional training modalities, on learner and patient outcomes. In this review, we discuss relevant adult learning principles that support simulation-based CVC training, review the literature on simulation-based CVC training, and highlight the use of simulation-based CVC training programs at various institutions. PMID:29872360

Central venous catheterization training: current perspectives on the role of simulation.

PubMed

Soffler, Morgan I; Hayes, Margaret M; Smith, C Christopher

2018-01-01

Simulation is a popular and effective training modality in medical education across a variety of domains. Central venous catheterization (CVC) is commonly undertaken by trainees, and carries significant risk for patient harm when carried out incorrectly. Multiple studies have evaluated the efficacy of simulation-based training programs, in comparison with traditional training modalities, on learner and patient outcomes. In this review, we discuss relevant adult learning principles that support simulation-based CVC training, review the literature on simulation-based CVC training, and highlight the use of simulation-based CVC training programs at various institutions.

The role of simulation in space operations training

NASA Astrophysics Data System (ADS)

Ocasio, Frank; Atkins, Dana

The expanding use of computer simulation to train aerospace personnel is reviewed emphasizing the increasing complexity of responsibilities in the operations segment. The inefficiency of on-the-job training is discussed, and the simulation technologies employed by the USAF Combat Crew Training Squadron are described. The Mission Control Complex-Kernel is employed to simulate an operational Satellite Control Squadron (SCS) and a downscaled SCS. A system for telemetry simulation is incorporated into the launch and early-orbit segments of the training, and the training emphasizes time-critical actions, schedule adherence, and the interaction with external organizations. Hands-on training is required to supplement the simulator training which cannot be used to simulate anomalies in satellites and ground systems. The use of a centralized simulator as an instructional tool facilitates and expedites the transition of the student to operational levels.

Virtual temporal bone: an interactive 3-dimensional learning aid for cranial base surgery.

PubMed

Kockro, Ralf A; Hwang, Peter Y K

2009-05-01

We have developed an interactive virtual model of the temporal bone for the training and teaching of cranial base surgery. The virtual model was based on the tomographic data of the Visible Human Project. The male Visible Human's computed tomographic data were volumetrically reconstructed as virtual bone tissue, and the individual photographic slices provided the basis for segmentation of the middle and inner ear structures, cranial nerves, vessels, and brainstem. These structures were created by using outlining and tube editing tools, allowing structural modeling either directly on the basis of the photographic data or according to information from textbooks and cadaver dissections. For training and teaching, the virtual model was accessed in the previously described 3-dimensional workspaces of the Dextroscope or Dextrobeam (Volume Interactions Pte, Ltd., Singapore), whose interfaces enable volumetric exploration from any perspective and provide virtual tools for drilling and measuring. We have simulated several cranial base procedures including approaches via the floor of the middle fossa and the lateral petrous bone. The virtual model suitably illustrated the core facts of anatomic spatial relationships while simulating different stages of bone drilling along a variety of surgical corridors. The system was used for teaching during training courses to plan and discuss operative anatomy and strategies. The Virtual Temporal Bone and its surrounding 3-dimensional workspace provide an effective way to study the essential surgical anatomy of this complex region and to teach and train operative strategies, especially when used as an adjunct to cadaver dissections.

Studies of Pilot Control During Launching and Reentry of Space Vehicles, Utilizing the Human Centrifuge

NASA Technical Reports Server (NTRS)

Clark, Carl C.; Woodling, C. H.

1959-01-01

With the ever increasing complexity of airplanes and the nearness to reality of manned space vehicles the use of pilot-controlled flight simulators has become imperative. The state of the art in flight simulation has progressed well with the demand. Pilot-controlled flight simulators are finding increasing uses in aeromedical research, airplane and airplane systems design, and preflight training. At the present many flight simulators are in existence with various degrees of sophistication and sundry purposes. These vary from fixed base simulators where the pilot applies control inputs according to visual cues presented to him on an instrument display to moving base simulators where various combinations of angular and linear motions are added in an attempt to improve the flight simulation.

14 CFR 121.413 - Initial and transition training and checking requirements: Check airmen (airplane), check airmen...

Code of Federal Regulations, 2014 CFR

2014-01-01

... flight simulator, or in a flight training device. This paragraph applies after March 19, 1997. (b) The... simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training... simulator or in a flight training device. (2) Training in the operation of flight simulators or flight...

Human Centered Hardware Modeling and Collaboration

NASA Technical Reports Server (NTRS)

Stambolian Damon; Lawrence, Brad; Stelges, Katrine; Henderson, Gena

2013-01-01

In order to collaborate engineering designs among NASA Centers and customers, to in clude hardware and human activities from multiple remote locations, live human-centered modeling and collaboration across several sites has been successfully facilitated by Kennedy Space Center. The focus of this paper includes innovative a pproaches to engineering design analyses and training, along with research being conducted to apply new technologies for tracking, immersing, and evaluating humans as well as rocket, vehic le, component, or faci lity hardware utilizing high resolution cameras, motion tracking, ergonomic analysis, biomedical monitoring, wor k instruction integration, head-mounted displays, and other innovative human-system integration modeling, simulation, and collaboration applications.

Surgical simulators in urological training--views of UK Training Programme Directors.

PubMed

Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

2012-09-01

What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Simulation training: a systematic review of simulation in arthroscopy and proposal of a new competency-based training framework.

PubMed

Tay, Charison; Khajuria, Ankur; Gupte, Chinmay

2014-01-01

Traditional orthopaedic training has followed an apprenticeship model whereby trainees enhance their skills by operating under guidance. However the introduction of limitations on training hours and shorter training programmes mean that alternative training strategies are required. To perform a literature review on simulation training in arthroscopy and devise a framework that structures different simulation techniques that could be used in arthroscopic training. A systematic search of Medline, Embase, Google Scholar and the Cochrane Databases were performed. Search terms included "virtual reality OR simulator OR simulation" and "arthroscopy OR arthroscopic". 14 studies evaluating simulators in knee, shoulder and hip arthroplasty were included. The majority of the studies demonstrated construct and transference validity but only one showed concurrent validity. More studies are required to assess its potential as a training and assessment tool, skills transference between simulators and to determine the extent of skills decay from prolonged delays in training. We also devised a "ladder of arthroscopic simulation" that provides a competency-based framework to implement different simulation strategies. The incorporation of simulation into an orthopaedic curriculum will depend on a coordinated approach between many bodies. But the successful integration of simulators in other areas of surgery supports a possible role for simulation in advancing orthopaedic education. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Developing a Simulation-Based Training Program for the Prehospital Professionals and Students on the Management of Middle East Respiratory Syndrome.

PubMed

Elcin, Melih; Onan, Arif; Odabasi, Orhan; Saylam, Melahat; Ilhan, Handan; Daylan Kockaya, Pinar; Gurcuoglu, Ilker; Uckuyu, Yavuz; Cengiz, Duygu; Nacar, Osman Arikan

2016-12-01

Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training. We developed 5 scenarios using SPs and an observation form. We included paramedic students and emergency medical service (EMS) providers in our study. They were involved in the simulations. A total of 24 paramedic students and 33 EMS providers participated in our study. Sixteen (84%) of 19 teams recognized the possibility of MERS as a measure of their awareness in the baseline evaluation. The participants lacked donning and doffing personal protective equipments, which revealed their baseline level of preparedness for MERS. Certain improvements in donning and doffing personal protective equipment were observed in the posttraining evaluation. The participants provided positive feedback on the training program. The training program was appropriate for both paramedic students and EMS providers. A positive educational climate was created. Because the main concerns of this study were awareness and preparedness, which required human interaction, the SP methodology was the optimal simulation modality.

Saturation pulse design for quantitative myocardial T1 mapping.

PubMed

Chow, Kelvin; Kellman, Peter; Spottiswoode, Bruce S; Nielles-Vallespin, Sonia; Arai, Andrew E; Salerno, Michael; Thompson, Richard B

2015-10-01

Quantitative saturation-recovery based T1 mapping sequences are less sensitive to systematic errors than the Modified Look-Locker Inversion recovery (MOLLI) technique but require high performance saturation pulses. We propose to optimize adiabatic and pulse train saturation pulses for quantitative T1 mapping to have <1 % absolute residual longitudinal magnetization (|MZ/M0|) over ranges of B0 and [Formula: see text] (B1 scale factor) inhomogeneity found at 1.5 T and 3 T. Design parameters for an adiabatic BIR4-90 pulse were optimized for improved performance within 1.5 T B0 (±120 Hz) and [Formula: see text] (0.7-1.0) ranges. Flip angles in hard pulse trains of 3-6 pulses were optimized for 1.5 T and 3 T, with consideration of T1 values, field inhomogeneities (B0 = ±240 Hz and [Formula: see text]=0.4-1.2 at 3 T), and maximum achievable B1 field strength. Residual MZ/M0 was simulated and measured experimentally for current standard and optimized saturation pulses in phantoms and in-vivo human studies. T1 maps were acquired at 3 T in human subjects and a swine using a SAturation recovery single-SHot Acquisition (SASHA) technique with a standard 90°-90°-90° and an optimized 6-pulse train. Measured residual MZ/M0 in phantoms had excellent agreement with simulations over a wide range of B0 and [Formula: see text]. The optimized BIR4-90 reduced the maximum residual |MZ/M0| to <1 %, a 5.8× reduction compared to a reference BIR4-90. An optimized 3-pulse train achieved a maximum residual |MZ/M0| <1 % for the 1.5 T optimization range compared to 11.3 % for a standard 90°-90°-90° pulse train, while a 6-pulse train met this target for the wider 3 T ranges of B0 and [Formula: see text]. The 6-pulse train demonstrated more uniform saturation across both the myocardium and entire field of view than other saturation pulses in human studies. T1 maps were more spatially homogeneous with 6-pulse train SASHA than the reference 90°-90°-90° SASHA in both human and animal studies. Adiabatic and pulse train saturation pulses optimized for different constraints found at 1.5 T and 3 T achieved <1 % residual |MZ/M0| in phantom experiments, enabling greater accuracy in quantitative saturation recovery T1 imaging.

Quasi-Supervised Scoring of Human Sleep in Polysomnograms Using Augmented Input Variables

PubMed Central

Yaghouby, Farid; Sunderam, Sridhar

2015-01-01

The limitations of manual sleep scoring make computerized methods highly desirable. Scoring errors can arise from human rater uncertainty or inter-rater variability. Sleep scoring algorithms either come as supervised classifiers that need scored samples of each state to be trained, or as unsupervised classifiers that use heuristics or structural clues in unscored data to define states. We propose a quasi-supervised classifier that models observations in an unsupervised manner but mimics a human rater wherever training scores are available. EEG, EMG, and EOG features were extracted in 30s epochs from human-scored polysomnograms recorded from 42 healthy human subjects (18 to 79 years) and archived in an anonymized, publicly accessible database. Hypnograms were modified so that: 1. Some states are scored but not others; 2. Samples of all states are scored but not for transitional epochs; and 3. Two raters with 67% agreement are simulated. A framework for quasi-supervised classification was devised in which unsupervised statistical models—specifically Gaussian mixtures and hidden Markov models—are estimated from unlabeled training data, but the training samples are augmented with variables whose values depend on available scores. Classifiers were fitted to signal features incorporating partial scores, and used to predict scores for complete recordings. Performance was assessed using Cohen's K statistic. The quasi-supervised classifier performed significantly better than an unsupervised model and sometimes as well as a completely supervised model despite receiving only partial scores. The quasi-supervised algorithm addresses the need for classifiers that mimic scoring patterns of human raters while compensating for their limitations. PMID:25679475

Quasi-supervised scoring of human sleep in polysomnograms using augmented input variables.

PubMed

Yaghouby, Farid; Sunderam, Sridhar

2015-04-01

The limitations of manual sleep scoring make computerized methods highly desirable. Scoring errors can arise from human rater uncertainty or inter-rater variability. Sleep scoring algorithms either come as supervised classifiers that need scored samples of each state to be trained, or as unsupervised classifiers that use heuristics or structural clues in unscored data to define states. We propose a quasi-supervised classifier that models observations in an unsupervised manner but mimics a human rater wherever training scores are available. EEG, EMG, and EOG features were extracted in 30s epochs from human-scored polysomnograms recorded from 42 healthy human subjects (18-79 years) and archived in an anonymized, publicly accessible database. Hypnograms were modified so that: 1. Some states are scored but not others; 2. Samples of all states are scored but not for transitional epochs; and 3. Two raters with 67% agreement are simulated. A framework for quasi-supervised classification was devised in which unsupervised statistical models-specifically Gaussian mixtures and hidden Markov models--are estimated from unlabeled training data, but the training samples are augmented with variables whose values depend on available scores. Classifiers were fitted to signal features incorporating partial scores, and used to predict scores for complete recordings. Performance was assessed using Cohen's Κ statistic. The quasi-supervised classifier performed significantly better than an unsupervised model and sometimes as well as a completely supervised model despite receiving only partial scores. The quasi-supervised algorithm addresses the need for classifiers that mimic scoring patterns of human raters while compensating for their limitations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of an avatar-based training program to promote suicide prevention awareness in a college setting.

PubMed

Rein, Benjamin A; McNeil, Daniel W; Hayes, Allison R; Hawkins, T Anne; Ng, H Mei; Yura, Catherine A

2018-07-01

Training programs exist that prepare college students, faculty, and staff to identify and support students potentially at risk for suicide. Kognito is an online program that trains users through simulated interactions with virtual humans. This study evaluated Kognito's effectiveness in preparing users to intervene with at-risk students. Training was completed by 2,727 university students, faculty, and staff from April, 2014 through September, 2015. Voluntary and mandatory participants at a land-grant university completed Kognito modules designed for higher education, along with pre- and post-assessments. All modules produced significant gains in reported Preparedness, Likelihood, and Self-Efficacy in intervening with troubled students. Despite initial disparities in reported abilities, after training participants reported being similarly capable of assisting at-risk students, including LGBTQ and veteran students. Kognito training appears to be effective, on a large scale, in educating users to act in a facilitative role for at-risk college students.

Supervised learning from human performance at the computationally hard problem of optimal traffic signal control on a network of junctions

PubMed Central

Box, Simon

2014-01-01

Optimal switching of traffic lights on a network of junctions is a computationally intractable problem. In this research, road traffic networks containing signallized junctions are simulated. A computer game interface is used to enable a human ‘player’ to control the traffic light settings on the junctions within the simulation. A supervised learning approach, based on simple neural network classifiers can be used to capture human player's strategies in the game and thus develop a human-trained machine control (HuTMaC) system that approaches human levels of performance. Experiments conducted within the simulation compare the performance of HuTMaC to two well-established traffic-responsive control systems that are widely deployed in the developed world and also to a temporal difference learning-based control method. In all experiments, HuTMaC outperforms the other control methods in terms of average delay and variance over delay. The conclusion is that these results add weight to the suggestion that HuTMaC may be a viable alternative, or supplemental method, to approximate optimization for some practical engineering control problems where the optimal strategy is computationally intractable. PMID:26064570

Supervised learning from human performance at the computationally hard problem of optimal traffic signal control on a network of junctions.

PubMed

Box, Simon

2014-12-01

Optimal switching of traffic lights on a network of junctions is a computationally intractable problem. In this research, road traffic networks containing signallized junctions are simulated. A computer game interface is used to enable a human 'player' to control the traffic light settings on the junctions within the simulation. A supervised learning approach, based on simple neural network classifiers can be used to capture human player's strategies in the game and thus develop a human-trained machine control (HuTMaC) system that approaches human levels of performance. Experiments conducted within the simulation compare the performance of HuTMaC to two well-established traffic-responsive control systems that are widely deployed in the developed world and also to a temporal difference learning-based control method. In all experiments, HuTMaC outperforms the other control methods in terms of average delay and variance over delay. The conclusion is that these results add weight to the suggestion that HuTMaC may be a viable alternative, or supplemental method, to approximate optimization for some practical engineering control problems where the optimal strategy is computationally intractable.

Creating Simulated Microgravity Patient Models

NASA Technical Reports Server (NTRS)

Hurst, Victor; Doerr, Harold K.; Bacal, Kira

2004-01-01

The Medical Operational Support Team (MOST) has been tasked by the Space and Life Sciences Directorate (SLSD) at the NASA Johnson Space Center (JSC) to integrate medical simulation into 1) medical training for ground and flight crews and into 2) evaluations of medical procedures and equipment for the International Space Station (ISS). To do this, the MOST requires patient models that represent the physiological changes observed during spaceflight. Despite the presence of physiological data collected during spaceflight, there is no defined set of parameters that illustrate or mimic a 'space normal' patient. Methods: The MOST culled space-relevant medical literature and data from clinical studies performed in microgravity environments. The areas of focus for data collection were in the fields of cardiovascular, respiratory and renal physiology. Results: The MOST developed evidence-based patient models that mimic the physiology believed to be induced by human exposure to a microgravity environment. These models have been integrated into space-relevant scenarios using a human patient simulator and ISS medical resources. Discussion: Despite the lack of a set of physiological parameters representing 'space normal,' the MOST developed space-relevant patient models that mimic microgravity-induced changes in terrestrial physiology. These models are used in clinical scenarios that will medically train flight surgeons, biomedical flight controllers (biomedical engineers; BME) and, eventually, astronaut-crew medical officers (CMO).

The drive-wise project: driving simulator training increases real driving performance in healthy older drivers

PubMed Central

Casutt, Gianclaudio; Theill, Nathan; Martin, Mike; Keller, Martin; Jäncke, Lutz

2014-01-01

Background: Age-related cognitive decline is often associated with unsafe driving behavior. We hypothesized that 10 active training sessions in a driving simulator increase cognitive and on-road driving performance. In addition, driving simulator training should outperform cognitive training. Methods: Ninety-one healthy active drivers (62–87 years) were randomly assigned to one of three groups: (1) a driving simulator training group, (2) an attention training group (vigilance and selective attention), or (3) a control group. The main outcome variables were on-road driving and cognitive performance. Seventy-seven participants (85%) completed the training and were included in the analyses. Training gains were analyzed using a multiple regression analysis with planned orthogonal comparisons. Results: The driving simulator-training group showed an improvement in on-road driving performance compared to the attention-training group. In addition, both training groups increased cognitive performance compared to the control group. Conclusion: Driving simulator training offers the potential to enhance driving skills in older drivers. Compared to the attention training, the simulator training seems to be a more powerful program for increasing older drivers' safety on the road. PMID:24860497

Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.

PubMed

Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

2016-01-01

The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Utilization of virtual reality for endotracheal intubation training.

PubMed

Mayrose, James; Kesavadas, T; Chugh, Kevin; Joshi, Dhananjay; Ellis, David G

2003-10-01

Tracheal intubation is performed for urgent airway control in injured patients. Current methods of training include working on cadavers and manikins, which lack the realism of a living human being. Work in this field has been limited due to the complex nature of simulating in real-time, the interactive forces and deformations which occur during an actual patient intubation. This study addressed the issue of intubation training in an attempt to bridge the gap between actual and virtual patient scenarios. The haptic device along with the real-time performance of the simulator give it both visual and physical realism. The three-dimensional viewing and interaction available through virtual reality make it possible for physicians, pre-hospital personnel and students to practice many endotracheal intubations without ever touching a patient. The ability for a medical professional to practice a procedure multiple times prior to performing it on a patient will both enhance the skill of the individual while reducing the risk to the patient.

A social cybernetic analysis of simulation-based, remotely delivered medical skills training in an austere environment: developing a test bed for spaceflight medicine.

PubMed

Musson, David M; Doyle, Thomas E

2012-01-01

This paper describes analysis of medical skills training exercises that were conducted at an arctic research station. These were conducted as part of an ongoing effort to establish high fidelity medical simulation test bed capabilities in remote and extreme "space analogue" environments for the purpose studying medical care in spaceflight. The methodological orientation followed by the authors is that of "second order cybernetics," or the science of studying human systems where the observer is involved within the system in question. Analyses presented include the identification of three distinct phases of the training activity, and two distinct levels of work groups-- termed "first-order teams" and "second-order teams." Depending on the phase of activity, first-order and second-order teams are identified, each having it own unique structure, composition, communications, goals, and challenges. Several specific teams are highlighted as case examples. Limitations of this approach are discussed, as are potential benefits to ongoing and planned research activity in this area.

Aerocapture, Entry, Descent and Landing (AEDL) Human Planetary Landing Systems. Section 10: AEDL Analysis, Test and Validation Infrastructure

NASA Technical Reports Server (NTRS)

Arnold, J.; Cheatwood, N.; Powell, D.; Wolf, A.; Guensey, C.; Rivellini, T.; Venkatapathy, E.; Beard, T.; Beutter, B.; Laub, B.

2005-01-01

Contents include the following: 3 Listing of critical capabilities (knowledge, procedures, training, facilities) and metrics for validating that they are mission ready. Examples of critical capabilities and validation metrics: ground test and simulations. Flight testing to prove capabilities are mission ready. Issues and recommendations.

Using Simulations To Understand Older Adults with Sensory Impairment.

ERIC Educational Resources Information Center

Clubok, Miriam

2000-01-01

Summarizes two popular models for increasing sensitivity to sensory impairment in the elderly and details a third model used in training human service students and practitioners. Ideas and techniques presented work toward understanding the impact of sensory impairment on the daily life of older adults and to identify coping techniques to improve…

Night Attack Workload Steering Group. Volume 3. Simulation and Human Factors Subgroup

DTIC Science & Technology

1982-06-01

information intepretation . The second is the use of pictorial formats or computer generated displays that combine many present-day displays into a small number...base exists in any form (digital, film , or model) which supports the wide area, long track, low level requirements levied by night attack training

Using Immersive Virtual Environments for Certification

NASA Technical Reports Server (NTRS)

Lutz, R.; Cruz-Neira, C.

1998-01-01

Immersive virtual environments (VEs) technology has matured to the point where it can be utilized as a scientific and engineering problem solving tool. In particular, VEs are starting to be used to design and evaluate safety-critical systems that involve human operators, such as flight and driving simulators, complex machinery training, and emergency rescue strategies.

Pilot training: What can surgeons learn from it?

PubMed

Sommer, Kai-Jörg

2014-03-01

To provide healthcare professionals with an insight into training in aviation and its possible transfer into surgery. From research online and into company archives, relevant publications and information were identified. Current airline pilot training consists of two categories, basic training and type-rating. Training methods comprise classroom instruction, computer-based training and practical training, in either the aircraft or a flight-training device, which ranges from a fixed-base flight-training device to a full flight simulator. Pilot training not only includes technical and procedural instruction, but also training in non-technical skills like crisis management, decision-making, leadership and communication. Training syllabuses, training devices and instructors are internationally standardized and these standards are legally binding. Re-qualification and recurrent training are mandatory at all stages of a pilot's and instructor's career. Surgeons and pilots have much in common, i.e., they work in a 'real-time' three-dimensional environment under high physiological and psychological stress, operating expensive equipment, and the ultimate cost for error is measured in human lives. However, their training differs considerably. Transferring these well-tried aviation methods into healthcare will make surgical training more efficient, more effective and ultimately safer.

NATO Human View Architecture and Human Networks

NASA Technical Reports Server (NTRS)

Handley, Holly A. H.; Houston, Nancy P.

2010-01-01

The NATO Human View is a system architectural viewpoint that focuses on the human as part of a system. Its purpose is to capture the human requirements and to inform on how the human impacts the system design. The viewpoint contains seven static models that include different aspects of the human element, such as roles, tasks, constraints, training and metrics. It also includes a Human Dynamics component to perform simulations of the human system under design. One of the static models, termed Human Networks, focuses on the human-to-human communication patterns that occur as a result of ad hoc or deliberate team formation, especially teams distributed across space and time. Parameters of human teams that effect system performance can be captured in this model. Human centered aspects of networks, such as differences in operational tempo (sense of urgency), priorities (common goal), and team history (knowledge of the other team members), can be incorporated. The information captured in the Human Network static model can then be included in the Human Dynamics component so that the impact of distributed teams is represented in the simulation. As the NATO militaries transform to a more networked force, the Human View architecture is an important tool that can be used to make recommendations on the proper mix of technological innovations and human interactions.

Developing a Field Artillery Training System Based on Devices and Simulations: Evaluation of Training Devices and Simulations

DTIC Science & Technology

1984-12-01

best trained by instruction alone or with simple demonstration materials. Training Devices are judged best for training the routine use of specific...pieces of equipment (e.g., Howitzer, BCS, DMD/FIST DMD, GLLD, LRF, map/compass/ plotting tools). Simulations are judged best for training more complex...at all phases of engagement operations. Simulations are also judged best for conducting training of any task under extreme environments and

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.

Silicone-based composite materials simulate breast tissue to be used as ultrasonography training phantoms.

PubMed

Ustbas, Burcin; Kilic, Deniz; Bozkurt, Ayhan; Aribal, Mustafa Erkin; Akbulut, Ozge

2018-08-01

A silicone-based composite breast phantom is fabricated to be used as an education model in ultrasonography training. A matrix of silicone formulations is tracked to mimic the ultrasonography and tactile response of human breast tissue. The performance of two different additives: (i) silicone oil and (ii) vinyl-terminated poly (dimethylsiloxane) (PDMS) are monitored by a home-made acoustic setup. Through the use of 75 wt% vinyl-terminated PDMS in two-component silicone elastomer mixture, a sound velocity of 1.29 ± 0.09 × 10 3  m/s and an attenuation coefficient of 12.99 ± 0.08 dB/cm-values those match closely to the human breast tissue-are measured with 5 MHz probe. This model can also be used for needle biopsy as well as for self-exam trainings. Herein, we highlight the fabrication of a realistic, durable, accessible, and cost-effective training platform that contains skin layer, inner breast tissue, and tumor masses. Copyright © 2018 Elsevier B.V. All rights reserved.

Importance of leadership in cardiac arrest situations: from simulation to real life and back.

PubMed

Hunziker, Sabnina; Tschan, Franziska; Semmer, Norbert K; Marsch, Stephan

2013-04-18

The 2010 American Heart Association guidelines now recommend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions because of the high heterogeneity of the situations, difficulties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fidelity video-assisted simulator studies from different research groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team performance. In addition, randomised controlled studies have provided evidence that medical students receiving leadership training subsequently showed improved CPR performance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.

Computer-based simulation training in emergency medicine designed in the light of malpractice cases.

PubMed

Karakuş, Akan; Duran, Latif; Yavuz, Yücel; Altintop, Levent; Calişkan, Fatih

2014-07-27

Using computer-based simulation systems in medical education is becoming more and more common. Although the benefits of practicing with these systems in medical education have been demonstrated, advantages of using computer-based simulation in emergency medicine education are less validated. The aim of the present study was to assess the success rates of final year medical students in doing emergency medical treatment and evaluating the effectiveness of computer-based simulation training in improving final year medical students' knowledge. Twenty four Students trained with computer-based simulation and completed at least 4 hours of simulation-based education between the dates Feb 1, 2010 - May 1, 2010. Also a control group (traditionally trained, n =24) was chosen. After the end of training, students completed an examination about 5 randomized medical simulation cases. In 5 cases, an average of 3.9 correct medical approaches carried out by computer-based simulation trained students, an average of 2.8 correct medical approaches carried out by traditionally trained group (t = 3.90, p < 0.005). We found that the success of students trained with simulation training in cases which required complicated medical approach, was statistically higher than the ones who didn't take simulation training (p ≤ 0.05). Computer-based simulation training would be significantly effective in learning of medical treatment algorithms. We thought that these programs can improve the success rate of students especially in doing adequate medical approach to complex emergency cases.

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

Some Factors Influencing Air Force Simulator Training Effectiveness. Technical Report.

ERIC Educational Resources Information Center

Caro, Paul W.

A study of U.S. Air Force simulator training was conducted to identify factors that influence the effectiveness of such training and to learn how its effectiveness is being determined. The research consisted of a survey of ten representative Air Force simulator training programs and a review of the simulator training research literature. A number…

The Persistent Issue of Simulator Sickness in Naval Aviation Training.

PubMed

Geyer, Daniel J; Biggs, Adam T

2018-04-01

Virtual simulations offer nearly unlimited training potential for naval aviation due to the wide array of scenarios that can be simulated in a safe, reliable, and cost-effective environment. This versatility has created substantial interest in using existing and emerging virtual technology to enhance training scenarios. However, the virtual simulations themselves may hinder training initiatives by inducing simulator sickness among the trainees, which is a series of symptoms similar to motion sickness that can arise from simulator use. Simulator sickness has been a problem for military aviation since the first simulators were introduced. The problem has also persisted despite the increasing fidelity and sense of immersion offered by new generations of simulators. As such, it is essential to understand the various problems so that trainers can ensure the best possible use of the simulators. This review will examine simulator sickness as it pertains to naval aviation training. Topics include: the prevailing theories on why symptoms develop, methods of measurement, contributing factors, effects on training, effects when used shipboard, aftereffects, countermeasures, and recommendations for future research involving virtual simulations in an aviation training environment.Geyer DJ, Biggs AT. The persistent issue of simulator sickness in naval aviation training. Aerosp Med Hum Perform. 2018; 89(4):396-405.

Construct Validity of Fresh Frozen Human Cadaver as a Training Model in Minimal Access Surgery

PubMed Central

Macafee, David; Pranesh, Nagarajan; Horgan, Alan F.

2012-01-01

Background: The construct validity of fresh human cadaver as a training tool has not been established previously. The aims of this study were to investigate the construct validity of fresh frozen human cadaver as a method of training in minimal access surgery and determine if novices can be rapidly trained using this model to a safe level of performance. Methods: Junior surgical trainees, novices (<3 laparoscopic procedure performed) in laparoscopic surgery, performed 10 repetitions of a set of structured laparoscopic tasks on fresh frozen cadavers. Expert laparoscopists (>100 laparoscopic procedures) performed 3 repetitions of identical tasks. Performances were scored using a validated, objective Global Operative Assessment of Laparoscopic Skills scale. Scores for 3 consecutive repetitions were compared between experts and novices to determine construct validity. Furthermore, to determine if the novices reached a safe level, a trimmed mean of the experts score was used to define a benchmark. Mann-Whitney U test was used for construct validity analysis and 1-sample t test to compare performances of the novice group with the benchmark safe score. Results: Ten novices and 2 experts were recruited. Four out of 5 tasks (nondominant to dominant hand transfer; simulated appendicectomy; intracorporeal and extracorporeal knot tying) showed construct validity. Novices’ scores became comparable to benchmark scores between the eighth and tenth repetition. Conclusion: Minimal access surgical training using fresh frozen human cadavers appears to have construct validity. The laparoscopic skills of novices can be accelerated through to a safe level within 8 to 10 repetitions. PMID:23318058

A 3D Human-Machine Integrated Design and Analysis Framework for Squat Exercises with a Smith Machine.

PubMed

Lee, Haerin; Jung, Moonki; Lee, Ki-Kwang; Lee, Sang Hun

2017-02-06

In this paper, we propose a three-dimensional design and evaluation framework and process based on a probabilistic-based motion synthesis algorithm and biomechanical analysis system for the design of the Smith machine and squat training programs. Moreover, we implemented a prototype system to validate the proposed framework. The framework consists of an integrated human-machine-environment model as well as a squat motion synthesis system and biomechanical analysis system. In the design and evaluation process, we created an integrated model in which interactions between a human body and machine or the ground are modeled as joints with constraints at contact points. Next, we generated Smith squat motion using the motion synthesis program based on a Gaussian process regression algorithm with a set of given values for independent variables. Then, using the biomechanical analysis system, we simulated joint moments and muscle activities from the input of the integrated model and squat motion. We validated the model and algorithm through physical experiments measuring the electromyography (EMG) signals, ground forces, and squat motions as well as through a biomechanical simulation of muscle forces. The proposed approach enables the incorporation of biomechanics in the design process and reduces the need for physical experiments and prototypes in the development of training programs and new Smith machines.

A simulation study of control and display requirements for zero-experience general aviation pilots

NASA Technical Reports Server (NTRS)

Stewart, Eric C.

1993-01-01

The purpose of this simulation study was to define the basic human factor requirements for operating an airplane in all weather conditions. The basic human factors requirements are defined as those for an operator who is a complete novice for airplane operations but who is assumed to have automobile driving experience. These operators thus have had no piloting experience or training of any kind. The human factor requirements are developed for a practical task which includes all of the basic maneuvers required to go from one airport to another airport in limited visibility conditions. The task was quite demanding including following a precise path with climbing and descending turns while simultaneously changing airspeed. The ultimate goal of this research is to increase the utility of general aviation airplanes - that is, to make them a practical mode of transportation for a much larger segment of the general population. This can be accomplished by reducing the training and proficiency requirements of pilots while improving the level of safety. It is believed that advanced technologies such as fly-by-wire (or light), and head-up pictorial displays can be of much greater benefit to the general aviation pilot than to the full-time, professional pilot.

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.

14 CFR 142.54 - Airline transport pilot certification training program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... training in a flight simulation training device— (1) Holds an aircraft type rating for the aircraft represented by the flight simulation training device utilized in the training program and have received... will be demonstrated in the flight simulation training device; and (2) Satisfies the requirements of...

14 CFR 121.408 - Training equipment other than flight simulation training devices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Training equipment other than flight simulation training devices. 121.408 Section 121.408 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... § 121.408 Training equipment other than flight simulation training devices. (a) The Administrator must...

Effectiveness of the Multilayered Caries Model and Visuo-tactile Virtual Reality Simulator for Minimally Invasive Caries Removal: A Randomized Controlled Trial.

PubMed

Dwisaptarini, A P; Suebnukarn, S; Rhienmora, P; Haddawy, P; Koontongkaew, S

This work presents the multilayered caries model with a visuo-tactile virtual reality simulator and a randomized controlled trial protocol to determine the effectiveness of the simulator in training for minimally invasive caries removal. A three-dimensional, multilayered caries model was reconstructed from 10 micro-computed tomography (CT) images of deeply carious extracted human teeth before and after caries removal. The full grey scale 0-255 yielded a median grey scale value of 0-9, 10-18, 19-25, 26-52, and 53-80 regarding dental pulp, infected carious dentin, affected carious dentin, normal dentin, and normal enamel, respectively. The simulator was connected to two haptic devices for a handpiece and mouth mirror. The visuo-tactile feedback during the operation varied depending on the grey scale. Sixth-year dental students underwent a pretraining assessment of caries removal on extracted teeth. The students were then randomly assigned to train on either the simulator (n=16) or conventional extracted teeth (n=16) for 3 days, after which the assessment was repeated. The posttraining performance of caries removal improved compared with pretraining in both groups (Wilcoxon, p<0.05). The equivalence test for proportional differences (two 1-sided t-tests) with a 0.2 margin confirmed that the participants in both groups had identical posttraining performance scores (95% CI=0.92, 1; p=0.00). In conclusion, training on the micro-CT multilayered caries model with the visuo-tactile virtual reality simulator and conventional extracted tooth had equivalent effects on improving performance of minimally invasive caries removal.

14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. (a) Each airplane simulator and other training device that is used in a training course permitted under § 121.409...

A Transfer of Training Study of Control Loader Dynamics

NASA Technical Reports Server (NTRS)

Cardullo, Frank M.; Stanco, Anthony A.; Kelly, Lon C.; Houck, Jacob A.; Grube, Richard C.

2011-01-01

The control inceptor used in a simulated vehicle is an important part in maintaining the fidelity of a simulation. The force feedback provided by the control inceptor gives the operator important cues to maintain adequate performance. The dynamics of a control inceptor are typically based on a second order spring mass damper system with damping, force gradient, breakout force, and natural frequency parameters. Changing these parameters can have a great effect on pilot or driver control of the vehicle. The neuromuscular system has a very important role in manipulating the control inceptor within a vehicle. Many studies by McRuer, Aponso, and Hess have dealt with modeling the neuromuscular system and quantifying the effects of a high fidelity control loader as compared to a low fidelity control loader. Humans are adaptive in nature and their control behavior changes based on different control loader dynamics. Humans will change their control behavior to maintain tracking bandwidth and minimize tracking error. This paper reports on a quasi-transfer of training experiment which was performed at the NASA Langley Research Center. The quasi transfer of training study used a high fidelity control loader and a low fidelity control loader. Subjects trained in both simulations and then were transferred to the high fidelity control loader simulation. The parameters for the high fidelity control loader were determined from the literature. The low fidelity control loader parameters were found through testing of a simple computer joystick. A disturbance compensatory task is employed. The compensatory task involves implementing a simple horizon out the window display. A disturbance consisting of a sum of sines is used. The task consists of the subject compensating for the disturbance on the roll angle of the aircraft. The vehicle dynamics are represented as 1/s and 1/s2. The subject will try to maintain level flight throughout the experiment. The subjects consist of non-pilots to remove any effects of pilot experience. First, this paper discusses the implementation of the disturbance compensation task. Second, the high and low fidelity parameters used within the experiment are presented. Finally, an explanation of results from the experiments is presented.

Framework for incorporating simulation into urology training.

PubMed

Arora, Sonal; Lamb, Benjamin; Undre, Shabnam; Kneebone, Roger; Darzi, Ara; Sevdalis, Nick

2011-03-01

• Changes to working hours, new technologies and increased accountability have rendered the need for alternative training environments for urologists. • Simulation offers a promising arena for learning to take place in a safe, realistic setting. • Despite its benefits, the incorporation of simulation into urological training programmes remains minimal. • The current status and future directions of simulation for training in technical and non-technical skills are reviewed as they pertain to urology. • A framework is presented for how simulation-based training could be incorporated into the entire urological curriculum. • The literature on simulation in technical and non-technical skills training is reviewed, with a specific focus upon urology. • To fully integrate simulation into a training curriculum, its possibilities for addressing all the competencies required by a urologist must be realized. • At an early stage of training, simulation has been used to develop basic technical skills and cognitive skills, such as decision-making and communication. • At an intermediate stage, the studies focus upon more advanced technical skills learnt with virtual reality simulators. • Non-technical skills training would include leadership and could be delivered with in situ models. • At the final stage, experienced trainees can practise technical and non-technical skills in full crisis simulations situated within a fully-simulated operating rooms. • Simulation can provide training in the technical and non-technical skills required to be a competent urologist. • The framework presented may guide how best to incorporate simulation into training curricula. • Future work should determine whether acquired skills transfer to clinical practice and improve patient care. © 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.

14 CFR 121.915 - Continuing qualification curriculum.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., flight training device, flight simulator, or other equipment, as appropriate, on normal, abnormal, and... training in the type flight training device or the type flight simulator, as appropriate, regarding... flight simulators or flight training devices: Training in operational flight procedures and maneuvers...

14 CFR 121.915 - Continuing qualification curriculum.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., flight training device, flight simulator, or other equipment, as appropriate, on normal, abnormal, and... training in the type flight training device or the type flight simulator, as appropriate, regarding... flight simulators or flight training devices: Training in operational flight procedures and maneuvers...

14 CFR 121.915 - Continuing qualification curriculum.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., flight training device, flight simulator, or other equipment, as appropriate, on normal, abnormal, and... training in the type flight training device or the type flight simulator, as appropriate, regarding... flight simulators or flight training devices: Training in operational flight procedures and maneuvers...

Simulation and training of lumbar punctures using haptic volume rendering and a 6DOF haptic device

NASA Astrophysics Data System (ADS)

Färber, Matthias; Heller, Julika; Handels, Heinz

2007-03-01

The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. The training of this procedure is usually done on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patient's risk. We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about image structures that can not be segmented. A real-time 3D visualization with optional stereo view shows the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is defined in an XML file together with haptic rendering and visualization parameters. In a first evaluation the visible human male data has been used to generate a virtual training body. Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic puncture simulation.

Introducing a laparoscopic simulation training and credentialing program in gynaecology: an observational study.

PubMed

Janssens, Sarah; Beckmann, Michael; Bonney, Donna

2015-08-01

Simulation training in laparoscopic surgery has been shown to improve surgical performance. To describe the implementation of a laparoscopic simulation training and credentialing program for gynaecology registrars. A pilot program consisting of protected, supervised laparoscopic simulation time, a tailored curriculum and a credentialing process, was developed and implemented. Quantitative measures assessing simulated surgical performance were measured over the simulation training period. Laparoscopic procedures requiring credentialing were assessed for both the frequency of a registrar being the primary operator and the duration of surgery and compared to a presimulation cohort. Qualitative measures regarding quality of surgical training were assessed pre- and postsimulation. Improvements were seen in simulated surgical performance in efficiency domains. Operative time for procedures requiring credentialing was reduced by 12%. Primary operator status in the operating theatre for registrars was unchanged. Registrar assessment of training quality improved. The introduction of a laparoscopic simulation training and credentialing program resulted in improvements in simulated performance, reduced operative time and improved registrar assessment of the quality of training. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Progress in virtual reality simulators for surgical training and certification.

PubMed

de Visser, Hans; Watson, Marcus O; Salvado, Olivier; Passenger, Joshua D

2011-02-21

There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. However, currently available VR simulators lack the fidelity to teach trainees past the novice-to-intermediate skills level. Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of physical realism, case complexity and performance assessment. Proper validation of VR simulators and an increased appreciation of their value by the medical profession are crucial for them to be accepted into surgical training curricula.

A review of virtual reality based training simulators for orthopaedic surgery.

PubMed

Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

A silicon sol-gel approach to the development of forensic blood substitutes: Design Considerations for Research and Training

NASA Astrophysics Data System (ADS)

Stotesbury, Theresa E.

The research and development of synthetic blood substitutes is a reported need within the forensic community. This work contributes to the growing body of knowledge in bloodstain pattern analysis by offering a materials science approach to designing, producing and testing synthetic forensic blood substitutes. A key deliverable from this research is the creation of a robust silicon-based material using the solution-gelation technique that has been validated for controlled passive drip and spatter simulation. The work investigates the physical properties (viscosity, surface tension and density) of forensic blood substitute formulations and describes the similarity in the spreading dynamics of the optimized material to whole human blood. It then explores how blood and other fluids behave in impact simulation using high-speed video analysis and supports the use of the optimized material for spatter simulation. Finally, the work highlights the practical value of the material as an educational tool for both basic and advanced bloodstain experimentation and training.

Snowplow Simulator Training Study

DOT National Transportation Integrated Search

2011-01-01

This report evaluates simulation training of IDOT snowplow operators to improve IDOT snow and ice removal : operations. Specifically, it assesses a drivers evaluation of snowplow simulation training immediately after : training in fall 2009 and ag...

Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models.

PubMed

Denadai, Rafael; Oshiiwa, Marie; Saad-Hossne, Rogério

2014-03-01

The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.

Advanced Technology Training System on Motor-Operated Valves

NASA Technical Reports Server (NTRS)

Wiederholt, Bradley J.; Widjaja, T. Kiki; Yasutake, Joseph Y.; Isoda, Hachiro

1993-01-01

This paper describes how features from the field of Intelligent Tutoring Systems are applied to the Motor-Operated Valve (MOV) Advanced Technology Training System (ATTS). The MOV ATTS is a training system developed at Galaxy Scientific Corporation for the Central Research Institute of Electric Power Industry in Japan and the Electric Power Research Institute in the United States. The MOV ATTS combines traditional computer-based training approaches with system simulation, integrated expert systems, and student and expert modeling. The primary goal of the MOV ATTS is to reduce human errors that occur during MOV overhaul and repair. The MOV ATTS addresses this goal by providing basic operational information of the MOV, simulating MOV operation, providing troubleshooting practice of MOV failures, and tailoring this training to the needs of each individual student. The MOV ATTS integrates multiple expert models (functional and procedural) to provide advice and feedback to students. The integration also provides expert model validation support to developers. Student modeling is supported by two separate student models: one model registers and updates the student's current knowledge of basic MOV information, while another model logs the student's actions and errors during troubleshooting exercises. These two models are used to provide tailored feedback to the student during the MOV course.

Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

PubMed

Shetty, Shohan; Zevin, Boris; Grantcharov, Teodor P; Roberts, Kurt E; Duffy, Andrew J

2014-01-01

Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The simulation laboratory was most commonly used during work hours; lack of free time during work hours was most commonly cited as a reason for underutilization. Factors influencing use of the simulation laboratory in order of importance were the need for skill development, an interest in minimally invasive surgery, mandatory/protected time in a simulation environment as part of the residency program curriculum, a recommendation by an attending surgeon, and proximity of the simulation center. The most preferred simulation tool was the live animal model followed by cadaveric tissue. Virtual reality simulators were among the least-preferred (25%) simulation tools. Most residents (91.0%) felt that mandatory/protected time in a simulation environment should be introduced into resident training protocols. Mandatory and protected time in a simulation environment as part of the resident training curriculum may improve participation in simulation training. A comprehensive curriculum, which includes the use of live animals, cadaveric tissue, and virtual reality simulators, may enhance the laparoscopic training experience and interest level of surgical trainees. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Transfer of Complex Skill Learning from Virtual to Real Rowing

PubMed Central

Rauter, Georg; Sigrist, Roland; Koch, Claudio; Crivelli, Francesco; van Raai, Mark; Riener, Robert; Wolf, Peter

2013-01-01

Simulators are commonly used to train complex tasks. In particular, simulators are applied to train dangerous tasks, to save costs, and to investigate the impact of different factors on task performance. However, in most cases, the transfer of simulator training to the real task has not been investigated. Without a proof for successful skill transfer, simulators might not be helpful at all or even counter-productive for learning the real task. In this paper, the skill transfer of complex technical aspects trained on a scull rowing simulator to sculling on water was investigated. We assume if a simulator provides high fidelity rendering of the interactions with the environment even without augmented feedback, training on such a realistic simulator would allow similar skill gains as training in the real environment. These learned skills were expected to transfer to the real environment. Two groups of four recreational rowers participated. One group trained on water, the other group trained on a simulator. Within two weeks, both groups performed four training sessions with the same licensed rowing trainer. The development in performance was assessed by quantitative biomechanical performance measures and by a qualitative video evaluation of an independent, blinded trainer. In general, both groups could improve their performance on water. The used biomechanical measures seem to allow only a limited insight into the rowers' development, while the independent trainer could also rate the rowers' overall impression. The simulator quality and naturalism was confirmed by the participants in a questionnaire. In conclusion, realistic simulator training fostered skill gains to a similar extent as training in the real environment and enabled skill transfer to the real environment. In combination with augmented feedback, simulator training can be further exploited to foster motor learning even to a higher extent, which is subject to future work. PMID:24376518

Lack of transfer of skills after virtual reality simulator training with haptic feedback.

PubMed

Våpenstad, Cecilie; Hofstad, Erlend Fagertun; Bø, Lars Eirik; Kuhry, Esther; Johnsen, Gjermund; Mårvik, Ronald; Langø, Thomas; Hernes, Toril Nagelhus

2017-12-01

Virtual reality (VR) simulators enrich surgical training and offer training possibilities outside of the operating room (OR). In this study, we created a criterion-based training program on a VR simulator with haptic feedback and tested it by comparing the performances of a simulator group against a control group. Medical students with no experience in laparoscopy were randomly assigned to a simulator group or a control group. In the simulator group, the candidates trained until they reached predefined criteria on the LapSim ® VR simulator (Surgical Science AB, Göteborg, Sweden) with haptic feedback (Xitact TM IHP, Mentice AB, Göteborg, Sweden). All candidates performed a cholecystectomy on a porcine organ model in a box trainer (the clinical setting). The performances were video rated by two surgeons blinded to subject training status. In total, 30 students performed the cholecystectomy and had their videos rated (N = 16 simulator group, N = 14 control group). The control group achieved better video rating scores than the simulator group (p < .05). The criterion-based training program did not transfer skills to the clinical setting. Poor mechanical performance of the simulated haptic feedback is believed to have resulted in a negative training effect.

Clinical simulation training improves the clinical performance of Chinese medical students

PubMed Central

Zhang, Ming-ya; Cheng, Xin; Xu, An-ding; Luo, Liang-ping; Yang, Xuesong

2015-01-01

Background Modern medical education promotes medical students’ clinical operating capacity rather than the mastery of theoretical knowledge. To accomplish this objective, clinical skill training using various simulations was introduced into medical education to cultivate creativity and develop the practical ability of students. However, quantitative analysis of the efficiency of clinical skill training with simulations is lacking. Methods In the present study, we compared the mean scores of medical students (Jinan University) who graduated in 2013 and 2014 on 16 stations between traditional training (control) and simulative training groups. In addition, in a clinical skill competition, the objective structured clinical examination (OSCE) scores of participating medical students trained using traditional and simulative training were compared. The data were statistically analyzed and qualitatively described. Results The results revealed that simulative training could significantly enhance the graduate score of medical students compared with the control. The OSCE scores of participating medical students in the clinical skill competition, trained using simulations, were dramatically higher than those of students trained through traditional methods, and we also observed that the OSCE marks were significantly increased for the same participant after simulative training for the clinical skill competition. Conclusions Taken together, these data indicate that clinical skill training with a variety of simulations could substantially promote the clinical performance of medical students and optimize the resources used for medical education, although a precise analysis of each specialization is needed in the future. PMID:26478142

Distributed Simulation as a modelling tool for the development of a simulation-based training programme for cardiovascular specialties.

PubMed

Kelay, Tanika; Chan, Kah Leong; Ako, Emmanuel; Yasin, Mohammad; Costopoulos, Charis; Gold, Matthew; Kneebone, Roger K; Malik, Iqbal S; Bello, Fernando

2017-01-01

Distributed Simulation is the concept of portable, high-fidelity immersive simulation. Here, it is used for the development of a simulation-based training programme for cardiovascular specialities. We present an evidence base for how accessible, portable and self-contained simulated environments can be effectively utilised for the modelling, development and testing of a complex training framework and assessment methodology. Iterative user feedback through mixed-methods evaluation techniques resulted in the implementation of the training programme. Four phases were involved in the development of our immersive simulation-based training programme: ( 1) initial conceptual stage for mapping structural criteria and parameters of the simulation training framework and scenario development ( n  = 16), (2) training facility design using Distributed Simulation , (3) test cases with clinicians ( n  = 8) and collaborative design, where evaluation and user feedback involved a mixed-methods approach featuring (a) quantitative surveys to evaluate the realism and perceived educational relevance of the simulation format and framework for training and (b) qualitative semi-structured interviews to capture detailed feedback including changes and scope for development. Refinements were made iteratively to the simulation framework based on user feedback, resulting in (4) transition towards implementation of the simulation training framework, involving consistent quantitative evaluation techniques for clinicians ( n  = 62). For comparative purposes, clinicians' initial quantitative mean evaluation scores for realism of the simulation training framework, realism of the training facility and relevance for training ( n  = 8) are presented longitudinally, alongside feedback throughout the development stages from concept to delivery, including the implementation stage ( n  = 62). Initially, mean evaluation scores fluctuated from low to average, rising incrementally. This corresponded with the qualitative component, which augmented the quantitative findings; trainees' user feedback was used to perform iterative refinements to the simulation design and components (collaborative design), resulting in higher mean evaluation scores leading up to the implementation phase. Through application of innovative Distributed Simulation techniques, collaborative design, and consistent evaluation techniques from conceptual, development, and implementation stages, fully immersive simulation techniques for cardiovascular specialities are achievable and have the potential to be implemented more broadly.

Vertical flight training: An overview of training and flight simulator technology with emphasis on rotary-wing requirements

NASA Technical Reports Server (NTRS)

Alderete, Thomas S.; Ascencio-Lee, Carmen E.; Bray, Richard; Carlton, John; Dohme, Jack; Eshow, Michelle M.; Francis, Stephen; Lee, Owen M.; Lintern, Gavan; Lombardo, David A.

1994-01-01

The principal purpose of this publication is to provide a broad overview of the technology that is relevant to the design of aviation training systems and of the techniques applicable to the development, use, and evaluation of those systems. The issues addressed in our 11 chapters are, for the most part, those that would be expected to surface in any informed discussion of the major characterizing elements of aviation training systems. Indeed, many of the same facets of vertical-flight training discussed were recognized and, to some extent, dealt with at the 1991 NASA/FAA Helicopter Simulator Workshop. These generic topics are essential to a sound understanding of training and training systems, and they quite properly form the basis of any attempt to systematize the development and evaluation of more effective, more efficient, more productive, and more economical approaches to aircrew training. Individual chapters address the following topics: an overview of the vertical flight industry: the source of training requirements; training and training schools: meeting current requirements; training systems design and development; transfer of training and cost-effectiveness; the military quest for flight training effectiveness; alternative training systems; training device manufacturing; simulator aero model implementation; simulation validation in the frequency domain; cockpit motion in helicopter simulation; and visual space perception in flight simulators.

Generating classes of 3D virtual mandibles for AR-based medical simulation.

PubMed

Hippalgaonkar, Neha R; Sider, Alexa D; Hamza-Lup, Felix G; Santhanam, Anand P; Jaganathan, Bala; Imielinska, Celina; Rolland, Jannick P

2008-01-01

Simulation and modeling represent promising tools for several application domains from engineering to forensic science and medicine. Advances in 3D imaging technology convey paradigms such as augmented reality (AR) and mixed reality inside promising simulation tools for the training industry. Motivated by the requirement for superimposing anatomically correct 3D models on a human patient simulator (HPS) and visualizing them in an AR environment, the purpose of this research effort was to develop and validate a method for scaling a source human mandible to a target human mandible within a 2 mm root mean square (RMS) error. Results show that, given a distance between 2 same landmarks on 2 different mandibles, a relative scaling factor may be computed. Using this scaling factor, results show that a 3D virtual mandible model can be made morphometrically equivalent to a real target-specific mandible within a 1.30 mm RMS error. The virtual mandible may be further used as a reference target for registering other anatomic models, such as the lungs, on the HPS. Such registration will be made possible by physical constraints among the mandible and the spinal column in the horizontal normal rest position.

Engineering and simulation of life science Spacelab experiments

NASA Technical Reports Server (NTRS)

Bush, B.; Rummel, J.; Johnston, R. S.

1977-01-01

Approaches to the planning and realization of Spacelab life sciences experiments, which may involve as many as 16 Space Shuttle missions and 100 tests, are discussed. In particular, a Spacelab simulation program, designed to evaluate problems associated with the use of live animal specimens, the constraints imposed by zero gravity on equipment operation, training of investigators and data management, is described. The simulated facility approximates the hardware and support systems of a current European Space Agency Spacelab model. Preparations necessary for the experimental program, such as crew activity plans, payload documentation and inflight experimental procedures are developed; health problems of the crew, including human/animal microbial contamination, are also assessed.

The Trick Simulation Toolkit: A NASA/Opensource Framework for Running Time Based Physics Models

NASA Technical Reports Server (NTRS)

Penn, John M.

2016-01-01

The Trick Simulation Toolkit is a simulation development environment used to create high fidelity training and engineering simulations at the NASA Johnson Space Center and many other NASA facilities. Its purpose is to generate a simulation executable from a collection of user-supplied models and a simulation definition file. For each Trick-based simulation, Trick automatically provides job scheduling, numerical integration, the ability to write and restore human readable checkpoints, data recording, interactive variable manipulation, a run-time interpreter, and many other commonly needed capabilities. This allows simulation developers to concentrate on their domain expertise and the algorithms and equations of their models. Also included in Trick are tools for plotting recorded data and various other supporting utilities and libraries. Trick is written in C/C++ and Java and supports both Linux and MacOSX computer operating systems. This paper describes Trick's design and use at NASA Johnson Space Center.

Simulators for Mariner Training and Licensing: Functional Specifications and Training Program Guidelines for a Maritime Cadet Simulator.

DTIC Science & Technology

1982-12-01

9 2 Criticality of Cadet Training Objectives .............................................. 10 3 Simulator Best, High ...simu- " The already high costs associated with at-sea training lator within the multiple media approach to cadet training have been escalating...Bridge Procedures. that color is desirable for high workloads; the additional cost for multicolor under nighttime conditions may not " Simulator

Virtual reality simulation training of mastoidectomy - studies on novice performance.

PubMed

Andersen, Steven Arild Wuyts

2016-08-01

Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate assessment following each procedure. Standard setting by establishing a proficiency level that can be used for mastery learning with deliberate practice could also further sophisticate directed, self-regulated learning in VR simulation-based training. VR simulation-based training should be embedded in a systematic and competency-based training curriculum for high-quality surgical skills training, ultimately leading to improved safety and patient care.

Cost-effective and low-technology options for simulation and training in neonatology.

PubMed

Bruno, Christie J; Glass, Kristen M

2016-11-01

The purpose of this review is to explore low-cost options for simulation and training in neonatology. Numerous cost-effective options exist for simulation and training in neonatology. Lower cost options are available for teaching clinical skills and procedural training in neonatal intubation, chest tube insertion, and pericardiocentesis, among others. Cost-effective, low-cost options for simulation-based education can be developed and shared in order to optimize the neonatal simulation training experience. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of the Remote Access Virtual Environment Network (RAVEN) for coordinated IVA-EVA astronaut training and evaluation.

PubMed

Cater, J P; Huffman, S D

1995-01-01

This paper presents a unique virtual reality training and assessment tool developed under a NASA grant, "Research in Human Factors Aspects of Enhanced Virtual Environments for Extravehicular Activity (EVA) Training and Simulation." The Remote Access Virtual Environment Network (RAVEN) was created to train and evaluate the verbal, mental and physical coordination required between the intravehicular (IVA) astronaut operating the Remote Manipulator System (RMS) arm and the EVA astronaut standing in foot restraints on the end of the RMS. The RAVEN system currently allows the EVA astronaut to approach the Hubble Space Telescope (HST) under control of the IVA astronaut and grasp, remove, and replace the Wide Field Planetary Camera drawer from its location in the HST. Two viewpoints, one stereoscopic and one monoscopic, were created all linked by Ethernet, that provided the two trainees with the appropriate training environments.

Emergent Capabilities Converging into M and S 2.0

NASA Technical Reports Server (NTRS)

Reitz, Emilie; Reist, Jay

2012-01-01

The continued operational environment complexity faced by the Department of Defense, despite a restricted resource environment, is a mandate for greater adaptability and availability in joint training. To address these constraints, this paper proposes a model for the potential integration of adaptability training, virtual world capabilities and immersive training into the wider Joint Live Virtual and Constructive (JLVC) Federation, supported by human, social, cultural and behavior modeling, and measurement and assessment. By fusing those capabilities and modeling and simulation enhancements into the JLVC federation, it will create a force who is more apt to arrive at and implement correct decisions, and more able to appropriately seize initiative in the field. The model would allow for the testing and training of capabilities and TTPs that cannot be reasonably explored to their logical conclusions in a 'live' environment, as well as enhance training fidelity for all echelons and tasks.

Development of the KOSMS management simulation training system and its application

NASA Astrophysics Data System (ADS)

Takatsu, Yoshiki

The use of games which simulate actual corporate management has recently become more common and is now utilized in various ways for in-house corporate training courses. KOSMS (Kobe Steel Management Simulation System), a training system designed to help improve the management skills of senior management staff, is a unique management simulation training system in which the participants, using personal computers, must make decisions concerning a variety of management activities, in simulated competition with other corporations. This report outlines the KOSMS system, and describes the basic structure and detailed contents of the management simulation models, and actual application of the KOSMS management simulation training.

Validation of the train energy and dynamics simulator (TEDS).

DOT National Transportation Integrated Search

2015-01-01

FRA has developed Train Energy and Dynamics Simulator (TEDS) based upon a longitudinal train dynamics and operations : simulation model which allows users to conduct safety and risk evaluations, incident investigations, studies of train operations, :...

An Annotated Selective Bibliography on Human Performance in Fault Diagnosis Tasks. Technical Report 435. Final Report.

ERIC Educational Resources Information Center

Johnson, William B.; And Others

This annotated bibliography developed in connection with an ongoing investigation of the use of computer simulations for fault diagnosis training cites 61 published works taken predominantly from the disciplines of engineering, psychology, and education. A review of the existing literature included computer searches of the past ten years of…

A computational model that predicts behavioral sensitivity to intracortical microstimulation

PubMed Central

Kim, Sungshin; Callier, Thierri; Bensmaia, Sliman J.

2016-01-01

Objective Intracortical microstimulation (ICMS) is a powerful tool to investigate the neural mechanisms of perception and can be used to restore sensation for patients who have lost it. While sensitivity to ICMS has previously been characterized, no systematic framework has been developed to summarize the detectability of individual ICMS pulse trains or the discriminability of pairs of pulse trains. Approach We develop a simple simulation that describes the responses of a population of neurons to a train of electrical pulses delivered through a microelectrode. We then perform an ideal observer analysis on the simulated population responses to predict the behavioral performance of non-human primates in ICMS detection and discrimination tasks. Main results Our computational model can predict behavioral performance across a wide range of stimulation conditions with high accuracy (R2 = 0.97) and generalizes to novel ICMS pulse trains that were not used to fit its parameters. Furthermore, the model provides a theoretical basis for the finding that amplitude discrimination based on ICMS violates Weber's law. Significance The model can be used to characterize the sensitivity to ICMS across the range of perceptible and safe stimulation regimes. As such, it will be a useful tool for both neuroscience and neuroprosthetics. PMID:27977419

A computational model that predicts behavioral sensitivity to intracortical microstimulation.

PubMed

Kim, Sungshin; Callier, Thierri; Bensmaia, Sliman J

2017-02-01

Intracortical microstimulation (ICMS) is a powerful tool to investigate the neural mechanisms of perception and can be used to restore sensation for patients who have lost it. While sensitivity to ICMS has previously been characterized, no systematic framework has been developed to summarize the detectability of individual ICMS pulse trains or the discriminability of pairs of pulse trains. We develop a simple simulation that describes the responses of a population of neurons to a train of electrical pulses delivered through a microelectrode. We then perform an ideal observer analysis on the simulated population responses to predict the behavioral performance of non-human primates in ICMS detection and discrimination tasks. Our computational model can predict behavioral performance across a wide range of stimulation conditions with high accuracy (R 2  = 0.97) and generalizes to novel ICMS pulse trains that were not used to fit its parameters. Furthermore, the model provides a theoretical basis for the finding that amplitude discrimination based on ICMS violates Weber's law. The model can be used to characterize the sensitivity to ICMS across the range of perceptible and safe stimulation regimes. As such, it will be a useful tool for both neuroscience and neuroprosthetics.

A computational model that predicts behavioral sensitivity to intracortical microstimulation

NASA Astrophysics Data System (ADS)

Kim, Sungshin; Callier, Thierri; Bensmaia, Sliman J.

2017-02-01

Objective. Intracortical microstimulation (ICMS) is a powerful tool to investigate the neural mechanisms of perception and can be used to restore sensation for patients who have lost it. While sensitivity to ICMS has previously been characterized, no systematic framework has been developed to summarize the detectability of individual ICMS pulse trains or the discriminability of pairs of pulse trains. Approach. We develop a simple simulation that describes the responses of a population of neurons to a train of electrical pulses delivered through a microelectrode. We then perform an ideal observer analysis on the simulated population responses to predict the behavioral performance of non-human primates in ICMS detection and discrimination tasks. Main results. Our computational model can predict behavioral performance across a wide range of stimulation conditions with high accuracy (R 2 = 0.97) and generalizes to novel ICMS pulse trains that were not used to fit its parameters. Furthermore, the model provides a theoretical basis for the finding that amplitude discrimination based on ICMS violates Weber’s law. Significance. The model can be used to characterize the sensitivity to ICMS across the range of perceptible and safe stimulation regimes. As such, it will be a useful tool for both neuroscience and neuroprosthetics.

Simulation-based training for nurses: Systematic review and meta-analysis.

PubMed

Hegland, Pål A; Aarlie, Hege; Strømme, Hilde; Jamtvedt, Gro

2017-07-01

Simulation-based training is a widespread strategy to improve health-care quality. However, its effect on registered nurses has previously not been established in systematic reviews. The aim of this systematic review is to evaluate effect of simulation-based training on nurses' skills and knowledge. We searched CDSR, DARE, HTA, CENTRAL, CINAHL, MEDLINE, Embase, ERIC, and SveMed+ for randomised controlled trials (RCT) evaluating effect of simulation-based training among nurses. Searches were completed in December 2016. Two reviewers independently screened abstracts and full-text, extracted data, and assessed risk of bias. We compared simulation-based training to other learning strategies, high-fidelity simulation to other simulation strategies, and different organisation of simulation training. Data were analysed through meta-analysis and narrative syntheses. GRADE was used to assess the quality of evidence. Fifteen RCTs met the inclusion criteria. For the comparison of simulation-based training to other learning strategies on nurses' skills, six studies in the meta-analysis showed a significant, but small effect in favour of simulation (SMD -1.09, CI -1.72 to -0.47). There was large heterogeneity (I 2 85%). For the other comparisons, there was large between-study variation in results. The quality of evidence for all comparisons was graded as low. The effect of simulation-based training varies substantially between studies. Our meta-analysis showed a significant effect of simulation training compared to other learning strategies, but the quality of evidence was low indicating uncertainty. Other comparisons showed inconsistency in results. Based on our findings simulation training appears to be an effective strategy to improve nurses' skills, but further good-quality RCTs with adequate sample sizes are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diagnostic Performance 1 H after Simulation Training Predicts Learning

ERIC Educational Resources Information Center

Consoli, Anna; Fraser, Kristin; Ma, Irene; Sobczak, Matthew; Wright, Bruce; McLaughlin, Kevin

2013-01-01

Although simulation training improves post-training performance, it is unclear how well performance soon after simulation training predicts longer term outcomes (i.e., learning). Here our objective was to assess the predictive value of performance 1 h post-training of performance 6 weeks later. We trained 84 first year medical students a simulated…

14 CFR 121.407 - Training program: Approval of airplane simulators and other training devices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Training program: Approval of airplane... Program § 121.407 Training program: Approval of airplane simulators and other training devices. Link to an amendment published at 78 FR 67836, Nov. 12, 2013. (a) Each airplane simulator and other training device...

Development and validation of a septoplasty training model using 3-dimensional printing technology.

PubMed

AlReefi, Mahmoud A; Nguyen, Lily H P; Mongeau, Luc G; Haq, Bassam Ul; Boyanapalli, Siddharth; Hafeez, Nauman; Cegarra-Escolano, Francois; Tewfik, Marc A

2017-04-01

Providing alternative training modalities may improve trainees' ability to perform septoplasty. Three-dimensional printing has been shown to be a powerful tool in surgical training. The objectives of this study were to explain the development of our 3-dimensional (3D) printed septoplasty training model, to assess its face and content validity, and to present evidence supporting its ability to distinguish between levels of surgical proficiency. Imaging data of a patient with a nasal septal deviation was selected for printing. Printing materials reproducing the mechanical properties of human tissues were selected based on literature review and prototype testing. Eight expert rhinologists, 6 senior residents, and 6 junior residents performed endoscopic septoplasties on the model and completed a postsimulation survey. Performance metrics in quality (final product analysis), efficiency (time), and safety (eg, perforation length, nares damage) were recorded and analyzed in a study-blind manner. The model was judged to be anatomically correct and the steps performed realistic, with scores of 4.05 ± 0.82 and 4.2 ± 1, respectively, on a 5-point Likert scale. Ninety-two percent of residents desired the simulator to be integrated into their teaching curriculum. There was a significant difference (p < 0.05) between the expert, intermediate, and novice groups in time taken and nares cuts, whereas other performance metrics showed no significant difference. To our knowledge, there are no other simulator training models for septoplasty. Our model incorporates 2 different materials mixed into the 3 relevant consistencies necessary to simulate septoplasty. Our findings provide evidence supporting the validity of the model. © 2016 ARS-AAOA, LLC.

[Improvement of team competence in the operating room : Training programs from aviation].

PubMed

Schmidt, C E; Hardt, F; Möller, J; Malchow, B; Schmidt, K; Bauer, M

2010-08-01

Growing attention has been drawn to patient safety during recent months due to media reports of clinical errors. To date only clinical incident reporting systems have been implemented in acute care hospitals as instruments of risk management. However, these systems only have a limited impact on human factors which account for the majority of all errors in medicine. Crew resource management (CRM) starts here. For the commissioning of a new hospital in Minden, training programs were installed in order to maintain patient safety in a new complex environment. The training was planned in three parts: All relevant processes were defined as standard operating procedures (SOP), visualized and then simulated in the new building. In addition, staff members (trainers) in leading positions were trained in CRM in order to train the complete staff. The training programs were analyzed by questionnaires. Selection of topics, relevance for practice and mode of presentation were rated as very good by 73% of the participants. The staff members ranked the topics communication in crisis situations, individual errors and compensating measures as most important followed by case studies and teamwork. Employees improved in compliance to the SOP, team competence and communication. In high technology environments with escalating workloads and interdisciplinary organization, staff members are confronted with increasing demands in knowledge and skills. To reduce errors under such working conditions relevant processes should be standardized and trained for the emergency situation. Human performance can be supported by well-trained interpersonal skills which are evolved in CRM training. In combination these training programs make a significant contribution to maintaining patient safety.

Current status of endoscopic simulation in gastroenterology fellowship training programs.

PubMed

Jirapinyo, Pichamol; Thompson, Christopher C

2015-07-01

Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to clinical cases. No programs currently use simulation as part of the evaluation process.

Classification of micro-Doppler signatures of human aquatic activity through simulation and measurement using transferred learning

NASA Astrophysics Data System (ADS)

Kim, Youngwook; Park, Jinhee; Moon, Taesup

2017-05-01

Remote detection of human aquatic activity can be applied not only to ocean surveillance but also to rescue operations. When a human is illuminated by electromagnetic waves, a Doppler signal is generated from his or her moving parts. Indeed, bodily movements are what make humans' micro-Doppler signatures unique, offering a chance to classify human motions. Certain studies have analyzed and attempted to recognize human aquatic activity, but the topic has yet to be extensively studied. In the present research, we simulate the micro-Doppler signatures of a swimming person in an attempt to investigate those signatures' characteristics. We model human arms as point scatterers while assuming a simple arm motion. By means of such a simulation, we can obtain spectrograms from a swimming person, then extend our measurement to multiple participants. Measurements are taken from five aquatic activities featuring five participants, comprising freestyle, backstroke, and breaststroke, pulling a boat, and rowing. As suggested by the simulation study, the spectrograms for the five activities show different micro-Doppler signatures; hence, we propose to classify them using a deep convolutional neural network (DCNN). In particular, we suggest the use of a transfer-learned DCNN, which is based on a DCNN pretrained by a large-scale RGB image dataset that is, ImageNet. The classification accuracy is calculated using fivefold cross-validation on our dataset. We find that a DCNN trained through transfer learning achieves the highest accuracy while also providing a significant performance boost over the conventional classification method.

Transfer of Training from Simulators to Operational Equipment--Are Simulators Effective?

ERIC Educational Resources Information Center

Thomson, Douglas R.

1989-01-01

Examines the degree of fidelity required of a computer simulation to ensure maximum transfer of training. Simulators used in the military services for training pilots are described; relationships between fidelity, transfer, and cost are explored; and feedback to the student and measures of training effectiveness are discussed. (nine references)…

Users' Perception of Medical Simulation Training: A Framework for Adopting Simulator Technology

ERIC Educational Resources Information Center

Green, Leili Hayati

2014-01-01

Users play a key role in many training strategies, yet some organizations often fail to understand the users' perception after a simulation training implementation, their attitude about acceptance or rejection of and integration of emerging simulation technology in medical training (Gaba, 2007, and Topol, 2012). Several factors are considered to…

[Training of resident physicians in the recognition and treatment of an anaphylaxis case in pediatrics with simulation models].

PubMed

Enríquez, Diego; Lamborizio, María J; Firenze, Lorena; Jaureguizar, María de la P; Díaz Pumará, Estanislao; Szyld, Edgardo

2017-08-01

To evaluate the performance of resident physicians in diagnosing and treating a case of anaphylaxis, six months after participating in simulation training exercises. Initially, a group of pediatric residents were trained using simulation techniques in the management of critical pediatric cases. Based on their performance in this exercise, participants were assigned to one of 3 groups. At six months post-training, 4 residents were randomly chosen from each group to be re-tested, using the same performance measure as previously used. During the initial training session, 56 of 72 participants (78%) correctly identified and treated the case. Six months after the initial training, all 12 (100%) resident physicians who were re-tested successfully diagnosed and treated the simulated anaphylaxis case. The training through simulation techniques allowed correction or optimization of the treatment of simulated anaphylaxis cases in resident physicians evaluated after 6 months of the initial training.

Aircraft Simulators and Pilot Training.

ERIC Educational Resources Information Center

Caro, Paul W.

Flight simulators are built as realistically as possible, presumably to enhance their training value. Yet, their training value is determined by the way they are used. Traditionally, simulators have been less important for training than have aircraft, but they are currently emerging as primary pilot training vehicles. This new emphasis is an…

14 CFR 142.59 - Flight simulators and flight training devices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Flight simulators and flight training... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES TRAINING CENTERS Personnel and Flight Training Equipment Requirements § 142.59 Flight simulators and flight training devices. (a) An applicant for, or...

14 CFR 142.59 - Flight simulators and flight training devices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Flight simulators and flight training... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES TRAINING CENTERS Personnel and Flight Training Equipment Requirements § 142.59 Flight simulators and flight training devices. (a) An applicant for, or...

14 CFR 142.59 - Flight simulators and flight training devices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Flight simulators and flight training... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES TRAINING CENTERS Personnel and Flight Training Equipment Requirements § 142.59 Flight simulators and flight training devices. (a) An applicant for, or...

14 CFR 142.59 - Flight simulators and flight training devices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Flight simulators and flight training... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES TRAINING CENTERS Personnel and Flight Training Equipment Requirements § 142.59 Flight simulators and flight training devices. (a) An applicant for, or...

14 CFR 142.59 - Flight simulators and flight training devices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Flight simulators and flight training... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES TRAINING CENTERS Personnel and Flight Training Equipment Requirements § 142.59 Flight simulators and flight training devices. (a) An applicant for, or...

Space Suit Performance: Methods for Changing the Quality of Quantitative Data

NASA Technical Reports Server (NTRS)

Cowley, Matthew; Benson, Elizabeth; Rajulu, Sudhakar

2014-01-01

NASA is currently designing a new space suit capable of working in deep space and on Mars. Designing a suit is very difficult and often requires trade-offs between performance, cost, mass, and system complexity. To verify that new suits will enable astronauts to perform to their maximum capacity, prototype suits must be built and tested with human subjects. However, engineers and flight surgeons often have difficulty understanding and applying traditional representations of human data without training. To overcome these challenges, NASA is developing modern simulation and analysis techniques that focus on 3D visualization. Early understanding of actual performance early on in the design cycle is extremely advantageous to increase performance capabilities, reduce the risk of injury, and reduce costs. The primary objective of this project was to test modern simulation and analysis techniques for evaluating the performance of a human operating in extra-vehicular space suits.

Spatial Disorientation Training in the Rotor Wing Flight Simulator.

PubMed

Powell-Dunford, Nicole; Bushby, Alaistair; Leland, Richard A

This study is intended to identify efficacy, evolving applications, best practices, and challenges of spatial disorientation (SD) training in flight simulators for rotor wing pilots. Queries of a UK Ministry of Defense research database and Pub Med were undertaken using the search terms 'spatial disorientation,' 'rotor wing,' and 'flight simulator.' Efficacy, evolving applications, best practices, and challenges of SD simulation for rotor wing pilots were also ascertained through discussion with subject matter experts and industrial partners. Expert opinions were solicited at the aeromedical physiologist, aeromedical psychologist, instructor pilot, aeromedical examiner, and corporate executive levels. Peer review literature search yielded 129 articles, with 5 relevant to the use of flight simulators for the spatial disorientation training of rotor wing pilots. Efficacy of such training was measured subjectively and objectively. A preponderance of anecdotal reports endorse the benefits of rotor wing simulator SD training, with a small trial substantiating performance improvement. Advancing technologies enable novel training applications. The mobile nature of flight students and concurrent anticollision technologies can make long-range assessment of SD training efficacy challenging. Costs of advanced technologies could limit the extent to which the most advanced simulators can be employed across the rotor wing community. Evidence suggests the excellent training value of rotor wing simulators for SD training. Objective data from further research, particularly with regards to evolving technologies, may justify further usage of advanced simulator platforms for SD training and research. Powell-Dunford N, Bushby A, Leland RA. Spatial disorientation training in the rotor wing flight simulator. Aerosp Med Hum Perform. 2016; 87(10):890-893.

Simulation in a dynamic prototyping environment: Petri nets or rules?

NASA Technical Reports Server (NTRS)

Moore, Loretta A.; Price, Shannon W.; Hale, Joseph P.

1994-01-01

An evaluation of a prototyped user interface is best supported by a simulation of the system. A simulation allows for dynamic evaluation of the interface rather than just a static evaluation of the screen's appearance. This allows potential users to evaluate both the look (in terms of the screen layout, color, objects, etc.) and feel (in terms of operations and actions which need to be performed) of a system's interface. Because of the need to provide dynamic evaluation of an interface, there must be support for producing active simulations. The high-fidelity training simulators are normally delivered too late to be effectively used in prototyping the displays. Therefore, it is important to build a low fidelity simulator, so that the iterative cycle of refining the human computer interface based upon a user's interactions can proceed early in software development.

Simulation in a dynamic prototyping environment: Petri nets or rules?

NASA Technical Reports Server (NTRS)

Moore, Loretta A.; Price, Shannon; Hale, Joseph P.

1994-01-01

An evaluation of a prototyped user interface is best supported by a simulation of the system. A simulation allows for dynamic evaluation of the interface rather than just a static evaluation of the screen's appearance. This allows potential users to evaluate both the look (in terms of the screen layout, color, objects, etc.) and feel (in terms of operations and actions which need to be performed) of a system's interface. Because of the need to provide dynamic evaluation of an interface, there must be support for producing active simulations. The high-fidelity training simulators are delivered too late to be effectively used in prototyping the displays. Therefore, it is important to build a low fidelity simulator, so that the iterative cycle of refining the human computer interface based upon a user's interactions can proceed early in software development.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

PubMed

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively). Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

Editorial: Challenges for the usability of AR and VR for clinical neurosurgical procedures.

PubMed

de Ribaupierre, Sandrine; Eagleson, Roy

2017-10-01

There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and "Smart OR" systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc). We discuss these tradeoffs and conclude with critical remarks.

Integration of visual and motion cues for simulator requirements and ride quality investigation. [computerized simulation of aircraft landing, visual perception of aircraft pilots

NASA Technical Reports Server (NTRS)

Young, L. R.

1975-01-01

Preliminary tests and evaluation are presented of pilot performance during landing (flight paths) using computer generated images (video tapes). Psychophysiological factors affecting pilot visual perception were measured. A turning flight maneuver (pitch and roll) was specifically studied using a training device, and the scaling laws involved were determined. Also presented are medical studies (abstracts) on human response to gravity variations without visual cues, acceleration stimuli effects on the semicircular canals, and neurons affecting eye movements, and vestibular tests.

Integrating Soft Set Theory and Fuzzy Linguistic Model to Evaluate the Performance of Training Simulation Systems

PubMed Central

Chang, Kuei-Hu; Chang, Yung-Chia; Chain, Kai; Chung, Hsiang-Yu

2016-01-01

The advancement of high technologies and the arrival of the information age have caused changes to the modern warfare. The military forces of many countries have replaced partially real training drills with training simulation systems to achieve combat readiness. However, considerable types of training simulation systems are used in military settings. In addition, differences in system set up time, functions, the environment, and the competency of system operators, as well as incomplete information have made it difficult to evaluate the performance of training simulation systems. To address the aforementioned problems, this study integrated analytic hierarchy process, soft set theory, and the fuzzy linguistic representation model to evaluate the performance of various training simulation systems. Furthermore, importance–performance analysis was adopted to examine the influence of saving costs and training safety of training simulation systems. The findings of this study are expected to facilitate applying military training simulation systems, avoiding wasting of resources (e.g., low utility and idle time), and providing data for subsequent applications and analysis. To verify the method proposed in this study, the numerical examples of the performance evaluation of training simulation systems were adopted and compared with the numerical results of an AHP and a novel AHP-based ranking technique. The results verified that not only could expert-provided questionnaire information be fully considered to lower the repetition rate of performance ranking, but a two-dimensional graph could also be used to help administrators allocate limited resources, thereby enhancing the investment benefits and training effectiveness of a training simulation system. PMID:27598390

Integrating Soft Set Theory and Fuzzy Linguistic Model to Evaluate the Performance of Training Simulation Systems.

PubMed

Chang, Kuei-Hu; Chang, Yung-Chia; Chain, Kai; Chung, Hsiang-Yu

2016-01-01

The advancement of high technologies and the arrival of the information age have caused changes to the modern warfare. The military forces of many countries have replaced partially real training drills with training simulation systems to achieve combat readiness. However, considerable types of training simulation systems are used in military settings. In addition, differences in system set up time, functions, the environment, and the competency of system operators, as well as incomplete information have made it difficult to evaluate the performance of training simulation systems. To address the aforementioned problems, this study integrated analytic hierarchy process, soft set theory, and the fuzzy linguistic representation model to evaluate the performance of various training simulation systems. Furthermore, importance-performance analysis was adopted to examine the influence of saving costs and training safety of training simulation systems. The findings of this study are expected to facilitate applying military training simulation systems, avoiding wasting of resources (e.g., low utility and idle time), and providing data for subsequent applications and analysis. To verify the method proposed in this study, the numerical examples of the performance evaluation of training simulation systems were adopted and compared with the numerical results of an AHP and a novel AHP-based ranking technique. The results verified that not only could expert-provided questionnaire information be fully considered to lower the repetition rate of performance ranking, but a two-dimensional graph could also be used to help administrators allocate limited resources, thereby enhancing the investment benefits and training effectiveness of a training simulation system.

Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

PubMed

Favier, Valentin; Zemiti, Nabil; Caravaca Mora, Oscar; Subsol, Gérard; Captier, Guillaume; Lebrun, Renaud; Crampette, Louis; Mondain, Michel; Gilles, Benjamin

2017-01-01

Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

Simulator fidelity requirements : the case of platform motion

DOT National Transportation Integrated Search

1998-05-01

Today, the use of airplane simulators in pilot training and evaluation is universal. Simulators not only enable savings in training cost, but they have also practically eliminated training accidents for major airlines. They allow the training of emer...

Exploring the use of high-fidelity simulation training to enhance clinical skills.

PubMed

Ann Kirkham, Lucy

2018-02-07

The use of interprofessional simulation training to enhance nursing students' performance of technical and non-technical clinical skills is becoming increasingly common. Simulation training can involve the use of role play, virtual reality or patient simulator manikins to replicate clinical scenarios and assess the nursing student's ability to, for example, undertake clinical observations or work as part of a team. Simulation training enables nursing students to practise clinical skills in a safe environment. Effective simulation training requires extensive preparation, and debriefing is necessary following a simulated training session to review any positive or negative aspects of the learning experience. This article discusses a high-fidelity simulated training session that was used to assess a group of third-year nursing students and foundation level 1 medical students. This involved the use of a patient simulator manikin in a scenario that required the collaborative management of a deteriorating patient. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach.

PubMed

McKay, Virginia R; Hoffer, Lee D; Combs, Todd B; Margaret Dolcini, M

2018-06-05

Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are sustained. Although human resource capacity and population outcomes are theoretically related, examining them over time within real-world experiments is difficult. Simulation approaches, especially agent-based models, offer advantages that complement existing methods. We used an agent-based model to examine the relationships among human resources, EBI delivery, and population outcomes by simulating provision of an EBI through a hypothetical agency and its staff. We used data from existing studies examining a widely implemented HIV prevention intervention to inform simulation design, calibration, and validity. Once we developed a baseline model, we used the model as a simulated laboratory by systematically varying three human resource variables: the number of staff positions, the staff turnover rate, and timing in training. We tracked the subsequent influence on EBI delivery and the level of population risk over time to describe the overall and dynamic relationships among these variables. Higher overall levels of human resource capacity at an agency (more positions) led to more extensive EBI delivery over time and lowered population risk earlier in time. In simulations representing the typical human resource investments, substantial influences on population risk were visible after approximately 2 years and peaked around 4 years. Human resources, especially staff positions, have an important impact on EBI sustainability and ultimately population health. A minimum level of human resources based on the context (e.g., size of the initial population and characteristics of the EBI) is likely needed for an EBI to have a meaningful impact on population outcomes. Furthermore, this model demonstrates how ABMs may be leveraged to inform research design and assess the impact of EBI sustainability in practice.

Models to teach lung sonopathology and ultrasound-guided thoracentesis.

PubMed

Wojtczak, Jacek A

2014-12-01

Lung sonography allows rapid diagnosis of lung emergencies such as pulmonary edema, hemothorax or pneumothorax. The ability to timely diagnose an intraoperative pneumothorax is an important skill for the anesthesiologist. However, lung ultrasound exams require an interpretation of not only real images but also complex acoustic artifacts such as A-lines and B-lines. Therefore, appropriate training to gain proficiency is important. Simulated environment using ultrasound phantom models allows controlled, supervised learning. We have developed hybrid models that combine dry or wet polyurethane foams, porcine rib cages and human hand simulating a rib cage. These models simulate fairly accurately pulmonary sonopathology and allow supervised teaching of lung sonography with the immediate feedback. In-vitro models can also facilitate learning of procedural skills, improving transducer and needle positioning and movement, rapid recognition of thoracic anatomy and hand - eye coordination skills. We described a new model to teach an ultrasound guided thoracentesis. This model consists of the experimenter's hand placed on top of the water-filled container with a wet foam. Metacarpal bones of the human hand simulate a rib cage and a wet foam simulates a diseased lung immersed in the pleural fluid. Positive fluid flow offers users feedback when a simulated pleural effusion is accurately assessed.

The flights before the flight - An overview of shuttle astronaut training

NASA Technical Reports Server (NTRS)

Sims, John T.; Sterling, Michael R.

1989-01-01

Space shuttle astronaut training is centered at NASA's Johnson Space Center in Houston, Texas. Each astronaut receives many different types of training from many sources. This training includes simulator training in the Shuttle Mission Simulator, in-flight simulator training in the Shuttle Training Aircraft, Extravehicular Activity training in the Weightless Environment Training Facility and a variety of lectures and briefings. Once the training program is completed each shuttle flight crew is well-prepared to perform the normal operations required for their flight and deal with any shuttle system malfunctions that might occur.

Warfighter decision making performance analysis as an investment priority driver

NASA Astrophysics Data System (ADS)

Thornley, David J.; Dean, David F.; Kirk, James C.

2010-04-01

Estimating the relative value of alternative tactics, techniques and procedures (TTP) and information systems requires measures of the costs and benefits of each, and methods for combining and comparing those measures. The NATO Code of Best Practice for Command and Control Assessment explains that decision making quality would ideally be best assessed on outcomes. Lessons learned in practice can be assessed statistically to support this, but experimentation with alternate measures in live conflict is undesirable. To this end, the development of practical experimentation to parameterize effective constructive simulation and analytic modelling for system utility prediction is desirable. The Land Battlespace Systems Department of Dstl has modeled human development of situational awareness to support constructive simulation by empirically discovering how evidence is weighed according to circumstance, personality, training and briefing. The human decision maker (DM) provides the backbone of the information processing activity associated with military engagements because of inherent uncertainty associated with combat operations. To develop methods for representing the process in order to assess equipment and non-technological interventions such as training and TTPs we are developing componentized or modularized timed analytic stochastic model components and instruments as part of a framework to support quantitative assessment of intelligence production and consumption methods in a human decision maker-centric mission space. In this paper, we formulate an abstraction of the human intelligence fusion process from the Defence Science and Technology Laboratory's (Dstl's) INCIDER model to include in our framework, and synthesize relevant cost and benefit characteristics.

Influencing Trust for Human-Automation Collaborative Scheduling of Multiple Unmanned Vehicles.

PubMed

Clare, Andrew S; Cummings, Mary L; Repenning, Nelson P

2015-11-01

We examined the impact of priming on operator trust and system performance when supervising a decentralized network of heterogeneous unmanned vehicles (UVs). Advances in autonomy have enabled a future vision of single-operator control of multiple heterogeneous UVs. Real-time scheduling for multiple UVs in uncertain environments requires the computational ability of optimization algorithms combined with the judgment and adaptability of human supervisors. Because of system and environmental uncertainty, appropriate operator trust will be instrumental to maintain high system performance and prevent cognitive overload. Three groups of operators experienced different levels of trust priming prior to conducting simulated missions in an existing, multiple-UV simulation environment. Participants who play computer and video games frequently were found to have a higher propensity to overtrust automation. By priming gamers to lower their initial trust to a more appropriate level, system performance was improved by 10% as compared to gamers who were primed to have higher trust in the automation. Priming was successful at adjusting the operator's initial and dynamic trust in the automated scheduling algorithm, which had a substantial impact on system performance. These results have important implications for personnel selection and training for futuristic multi-UV systems under human supervision. Although gamers may bring valuable skills, they may also be potentially prone to automation bias. Priming during training and regular priming throughout missions may be one potential method for overcoming this propensity to overtrust automation. © 2015, Human Factors and Ergonomics Society.

14 CFR 135.339 - Initial and transition training and checking: Check airmen (aircraft), check airmen (simulator).

Code of Federal Regulations, 2011 CFR

2011-01-01

... an aircraft, in a flight simulator, or in a flight training device. This paragraph applies after... accomplished in full or in part in flight, in a flight simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training for check airmen (simulator) must include the...

14 CFR 135.339 - Initial and transition training and checking: Check airmen (aircraft), check airmen (simulator).

Code of Federal Regulations, 2010 CFR

2010-01-01

... an aircraft, in a flight simulator, or in a flight training device. This paragraph applies after... accomplished in full or in part in flight, in a flight simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training for check airmen (simulator) must include the...

14 CFR 135.339 - Initial and transition training and checking: Check airmen (aircraft), check airmen (simulator).

Code of Federal Regulations, 2014 CFR

2014-01-01

... an aircraft, in a flight simulator, or in a flight training device. This paragraph applies after... accomplished in full or in part in flight, in a flight simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training for check airmen (simulator) must include the...

14 CFR 135.339 - Initial and transition training and checking: Check airmen (aircraft), check airmen (simulator).

Code of Federal Regulations, 2013 CFR

2013-01-01

... an aircraft, in a flight simulator, or in a flight training device. This paragraph applies after... accomplished in full or in part in flight, in a flight simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training for check airmen (simulator) must include the...

14 CFR 135.339 - Initial and transition training and checking: Check airmen (aircraft), check airmen (simulator).

Code of Federal Regulations, 2012 CFR

2012-01-01

... an aircraft, in a flight simulator, or in a flight training device. This paragraph applies after... accomplished in full or in part in flight, in a flight simulator, or in a flight training device, as appropriate. (g) The initial and transition flight training for check airmen (simulator) must include the...

Helicopter simulation: Making it work

NASA Technical Reports Server (NTRS)

Payne, Barry

1992-01-01

The opportunities for improved training and checking by using helicopter simulators are greater than they are for airplane pilot training. Simulators permit the safe creation of training environments that are conducive to the development of pilot decision-making, situational awareness, and cockpit management. This paper defines specific attributes required in a simulator to meet a typical helicopter operator's training and checking objectives.

A systematic review of evidence for education and training interventions in microsurgery.

PubMed

Ghanem, Ali M; Hachach-Haram, Nadine; Leung, Clement Chi Ming; Myers, Simon Richard

2013-07-01

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

Army-NASA aircrew/aircraft integration program (A3I) software detailed design document, phase 3

NASA Technical Reports Server (NTRS)

Banda, Carolyn; Chiu, Alex; Helms, Gretchen; Hsieh, Tehming; Lui, Andrew; Murray, Jerry; Shankar, Renuka

1990-01-01

The capabilities and design approach of the MIDAS (Man-machine Integration Design and Analysis System) computer-aided engineering (CAE) workstation under development by the Army-NASA Aircrew/Aircraft Integration Program is detailed. This workstation uses graphic, symbolic, and numeric prototyping tools and human performance models as part of an integrated design/analysis environment for crewstation human engineering. Developed incrementally, the requirements and design for Phase 3 (Dec. 1987 to Jun. 1989) are described. Software tools/models developed or significantly modified during this phase included: an interactive 3-D graphic cockpit design editor; multiple-perspective graphic views to observe simulation scenarios; symbolic methods to model the mission decomposition, equipment functions, pilot tasking and loading, as well as control the simulation; a 3-D dynamic anthropometric model; an intermachine communications package; and a training assessment component. These components were successfully used during Phase 3 to demonstrate the complex interactions and human engineering findings involved with a proposed cockpit communications design change in a simulated AH-64A Apache helicopter/mission that maps to empirical data from a similar study and AH-1 Cobra flight test.

Flight simulator for hypersonic vehicle and a study of NASP handling qualities

NASA Technical Reports Server (NTRS)

Ntuen, Celestine A.; Park, Eui H.; Deeb, Joseph M.; Kim, Jung H.

1992-01-01

The research goal of the Human-Machine Systems Engineering Group was to study the existing handling quality studies in aircraft with sonic to supersonic speeds and power in order to understand information requirements needed for a hypersonic vehicle flight simulator. This goal falls within the NASA task statements: (1) develop flight simulator for hypersonic vehicle; (2) study NASP handling qualities; and (3) study effects of flexibility on handling qualities and on control system performance. Following the above statement of work, the group has developed three research strategies. These are: (1) to study existing handling quality studies and the associated aircraft and develop flight simulation data characterization; (2) to develop a profile for flight simulation data acquisition based on objective statement no. 1 above; and (3) to develop a simulator and an embedded expert system platform which can be used in handling quality experiments for hypersonic aircraft/flight simulation training.

14 CFR 61.163 - Aeronautical experience: Powered-lift category rating.

Code of Federal Regulations, 2013 CFR

2013-01-01

... time in a flight simulator or flight training device. (ii) A maximum of 50 hours of training in a flight simulator or flight training device may be credited toward the instrument flight time requirements... training center certificated under part 142 of this chapter. (iii) Training in a flight simulator or flight...

14 CFR 61.163 - Aeronautical experience: Powered-lift category rating.

Code of Federal Regulations, 2014 CFR

2014-01-01

... time in a flight simulator or flight training device. (ii) A maximum of 50 hours of training in a flight simulator or flight training device may be credited toward the instrument flight time requirements... training center certificated under part 142 of this chapter. (iii) Training in a flight simulator or flight...

14 CFR 61.163 - Aeronautical experience: Powered-lift category rating.

Code of Federal Regulations, 2012 CFR

2012-01-01

... time in a flight simulator or flight training device. (ii) A maximum of 50 hours of training in a flight simulator or flight training device may be credited toward the instrument flight time requirements... training center certificated under part 142 of this chapter. (iii) Training in a flight simulator or flight...

Rapid E-Learning Simulation Training and User Response

ERIC Educational Resources Information Center

Rackler, Angeline

2011-01-01

A new trend in e-learning development is to have subject matter experts use rapid development tools to create training simulations. This type of training is called rapid e-learning simulation training. Though companies are using rapid development tools to create training quickly and cost effectively, there is little empirical research to indicate…

Operational NDT simulator, towards human factors integration in simulated probability of detection

NASA Astrophysics Data System (ADS)

Rodat, Damien; Guibert, Frank; Dominguez, Nicolas; Calmon, Pierre

2017-02-01

In the aeronautic industry, the performance demonstration of Non-Destructive Testing (NDT) procedures relies on Probability Of Detection (POD) analyses. This statistical approach measures the ability of the procedure to detect a flaw with regard to one of its characteristic dimensions. The inspection chain is evaluated as a whole, including equipment configuration, probe effciency but also operator manipulations. Traditionally, a POD study requires an expensive campaign during which several operators apply the procedure on a large set of representative samples. Recently, new perspectives for the POD estimation have been introduced using NDT simulation to generate data. However, these approaches do not offer straightforward solutions to take the operator into account. The simulation of human factors, including cognitive aspects, often raises questions. To address these diffculties, we propose a concept of operational NDT simulator [1]. This work presents the first steps in the implementation of such simulator for ultrasound phased array inspection of composite parts containing Flat Bottom Holes (FBHs). The final system will look like a classical ultrasound testing equipment with a single exception: the displayed signals will be synthesized. Our hardware (ultrasound acquisition card, 3D position tracker) and software (position analysis, inspection scenario, synchronization, simulations) environments are developed as a bench to test the meta-modeling techniques able to provide fast-simulated realistic ultra-sound signals. The results presented here are obtained by on-the-fly merging of real and simulated signals. They confirm the feasibility of our approach: the replacement of real signals by purely simulated ones has been unnoticed by operators. We believe this simulator is a great prospect for POD evaluation including human factors, and may also find applications for training or procedure set-up.

14 CFR 121.921 - Training devices and simulators.

Code of Federal Regulations, 2013 CFR

2013-01-01

... devices and simulators. (a) Each flight training device or airplane simulator that will be used in an AQP... device or flight simulator qualification level: (1) Required evaluation of individual or crew proficiency... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Training devices and simulators. 121.921...

14 CFR 121.921 - Training devices and simulators.

Code of Federal Regulations, 2011 CFR

2011-01-01

... devices and simulators. (a) Each flight training device or airplane simulator that will be used in an AQP... device or flight simulator qualification level: (1) Required evaluation of individual or crew proficiency... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Training devices and simulators. 121.921...

14 CFR 121.921 - Training devices and simulators.

Code of Federal Regulations, 2014 CFR

2014-01-01

... devices and simulators. (a) Each flight training device or airplane simulator that will be used in an AQP... device or flight simulator qualification level: (1) Required evaluation of individual or crew proficiency... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Training devices and simulators. 121.921...

14 CFR 121.921 - Training devices and simulators.

Code of Federal Regulations, 2012 CFR

2012-01-01

... devices and simulators. (a) Each flight training device or airplane simulator that will be used in an AQP... device or flight simulator qualification level: (1) Required evaluation of individual or crew proficiency... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Training devices and simulators. 121.921...

Association of Surgeons in Training conference: Belfast 2014.

PubMed

Beamish, A J; Gokani, V; Radford, P; Sinclair, P; Fitzgerald, J E F

2014-11-01

The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations and represents trainees in all ten surgical specialties. ASiT was delighted to welcome all four surgical Royal College Presidents and over 650 delegates to Belfast for ASiT 2014. With a theme of Marginal Gains, the conference programme explored collaboration, simulation training and human factors, complimented by debates including the Shape of Training Review (ShOT), several focussed parallel sessions and ten subsidised pre-conference training courses. Almost £4000 was awarded by the incoming President, Mr Vimal Gokani, to delegates across more than 30 prizes for delegates who presented the highest scoring academic work from over 1200 submitted abstracts. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Field of View Evaluation for Flight Simulators Used in Spatial Disorientation Training

DTIC Science & Technology

2014-01-01

Naval Medical Research Unit Dayton FIELD OF VIEW EVALUATION FOR FLIGHT SIMULATORS USED IN SPATIAL DISORIENTATION TRAINING WILLIAMS, H.P...COVERED (from – to) 2013JUL30 to 2014JUN30 4. TITLE Field of View Evaluation for Flight Simulators Used in Spatial Disorientation Training 5a...simulator systems as well, and implications and recommendations for SD training are discussed. 3 Field of View Evaluation for Flight Simulators

Human Factors in Training - Space Medicine Proficiency Training

NASA Technical Reports Server (NTRS)

Connell, Erin; Arsintescu, Lucia

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction ratings were captured.

14 CFR 141.33 - Personnel.

Code of Federal Regulations, 2014 CFR

2014-01-01

... providing training in a flight simulation training device, have received training and evaluation within the... motion limitations of simulation; (D) Minimum equipment requirements for each curriculum; and (E) The maneuvers that will be demonstrated in the flight simulation training device. (b) An applicant for a pilot...

14 CFR 91.1073 - Training program: General.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Provide enough flight instructors, check pilots, and simulator instructors to conduct required flight training and flight checks, and simulator training courses allowed under this subpart. (b) Whenever a... ensure that each pilot annually completes at least one flight training session in an approved simulator...

14 CFR 91.1073 - Training program: General.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Provide enough flight instructors, check pilots, and simulator instructors to conduct required flight training and flight checks, and simulator training courses allowed under this subpart. (b) Whenever a... ensure that each pilot annually completes at least one flight training session in an approved simulator...

14 CFR 91.1073 - Training program: General.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Provide enough flight instructors, check pilots, and simulator instructors to conduct required flight training and flight checks, and simulator training courses allowed under this subpart. (b) Whenever a... ensure that each pilot annually completes at least one flight training session in an approved simulator...

14 CFR 91.1073 - Training program: General.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Provide enough flight instructors, check pilots, and simulator instructors to conduct required flight training and flight checks, and simulator training courses allowed under this subpart. (b) Whenever a... ensure that each pilot annually completes at least one flight training session in an approved simulator...

Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block.

PubMed

Corrêa, Cléber Gimenez; Machado, Maria Aparecida de Andrade Moreira; Ranzini, Edith; Tori, Romero; Nunes, Fátima de Lourdes Santos

2017-01-01

This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance), Tukey post-hoc test and averages for the results' analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts). The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler), as well as visual (appearance, scale, and position of objects) and haptic aspects (motion space, tactile sensation, and motion reproduction). The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues' resistance. The evaluation of visual aspects was influenced by the participants' experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01). The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it. The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.

Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

PubMed

Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

2017-12-01

Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

The Role of Ultrasound Simulation in Obstetrics and Gynecology Training: A UK Trainees' Perspective.

PubMed

Patel, Hersha; Chandrasekaran, Dhivya; Myriokefalitaki, Eva; Gebeh, Alpha; Jones, Kate; Jeve, Yadava B

2016-10-01

Ultrasonography is a core skill required by all obstetrics and gynecology trainees; however, training opportunities in clinical ultrasound are declining. Simulation ultrasound training has been proposed as a strategy to overcome this.The study aims were to determine the current availability of clinical and simulation ultrasound training in obstetrics and gynecology in the United Kingdom and to explore the trainees' perspective on the role of ultrasound simulation. All obstetrics and gynecology trainees within the East Midlands Local Education Training Board in the United Kingdom were asked to complete an anonymous web-based survey in July 2014. Of 140 trainees, 70 (50%) responded to the survey, and 69% reported rarely having dedicated clinical ultrasound sessions. Fifty percent had failed to achieve ultrasound competencies required for their stage of training, and 83% felt that the pressures of service provision limited their exposure to clinical ultrasound.Seventy-three percent of the trainees considered ultrasound simulation to be an essential component of training, and 69% agreed that it would help improve their clinical skills. Only 50% had access to an ultrasound simulator. Seventy-seven percent of the trainees thought that it would be useful to have ultrasound simulation integrated into training. Trainees are struggling to achieve minimal ultrasound competences with clinical ultrasound training alone. They believe that ultrasound simulation will shorten the learning curve and improve their clinical skills and knowledge. Despite the cost implications of simulation training, we propose that consideration is given to formal integration of ultrasound simulation into the curriculum as a possible way forward.

Simulation-based bronchoscopy training: systematic review and meta-analysis.

PubMed

Kennedy, Cassie C; Maldonado, Fabien; Cook, David A

2013-07-01

Simulation-based bronchoscopy training is increasingly used, but effectiveness remains uncertain. We sought to perform a comprehensive synthesis of published work on simulation-based bronchoscopy training. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, and Scopus for eligible articles through May 11, 2011. We included all original studies involving health professionals that evaluated, in comparison with no intervention or an alternative instructional approach, simulation-based training for flexible or rigid bronchoscopy. Study selection and data abstraction were performed independently and in duplicate. We pooled results using random effects meta-analysis. From an initial pool of 10,903 articles, we identified 17 studies evaluating simulation-based bronchoscopy training. In comparison with no intervention, simulation training was associated with large benefits on skills and behaviors (pooled effect size, 1.21 [95% CI, 0.82-1.60]; n=8 studies) and moderate benefits on time (0.62 [95% CI, 0.12-1.13]; n=7). In comparison with clinical instruction, behaviors with real patients showed nonsignificant effects favoring simulation for time (0.61 [95% CI, -1.47 to 2.69]) and process (0.33 [95% CI, -1.46 to 2.11]) outcomes (n=2 studies each), although variation in training time might account for these differences. Four studies compared alternate simulation-based training approaches. Inductive analysis to inform instructional design suggested that longer or more structured training is more effective, authentic clinical context adds value, and animal models and plastic part-task models may be superior to more costly virtual-reality simulators. Simulation-based bronchoscopy training is effective in comparison with no intervention. Comparative effectiveness studies are few.

First validation of the PASSPORT training environment for arthroscopic skills.

PubMed

Tuijthof, Gabriëlle J M; van Sterkenburg, Maayke N; Sierevelt, Inger N; van Oldenrijk, Jakob; Van Dijk, C Niek; Kerkhoffs, Gino M M J

2010-02-01

The demand for high quality care is in contrast to reduced training time for residents to develop arthroscopic skills. Thereto, simulators are introduced to train skills away from the operating room. In our clinic, a physical simulation environment to Practice Arthroscopic Surgical Skills for Perfect Operative Real-life Treatment (PASSPORT) is being developed. The PASSPORT concept consists of maintaining the normal arthroscopic equipment, replacing the human knee joint by a phantom, and integrating registration devices to provide performance feedback. The first prototype of the knee phantom allows inspection, treatment of menisci, irrigation, and limb stressing. PASSPORT was evaluated for face and construct validity. Construct validity was assessed by measuring the performance of two groups with different levels of arthroscopic experience (20 surgeons and 8 residents). Participants performed a navigation task five times on PASSPORT. Task times were recorded. Face validity was assessed by completion of a short questionnaire on the participants' impressions and comments for improvements. Construct validity was demonstrated as the surgeons (median task time 19.7 s [8.0-37.6]) were more efficient than the residents (55.2 s [27.9-96.6]) in task completion for each repetition (Mann-Whitney U test, P < 0.05). The prototype of the knee phantom sufficiently imitated limb outer appearance (79%), portal resistance (82%), and arthroscopic view (81%). Improvements are required for the stressing device and the material of cruciate ligaments. Our physical simulation environment (PASSPORT) demonstrates its potential to evolve as a training modality. In future, automated performance feedback is aimed for.

Virtual reality training for endoscopic surgery: voluntary or obligatory?

PubMed

van Dongen, K W; van der Wal, W A; Rinkes, I H M Borel; Schijven, M P; Broeders, I A M J

2008-03-01

Virtual reality (VR) simulators have been developed to train basic endoscopic surgical skills outside of the operating room. An important issue is how to create optimal conditions for integration of these types of simulators into the surgical training curriculum. The willingness of surgical residents to train these skills on a voluntary basis was surveyed. Twenty-one surgical residents were given unrestricted access to a VR simulator for a period of four months. After this period, a competitive element was introduced to enhance individual training time spent on the simulator. The overall end-scores for individual residents were announced periodically to the full surgical department, and the winner was awarded a prize. In the first four months of study, only two of the 21 residents (10%) trained on the simulator, for a total time span of 163 minutes. After introducing the competitive element the number of trainees increased to seven residents (33%). The amount of training time spent on the simulator increased to 738 minutes. Free unlimited access to a VR simulator for training basic endoscopic skills, without any form of obligation or assessment, did not motivate surgical residents to use the simulator. Introducing a competitive element for enhancing training time had only a marginal effect. The acquisition of expensive devices to train basic psychomotor skills for endoscopic surgery is probably only effective when it is an integrated and mandatory part of the surgical curriculum.

Simulation-based driver and vehicle crew training: applications, efficacy and future directions.

PubMed

Goode, Natassia; Salmon, Paul M; Lenné, Michael G

2013-05-01

Simulation is widely used as a training tool in many domains, and more recently the use of vehicle simulation as a tool for driver and vehicle crew training has become popular (de Winter et al., 2009; Pradhan et al., 2009). This paper presents an overview of how vehicle simulations are currently used to train driving-related procedural and higher-order cognitive skills, and team-based procedural and non-technical teamwork skills for vehicle crews, and evaluates whether there is evidence these training programs are effective. Efficacy was evaluated in terms of whether training achieves learning objectives and whether the attainment of those objectives enhances real world performance on target tasks. It was concluded that while some higher-order cognitive skills training programs have been shown to be effective, in general the adoption of simulation technology has far outstripped the pace of empirical research in this area. The paper concludes with a discussion of the issues that require consideration when developing and evaluating vehicle simulations for training purposes - based not only on what is known from the vehicle domain, but what can be inferred from other domains in which simulation is an established training approach, such as aviation (e.g. Jentsch et al., 2011) and medicine (e.g. McGaghie et al., 2010). STATEMENT OF RELEVANCE: Simulation has become a popular tool for driver and vehicle crew training in civilian and military settings. This review considers whether there is evidence that this training method leads to learning and the transfer of skills to real world performance. Evidence from other domains, such as aviation and medicine, is drawn upon to inform the design and evaluation of future vehicle simulation training systems. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Prospective, randomized assessment of transfer of training (ToT) and transfer effectiveness ratio (TER) of virtual reality simulation training for laparoscopic skill acquisition.

PubMed

Gallagher, Anthony G; Seymour, Neal E; Jordan-Black, Julie-Anne; Bunting, Brendan P; McGlade, Kieran; Satava, Richard Martin

2013-06-01

We assessed the effectiveness of ToT from VR laparoscopic simulation training in 2 studies. In a second study, we also assessed the TER. ToT is a detectable performance improvement between equivalent groups, and TER is the observed percentage performance differences between 2 matched groups carrying out the same task but with 1 group pretrained on VR simulation. Concordance between simulated and in-vivo procedure performance was also assessed. Prospective, randomized, and blinded. In Study 1, experienced laparoscopic surgeons (n = 195) and in Study 2 laparoscopic novices (n = 30) were randomized to either train on VR simulation before completing an equivalent real-world task or complete the real-world task only. Experienced laparoscopic surgeons and novices who trained on the simulator performed significantly better than their controls, thus demonstrating ToT. Their performance showed a TER between 7% and 42% from the virtual to the real tasks. Simulation training impacted most on procedural error reduction in both studies (32-42%). The correlation observed between the VR and real-world task performance was r > 0·96 (Study 2). VR simulation training offers a powerful and effective platform for training safer skills.

Role of in-situ simulation for training in healthcare: opportunities and challenges.

PubMed

Kurup, Viji; Matei, Veronica; Ray, Jessica

2017-12-01

Simulation has now been acknowledged as an important part of training in healthcare, and most academic hospitals have a dedicated simulation center. In-situ simulation occurs in patient care units with scenarios involving healthcare professionals in their actual working environment. The purpose of this review is to describe the process of putting together the components of in-situ simulation for training programs and to review outcomes studied, and challenges with this approach. In-situ simulation has been used to 'test-drive' new centers, train personnel in new procedures in existing centers, for recertification training and to uncover latent threats in clinical care areas. It has also emerged as an attractive alternative to traditional simulations for institutions that do not have their own simulation center. In-situ simulation can be used to improve reliability and safety especially in areas of high risk, and in high-stress environments. It is also a reasonable and attractive alternative for programs that want to conduct interdisciplinary simulations for their trainees and faculty, and for those who do not have access to a fully functional simulation center. Further research needs to be done in assessing effectiveness of training using this method and the effect of such training on clinical outcomes.

Cadaver-based training is superior to simulation training for cricothyrotomy and tube thoracostomy.

PubMed

Takayesu, James Kimo; Peak, David; Stearns, Dana

2017-02-01

Emergency medicine (EM) training mandates that residents be able to competently perform low-frequency critical procedures upon graduation. Simulation is the main method of training in addition to clinical patient care. Access to cadaver-based training is limited due to cost and availability. The relative fidelity and perceived value of cadaver-based simulation training is unknown. This pilot study sought to describe the relative value of cadaver training compared to simulation for cricothyrotomy and tube thoracostomy. To perform a pilot study to assess whether there is a significant difference in fidelity and educational experience of cadaver-based training compared to simulation training. To understand how important this difference is in training residents in low-frequency procedures. Twenty-two senior EM residents (PGY3 and 4) who had completed standard simulation training on cricothyrotomy and tube thoracostomy participated in a formalin-fixed cadaver training program. Participants were surveyed on the relative fidelity of the training using a 100 point visual analogue scale (VAS) with 100 defined as equal to performing the procedure on a real patient. Respondents were also asked to estimate how much the cadaveric training improved the comfort level with performing the procedures on a scale between 0 and 100 %. Open-response feedback was also collected. The response rate was 100 % (22/22). The average fidelity of the cadaver versus simulation training was 79.9 ± 7.0 vs. 34.7 ± 13.4 for cricothyrotomy (p < 0.0001) and 86 ± 8.6 vs. 38.4 ± 19.3 for tube thoracostomy (p < 0.0001). Improvement in comfort levels performing procedures after the cadaveric training was rated as 78.5 ± 13.3 for tube thoracostomy and 78.7 ± 14.3 for cricothyrotomy. All respondents felt this difference in fidelity to be important for procedural training with 21/22 respondents specifically citing the importance of superior landmark and tissue fidelity compared to simulation training. Cadaver-based training provides superior landmark and tissue fidelity compared to simulation training and may be a valuable addition to EM residency training for certain low-frequency procedures.

Human factors in aviation

NASA Technical Reports Server (NTRS)

Wiener, Earl L. (Editor); Nagel, David C. (Editor)

1988-01-01

The fundamental principles of human-factors (HF) analysis for aviation applications are examined in a collection of reviews by leading experts, with an emphasis on recent developments. The aim is to provide information and guidance to the aviation community outside the HF field itself. Topics addressed include the systems approach to HF, system safety considerations, the human senses in flight, information processing, aviation workloads, group interaction and crew performance, flight training and simulation, human error in aviation operations, and aircrew fatigue and circadian rhythms. Also discussed are pilot control; aviation displays; cockpit automation; HF aspects of software interfaces; the design and integration of cockpit-crew systems; and HF issues for airline pilots, general aviation, helicopters, and ATC.

Mathematical modeling and spectrum analysis of the physiological patello-femoral pulse train produced by slow knee movement.

PubMed

Zhang, Y T; Frank, C B; Rangayyan, R M; Bell, G D

1992-09-01

Analysis of vibration signals emitted by the knee joint has the potential for the development of a noninvasive procedure for the diagnosis and monitoring of knee pathology. In order to obtain as much information as possible from the power density spectrum of the knee vibration signal, it is necessary to identify the physiological factors (or physiologically relevant parameters) that shape the spectrum. This paper presents a mathematical model for knee vibration signals, in particular the physiological patello-femoral pulse (PFP) train produced by slow knee movement. It demonstrates through the mathematical model that the repetition rate of the physiological PFP train introduces repeated peaks in the power spectrum, and that it affects the spectrum mainly at low frequencies. The theoretical results also show that the spectral peaks at multiples of the PFP repetition rate become more evident when the variance of the interpulse interval (IPI) is small, and that these spectral peaks shift toward higher frequencies with increasing PFP repetition rates. To evaluate the mathematical model, a simulation algorithm was developed, which generates PFP signals with adjustable repetition rate and IPI variance. Signals generated by simulation were seen to possess representative spectral characteristics typically observed in physiological PFP signals. This simulation procedure allows an interactive examination of several factors which affect the PFP train spectrum. Finally, in vivo measurements of physiological PFP signals of normal volunteers are presented. Results of simulations and analysis of signals recorded from human subjects support the mathematical model's prediction that the IPI statistics play a very significant role in determining the low-end power spectrum of the physiological PFP signal.(ABSTRACT TRUNCATED AT 250 WORDS)

Building a simulation-based crisis resource management course for emergency medicine, phase 1: Results from an interdisciplinary needs assessment survey.

PubMed

Hicks, Christopher M; Bandiera, Glen W; Denny, Christopher J

2008-11-01

Emergency department (ED) resuscitation requires the coordinated efforts of an interdisciplinary team. Human errors are common and have a negative impact on patient safety. Although crisis resource management (CRM) skills are utilized in other clinical domains, most emergency medicine (EM) caregivers currently receive no formal CRM training. The objectives were to compile and compare attitudes toward CRM training among EM staff physicians, nurses, and residents at two Canadian academic teaching hospitals. Emergency physicians (EPs), residents, and nurses were asked to complete a Web survey that included Likert scales and short answer questions. Focus groups and pilot testing were used to inform survey development. Thematic content analysis was performed on the qualitative data set and compared to quantitative results. The response rate was 75.7% (N = 84). There was strong consensus regarding the importance of core CRM principles (i.e., effective communication, team leadership, resource utilization, problem-solving, situational awareness) in ED resuscitation. Problems with coordinating team actions (58.8%), communication (69.6%), and establishing priorities (41.3%) were among factors implicated in adverse events. Interdisciplinary collaboration (95.1%), efficiency of patient care (83.9%), and decreased medical error (82.6%) were proposed benefits of CRM training. Communication between disciplines is a barrier to effective ED resuscitation for 94.4% of nurses and 59.7% of EPs (p = 0.008). Residents reported a lack of exposure to (64.3%), yet had interest in (96.4%) formal CRM education using human patient simulation. Nurses rate communication as a barrier to teamwork more frequently than physicians. EM residents are keen to learn CRM skills. An opportunity exists to create a novel interdisciplinary CRM curriculum to improve EM team performance and mitigate human error.

14 CFR 61.51 - Pilot logbooks.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the aircraft departed and arrived, or for lessons in a flight simulator or flight training device, the location where the lesson occurred. (iv) Type and identification of aircraft, flight simulator, flight.... (v) Training received in a flight simulator, flight training device, or aviation training device from...

14 CFR 61.51 - Pilot logbooks.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the aircraft departed and arrived, or for lessons in a flight simulator or flight training device, the location where the lesson occurred. (iv) Type and identification of aircraft, flight simulator, flight.... (v) Training received in a flight simulator, flight training device, or aviation training device from...

14 CFR 61.51 - Pilot logbooks.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the aircraft departed and arrived, or for lessons in a flight simulator or flight training device, the location where the lesson occurred. (iv) Type and identification of aircraft, flight simulator, flight.... (v) Training received in a flight simulator, flight training device, or aviation training device from...

Teaching Elliptical Excision Skills to Novice Medical Students: A Randomized Controlled Study Comparing Low- and High-Fidelity Bench Models

PubMed Central

Denadai, Rafael; Oshiiwa, Marie; Saad-Hossne, Rogério

2014-01-01

Background: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. Aims: To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Materials and Methods: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills’ training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs’ skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. Results: The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills’ training) was considered large (>0.80) in all measurements. Conclusion: The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials. PMID:24700937

Unannounced in situ simulations: integrating training and clinical practice.

PubMed

Walker, Susanna T; Sevdalis, Nick; McKay, Anthony; Lambden, Simon; Gautama, Sanjay; Aggarwal, Rajesh; Vincent, Charles

2013-06-01

Simulation-based training for healthcare providers is well established as a viable, efficacious training tool, particularly for the training of non-technical team-working skills. These skills are known to be critical to effective teamwork, and important in the prevention of error and adverse events in hospitals. However, simulation suites are costly to develop and releasing staff to attend training is often difficult. These factors may restrict access to simulation training. We discuss our experiences of 'in situ' simulation for unannounced cardiac arrest training when the training is taken to the clinical environment. This has the benefit of decreasing required resources, increasing realism and affordability, and widening multidisciplinary team participation, thus enabling assessment and training of non-technical team-working skills in real clinical teams. While there are practical considerations of delivering training in the clinical environment, we feel there are many potential benefits compared with other forms of simulation training. We are able to tailor the training to the needs of the location, enabling staff to see a scenario that is relevant to their practice. This is particularly useful for staff who have less exposure to cardiac arrest events, such as radiology staff. We also describe the important benefit of risk assessment for a clinical environment. During our simulations we have identified a number of issues that, had they occurred during a real resuscitation attempt, may have led to patient harm or patient death. For these reasons we feel in situ simulation should be considered by every hospital as part of a patient safety initiative.

Comparison of self-efficacy and its improvement after artificial simulator or live animal model emergency procedure training.

PubMed

Hall, Andrew B; Riojas, Ramon; Sharon, Danny

2014-03-01

The objective of this study is to compare post-training self-efficacy between artificial simulators and live animal training for the performance of emergency medical procedures. Volunteer airmen of the 81st Medical Group, without prior medical procedure training, were randomly assigned to two experimental arms consisting of identical lectures and training of diagnostic peritoneal lavage, thoracostomy (chest tube), and cricothyroidotomy on either the TraumaMan (Simulab Corp., Seattle, Washington) artificial simulator or a live pig (Sus scrofa domestica) model. Volunteers were given a postlecture and postskills training assessment of self-efficacy. Twenty-seven volunteers that initially performed artificial simulator training subsequently underwent live animal training and provided assessments comparing both modalities. The results were first, postskills training self-efficacy scores were significantly higher than postlecture scores for either training mode and for all procedures (p < 0.0001). Second, post-training self-efficacy scores were not statistically different between live animal and artificial simulator training for diagnostic peritoneal lavage (p = 0.555), chest tube (p = 0.486), and cricothyroidotomy (p = 0.329). Finally, volunteers undergoing both training modalities indicated preference for live animal training (p < 0.0001). We conclude that artificial simulator and live animal training produce equivalent levels of self-efficacy after initial training, but there is a preference in using a live animal model to achieve those skills. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Manikin Human-Patient Simulator Training.

PubMed

Horn, Gregory T; Bowling, F Y; Lowe, David E; Parimore, James G; Stagliano, David R; Studer, Nicholas M

Human-patient simulators (HPSs) may help enhance medical education. Manikin HPS devices respond to common field medical interventions, such as cricothyroidotomy, and have realistic feedback features, such as respirations and pulses. This study surveys Special Operations Medics for evaluations of HPS features. Of 518 subjects, 376 completed testing and surveys with valid responses. A total of 102 variables were divided into three categories-general characteristics, procedures, and injuries-and assessed on a fivepoint Likert scale. The Student t test was used to analyze data together and as separate groups against each other and against an aggregated mean. Features that received high scores (i.e., higher than 4.5/5) corresponded closely with pillars of the Tactical Combat Casualty Care (TCCC) curriculum, basic life support, and realism. US Army Special Operations Command and US Special Operations Command Medics have overall high confidence in manikin HPS devices and specifically in those that align with TCCC training and lifesaving procedures. The skills most valued coincide with difficult-to-practice measures, such as cricothyroidotomy and wound packing. Features such as prerecorded sounds, sex, automated movements, skin color, defibrillation, bowel sounds, and electrocardiogram are rated lower. These evaluations may guide future development or procurement of manikin HPS devices. 2017.

Predictive Computational Modeling of Chromatin Folding

NASA Astrophysics Data System (ADS)

di Pierro, Miichele; Zhang, Bin; Wolynes, Peter J.; Onuchic, Jose N.

In vivo, the human genome folds into well-determined and conserved three-dimensional structures. The mechanism driving the folding process remains unknown. We report a theoretical model (MiChroM) for chromatin derived by using the maximum entropy principle. The proposed model allows Molecular Dynamics simulations of the genome using as input the classification of loci into chromatin types and the presence of binding sites of loop forming protein CTCF. The model was trained to reproduce the Hi-C map of chromosome 10 of human lymphoblastoid cells. With no additional tuning the model was able to predict accurately the Hi-C maps of chromosomes 1-22 for the same cell line. Simulations show unknotted chromosomes, phase separation of chromatin types and a preference of chromatin of type A to sit at the periphery of the chromosomes.

Crew activities, science, and hazards of manned missions to Mars

NASA Technical Reports Server (NTRS)

Clark, Benton C.

1988-01-01

The crew scientific and nonscientific activities that will occur at each stage of a mission to Mars are examined. Crew activities during the interplanetary flight phase will include simulations, maintenance and monitoring, communications, upgrading procedures and operations, solar activity monitoring, cross-training and sharpening of skills, physical conditioning, and free-time activities. Scientific activities will address human physiology, human psychology, sociology, astronomy, space environment effects, manufacturing, and space agriculture. Crew activities on the Martian surface will include exploration, construction, manufacturing, food production, maintenance and training, and free time. Studies of Martian geology and atmosphere, of the life forms that may exist there, and of the Martian moons will occur on the planet's surface. Crew activities and scientific studies that will occur in Mars orbit, and the hazards relevant to each stage of the mission, are also addressed.