Sample records for training simulators

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. [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.

  15. 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.

  16. 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.

  17. 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...

  18. [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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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...

  5. Effectiveness of online simulation training: Measuring faculty knowledge, perceptions, and intention to adopt.

    PubMed

    Kim, Sujeong; Park, Chang; O'Rourke, Jennifer

    2017-04-01

    Best practice standards of simulation recommend standardized simulation training for nursing faculty. Online training may offer an effective and more widely available alternative to in-person training. Using the Theory of Planned Behavior, this study evaluated the effectiveness of an online simulation training program, examining faculty's foundational knowledge of simulation as well as perceptions and intention to adopt. One-group pretest-posttest design. A large school of nursing with a main campus and five regional campuses in the Midwestern United States. Convenience sample of 52 faculty participants. Knowledge of foundational simulation principles was measured by pre/post-training module quizzes. Perceptions and the intention to adopt simulation were measured using the Faculty Attitudes and Intent to Use Related to the Human Patient Simulator questionnaire. There was a significant improvement in faculty knowledge after training and observable improvements in attitudes. Attitudes significantly influenced the intention to adopt simulation (B=2.54, p<0.001). Online simulation training provides an effective alternative for training large numbers of nursing faculty who seek to implement best practice of standards within their institutions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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…

  17. 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.

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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.

  5. 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...

  6. 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...

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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...

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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, :...

  3. 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.

  4. 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…

  5. 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...

  6. 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.

  7. 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)…

  8. 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…

  9. [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.

  10. 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…

  11. 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...

  12. 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...

  13. 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. 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...

  15. 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...

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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.

  11. 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.

  12. 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...

  13. 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. 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...

  15. 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…

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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.

  1. 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

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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...

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. Cost-effectiveness of simulation-based team training in obstetric emergencies (TOSTI study).

    PubMed

    van de Ven, J; van Baaren, G J; Fransen, A F; van Runnard Heimel, P J; Mol, B W; Oei, S G

    2017-09-01

    Team training is frequently applied in obstetrics. We aimed to evaluate the cost-effectiveness of obstetric multi-professional team training in a medical simulation centre. We performed a model-based cost-effectiveness analysis to evaluate four strategies for obstetric team training from a hospital perspective (no training, training without on-site repetition and training with 6 month or 3-6-9 month repetition). Data were retrieved from the TOSTI study, a randomised controlled trial evaluating team training in a medical simulation centre. We calculated the incremental cost-effectiveness ratio (ICER), which represent the costs to prevent the adverse outcome, here (1) the composite outcome of obstetric complications and (2) specifically neonatal trauma due to shoulder dystocia. Mean costs of a one-day multi-professional team training in a medical simulation centre were €25,546 to train all personnel of one hospital. A single training in a medical simulation centre was less effective and more costly compared to strategies that included repetition training. Compared to no training, the ICERs to prevent a composite outcome of obstetric complications were €3432 for a single repetition training course on-site six months after the initial training and €5115 for a three monthly repetition training course on-site after the initial training during one year. When we considered neonatal trauma due to shoulder dystocia, a three monthly repetition training course on-site after the initial training had an ICER of €22,878. Multi-professional team training in a medical simulation centre is cost-effective in a scenario where repetition training sessions are performed on-site. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The Evolution of Medical Training Simulation in the U.S. Military.

    PubMed

    Linde, Amber S; Kunkler, Kevin

    2016-01-01

    The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

  3. 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.

  4. 14 CFR 135.336 - Airline transport pilot certification training program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (v) Evaluation. (4) If providing training in a flight simulation training device, holds an aircraft type rating for the aircraft represented by the flight simulation training device utilized in the... simulation; (iv) Minimum equipment requirements for each curriculum; and (v) The maneuvers that will be...

  5. Some Factors Influencing Transfer of Simulator Training.

    ERIC Educational Resources Information Center

    Caro, Paul W.

    Studies of transfer of training may be used to determine whether simulator training improves pilot performance in an aircraft. Some approaches to determining simulator training effectiveness, such as surveys of pilot and instructor opinions, are not considered particularly reliable. Several other approaches have also been suggested. One factor…

  6. Teaching aseptic technique for central venous access under ultrasound guidance: a randomized trial comparing didactic training alone to didactic plus simulation-based training.

    PubMed

    Latif, Rana K; Bautista, Alexander F; Memon, Saima B; Smith, Elizabeth A; Wang, Chenxi; Wadhwa, Anupama; Carter, Mary B; Akca, Ozan

    2012-03-01

    Our goal was to determine whether simulation combined with didactic training improves sterile technique during ultrasound (US)-guided central venous catheter (CVC) insertion compared with didactic training alone among novices. We hypothesized that novices who receive combined didactic and simulation-based training would perform similarly to experienced residents in aseptic technique, knowledge, and perception of comfort during US-guided CVC insertion on a simulator. Seventy-two subjects were enrolled in a randomized, controlled trial of an educational intervention. Fifty-four novices were randomized into either the didactic group or the simulation combined with didactic group. Both groups received didactic training but the simulation combined with didactic group also received simulation-based CVC insertion training. Both groups were tested by demonstrating US-guided CVC insertion on a simulator. Aseptic technique was scored on 8 steps as "yes/no" and also using a 7-point Likert scale with 7 being "excellent technique" by a rater blinded to subject randomization. After initial testing, the didactic group was offered simulation-based training and retesting. Both groups also took a pre- and posttraining test of knowledge and rated their comfort with US and CVC insertion pre- and posttraining on a 5-point Likert scale. Subsequently, 18 experienced residents also took the test of knowledge, rated their comfort level, and were scored while performing aseptic US-guided CVC insertion using a simulator. The simulation combined with didactic group achieved a 167% (95% confidence interval [CI] 133%-167%) incremental increase in yes/no scores and 115% (CI 112%-127%) incremental increase in Likert scale ratings on aseptic technique compared with novices in the didactic group. Compared with experienced residents, simulation combined with didactic trained novices achieved an increase in aseptic scores with a 33.3% (CI 16.7%-50%) increase in yes/no ratings and a 20% (CI 13.3%-40%) increase in Likert scaled ratings, and scored 2.5-fold higher on the test of knowledge. There was a 3-fold increase in knowledge and 2-fold increase in comfort level among all novices (P < 0.001) after combined didactic and simulation-based training. Simulation combined with didactic training is superior to didactic training alone for acquisition of clinical skills such as US-guided CVC insertion. After combined didactic and simulation-based training, novices can outperform experienced residents in aseptic technique as well as in measurements of knowledge.

  7. Simulating 'the right stuff'

    NASA Astrophysics Data System (ADS)

    Fischetti, M. A.; Truxal, C.

    1985-03-01

    The present investigation is mainly concerned with simulators employed in the training of pilots in the Armed Services and other military personnel, taking into account certain problems and approaches for overcoming them. The use of simulators for training programs has a number of advantages compared to training involving a use of the actual equipment. Questions arise, however, regarding the value of such a training. Thus, it has been said that, while simulators gave students practice in manual skill, they could not teach them to handle the stress of being in a real aircraft. It has also been argued that some tasks are not represented accurately enough for proper training. In response to this criticism, the capacity of the simulators has been greatly improved. However, this development leads to problems related to the cost of simulator training. Attention is given to better visuals for flight simulators, the current generation of graphics imagery and expected improvements, possibilities for reducing flight simulator costs, and advances due to progress in microcomputers.

  8. Reliance on Simulation in Initial Entry Rifle Marksmanship Training and Future Directions for Simulation

    DTIC Science & Technology

    2016-11-01

    Engagement Simulation Training, and a day of dry -fire. The comparison was conducted during training with iron sights. On the two criterion measures, the...other five days of training consisted of two days of Engagement Skills Trainer (EST) 2000 training, one day of dry -fire, and two days of live-fire...0 / RM1 Preliminary Marksmanship Training Same as Baseline 1 / RM2 EST 2000 (grouping/zeroing) Test-D Drills 2 / RM3 Dry -Fire Training 25m Live-Fire

  9. Simulation-Based Bronchoscopy Training

    PubMed Central

    Kennedy, Cassie C.; Maldonado, Fabien

    2013-01-01

    Background: 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. Methods: 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. Results: 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. Conclusions: Simulation-based bronchoscopy training is effective in comparison with no intervention. Comparative effectiveness studies are few. PMID:23370487

  10. Simulators for corporate pilot training and evaluation

    NASA Technical Reports Server (NTRS)

    Treichel, Curt

    1992-01-01

    Corporate aviation relies heavily on simulation to meet training and evaluation requirements. It appreciates the savings in fuel, money, noise, and time, and the added safety it provides. Also, simulation provides opportunities to experience many emergencies that cannot be safely practiced in the aircraft. There is a need to focus on the advantages of simulator training over aircraft training and to provide appropriate changes in the regulations to allow the community to make it possible for users to take full advantage of simulation.

  11. On the Bridge to Learn: Analysing the Social Organization of Nautical Instruction in a Ship Simulator

    ERIC Educational Resources Information Center

    Hontvedt, Magnus; Arnseth, Hans Christian

    2013-01-01

    Research on simulator training has rarely focused on the way simulated contexts are constructed collaboratively. This study sheds light on how structuring role-play and fostering social interactions may prove fruitful for designing simulator training. The article reports on a qualitative study of nautical students training in a ship simulator. The…

  12. Simulation improves procedural protocol adherence during central venous catheter placement: a randomized-controlled trial

    PubMed Central

    Peltan, Ithan D.; Shiga, Takashi; Gordon, James A.; Currier, Paul F.

    2015-01-01

    Background Simulation training may improve proficiency at and reduces complications from central venous catheter (CVC) placement, but the scope of simulation’s effect remains unclear. This randomized controlled trial evaluated the effects of a pragmatic CVC simulation program on procedural protocol adherence, technical skill, and patient outcomes. Methods Internal medicine interns were randomized to standard training for CVC insertion or standard training plus simulation-based mastery training. Standard training involved a lecture, a video-based online module, and instruction by the supervising physician during actual CVC insertions. Intervention-group subjects additionally underwent supervised training on a venous access simulator until they demonstrated procedural competence. Raters evaluated interns’ performance during internal jugular CVC placement on actual patients in the medical intensive care unit. Generalized estimating equations were used to account for outcome clustering within trainees. Results We observed 52 interns place 87 CVCs. Simulation-trained interns exhibited better adherence to prescribed procedural technique than interns who received only standard training (p=0.024). There were no significant differences detected in first-attempt or overall cannulation success rates, mean needle passes, global assessment scores or complication rates. Conclusions Simulation training added to standard training improved protocol adherence during CVC insertion by novice practitioners. This study may have been too small to detect meaningful differences in venous cannulation proficiency and other clinical outcomes, highlighting the difficulty of patient-centered simulation research in settings where poor outcomes are rare. For high-performing systems, where protocol deviations may provide an important proxy for rare procedural complications, simulation may improve CVC insertion quality and safety. PMID:26154250

  13. Specification of Training Simulator Fidelity: A Research Plan. Technical Report 558.

    ERIC Educational Resources Information Center

    Baum, David R.; And Others

    This report presents a research plan to guide the determination of the empirical relationship between level of maintenance training simulator fidelity and training effectiveness. Chapter I describes data collection and analysis activities undertaken to provide guidance for fidelity decision making by the training simulator development community.…

  14. Payload Crew Training Complex (PCTC) utilization and training plan

    NASA Technical Reports Server (NTRS)

    Self, M. R.

    1980-01-01

    The physical facilities that comprise the payload crew training complex (PCTC) are described including the host simulator; experiment simulators; Spacelab aft flight deck, experiment pallet, and experiment rack mockups; the simulation director's console; payload operations control center; classrooms; and supporting soft- and hardware. The parameters of a training philosophy for payload crew training at the PCTC are established. Finally the development of the training plan is addressed including discussions of preassessment, and evaluation options.

  15. Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time.

    PubMed

    Dunn, John C; Belmont, Philip J; Lanzi, Joseph; Martin, Kevin; Bader, Julia; Owens, Brett; Waterman, Brian R

    2015-01-01

    Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and continue to train throughout the academic year. Published by Elsevier Inc.

  16. Using gaming simulation to evaluate bioterrorism and emergency readiness training.

    PubMed

    Olson, Debra K; Scheller, Amy; Wey, Andrew

    2014-01-01

    The University of Minnesota: Simulations, Exercises and Effective Education: Preparedness and Emergency Response Learning Center uses simulations, which allow trainees to participate in realistic scenarios, to develop and evaluate competency. In a previous study, participants in Disaster in Franklin County: A Public Health Simulation demonstrated that prior bioterrorism and emergency readiness training (BT/ER) is significantly associated with better performance in a simulated emergency. We conducted a second analysis with a larger data set, remapping simulation questions to the Public Health Preparedness and Response Core Competency Model, Version 1.0. We performed an outcome evaluation of the impact of public health preparedness training. In particular, we compared individuals with significant BT/ER training to individuals without training on the basis of performance in a simulated emergency. We grouped participants as group 1 (≥45 hours of BT/ER training) and group 2 (<45 hours). Dependent variables included effectiveness of chosen responses within the gaming simulation, which was measured as the proportion of questions answered correctly for each participant. The relationship of effectiveness with significant BT/ER training was estimated using either multiple linear or logistic regression. For overall effectiveness, group 1 had 2% more correct decisions, on average, than group 2 (P < .001). Group 1 performed significantly better, on average, than group 2 for competency 1.1 (P = .001) and competency 2.3 (P < .001). However, group 1 was significantly worse on competency 1.2 than group 2. Results indicate that prior training is significantly associated with better performance in a simulated emergency using gaming technology. Effectiveness differed by competency, indicating that more training may be needed in certain competency areas. Next steps to enhancing the usefulness of simulations in training should go beyond questioning if the learner learned and included questions related to the organizational factors that contributed to simulation effectiveness, and attributes of the simulation that encouraged competency and capacity building.

  17. Simulation-based training for thoracoscopic lobectomy: a randomized controlled trial: virtual-reality versus black-box simulation.

    PubMed

    Jensen, Katrine; Ringsted, Charlotte; Hansen, Henrik Jessen; Petersen, René Horsleben; Konge, Lars

    2014-06-01

    Video-assisted thoracic surgery is gradually replacing conventional open thoracotomy as the method of choice for the treatment of early-stage non-small cell lung cancers, and thoracic surgical trainees must learn and master this technique. Simulation-based training could help trainees overcome the first part of the learning curve, but no virtual-reality simulators for thoracoscopy are commercially available. This study aimed to investigate whether training on a laparoscopic simulator enables trainees to perform a thoracoscopic lobectomy. Twenty-eight surgical residents were randomized to either virtual-reality training on a nephrectomy module or traditional black-box simulator training. After a retention period they performed a thoracoscopic lobectomy on a porcine model and their performance was scored using a previously validated assessment tool. The groups did not differ in age or gender. All participants were able to complete the lobectomy. The performance of the black-box group was significantly faster during the test scenario than the virtual-reality group: 26.6 min (SD 6.7 min) versus 32.7 min (SD 7.5 min). No difference existed between the two groups when comparing bleeding and anatomical and non-anatomical errors. Simulation-based training and targeted instructions enabled the trainees to perform a simulated thoracoscopic lobectomy. Traditional black-box training was more effective than virtual-reality laparoscopy training. Thus, a dedicated simulator for thoracoscopy should be available before establishing systematic virtual-reality training programs for trainees in thoracic surgery.

  18. Development and validation of an artificial wetlab training system for the lumbar discectomy.

    PubMed

    Adermann, Jens; Geissler, Norman; Bernal, Luis E; Kotzsch, Susanne; Korb, Werner

    2014-09-01

    An initial research indicated that realistic haptic simulators with an adapted training concept are needed to enhance the training for spinal surgery. A cognitive task analysis (CTA) was performed to define a realistic and helpful scenario-based simulation. Based on the results a simulator for lumbar discectomy was developed. Additionally, a realistic training operating room was built for a pilot. The results were validated. The CTA showed a need for realistic scenario-based training in spine surgery. The developed simulator consists of synthetic bone structures, synthetic soft tissue and an advanced bleeding system. Due to the close interdisciplinary cooperation of surgeons between engineers and psychologists, the iterative multicentre validation showed that the simulator is visually and haptically realistic. The simulator offers integrated sensors for the evaluation of the traction being used and the compression during surgery. The participating surgeons in the pilot workshop rated the simulator and the training concept as very useful for the improvement of their surgical skills. In the context of the present work a precise definition for the simulator and training concept was developed. The additional implementation of sensors allows the objective evaluation of the surgical training by the trainer. Compared to other training simulators and concepts, the high degree of objectivity strengthens the acceptance of the feedback. The measured data of the nerve root tension and the compression of the dura can be used for intraoperative control and a detailed postoperative evaluation.

  19. Formulation of consumables management models: Consumables analysis/crew simulator interface requirements

    NASA Technical Reports Server (NTRS)

    Zamora, M. A.

    1977-01-01

    Consumables analysis/crew training simulator interface requirements were defined. Two aspects were investigated: consumables analysis support techniques to crew training simulator for advanced spacecraft programs, and the applicability of the above techniques to the crew training simulator for the space shuttle program in particular.

  20. High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

    PubMed

    Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

    2012-04-01

    Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents consistently overestimated their nontechnical performance. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Emotion, cognitive load and learning outcomes during simulation training.

    PubMed

    Fraser, Kristin; Ma, Irene; Teteris, Elise; Baxter, Heather; Wright, Bruce; McLaughlin, Kevin

    2012-11-01

    Simulation training has emerged as an effective way to complement clinical training of medical students. Yet outcomes from simulation training must be considered suboptimal when 25-30% of students fail to recognise a cardiac murmur on which they were trained 1 hour previously. There are several possible explanations for failure to improve following simulation training, which include the impact of heightened emotions on learning and cognitive overload caused by interactivity with high-fidelity simulators. This study was conducted to assess emotion during simulation training and to explore the relationships between emotion and cognitive load, and diagnostic performance. We trained 84 Year 1 medical students on a scenario of chest pain caused by symptomatic aortic stenosis. After training, students were asked to rate their emotional state and cognitive load. We then provided training on a dyspnoea scenario before asking participants to diagnose the murmur in which they had been trained (aortic stenosis) and a novel murmur (mitral regurgitation). We used factor analysis to identify the principal components of emotion, and then studied the associations between these components of emotion and cognitive load and diagnostic performance. We identified two principal components of emotion, which we felt represented invigoration and tranquillity. Both of these were associated with cognitive load with adjusted regression coefficients of 0.63 (95% confidence interval [CI] 0.28-0.99; p = 0.001) and - 0.44 (95% CI - 0.77 to - 0.10; p = 0.009), respectively. We found a significant negative association between cognitive load and the odds of subsequently identifying the trained murmur (odds ratio 0.27, 95% CI 0.11-0.67; p = 0.004). We found that increased invigoration and reduced tranquillity during simulation training were associated with increased cognitive load, and that the likelihood of correctly identifying a trained murmur declined with increasing cognitive load. Further studies are needed to evaluate the impact on performance of strategies to alter emotion and cognitive load during simulation training. © Blackwell Publishing Ltd 2012.

  2. Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

    PubMed

    Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

    2018-06-01

    New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

  3. Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery.

    PubMed

    Phé, Véronique; Cattarino, Susanna; Parra, Jérôme; Bitker, Marc-Olivier; Ambrogi, Vanina; Vaessen, Christophe; Rouprêt, Morgan

    2017-06-01

    The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons' performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Virtual Reality Simulator Systems in Robotic Surgical Training.

    PubMed

    Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

    2018-06-01

    The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

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

    PubMed

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

    2012-01-01

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

  6. Logistics of Trainsets Creation with the Use of Simulation Models

    NASA Astrophysics Data System (ADS)

    Sedláček, Michal; Pavelka, Hynek

    2016-12-01

    This paper focuses on rail transport in following the train formation operational processes problem using computer simulations. The problem has been solved using SIMUL8 and applied to specific train formation station in the Czech Republic. The paper describes a proposal simulation model of the train formation work. Experimental modeling with an assessment of achievements and design solution for optimizing of the train formation operational process is also presented.

  7. The Relationship of Endoscopic Proficiency to Educational Expense for Virtual Reality Simulator Training Amongst Surgical Trainees.

    PubMed

    Raque, Jessica; Goble, Adam; Jones, Veronica M; Waldman, Lindsey E; Sutton, Erica

    2015-07-01

    With the introduction of Fundamentals of Endoscopic Surgery, training methods in flexible endoscopy are being augmented with simulation-based curricula. The investment for virtual reality simulators warrants further research into its training advantage. Trainees were randomized into bedside or simulator training groups (BED vs SIM). SIM participated in a proficiency-based virtual reality curriculum. Trainees' endoscopic skills were rated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) in the patient care setting. The number of cases to reach 90 per cent of the maximum GAGES score and calculated costs of training were compared. Nineteen residents participated in the study. There was no difference in the average number of cases required to achieve 90 per cent of the maximum GAGES score for esophagogastroduodenoscopy, 13 (SIM) versus11 (BED) (P = 0.63), or colonoscopy 21 (SIM) versus 4 (BED) (P = 0.34). The average per case cost of training for esophagogastroduodenoscopy was $35.98 (SIM) versus $39.71 (BED) (P = 0.50), not including the depreciation costs associated with the simulator ($715.00 per resident over six years). Use of a simulator appeared to increase the cost of training without accelerating the learning curve or decreasing faculty time spent in instruction. The importance of simulation in endoscopy training will be predicated on more cost-effective simulators.

  8. Systematic review of skills transfer after surgical simulation-based training.

    PubMed

    Dawe, S R; Pena, G N; Windsor, J A; Broeders, J A J L; Cregan, P C; Hewett, P J; Maddern, G J

    2014-08-01

    Simulation-based training assumes that skills are directly transferable to the patient-based setting, but few studies have correlated simulated performance with surgical performance. A systematic search strategy was undertaken to find studies published since the last systematic review, published in 2007. Inclusion of articles was determined using a predetermined protocol, independent assessment by two reviewers and a final consensus decision. Studies that reported on the use of surgical simulation-based training and assessed the transferability of the acquired skills to a patient-based setting were included. Twenty-seven randomized clinical trials and seven non-randomized comparative studies were included. Fourteen studies investigated laparoscopic procedures, 13 endoscopic procedures and seven other procedures. These studies provided strong evidence that participants who reached proficiency in simulation-based training performed better in the patient-based setting than their counterparts who did not have simulation-based training. Simulation-based training was equally as effective as patient-based training for colonoscopy, laparoscopic camera navigation and endoscopic sinus surgery in the patient-based setting. These studies strengthen the evidence that simulation-based training, as part of a structured programme and incorporating predetermined proficiency levels, results in skills transfer to the operative setting. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  9. Perceived Barriers to the Use of High-Fidelity Hands-On Simulation Training for Contrast Reaction Management: Why Programs are Not Using It.

    PubMed

    Chinnugounder, Sankar; Hippe, Daniel S; Maximin, Suresh; O'Malley, Ryan B; Wang, Carolyn L

    2015-01-01

    Although subjective and objective benefits of high-fidelity simulation have been reported in medicine, there has been slow adoption in radiology. The purpose of our study was to identify the perceived barriers in the use of high-fidelity hands-on simulation for contrast reaction management training. An IRB exempt 32 questions online web survey was sent to 179 non-military radiology residency program directors listed in the Fellowship and Residency Electronic Interactive Database Access system (FREIDA). Survey questions included the type of contrast reaction management training, cost, time commitment of residents and faculty, and the reasons for not using simulation training. Responses from the survey were summarized as count (percentage), mean ± standard deviation (SD), or median (range). 84 (47%) of 179 programs responded, of which 88% offered CRM training. Most (72%) conducted the CRM training annually while only 4% conducted it more frequently. Didactic lecture was the most frequently used training modality (97%), followed by HFS (30%) and computer-based simulation (CBS) (19%); 5.5% used both HFS and CBS. Of the 51 programs that offer CRM training but do not use HFS, the most common reason reported was insufficient availability (41%). Other reported reasons included cost (33%), no access to simulation centers (33%), lack of trained faculty (27%) and time constraints (27%). Although high-fidelity hands-on simulation training is the best way to reproduce real-life contrast reaction scenarios, many institutions do not provide this training due to constraints such as cost, lack of access or insufficient availability of simulation labs, and lack of trained faculty. As a specialty, radiology needs to better address these barriers at both an institutional and national level. Copyright © 2015 Mosby, Inc. All rights reserved.

  10. Effect of dyad training on medical students' cardiopulmonary resuscitation performance.

    PubMed

    Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

    2017-03-01

    We investigated the effects of dyadic training on medical students' resuscitation performance during cardiopulmonary resuscitation (CPR) training.We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills.Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022).Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance.

  11. Effect of dyad training on medical students’ cardiopulmonary resuscitation performance

    PubMed Central

    Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

    2017-01-01

    Abstract We investigated the effects of dyadic training on medical students’ resuscitation performance during cardiopulmonary resuscitation (CPR) training. We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills. Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022). Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance. PMID:28353555

  12. Progress through precedent: Going where no helicopter simulator has gone before

    NASA Technical Reports Server (NTRS)

    Adams, Richard J.

    1992-01-01

    Helicopter simulators have been approved by means of special exemption; there are no FAA standards for simulators used in training or airmen Certification checking. The fixed-wing industry provides a precedent which can be used for expediting implementation of helicopter simulators. The analysis in this paper is founded on the experience with that precedent and is driven by a clear definition of helicopter user needs for (1) improved training at lower cost, (2) more comprehensive emergency training at lower risk, (3) increased fidelity of transition and instrument training compared with low-cost aircraft alternatives, and (4) certification credit for improved simulator training.

  13. 14 CFR Appendix E to Part 60 - Qualification Performance Standards for Quality Management Systems for Flight Simulation Training...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Quality Management Systems for Flight Simulation Training Devices E Appendix E to Part 60 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION...—Qualification Performance Standards for Quality Management Systems for Flight Simulation Training Devices Begin...

  14. Simulation Activity in Otolaryngology Residencies.

    PubMed

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  15. Snowplow simulator training evaluation : research notes

    DOT National Transportation Integrated Search

    2006-11-01

    Two years of experience with simulator training for snowplow operators in Arizona leaves an optimistic feeling about the potential of simulators as an integral part of comprehensive winter maintenance and driver-skill training programs. Further resea...

  16. [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.

  17. Development and implementation of centralized simulation training: evaluation of feasibility, acceptability and construct validity.

    PubMed

    Shamim Khan, Mohammad; Ahmed, Kamran; Gavazzi, Andrea; Gohil, Rishma; Thomas, Libby; Poulsen, Johan; Ahmed, Munir; Jaye, Peter; Dasgupta, Prokar

    2013-03-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: A competent urologist should not only have effective technical skills, but also other attributes that would make him/her a complete surgeon. These include team-working, communication and decision-making skills. Although evidence for effectiveness of simulation exists for individual simulators, there is a paucity of evidence for utility and effectiveness of these simulators in training programmes that aims to combine technical and non-technical skills training. This article explains the process of development and validation of a centrally coordinated simulation program (Participants - South-East Region Specialist Registrars) under the umbrella of the British Association for Urological Surgeons (BAUS) and the London Deanery. This program incorporated training of both technical (synthetic, animal and virtual reality models) and non-technical skills (simulated operating theatres). To establish the feasibility and acceptability of a centralized, simulation-based training-programme. Simulation is increasingly establishing its role in urological training, with two areas that are relevant to urologists: (i) technical skills and (ii) non-technical skills. For this London Deanery supported pilot Simulation and Technology enhanced Learning Initiative (STeLI) project, we developed a structured multimodal simulation training programme. The programme incorporated: (i) technical skills training using virtual-reality simulators (Uro-mentor and Perc-mentor [Symbionix, Cleveland, OH, USA], Procedicus MIST-Nephrectomy [Mentice, Gothenburg, Sweden] and SEP Robotic simulator [Sim Surgery, Oslo, Norway]); bench-top models (synthetic models for cystocopy, transurethral resection of the prostate, transurethral resection of bladder tumour, ureteroscopy); and a European (Aalborg, Denmark) wet-lab training facility; as well as (ii) non-technical skills/crisis resource management (CRM), using SimMan (Laerdal Medical Ltd, Orpington, UK) to teach team-working, decision-making and communication skills. The feasibility, acceptability and construct validity of these training modules were assessed using validated questionnaires, as well as global and procedure/task-specific rating scales. In total 33, three specialist registrars of different grades and five urological nurses participated in the present study. Construct-validity between junior and senior trainees was significant. Of the participants, 90% rated the training models as being realistic and easy to use. In total 95% of the participants recommended the use of simulation during surgical training, 95% approved the format of the teaching by the faculty and 90% rated the sessions as well organized. A significant number of trainees (60%) would like to have easy access to a simulation facility to allow more practice and enhancement of their skills. A centralized simulation programme that provides training in both technical and non-technical skills is feasible. It is expected to improve the performance of future surgeons in a simulated environment and thus improve patient safety. © 2012 BJU International.

  18. Ventilator caregiver education through the use of high-fidelity pediatric simulators: a pilot study.

    PubMed

    Tofil, Nancy M; Rutledge, Chrystal; Zinkan, J Lynn; Youngblood, Amber Q; Stone, Julie; Peterson, Dawn Taylor; Slayton, Donna; Makris, Chris; Magruder, Terri; White, Marjorie Lee

    2013-11-01

    Introduction. Home ventilator programs (HVP) have been developed to train parents of critically ill children. Simulators are used in health care, but not often for parents. We added simulation to our HVP and assessed parents' response. Methods. In July 2008, the HVP at Children's of Alabama added simulation to parent training. Debriefing was provided after the training session to reinforce correct skills and critical thinking. Follow-up surveys were completed after training. Results. Fifteen families participated. All parents were confident in changing tracheostomies, knowing signs of breathing difficulties, and responding to alarms. 71% strongly agree that simulation resulted in feeling better prepared to care for their child. 86% felt simulation improved their confidence in taking care of their child. Conclusion. Simulators provide a crucial transition between learned skills and application. This novel use of simulation-based education improves parents' confidence in emergencies and may lead to shortened training resulting in cost savings.

  19. A survey of simulators for palpation training.

    PubMed

    Zhang, Yan; Phillips, Roger; Ward, James; Pisharody, Sandhya

    2009-01-01

    Palpation is a widely used diagnostic method in medical practice. The sensitivity of palpation is highly dependent upon the skill of clinicians, which is often difficult to master. There is a need of simulators in palpation training. This paper summarizes important work and the latest achievements in simulation for palpation training. Three types of simulators; physical models, Virtual Reality (VR) based simulations, and hybrid (computerized and physical) simulators, are surveyed. Comparisons among different kinds of simulators are presented.

  20. Workforce Modeling & Simulation Education and Training for Lifelong Learning: Modeling & Simulation Education Catalog

    DTIC Science & Technology

    2007-03-01

    LEARNING : MODELING & SIMULATION EDUCATION CATALOG by Jean Catalano Jarema M. Didoszak March 2007...Technical Report, 11/06 – 02/07 4. TITLE AND SUBTITLE: Workforce Modeling & Simulation Education and Training for Lifelong Learning ...Modeling and Simulation Education and Training for Lifelong Learning project. The catalog contains searchable information about 253 courses from 23 U.S

  1. Moving the Needle: Simulation's Impact on Patient Outcomes.

    PubMed

    Cox, Tiffany; Seymour, Neal; Stefanidis, Dimitrios

    2015-08-01

    This review investigates the available literature that addresses the impact simulator training has on patient outcomes. The authors conducted a comprehensive literature search of studies reporting outcomes of simulation training and categorized studies based on the Kirkpatrick model of training evaluation. Kirkpatrick level 4 studies reporting patient outcomes were identified and included in this review. Existing evidence is promising, demonstrating patient benefits as a result of simulation training for central line placement, obstetric emergencies, cataract surgery, laparoscopic inguinal hernia repair, and team training. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. United States Air Force Training Line Simulator. Final Report.

    ERIC Educational Resources Information Center

    Nauta, Franz; Pierce, Michael B.

    This report describes the technical aspects and potential applications of a computer-based model simulating the flow of airmen through basic training and entry-level technical training. The objective of the simulation is to assess the impacts of alternative recruit classification and training policies under a wide variety of assumptions regarding…

  3. Enhancing Job-Site Training of Supported Workers with Autism: A Reemphasis on Simulation

    ERIC Educational Resources Information Center

    Lattimore, L. Perry; Parsons, Marsha B.; Reid, Dennis H.

    2006-01-01

    Currently recommended practice in supported work emphasizes training job skills to workers with severe disabilities while on the job. Early behavioral research indicated that skills needed in natural environments could also be trained in simulated settings. We compared job-site plus simulation training for teaching job skills to supported workers…

  4. The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

    PubMed

    Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

    2018-01-01

    The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.

  5. A comparison of human cadaver and augmented reality simulator models for straight laparoscopic colorectal skills acquisition training.

    PubMed

    LeBlanc, Fabien; Champagne, Bradley J; Augestad, Knut M; Neary, Paul C; Senagore, Anthony J; Ellis, Clyde N; Delaney, Conor P

    2010-08-01

    The aim of this study was to compare the human cadaver model with an augmented reality simulator for straight laparoscopic colorectal skills acquisition. Thirty-five sigmoid colectomies were performed on a cadaver (n = 7) or an augmented reality simulator (n = 28) during a laparoscopic training course. Prior laparoscopic colorectal experience was assessed. Objective structured technical skills assessment forms were completed by trainers and trainees independently. Groups were compared according to technical skills and events scores and satisfaction with training model. Prior laparoscopic experience was similar in both groups. For trainers and trainees, technical skills scores were considerably better on the simulator than on the cadaver. For trainers, generic events score was also considerably better on the simulator than on the cadaver. The main generic event occurring on both models was errors in the use of retraction. The main specific event occurring on both models was bowel perforation. Global satisfaction was better for the cadaver than for the simulator model (p < 0.001). The human cadaver model was more difficult but better appreciated than the simulator for laparoscopic sigmoid colectomy training. Simulator training followed by cadaver training can appropriately integrate simulators into the learning curve and maintain the benefits of both training methodologies. Published by Elsevier Inc.

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

    PubMed Central

    Neef, N A; Lensbower, J; Hockersmith, I; DePalma, V; Gray, K

    1990-01-01

    We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives. PMID:2074236

  7. Sustaining simulation training programmes--experience from maternity care.

    PubMed

    Ayres-de-Campos, D; Deering, S; Siassakos, D

    2011-11-01

    There is little scientific evidence to support the majority of simulation-based maternity training programmes, but some characteristics appear to be associated with sustainability. Among these are a clear institutional-level commitment to the course, strong leadership in course organisation, a curriculum relevant to clinical practice, a nonthreatening learning environment, the establishment of multiprofessional training and the use of simulators appropriate to the learning objectives. There is still some debate on whether simulation-based sessions should be carried out in dedicated training time outside normal working hours or in ad-hoc drills that are run during clinical sessions, whether they should be located in clinical areas, simulation centres, or both, and whether or not they should include standardised generic teamwork training sessions. In this review, we discuss the main characteristics that appear to make a simulation-based training programme a sustainable initiative. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  8. Training in surgical oncology - the role of VR simulation.

    PubMed

    Lewis, T M; Aggarwal, R; Rajaretnam, N; Grantcharov, T P; Darzi, A

    2011-09-01

    There have been dramatic changes in surgical training over the past two decades which have resulted in a number of concerns for the development of future surgeons. Changes in the structure of cancer services, working hour restrictions and a commitment to patient safety has led to a reduction in training opportunities that are available to the surgeon in training. Simulation and in particular virtual reality (VR) simulation has been heralded as an effective adjunct to surgical training. Advances in VR simulation has allowed trainees to practice realistic full length procedures in a safe and controlled environment, where mistakes are permitted and can be used as learning points. There is considerable evidence to demonstrate that the VR simulation can be used to enhance technical skills and improve operating room performance. Future work should focus on the cost effectiveness and predictive validity of VR simulation, which in turn would increase the uptake of simulation and enhance surgical training. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Virtual reality lead extraction as a method for training new physicians: a pilot study.

    PubMed

    Maytin, Melanie; Daily, Thomas P; Carillo, Roger G

    2015-03-01

    It is estimated that the demand for transvenous lead extraction (TLE) has reached an annual extraction rate of nearly 24,000 patients worldwide. Despite technologic advances, TLE still has the potential for significant morbidity and mortality. Complication rates with TLE directly parallel operator experience. However, obtaining adequate training during and postfellowship can be difficult. Given the potential for catastrophic complications and the steep learning curve (up to 300 cases) associated with this procedure, we sought to validate a virtual reality (VR) lead extraction simulator as an innovative training and evaluation tool for physicians new to TLE. We randomized eight electrophysiology fellows to VR simulator versus conventional training. We compared procedural skill competency between the groups using simulator competency, tactile measurements, markers of proficiency and attitudes, and cognitive abilities battery. Practical skills and simulator complications differed significantly between the VR simulator and conventional training groups. The VR simulator group executed patient preparation and procedure performance better than the conventional group (P < 0.01). All four fellows randomized to conventional training experienced a simulator complication (two superior vena cava [SVC] tears, three right ventricle [RV] avulsions) versus one fellow in the VR simulator group (one SVC tear) (P = 0.02). Tactile measurements revealed a trend toward excess pushing versus pulling forces among the conventionally trained group. The time for lead removal was also significantly higher in the conventional training group (12.46 minutes vs 5.54 minutes, P = 0.02). There was no significant difference in baseline or posttraining cognitive ability. We contend that the implementation of alternative training tools such as a VR simulation model will improve physician training and allow for an innovative pathway to assess the achievement of competency. ©2014 Wiley Periodicals, Inc.

  10. Laparoscopic simulation training in gynaecology: Current provision and staff attitudes - a cross-sectional survey.

    PubMed

    Burden, Christy; Fox, Robert; Hinshaw, Kim; Draycott, Timothy J; James, Mark

    2016-01-01

    The objectives of this study were to explore current provision of laparoscopic simulation training, and to determine attitudes of trainers and trainees to the role of simulators in surgical training across the UK. An anonymous cross-sectional survey with cluster sampling was developed and circulated. All Royal College of Obstetricians and Gynaecologists (RCOG) Training Programme Directors (TPD), College Tutors (RCT) and Trainee representatives (TR) across the UK were invited to participate. One hundred and ninety-six obstetricians and gynaecologists participated. Sixty-three percent of hospitals had at least one box trainer, and 14.6% had least one virtual-reality simulator. Only 9.3% and 3.6% stated that trainees used a structured curriculum on box and virtual-reality simulators, respectively. Respondents working in a Large/Teaching hospital (p = 0.008) were more likely to agree that simulators enhance surgical training. Eighty-nine percent agreed that simulators improve the quality of training, and should be mandatory or desirable for junior trainees. Consultants (p = 0.003) and respondents over 40 years (p = 0.011) were more likely to hold that a simulation test should be undertaken before live operation. Our data demonstrated, therefore, that availability of laparoscopic simulators is inconsistent, with limited use of mandatory structured curricula. In contrast, both trainers and trainees recognise a need for greater use of laparoscopic simulation for surgical training.

  11. T-4G Simulator and T-4 Ground Training Devices in USAF Undergraduate Pilot Training.

    ERIC Educational Resources Information Center

    Woodruff, Robert R.; Smith, James F.

    The objective of the project was to investigate the utility of using an A/F37A-T4G T-37 flight simulator within the context of Air Force undergraduate pilot training. Twenty-one subjects, selected from three undergraduate pilot training classes, were given contact flight training in a TP4G/EPT simulator before going to T-37 aircraft for further…

  12. The role of simulation in neurosurgery.

    PubMed

    Rehder, Roberta; Abd-El-Barr, Muhammad; Hooten, Kristopher; Weinstock, Peter; Madsen, Joseph R; Cohen, Alan R

    2016-01-01

    In an era of residency duty-hour restrictions, there has been a recent effort to implement simulation-based training methods in neurosurgery teaching institutions. Several surgical simulators have been developed, ranging from physical models to sophisticated virtual reality systems. To date, there is a paucity of information describing the clinical benefits of existing simulators and the assessment strategies to help implement them into neurosurgical curricula. Here, we present a systematic review of the current models of simulation and discuss the state-of-the-art and future directions for simulation in neurosurgery. Retrospective literature review. Multiple simulators have been developed for neurosurgical training, including those for minimally invasive procedures, vascular, skull base, pediatric, tumor resection, functional neurosurgery, and spine surgery. The pros and cons of existing systems are reviewed. Advances in imaging and computer technology have led to the development of different simulation models to complement traditional surgical training. Sophisticated virtual reality (VR) simulators with haptic feedback and impressive imaging technology have provided novel options for training in neurosurgery. Breakthrough training simulation using 3D printing technology holds promise for future simulation practice, proving high-fidelity patient-specific models to complement residency surgical learning.

  13. Virtual reality-based simulation training for ventriculostomy: an evidence-based approach.

    PubMed

    Schirmer, Clemens M; Elder, J Bradley; Roitberg, Ben; Lobel, Darlene A

    2013-10-01

    Virtual reality (VR) simulation-based technologies play an important role in neurosurgical resident training. The Congress of Neurological Surgeons (CNS) Simulation Committee developed a simulation-based curriculum incorporating VR simulators to train residents in the management of common neurosurgical disorders. To enhance neurosurgical resident training for ventriculostomy placement using simulation-based training. A course-based neurosurgical simulation curriculum was introduced at the Neurosurgical Simulation Symposium at the 2011 and 2012 CNS annual meetings. A trauma module was developed to teach ventriculostomy placement as one of the neurosurgical procedures commonly performed in the management of traumatic brain injury. The course offered both didactic and simulator-based instruction, incorporating written and practical pretests and posttests and questionnaires to assess improvement in skill level and to validate the simulators as teaching tools. Fourteen trainees participated in the didactic component of the trauma module. Written scores improved significantly from pretest (75%) to posttest (87.5%; P < .05). Seven participants completed the ventriculostomy simulation. Significant improvements were observed in anatomy (P < .04), burr hole placement (P < .03), final location of the catheter (P = .05), and procedure completion time (P < .004). Senior residents planned a significantly better trajectory (P < .01); junior participants improved most in terms of identifying the relevant anatomy (P < .03) and the time required to complete the procedure (P < .04). VR ventriculostomy placement as part of the CNS simulation trauma module complements standard training techniques for residents in the management of neurosurgical trauma. Improvement in didactic and hands-on knowledge by course participants demonstrates the usefulness of the VR simulator as a training tool.

  14. Description and Preliminary Training Evaluation of an Arc Welding Simulator. Research Report SRR 73-23.

    ERIC Educational Resources Information Center

    Abrams, Macy L.; And Others

    A prototype arc welding training simulator was designed to provide immediate, discriminative feedback and the capacity for concentrated practice. Two randomly selected groups of welding trainees were compared to evaluate the simulator, one group being trained using the simulator and the other using conventional practice. Preliminary data indicated…

  15. MSFC Skylab neutral buoyancy simulator

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The use of a neutral buoyancy simulator for developing extravehicular activity systems and for training astronauts in weightless activities is discussed. The construction of the facility and the operations are described. The types of tests and the training activities conducted in the simulator are reported. Photographs of the components of the simulator and actual training exercises are included.

  16. Does Training Learners on Simulators Benefit Real Patients?

    ERIC Educational Resources Information Center

    Teteris, Elise; Fraser, Kristin; Wright, Bruce; McLaughlin, Kevin

    2012-01-01

    Despite limited data on patient outcomes, simulation training has already been adopted and embraced by a large number of medical schools. Yet widespread acceptance of simulation should not relieve us of the duty to demonstrate if, and under which circumstances, training learners on simulation benefits real patients. Here we review the data on…

  17. 14 CFR 125.297 - Approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., testing, and checking required by this subpart. (b) Each flight simulator and flight training device that... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Approval of flight simulators and flight... Flight Crewmember Requirements § 125.297 Approval of flight simulators and flight training devices. (a...

  18. 14 CFR 125.297 - Approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., testing, and checking required by this subpart. (b) Each flight simulator and flight training device that... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Approval of flight simulators and flight... Flight Crewmember Requirements § 125.297 Approval of flight simulators and flight training devices. (a...

  19. 14 CFR 125.297 - Approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., testing, and checking required by this subpart. (b) Each flight simulator and flight training device that... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Approval of flight simulators and flight... Flight Crewmember Requirements § 125.297 Approval of flight simulators and flight training devices. (a...

  20. 14 CFR 125.297 - Approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., testing, and checking required by this subpart. (b) Each flight simulator and flight training device that... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Approval of flight simulators and flight... Flight Crewmember Requirements § 125.297 Approval of flight simulators and flight training devices. (a...

  1. 14 CFR 125.297 - Approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., testing, and checking required by this subpart. (b) Each flight simulator and flight training device that... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Approval of flight simulators and flight... Flight Crewmember Requirements § 125.297 Approval of flight simulators and flight training devices. (a...

  2. The role of simulation in urological training - A quantitative study of practice and opinions.

    PubMed

    Aydin, Abdullatif; Ahmed, Kamran; Shafi, Ahmed M A; Khan, Muhammad Shamim; Dasgupta, Prokar

    2016-12-01

    Over the past few decades, simulation-based training has rapidly been adopted by many centres for effective technical and non-technical skills training, as a supplementary method to traditional operating room experience. The aim of this study is to assess the current practice in training and seek opinion regarding the future role of simulation in urological training. A cross sectional survey was designed and distributed amongst expert and trainee urological surgeons. The survey consisted of twenty-two questions that were split into three sections; Introduction (6), Technical Skills training in urology (10) and Non-technical skills training in urology (6). A total of 91 residents and 172 specialists completed the survey. In both groups, there was an agreed consensus that laparoscopic training and exposure was insufficient as only 21% of trainees and 23% of specialists believed that they had sufficient training in this area. Furthermore, both groups lacked simulation-based training in common urological procedures including nephrectomy (62%), cystoscopy (69-74%), ureteroscopy (47-59%), transurethral resection of the prostate (56-65%) and percutaneous renal surgery (76-73%). 90% of trainees and 70% of specialists believed (agreed and strongly agreed) that there is a role for non-technical skills simulation in urological training. Simulation training has been under-used thus far and trainees face an uphill challenge to enhance their skills and technical abilities in the operating room. Simulation is recommended by both trainees and specialists and may represent one of the solutions to the challenges of safe and effective urology procedural training. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  3. Numerical Simulation of Nonperiodic Rail Operation Diagram Characteristics

    PubMed Central

    Qian, Yongsheng; Wang, Bingbing; Zeng, Junwei; Wang, Xin

    2014-01-01

    This paper succeeded in utilizing cellular automata (CA) model to simulate the process of the train operation under the four-aspect color light system and getting the nonperiodic diagram of the mixed passenger and freight tracks. Generally speaking, the concerned models could simulate well the situation of wagon in preventing trains from colliding when parking and restarting and of the real-time changes the situation of train speeds and displacement and get hold of the current train states in their departures and arrivals. Finally the model gets the train diagram that simulates the train operation in different ratios of the van and analyzes some parameter characters in the process of train running, such as time, speed, through capacity, interval departing time, and departing numbers. PMID:25435863

  4. Apollo experience report: Simulation of manned space flight for crew training

    NASA Technical Reports Server (NTRS)

    Woodling, C. H.; Faber, S.; Vanbockel, J. J.; Olasky, C. C.; Williams, W. K.; Mire, J. L. C.; Homer, J. R.

    1973-01-01

    Through space-flight experience and the development of simulators to meet the associated training requirements, several factors have been established as fundamental for providing adequate flight simulators for crew training. The development of flight simulators from Project Mercury through the Apollo 15 mission is described. The functional uses, characteristics, and development problems of the various simulators are discussed for the benefit of future programs.

  5. Impact of Using a Robot Patient for Nursing Skill Training in Patient Transfer

    ERIC Educational Resources Information Center

    Huang, Zhifeng; Lin, Chingszu; Kanai-Pak, Masako; Maeda, Jukai; Kitajima, Yasuko; Nakamura, Mitsuhiro; Kuwahara, Noriaki; Ogata, Taiki; Ota, Jun

    2017-01-01

    In the past few decades, simulation training has been used to help nurses improve their patient-transfer skills. However, the effectiveness of such training remains limited because it lacks effective ways of simulating patients' actions realistically. It is difficult for nurses to use the skills learned from simulation training to transfer an…

  6. Implementation and evaluation of a dilation and evacuation simulation training curriculum.

    PubMed

    York, Sloane L; McGaghie, William C; Kiley, Jessica; Hammond, Cassing

    2016-06-01

    To evaluate obstetrics and gynecology resident physicians' performance following a simulation curriculum on dilation and evacuation (D&E) procedures. This study included two phases: simulation curriculum development and resident physician performance evaluation following training on a D&E simulator. Trainees participated in two evaluations. Simulation training evaluated participants performing six cases on a D&E simulator, measuring procedural time and a 26-step checklist of D&E steps. The operative training portion evaluated residents' performance after training on the simulator using mastery learning techniques. Intra-operative evaluation was based on a 21-step checklist score, Objective Structured Assessment of Technical Skills (OSATS), and percentage of cases completed. Twenty-two residents participated in simulation training, demonstrating improved performance from cases one and two to cases five and six, as measured by checklist score and procedural time (p<.001 and p=.001, respectively). Of 10 participants in the operative training, all performed at least three D&Es, while seven performed at least six cases. While checklist scores did not change significantly from the first to sixth case (mean for first case: 18.3; for sixth case: 19.6; p=.593), OSATS ratings improved from case one (19.7) to case three (23.5; p=.001) and to case six (26.8; p=.005). Trainees completed approximately 71.6% of their first case (range: 21.4-100%). By case six, the six participants performed 81.2% of the case (range: 14.3-100%). D&E simulation using a newly-developed uterine model and simulation curriculum improves resident technical skills. Simulation training with mastery learning techniques transferred to high level of performance in OR using checklist. The OSATS measured skills and showed improvement in performance with subsequent cases. Implementation of a D&E simulation curriculum offers potential for improved surgical training and abortion provision. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. STS-98 Crew Training

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Footage shows the crew of STS-98 during various phases of their training, including an undocking simulation in the Fixed Bases Shuttle Mission Simulator (SMS), bailout training, and extravehicular activity (EVA) training at the NBL.

  8. Simulators for Mariner Training and Licensing. Phase 3: Investigation of Horizontal Field of View Requirements for Simulator-Based Training of Maritime Cadets,

    DTIC Science & Technology

    1981-12-01

    addressing the "at-sea equivalence issue." * Request that the radar simulator-based training schools stress the importance of multiple navigational...potentially high cost simulator/training program variables, namely: e Target maneuverability Independent versus canned * Color visual scene Color versus... high wind conditions (40 knots). It appears that this may be due to insufficient understanding of: (1) responsiveness of the vessel to various rudder

  9. Return to Flight: Crew Activities Resource Reel 1 of 2

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The crew of the STS-114 Discovery Mission is seen in various aspects of training for space flight. The crew activities include: 1) STS-114 Return to Flight Crew Photo Session; 2) Tile Repair Training on Precision Air Bearing Floor; 3) SAFER Tile Inspection Training in Virtual Reality Laboratory; 4) Guidance and Navigation Simulator Tile Survey Training; 5) Crew Inspects Orbital Boom and Sensor System (OBSS); 6) Bailout Training-Crew Compartment; 7) Emergency Egress Training-Crew Compartment Trainer (CCT); 8) Water Survival Training-Neutral Buoyancy Lab (NBL); 9) Ascent Training-Shuttle Motion Simulator; 10) External Tank Photo Training-Full Fuselage Trainer; 11) Rendezvous and Docking Training-Shuttle Engineering Simulator (SES) Dome; 12) Shuttle Robot Arm Training-SES Dome; 13) EVA Training Virtual Reality Lab; 14) EVA Training Neutral Buoyancy Lab; 15) EVA-2 Training-NBL; 16) EVA Tool Training-Partial Gravity Simulator; 17) Cure in Place Ablator Applicator (CIPAA) Training Glove Vacuum Chamber; 16) Crew Visit to Merritt Island Launch Area (MILA); 17) Crew Inspection-Space Shuttle Discovery; and 18) Crew Inspection-External Tank and Orbital Boom and Sensor System (OBSS). The crew are then seen answering questions from the media at the Space Shuttle Landing Facility.

  10. Simulator training to minimize ionizing radiation exposure in the catheterization laboratory.

    PubMed

    Katz, Aric; Shtub, Avraham; Solomonica, Amir; Poliakov, Adva; Roguin, Ariel

    2017-03-01

    To learn about radiation and how to lower it. Patients and operators are routinely exposed to high doses of ionizing radiation during catheterization procedures. This increased exposure to ionizing radiation is partially due to a lack of awareness to the effects of ionizing radiation, and lack of knowledge on the distribution and behavior of scattered radiation. A simulator, which incorporates data on scattered ionizing radiation, was built based on multiple phantom measurements and used for teaching radiation safety. The validity of the simulator was confirmed in three catheterization laboratories and tested by 20 interventional cardiologists. All evaluators were tested by an objective knowledge examination before, immediately following, and 12 weeks after simulator-based learning and training. A subjective Likert questionnaire on satisfaction with simulation-based learning and training was also completed. The 20 evaluators learned and retained the knowledge that they gained from using the simulator: the average scores of the knowledge examination pre-simulator training was 54 ± 15% (mean ± standard deviation), and this score significantly increased after training to 94 ± 10% (p < 0.001). The evaluators also reported high levels of satisfaction following simulation-based learning and training according to the results of the subjective Likert questionnaire. Simulators can be used to train cardiology staff and fellows and to further educate experienced personnel on radiation safety. As a result of simulator training, the operator gains knowledge, which can then be applied in the catheterization laboratory in order to reduce radiation doses to the patient and to the operator, thereby improving the safety of the intervention.

  11. Ultrasound-Guided Regional Anesthesia Simulation Training: A Systematic Review.

    PubMed

    Chen, Xiao Xu; Trivedi, Vatsal; AlSaflan, AbdulHadi A; Todd, Suzanne Clare; Tricco, Andrea C; McCartney, Colin J L; Boet, Sylvain

    Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality. After screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching. Ultrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.

  12. Mechanical simulators for training for laparoscopic surgery in urology.

    PubMed

    Rassweiler, Jens; Klein, Jan; Teber, Dogu; Schulze, Michael; Frede, Thomas

    2007-03-01

    The introduction of laparoscopic surgery into urology has led to new training concepts differing significantly from previous concepts of training for open surgery. This paper focuses on the type and importance of mechanical simulators in laparoscopic training. On the basis of our own studies and experience with the development of various concepts of laparoscopic training, including different modules (i.e., Pelvi-trainer, animal models, clinical mentoring) since 1991, we reviewed the current literature concerning all types of simulators. We focused on training for laparoscopic ablative and reconstructive surgery using mechanical simulators. The principle of a mechanical simulator (i.e., a box with the possibility of trocar insertion) has not changed during the last decade. However, the types of Pelvi-trainers and the models used inside have been improved significantly. According to the task of the simulator, various sophisticated models have been developed, including standardized phantoms, animal organs, and even perfused segments of porcine organs. For laparoscopic suturing, various step-by-step training concepts have been presented. These can be used for determination of the ability of a physician with an interest in laparoscopic surgery, but also to classify the training status of a laparosopic surgeon. Training in laparoscopic surgery has become an important topic, not only in learning a procedure, but also in maintaining skills and preparing for the management of complications. For these purposes, mechanical simulators will definitely play an important role in the future.

  13. Motion sickness adaptation to Coriolis-inducing head movements in a sustained G flight simulator.

    PubMed

    Newman, Michael C; McCarthy, Geoffrey W; Glaser, Scott T; Bonato, Frederick; Bubka, Andrea

    2013-02-01

    Technological advances have allowed centrifuges to become more than physiological testing and training devices; sustained G, fully interactive flight simulation is now possible. However, head movements under G can result in vestibular stimulation that can lead to motion sickness (MS) symptoms that are potentially distracting, nauseogenic, and unpleasant. In the current study an MS adaptation protocol was tested for head movements under +Gz. Experienced pilots made 14 predetermined head movements in a sustained G flight simulator (at 3 +Gz) on 5 consecutive days and 17 d after training. Symptoms were measured after each head turn using a subjective 0-10 MS scale. The Simulator Sickness Questionnaire (SSQ) was also administered before and after each daily training session. After five daily training sessions, normalized mean MS scores were 58% lower than on Day 1. Mean total, nausea, and disorientation SSQ scores were 55%, 52%, and 78% lower, respectively. During retesting 17 d after training, nearly all scores indicated 90-100% retention of training benefits. The reduction of unpleasant effects associated with sustained G flight simulation using an adaptation training protocol may enhance the effectiveness of simulation. Practical use of sustained G simulators is also likely to be interspersed with other types of ground and in-flight training. Hence, it would be undesirable and unpleasant for trainees to lose adaptation benefits after a short gap in centrifuge use. However, current results suggest that training gaps in excess of 2 wk may be permissible with almost no loss of adaptation training benefits.

  14. Connecting the Links: Narratives, Simulations and Serious Games in Prehospital Training.

    PubMed

    Heldal, Ilona; Backlund, Per; Johannesson, Mikael; Lebram, Mikael; Lundberg, Lars

    2017-01-01

    Due to rapid and substantial changes in the health sector, collaboration and supporting technologies get more into focus. Changes in education and training are also required. Simulations and serious games (SSG) are often advocated as promising technologies supporting training of many and in the same manner, or increasing the skills necessary to deal with new, dangerous, complex or unexpected situations. The aim of this paper is to illustrate and discuss resources needed for planning and performing collaborative contextual training scenarios. Based on a practical study involving prehospital nurses and different simulator technologies the often-recurring activity chains in prehospital training were trained. This paper exemplifies the benefit of using narratives and SSGs for contextual training contributing to higher user experiences. The benefits of using simulation technologies aligned by processes can be easier defined by narratives from practitioners. While processes help to define more efficient and effective training, narratives and SSGs are beneficial to design scenarios with clues for higher user experiences. By discussing illustrative examples, the paper contributes to better understanding of how to plan simulation-technology rich training scenarios.

  15. Putting the MeaT into TeaM Training: Development, Delivery, and Evaluation of a Surgical Team-Training Workshop.

    PubMed

    Seymour, Neal E; Paige, John T; Arora, Sonal; Fernandez, Gladys L; Aggarwal, Rajesh; Tsuda, Shawn T; Powers, Kinga A; Langlois, Gerard; Stefanidis, Dimitrios

    2016-01-01

    Despite importance to patient care, team training is infrequently used in surgical education. To address this, a workshop was developed by the Association for Surgical Education Simulation Committee to teach team training using high-fidelity patient simulators and the American College of Surgeons-Association of Program Directors in Surgery team-training curriculum. Workshops were conducted at 3 national meetings. Participants completed preworkshop and postworkshop questionnaires to define experience, confidence in using simulation, intention to implement, as well as workshop content quality. The course consisted of (A) a didactic review of Preparation, Implementation, and Debriefing and (B) facilitated small group simulation sessions followed by debriefings. Of 78 participants, 51 completed the workshops. Overall, 65% indicated that residents at their institutions used patient simulation, but only 33% used the American College of Surgeons-the Association of Program Directors in Surgery team-training modules. The workshop increased confidence to implement simulation team training (3.4 ± 1.3 vs 4.5 ± 0.9). Quality and importance were rated highly (5.4 ± 00.6, highest score = 6). Preparation for simulation-based team training is possible in this workshop setting, although the effect on actual implementation remains to be determined. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. U.S. DOT/TSC Train Performance Simulator

    DOT National Transportation Integrated Search

    1978-09-01

    A Train Performance Simulator (TPS) is a computer program which simulates the operation of a train over a railway route. It may be used for a variety of purposes to determine the effects of some operational strategy or equipment change upon schedules...

  17. Analysis of the Transfer of Training, Substitution, and Fidelity of Simulation of Training Equipment. TAEG Report 2.

    ERIC Educational Resources Information Center

    Naval Training Equipment Center, Orlando, FL. Training Analysis and Evaluation Group.

    This report summarizes, evaluates, and synthesizes the data on the training value of training devices. The report discusses the issues of substitution of some operational training time by training devices and the relationship between training effectiveness and cost (fidelity of simulation). These general conclusions were made: 1) Experiments…

  18. Simulators in the urological training armamentarium: A boon or a bane?

    PubMed

    Aggarwal, Gaurav; Adhikary, Samiran D

    2017-06-01

    Simulation devices have grasped the attention of almost all industries worldwide and the medical field has not been exempt. With technological advancement, it becomes important to assess whether medical simulators are the way forward as an adjunct or as a replacement to traditional training approaches by assessing their safety, efficacy and cost-effectiveness, and whether they should be made mandatory in the curriculum of urology training. The present review aims to clarify some of these issues, as well as assess their role in urological training and present both the pros and cons of this simulation-based training.

  19. Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial.

    PubMed

    Stefanidis, Dimitrios; Scerbo, Mark W; Montero, Paul N; Acker, Christina E; Smith, Warren D

    2012-01-01

    We hypothesized that novices will perform better in the operating room after simulator training to automaticity compared with traditional proficiency based training (current standard training paradigm). Simulator-acquired skill translates to the operating room, but the skill transfer is incomplete. Secondary task metrics reflect the ability of trainees to multitask (automaticity) and may improve performance assessment on simulators and skill transfer by indicating when learning is complete. Novices (N = 30) were enrolled in an IRB-approved, blinded, randomized, controlled trial. Participants were randomized into an intervention (n = 20) and a control (n = 10) group. The intervention group practiced on the FLS suturing task until they achieved expert levels of time and errors (proficiency), were tested on a live porcine fundoplication model, continued simulator training until they achieved expert levels on a visual spatial secondary task (automaticity) and were retested on the operating room (OR) model. The control group participated only during testing sessions. Performance scores were compared within and between groups during testing sessions. : Intervention group participants achieved proficiency after 54 ± 14 and automaticity after additional 109 ± 57 repetitions. Participants achieved better scores in the OR after automaticity training [345 (range, 0-537)] compared with after proficiency-based training [220 (range, 0-452; P < 0.001]. Simulator training to automaticity takes more time but is superior to proficiency-based training, as it leads to improved skill acquisition and transfer. Secondary task metrics that reflect trainee automaticity should be implemented during simulator training to improve learning and skill transfer.

  20. Laparoscopic skills maintenance: a randomized trial of virtual reality and box trainer simulators.

    PubMed

    Khan, Montaha W; Lin, Diwei; Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy

    2014-01-01

    A number of simulators have been developed to teach surgical trainees the basic skills required to effectively perform laparoscopic surgery; however, consideration needs to be given to how well the skills taught by these simulators are maintained over time. This study compared the maintenance of laparoscopic skills learned using box trainer and virtual reality simulators. Participants were randomly allocated to be trained and assessed using either the Society of American Gastrointestinal Endoscopic Surgeons Fundamentals of Laparoscopic Surgery (FLS) simulator or the Surgical Science virtual reality simulator. Once participants achieved a predetermined level of proficiency, they were assessed 1, 3, and 6 months later. At each assessment, participants were given 2 practice attempts and assessed on their third attempt. The study was conducted through the Simulated Surgical Skills Program that was held at the Royal Australasian College of Surgeons, Adelaide, Australia. Overall, 26 participants (13 per group) completed the training and all follow-up assessments. There were no significant differences between simulation-trained cohorts for age, gender, training level, and the number of surgeries previously performed, observed, or assisted. Scores for the FLS-trained participants did not significantly change over the follow-up period. Scores for LapSim-trained participants significantly deteriorated at the first 2 follow-up points (1 and 3 months) (p < 0.050), but returned to be near initial levels by the final follow-up (6 months). This research showed that basic laparoscopic skills learned using the FLS simulator were maintained more consistently than those learned on the LapSim simulator. However, by the final follow-up, both simulator-trained cohorts had skill levels that were not significantly different to those at proficiency after the initial training period. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Guidelines for Line-Oriented Flight Training, Volume 1

    NASA Technical Reports Server (NTRS)

    Lauber, J. K.; Foushee, H. C.

    1981-01-01

    Line-Oriented Flight Training (LOFT) is a developing training technology which synthesizes high-fidelity aircraft simulation and high-fidelity line-operations simulation to provide realistic, dynamic pilot training in a simulated line environment. LOFT is an augmentation of existing pilot training which concentrates upon command, leadership, and resource management skills. This report, based on an NASA/Industry workshop held in January, 1981, is designed to serve as a handbook for LOFT users. In addition to providing background information, guidelines are presented for designing LOFT scenarios, conducting real-time LOFT operations, pilot debriefing, and instructor qualification and training. The final chapter addressed other uses of LOFT and line-operations (or full-mission) simulation.

  2. 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.

  3. Advanced Simulation in Undergraduate Pilot Training: Systems Integration. Final Report (February 1972-March 1975).

    ERIC Educational Resources Information Center

    Larson, D. F.; Terry, C.

    The Advanced Simulator for Undergraduate Pilot Training (ASUPT) was designed to investigate the role of simulation in the future Undergraduate Pilot Training (UPT) program. The problem addressed in this report was one of integrating two unlike components into one synchronized system. These two components were the Basic T-37 Simulators and their…

  4. What is going on in augmented reality simulation in laparoscopic surgery?

    PubMed

    Botden, Sanne M B I; Jakimowicz, Jack J

    2009-08-01

    To prevent unnecessary errors and adverse results of laparoscopic surgery, proper training is of paramount importance. A safe way to train surgeons for laparoscopic skills is simulation. For this purpose traditional box trainers are often used, however they lack objective assessment of performance. Virtual reality laparoscopic simulators assess performance, but lack realistic haptic feedback. Augmented reality (AR) combines a virtual reality (VR) setting with real physical materials, instruments, and feedback. This article presents the current developments in augmented reality laparoscopic simulation. Pubmed searches were performed to identify articles regarding surgical simulation and augmented reality. Identified companies manufacturing an AR laparoscopic simulator received the same questionnaire referring to the features of the simulator. Seven simulators that fitted the definition of augmented reality were identified during the literature search. Five of the approached manufacturers returned a completed questionnaire, of which one simulator appeared to be VR and was therefore not applicable for this review. Several augmented reality simulators have been developed over the past few years and they are improving rapidly. We recommend the development of AR laparoscopic simulators for component tasks of procedural training. AR simulators should be implemented in current laparoscopic training curricula, in particular for laparoscopic suturing training.

  5. The effect of a simulation training package on skill acquisition for duplex arterial stenosis detection.

    PubMed

    Jaffer, Usman; Normahani, Pasha; Singh, Prashant; Aslam, Mohammed; Standfield, Nigel J

    2015-01-01

    In vascular surgery, duplex ultrasonography is a valuable diagnostic tool in patients with peripheral vascular disease, and there is increasing demand for vascular surgeons to be able to perform duplex scanning. This study evaluates the role of a novel simulation training package on vascular ultrasound (US) skill acquisition. A total of 19 novices measured predefined stenosis in a simulated pulsatile vessel using both peak systolic velocity ratio (PSVR) and diameter reduction (DR) methods before and after a short period of training using a simulated training package. The training package consisted of a simulated pulsatile vessel phantom, a set of instructional videos, duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool, and a portable US scanner. Quantitative metrics (procedure time, percentage error using PSVR and DR methods, DUOSAT scores, and global rating scores) before and after training were compared. Subjects spent a median time of 144 mins (IQR: 60-195) training using the simulation package. Subjects exhibited statistically significant improvements when comparing pretraining and posttraining DUOSAT scores (pretraining = 17 [16-19.3] vs posttraining = 30 [27.8-31.8]; p < 0.01), global rating score (pretraining = 1 [1-2] vs posttraining = 4 [3.8-4]; p < 0.01), percentage error using both the DR (pretraining = 12.6% [9-29.6] vs posttraining = 10.3% [8.9-11.1]; p = 0.03) and PSVR (pretraining = 60% [40-60] vs posttraining = 20% [6.7-20]; p < 0.01) methods. In this study, subjects with no previous practical US experience developed the ability to both acquire and interpret arterial duplex images in a pulsatile simulated phantom following a short period of goal direct training using a simulation training package. A simulation training package may be a valuable tool for integration into a vascular training program. However, further work is needed to explore whether these newly attained skills are translated into clinical assessment. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  6. International benchmarking of longitudinal train dynamics simulators: results

    NASA Astrophysics Data System (ADS)

    Wu, Qing; Spiryagin, Maksym; Cole, Colin; Chang, Chongyi; Guo, Gang; Sakalo, Alexey; Wei, Wei; Zhao, Xubao; Burgelman, Nico; Wiersma, Pier; Chollet, Hugues; Sebes, Michel; Shamdani, Amir; Melzi, Stefano; Cheli, Federico; di Gialleonardo, Egidio; Bosso, Nicola; Zampieri, Nicolò; Luo, Shihui; Wu, Honghua; Kaza, Guy-Léon

    2018-03-01

    This paper presents the results of the International Benchmarking of Longitudinal Train Dynamics Simulators which involved participation of nine simulators (TABLDSS, UM, CRE-LTS, TDEAS, PoliTo, TsDyn, CARS, BODYSIM and VOCO) from six countries. Longitudinal train dynamics results and computing time of four simulation cases are presented and compared. The results show that all simulators had basic agreement in simulations of locomotive forces, resistance forces and track gradients. The major differences among different simulators lie in the draft gear models. TABLDSS, UM, CRE-LTS, TDEAS, TsDyn and CARS had general agreement in terms of the in-train forces; minor differences exist as reflections of draft gear model variations. In-train force oscillations were observed in VOCO due to the introduction of wheel-rail contact. In-train force instabilities were sometimes observed in PoliTo and BODYSIM due to the velocity controlled transitional characteristics which could have generated unreasonable transitional stiffness. Regarding computing time per train operational second, the following list is in order of increasing computing speed: VOCO, TsDyn, PoliTO, CARS, BODYSIM, UM, TDEAS, CRE-LTS and TABLDSS (fastest); all simulators except VOCO, TsDyn and PoliTo achieved faster speeds than real-time simulations. Similarly, regarding computing time per integration step, the computing speeds in order are: CRE-LTS, VOCO, CARS, TsDyn, UM, TABLDSS and TDEAS (fastest).

  7. 14 CFR 121.413 - Initial and transition training and checking requirements: Check airmen (airplane), check airmen...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accomplished in part or in full in an airplane, in a flight simulator, or in a flight training device. This... 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...

  8. 14 CFR 121.413 - Initial and transition training and checking requirements: Check airmen (airplane), check airmen...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... accomplished in part or in full in an airplane, in a flight simulator, or in a flight training device. This... 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...

  9. 14 CFR 121.413 - Initial and transition training and checking requirements: Check airmen (airplane), check airmen...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accomplished in part or in full in an airplane, in a flight simulator, or in a flight training device. This... 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...

  10. 14 CFR 121.413 - Initial and transition training and checking requirements: Check airmen (airplane), check airmen...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accomplished in part or in full in an airplane, in a flight simulator, or in a flight training device. This... 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...

  11. Leveraging Simulation Against the F-16 Flying Training Gap

    DTIC Science & Technology

    2005-11-01

    must leverage emerging simulation technology into combined flight training to counter mission employment complexity created by technology itself...two or more of these stand-alone simulators creates a mission training center (MTC), which when further networked create distributed mission...operations (DMO). Ultimately, the grand operational vision of DMO is to interconnect non-collocated users creating a “virtual” joint training environment

  12. The effect of distributed virtual reality simulation training on cognitive load during subsequent dissection training.

    PubMed

    Andersen, Steven Arild Wuyts; Konge, Lars; Sørensen, Mads Sølvsten

    2018-05-07

    Complex tasks such as surgical procedures can induce excessive cognitive load (CL), which can have a negative effect on learning, especially for novices. To investigate if repeated and distributed virtual reality (VR) simulation practice induces a lower CL and higher performance in subsequent cadaveric dissection training. In a prospective, controlled cohort study, 37 residents in otorhinolaryngology received VR simulation training either as additional distributed practice prior to course participation (intervention) (9 participants) or as standard practice during the course (control) (28 participants). Cognitive load was estimated as the relative change in secondary-task reaction time during VR simulation and cadaveric procedures. Structured distributed VR simulation practice resulted in lower mean reaction times (32% vs. 47% for the intervention and control group, respectively, p < 0.01) as well as a superior final-product performance during subsequent cadaveric dissection training. Repeated and distributed VR simulation causes a lower CL to be induced when the learning situation is increased in complexity. A suggested mechanism is the formation of mental schemas and reduction of the intrinsic CL. This has potential implications for surgical skills training and suggests that structured, distributed training be systematically implemented in surgical training curricula.

  13. DIMENSIONS OF SIMULATION.

    ERIC Educational Resources Information Center

    CRAWFORD, MEREDITH P.

    OPEN AND CLOSED LOOP SIMULATION IS DISCUSSED FROM THE VIEWPOINT OF RESEARCH AND DEVELOPMENT IN TRAINING TECHNIQUES. AREAS DISCUSSED INCLUDE--(1) OPEN-LOOP ENVIRONMENTAL SIMULATION, (2) SIMULATION NOT INVOLVING PEOPLE, (3) ANALYSIS OF OCCUPATIONS, (4) SIMULATION FOR TRAINING, (5) REAL-SIZE SYSTEM SIMULATION, (6) TECHNIQUES OF MINIATURIZATION, AND…

  14. 76 FR 20052 - Notice of Issuance of Regulatory Guide

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-11

    ... Guide 1.149, ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License..., ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License Examinations, and... simulation facility for use in operator and senior operator training, license examination operating tests...

  15. 14 CFR 61.1 - Applicability and definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....2. Aeronautical experience means pilot time obtained in an aircraft, flight simulator, or flight... from an authorized instructor in an aircraft, flight simulator, or flight training device; or (iii) Gives training as an authorized instructor in an aircraft, flight simulator, or flight training device...

  16. A Comparison of Current Naval Marksmanship Training Vs. Simulation-Based Marksmanship Training with the Use of Indoor Simulated Marksmanship Trainer (Ismt)

    DTIC Science & Technology

    2014-03-01

    purpose of the study was to determine if the use of a simulator is at least as effective in marksmanship training as traditional dry fire techniques...determine if the use of a simulator is at least as effective in marksmanship training as traditional dry fire techniques. A between-groups study with a...marksmanship. Naval commands could use the information to effectively maintain gun qualifications for inport duty section watch bills and constant anti

  17. Colonoscopy procedure simulation: virtual reality training based on a real time computational approach.

    PubMed

    Wen, Tingxi; Medveczky, David; Wu, Jackie; Wu, Jianhuang

    2018-01-25

    Colonoscopy plays an important role in the clinical screening and management of colorectal cancer. The traditional 'see one, do one, teach one' training style for such invasive procedure is resource intensive and ineffective. Given that colonoscopy is difficult, and time-consuming to master, the use of virtual reality simulators to train gastroenterologists in colonoscopy operations offers a promising alternative. In this paper, a realistic and real-time interactive simulator for training colonoscopy procedure is presented, which can even include polypectomy simulation. Our approach models the colonoscopy as thick flexible elastic rods with different resolutions which are dynamically adaptive to the curvature of the colon. More material characteristics of this deformable material are integrated into our discrete model to realistically simulate the behavior of the colonoscope. We present a simulator for training colonoscopy procedure. In addition, we propose a set of key aspects of our simulator that give fast, high fidelity feedback to trainees. We also conducted an initial validation of this colonoscopic simulator to determine its clinical utility and efficacy.

  18. Above-real-time training (ARTT) improves transfer to a simulated flight control task.

    PubMed

    Donderi, D C; Niall, Keith K; Fish, Karyn; Goldstein, Benjamin

    2012-06-01

    The aim of this study was to measure the effects of above-real-time-training (ARTT) speed and screen resolution on a simulated flight control task. ARTT has been shown to improve transfer to the criterion task in some military simulation experiments. We tested training speed and screen resolution in a project, sponsored by Defence Research and Development Canada, to develop components for prototype air mission simulators. For this study, 54 participants used a single-screen PC-based flight simulation program to learn to chase and catch an F-18A fighter jet with another F-18A while controlling the chase aircraft with a throttle and side-stick controller. Screen resolution was varied between participants, and training speed was varied factorially across two sessions within participants. Pretest and posttest trials were at high resolution and criterion (900 knots) speed. Posttest performance was best with high screen resolution training and when one ARTT training session was followed by a session of criterion speed training. ARTT followed by criterion training improves performance on a visual-motor coordination task. We think that ARTT influences known facilitators of transfer, including similarity to the criterion task and contextual interference. Use high-screen resolution, start with ARTT, and finish with criterion speed training when preparing a mission simulation.

  19. Current status of validation for robotic surgery simulators - a systematic review.

    PubMed

    Abboudi, Hamid; Khan, Mohammed S; Aboumarzouk, Omar; Guru, Khurshid A; Challacombe, Ben; Dasgupta, Prokar; Ahmed, Kamran

    2013-02-01

    To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on feasibility, validity, cost-effectiveness, reliability and educational impact. We identified 19 studies investigating simulation options in robotic surgery. There are five different robotic surgery simulation platforms available on the market. In all, 11 studies sought opinion and compared performance between two different groups; 'expert' and 'novice'. Experts ranged in experience from 21-2200 robotic cases. The novice groups consisted of participants with no prior experience on a robotic platform and were often medical students or junior doctors. The Mimic dV-Trainer(®), ProMIS(®), SimSurgery Educational Platform(®) (SEP) and Intuitive systems have shown face, content and construct validity. The Robotic Surgical SimulatorTM system has only been face and content validated. All of the simulators except SEP have shown educational impact. Feasibility and cost-effectiveness of simulation systems was not evaluated in any trial. Virtual reality simulators were shown to be effective training tools for junior trainees. Simulation training holds the greatest potential to be used as an adjunct to traditional training methods to equip the next generation of robotic surgeons with the skills required to operate safely. However, current simulation models have only been validated in small studies. There is no evidence to suggest one type of simulator provides more effective training than any other. More research is needed to validate simulated environments further and investigate the effectiveness of animal and cadaveric training in robotic surgery. © 2012 BJU International.

  20. The Evolution of On-Board Emergency Training for the International Space Station Crew

    NASA Technical Reports Server (NTRS)

    LaBuff, Skyler

    2015-01-01

    The crew of the International Space Station (ISS) receives extensive ground-training in order to safely and effectively respond to any potential emergency event while on-orbit, but few people realize that their training is not concluded when they launch into space. The evolution of the emergency On- Board Training events (OBTs) has recently moved from paper "scripts" to an intranet-based software simulation that allows for the crew, as well as the flight control teams in Mission Control Centers across the world, to share in an improved and more realistic training event. This emergency OBT simulator ensures that the participants experience the training event as it unfolds, completely unaware of the type, location, or severity of the simulated emergency until the scenario begins. The crew interfaces with the simulation software via iPads that they keep with them as they translate through the ISS modules, receiving prompts and information as they proceed through the response. Personnel in the control centers bring up the simulation via an intranet browser at their console workstations, and can view additional telemetry signatures in simulated ground displays in order to assist the crew and communicate vital information to them as applicable. The Chief Training Officers and emergency instructors set the simulation in motion, choosing the type of emergency (rapid depressurization, fire, or toxic atmosphere) and specific initial conditions to emphasize the desired training objectives. Project development, testing, and implementation was a collaborative effort between ISS emergency instructors, Chief Training Officers, Flight Directors, and the Crew Office using commercial off the shelf (COTS) hardware along with simulation software created in-house. Due to the success of the Emergency OBT simulator, the already-developed software has been leveraged and repurposed to develop a new emulator used during fire response ground-training to deliver data that the crew receives from the handheld Compound Specific Analyzer for Combustion Products (CSA-CP). This CSA-CP emulator makes use of a portion of codebase from the Emergency OBT simulator dealing with atmospheric contamination during fire scenarios, and feeds various data signatures to crew via an iPod Touch with a flight-like CSA-CP display. These innovative simulations, which make use of COTS hardware with custom in-house software, have yielded drastic improvements to emergency training effectiveness and risk reduction for ISS crew and flight control teams during on-orbit and ground training events.

  1. The future of simulation technologies for complex cardiovascular procedures.

    PubMed

    Cates, Christopher U; Gallagher, Anthony G

    2012-09-01

    Changing work practices and the evolution of more complex interventions in cardiovascular medicine are forcing a paradigm shift in the way doctors are trained. Implantable cardioverter defibrillator (ICD), transcatheter aortic valve implantation (TAVI), carotid artery stenting (CAS), and acute stroke intervention procedures are forcing these changes at a faster pace than in other disciplines. As a consequence, cardiovascular medicine has had to develop a sophisticated understanding of precisely what is meant by 'training' and 'skill'. An evolving conclusion is that procedure training on a virtual reality (VR) simulator presents a viable current solution. These simulations should characterize the important performance characteristics of procedural skill that have metrics derived and defined from, and then benchmarked to experienced operators (i.e. level of proficiency). Simulation training is optimal with metric-based feedback, particularly formative trainee error assessments, proximate to their performance. In prospective, randomized studies, learners who trained to a benchmarked proficiency level on the simulator performed significantly better than learners who were traditionally trained. In addition, cardiovascular medicine now has available the most sophisticated virtual reality simulators in medicine and these have been used for the roll-out of interventions such as CAS in the USA and globally with cardiovascular society and industry partnered training programmes. The Food and Drug Administration has advocated the use of VR simulation as part of the approval of new devices and the American Board of Internal Medicine has adopted simulation as part of its maintenance of certification. Simulation is rapidly becoming a mainstay of cardiovascular education, training, certification, and the safe adoption of new technology. If cardiovascular medicine is to continue to lead in the adoption and integration of simulation, then, it must take a proactive position in the development of metric-based simulation curriculum, adoption of proficiency benchmarking definitions, and then resolve to commit resources so as to continue to lead this revolution in physician training.

  2. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

    PubMed

    Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

    2015-01-01

    Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

  3. Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents.

    PubMed

    Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

    2018-01-01

    To identify residents' perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann-Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor's intervention, and 3) prior simulation training. The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Residents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification.

  4. Midwifery students' experiences of simulation- and skills training.

    PubMed

    Lendahls, Lena; Oscarsson, Marie G

    2017-03-01

    In Sweden, simulation- and skills training are implemented in midwifery education in order to prepare students for clinical practice. Research regarding the use of both low to high levels of fidelity in simulation in midwifery programme is limited. The aim of this study was to explore midwifery students' experiences of simulation- and skills training. Midwifery students (n=61), at advanced level, were interviewed in 13 group interviews from 2011 to 2105. A semi-structured interview guide was used, and data were analysed by content analysis. The results are presented in four main categories: develops hands on skills and communication, power of collaborative learning, highly valued learning environment and facilitates clinical practice. The majority of students felt that the simulation- and skills training were necessary to become familiar with hands on skills. Having repetitive practices in a safe and secure environment was viewed as important, and students highly valued that mistakes could be made without fear of comprising patient safety. Student's collaboration, reflections and critical thinking increased learning ability. Simulation- and skills training created links between theory and practice, and the lecturer had an important role in providing instructions and feedback. Students felt prepared and confident before their clinical practice, and simulation- and skills training increased safety for all involved, resulting in students being more confident, as patients in clinical practice became less exposed. Furthermore, mentors were satisfied with students' basic skills. Simulation- and skills training support the development of midwifery skills. It creates links between theory and practice, which facilitates students' learning ability. Training needs to include reflections and critical thinking in order to develop their learning. The lecturer has an important role in encouraging time for reflections and creating safe environment during the skills and simulation training. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents

    PubMed Central

    Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

    2018-01-01

    Objective To identify residents’ perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. Design The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann–Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor’s intervention, and 3) prior simulation training. Setting The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Results Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Conclusion Residents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification. PMID:29785084

  6. OR fire virtual training simulator: design and face validity.

    PubMed

    Dorozhkin, Denis; Olasky, Jaisa; Jones, Daniel B; Schwaitzberg, Steven D; Jones, Stephanie B; Cao, Caroline G L; Molina, Marcos; Henriques, Steven; Wang, Jinling; Flinn, Jeff; De, Suvranu

    2017-09-01

    The Virtual Electrosurgical Skill Trainer is a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees, practicing surgeons, anesthesiologist, and nurses to interact with a virtual OR environment, which includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher. Wearing a head-mounted display, participants must correctly identify the "fire triangle" elements and then successfully contain an OR fire. Within these virtual reality scenarios, trainees learn to react appropriately to the simulated emergency. A study targeted at establishing the face validity of the virtual OR fire simulator was undertaken at the 2015 Society of American Gastrointestinal and Endoscopic Surgeons conference. Forty-nine subjects with varying experience participated in this Institutional Review Board-approved study. The subjects were asked to complete the OR fire training/prevention sequence in the VEST simulator. Subjects were then asked to answer a subjective preference questionnaire consisting of sixteen questions, focused on the usefulness and fidelity of the simulator. On a 5-point scale, 12 of 13 questions were rated at a mean of 3 or greater (92%). Five questions were rated above 4 (38%), particularly those focusing on the simulator effectiveness and its usefulness in OR fire safety training. A total of 33 of the 49 participants (67%) chose the virtual OR fire trainer over the traditional training methods such as a textbook or an animal model. Training for OR fire emergencies in fully immersive VR environments, such as the VEST trainer, may be the ideal training modality. The face validity of the OR fire training module of the VEST simulator was successfully established on many aspects of the simulation.

  7. Defining and comparing learning actions in two simulation modalities: students training on a latex arm and each other's arms.

    PubMed

    Ravik, Monika; Havnes, Anton; Bjørk, Ida Torunn

    2017-12-01

    To explore, describe and compare learning actions that nursing students used during peripheral vein cannulation training on a latex arm or each other's arms in a clinical skills centre. Simulation-based training is thought to enhance learning and transfer of learning from simulation to the clinical setting and is commonly recommended in nursing education. What students actually are doing during simulation-based training is, however, less explored. The analysis of learning actions used during simulation-based training could contribute to development and improvement of simulation as a learning strategy in nursing education. A qualitative explorative and descriptive research design, involving content analysis of video recordings, was used. Video-supported observation of nine nursing students practicing vein cannulation was conducted in a clinical skills centre in late 2012. The students engaged in various learning actions. Students training on a latex arm used a considerably higher number of learning actions relative to those training on each other's arms. In both groups, students' learning actions consisted mainly of seeking and giving support. The teacher provided students training on each other's arms with detailed feedback regarding insertion of the cannula into the vein, while those training on a latex arm received sparse feedback from the teacher and fellow students. The teacher played an important role in facilitating nursing students' practical skill learning during simulation. The provision of support from both teachers and students should be emphasised to ensure that nursing students' learning needs are met. This study suggest that student nurses may be differently and inadequately prepared in peripheral vein cannulation in two simulation modalities used in the academic setting; training on a latex arm and on each other's arms. © 2017 John Wiley & Sons Ltd.

  8. Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room

    PubMed Central

    Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank

    2016-01-01

    Purpose To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons’ performance. Methods In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Results Comparing each surgeon’s performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Conclusions Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance. PMID:26964040

  9. Training Community Modeling and Simulation Business Plan, 2007 Edition. Volume 1: Review of Training Capabilities

    DTIC Science & Technology

    2009-02-01

    Simulation Business Plan, 2007 Edition Volume I: Review of Training Capabilities J.D. Fletcher, IDA Frederick E. Hartman , IDA Robert Halayko, Addx Corp...Community Modeling and Simulation Business Plan, 2007 Edition Volume I: Review of Training Capabilities J.D. Fletcher, IDA Frederick E. Hartman , IDA...Steering Committee for the training community led by the Office of the Under Secretary of Defense (Personnel and Readiness), OUSD( P &R). The task was

  10. Longitudinal train dynamics: an overview

    NASA Astrophysics Data System (ADS)

    Wu, Qing; Spiryagin, Maksym; Cole, Colin

    2016-12-01

    This paper discusses the evolution of longitudinal train dynamics (LTD) simulations, which covers numerical solvers, vehicle connection systems, air brake systems, wagon dumper systems and locomotives, resistance forces and gravitational components, vehicle in-train instabilities, and computing schemes. A number of potential research topics are suggested, such as modelling of friction, polymer, and transition characteristics for vehicle connection simulations, studies of wagon dumping operations, proper modelling of vehicle in-train instabilities, and computing schemes for LTD simulations. Evidence shows that LTD simulations have evolved with computing capabilities. Currently, advanced component models that directly describe the working principles of the operation of air brake systems, vehicle connection systems, and traction systems are available. Parallel computing is a good solution to combine and simulate all these advanced models. Parallel computing can also be used to conduct three-dimensional long train dynamics simulations.

  11. Burns education: The emerging role of simulation for training healthcare professionals.

    PubMed

    Sadideen, Hazim; Goutos, Ioannis; Kneebone, Roger

    2017-02-01

    Burns education appears to be under-represented in UK undergraduate curricula. However current postgraduate courses in burns education provide formal training in resuscitation and management. Simulation has proven to be a powerful modality to advance surgical training in both technical and non-technical skills. We present a literature review that summarises the format of current burns education, and provides detailed insight into historic, current and novel advances in burns simulation for both technical and non-technical skills, that can be used to augment surgical training. Addressing the economic and practical limitations of current immersive surgical simulation is important, and this review proposes future directions for integration of innovative simulation strategies into training curricula. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. Needs assessment for simulation training in neuroendoscopy: a Canadian national survey.

    PubMed

    Haji, Faizal A; Dubrowski, Adam; Drake, James; de Ribaupierre, Sandrine

    2013-02-01

    In recent years, dramatic changes in surgical education have increased interest in simulation-based training for complex surgical skills. This is particularly true for endoscopic third ventriculostomy (ETV), given the potential for serious intraoperative errors arising from surgical inexperience. However, prior to simulator development, a thorough assessment of training needs is essential to ensure development of educationally relevant platforms. The purpose of this study was to conduct a national needs assessment addressing specific goals of instruction, to guide development of simulation platforms, training curricula, and assessment metrics for ETV. Canadian neurosurgeons performing ETV were invited to participate in a structured online questionnaire regarding the procedural steps for ETV, the frequency and significance of intraoperative errors committed while learning the technique, and simulation training modules of greatest potential educational benefit. Descriptive data analysis was completed for both quantitative and qualitative responses. Thirty-two (55.2%) of 58 surgeons completed the survey. All believed that virtual reality simulation training for ETV would be a valuable addition to clinical training. Selection of ventriculostomy site, navigation within the ventricles, and performance of the ventriculostomy ranked as the most important steps to simulate. Technically inadequate ventriculostomy and inappropriate fenestration site selection were ranked as the most frequent/significant errors. A standard ETV module was thought to be most beneficial for resident training. To inform the development of a simulation-based training program for ETV, the authors have conducted a national needs assessment. The results provide valuable insight to inform key design elements necessary to construct an educationally relevant device and educational program.

  13. Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches.

    PubMed

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

    2009-01-01

    Virtual reality (VR) simulators for laparoscopy and endoscopy may be valuable tools for resident education. However, the cost of such training in terms of trainee and instructor time may vary depending upon whether an independent or proctored approach is employed. We performed a randomized controlled trial to compare independent and proctored methods of proficiency-based VR simulator training. Medical students were randomized to independent or proctored training groups. Groups were compared with respect to the number of training hours and task repetitions required to achieve expert level proficiency on laparoscopic and endoscopic simulators. Cox regression modeling was used to compare time to proficiency between groups, with adjustment for appropriate covariates. Thirty-six medical students (18 independent, 18 proctored) were enrolled. Achievement of overall simulator proficiency required a median of 11 hours of training (range, 6-21 hours). Laparoscopic and endoscopic proficiency were achieved after a median of 11 (range, 6-32) and 10 (range, 5-27) task repetitions, respectively. The number of repetitions required to achieve proficiency was similar between groups. After adjustment for covariates, trainees in the independent group achieved simulator proficiency with significantly fewer hours of training (hazard ratio, 2.62; 95% confidence interval, 1.01-6.85; p = 0.048). Our study quantifies the cost, in instructor and trainee hours, of proficiency-based laparoscopic and endoscopic VR simulator training, and suggests that proctored instruction does not offer any advantages to trainees. The independent approach may be preferable for surgical residency programs desiring to implement VR simulator training.

  14. Virtual operating room for team training in surgery.

    PubMed

    Abelson, Jonathan S; Silverman, Elliott; Banfelder, Jason; Naides, Alexandra; Costa, Ricardo; Dakin, Gregory

    2015-09-01

    We proposed to develop a novel virtual reality (VR) team training system. The objective of this study was to determine the feasibility of creating a VR operating room to simulate a surgical crisis scenario and evaluate the simulator for construct and face validity. We modified ICE STORM (Integrated Clinical Environment; Systems, Training, Operations, Research, Methods), a VR-based system capable of modeling a variety of health care personnel and environments. ICE STORM was used to simulate a standardized surgical crisis scenario, whereby participants needed to correct 4 elements responsible for loss of laparoscopic visualization. The construct and face validity of the environment were measured. Thirty-three participants completed the VR simulation. Attendings completed the simulation in less time than trainees (271 vs 201 seconds, P = .032). Participants felt the training environment was realistic and had a favorable impression of the simulation. All participants felt the workload of the simulation was low. Creation of a VR-based operating room for team training in surgery is feasible and can afford a realistic team training environment. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Astronaut Fred Haise participates in simulation training

    NASA Image and Video Library

    1970-04-07

    S70-34412 (4 April 1970) --- Astronaut Fred W. Haise Jr., Apollo 13 lunar module pilot, participates in simulation training in preparation for the scheduled lunar landing mission. He is in the Apollo Lunar Module Mission Simulator in the Kennedy Space Center's Flight Crew Training building.

  16. Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial.

    PubMed

    Kerr, Brendan; Hawkins, Trisha Lee-Ann; Herman, Robert; Barnes, Sue; Kaufmann, Stephanie; Fraser, Kristin; Ma, Irene W Y

    2013-07-18

    Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop. Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76) nor did significantly decrease in the simulation group (d= - 0.44; p=0.19). Self-reported comfort in patient assessment parameters increased in both groups (p<0.05 in all). However, only the simulation group reported an increase in comfort in patient management (d=1.1, p=0.051 for the traditional group and d=1.3; p= 0.0003 for the simulation group). At 1 month, comfort measures in the traditional group increased consistently over time while these measures in the simulation group increased post-workshop but decreased by 1 month, suggesting that some of the effects of training with simulation may be short lived. The use of simulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial.

  17. Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial

    PubMed Central

    Kerr, Brendan; Hawkins, Trisha Lee-Ann; Herman, Robert; Barnes, Sue; Kaufmann, Stephanie; Fraser, Kristin; Ma, Irene W. Y.

    2013-01-01

    Introduction Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76) nor did significantly decrease in the simulation group (d= − 0.44; p=0.19). Self-reported comfort in patient assessment parameters increased in both groups (p<0.05 in all). However, only the simulation group reported an increase in comfort in patient management (d=1.1, p=0.051 for the traditional group and d=1.3; p= 0.0003 for the simulation group). At 1 month, comfort measures in the traditional group increased consistently over time while these measures in the simulation group increased post-workshop but decreased by 1 month, suggesting that some of the effects of training with simulation may be short lived. Discussion The use of simulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial. PMID:23870304

  18. Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial.

    PubMed

    Kerr, Brendan; Lee-Ann Hawkins, Trisha; Herman, Robert; Barnes, Sue; Kaufmann, Stephanie; Fraser, Kristin; Ma, Irene W Y

    2013-01-01

    Introduction Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76) nor did significantly decrease in the simulation group (d= - 0.44; p=0.19). Self-reported comfort in patient assessment parameters increased in both groups (p<0.05 in all). However, only the simulation group reported an increase in comfort in patient management (d=1.1, p=0.051 for the traditional group and d=1.3; p= 0.0003 for the simulation group). At 1 month, comfort measures in the traditional group increased consistently over time while these measures in the simulation group increased post-workshop but decreased by 1 month, suggesting that some of the effects of training with simulation may be short lived. Discussion The use of simulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial.

  19. Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study.

    PubMed

    Schlickum, Marcus; Hedman, Leif; Felländer-Tsai, Li

    2016-02-21

    To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

  20. Simulation For Task Practice in Technical Training.

    ERIC Educational Resources Information Center

    Mallory, W. J.

    1981-01-01

    Describes two programs used by the Ford Motor Company to train manufacturing skilled trades personnel. Programmable Controller Maintenance Training Program for Industrial Technicians and Troubleshooting Strategy Program use simulation and provide improved task performance after training. (JOW)

  1. Evaluation of a haptics-based virtual reality temporal bone simulator for anatomy and surgery training.

    PubMed

    Fang, Te-Yung; Wang, Pa-Chun; Liu, Chih-Hsien; Su, Mu-Chun; Yeh, Shih-Ching

    2014-02-01

    Virtual reality simulation training may improve knowledge of anatomy and surgical skills. We evaluated a 3-dimensional, haptic, virtual reality temporal bone simulator for dissection training. The subjects were 7 otolaryngology residents (3 training sessions each) and 7 medical students (1 training session each). The virtual reality temporal bone simulation station included a computer with software that was linked to a force-feedback hand stylus, and the system recorded performance and collisions with vital anatomic structures. Subjects performed virtual reality dissections and completed questionnaires after the training sessions. Residents and students had favorable responses to most questions of the technology acceptance model (TAM) questionnaire. The average TAM scores were above neutral for residents and medical students in all domains, and the average TAM score for residents was significantly higher for the usefulness domain and lower for the playful domain than students. The average satisfaction questionnaire for residents showed that residents had greater overall satisfaction with cadaver temporal bone dissection training than training with the virtual reality simulator or plastic temporal bone. For medical students, the average comprehension score was significantly increased from before to after training for all anatomic structures. Medical students had significantly more collisions with the dura than residents. The residents had similar mean performance scores after the first and third training sessions for all dissection procedures. The virtual reality temporal bone simulator provided satisfactory training for otolaryngology residents and medical students. Copyright © 2013. Published by Elsevier Ireland Ltd.

  2. 14 CFR 61.64 - Use of a flight simulator and flight training device.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Use of a flight simulator and flight... Ratings and Pilot Authorizations § 61.64 Use of a flight simulator and flight training device. (a) Use of a flight simulator or flight training device. If an applicant for a certificate or rating uses a...

  3. 14 CFR 61.64 - Use of a flight simulator and flight training device.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Use of a flight simulator and flight... Ratings and Pilot Authorizations § 61.64 Use of a flight simulator and flight training device. (a) Use of a flight simulator or flight training device. If an applicant for a certificate or rating uses a...

  4. Advanced Simulation in Undergraduate Pilot Training: Automatic Instructional System. Final Report for the Period March 1971-January 1975.

    ERIC Educational Resources Information Center

    Faconti, Victor; Epps, Robert

    The Advanced Simulator for Undergraduate Pilot Training (ASUPT) was designed to investigate the role of simulation in the future Undergraduate Pilot Training (UPT) program. The Automated Instructional System designed for the ASUPT simulator was described in this report. The development of the Automated Instructional System for ASUPT was based upon…

  5. Validation and learning in the Procedicus KSA virtual reality surgical simulator.

    PubMed

    Ström, P; Kjellin, A; Hedman, L; Johnson, E; Wredmark, T; Felländer-Tsai, L

    2003-02-01

    Advanced simulator training within medicine is a rapidly growing field. Virtual reality simulators are being introduced as cost-saving educational tools, which also lead to increased patient safety. Fifteen medical students were included in the study. For 10 medical students performance was monitored, before and after 1 h of training, in two endoscopic simulators (the Procedicus KSA with haptic feedback and anatomical graphics and the established MIST simulator without this haptic feedback and graphics). Five medical students performed 50 tests in the Procedicus KSA in order to analyze learning curves. One of these five medical students performed multiple training sessions during 2 weeks and performed more than 300 tests. There was a significant improvement after 1 h of training regarding time, movement economy, and total score. The results in the two simulators were highly correlated. Our results show that the use of surgical simulators as a pedagogical tool in medical student training is encouraging. It shows rapid learning curves and our suggestion is to introduce endoscopic simulator training in undergraduate medical education during the course in surgery when motivation is high and before the development of "negative stereotypes" and incorrect practices.

  6. [Improvement of emergency physician education through simulator training. Consideration on the basis of the model project "NASimSaar25"].

    PubMed

    Armbruster, W; Kubulus, D; Schlechtriemen, T; Adler, J; Höhn, M; Schmidt, D; Duchêne, S; Steiner, P; Volk, T; Wrobel, M

    2014-09-01

    Prehospital emergency medicine is a challenge for trainee emergency physicians. Rare injuries and diseases as well as patients in extreme age groups can unexpectedly face emergency physicians. In the regulations on medical education the German Medical Association requires participation in 50 emergency missions under the supervision of an experienced emergency physician. This needs to be improved because on-the-job training does not generally represent the whole spectrum of emergency medicine and a good and structured training under on call conditions is nearly impossible. The subject of the model project described was whether practical training for emergency physicians can be achieved by participation in simulation training instead of real emergency situations. After modification of the Saarland regulations on medical education it was possible to replace up to 25 participations in emergency missions by simulation training. The concept of the course NASimSaar25 requires participants to complete 25 simulator cases in 3 days in small training groups. Emergency situations from all medical disciplines need to be treated. A special focus is on the treatment of life-threatening and rare diseases and injuries. Modern simulators and actors are used. The debriefings are conducted by experienced tutors based on approved principles. Medical contents, learning targets from the field of crew resource management (CRM) and soft skills are discussed in these debriefings. Education in the field of emergency medicine can be improved by simulator-based learning and training. However, practical work under a tutor in real and clinical experience cannot be completely replaced by simulation. Simulator training can only be successful if theoretical knowledge has already been acquired. A simulator-based course concept can result in an improvement of emergency medical education. The model project NASimSaar25 was well received by the target audience and mostly very well evaluated in terms of learning and reality. If this project becomes established the demand on simulation-based training will increase. The training should achieve a consistent standard of quality.

  7. Mobile in Situ Simulation as a Tool for Evaluation and Improvement of Trauma Treatment in the Emergency Department.

    PubMed

    Amiel, Imri; Simon, Daniel; Merin, Ofer; Ziv, Amitai

    2016-01-01

    Medical simulation is an increasingly recognized tool for teaching, coaching, training, and examining practitioners in the medical field. For many years, simulation has been used to improve trauma care and teamwork. Despite technological advances in trauma simulators, including better means of mobilization and control, most reported simulation-based trauma training has been conducted inside simulation centers, and the practice of mobile simulation in hospitals' trauma rooms has not been investigated fully. The emergency department personnel from a second-level trauma center in Israel were evaluated. Divided into randomly formed trauma teams, they were reviewed twice using in situ mobile simulation training at the hospital's trauma bay. In all, 4 simulations were held before and 4 simulations were held after a structured learning intervention. The intervention included a 1-day simulation-based training conducted at the Israel Center for Medical Simulation (MSR), which included video-based debriefing facilitated by the hospital's 4 trauma team leaders who completed a 2-day simulation-based instructors' course before the start of the study. The instructors were also trained on performance rating and thus were responsible for the assessment of their respective teams in real time as well as through reviewing of the recorded videos; thus enabling a comparison of the performances in the mobile simulation exercise before and after the educational intervention. The internal reliability of the experts' evaluation calculated in the Cronbach α model was found to be 0.786. Statistically significant improvement was observed in 4 of 10 parameters, among which were teamwork (29.64%) and communication (24.48%) (p = 0.00005). The mobile in situ simulation-based training demonstrated efficacy both as an assessment tool for trauma teams' function and an educational intervention when coupled with in vitro simulation-based training, resulting in a significant improvement of the teams' function in various aspects of treatment. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. A pilot study of surgical training using a virtual robotic surgery simulator.

    PubMed

    Tergas, Ana I; Sheth, Sangini B; Green, Isabel C; Giuntoli, Robert L; Winder, Abigail D; Fader, Amanda N

    2013-01-01

    Our objectives were to compare the utility of learning a suturing task on the virtual reality da Vinci Skills Simulator versus the da Vinci Surgical System dry laboratory platform and to assess user satisfaction among novice robotic surgeons. Medical trainees were enrolled prospectively; one group trained on the virtual reality simulator, and the other group trained on the da Vinci dry laboratory platform. Trainees received pretesting and post-testing on the dry laboratory platform. Participants then completed an anonymous online user experience and satisfaction survey. We enrolled 20 participants. Mean pretest completion times did not significantly differ between the 2 groups. Training with either platform was associated with a similar decrease in mean time to completion (simulator platform group, 64.9 seconds [P = .04]; dry laboratory platform group, 63.9 seconds [P < .01]). Most participants (58%) preferred the virtual reality platform. The majority found the training "definitely useful" in improving robotic surgical skills (mean, 4.6) and would attend future training sessions (mean, 4.5). Training on the virtual reality robotic simulator or the dry laboratory robotic surgery platform resulted in significant improvements in time to completion and economy of motion for novice robotic surgeons. Although there was a perception that both simulators improved performance, there was a preference for the virtual reality simulator. Benefits unique to the simulator platform include autonomy of use, computerized performance feedback, and ease of setup. These features may facilitate more efficient and sophisticated simulation training above that of the conventional dry laboratory platform, without loss of efficacy.

  9. A randomized controlled trial of simulation-based training for ear, nose, and throat emergencies.

    PubMed

    Smith, Matthew Edward; Navaratnam, Annakan; Jablenska, Lily; Dimitriadis, Panagiotis A; Sharma, Rishi

    2015-08-01

    Life-threatening ear, nose, and throat (ENT) emergencies are uncommon but require immediate skilled management. We investigated if traditional lecture-based teaching can be improved by a simulation and lecture hybrid approach. A single-blinded, prospective, randomized controlled trial. Two groups of interns with no previous ENT experience were randomized to one of two training groups: a simulation/lecture hybrid group or a lecture-only control group. Both groups received 90 minutes of training covering the assessment of critically ill patients and four ENT emergency topics. Both groups received the same initial lecture slides. The control group received additional slides, and the simulation group received simulated emergency scenario training using basic mannequins. Following the training, candidates were asked to provide feedback on their perception of training, and they were formally assessed with a standardized one-to-one viva. Thirty-eight interns were recruited: 18 in the control group and 20 in the simulation group. The candidates in the simulation group performed significantly better in all viva situations (P < .05) and had better perception of learning (P < .05). Additionally, the simulation group was more likely to recommend the training to a colleague (P < .05). We have demonstrated that replacing traditional lecture-based training with a mixture of lectures and emergency scenario simulation is more effective at preparing junior doctors for ENT emergencies, and better met their learning needs. Implementing this kind of teaching is feasible with a minimum of additional resources or time. 1b © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  10. The Role of Simulation in Microsurgical Training.

    PubMed

    Evgeniou, Evgenios; Walker, Harriet; Gujral, Sameer

    Simulation has been established as an integral part of microsurgical training. The aim of this study was to assess and categorize the various simulation models in relation to the complexity of the microsurgical skill being taught and analyze the assessment methods commonly employed in microsurgical simulation training. Numerous courses have been established using simulation models. These models can be categorized, according to the level of complexity of the skill being taught, into basic, intermediate, and advanced. Microsurgical simulation training should be assessed using validated assessment methods. Assessment methods vary significantly from subjective expert opinions to self-assessment questionnaires and validated global rating scales. The appropriate assessment method should carefully be chosen based on the simulation modality. Simulation models should be validated, and a model with appropriate fidelity should be chosen according to the microsurgical skill being taught. Assessment should move from traditional simple subjective evaluations of trainee performance to validated tools. Future studies should assess the transferability of skills gained during simulation training to the real-life setting. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads.

    PubMed

    Lee, Gyusung I; Lee, Mija R

    2018-01-01

    While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG's TPM was initially long but substantially shortened as the group became familiar with PM. Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

  12. The experiences of last-year student midwives with High-Fidelity Perinatal Simulation training: A qualitative descriptive study.

    PubMed

    Vermeulen, Joeri; Beeckman, Katrien; Turcksin, Rivka; Van Winkel, Lies; Gucciardo, Léonardo; Laubach, Monika; Peersman, Wim; Swinnen, Eva

    2017-06-01

    Simulation training is a powerful and evidence-based teaching method in healthcare. It allows students to develop essential competences that are often difficult to achieve during internships. High-Fidelity Perinatal Simulation exposes them to real-life scenarios in a safe environment. Although student midwives' experiences need to be considered to make the simulation training work, these have been overlooked so far. To explore the experiences of last-year student midwives with High-Fidelity Perinatal Simulation training. A qualitative descriptive study, using three focus group conversations with last-year student midwives (n=24). Audio tapes were transcribed and a thematic content analysis was performed. The entire data set was coded according to recurrent or common themes. To achieve investigator triangulation and confirm themes, discussions among the researchers was incorporated in the analysis. Students found High-Fidelity Perinatal Simulation training to be a positive learning method that increased both their competence and confidence. Their experiences varied over the different phases of the High-Fidelity Perinatal Simulation training. Although uncertainty, tension, confusion and disappointment were experienced throughout the simulation trajectory, they reported that this did not affect their learning and confidence-building. As High-Fidelity Perinatal Simulation training constitutes a helpful learning experience in midwifery education, it could have a positive influence on maternal and neonatal outcomes. In the long term, it could therefore enhance the midwifery profession in several ways. The present study is an important first step in opening up the debate about the pedagogical use of High-Fidelity Perinatal Simulation training within midwifery education. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Specification of Training Simulator Fidelity: A Research Plan

    DTIC Science & Technology

    1982-02-01

    Knowlede --Dunnette (1976) has recently reviewed the literature in the areas of human skills, abilities, and knowledges. The establishment of what types... management 6. Other than rational user responses to R&D studies and to training simulators 7. Deficiencies in training simulator design 23...proficient at managing the introduction of training innovations by applying those factors that can be controlled to influence acceptance. (p. 19) The

  14. Developing Performance Measures for Army Aviation Collective Training

    DTIC Science & Technology

    2011-05-01

    simulation-based training, such as ATX, is determined by performance improvement of participants within the virtual-training environment (Bell & Waag ...of the collective behavior (Bell & Waag , 1998). In ATX, system-based (i.e., simulator) data can be used to extract measures such as timing of events...to CABs. 20 21 References Bell, H. H., & Waag , W. L. (1998). Evaluating the effectiveness of flight simulators for training combat

  15. Improving the quality of transvaginal ultrasound scan by simulation training for general practice residents.

    PubMed

    Le Lous, M; De Chanaud, N; Bourret, A; Senat, M V; Colmant, C; Jaury, P; Tesnière, A; Tsatsaris, V

    2017-01-01

    Ultrasonography (US) is an essential tool for the diagnosis of acute gynecological conditions. General practice (GP) residents are involved in the first-line management of gynecologic emergencies. They are not familiar with US equipment. Initial training on simulators was conducted.The aim of this study was to evaluate the impact of simulation-based training on the quality of the sonographic images achieved by GP residents 2 months after the simulation training versus clinical training alone. Young GP residents assigned to emergency gynecology departments were invited to a one-day simulation-based US training session. A prospective controlled trial aiming to assess the impact of such training on TVS (transvaginal ultrasound scan) image quality was conducted. The first group included GP residents who attended the simulation training course. The second group included GP residents who did not attend the course. Written consent to participate was obtained from all participants. Images achieved 2 months after the training were scored using standardized quality criteria and compared in both groups. The stress generated by this examination was also assessed with a simple numeric scale. A total of 137 residents attended the simulation training, 26 consented to participate in the controlled trial. Sonographic image quality was significantly better in the simulation group for the sagittal view of the uterus (3.6 vs 2.7, p  = 0.01), for the longitudinal view of the right ovary (2.8 vs 1.4, p  = 0.027), and for the Morrison space (1.7 vs 0.4, p  = 0.034), but the difference was not significant for the left ovary (2.9 vs 1.7, p  = 0.189). The stress generated by TVS after 2 months was not different between the groups (6.0 vs 4.8, p  = 0.4). Simulation-based training improved the quality of pelvic US images in GP residents assessed after 2 months of experience in gynecology compared to clinical training alone.

  16. Space Station Simulation Computer System (SCS) study for NASA/MSFC. Concept document

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA's Space Station Freedom Program (SSFP) planning efforts have identified a need for a payload training simulator system to serve as both a training facility and as a demonstrator to validate operational concepts. The envisioned MSFC Payload Training Complex (PTC) required to meet this need will train the Space Station Payload of experiments that will be onboard the Space Station Freedom. The simulation will support the Payload Training Complex at MSFC. The purpose of this SCS Study is to investigate issues related to the SCS, alternative requirements, simulator approaches, and state-of-the-art technologies to develop candidate concepts and designs.

  17. Training for percutaneous renal access on a virtual reality simulator.

    PubMed

    Zhang, Yi; Yu, Cheng-fan; Liu, Jin-shun; Wang, Gang; Zhu, He; Na, Yan-qun

    2013-01-01

    The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor(TM) after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt. During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P = 0.03 and 0.02, respectively). The training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access.

  18. Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform.

    PubMed

    Pennington, Kelly M; Dong, Yue; Coville, Hongchuan H; Wang, Bo; Gajic, Ognjen; Kelm, Diana J

    2018-12-01

    The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics. The study design was a prospective study evaluating team dynamics before and after remote simulation. Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses). The study was conducted at nine training sites in eight countries. Study subjects completed 2-3 simulation scenarios of acute crises before and after training with the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). Pre- and post-CERTAIN training simulations were evaluated by two independent reviewers utilizing the Team Emergency Assessment Measure (TEAM), which is a 11-item questionnaire that has been validated for assessing teamwork in the intensive care unit. Any discrepancies of greater than 1 point between the two reviewers on any question on the TEAM assessment were sent to a third reviewer to judge. The score that was deemed discordant by the third judge was eliminated. Pre- and post-CERTAIN training TEAM scores were averaged and compared. Of the nine teams evaluated, six teams demonstrated an overall improvement in global team performance following CERTAIN virtual training. For each of the 11 TEAM assessments, a trend toward improvement following CERTAIN training was noted; however, no assessment had universal improvement. 'Team composure and control' had the least absolute score improvement following CERTAIN training. The greatest improvement in the TEAM assessment scores was in the 'team's ability to complete tasks in a timely manner' and in the 'team leader's communication to the team'. The assessment of team dynamics using long distance, virtual simulation training appears to be feasible and may result in improved team performance during simulated patient crises; however, language and video quality were the two largest barriers noted during the review process.

  19. An electric scooter simulation program for training the driving skills of stroke patients with mobility problems: a pilot study.

    PubMed

    Jannink, Michiel J A; Erren-Wolters, C Victorien; de Kort, Alexander C; van der Kooij, Herman

    2008-12-01

    This paper describes an electric scooter simulation program and a first evaluation study in which we explored if it is possible to train the driving skills of future users of electric mobility scooters by means of an electric scooter simulation program in addition to conventional electric scooter training. Within this explorative study,10 stroke survivors were randomly assigned to either the control (n=5) or the electric scooter simulation intervention group (n=5). Participants were assessed twice on the functional evaluating rating scale. During the followup measurement, subjective experiences regarding both forms of electric scooter training were elicited by a questionnaire. After a training period of 5 weeks, both groups improved on the Functional Evaluation Rating Scale. It can be concluded that the patients with stroke were satisfied with the electric scooter simulation training.

  20. Astronaut Frank Borman during training exercise in Apollo Mission simulator

    NASA Image and Video Library

    1967-08-01

    S67-50590 (1867) --- Astronaut Frank Borman, assigned duty as commander of the Apollo 8 mission, participates in a training exercise in the Apollo Mission simulator in the Mission Simulation and training Facility, Building 5, at the Manned Spacecraft Center, Houston, Texas. Photo credit: NASA

  1. 14 CFR 61.1 - Applicability and definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of this part: (1) Aeronautical experience means pilot time obtained in an aircraft, flight simulator... simulator, or flight training device; or (iii) Gives training as an authorized instructor in an aircraft, flight simulator, or flight training device. (16) Practical test means a test on the areas of operations...

  2. 49 CFR 1552.1 - Scope and definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Definitions. As used in this part: Aircraft simulator means a flight simulator or flight training device, as.... Flight training means instruction received from a flight school in an aircraft or aircraft simulator..., DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight Training for Aliens and Other...

  3. 49 CFR 1552.1 - Scope and definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Definitions. As used in this part: Aircraft simulator means a flight simulator or flight training device, as.... Flight training means instruction received from a flight school in an aircraft or aircraft simulator..., DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight Training for Aliens and Other...

  4. 14 CFR 61.1 - Applicability and definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of this part: (1) Aeronautical experience means pilot time obtained in an aircraft, flight simulator... simulator, or flight training device; or (iii) Gives training as an authorized instructor in an aircraft, flight simulator, or flight training device. (16) Practical test means a test on the areas of operations...

  5. 49 CFR 1552.1 - Scope and definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Definitions. As used in this part: Aircraft simulator means a flight simulator or flight training device, as.... Flight training means instruction received from a flight school in an aircraft or aircraft simulator..., DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight Training for Aliens and Other...

  6. 49 CFR 1552.1 - Scope and definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Definitions. As used in this part: Aircraft simulator means a flight simulator or flight training device, as.... Flight training means instruction received from a flight school in an aircraft or aircraft simulator..., DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight Training for Aliens and Other...

  7. 49 CFR 1552.1 - Scope and definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Definitions. As used in this part: Aircraft simulator means a flight simulator or flight training device, as.... Flight training means instruction received from a flight school in an aircraft or aircraft simulator..., DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY FLIGHT SCHOOLS Flight Training for Aliens and Other...

  8. Web-Based Simulation in Psychiatry Residency Training: A Pilot Study

    ERIC Educational Resources Information Center

    Gorrindo, Tristan; Baer, Lee; Sanders, Kathy M.; Birnbaum, Robert J.; Fromson, John A.; Sutton-Skinner, Kelly M.; Romeo, Sarah A.; Beresin, Eugene V.

    2011-01-01

    Background: Medical specialties, including surgery, obstetrics, anesthesia, critical care, and trauma, have adopted simulation technology for measuring clinical competency as a routine part of their residency training programs; yet, simulation technologies have rarely been adapted or used for psychiatry training. Objective: The authors describe…

  9. 14 CFR 141.41 - Flight simulators, flight training devices, and training aids.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., and training aids. 141.41 Section 141.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aids. An applicant for a pilot school certificate or a provisional pilot school certificate must show that its flight simulators, flight training devices, training aids, and equipment meet the following...

  10. 14 CFR 141.41 - Flight simulators, flight training devices, and training aids.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., and training aids. 141.41 Section 141.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aids. An applicant for a pilot school certificate or a provisional pilot school certificate must show that its flight simulators, flight training devices, training aids, and equipment meet the following...

  11. 14 CFR 141.41 - Flight simulators, flight training devices, and training aids.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., and training aids. 141.41 Section 141.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aids. An applicant for a pilot school certificate or a provisional pilot school certificate must show that its flight simulators, flight training devices, training aids, and equipment meet the following...

  12. 14 CFR 141.41 - Flight simulators, flight training devices, and training aids.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., and training aids. 141.41 Section 141.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aids. An applicant for a pilot school certificate or a provisional pilot school certificate must show that its flight simulators, flight training devices, training aids, and equipment meet the following...

  13. 14 CFR 61.156 - Training requirements: Airplane category-multiengine class rating or airplane type rating...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... simulation training device qualified under part 60 of this chapter that represents a multiengine turbine... completed in a Level 4 or higher flight simulation training device. The training must include the following...

  14. Local and national laparoscopic skill competitions: residents' opinions and impact on adoption of simulation-based training.

    PubMed

    McCreery, Greig L; El-Beheiry, Mostafa; Schlachta, Christopher M

    2017-11-01

    Dedicated practice using laparoscopic simulators improves operative performance. Yet, voluntary utilization is minimal. We hypothesized that skill competition between peers, at the local and national level, positively influences residents' use of laparoscopic simulators. A web-based survey evaluated the relationship between Canadian General Surgery residents' use of laparoscopic simulation and participation in competition. Secondary outcomes assessed attitudes regarding simulation training, factors limiting use, and associations between competition level and usage. One hundred ninety (23%) of 826 potential participants responded. Eighty-three percent rated their laparoscopic abilities as novice or intermediate. More than 70% agreed that use of simulation practice improves intra-operative performance, and should be a mandatory component of training. However, 58% employed simulator practice less than once per month, and 18% never used a simulator. Sixty-five percent engaged in simulator training for 5 h or less over the preceding 6 months. Seventy-three percent had participated in laparoscopic skill competition. Of those, 51% agreed that competition was a motivation for simulation practice. No association was found between those with competition experience and simulator use. However, 83% of those who had competed nationally reported >5 h of simulator use in the previous 6 months compared to those with no competition experience (26%), local competition (40%), and local national-qualifying competition (23%) (p < 0.001). This study does not support the hypothesis that competition alone universally increases voluntary use of simulation-based training, with only the minority of individuals competing at the national level demonstrated significantly higher simulation use. However, simulation training was perceived as a valuable exercise. Lack of time and access to simulators, as opposed to lack of interest, were the most commonly reported to limited use.

  15. Payload crew training complex simulation engineer's handbook

    NASA Technical Reports Server (NTRS)

    Shipman, D. L.

    1984-01-01

    The Simulation Engineer's Handbook is a guide for new engineers assigned to Experiment Simulation and a reference for engineers previously assigned. The experiment simulation process, development of experiment simulator requirements, development of experiment simulator hardware and software, and the verification of experiment simulators are discussed. The training required for experiment simulation is extensive and is only referenced in the handbook.

  16. The use of simulation in healthcare: from systems issues, to team building, to task training, to education and high stakes examinations.

    PubMed

    Orledge, Jeffrey; Phillips, William J; Murray, W Bosseau; Lerant, Anna

    2012-08-01

    Simulation in healthcare is becoming increasingly used. This review will spotlight some of the uses of simulation in healthcare training. Previously, evaluation of simulation training was typically from evaluations from trainees. Recent articles, however, have linked simulation training to actual patient outcomes and demonstrated skill retention up to 1 year. Objective measurements have demonstrated positive effects on healthcare education, have been successfully used in high stakes examinations, and have uncovered systems and patient safety issues. This article will review some recent studies showing how simulation can have a positive effect on patient outcomes and skill retention, uncover systems issues related to patient safety, and how simulation can be used in credentialing, and other high stakes examinations.

  17. The role of simulation in teaching pediatric resuscitation: current perspectives

    PubMed Central

    Lin, Yiqun; Cheng, Adam

    2015-01-01

    The use of simulation for teaching the knowledge, skills, and behaviors necessary for effective pediatric resuscitation has seen widespread growth and adoption across pediatric institutions. In this paper, we describe the application of simulation in pediatric resuscitation training and review the evidence for the use of simulation in neonatal resuscitation, pediatric advanced life support, procedural skills training, and crisis resource management training. We also highlight studies supporting several key instructional design elements that enhance learning, including the use of high-fidelity simulation, distributed practice, deliberate practice, feedback, and debriefing. Simulation-based training is an effective modality for teaching pediatric resuscitation concepts. Current literature has revealed some research gaps in simulation-based education, which could indicate the direction for the future of pediatric resuscitation research. PMID:25878517

  18. Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

    PubMed Central

    2010-01-01

    Background The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School. Methods In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test. Results At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training. Conclusions Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training. PMID:20082701

  19. STS-26 crew trains in JSC fixed-based (FB) shuttle mission simulator (SMS)

    NASA Technical Reports Server (NTRS)

    1987-01-01

    STS-26 Discovery, Orbiter Vehicle (OV) 103, mission specialists pose on aft flight deck in fixed-based (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5. Left to right, Mission Specialist (MS) John M. Lounge, MS George D. Nelson, and MS David C. Hilmers await start of FB-SMS simulation. The long simulation, part of the training for their anticipated June 1988 flight, began 10-20-87.

  20. 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.

  1. An analysis of airline landing flare data based on flight and training simulator measurements

    NASA Technical Reports Server (NTRS)

    Heffley, R. K.; Schulman, T. M.; Clement, T. M.

    1982-01-01

    Landings by experienced airline pilots transitioning to the DC-10, performed in flight and on a simulator, were analyzed and compared using a pilot-in-the-loop model of the landing maneuver. By solving for the effective feedback gains and pilot compensation which described landing technique, it was possible to discern fundamental differences in pilot behavior between the actual aircraft and the simulator. These differences were then used to infer simulator fidelity in terms of specific deficiencies and to quantify the effectiveness of training on the simulator as compared to training in flight. While training on the simulator, pilots exhibited larger effective lag in commanding the flare. The inability to compensate adequately for this lag was associated with hard or inconsistent landings. To some degree this deficiency was carried into flight, thus resulting in a slightly different and inferior landing technique than exhibited by pilots trained exclusively on the actual aircraft.

  2. It is not how much you have but how you use it: toward a rational use of simulation to support aviation training.

    PubMed

    Salas, E; Bowers, C A; Rhodenizer, L

    1998-01-01

    One of the most remarkable changes in aviation training over the past few decades is the use of simulation. The capabilities now offered by simulation have created unlimited opportunities for aviation training. In fact, aviation training is now more realistic, safe, cost-effective, and flexible than ever before. However, we believe that a number of misconceptions--or invalid assumptions--exist in the simulation community that prevent us from fully exploiting and utilizing recent scientific advances in a number of related fields in order to further enhance aviation training. These assumptions relate to the overreliance on high-fidelity simulation and to the misuse of simulation to enhance learning of complex skills. The purpose of this article is to discuss these assumptions in the hope of initiating a dialogue between behavioral scientists and engineers.

  3. 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.

  4. Is There Bias against Simulation in Microsurgery Training?

    PubMed

    Theman, Todd A; Labow, Brian I

    2016-09-01

    Background While other surgical specialties have embraced virtual reality simulation for training and recertification, microsurgery has lagged. This study aims to assess the opinions of microsurgeons on the role of simulation in microsurgery assessment and training. Methods We surveyed faculty members of the American Society of Reconstructive Microsurgery to ascertain opinions on their use of simulation in training and opinions about the utility of simulation for skills acquisition, teaching, and skills assessment. The 21-question survey was disseminated online to 675 members. Results Eighty-nine members completed the survey for a 13.2% response rate. Few microsurgeons have experience with high-fidelity simulation, and opinions on its utility are internally inconsistent. Although 84% of respondents could not identify a reason why simulation would not be useful, only 24% believed simulation is a useful measure of clinical performance. Nearly three-fourths of respondents were skeptical that simulation would improve their skills. Ninety-four percent had no experience with simulator-based assessment. Conclusion Simulation has been shown to improve skills acquisition in microsurgery, but our survey suggests that unfamiliarity may foster bias against the technology. Failure to incorporate simulation may adversely affect training and may put surgeons at a disadvantage should these technologies be adopted for recertification by regulatory agencies. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. 14 CFR 60.1 - Applicability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.1 Applicability. (a) This part... simulation training devices (FSTD) used for meeting training, evaluation, or flight experience requirements...

  6. 14 CFR 60.1 - Applicability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.1 Applicability. (a) This part... simulation training devices (FSTD) used for meeting training, evaluation, or flight experience requirements...

  7. 14 CFR 60.1 - Applicability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.1 Applicability. (a) This part... simulation training devices (FSTD) used for meeting training, evaluation, or flight experience requirements...

  8. 14 CFR 60.1 - Applicability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.1 Applicability. (a) This part... simulation training devices (FSTD) used for meeting training, evaluation, or flight experience requirements...

  9. 14 CFR 60.1 - Applicability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.1 Applicability. (a) This part... simulation training devices (FSTD) used for meeting training, evaluation, or flight experience requirements...

  10. 14 CFR 91.1093 - Initial and transition training and checking: Check pilots (aircraft), check pilots (simulator).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... observation check may be accomplished in part or in full in an aircraft, in a flight simulator, or in a flight... 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 a check pilot (simulator) must include the...

  11. 14 CFR 91.1093 - Initial and transition training and checking: Check pilots (aircraft), check pilots (simulator).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... observation check may be accomplished in part or in full in an aircraft, in a flight simulator, or in a flight... 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 a check pilot (simulator) must include the...

  12. 14 CFR 91.1093 - Initial and transition training and checking: Check pilots (aircraft), check pilots (simulator).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... observation check may be accomplished in part or in full in an aircraft, in a flight simulator, or in a flight... 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 a check pilot (simulator) must include the...

  13. 14 CFR 91.1093 - Initial and transition training and checking: Check pilots (aircraft), check pilots (simulator).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... observation check may be accomplished in part or in full in an aircraft, in a flight simulator, or in a flight... 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 a check pilot (simulator) must include the...

  14. 14 CFR 91.1093 - Initial and transition training and checking: Check pilots (aircraft), check pilots (simulator).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... observation check may be accomplished in part or in full in an aircraft, in a flight simulator, or in a flight... 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 a check pilot (simulator) must include the...

  15. STS-31 Pilot Bolden with beverages on the FB-SMS middeck during JSC training

    NASA Technical Reports Server (NTRS)

    1988-01-01

    STS-31 Pilot Charles F. Bolden holds three beverage containers while in front of the galley on the middeck of the fixed based (FB) shuttle mission simulator (SMS) during a training simulation at JSC's Mission Simulation and Training Facility Bldg 5. From the middeck, Bolden, wearing lightweight headset, simulates a communications link with ground controllers and fellow crewmembers.

  16. 2nd Annual Invited Experts Meeting on Simulation-Based Medical Training

    DTIC Science & Technology

    2005-12-01

    medicine, government, and regulatory officials with medical simulation and patient safety experts. In 2005, TATRC continued its support of this effort...standardized patients allow students to interact with “actors” specifically trained to present their medical histories, simulate physical symptoms, and...simulation-based medical training benefits all of us, as follows: • Patients benefit from improved health outcomes and reduced errors and deaths

  17. Preparing for Large-Force Exercises with Distributed Simulation: A Panel Presentation

    DTIC Science & Technology

    2010-07-01

    Preparing for Large Force Exercises with Distributed Simulation: A Panel Presentation Peter Crane, Winston Bennett, Michael France Air Force...used distributed simulation training to complement live-fly exercises to prepare for LFEs. In this panel presentation , the speakers will describe... presentations on how detailed analysis of training needs is necessary to structure simulator scenarios and how future training exercises could be made more

  18. GEMINI-TITAN (GT)-12 - TRAINING (PRIOR) - MISSION SIMULATOR

    NASA Image and Video Library

    1966-09-06

    S66-45579 (6 Sept. 1966) --- Astronaut James A. Lovell Jr. (right), prime crew command pilot of the Gemini-12 spaceflight, talks with Burton M. Gifford (left) and Duane K. Mosel (center), both with the Simulation Branch, Flight Crew Support Division. Lovell was preparing to undergo flight training in the Gemini Mission Simulator in Building 5, Mission Simulation and Training Facility. Photo credit: NASA

  19. Fidelity and Validity in Distributed Interactive Simulation: Questions and Answers

    DTIC Science & Technology

    1992-11-01

    future work in (a) collective training (b) the development and evaluation of tactical concepts and doctrine, (c) system test and evaluation, and (d...exercises. 14. SUBJECT TERMS 15. NUMBER OF PAGES distributed interactive simulation, simulation, training, test and evaluation, 37 simulator fidelity...revolutionizing future work in (a) collective training, (b) the development and evaluation of tactical concepts and doctrine, (c) system test and evaluation

  20. The utility of simulation in medical education: what is the evidence?

    PubMed

    Okuda, Yasuharu; Bryson, Ethan O; DeMaria, Samuel; Jacobson, Lisa; Quinones, Joshua; Shen, Bing; Levine, Adam I

    2009-08-01

    Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are "practicing" on them, clinical medicine is becoming focused more on patient safety and quality than on bedside teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap. This article reviews the evidence for the utility of simulation in medical education. We conducted a MEDLINE search of original articles and review articles related to simulation in education with key words such as simulation, mannequin simulator, partial task simulator, graduate medical education, undergraduate medical education, and continuing medical education. Articles, related to undergraduate medical education, graduate medical education, and continuing medical education were used in the review. One hundred thirteen articles were included in this review. Simulation-based training was demonstrated to lead to clinical improvement in 2 areas of simulation research. Residents trained on laparoscopic surgery simulators showed improvement in procedural performance in the operating room. The other study showed that residents trained on simulators were more likely to adhere to the advanced cardiac life support protocol than those who received standard training for cardiac arrest patients. In other areas of medical training, simulation has been demonstrated to lead to improvements in medical knowledge, comfort in procedures, and improvements in performance during retesting in simulated scenarios. Simulation has also been shown to be a reliable tool for assessing learners and for teaching topics such as teamwork and communication. Only a few studies have shown direct improvements in clinical outcomes from the use of simulation for training. Multiple studies have demonstrated the effectiveness of simulation in the teaching of basic science and clinical knowledge, procedural skills, teamwork, and communication as well as assessment at the undergraduate and graduate medical education levels. As simulation becomes increasingly prevalent in medical school and resident education, more studies are needed to see if simulation training improves patient outcomes.

  1. 14 CFR 61.65 - Instrument rating requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... authorized instructor in an aircraft, flight simulator, or flight training device that represents an airplane... appropriate to the rating sought; or (ii) A flight simulator or a flight training device appropriate to the... authorized instructor in an aircraft, or in a flight simulator or flight training device, in accordance with...

  2. SIMULATION IN TRAINING AND EDUCATION.

    ERIC Educational Resources Information Center

    CRAWFORD, MEREDITH P.

    THE KEY CONCEPTS OF SYSTEM AND SIMULATION AS THEY ARE APPLIED TO TRAINING AND EDUCATION ARE DISCUSSED. THE GENERAL CHARACTERISTICS OF MACHINE-ASCENDANT SYSTEMS THAT FACILITATE THE ORDERLY DESIGN PROCESS OF TRAINING SIMULATORS ARE PRESENTED--(1) PURPOSE OF THE SYSTEM AND LIMITS OF ACCEPTABLE HUMAN BEHAVIOR, (2) RESPONSE CHARACTERISTICS OF THE…

  3. Simulator Motion as a Factor in Flight Simulator Training Effectiveness.

    ERIC Educational Resources Information Center

    Jacobs, Robert S.

    The document reviews the literature concerning the training effectiveness of flight simulators and describes an experiment in progress at the University of Illinois' Institute of Aviation which is an initial attempt to develop systematically the relationship between motion cue fidelity and resultant training effectiveness. The literature review…

  4. Reducing the Risks of Military Aircrew Training through Simulation Technology.

    ERIC Educational Resources Information Center

    Farrow, Douglas R.

    1982-01-01

    This discussion of the types of risks associated with military aircrew training and the varieties of training devices and techniques currently utilized to minimize those risks includes an examination of flight trainer simulators and complex mission simulators for coping with military aviation hazards. Four references are listed. (Author/MER)

  5. Simulation and Shoulder Dystocia.

    PubMed

    Shaddeau, Angela K; Deering, Shad

    2016-12-01

    Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury. Given the evidence, simulation training for shoulder dystocia should be conducted at all institutions that provide delivery services.

  6. Application of Arrester Simulation Device in Training

    NASA Astrophysics Data System (ADS)

    Baoquan, Zhang; Ziqi, Chai; Genghua, Liu; Wei, Gao; Kaiyue, Wu

    2017-12-01

    Combining with the arrester simulation device put into use successfully, this paper introduces the application of arrester test in the insulation resistance measurement, counter test, Leakage current test under DC 1mA voltage and leakage current test under 0.75U1mA. By comparing with the existing training, this paper summarizes the arrester simulation device’s outstanding advantages including real time monitoring, multi-type fault data analysis and acousto-optic simulation. It effectively solves the contradiction between authenticity and safety in the existing test training, and provides a reference for further training.

  7. Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees.

    PubMed

    Auffermann, William F; Henry, Travis S; Little, Brent P; Tigges, Stefan; Tridandapani, Srini

    2015-11-01

    Simulation has been used as an educational and assessment tool in several fields, generally involving training of physical skills. To date, simulation has found limited application in teaching and assessment of skills related to image perception and interpretation. The goal of this pilot study was to evaluate the feasibility of simulation as a tool for teaching and assessment of skills related to perception of nodules on chest radiography. This study received an exemption from the institutional review board. Subjects consisted of nonradiology health care trainees. Subjects underwent training and assessment of pulmonary nodule identification skills on chest radiographs at simulated radiology workstations. Subject performance was quantified by changes in area under the localization receiver operating characteristic curve. At the conclusion of the study, all subjects were given a questionnaire with five questions comparing learning at a simulated workstation with training using conventional materials. Statistical significance for questionnaire responses was tested using the Wilcoxon signed rank test. Subjects demonstrated statistically significant improvement in nodule identification after training at a simulated radiology workstation (change in area under the curve, 0.1079; P = .015). Subjects indicated that training on simulated radiology workstations was preferable to conventional training methods for all questions; P values for all questions were less than .01. Simulation may be a useful tool for teaching and assessment of skills related to medical image perception and interpretation. Further study is needed to determine which skills and trainee populations may be most amenable to training and assessment using simulation. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. The impact of residents' training in Electronic Medical Record (EMR) use on their competence: report of a pragmatic trial.

    PubMed

    Reis, Shmuel; Sagi, Doron; Eisenberg, Orit; Kuchnir, Yosi; Azuri, Joseph; Shalev, Varda; Ziv, Amitai

    2013-12-01

    Even though Electronic Medical Records (EMRs) are increasingly used in healthcare organizations there is surprisingly little theoretical work or educational programs in this field. This study is aimed at comparing two training programs for doctor-patient-computer communication (DPCC). 36 Family Medicine Residents (FMRs) participated in this study. All FMRs went through twelve identical simulated encounters, six pre and six post training. The experiment group received simulation based training (SBT) while the control group received traditional lecture based training. Performance, attitude and sense of competence of all FMRs improved, but no difference was found between the experiment and control groups. FMRs from the experiment group evaluated the contribution of the training phase higher than control group, and showed higher satisfaction. We assume that the mere exposure to simulation served as a learning experience and enabled deliberate practice that was more powerful than training. Because DPCC is a new field, all participants in such studies, including instructors and raters, should receive basic training of DPCC skills. Simulation enhances DPCC skills. Future studies of this kind should control the exposure to simulation prior to the training phase. Training and assessment of clinical communication should include EMR related skills. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Construction of the real patient simulator system.

    PubMed

    Chan, Richard; Sun, C T

    2012-05-01

    Simulation for perfusion education has been used for at least the past 25 years. The earlier models were either electronic (computer games) or fluid dynamic models and provided invaluable adjuncts to perfusion training and education. In 2009, the *North Shore-LIJ Health System at Great Neck, New York, opened an innovative "Bioskill Center" dedicated to simulated virtual reality advanced hands-on surgical training as well as perfusion simulation. Professional cardiac surgical organizations now show great interest in using simulation for training and recertification. Simulation will continue to be the direction for future perfusion training and education. This manuscript introduces a cost-effective system developed from discarded perfusion products and it is not intended to detail the actual lengthy process of its construction.

  10. Adaptive thinking & leadership simulation game training for special forces officers.

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

    Raybourn, Elaine Marie; Mendini, Kip; Heneghan, Jerry

    Complex problem solving approaches and novel strategies employed by the military at the squad, team, and commander level are often best learned experimentally. Since live action exercises can be costly, advances in simulation game training technology offer exciting ways to enhance current training. Computer games provide an environment for active, critical learning. Games open up possibilities for simultaneous learning on multiple levels; players may learn from contextual information embedded in the dynamics of the game, the organic process generated by the game, and through the risks, benefits, costs, outcomes, and rewards of alternative strategies that result from decision making. Inmore » the present paper we discuss a multiplayer computer game simulation created for the Adaptive Thinking & Leadership (ATL) Program to train Special Forces Team Leaders. The ATL training simulation consists of a scripted single-player and an immersive multiplayer environment for classroom use which leverages immersive computer game technology. We define adaptive thinking as consisting of competencies such as negotiation and consensus building skills, the ability to communicate effectively, analyze ambiguous situations, be self-aware, think innovatively, and critically use effective problem solving skills. Each of these competencies is an essential element of leader development training for the U.S. Army Special Forces. The ATL simulation is used to augment experiential learning in the curriculum for the U.S. Army JFK Special Warfare Center & School (SWCS) course in Adaptive Thinking & Leadership. The school is incorporating the ATL simulation game into two additional training pipelines (PSYOPS and Civil Affairs Qualification Courses) that are also concerned with developing cultural awareness, interpersonal communication adaptability, and rapport-building skills. In the present paper, we discuss the design, development, and deployment of the training simulation, and emphasize how the multiplayer simulation game is successfully used in the Special Forces Officer training program.« less

  11. Stress Inoculation through Cognitive and Biofeedback Training

    DTIC Science & Technology

    2010-12-01

    based on Heart Rate Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a...Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a mobile device...and studies (e.g. Fletcher & Tobias, 2006; Thayer, 2009). HRV Coherence Training for Stress Resilience Satisfactory performance in stressful

  12. Simulation training for medical emergencies in the dental setting using an inexpensive software application.

    PubMed

    Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

    2017-11-09

    Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P < .01). For the item "I can treat vasovagal syncope/anaphylaxis adequately," the percentage responding "Strongly agree" or "Agree" increased from 14% to 56% for vasovagal syncope and from 6% to 42% for anaphylaxis with simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study

    PubMed Central

    Hedman, Leif; Felländer-Tsai, Li

    2016-01-01

    Objectives To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Methods Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience.  Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. Results A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). Conclusions This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.  PMID:26897701

  14. Simulation-Based Dysphagia Training: Teaching Interprofessional Clinical Reasoning in a Hospital Environment.

    PubMed

    Miles, Anna; Friary, Philippa; Jackson, Bianca; Sekula, Julia; Braakhuis, Andrea

    2016-06-01

    This study evaluated hospital readiness and interprofessional clinical reasoning in speech-language pathology and dietetics students following a simulation-based teaching package. Thirty-one students participated in two half-day simulation workshops. The training included orientation to the hospital setting, part-task skill learning and immersive simulated cases. Students completed workshop evaluation forms. They filled in a 10-question survey regarding confidence, knowledge and preparedness for working in a hospital environment before and immediately after the workshops. Students completed written 15-min clinical vignettes at 1 month prior to training, immediately prior to training and immediately after training. A marking rubric was devised to evaluate the responses to the clinical vignettes within a framework of interprofessional education. The simulation workshops were well received by all students. There was a significant increase in students' self-ratings of confidence, preparedness and knowledge following the study day (p < .001). There was a significant increase in student overall scores in clinical vignettes after training with the greatest increase in clinical reasoning (p < .001). Interprofessional simulation-based training has benefits in developing hospital readiness and clinical reasoning in allied health students.

  15. Comprehensive Training Curricula for Minimally Invasive Surgery

    PubMed Central

    Palter, Vanessa N

    2011-01-01

    Background The unique skill set required for minimally invasive surgery has in part contributed to a certain portion of surgical residency training transitioning from the operating room to the surgical skills laboratory. Simulation lends itself well as a method to shorten the learning curve for minimally invasive surgery by allowing trainees to practice the unique motor skills required for this type of surgery in a safe, structured environment. Although a significant amount of important work has been done to validate simulators as viable systems for teaching technical skills outside the operating room, the next step is to integrate simulation training into a comprehensive curriculum. Objectives This narrative review aims to synthesize the evidence and educational theories underlining curricula development for technical skills both in a broad context and specifically as it pertains to minimally invasive surgery. Findings The review highlights the critical aspects of simulation training, such as the effective provision of feedback, deliberate practice, training to proficiency, the opportunity to practice at varying levels of difficulty, and the inclusion of both cognitive teaching and hands-on training. In addition, frameworks for integrating simulation training into a comprehensive curriculum are described. Finally, existing curricula on both laparoscopic box trainers and virtual reality simulators are critically evaluated. PMID:22942951

  16. Innovations in surgery simulation: a review of past, current and future techniques

    PubMed Central

    Burtt, Karen; Solorzano, Carlos A.; Carey, Joseph N.

    2016-01-01

    As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon’s skill set, decrease hospital costs, and improve patient outcomes. PMID:28090509

  17. Innovations in surgery simulation: a review of past, current and future techniques.

    PubMed

    Badash, Ido; Burtt, Karen; Solorzano, Carlos A; Carey, Joseph N

    2016-12-01

    As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

  18. Simulation-based training in flexible fibreoptic intubation: A randomised study.

    PubMed

    Nilsson, Philip M; Russell, Lene; Ringsted, Charlotte; Hertz, Peter; Konge, Lars

    2015-09-01

    Flexible fibreoptic intubation (FOI) is a key element in difficult airway management. Training of FOI skills is an important part of the anaesthesiology curriculum. Simulation-based training has been shown to be effective when learning FOI, but the optimal structure of the training is debated. The aspect of dividing the training into segments (part-task training) or assembling into one piece (whole-task training) has not been studied. The aims of this study were to compare the effect of training the motor skills of FOI as part-task training or as whole-task training and to relate the performance levels achieved by the novices to the standard of performance of experienced FOI practitioners. A randomised controlled study. Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, between January and April 2013. Twenty-three anaesthesia residents in their first year of training in anaesthesiology with no experience in FOI, and 10 anaesthesia consultants experienced in FOI. The novices to FOI were allocated randomly to receive either part-task or whole-task training of FOI on virtual reality simulators. Procedures were subsequently trained on a manikin and assessed by an experienced anaesthesiologist. The experienced group was assessed in the same manner with no prior simulation-based training. The primary outcome measure was the score of performance on testing FOI skills on a manikin. A positive learning effect was observed in both the part-task training group and the whole-task training group. There was no statistically significant difference in final performance scores of the two novice groups (P = 0.61). Furthermore, both groups of novices were able to improve their skill level significantly by the end of manikin training to levels comparable to the experienced anaesthesiologists. Part-task training did not prove more effective than whole-task training when training novices in FOI skills. FOI is very suitable for simulation-based training and segmentation of the procedure during training is not necessary.

  19. Simulation technology for resuscitation training: a systematic review and meta-analysis.

    PubMed

    Mundell, William C; Kennedy, Cassie C; Szostek, Jason H; Cook, David A

    2013-09-01

    To summarize current available data on simulation-based training in resuscitation for health care professionals. MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and reference lists of published reviews. Published studies of any language or date that enrolled health professions' learners to investigate the use of technology-enhanced simulation to teach resuscitation in comparison with no intervention or alternative training. Data were abstracted in duplicate. We identified themes examining different approaches to curriculum design. We pooled results using random effects meta-analysis. 182 studies were identified involving 16,636 participants. Overall, simulation-based training of resuscitation skills, in comparison to no intervention, appears effective regardless of assessed outcome, level of learner, study design, or specific task trained. In comparison to no intervention, simulation training improved outcomes of knowledge (Hedges' g) 1.05 (95% confidence interval, 0.81-1.29), process skill 1.13 (0.99-1.27), product skill 1.92 (1.26-2.60), time skill 1.77 (1.13-2.42) and patient outcomes 0.26 (0.047-0.48). In comparison with non-simulation intervention, learner satisfaction 0.79 (0.27-1.31) and process skill 0.35 (0.12-0.59) outcomes favored simulation. Studies investigating how to optimize simulation training found higher process skill outcomes in courses employing "booster" practice 0.13 (0.03-0.22), team/group dynamics 0.51 (0.06-0.97), distraction 1.76 (1.02-2.50) and integrated feedback 0.49 (0.17-0.80) compared to courses without these features. Most analyses reflected high between-study inconsistency (I(2) values >50%). Simulation-based training for resuscitation is highly effective. Design features of "booster" practice, team/group dynamics, distraction and integrated feedback improve effectiveness. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Hand-assisted laparoscopic sigmoid colectomy skills acquisition: augmented reality simulator versus human cadaver training models.

    PubMed

    Leblanc, Fabien; Senagore, Anthony J; Ellis, Clyde N; Champagne, Bradley J; Augestad, Knut M; Neary, Paul C; Delaney, Conor P

    2010-01-01

    The aim of this study was to compare a simulator with the human cadaver model for hand-assisted laparoscopic colorectal skills acquisition training. An observational prospective comparative study was conducted to compare the laparoscopic surgery training models. The study took place during the laparoscopic colectomy training course performed at the annual scientific meeting of the American Society of Colon and Rectal Surgeons. Thirty four practicing surgeons performed hand-assisted laparoscopic sigmoid colectomy on human cadavers (n = 7) and on an augmented reality simulator (n = 27). Prior laparoscopic colorectal experience was assessed. Trainers and trainees completed independently objective structured assessment forms. Training models were compared by trainees' technical skills scores, events scores, and satisfaction. Prior laparoscopic experience was similar in both surgeon groups. Generic and specific skills scores were similar on both training models. Generic events scores were significantly better on the cadaver model. The 2 most frequent generic events occurring on the simulator were poor hand-eye coordination and inefficient use of retraction. Specific events were scored better on the simulator and reached the significance limit (p = 0.051) for trainers. The specific events occurring on the cadaver were intestinal perforation and left ureter identification difficulties. Overall satisfaction was better for the cadaver than for the simulator model (p = 0.009). With regard to skills scores, the augmented reality simulator had adequate qualities for the hand-assisted laparoscopic colectomy training. Nevertheless, events scores highlighted weaknesses of the anatomical replication on the simulator. Although improvements likely will be required to incorporate the simulator more routinely into the colorectal training, it may be useful in its current form for more junior trainees or those early on their learning curve. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2007-03-01

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

  2. Simulation Training: Evaluating the Instructor’s Contribution to a Wizard of Oz Simulator in Obstetrics and Gynecology Ultrasound Training

    PubMed Central

    Tepper, Ronnie

    2017-01-01

    Background Workplaces today demand graduates who are prepared with field-specific knowledge, advanced social skills, problem-solving skills, and integration capabilities. Meeting these goals with didactic learning (DL) is becoming increasingly difficult. Enhanced training methods that would better prepare tomorrow’s graduates must be more engaging and game-like, such as feedback based e-learning or simulation-based training, while saving time. Empirical evidence regarding the effectiveness of advanced learning methods is lacking. Objective quantitative research comparing advanced training methods with DL is sparse. Objectives This quantitative study assessed the effectiveness of a computerized interactive simulator coupled with an instructor who monitored students’ progress and provided Web-based immediate feedback. Methods A low-cost, globally accessible, telemedicine simulator, developed at the Technion—Israel Institute of Technology, Haifa, Israel—was used. A previous study in the field of interventional cardiology, evaluating the efficacy of the simulator to enhanced learning via knowledge exams, presented promising results of average scores varying from 94% after training and 54% before training (n=20) with P<.001. Two independent experiments involving obstetrics and gynecology (Ob-Gyn) physicians and senior ultrasound sonographers, with 32 subjects, were conducted using a new interactive concept of the WOZ (Wizard of OZ) simulator platform. The contribution of an instructor to learning outcomes was evaluated by comparing students’ knowledge before and after each interactive instructor-led session as well as after fully automated e-learning in the field of Ob-Gyn. Results from objective knowledge tests were analyzed using hypothesis testing and model fitting. Results A significant advantage (P=.01) was found in favor of the WOZ training approach. Content type and training audience were not significant. Conclusions This study evaluated the contribution of an integrated teaching environment using a computerized interactive simulator, with an instructor providing immediate Web-based immediate feedback to trainees. Involvement of an instructor in the simulation-based training process provided better learning outcomes that varied training content and trainee populations did not affect the overall learning gains. PMID:28432039

  3. Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial.

    PubMed

    Grover, Samir C; Garg, Ankit; Scaffidi, Michael A; Yu, Jeffrey J; Plener, Ian S; Yong, Elaine; Cino, Maria; Grantcharov, Teodor P; Walsh, Catharine M

    2015-12-01

    GI endoscopy simulation-based training augments early clinical performance; however, the optimal manner by which to deliver training is unknown. We aimed to validate a simulation-based structured comprehensive curriculum (SCC) designed to teach technical, cognitive, and integrative competencies in colonoscopy. Single-blinded, randomized, controlled trial. Endoscopic simulation course at an academic hospital. Thirty-three novice endoscopists were allocated to an SCC group or self-regulated learning (SRL) group. The SCC group received a curriculum consisting of 6 hours of didactic lectures and 8 hours of virtual reality simulation-based training with expert feedback. The SRL group was provided a list of desired objectives and was instructed to practice on the simulator for an equivalent time (8 hours). Clinical transfer was assessed during 2 patient colonoscopies using the Joint Advisory Group Direct Observation of Procedural Skills (JAG DOPS) scale. Secondary outcome measures included differences in procedural knowledge, immediate post-training simulation performance, and delayed post-training (4-6 weeks) performance during an integrated scenario test on the JAG DOPS communication and integrated scenario global rating scales. There was no significant difference in baseline or post-training performance on the simulator task. The SCC group performed superiorly during their first and second clinical colonoscopies. Additionally, the SCC group demonstrated significantly better knowledge and colonoscopy-specific performance, communication, and global performance during the integrated scenario. We were unable to measure SRL participants' effort outside of mandatory training. In addition, feedback metrics and number of available simulation cases are limited. These results support integration of endoscopy simulation into a structured curriculum incorporating instructional feedback and complementary didactic knowledge as a means to augment technical, cognitive, and integrative skills acquisition, as compared with SRL on virtual reality simulators. ( NCT01991522.) Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. [Clinical and communication simulation workshop for fellows in gastroenterology: the trainees' perspective].

    PubMed

    Lang, Alon; Melzer, Ehud; Bar-Meir, Simon; Eliakim, Rami; Ziv, Amitai

    2006-11-01

    The continuing development in computer-based medical simulators provides an ideal platform for simulator-assisted training programs for medical trainees. Computer-based endoscopic simulators provide a virtual reality environment for training endoscopic procedures. This study illustrates the use of a comprehensive training model combining the use of endoscopic simulators with simulated (actor) patients (SP). To evaluate the effectiveness of a comprehensive simulation workshop from the trainee perspective. Four case studies were developed with emphasis on communication skills. Three workshops with 10 fellows in each were conducted. During each workshop the trainees spent half of the time in SP case studies and the remaining half working with computerized endoscopic simulators with continuous guidance by an expert endoscopist. Questionnaires were completed by the fellows at the end of the workshop. Seventy percent of the fellows felt that the endoscopic simulator was close or very close to reality for gastroscopy and 63% for colonoscopy. Eighty eight percent thought the close guidance was important for the learning process with the simulator. Eighty percent felt that the case studies were an important learning experience for risk management. Further evaluation of multi-modality simulation workshops in gastroenterologist training is needed to identify how best to incorporate this form of instruction into training for gastroenterologists.

  6. Design of 3D simulation engine for oilfield safety training

    NASA Astrophysics Data System (ADS)

    Li, Hua-Ming; Kang, Bao-Sheng

    2015-03-01

    Aiming at the demand for rapid custom development of 3D simulation system for oilfield safety training, this paper designs and implements a 3D simulation engine based on script-driven method, multi-layer structure, pre-defined entity objects and high-level tools such as scene editor, script editor, program loader. A scripting language been defined to control the system's progress, events and operating results. Training teacher can use this engine to edit 3D virtual scenes, set the properties of entity objects, define the logic script of task, and produce a 3D simulation training system without any skills of programming. Through expanding entity class, this engine can be quickly applied to other virtual training areas.

  7. Update on simulation-based surgical training and assessment in ophthalmology: a systematic review.

    PubMed

    Thomsen, Ann Sofia S; Subhi, Yousif; Kiilgaard, Jens Folke; la Cour, Morten; Konge, Lars

    2015-06-01

    This study reviews the evidence behind simulation-based surgical training of ophthalmologists to determine (1) the validity of the reported models and (2) the ability to transfer skills to the operating room. Simulation-based training is established widely within ophthalmology, although it often lacks a scientific basis for implementation. We conducted a systematic review of trials involving simulation-based training or assessment of ophthalmic surgical skills among health professionals. The search included 5 databases (PubMed, EMBASE, PsycINFO, Cochrane Library, and Web of Science) and was completed on March 1, 2014. Overall, the included trials were divided into animal, cadaver, inanimate, and virtual-reality models. Risk of bias was assessed using the Cochrane Collaboration's tool. Validity evidence was evaluated using a modern validity framework (Messick's). We screened 1368 reports for eligibility and included 118 trials. The most common surgery simulated was cataract surgery. Most validity trials investigated only 1 or 2 of 5 sources of validity (87%). Only 2 trials (48 participants) investigated transfer of skills to the operating room; 4 trials (65 participants) evaluated the effect of simulation-based training on patient-related outcomes. Because of heterogeneity of the studies, it was not possible to conduct a quantitative analysis. The methodologic rigor of trials investigating simulation-based surgical training in ophthalmology is inadequate. To ensure effective implementation of training models, evidence-based knowledge of validity and efficacy is needed. We provide a useful tool for implementation and evaluation of research in simulation-based training. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  8. Laparoscopic skill improvement after virtual reality simulator training in medical students as assessed by augmented reality simulator.

    PubMed

    Nomura, Tsutomu; Mamada, Yasuhiro; Nakamura, Yoshiharu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Isturo; Mizuguchi, Yoshiaki; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

    2015-11-01

    Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01). Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  9. Implementation and assessment of a curriculum for bedside ultrasound training.

    PubMed

    Turner, Elizabeth E; Fox, J Christian; Rosen, Mark; Allen, Angela; Rosen, Sasha; Anderson, Craig

    2015-05-01

    This study assessed a curriculum for bedside ultrasound (US) and compared outcomes from 2 common training pathways. The program consisted of e-learning paired with expert-led hands-on training administered to pulmonary/critical care and cardiology fellows with no prior formal training in bedside US. This "simulation-based learner" group completed a survey of attitudes and confidence before and after training, and knowledge and skills were assessed after training. The surveys and scores of the simulation-based learners were compared to the scores of "experts," who were US-trained emergency physicians, and "apprentice learners," who were intensivist physicians informally trained in bedside US on the job during fellowships. There was a significant difference in the self-reported level of prior training between the groups (simulation-based learners, 2.8; apprentice learners, 3.7; experts, 4.1, on a scale of 1-5 [P= .02]) but no difference in the interest level or perceived importance of bedside US. The study curriculum was successful, as shown by scores that exceeded the comparison groups in the cardiac and pulmonary courses (cardiac: simulation-based learners, 80%; apprentice learners, 73%; experts, 62% [P= .001]; pulmonary: 84%, 75%, and 72%, respectively [P =.02]). The simulation-based learners gained confidence in skills, whereas the comparison groups lost confidence after testing (P < .005); however, the simulation-based learners gained confidence in US subject areas that were not taught (abdomen [P <.002] and miscellaneous [P =.005]). The simulation-based learner curriculum resulted in comparable or greater knowledge and confidence in each area of US versus the comparison groups. Findings of overgeneralization of confidence highlight the importance of quality assurance and supervision in bedside US training programs. © 2015 by the American Institute of Ultrasound in Medicine.

  10. Infrared imagery acquisition process supporting simulation and real image training

    NASA Astrophysics Data System (ADS)

    O'Connor, John

    2012-05-01

    The increasing use of infrared sensors requires development of advanced infrared training and simulation tools to meet current Warfighter needs. In order to prepare the force, a challenge exists for training and simulation images to be both realistic and consistent with each other to be effective and avoid negative training. The US Army Night Vision and Electronic Sensors Directorate has corrected this deficiency by developing and implementing infrared image collection methods that meet the needs of both real image trainers and real-time simulations. The author presents innovative methods for collection of high-fidelity digital infrared images and the associated equipment and environmental standards. The collected images are the foundation for US Army, and USMC Recognition of Combat Vehicles (ROC-V) real image combat ID training and also support simulations including the Night Vision Image Generator and Synthetic Environment Core. The characteristics, consistency, and quality of these images have contributed to the success of these and other programs. To date, this method has been employed to generate signature sets for over 350 vehicles. The needs of future physics-based simulations will also be met by this data. NVESD's ROC-V image database will support the development of training and simulation capabilities as Warfighter needs evolve.

  11. Helicopter training simulators: Key market factors

    NASA Technical Reports Server (NTRS)

    Mcintosh, John

    1992-01-01

    Simulators will gain an increasingly important role in training helicopter pilots only if the simulators are of sufficient fidelity to provide positive transfer of skills to the aircraft. This must be done within an economic model of return on investment. Although rotor pilot demand is still only a small percentage of overall pilot requirements, it will grow in significance. This presentation described the salient factors influencing the use of helicopter training simulators.

  12. Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial

    PubMed Central

    Tolsgaard, M G; Ringsted, C; Dreisler, E; Nørgaard, L N; Petersen, J H; Madsen, M E; Freiesleben, N L C; Sørensen, J L; Tabor, A

    2015-01-01

    Objective To study the effect of initial simulation-based transvaginal sonography (TVS) training compared with clinical training only, on the clinical performance of residents in obstetrics and gynecology (Ob-Gyn), assessed 2 months into their residency. Methods In a randomized study, new Ob-Gyn residents (n = 33) with no prior ultrasound experience were recruited from three teaching hospitals. Participants were allocated to either simulation-based training followed by clinical training (intervention group; n = 18) or clinical training only (control group; n = 15). The simulation-based training was performed using a virtual-reality TVS simulator until an expert performance level was attained, and was followed by training on a pelvic mannequin. After 2 months of clinical training, one TVS examination was recorded for assessment of each resident's clinical performance (n = 26). Two ultrasound experts blinded to group allocation rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. Results During the 2 months of clinical training, participants in the intervention and control groups completed an average ± SD of 58 ± 41 and 63 ± 47 scans, respectively (P = 0.67). In the subsequent clinical performance test, the intervention group achieved higher OSAUS scores than did the control group (mean score, 59.1% vs 37.6%, respectively; P < 0.001). A greater proportion of the intervention group passed a pre-established pass/fail level than did controls (85.7% vs 8.3%, respectively; P < 0.001). Conclusion Simulation-based ultrasound training leads to substantial improvement in clinical performance that is sustained after 2 months of clinical training. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. PMID:25580809

  13. 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.

  14. [Impact of simulation to reduce neonatal and maternal morbidity of shoulder dystocia].

    PubMed

    Legendre, G; Bouet, P-E; Sentilhes, L

    2015-12-01

    To assess the role of simulation in reducing morbidity and mortality of shoulder dystocia. A systematic literature review was conducted in the Medline database. Regarding the prevention of complications of shoulder dystocia, practical training using mannequin is associated with improvements in management shoulder dystocia than training using video tutorial (EL2). Practical training using simulation for shoulder dystocia allows an improvement for manoeuvres mainly for trainees, but simulation seems to benefit to all caregivers for the communication (EL3). The effect of training sessions using simulation for learning writing the medical observation allows only a modest improvement in the medical record transcription (EL3). The interest of a specific grid for reporting shoulder dystocia seems interesting to increase the amount of information transcribed by the caregiver (EL3). The establishment of a practical training using simulation and concerning all caregivers of the delivery room is associated with a significant reduction in neonatal injury (EL3). The establishment of a training program using simulation does not seem to decrease maternal morbidity in case of shoulder dystocia (EL3). A teaching using simulation for the management of shoulder dystocia is encouraged for the initial and continuing formation of different actors in the delivery room (professional agreement). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Retention of Vaginal Breech Delivery Skills Taught in Simulation.

    PubMed

    Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

    2018-02-01

    The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P <0.001; senior, P <0.001) and the delayed post-training assessment (P <0.001 and P = 0.001, respectively). There was a significant decline in skills between the immediate and delayed post-training sessions for junior and senior residents (P = 0.003 and P <0.001, respectively). Both junior and senior residents gained more comfort immediately after the training (P <0.001 and P <0.001, respectively), without a significant change between immediate post-training and delayed post-training comfort levels (P = 0.19 and P = 0.11, respectively). Residents retained vaginal breech delivery skills taught in simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  16. Implementation of laparoscopic virtual-reality simulation training in gynaecology: a mixed-methods design.

    PubMed

    Burden, Christy; Appleyard, Tracy-Louise; Angouri, Jo; Draycott, Timothy J; McDermott, Leanne; Fox, Robert

    2013-10-01

    Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational challenge. We undertook a pilot study to assess the feasibility of the implementation of a laparoscopic VR simulation programme into a single unit. An observational study with qualitative analysis of semi-structured group interviews. Trainees in gynaecology (n=9) were scheduled to undertake a pre-validated structured training programme on a laparoscopic VR simulator (LapSim(®)) over six months. The main outcome measure was the trainees' progress through the training modules in six months. Trainees' perceptions of the feasibility and barriers to the implementation of laparoscopic VR training were assessed in focus groups after training. Sixty-six percent of participants completed six of ten modules. Overall, feedback from the focus groups was positive; trainees felt training improved their dexterity, hand-eye co-ordination and confidence in theatre. Negative aspects included lack of haptic feedback, and facility for laparoscopic port placement training. Time restriction emerged as the main barrier to training. Despite positive perceptions of training, no trainee completed more than two-thirds of the modules of a self-directed laparoscopic VR training programme. Suggested improvements to the integration of future laparoscopic VR training include an additional theoretical component with a fuller understanding of benefits of VR training, and scheduled supervision. Ultimately, the success of a laparoscopic VR simulation training programme might only be improved if it is a mandatory component of the curriculum, together with dedicated time for training. Future multi-centred implementation studies of validated laparoscopic VR curricula are required. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Variability in the Use of Simulation for Procedural Training in Radiology Residency: Opportunities for Improvement.

    PubMed

    Matalon, Shanna A; Chikarmane, Sona A; Yeh, Eren D; Smith, Stacy E; Mayo-Smith, William W; Giess, Catherine S

    2018-03-19

    Increased attention to quality and safety has led to a re-evaluation of the classic apprenticeship model for procedural training. Many have proposed simulation as a supplementary teaching tool. The purpose of this study was to assess radiology resident exposure to procedural training and procedural simulation. An IRB-exempt online survey was distributed to current radiology residents in the United States by e-mail. Survey results were summarized using frequency and percentages. Chi-square tests were used for statistical analysis where appropriate. A total of 353 current residents completed the survey. 37% (n = 129/353) of respondents had never used procedure simulation. Of the residents who had used simulation, most did not do so until after having already performed procedures on patients (59%, n = 132/223). The presence of a dedicated simulation center was reported by over half of residents (56%, n = 196/353) and was associated with prior simulation experience (P = 0.007). Residents who had not had procedural simulation were somewhat likely or highly likely (3 and 4 on a 4-point Likert-scale) to participate if it were available (81%, n = 104/129). Simulation training was associated with higher comfort levels in performing procedures (P < 0.001). Although procedural simulation training is associated with higher comfort levels when performing procedures, there is variable use in radiology resident training and its use is not currently optimized. Given the increased emphasis on patient safety, these results suggest the need to increase procedural simulation use during residency, including an earlier introduction to simulation before patient exposure. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Surgical simulation training in orthopedics: current insights.

    PubMed

    Kalun, Portia; Wagner, Natalie; Yan, James; Nousiainen, Markku T; Sonnadara, Ranil R

    2018-01-01

    While the knowledge required of residents training in orthopedic surgery continues to increase, various factors, including reductions in work hours, have resulted in decreased clinical learning opportunities. Recent work suggests residents graduate from their training programs without sufficient exposure to key procedures. In response, simulation is increasingly being incorporated into training programs to supplement clinical learning. This paper reviews the literature to explore whether skills learned in simulation-based settings results in improved clinical performance in orthopedic surgery trainees. A scoping review of the literature was conducted to identify papers discussing simulation training in orthopedic surgery. We focused on exploring whether skills learned in simulation transferred effectively to a clinical setting. Experimental studies, systematic reviews, and narrative reviews were included. A total of 15 studies were included, with 11 review papers and four experimental studies. The review articles reported little evidence regarding the transfer of skills from simulation to the clinical setting, strong evidence that simulator models discriminate among different levels of experience, varied outcome measures among studies, and a need to define competent performance in both simulated and clinical settings. Furthermore, while three out of the four experimental studies demonstrated transfer between the simulated and clinical environments, methodological study design issues were identified. Our review identifies weak evidence as to whether skills learned in simulation transfer effectively to clinical practice for orthopedic surgery trainees. Given the increased reliance on simulation, there is an immediate need for comprehensive studies that focus on skill transfer, which will allow simulation to be incorporated effectively into orthopedic surgery training programs.

  19. Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

    ERIC Educational Resources Information Center

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-01-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

  20. Effect of Training in Rational Decision Making on the Quality of Simulated Career Decisions.

    ERIC Educational Resources Information Center

    Krumboltz, John D.; And Others

    1982-01-01

    Determined if training in rational decision making improves the quality of simulated career decisions. Training in rational decision making resulted in superior performance for females on one subscore of the knowledge measure. It also resulted in superior simulated career choices by females and younger males. (Author)

  1. Data-driven train set crash dynamics simulation

    NASA Astrophysics Data System (ADS)

    Tang, Zhao; Zhu, Yunrui; Nie, Yinyu; Guo, Shihui; Liu, Fengjia; Chang, Jian; Zhang, Jianjun

    2017-02-01

    Traditional finite element (FE) methods are arguably expensive in computation/simulation of the train crash. High computational cost limits their direct applications in investigating dynamic behaviours of an entire train set for crashworthiness design and structural optimisation. On the contrary, multi-body modelling is widely used because of its low computational cost with the trade-off in accuracy. In this study, a data-driven train crash modelling method is proposed to improve the performance of a multi-body dynamics simulation of train set crash without increasing the computational burden. This is achieved by the parallel random forest algorithm, which is a machine learning approach that extracts useful patterns of force-displacement curves and predicts a force-displacement relation in a given collision condition from a collection of offline FE simulation data on various collision conditions, namely different crash velocities in our analysis. Using the FE simulation results as a benchmark, we compared our method with traditional multi-body modelling methods and the result shows that our data-driven method improves the accuracy over traditional multi-body models in train crash simulation and runs at the same level of efficiency.

  2. Simulation training in video-assisted urologic surgery.

    PubMed

    Hoznek, András; Salomon, Laurent; de la Taille, Alexandre; Yiou, René; Vordos, Dimitrios; Larre, Stéphane; Abbou, Clément-Claude

    2006-03-01

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

  3. Training Implications of the Tactical Aircraft Recapitalization

    DTIC Science & Technology

    2008-06-13

    and Wayne L. Waag , The Use of Simulators for Training In-Flight and Emergency Procedures in AGARD-AG-248 (Neuilly-Sur-Seine, France: Advisory Group...11 Edward E. Eddowes and Wayne L. Waag , The Use of Simulators for Training In-Flight and Emergency Procedures in AGARD-AG-248 (Neuilly-Sur...17 Edward E. Eddowes and Wayne L. Waag , The Use of Simulators for Training In-Flight and Emergency Procedures in AGARD-AG-248 (Neuilly-Sur-Seine

  4. Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology.

    PubMed

    Brewin, James; Tang, Jessica; Dasgupta, Prokar; Khan, Muhammad S; Ahmed, Kamran; Bello, Fernando; Kneebone, Roger; Jaye, Peter

    2015-07-01

    To evaluate the face, content and construct validity of the distributed simulation (DS) environment for technical and non-technical skills training in endourology. To evaluate the educational impact of DS for urology training. DS offers a portable, low-cost simulated operating room environment that can be set up in any open space. A prospective mixed methods design using established validation methodology was conducted in this simulated environment with 10 experienced and 10 trainee urologists. All participants performed a simulated prostate resection in the DS environment. Outcome measures included surveys to evaluate the DS, as well as comparative analyses of experienced and trainee urologist's performance using real-time and 'blinded' video analysis and validated performance metrics. Non-parametric statistical methods were used to compare differences between groups. The DS environment demonstrated face, content and construct validity for both non-technical and technical skills. Kirkpatrick level 1 evidence for the educational impact of the DS environment was shown. Further studies are needed to evaluate the effect of simulated operating room training on real operating room performance. This study has shown the validity of the DS environment for non-technical, as well as technical skills training. DS-based simulation appears to be a valuable addition to traditional classroom-based simulation training. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

  5. Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

    PubMed

    Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

    2016-11-01

    To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P < .008), and tested performance (P < .043) after the addition of simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Assessment potential of a new suture simulator in laparoscopic surgical skills training.

    PubMed

    Takeoka, Tomohira; Takiguchi, Shuji; Uemura, Munenori; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Kurokawa, Yukinori; Makino, Tomoki; Yamasaki, Makoto; Mori, Masaki; Yuichiro Doki, And

    2017-12-01

    The skills necessary for performing effective laparoscopic suturing are difficult to acquire; as a result, simulators for learning these skills are rapidly becoming integrated into surgical training. The aim of the study was to verify whether a new hybrid simulator has the potential to measure skill improvement in young, less experienced gastroenterological surgeons. The study included 12 surgeons (median age, 29 (27-38)] years; 11 men (91.7%), one woman (8.3%)) who participated in a two-day laparoscopic training seminar. We used the new simulator before and after the program to evaluate individual performance. Skills were evaluated using five criteria: volume of air pressure leakage, number of full-thickness sutures, suture tension, wound area, and performance time. Air pressure leakage was significantly higher after than before the training (p = .027). The number of full-thickness sutures was significantly higher post-training (p < .01). Suture tension was significantly less post-training (p = .011). Wound opening areas were significantly smaller post-training (p = .018). Performance time was significantly shorter post-training (p = .032). Our study demonstrated the assessment quality of this new laparoscopic suture simulator.

  7. Intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care: a descriptive qualitative study.

    PubMed

    Ballangrud, Randi; Hall-Lord, Marie Louise; Persenius, Mona; Hedelin, Birgitta

    2014-08-01

    To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. The study uses a qualitative descriptive design. Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. A Comparison of the Perceptual and Technical Demands of Tennis Training, Simulated Match Play, and Competitive Tournaments.

    PubMed

    Murphy, Alistair P; Duffield, Rob; Kellett, Aaron; Reid, Machar

    2016-01-01

    High-performance tennis environments aim to prepare athletes for competitive demands through simulated-match scenarios and drills. With a dearth of direct comparisons between training and tournament demands, the current investigation compared the perceptual and technical characteristics of training drills, simulated match play, and tournament matches. Data were collected from 18 high-performance junior tennis players (gender: 10 male, 8 female; age 16 ± 1.1 y) during 6 ± 2 drill-based training sessions, 5 ± 2 simulated match-play sessions, and 5 ± 3 tournament matches from each participant. Tournament matches were further distinguished by win or loss and against seeded or nonseeded opponents. Notational analysis of stroke and error rates, winners, and serves, along with rating of perceived physical exertion (RPE) and mental exertion was measured postsession. Repeated-measures analyses of variance and effect-size analysis revealed that training sessions were significantly shorter in duration than tournament matches (P < .05, d = 1.18). RPEs during training and simulated match-play sessions were lower than in tournaments (P > .05; d = 1.26, d = 1.05, respectively). Mental exertion in training was lower than in both simulated match play and tournaments (P > .05; d = 1.10, d = 0.86, respectively). Stroke rates during tournaments exceeded those observed in training (P < .05, d = 3.41) and simulated-match-play (P < .05, d = 1.22) sessions. Furthermore, the serve was used more during tournaments than simulated match play (P < .05, d = 4.28), while errors and winners were similar independent of setting (P > .05, d < 0.80). Training in the form of drills or simulated match play appeared to inadequately replicate tournament demands in this cohort of players. Coaches should be mindful of match demands to best prescribe sessions of relevant duration, as well as internal (RPE) and technical (stroke rate) load, to aid tournament preparation.

  9. Virtual reality training in neurosurgery: Review of current status and future applications

    PubMed Central

    Alaraj, Ali; Lemole, Michael G.; Finkle, Joshua H.; Yudkowsky, Rachel; Wallace, Adam; Luciano, Cristian; Banerjee, P. Pat; Rizzi, Silvio H.; Charbel, Fady T.

    2011-01-01

    Background: Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced virtual reality (VR) simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. Methods: A PubMed review of the literature was performed for the MESH words “Virtual reality, “Augmented Reality”, “Simulation”, “Training”, and “Neurosurgery”. Relevant articles were retrieved and reviewed. A review of the literature was performed for the history, current status of VR simulation in neurosurgery. Results: Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and credential surgeons as technically competent. The number of published literature discussing the application of VR simulation in neurosurgery training has evolved over the last decade from data visualization, including stereoscopic evaluation to more complex augmented reality models. With the revolution of computational analysis abilities, fully immersive VR models are currently available in neurosurgery training. Ventriculostomy catheters insertion, endoscopic and endovascular simulations are used in neurosurgical residency training centers across the world. Recent studies have shown the coloration of proficiency with those simulators and levels of experience in the real world. Conclusion: Fully immersive technology is starting to be applied to the practice of neurosurgery. In the near future, detailed VR neurosurgical modules will evolve to be an essential part of the curriculum of the training of neurosurgeons. PMID:21697968

  10. AFHRL/FT [Air Force Human Resources Laboratory/Flight Training] Capabilities in Undergraduate Pilot Training Simulation Research: Executive Summary.

    ERIC Educational Resources Information Center

    Matheny, W. G.; And Others

    The document presents a summary description of the Air Force Human Resource Laboratory's Flying Training Division (AFHRL/FT) research capabilities for undergraduate pilot training. One of the research devices investigated is the Advanced Simulator for Undergraduate Pilot Training (ASUPT). The equipment includes the ASUPT, the instrumented T-37…

  11. Training Effectiveness Evaluation (TEE) of the Advanced Fire Fighting Training System. Focus on the Trained Person.

    ERIC Educational Resources Information Center

    Cordell, Curtis C.; And Others

    A training effectiveness evaluation of the Navy Advanced Fire Fighting Training System was conducted. This system incorporates simulated fires as well as curriculum materials and instruction. The fires are non-pollutant, computer controlled, and installed in a simulated shipboard environment. Two teams of 15 to 16 persons, with varying amounts of…

  12. [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.

  13. Student peer teaching in paediatric simulation training is a feasible low-cost alternative for education.

    PubMed

    Wagner, Michael; Mileder, Lukas P; Goeral, Katharina; Klebermass-Schrehof, Katrin; Cardona, Francesco S; Berger, Angelika; Schmölzer, Georg M; Olischar, Monika

    2017-06-01

    The World Health Organization recommends regular simulation training to prevent adverse healthcare events. We used specially trained medical students to provide paediatric simulation training to their peers and assessed feasibility, cost and confidence of students who attended the courses. Students at the Medical University of Vienna, Austria were eligible to participate. Students attended two high-fidelity simulation training sessions, delivered by peers, which were videorecorded for evaluation. The attendees then completed questionnaires before and after the training. Associated costs and potential benefits were analysed. From May 2013 to June 2015, 152 students attended the sessions and 57 (37.5%) completed both questionnaires. Satisfaction was high, with 95% stating their peer tutor was competent and 90% saying that peer tutors were well prepared. The attendees' confidence in treating critically ill children significantly improved after training (p < 0.001). The average costs for a peer tutor were six Euros per working hour, compared to 35 Euros for a physician. Using peer tutors for paediatric simulation training was a feasible and low-cost option that increased the number of medical students who could be trained and increased the self-confidence of the attendees. Satisfaction with the peer tutors was high. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills.

    PubMed

    van Dongen, Koen W; Ahlberg, Gunnar; Bonavina, Luigi; Carter, Fiona J; Grantcharov, Teodor P; Hyltander, Anders; Schijven, Marlies P; Stefani, Alessandro; van der Zee, David C; Broeders, Ivo A M J

    2011-01-01

    Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was to establish consensus on exercise configurations and on a validated training program for a virtual reality simulator, based on the experience of international experts to set criterion levels to construct a proficiency-based training program. A consensus meeting was held with eight European teams, all extensively experienced in using the VR simulator. Construct validity of the training program was tested by 20 experts and 60 novices. The data were analyzed by using the t test for equality of means. Consensus was achieved on training designs, exercise configuration, and examination. Almost all exercises (7/8) showed construct validity. In total, 50 of 94 parameters (53%) showed significant difference. A European, multicenter, validated, training program was constructed according to the general consensus of a large international team with extended experience in virtual reality simulation. Therefore, a proficiency-based training program can be offered to training centers that use this simulator for training in basic psychomotor skills in endoscopic surgery.

  15. [Educational usefulness of lung auscultation training with an auscultation simulator].

    PubMed

    Arimura, Yasuji; Komatsu, Hiroyuki; Yanagi, Shigehisa; Matsumoto, Nobuhiro; Okayama, Akihiko; Hayashi, Katsuhiro; Nakazato, Masamitsu

    2011-06-01

    We examined the educational usefulness of lung auscultation training with an auscultation simulator "Mr. Lung". Auscultation training was conducted for fifth-year students of the Medical Department of the University of Miyazaki, and consisted of a lecture by a pulmonologist (Board Certified Member of the Japanese Respiratory Society) and skill training using Mr. Lung for a total of 90 min. We compared the percentages of students who correctly identified 4 adventitious sounds before and after training. We also investigated the responses to a self-report questionnaire on self-evaluation after training, auscultation experiences before training, and opinions regarding medical education with the simulator. The subjects' correct answer rate before training was 40% or less and that for the correct identification of rhonchi was the lowest (5%). The correct answer rate, which was not influenced by previous experience of auscultation, significantly increased after training (80% or more). In the self-report questionnaire, about 90% of the students answered that the ability to identify lung sounds by auscultation was necessary for all doctors and that the simulator was effective for acquiring this skill. The auscultation simulator may be useful for medical students not only to enhance auscultatory skills but also to realize the importance of auscultation in clinical examination.

  16. Cattle Uterus: A Novel Animal Laboratory Model for Advanced Hysteroscopic Surgery Training

    PubMed Central

    Ewies, Ayman A. A.; Khan, Zahid R.

    2015-01-01

    In recent years, due to reduced training opportunities, the major shift in surgical training is towards the use of simulation and animal laboratories. Despite the merits of Virtual Reality Simulators, they are far from representing the real challenges encountered in theatres. We introduce the “Cattle Uterus Model” in the hope that it will be adopted in training courses as a low cost and easy-to-set-up tool. It adds new dimensions to the advanced hysteroscopic surgery training experience by providing tactile sensation and simulating intraoperative difficulties. It complements conventional surgical training, aiming to maximise clinical exposure and minimise patients' harm. PMID:26265918

  17. A development of surgical simulator for training of operative skills using patient-specific data.

    PubMed

    Ogata, Masato; Nagasaka, Manabu; Inuiya, Toru; Makiyama, Kazuhide; Kubota, Yoshinobu

    2011-01-01

    At the Advanced Medical Research Center at Yokohama City University School of Medicine, we have been developing a practical surgical simulator for renal surgery. Unlike already commercialized laparoscopic surgical simulators, our surgical simulator is capable of using patient-specific models for preoperative training and improvement of laparoscopic surgical skills. We have been evaluating the simulator clinically with the aim of using it in renal surgery training at Yokohama City University Hospital. The simulator can be applied to other types of laparoscopic surgery, such as gynecological, thoracic, and gastrointestinal. Here, we report on the technical aspects of the simulator.

  18. 14 CFR Appendix H to Part 121 - Advanced Simulation

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Advanced Simulation H Appendix H to Part... Simulation This appendix provides guidelines and a means for achieving flightcrew training in advanced... simulator, as appropriate. Advanced Simulation Training Program For an operator to conduct Level C or D...

  19. 14 CFR Appendix H to Part 121 - Advanced Simulation

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Advanced Simulation H Appendix H to Part... Simulation This appendix provides guidelines and a means for achieving flightcrew training in advanced... simulator, as appropriate. Advanced Simulation Training Program For an operator to conduct Level C or D...

  20. 14 CFR Appendix H to Part 121 - Advanced Simulation

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Advanced Simulation H Appendix H to Part... Simulation This appendix provides guidelines and a means for achieving flightcrew training in advanced... simulator, as appropriate. Advanced Simulation Training Program For an operator to conduct Level C or D...

  1. Procedural training and assessment of competency utilizing simulation.

    PubMed

    Sawyer, Taylor; Gray, Megan M

    2016-11-01

    This review examines the current environment of neonatal procedural learning, describes an updated model of skills training, defines the role of simulation in assessing competency, and discusses potential future directions for simulation-based competency assessment. In order to maximize impact, simulation-based procedural training programs should follow a standardized and evidence-based approach to designing and evaluating educational activities. Simulation can be used to facilitate the evaluation of competency, but must incorporate validated assessment tools to ensure quality and consistency. True competency evaluation cannot be accomplished with simulation alone: competency assessment must also include evaluations of procedural skill during actual clinical care. Future work in this area is needed to measure and track clinically meaningful patient outcomes resulting from simulation-based training, examine the use of simulation to assist physicians undergoing re-entry to practice, and to examine the use of procedural skills simulation as part of a maintenance of competency and life-long learning. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Efficacy of Surgical Simulation Training in a Low-Income Country.

    PubMed

    Tansley, Gavin; Bailey, Jonathan G; Gu, Yuqi; Murray, Michelle; Livingston, Patricia; Georges, Ntakiyiruta; Hoogerboord, Marius

    2016-11-01

    Simulation training has evolved as an important component of postgraduate surgical education and has shown to be effective in teaching procedural skills. Despite potential benefits to low- and middle-income countries (LMIC), simulation training is predominately used in high-income settings. This study evaluates the effectiveness of simulation training in one LMIC (Rwanda). Twenty-six postgraduate surgical trainees at the University of Rwanda (Kigali, Rwanda) and Dalhousie University (Halifax, Canada) participated in the study. Participants attended one 3-hour simulation session using a high-fidelity, tissue-based model simulating the creation of an end ileostomy. Each participant was anonymously recorded completing the assigned task at three time points: prior to, immediately following, and 90 days following the simulation training. A single blinded expert reviewer assessed the performance using the Objective Structured Assessment of Technical Skill (OSATS) instrument. The mean OSATS score improvement for participants who completed all the assessments was 6.1 points [95 % Confidence Interval (CI) 2.2-9.9, p = 0.005]. Improvement was sustained over a 90-day period with a mean improvement of 4.1 points between the first and third attempts (95 % CI 0.3-7.9, p = 0.038). Simulation training was effective in both study sites, though most gains occurred with junior-level learners, with a mean improvement of 8.3 points (95 % CI 5.1-11.6, p < 0.001). Significant improvements were not identified for senior-level learners. This study supports the benefit for simulation in surgical training in LMICs. Skill improvements were limited to junior-level trainees. This work provides justification for investment in simulation-based curricula in Rwanda and potentially other LMICs.

  3. Using the mind as a simulator: a randomized controlled trial of mental training.

    PubMed

    Eldred-Evans, David; Grange, Philippe; Cheang, Adrian; Yamamoto, Hidekazu; Ayis, Salma; Mulla, Mubashir; Immenroth, Marc; Sharma, Davendra; Reedy, Gabriel

    2013-01-01

    Laparoscopic simulators have been introduced as safe and effective methods of developing basic skills. Mental training is a novel training method likened to using the mind as a simulator to mentally rehearse the movements of a task or operation. It is widely used by professional athletes and musicians and has been suggested as a technique that could be used by surgical trainees. The purpose of this study was to assess the use of mental training in developing basic laparoscopic skills in novices. Sixty-four medical students without laparoscopic experience were randomized into 4 groups. The first 3 groups were trained to cut a circle on a box trainer. Group 1 received no additional training (BT), Group 2 received additional virtual reality training (BT + VRS), and Group 3 received additional mental training (BT + MT). The fourth group was trained on a virtual reality simulator with additional mental training (box-free). The following 4 assessment criterias: time, accuracy, precision and overall performance were measured on both the box-trainer and virtual simulator. The mental training group (BT + MT) demonstrated improved laparoscopic skills over both assessments. The improvement in skills in the VRS group (BT + VRS) was limited to VRS assessment and not observed in the box assessment. The fourth group (box-free) had the worst performance on both methods of assessment. The addition of mental training led to improved laparoscopic skills development. It is a flexible technique and has the potential to challenge VRS as a more cost-effective training method associated with lower capital investment. Given the benefits of mental training with further research, it could be considered for inclusion in training curricula. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Integration of laparoscopic virtual-reality simulation into gynaecology training.

    PubMed

    Burden, C; Oestergaard, J; Larsen, C R

    2011-11-01

    Surgery carries the risk of serious harm, as well as benefit, to patients. For healthcare organisations, theatre time is an expensive commodity and litigation costs for surgical specialities are very high. Advanced laparoscopic surgery, now widely used in gynaecology for improved outcomes and reduced length of stay, involves longer operation times and a higher rate of complications for surgeons in training. Virtual-reality (VR) simulation is a relatively new training method that has the potential to promote surgical skill development before advancing to surgery on patients themselves. VR simulators have now been on the market for more than 10 years and, yet, few countries in the world have fully integrated VR simulation training into their gynaecology surgical training programmes. In this review, we aim to summarise the VR simulators currently available together with evidence of their effectiveness in gynaecology, to understand their limitations and to discuss their incorporation into national training curricula. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  5. Training and certification in endobronchial ultrasound-guided transbronchial needle aspiration

    PubMed Central

    Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost

    2017-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) plays a key role in the staging of lung cancer, which is crucial for allocation to surgical treatment. EBUS-TBNA is a complicated procedure and simulation-based training is helpful in the first part of the long learning curve prior to performing the procedure on actual patients. New trainees should follow a structured training programme consisting of training on simulators to proficiency as assessed with a validated test followed by supervised practice on patients. The simulation-based training is superior to the traditional apprenticeship model and is recommended in the newest guidelines. EBUS-TBNA and oesophageal ultrasound-guided fine needle aspiration (EUS-FNA or EUS-B-FNA) are complementary to each other and the combined techniques are superior to either technique alone. It is logical to learn and to perform the two techniques in combination, however, for lung cancer staging solely EBUS-TBNA simulators exist, but hopefully in the future simulation-based training in EUS will be possible. PMID:28840013

  6. Desktop-based computer-assisted orthopedic training system for spinal surgery.

    PubMed

    Rambani, Rohit; Ward, James; Viant, Warren

    2014-01-01

    Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery. To develop a training system for pedicle screw fixation and validate its effectiveness in a cohort of junior orthopedic trainees. Fully simulated computer-navigated training system is used to train junior orthopedic trainees perform pedicle screw insertion in the lumbar spine. Real patient computed tomography scans are used to produce the real-time fluoroscopic images of the lumbar spine. The training system was developed to simulate pedicle screw insertion in the lumbar spine. A total of 12 orthopedic senior house officers performed pedicle screw insertion in the lumbar spine before and after the training on training system. The results were assessed based on the scoring system, which included the amount of time taken, accuracy of pedicle screw insertion, and the number of exposures requested to complete the procedure. The result shows a significant improvement in amount of time taken, accuracy of fixation, and the number of exposures after the training on simulator system. This was statistically significant using paired Student t test (p < 0.05). Fully simulated computer-navigated training system is an efficient training tool for young orthopedic trainees. This system can be used to augment training in the operating room, and trainees acquire their skills in the comfort of their study room or in the training room in the hospital. The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Air traffic control in airline pilot simulator training and evaluation

    DOT National Transportation Integrated Search

    2001-01-01

    Much airline pilot training and checking occurs entirely in the simulator, and the first time a pilot flies a particular airplane, it may carry passengers. Simulator qualification standards, however, focus on the simulation of the airplane without re...

  8. Effects of training and simulated combat stress on leg tourniquet application accuracy, time, and effectiveness.

    PubMed

    Schreckengaust, Richard; Littlejohn, Lanny; Zarow, Gregory J

    2014-02-01

    The lower extremity tourniquet failure rate remains significantly higher in combat than in preclinical testing, so we hypothesized that tourniquet placement accuracy, speed, and effectiveness would improve during training and decline during simulated combat. Navy Hospital Corpsman (N = 89), enrolled in a Tactical Combat Casualty Care training course in preparation for deployment, applied Combat Application Tourniquet (CAT) and the Special Operations Forces Tactical Tourniquet (SOFT-T) on day 1 and day 4 of classroom training, then under simulated combat, wherein participants ran an obstacle course to apply a tourniquet while wearing full body armor and avoiding simulated small arms fire (paint balls). Application time and pulse elimination effectiveness improved day 1 to day 4 (p < 0.005). Under simulated combat, application time slowed significantly (p < 0.001), whereas accuracy and effectiveness declined slightly. Pulse elimination was poor for CAT (25% failure) and SOFT-T (60% failure) even in classroom conditions following training. CAT was more quickly applied (p < 0.005) and more effective (p < 0.002) than SOFT-T. Training fostered fast and effective application of leg tourniquets while performance declined under simulated combat. The inherent efficacy of tourniquet products contributes to high failure rates under combat conditions, pointing to the need for superior tourniquets and for rigorous deployment preparation training in simulated combat scenarios. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  9. Surgical simulation: Current practices and future perspectives for technical skills training.

    PubMed

    Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

    2018-06-17

    Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

  10. Payload IVA training and simulation

    NASA Technical Reports Server (NTRS)

    Monsees, J. H.

    1982-01-01

    The development of a training program for the intravehicular operation of space shuttle payloads is discussed. The priorities for the program are compliance with established training standards, and accommodating changes. Simulation devices are also reviewed.

  11. 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

  12. Current state of virtual reality simulation in robotic surgery training: a review.

    PubMed

    Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

    2016-06-01

    Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

  13. Flight Hour Reductions in Fleet Replacement Pilot Training through Simulation.

    ERIC Educational Resources Information Center

    Smode, Alfred F.

    A project was undertaken to integrate the 2F87F operational flight trainer into the program for training replacement patrol plane pilots. The objectives were to determine the potential of the simulator as a substitute environment for learning aircraft tasks and to effectively utilize the simulator in pilot training. The students involved in the…

  14. 14 CFR 121.424 - Pilots: Initial, transition, and upgrade flight training.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... initial flight training that are capable of being performed in an airplane simulator without a visual system; and (ii) A flight check in the simulator or the airplane to the level of proficiency of a pilot... training required by § 121.423 must be performed in a Level C or higher full flight simulator unless the...

  15. Training effectiveness assessment: Where are we?

    NASA Technical Reports Server (NTRS)

    Mcgowan, Greg

    1992-01-01

    Over 9,000 pilot training courses have been conducted at FSI using the Bell 222 and Sikorsky S-76 simulators. Through the use of FAA exemptions, these simulators can be used for certain training and checking credit. The history of the development and use of commercial helicopter simulators and the opportunities for their increased utilization and use were explored.

  16. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    ERIC Educational Resources Information Center

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  17. Effects of a Reading Strategy Training Aimed at Improving Mental Simulation in Primary School Children

    ERIC Educational Resources Information Center

    de Koning, Björn B.; Bos, Lisanne T.; Wassenburg, Stephanie I.; van der Schoot, Menno

    2017-01-01

    This study investigated the effects of a mental simulation training targeted at improving children's reading comprehension. In a 4-week period, one group of third and fourth graders (n = 75) learned to draw upon their sensorimotor memories and experiences to mentally simulate text (experimental training group), whereas another group (n = 51)…

  18. Simulation-based transthoracic echocardiography: “An anesthesiologist's perspective”

    PubMed Central

    Magoon, Rohan; Sharma, Amita; Ladha, Suruchi; Kapoor, Poonam Malhotra; Hasija, Suruchi

    2016-01-01

    With the growing requirement of echocardiography in the perioperative management, the anesthesiologists need to be well trained in transthoracic echocardiography (TTE). Lack of formal, structured teaching program precludes the same. The present article reviews the expanding domain of TTE, simulation-based TTE training, the advancements, current limitations, and the importance of simulation-based training for the anesthesiologists. PMID:27397457

  19. Flight Simulator Platform Motion and Air Transport Pilot Training

    NASA Technical Reports Server (NTRS)

    Lee, Alfred T.; Bussolari, Steven R.

    1989-01-01

    The influence of flight simulator platform motion on pilot training and performance was examined In two studies utilizing a B-727-200 aircraft simulator. The simulator, located at Ames Research Center, Is certified by the FAA for upgrade and transition training in air carrier operations. Subjective ratings and objective performance of experienced B-727 pilots did not reveal any reliable effects of wide variations In platform motion de- sign. Motion platform variations did, however, affect the acquisition of control skill by pilots with no prior heavy aircraft flying experience. The effect was limited to pitch attitude control inputs during the early phase of landing training. Implications for the definition of platform motion requirements in air transport pilot training are discussed.

  20. Virtual agents in a simulated virtual training environment

    NASA Technical Reports Server (NTRS)

    Achorn, Brett; Badler, Norman L.

    1993-01-01

    A drawback to live-action training simulations is the need to gather a large group of participants in order to train a few individuals. One solution to this difficulty is the use of computer-controlled agents in a virtual training environment. This allows a human participant to be replaced by a virtual, or simulated, agent when only limited responses are needed. Each agent possesses a specified set of behaviors and is capable of limited autonomous action in response to its environment or the direction of a human trainee. The paper describes these agents in the context of a simulated hostage rescue training session, involving two human rescuers assisted by three virtual (computer-controlled) agents and opposed by three other virtual agents.

  1. 14 CFR 60.35 - Specific full flight simulator compliance requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... the extent necessary for the training, testing, and/or checking that comprise the simulation portion...

  2. 14 CFR 60.35 - Specific full flight simulator compliance requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... the extent necessary for the training, testing, and/or checking that comprise the simulation portion...

  3. 14 CFR 60.35 - Specific full flight simulator compliance requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... the extent necessary for the training, testing, and/or checking that comprise the simulation portion...

  4. 14 CFR 60.35 - Specific full flight simulator compliance requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... the extent necessary for the training, testing, and/or checking that comprise the simulation portion...

  5. 14 CFR 60.35 - Specific full flight simulator compliance requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... the extent necessary for the training, testing, and/or checking that comprise the simulation portion...

  6. Rasmussen's model of human behavior in laparoscopy training.

    PubMed

    Wentink, M; Stassen, L P S; Alwayn, I; Hosman, R J A W; Stassen, H G

    2003-08-01

    Compared to aviation, where virtual reality (VR) training has been standardized and simulators have proven their benefits, the objectives, needs, and means of VR training in minimally invasive surgery (MIS) still have to be established. The aim of the study presented is to introduce Rasmussen's model of human behavior as a practical framework for the definition of the training objectives, needs, and means in MIS. Rasmussen distinguishes three levels of human behavior: skill-, rule-, and knowledge-based behaviour. The training needs of a laparoscopic novice can be determined by identifying the specific skill-, rule-, and knowledge-based behavior that is required for performing safe laparoscopy. Future objectives of VR laparoscopy trainers should address all three levels of behavior. Although most commercially available simulators for laparoscopy aim at training skill-based behavior, especially the training of knowledge-based behavior during complications in surgery will improve safety levels. However, the cost and complexity of a training means increases when the training objectives proceed from the training of skill-based behavior to the training of complex knowledge-based behavior. In aviation, human behavior models have been used successfully to integrate the training of skill-, rule-, and knowledge-based behavior in a full flight simulator. Understanding surgeon behavior is one of the first steps towards a future full-scale laparoscopy simulator.

  7. Bronchoscopy Simulation Training as a Tool in Medical School Education.

    PubMed

    Gopal, Mallika; Skobodzinski, Alexus A; Sterbling, Helene M; Rao, Sowmya R; LaChapelle, Christopher; Suzuki, Kei; Litle, Virginia R

    2018-07-01

    Procedural simulation training is rare at the medical school level and little is known about its usefulness in improving anatomic understanding and procedural confidence in students. Our aim is to assess the impact of bronchoscopy simulation training on bronchial anatomy knowledge and technical skills in medical students. Medical students were recruited by email, consented, and asked to fill out a survey regarding their baseline experience. Two thoracic surgeons measured their knowledge of bronchoscopy on a virtual reality bronchoscopy simulator using the Bronchoscopy Skills and Tasks Assessment Tool (BSTAT), a validated 65-point checklist (46 for anatomy, 19 for simulation). Students performed four self-directed training sessions of 15 minutes per week. A posttraining survey and BSTAT were completed afterward. Differences between pretraining and posttraining scores were analyzed with paired Student's t tests and random intercept linear regression models accounting for baseline BSTAT score, total training time, and training year. The study was completed by 47 medical students with a mean training time of 81.5 ± 26.8 minutes. Mean total BSTAT score increased significantly from 12.3 ± 5.9 to 48.0 ± 12.9 (p < 0.0001); mean scores for bronchial anatomy increased from 0.1 ± 0.9 to 31.1 ± 12.3 (p < 0.0001); and bronchoscopy navigational skills increased from 12.1 ± 5.7 to 17.4 ± 2.5 (p < 0.0001). Total training time and frequency of training did not have a significant impact on level of improvement. Self-driven bronchoscopy simulation training in medical students led to improvements in bronchial anatomy knowledge and bronchoscopy skills. Further investigation is under way to determine the impact of bronchoscopy simulation training on future specialty interest and long-term skills retention. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

    PubMed

    Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees' motivations and actual attendance rates. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Using gaming simulation to evaluate bioterrorism and emergency readiness education.

    PubMed

    Olson, Debra K; Scheller, Amy; Larson, Susan; Lindeke, Linda; Edwardson, Sandra

    2010-01-01

    We performed an outcome evaluation of the impact of public health preparedness training as a group comparison posttest design to determine the differences in the way individuals who had participated in training performed in a simulated emergency. The Experimental Group 1 included students who had graduated from or were currently enrolled in the bioterrorism and emergency readiness (BT/ER) curriculum at the University of Minnesota School of Public Health. The comparison groups included individuals who had access to the Internet and were aware of the 2006 online simulation Disaster in Franklin County: A Public Health Simulation. The evaluation process employed surveys and the gaming simulation as sources for primary data. Participants in the BT/ER curriculum (p=0.0001) and other participants completing at least 45 hours of training in the past year (p=0.0001) demonstrated higher effectiveness scores (accuracy of chosen responses within the simulation) than participants who did not report significant amounts of training. This evaluation research demonstrated that training is significantly associated with better performance in a simulated emergency using gaming technology.

  10. Wrist Arthroscopy: Can We Gain Proficiency Through Knee Arthroscopy Simulation?

    PubMed

    Ode, Gabriella; Loeffler, Bryan; Chadderdon, Robert Christopher; Haines, Nikkole; Scannell, Brian; Patt, Joshua; Gaston, Glenn

    2018-05-02

    Wrist arthroscopy is a challenging discipline with limited training exposure during residency. The purpose of this study was to evaluate the effectiveness of virtual knee arthroscopy simulation training for gaining proficiency in wrist arthroscopy. Participants were recorded performing a cadaveric wrist arthroscopy simulation. The residents then practiced knee arthroscopy on a virtual reality simulator and repeated the wrist arthroscopy simulation. All videos were blinded prior to assessment. Proficiency was graded using the Arthroscopic Surgery Skill Evaluation Tool global rating scale. In addition, participants were asked to complete a survey assessing the value of the virtual reality knee arthroscopy simulator for wrist arthroscopy. Orthopaedic Surgery Residency Program, Carolinas Medical Center, a large, public, nonprofit hospital located in Charlotte, North Carolina. Orthopaedic residents at our center were asked to participate in the simulation training. Participation was voluntary and nonincentivized. All orthopaedic residents at our institution (N = 27) agreed to participate. In total, there were 10 Intern (PGY-0 and PGY-1), 10 Junior (PGY-2 and PGY-3), and 7 Senior (PGY-4 and PGY-5) residents. In addition, a fellowship-trained hand surgeon was recruited to participate in the study, performing the wrist arthoscopy simulation. Two additional fellowship-trained hand surgeons, for a total of 3, assessed the blinded videos. There was a trend toward better wrist Arthroscopic Surgery Skill Evaluation Tool scores by training level, although the difference was not statistically significant. Interns improved by an average of 1.8 points between baseline and postknee simulation tests. Junior and senior residents decreased by 1.6 and 5.0 points, respectively. Knee arthroscopy simulation training did not objectively improve wrist arthroscopy proficiency among residents. A wrist-specific arthroscopy simulation program is needed if measurable competence through simulation is desired. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Simulators for Mariner Training and Licensing: Guidelines for Deck Officer Training Systems.

    DTIC Science & Technology

    1982-12-01

    Information regarding the three major elements of the training system - the simu- lator design , the training program structure, and the instructor...1.1.2 Empirical Research/ Experimentation Phase ........................................ 1 1.1.3 Major Product...3 3.2 Simulator Design (Critical Characteristics) ......................................... 13 3.2.1 Visual Scee

  12. Aircrew Training Devices: Utility and Utilization of Advanced Instructional Features (Phase IV--Summary Report).

    ERIC Educational Resources Information Center

    Polzella, Donald J.; And Others

    Modern aircrew training devices (ATDs) are equipped with sophisticated hardware and software capabilities, known as advanced instructional features (AIFs), that permit a simulator instructor to prepare briefings, manage training, vary task difficulty/fidelity, monitor performance, and provide feedback for flight simulation training missions. The…

  13. Training Surgical Residents With a Haptic Robotic Central Venous Catheterization Simulator.

    PubMed

    Pepley, David F; Gordon, Adam B; Yovanoff, Mary A; Mirkin, Katelin A; Miller, Scarlett R; Han, David C; Moore, Jason Z

    Ultrasound guided central venous catheterization (CVC) is a common surgical procedure with complication rates ranging from 5 to 21 percent. Training is typically performed using manikins that do not simulate anatomical variations such as obesity and abnormal vessel positioning. The goal of this study was to develop and validate the effectiveness of a new virtual reality and force haptic based simulation platform for CVC of the right internal jugular vein. A CVC simulation platform was developed using a haptic robotic arm, 3D position tracker, and computer visualization. The haptic robotic arm simulated needle insertion force that was based on cadaver experiments. The 3D position tracker was used as a mock ultrasound device with realistic visualization on a computer screen. Upon completion of a practice simulation, performance feedback is given to the user through a graphical user interface including scoring factors based on good CVC practice. The effectiveness of the system was evaluated by training 13 first year surgical residents using the virtual reality haptic based training system over a 3 month period. The participants' performance increased from 52% to 96% on the baseline training scenario, approaching the average score of an expert surgeon: 98%. This also resulted in improvement in positive CVC practices including a 61% decrease between final needle tip position and vein center, a decrease in mean insertion attempts from 1.92 to 1.23, and a 12% increase in time spent aspirating the syringe throughout the procedure. A virtual reality haptic robotic simulator for CVC was successfully developed. Surgical residents training on the simulation improved to near expert levels after three robotic training sessions. This suggests that this system could act as an effective training device for CVC. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. A virtual reality endoscopic simulator augments general surgery resident cancer education as measured by performance improvement.

    PubMed

    White, Ian; Buchberg, Brian; Tsikitis, V Liana; Herzig, Daniel O; Vetto, John T; Lu, Kim C

    2014-06-01

    Colorectal cancer is the second most common cause of death in the USA. The need for screening colonoscopies, and thus adequately trained endoscopists, particularly in rural areas, is on the rise. Recent increases in required endoscopic cases for surgical resident graduation by the Surgery Residency Review Committee (RRC) further emphasize the need for more effective endoscopic training during residency to determine if a virtual reality colonoscopy simulator enhances surgical resident endoscopic education by detecting improvement in colonoscopy skills before and after 6 weeks of formal clinical endoscopic training. We conducted a retrospective review of prospectively collected surgery resident data on an endoscopy simulator. Residents performed four different clinical scenarios on the endoscopic simulator before and after a 6-week endoscopic training course. Data were collected over a 5-year period from 94 different residents performing a total of 795 colonoscopic simulation scenarios. Main outcome measures included time to cecal intubation, "red out" time, and severity of simulated patient discomfort (mild, moderate, severe, extreme) during colonoscopy scenarios. Average time to intubation of the cecum was 6.8 min for those residents who had not undergone endoscopic training versus 4.4 min for those who had undergone endoscopic training (p < 0.001). Residents who could be compared against themselves (pre vs. post-training), cecal intubation times decreased from 7.1 to 4.3 min (p < 0.001). Post-endoscopy rotation residents caused less severe discomfort during simulated colonoscopy than pre-endoscopy rotation residents (4 vs. 10%; p = 0.004). Virtual reality endoscopic simulation is an effective tool for both augmenting surgical resident endoscopy cancer education and measuring improvement in resident performance after formal clinical endoscopic training.

  15. Simulator platform motion requirements for recurrent airline pilot training and evaluation

    DOT National Transportation Integrated Search

    2004-09-30

    This report presents the results of two studies that examined the effect of enhanced hexapod-simulator motion on recurrent evaluation in the simulator, on the course of recurrent training in the simulator, and on "quasi-transfer" of this recurrent tr...

  16. Evaluation of surgical training in the era of simulation

    PubMed Central

    Shaharan, Shazrinizam; Neary, Paul

    2014-01-01

    AIM: To assess where we currently stand in relation to simulator-based training within modern surgical training curricula. METHODS: A systematic literature search was performed in PubMed database using keywords “simulation”, “skills assessment” and “surgery”. The studies retrieved were examined according to the inclusion and exclusion criteria. Time period reviewed was 2000 to 2013. The methodology of skills assessment was examined. RESULTS: Five hundred and fifteen articles focussed upon simulator based skills assessment. Fifty-two articles were identified that dealt with technical skills assessment in general surgery. Five articles assessed open skills, 37 assessed laparoscopic skills, 4 articles assessed both open and laparoscopic skills and 6 assessed endoscopic skills. Only 12 articles were found to be integrating simulators in the surgical training curricula. Observational assessment tools, in the form of Objective Structured Assessment of Technical Skills (OSATS) dominated the literature. CONCLUSION: Observational tools such as OSATS remain the top assessment instrument in surgical training especially in open technical skills. Unlike the aviation industry, simulation based assessment has only now begun to cross the threshold of incorporation into mainstream skills training. Over the next decade we expect the promise of simulator-based training to finally take flight and begin an exciting voyage of discovery for surgical trainees. PMID:25228946

  17. Studying distributed cognition of simulation-based team training with DiCoT.

    PubMed

    Rybing, Jonas; Nilsson, Heléne; Jonson, Carl-Oscar; Bang, Magnus

    2016-03-01

    Health care organizations employ simulation-based team training (SBTT) to improve skill, communication and coordination in a broad range of critical care contexts. Quantitative approaches, such as team performance measurements, are predominantly used to measure SBTTs effectiveness. However, a practical evaluation method that examines how this approach supports cognition and teamwork is missing. We have applied Distributed Cognition for Teamwork (DiCoT), a method for analysing cognition and collaboration aspects of work settings, with the purpose of assessing the methodology's usefulness for evaluating SBTTs. In a case study, we observed and analysed four Emergo Train System® simulation exercises where medical professionals trained emergency response routines. The study suggests that DiCoT is an applicable and learnable tool for determining key distributed cognition attributes of SBTTs that are of importance for the simulation validity of training environments. Moreover, we discuss and exemplify how DiCoT supports design of SBTTs with a focus on transfer and validity characteristics. Practitioner Summary: In this study, we have evaluated a method to assess simulation-based team training environments from a cognitive ergonomics perspective. Using a case study, we analysed Distributed Cognition for Teamwork (DiCoT) by applying it to the Emergo Train System®. We conclude that DiCoT is useful for SBTT evaluation and simulator (re)design.

  18. Simulation and training in Urology - in collaboration with ESU/ESUT.

    PubMed

    Veneziano, Domenico; Cacciamani, Giovanni; Shekhar Biyani, Chandra

    2018-01-01

    Being a Surgeon today means taking on your shoulders countless responsibilities. It is definitely a high-stakes job but, even though the professionals do not go through the intense, focused and demanding training schedule as followed by the other equally risky fields, it doesn't yet require any practical training certification. Simulation was introduced in the aviation field in the early '30s with the "Link Trainer", designed to reproduce the most difficult flying case scenario: landing on an air-carrier. After almost a century, flight simulation is still becoming more sophisticated, while surgical training is slowly starting to fill the gap. The aim of a simulator is to produce an "imitation of the operation of a real-world process or system over time". This short but effective definition explains why simulators are utilised across different fields. There is no doubt that surgeons are continuously undergoing a condition of stress, even in nonthreatening situations, while performing a procedure. This condition adds a relevant variable to surgery, meaning that mastering technical skills is not always equal to "safe surgery". This is why "non-technical skills" (NTS) training should be a part of any simulation based training opportunity and will probably start to be always more part of the Handson Training programs.

  19. Comparison between Simulation-based Training and Lecture-based Education in Teaching Situation Awareness. A Randomized Controlled Study.

    PubMed

    Lee Chang, Alfredo; Dym, Andrew A; Venegas-Borsellino, Carla; Bangar, Maneesha; Kazzi, Massoud; Lisenenkov, Dmitry; Qadir, Nida; Keene, Adam; Eisen, Lewis Ari

    2017-04-01

    Situation awareness has been defined as the perception of the elements in the environment within volumes of time and space, the comprehension of their meaning, and the projection of their status in the near future. Intensivists often make time-sensitive critical decisions, and loss of situation awareness can lead to errors. It has been shown that simulation-based training is superior to lecture-based training for some critical scenarios. Because the methods of training to improve situation awareness have not been well studied in the medical field, we compared the impact of simulation vs. lecture training using the Situation Awareness Global Assessment Technique (SAGAT) score. To identify an effective method for teaching situation awareness. We randomly assigned 17 critical care fellows to simulation vs. lecture training. Training consisted of eight cases on airway management, including topics such as elevated intracranial pressure, difficult airway, arrhythmia, and shock. During the testing scenario, at random times between 4 and 6 minutes into the simulation, the scenario was frozen, and the screens were blanked. Respondents then completed the 28 questions on the SAGAT scale. Sample items were categorized as Perception, Projection, and Comprehension of the situation. Results were analyzed using SPSS Version 21. Eight fellows from the simulation group and nine from the lecture group underwent simulation testing. Sixty-four SAGAT scores were recorded for the simulation group and 48 scores were recorded for the lecture group. The mean simulation vs. lecture group SAGAT score was 64.3 ± 10.1 (SD) vs. 59.7 ± 10.8 (SD) (P = 0.02). There was also a difference in the median Perception ability between the simulation vs. lecture groups (61.1 vs. 55.5, P = 0.01). There was no difference in the median Projection and Comprehension scores between the two groups (50.0 vs. 50.0, P = 0.92, and 83.3 vs. 83.3, P = 0.27). We found a significant, albeit modest, difference between simulation training and lecture training on the total SAGAT score of situation awareness mainly because of the improvement in perception ability. Simulation may be a superior method of teaching situation awareness.

  20. [Simulation-based training in anesthesia and emergency medicine: preparation for the unexpected: on the way to new standards of education in Germany].

    PubMed

    Issleib, Malte; Zöllner, C

    2015-01-01

    Medical expertise consists of knowledge, professional skills and individual attitudes. Training and education of this expertise starts in medical school and develops throughout the qualification process of anesthesists and emergency physicians. Medical decisions are not only rational but also intuitive. The combination of these characteristics cannot and should not be trained on patients. The implementation of modern simulation techniques offers the opportunity to train for emergency situations similar to training systems in the energy industry and aviation. Repetitive training of rare emergency situations brings routine to seldomly used procedures. In simulation training mistakes can be detected and systematically corrected. The team interactions and soft skills can also be focussed on. Video analysis gives the participant the opportunity for self-reflection and can lead to correction of individual behavior patterns. This dimension of education cannot be done in real patient care. This training goes far beyond the level of skills training. Through simulation training involves the whole team, the communication and the interaction between the team members in medically challenging situations. Crisis resource management leads to measurable improvements in patient safety and safety culture as well as personnel satisfaction.

  1. Prospective randomized comparison of standard didactic lecture versus high-fidelity simulation for radiology resident contrast reaction management training.

    PubMed

    Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H

    2011-06-01

    The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.

  2. Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills.

    PubMed

    Rahm, Stefan; Wieser, Karl; Bauer, David E; Waibel, Felix Wa; Meyer, Dominik C; Gerber, Christian; Fucentese, Sandro F

    2018-05-16

    Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator. Twenty residents and five experts in arthroscopy were included. All participants performed a test including knee -and shoulder arthroscopy tasks on a virtual reality knee- and shoulder arthroscopy simulator. The residents had to complete a competency based training program. Thereafter, the previously completed test was retaken. We evaluated the metric data of the simulator using a z-score and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess training effects in residents and performance levels in experts. The residents significantly improved from pre- to post training in the overall z-score: - 9.82 (range, - 20.35 to - 1.64) to - 2.61 (range, - 6.25 to 1.5); p < 0.001. The overall ASSET score improved from 55 (27 to 84) percent to 75 (48 to 92) percent; p < 0.001. The experts, however, achieved a significantly higher z-score in the shoulder tasks (p < 0.001 and a statistically insignificantly higher z-score in the knee tasks with a p = 0.921. The experts mean overall ASSET score (knee and shoulder) was significantly higher in the therapeutic tasks (p < 0.001) compared to the residents post training result. The use of a competency based simulator training with this specific device for 3-5 h is an effective tool to advance basic arthroscopic skills of resident in training from 0 to 5 years based on simulator measures and simulator based ASSET testing. Therefore, we conclude that this sort of training method appears useful to learn the handling of the camera, basic anatomy and the triangulation with instruments.

  3. Scenario Development Process at the Vertical Motion Simulator

    NASA Technical Reports Server (NTRS)

    Reardon, Scott E.; Beard, Steven D.; Lewis, Emily

    2017-01-01

    There has been a significant effort within the simulation community to standardize many aspects of flight simulation. More recently, an effort has begun to develop a formal scenario definition language for aviation. A working group within the AIAA Modeling and Simulation Technical Committee has been created to develop a standard aviation scenario definition language, though much of the initial effort has been tailored to training simulators. Research and development (R&D) simulators, like the Vertical Motion Simulator (VMS), and training simulators have different missions and thus have different scenario requirements. The purpose of this paper is to highlight some of the unique tasks and scenario elements used at the VMS so they may be captured by scenario standardization efforts. The VMS most often performs handling qualities studies and transfer of training studies. Three representative handling qualities simulation studies and two transfer of training simulation studies are described in this paper. Unique scenario elements discussed in this paper included special out-the-window (OTW) targets and environmental conditions, motion system parameters, active inceptor parameters, and configurable vehicle math model parameters.

  4. STS-26 crew trains in JSC fixed-based (FB) shuttle mission simulator (SMS)

    NASA Technical Reports Server (NTRS)

    1987-01-01

    STS-26 Discovery, Orbiter Vehicle (OV) 103, Commander Frederick H. Hauck (left) and Pilot Richard O. Covey train in JSC fixed-based (FB) shuttle mission simulator (SMS) located in the Mission Simulation and Training Facility Bldg 5. On FB-SMS flight deck, Hauck and Covey man their respective stations. Mission Specialist (MS) David C. Hilmers is partially visible in the foreground. A simulation for their anticipated June 1988 flight began 10-20-87.

  5. Adding an Intelligent Tutoring System to an Existing Training Simulation

    DTIC Science & Technology

    2006-01-01

    to apply information in a job should be the goal of training. Also, conventional IMI is not able to meaningfully incorporate use of free - play simulators...incorporating desktop free - play simulators into computer-based training since the software can stand in for a human tutor in all the roles. Existing IMI...2. ITS can integrate free - play simulators and IMI BC2010 ITS DESCRIPTION Overview Figure 3 illustrates the interaction between BC2010, ITS

  6. Effectiveness of early cardiology undergraduate learning using simulation on retention, application of learning and level of confidence during clinical clerkships

    PubMed Central

    Lin, Weiqin; Lee, Glenn K; Loh, Joshua P; Tay, Edgar L; Sia, Winnie; Lau, Tang-Ching; Hooi, Shing-Chuan; Poh, Kian-Keong

    2015-01-01

    INTRODUCTION This study aimed to assess the effectiveness of the use of a cardiopulmonary patient simulator in the teaching of second-year medical students. Effectiveness was measured in terms of the extent of knowledge retention and students’ ability to apply the skills learned in subsequent real-life patient contact. METHODS In this study, ten third-year medical students who had previously undergone simulator training as part of their second-year curriculum underwent an objective structured clinical examination (OSCE) and a multiple-choice question (MCQ) test to assess their ability to apply the knowledge gained during the simulator training when dealing with real patients. The performance of this group of students was compared with that of a group of ten fourth-year medical students who did not undergo simulation training. RESULTS Although the third-year medical students performed well in the OSCE, they were outperformed by the group of fourth-year medical students, who had an extra year of clinical exposure. The MCQ scores of the two groups of students were similar. Post-simulation training survey revealed that students were generally in favour of incorporating cardiopulmonary simulator training in the preclinical curriculum. CONCLUSION Cardiopulmonary simulator training is a useful tool for the education of preclinical medical students. It aids the translation of preclinical knowledge into real-life clinical skills. PMID:25715855

  7. Educating the delivery of bad news in medicine: Preceptorship versus simulation

    PubMed Central

    Jacques, Andrew P; Adkins, Eric J; Knepel, Sheri; Boulger, Creagh; Miller, Jessica; Bahner, David P

    2011-01-01

    Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice. PMID:22229135

  8. Educating the delivery of bad news in medicine: Preceptorship versus simulation.

    PubMed

    Jacques, Andrew P; Adkins, Eric J; Knepel, Sheri; Boulger, Creagh; Miller, Jessica; Bahner, David P

    2011-07-01

    Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice.

  9. STS-104 Crew Training Clips

    NASA Technical Reports Server (NTRS)

    2001-01-01

    The crewmembers of STS-104, Commander Steven Lindsey, Pilot Charles Hobaugh, and Mission Specialists Michael Gernhardt, James Reilly, and Janet Kavandi, are seen during various stages of their training. Footage shows the following: (1) Water Survival Training at the Neutral Buoyancy Laboratory (NBL); (2) Rendezvous and Docking Training in the Shuttle Mission Simulator; (3) Training in the Space Station Airlock; (4) Training in the Virtual Reality Lab; (5) Post-insertion Operations in the Fixed Base Simulator; (6) Extravehicular Activity Training at the NBL; (7) Crew Stowage Training in the Space Station Mock-up Training Facility; and (8) Water Transfer Training in the Crew Compartment Trainer.

  10. 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.

  11. A National Survey on Teaching and Assessing Technical Proficiency in Vascular Surgery in Canada.

    PubMed

    Drudi, Laura; Hossain, Sajjid; Mackenzie, Kent S; Corriveau, Marc-Michel; Abraham, Cherrie Z; Obrand, Daniel I; Vassiliou, Melina; Gill, Heather; Steinmetz, Oren K

    2016-05-01

    This survey aims to explore trainees' perspectives on how Canadian vascular surgery training programs are using simulation in teaching and assessing technical skills through a cross-sectional national survey. A 10-min online questionnaire was sent to Program Directors of Canada's Royal College of Physicians and Surgeons' of Canada approved training programs in vascular surgery. This survey was distributed among residents and fellows who were studying in the 2013-2014 academic year. Twenty-eight (58%) of the 48 Canadian vascular surgery trainees completed the survey. A total of 68% of the respondents were part of the 0 + 5 integrated vascular surgery training program. The use of simulation in the assessment of technical skills at the beginning of training was reported by only 3 (11%) respondents, whereas 43% reported that simulation was used in their programs in the assessment of technical skills at some time during their training. Training programs most often provided simulation as a method of teaching and learning endovascular abdominal aortic or thoracic aneurysm repair (64%). Furthermore, 96% of trainees reported the most common resource to learn and enhance technical skills was dialog with vascular surgery staff. Surveyed vascular surgery trainees in Canada report that simulation is rarely used as a tool to assess baseline technical skills at the beginning of training. Less than half of surveyed trainees in vascular surgery programs in Canada report that simulation is being used for skills acquisition. Currently, in Canadian training programs, simulation is most commonly used to teach endovascular skills. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Does Simulator Sickness Impair Learning Decision Making While Driving a Police Vehicle? (Le mal du simulateur: un frein à l'apprentissage de la prise de décision en conduite d'un véhicule de police?)

    ERIC Educational Resources Information Center

    Paquette, Eve; Bélanger, Danielle-Claude

    2015-01-01

    The use of driving simulators is an innovation for police training in Quebec. There are some issues related to their impact on training objectives. This article presents the results of a study involving 71 police cadets who participated in six training sessions with a driving simulator. The training sessions were designed for developing the…

  13. Source Selection Simulation: Intact Team Training on Picking a Provider

    DTIC Science & Technology

    2015-06-01

    seat of a new $100 million stealth fighter before giving her flight simulation time. The ar- gument for source-selection simulation ( SSS ) training is...dynamic is the creation of the SSS Tool. Drawing on his success in using a similar tool in contingency contracting, Long decided we should use a Web...of SSS intact team training. On Sept. 30–Oct. 3, 2014, Professors Long and Elsesser de- livered DAU’s first-ever Intact Team SSS Training to Eglin’s

  14. Virtual reality in laparoscopic surgery.

    PubMed

    Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

    2004-01-01

    Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery.

  15. Emergency Airway Response Team Simulation Training: A Nursing Perspective.

    PubMed

    Crimlisk, Janet T; Krisciunas, Gintas P; Grillone, Gregory A; Gonzalez, R Mauricio; Winter, Michael R; Griever, Susan C; Fernandes, Eduarda; Medzon, Ron; Blansfield, Joseph S; Blumenthal, Adam

    Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period. Sixty-three nurses from the emergency department (ED) and the intensive care units (ICUs) completed the simulation. Participants were evaluated before and after the simulation program with a knowledge-based test and a team dynamics and confidence questionnaire. Additional comparisons were made between ED and ICU nurses and between nurses with previous EART experience and those without previous EART experience. Comparison of presimulation (presim) and postsimulation (postsim) results indicated a statistically significant gain in both team dynamics and confidence and Knowledge Test scores (P < .01). There were no differences in scores between ED and ICU groups in presim or postsim scores; nurses with previous EART experience demonstrated significantly higher presim scores than nurses without EART experience, but there were no differences between these nurse groups at postsim. This project supports the use of simulation training to increase nurses' knowledge, confidence, and team dynamics in an EART response. Importantly, nurses with no previous experience achieved outcome scores similar to nurses who had experience, suggesting that emergency airway simulation is an effective way to train both new and experienced nurses.

  16. Face and construct validity of a computer-based virtual reality simulator for ERCP.

    PubMed

    Bittner, James G; Mellinger, John D; Imam, Toufic; Schade, Robert R; Macfadyen, Bruce V

    2010-02-01

    Currently, little evidence supports computer-based simulation for ERCP training. To determine face and construct validity of a computer-based simulator for ERCP and assess its perceived utility as a training tool. Novice and expert endoscopists completed 2 simulated ERCP cases by using the GI Mentor II. Virtual Education and Surgical Simulation Laboratory, Medical College of Georgia. Outcomes included times to complete the procedure, reach the papilla, and use fluoroscopy; attempts to cannulate the papilla, pancreatic duct, and common bile duct; and number of contrast injections and complications. Subjects assessed simulator graphics, procedural accuracy, difficulty, haptics, overall realism, and training potential. Only when performance data from cases A and B were combined did the GI Mentor II differentiate novices and experts based on times to complete the procedure, reach the papilla, and use fluoroscopy. Across skill levels, overall opinions were similar regarding graphics (moderately realistic), accuracy (similar to clinical ERCP), difficulty (similar to clinical ERCP), overall realism (moderately realistic), and haptics. Most participants (92%) claimed that the simulator has definite training potential or should be required for training. Small sample size, single institution. The GI Mentor II demonstrated construct validity for ERCP based on select metrics. Most subjects thought that the simulated graphics, procedural accuracy, and overall realism exhibit face validity. Subjects deemed it a useful training tool. Study repetition involving more participants and cases may help confirm results and establish the simulator's ability to differentiate skill levels based on ERCP-specific metrics.

  17. Evaluating an automated haptic simulator designed for veterinary students to learn bovine rectal palpation.

    PubMed

    Baillie, Sarah; Crossan, Andrew; Brewster, Stephen A; May, Stephen A; Mellor, Dominic J

    2010-10-01

    Simulators provide a potential solution to some of the challenges faced when teaching internal examinations to medical or veterinary students. A virtual reality simulator, the Haptic Cow, has been developed to teach bovine rectal palpation to veterinary students, and significant training benefits have been demonstrated. However, the training needs to be delivered by an instructor, a requirement that limits availability. This article describes the development and evaluation of an automated version that students could use on their own. An automated version was developed based on a recording of an expert's examination. The performance of two groups of eight students was compared. All students had undergone the traditional training in the course, namely lectures and laboratory practicals, and then group S used the simulator whereas group R had no additional training. The students were set the task of finding the uterus when examining cows. The simulator was then made available to students, and feedback about the "usability" was gathered with a questionnaire. The group whose training had been supplemented with a simulator session were significantly better at finding the uterus. The questionnaire feedback was positive and indicated that students found the simulator easy to use. The automated simulator equipped students with useful skills for examining cows. In addition, a simulator that does not need the presence of an instructor will increase the availability of training for students and be a more sustainable option for institutions.

  18. Comparison of oral surgery task performance in a virtual reality surgical simulator and an animal model using objective measures.

    PubMed

    Ioannou, Ioanna; Kazmierczak, Edmund; Stern, Linda

    2015-01-01

    The use of virtual reality (VR) simulation for surgical training has gathered much interest in recent years. Despite increasing popularity and usage, limited work has been carried out in the use of automated objective measures to quantify the extent to which performance in a simulator resembles performance in the operating theatre, and the effects of simulator training on real world performance. To this end, we present a study exploring the effects of VR training on the performance of dentistry students learning a novel oral surgery task. We compare the performance of trainees in a VR simulator and in a physical setting involving ovine jaws, using a range of automated metrics derived by motion analysis. Our results suggest that simulator training improved the motion economy of trainees without adverse effects on task outcome. Comparison of surgical technique on the simulator with the ovine setting indicates that simulator technique is similar, but not identical to real world technique.

  19. Building an intelligent tutoring system for procedural domains

    NASA Technical Reports Server (NTRS)

    Warinner, Andrew; Barbee, Diann; Brandt, Larry; Chen, Tom; Maguire, John

    1990-01-01

    Jobs that require complex skills that are too expensive or dangerous to develop often use simulators in training. The strength of a simulator is its ability to mimic the 'real world', allowing students to explore and experiment. A good simulation helps the student develop a 'mental model' of the real world. The closer the simulation is to 'real life', the less difficulties there are transferring skills and mental models developed on the simulator to the real job. As graphics workstations increase in power and become more affordable they become attractive candidates for developing computer-based simulations for use in training. Computer based simulations can make training more interesting and accessible to the student.

  20. Virtual rounds: simulation-based education in procedural medicine

    NASA Astrophysics Data System (ADS)

    Shaffer, David W.; Meglan, Dwight A.; Ferrell, Margaret; Dawson, Steven L.

    1999-07-01

    Computer-based simulation is a goal for training physicians in specialties where traditional training puts patients at risk. Intuitively, interactive simulation of anatomy, pathology, and therapeutic actions should lead to shortening of the learning curve for novice or inexperienced physicians. Effective transfer of knowledge acquired in simulators must be shown for such devices to be widely accepted in the medical community. We have developed an Interventional Cardiology Training Simulator which incorporates real-time graphic interactivity coupled with haptic response, and an embedded curriculum permitting rehearsal, hypertext links, personal archiving and instructor review and testing capabilities. This linking of purely technical simulation with educational content creates a more robust educational purpose for procedural simulators.

  1. 14 CFR Appendix M to Part 141 - Combined Private Pilot Certification and Instrument Rating Course

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... practical test, within 60 days preceding the date of the test. (c) For use of flight simulators or flight training devices: (1) The course may include training in a combination of flight simulators, flight... instructor. (2) Training in a flight simulator that meets the requirements of § 141.41(a) of this part may be...

  2. 14 CFR Appendix M to Part 141 - Combined Private Pilot Certification and Instrument Rating Course

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... practical test, within 60 days preceding the date of the test. (c) For use of flight simulators or flight training devices: (1) The course may include training in a combination of flight simulators, flight... instructor. (2) Training in a flight simulator that meets the requirements of § 141.41(a) of this part may be...

  3. 14 CFR Appendix M to Part 141 - Combined Private Pilot Certification and Instrument Rating Course

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... practical test, within 60 days preceding the date of the test. (c) For use of flight simulators or flight training devices: (1) The course may include training in a combination of flight simulators, flight... instructor. (2) Training in a flight simulator that meets the requirements of § 141.41(a) of this part may be...

  4. STS-31 crewmembers review checklist with instructor on JSC's FB-SMS middeck

    NASA Technical Reports Server (NTRS)

    1988-01-01

    STS-31 Discovery, Orbiter Vehicle (OV) 103, Mission Specialist (MS) Bruce McCandless II (left) and Pilot Charles F. Bolden (right) discuss procedures with a training instructor on the middeck of JSC's fixed-based (FB) Shuttle Mission Simulator (SMS). The three are pointing to a checklist during this training simulation in the Mission Simulation and Training Facility Bldg 5.

  5. STS-26 MS Lounge in fixed based (FB) shuttle mission simulator (SMS)

    NASA Technical Reports Server (NTRS)

    1988-01-01

    STS-26 Discovery, Orbiter Vehicle (OV) 103, Mission Specialist (MS) John M. Lounge, wearing comunications kit assembly headset and crouched on the aft flight deck, performs checklist inspection during training session. The STS-26 crew is training in the fixed base (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5.

  6. Patient Simulators Train Emergency Caregivers

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Johnson Space Center teamed up with Sarasota, Florida-based METI (now CAE Healthcare) through the STTR program to ruggedize the company’s patient simulators for training astronauts in microgravity environments. The design modifications were implemented in future patient simulators that are now used to train first responders in the US military as well as fire departments and other agencies that work in disaster zones.

  7. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training.

    PubMed

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-05-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p < 0.001) whereas the high-fidelity program had the highest implementation cost (p < 0.001). While the most cost-effective program depended on the decision makers' willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators).

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

    PubMed

    Ahlberg, G; Hultcrantz, R; Jaramillo, E; Lindblom, A; Arvidsson, D

    2005-12-01

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

  9. STS-8 crewmembers during shuttle mission simulation training

    NASA Image and Video Library

    1983-06-01

    S83-33032 (23 May 1983) --- Astronauts Guion S. Bluford, right, and Daniel C. Brandenstein man their respective Challenger entry and ascent stations in the Shuttle Mission Simulator (SMS) at NASA's Johnson Space Center (JSC) during a training session for the STS-8 mission. Brandenstein is in the pilot's station, while Bluford, a mission specialist, occupies one of the two aft flight deck seats. Both are wearing civilian clothes for this training exercise. This motion based simulator represents the scene of a great deal of training and simulation activity, leading up to crew preparedness for Space Transportation System (STS) mission. Photo credt: NASA/Otis Imboden, National Geographic

  10. Can surgical simulation be used to train detection and classification of neural networks?

    PubMed

    Zisimopoulos, Odysseas; Flouty, Evangello; Stacey, Mark; Muscroft, Sam; Giataganas, Petros; Nehme, Jean; Chow, Andre; Stoyanov, Danail

    2017-10-01

    Computer-assisted interventions (CAI) aim to increase the effectiveness, precision and repeatability of procedures to improve surgical outcomes. The presence and motion of surgical tools is a key information input for CAI surgical phase recognition algorithms. Vision-based tool detection and recognition approaches are an attractive solution and can be designed to take advantage of the powerful deep learning paradigm that is rapidly advancing image recognition and classification. The challenge for such algorithms is the availability and quality of labelled data used for training. In this Letter, surgical simulation is used to train tool detection and segmentation based on deep convolutional neural networks and generative adversarial networks. The authors experiment with two network architectures for image segmentation in tool classes commonly encountered during cataract surgery. A commercially-available simulator is used to create a simulated cataract dataset for training models prior to performing transfer learning on real surgical data. To the best of authors' knowledge, this is the first attempt to train deep learning models for surgical instrument detection on simulated data while demonstrating promising results to generalise on real data. Results indicate that simulated data does have some potential for training advanced classification methods for CAI systems.

  11. Fire training in a virtual-reality environment

    NASA Astrophysics Data System (ADS)

    Freund, Eckhard; Rossmann, Jurgen; Bucken, Arno

    2005-03-01

    Although fire is very common in our daily environment - as a source of energy at home or as a tool in industry - most people cannot estimate the danger of a conflagration. Therefore it is important to train people in combating fire. Beneath training with propane simulators or real fires and real extinguishers, fire training can be performed in virtual reality, which means a pollution-free and fast way of training. In this paper we describe how to enhance a virtual-reality environment with a real-time fire simulation and visualisation in order to establish a realistic emergency-training system. The presented approach supports extinguishing of the virtual fire including recordable performance data as needed in teletraining environments. We will show how to get realistic impressions of fire using advanced particle-simulation and how to use the advantages of particles to trigger states in a modified cellular automata used for the simulation of fire-behaviour. Using particle systems that interact with cellular automata it is possible to simulate a developing, spreading fire and its reaction on different extinguishing agents like water, CO2 or oxygen. The methods proposed in this paper have been implemented and successfully tested on Cosimir, a commercial robot-and VR-simulation-system.

  12. Teaching tactical combat casualty care using the TC3 sim game-based simulation: a study to measure training effectiveness.

    PubMed

    Sotomayor, Teresita M

    2010-01-01

    The effectiveness of games as instructional tools has been debated over the past several decades. This is due to the lack of empirical data to support such claims. The US ARMY developed a game-based simulation to support Tactical Combat Casualty Care (TCCC) Training. The TC3 Game based Simulation is a first person game that allows a Soldier to play the role of a combat medic during an infantry squad mission in an urban environment. This research documents results from a training effectiveness evaluation conducted at the Department of Combat Medic Training (Ft Sam Houston) in an effort to explore the capability of the game based simulation as a potential tool to support the TCCC program of instruction. Reaction to training, as well as, acquisition of knowledge and transfer of skills were explored using Kirkpatrick's Model of Training Effectiveness Evaluation. Results from the evaluation are discussed.

  13. The role of cognitive training in endourology: a randomised controlled trial.

    PubMed

    Shah, M; Aydin, A; Moran, A; Khan, M S; Dasgupta, P; Ahmed, K

    2018-04-01

    Cognitive training is an important training modality which allows the user to rehearse a procedure without physically carrying it out. This has led to recent interests to incorporate cognitive training within surgical education but research is currently limited. The use of cognitive training in surgery is not clear-cut and so this study aimed to determine whether, relative to a control condition, the use of cognitive training improves technical surgical skills on a ureteroscopy simulator, and if so whether one cognitive training method is superior. This prospective, comparative study recruited 59 medical students and randomised them to one of three groups: control- simulation training only (n=20), flashcards cognitive training group (n=20) or mental imagery cognitive training group (n=19). All participants completed three tasks at baseline on the URO Mentor simulator followed by the cognitive intervention if randomised to receive it. Participants then returned to perform an assessment task on the simulator. Outcome measures from the URO Mentor performance report was used for analysis and a quantitative survey was given to all participants to assess usefulness of training received. This study showed cognitive training to have minimal effects on technical skills of participants. The mental imagery group had fewer laser misfires in the assessment task when compared to both control and flashcards group (P=.017, P=.036, respectively). The flashcards group rated their preparation to be most useful when compared to control (P=.0125). Other parameters analysed between the groups did not reach statistical significance. Cognitive training was found to be feasible and cost effective when carried out in addition to simulation training. This study has shown that the role of cognitive training within acquisition of surgical skills is minimal and that no form of cognitive training was superior to another. Further research needs to be done to evaluate other ways of performing cognitive training. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  14. Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator. A randomized blinded study.

    PubMed

    Cannon, W Dilworth; Garrett, William E; Hunter, Robert E; Sweeney, Howard J; Eckhoff, Donald G; Nicandri, Gregg T; Hutchinson, Mark R; Johnson, Donald D; Bisson, Leslie J; Bedi, Asheesh; Hill, James A; Koh, Jason L; Reinig, Karl D

    2014-11-05

    There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room. Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating. Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure. We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group. We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  15. Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

    PubMed

    Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

    2015-07-01

    The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Effects of Technological Advances in Surgical Education on Quantitative Outcomes From Residency Programs.

    PubMed

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on current technology for surgical education and to evaluate the effect of technological advances on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, and Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: technology for surgical education, simulation-based surgical training, simulation-based nontechnical skills (NTS) training, ACGME Core Competencies, ABSITE scores, and ABS pass rate. Our initial search list included the following: 648 on technology for surgical education, 413 on simulation-based surgical training, 51 on simulation-based NTS training, 78 on ABSITE scores, and 33 on ABS pass rate. Further, 42 articles on technological advances for surgical education met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 33 of 42 and 26 of 42 publications on technological advances for surgical education showed objective improvements regarding patient care and medical knowledge, respectively, whereas only 2 of 42 publications showed improved ABSITE scores, but none showed improved ABS pass rates. Improvements in the other ACGME core competencies were documented in 14 studies, 9 of which were on simulation-based NTS training. Most of the studies on technological advances for surgical education have shown a positive effect on patient care and medical knowledge. However, the effect of simulation-based surgical training and simulation-based NTS training on ABSITE scores and ABS certification has not been assessed. Studies on technological advances in surgical education and simulation-based NTS training showing quantitative evidence that surgery residency program objectives are achieved are still needed. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. 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.

  18. 14 CFR 91.1103 - Pilots: Initial, transition, upgrade, requalification, and differences flight training.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... simulator or training device; and (2) A flight check in the aircraft or a check in the simulator or training..., requalification, and differences flight training. 91.1103 Section 91.1103 Aeronautics and Space FEDERAL AVIATION... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1103 Pilots: Initial...

  19. 14 CFR 91.1103 - Pilots: Initial, transition, upgrade, requalification, and differences flight training.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... simulator or training device; and (2) A flight check in the aircraft or a check in the simulator or training..., requalification, and differences flight training. 91.1103 Section 91.1103 Aeronautics and Space FEDERAL AVIATION... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1103 Pilots: Initial...

  20. 14 CFR 91.1103 - Pilots: Initial, transition, upgrade, requalification, and differences flight training.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... simulator or training device; and (2) A flight check in the aircraft or a check in the simulator or training..., requalification, and differences flight training. 91.1103 Section 91.1103 Aeronautics and Space FEDERAL AVIATION... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1103 Pilots: Initial...

  1. 14 CFR 91.1103 - Pilots: Initial, transition, upgrade, requalification, and differences flight training.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... simulator or training device; and (2) A flight check in the aircraft or a check in the simulator or training..., requalification, and differences flight training. 91.1103 Section 91.1103 Aeronautics and Space FEDERAL AVIATION... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1103 Pilots: Initial...

  2. 14 CFR 91.1103 - Pilots: Initial, transition, upgrade, requalification, and differences flight training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... simulator or training device; and (2) A flight check in the aircraft or a check in the simulator or training..., requalification, and differences flight training. 91.1103 Section 91.1103 Aeronautics and Space FEDERAL AVIATION... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1103 Pilots: Initial...

  3. 14 CFR 91.1091 - Qualifications: Flight instructors (aircraft) and flight instructors (simulator).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... or 135 of this chapter; (2) Has satisfactorily completed the training phases for the aircraft... appropriate training phases for the aircraft, including recurrent training, that are required to serve as a... aircraft, in a flight simulator, or in a flight training device for a particular type, class, or category...

  4. Evaluation of Electronic Counter-Countermeasures Training Using Microcomputer-Based Technology: Phase I. Basic Jamming Recognition.

    ERIC Educational Resources Information Center

    Gardner, Susan G.; Ellis, Burl D.

    Seven microcomputer-based training systems with videotape players/monitors were installed to provide electronic counter-countermeasures (ECCM) simulation training, drill and practice, and performance testing for three courses at a fleet combat training center. Narrated videotape presentations of simulated and live jamming followed by a drill and…

  5. 14 CFR 61.4 - Qualification and approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for certain flight training devices. (b) Any device used for flight training, testing, or checking... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Qualification and approval of flight simulators and flight training devices. 61.4 Section 61.4 Aeronautics and Space FEDERAL AVIATION...

  6. 14 CFR 61.4 - Qualification and approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... for certain flight training devices. (b) Any device used for flight training, testing, or checking... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Qualification and approval of flight simulators and flight training devices. 61.4 Section 61.4 Aeronautics and Space FEDERAL AVIATION...

  7. 14 CFR 61.4 - Qualification and approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... for certain flight training devices. (b) Any device used for flight training, testing, or checking... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Qualification and approval of flight simulators and flight training devices. 61.4 Section 61.4 Aeronautics and Space FEDERAL AVIATION...

  8. 14 CFR 61.4 - Qualification and approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... for certain flight training devices. (b) Any device used for flight training, testing, or checking... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Qualification and approval of flight simulators and flight training devices. 61.4 Section 61.4 Aeronautics and Space FEDERAL AVIATION...

  9. 14 CFR 61.4 - Qualification and approval of flight simulators and flight training devices.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... for certain flight training devices. (b) Any device used for flight training, testing, or checking... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Qualification and approval of flight simulators and flight training devices. 61.4 Section 61.4 Aeronautics and Space FEDERAL AVIATION...

  10. Social Acceptability of Menstrual-Care Training Methods for Young Women with Developmental Disabilities.

    ERIC Educational Resources Information Center

    Epps, Susan; And Others

    1990-01-01

    The acceptability of two different training methods (simulation training using a doll and simulation training on self) for teaching menstrual hygiene skills to young women with developmental disabilities was evaluated in two experiments. Results suggested that opinions about treatment acceptability should be obtained from both professional and…

  11. Simulation-based team training improved the self-assessed ability of physicians, nurses and midwives to perform neonatal resuscitation.

    PubMed

    Malmström, B; Nohlert, E; Ewald, U; Widarsson, M

    2017-08-01

    The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period. The questionnaire focused on four important domains: communication, leadership, confidence and technical skills. The study was carried out in Sweden from 2005 to 2007. The response rate was 84%. Improvements in the participants' self-assessed ability to perform neonatal resuscitation were seen in all four domains after training (p < 0.001). Professionally inexperienced personnel showed a significant improvement in the technical skills domain compared to experienced personnel (p = 0.001). No differences were seen between professions or time since training in any of the four domains. Personnel with less previous experience with neonatal resuscitation showed improved confidence (p = 0.007) and technical skills (p = 0.003). A full-day course on simulation-based team training with video-supported debriefing improved the participants' self-assessed ability to perform neonatal resuscitation. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Evaluating Behavioral Skills Training with and without Simulated in Situ Training for Teaching Safety Skills to Children

    ERIC Educational Resources Information Center

    Miltenberger, Raymond; Gross, Amy; Knudson, Peter; Bosch, Amanda; Jostad, Candice; Breitwieser, Carrie Brower

    2009-01-01

    This study compared the effectiveness of behavioral skills training (BST) to BST plus simulated in situ training (SIT) for teaching safety skills to children to prevent gun play. The results were evaluated in a posttest only control group design. Following the first assessment, participants in both training groups and the control group who did not…

  13. Impact of Training Method on the Behavior of Physicians towards the Use of Computerized Provider Order Entry Systems

    ERIC Educational Resources Information Center

    Martinez, Fernando

    2012-01-01

    The use of workflow or simulated training has been used in the training of medical students for several decades. As technology emerged, training using simulation has grown as an effective way of enhancing training outcomes and increasing the clinical effectiveness of medical students. As a result of a heightened focus on the integration of…

  14. Generalized Operations Simulation Environment for Aircraft Maintenance Training

    DTIC Science & Technology

    2004-04-01

    Operations Simulation Environment ( GOSE ) project is a collaborative effort between AETC and AFRL to develop common, cost-effective, generalized VR training...maintenance training domain since it provided an opportunity to build on the VEST architecture. Development of GOSE involves re-engineering VEST as a scalable...modular, immersive VR training system comprised of PC-based hardware and software. GOSE initiatives include: (a) formalize training needs across

  15. 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.

  16. Retention of laparoscopic and robotic skills among medical students: a randomized controlled trial.

    PubMed

    Orlando, Megan S; Thomaier, Lauren; Abernethy, Melinda G; Chen, Chi Chiung Grace

    2017-08-01

    Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. To investigate the retention of laparoscopic and robotic skills after simulation training. We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc., Waltham, MA) or robotic (N = 20, dV-Trainer, Mimic, Seattle, WA) platforms. In the first stage, two expert surgeons evaluated participants on both tasks before (Stage 1: Baseline) and immediately after training (Stage 1: Post-training) using a modified validated global rating scale of laparoscopic and robotic operative performance. In Stage 2, participants were evaluated on both tasks 11-20 weeks after training. Of the 40 students who participated in Stage 1, 23 (11 laparoscopic and 12 robotic) underwent repeat evaluation. During Stage 2, there were no significant differences between groups in objective or subjective measures for the laparoscopic task. Laparoscopic-trained participants' performances on the laparoscopic task were improved during Stage 2 compared to baseline measured by time to task completion, but not by the modified global rating scale. During the robotic task, the robotic-trained group demonstrated superior economy of motion (p = .017), Tissue Handling (p = .020), and fewer errors (p = .018) compared to the laparoscopic-trained group. Robotic skills acquisition from baseline with no significant deterioration as measured by modified global rating scale scores was observed among robotic-trained participants during Stage 2. Robotic skills acquired through simulation appear to be better maintained than laparoscopic simulation skills. This study is registered on ClinicalTrials.gov (NCT02370407).

  17. STS-7 crew training in the shuttle mission simulator

    NASA Technical Reports Server (NTRS)

    1983-01-01

    STS-7 crew training in the shuttle mission simulator (SMS). Astronaut Frederick H. Hauck, STS-7 pilot, gets some assistance with his safety helmet from Alan M. Rochford, a suit specialist, during a training session in the JSC mission simulations and training facility (32722); Four of the five STS-7 crewmembers train in the shuttle mission simulator (SMS), taking the same seats they will occupy during launch and landing. Pictured, left to right, are Astronauts Robert L. Crippen, commander; Frederick H. Hauck, pilot; Dr. Sally K. Ride and John M. Fabian (almost totally obscured), mission specialists. The crew is wearing civilian clothes and their shuttle helmets (32723); Portrait view of Dr. Ride exiting the SMS (32724); Dr. Ride and other crew preparing to leave the SMS (32725).

  18. Space Station Simulation Computer System (SCS) study for NASA/MSFC. Volume 2: Baseline architecture report

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA's Space Station Freedom Program (SSFP) planning efforts have identified a need for a payload training simulator system to serve as both a training facility and as a demonstrator to validate operational concepts. The envisioned MSFC Payload Training Complex (PTC) required to meet this need will train the Space Station payload scientists, station scientists, and ground controllers to operate the wide variety of experiments that will be onboard the Space Station Freedom. The Simulation Computer System (SCS) is the computer hardware, software, and workstations that will support the Payload Training Complex at MSFC. The purpose of this SCS Study is to investigate issues related to the SCS, alternative requirements, simulator approaches, and state-of-the-art technologies to develop candidate concepts and designs.

  19. Space Station Simulation Computer System (SCS) study for NASA/MSFC. Phased development plan

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA's Space Station Freedom Program (SSFP) planning efforts have identified a need for a payload training simulator system to serve as both a training facility and as a demonstrator to validate operational concepts. The envisioned MSFC Payload Training Complex (PTC) required to meet this need will train the Space Station payload scientists, station scientists and ground controllers to operate the wide variety of experiments that will be onboard the Space Station Freedom. The Simulation Computer System (SCS) is made up of computer hardware, software, and workstations that will support the Payload Training Complex at MSFC. The purpose of this SCS Study is to investigate issues related to the SCS, alternative requirements, simulator approaches, and state-of-the-art technologies to develop candidate concepts and designs.

  20. Space Station Simulation Computer System (SCS) study for NASA/MSFC. Volume 1: Baseline architecture report

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA's Space Station Freedom Program (SSFP) planning efforts have identified a need for a payload training simulator system to serve as both a training facility and as a demonstrator to validate operational concepts. The envisioned MSFC Payload Training Complex (PTC) required to meet this need will train the Space Station payload scientists, station scientists, and ground controllers to operate the wide variety of experiments that will be onboard the Space Station Freedom. The Simulation Computer System (SCS) is made up of the computer hardware, software, and workstations that will support the Payload Training Complex at MSFC. The purpose of this SCS Study is to investigate issues related to the SCS, alternative requirements, simulator approaches, and state-of-the-art technologies to develop candidate concepts and designs.

  1. Space Station Simulation Computer System (SCS) study for NASA/MSFC. Operations concept report

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA's Space Station Freedom Program (SSFP) planning efforts have identified a need for a payload training simulator system to serve as both a training facility and as a demonstrator to validate operational concepts. The envisioned MSFC Payload Training Complex (PTC) required to meet this need will train the Space Station payload scientists, station scientists, and ground controllers to operate the wide variety of experiments that will be onboard the Space Station Freedom. The Simulation Computer System (SCS) is made up of computer hardware, software, and workstations that will support the Payload Training Complex at MSFC. The purpose of this SCS Study is to investigate issues related to the SCS, alternative requirements, simulator approaches, and state-of-the-art technologies to develop candidate concepts and designs.

  2. Training the elderly in pedestrian safety: Transfer effect between two virtual reality simulation devices.

    PubMed

    Maillot, Pauline; Dommes, Aurélie; Dang, Nguyen-Thong; Vienne, Fabrice

    2017-02-01

    A virtual-reality training program has been developed to help older pedestrians make safer street-crossing decisions in two-way traffic situations. The aim was to develop a small-scale affordable and transportable simulation device that allowed transferring effects to a full-scale device involving actual walking. 20 younger adults and 40 older participants first participated in a pre-test phase to assess their street crossings using both full-scale and small-scale simulation devices. Then, a trained older group (20 participants) completed two 1.5-h training sessions with the small-scale device, whereas an older control group received no training (19 participants). Thereafter, the 39 older trained and untrained participants took part in a 1.5-h post-test phase again with both devices. Pre-test phase results suggested significant differences between both devices in the group of older participants only. Unlike younger participants, older participants accepted more often to cross and had more collisions on the small-scale simulation device than on the full-scale one. Post-test phase results showed that training older participants on the small-scale device allowed a significant global decrease in the percentage of accepted crossings and collisions on both simulation devices. But specific improvements regarding the way participants took into account the speed of approaching cars and vehicles in the far lane were notable only on the full-scale simulation device. The findings suggest that the small-scale simulation device triggers a greater number of unsafe decisions compared to a full-scale one that allows actual crossings. But findings reveal that such a small-scale simulation device could be a good means to improve the safety of street-crossing decisions and behaviors among older pedestrians, suggesting a transfer of learning effect between the two simulation devices, from training people with a miniature device to measuring their specific progress with a full-scale one. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Helping mothers survive bleeding after birth: an evaluation of simulation-based training in a low-resource setting.

    PubMed

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris; Mduma, Estomih; Broerse, Jacqueline; Evjen-Olsen, Bjørg; van Roosmalen, Jos; Stekelenburg, Jelle

    2014-03-01

    To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. Educational intervention study. Rural referral hospital in Northern Tanzania. Clinicians, nurse-midwives, medical attendants, and ambulance drivers involved in maternity care. In March 2012, health care workers were trained in HMS BAB, a half-day simulation-based training, using a train-the-trainer model. The training focused on basic delivery care, active management of third stage of labor, and treatment of postpartum hemorrhage, including bimanual uterine compression. Evaluation questionnaires provided information on course perception. Knowledge, skills, and confidence of facilitators and learners were tested before and after training. Four master trainers trained eight local facilitators, who subsequently trained 89 learners. After training, all facilitators passed the knowledge test, but pass rates for the skills test were low (29% pass rate for basic delivery and 0% pass rate for management of postpartum hemorrhage). Evaluation revealed that HMS BAB training was considered acceptable and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were low (3% pass rate for basic delivery and management of postpartum hemorrhage). The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Effectiveness evaluation of simulative workshops for newly licensed drivers.

    PubMed

    Rosenbloom, Tova; Eldror, Ehud

    2014-02-01

    The current study set to examine the effects of simulator use in driving instruction on newly licensed drivers, comparing the road safety knowledge and reported intended behavior, as well as the actual driving performance of new drivers. Participants consisted of 280 newly licensed driver, of which 140 whose drivers license training included additional simulator-based lessons, and 140 drivers whose training precluded simulator-based lessons. All drivers answered questionnaires pertaining to their intended safe driving behaviors (according to Ajzen's (2000) theory of planned behavior), and to their traffic safety knowledge. Of the initial sample, 40 drivers received actual driving performance evaluation by an expert driving instructor, as well as by in-vehicle data recorders (IVDRs). We assumed that safer drivers report safer driving intentions, demonstrate greater traffic safety knowledge, evaluated as safer drivers by the driving instructor, and display lower and stable driving parameters on the IVDRs. We hypothesized that theoretical driving studies combined with practical training on simulators will elevate the safety level of novices driving. Hierarchical regression analyses on driving intentions indicated that drivers who did not receive simulator-based lessons demonstrated safer driving intentions compared to drivers who received simulator-based lessons. This pattern possibly indicating the drivers who received simulator-based lessons felt more confident in their driving abilities compared to drivers who did not receive simulated training. No significant difference was found in traffic safety knowledge, or in the evaluation of the expert driving instructor. IDVR data comparisons indicated drivers who received simulator-based lessons braked more often and were less prone to headway events, suggesting a more responsive driving style. These findings do not point to any significant advantage or disadvantage of the current simulator-based driving training over other driving training methods. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. SimSup's Loop: A Control Theory Approach to Spacecraft Operator Training

    NASA Technical Reports Server (NTRS)

    Owens, Brandon Dewain; Crocker, Alan R.

    2015-01-01

    Immersive simulation is a staple of training for many complex system operators, including astronauts and ground operators of spacecraft. However, while much has been written about simulators, simulation facilities, and operator certification programs, the topic of how one develops simulation scenarios to train a spacecraft operator is relatively understated in the literature. In this paper, an approach is presented for using control theory as the basis for developing the immersive simulation scenarios for a spacecraft operator training program. The operator is effectively modeled as a high level controller of lower level hardware and software control loops that affect a select set of system state variables. Simulation scenarios are derived from a STAMP-based hazard analysis of the operator's high and low level control loops. The immersive simulation aspect of the overall training program is characterized by selecting a set of scenarios that expose the operator to the various inadequate control actions that stem from control flaws and inadequate control executions in the different sections of the typical control loop. Results from the application of this approach to the Lunar Atmosphere and Dust Environment Explorer (LADEE) mission are provided through an analysis of the simulation scenarios used for operator training and the actual anomalies that occurred during the mission. The simulation scenarios and inflight anomalies are mapped to specific control flaws and inadequate control executions in the different sections of the typical control loop to illustrate the characteristics of anomalies arising from the different sections of the typical control loop (and why it is important for operators to have exposure to these characteristics). Additionally, similarities between the simulation scenarios and inflight anomalies are highlighted to make the case that the simulation scenarios prepared the operators for the mission.

  6. Nanophotonic particle simulation and inverse design using artificial neural networks.

    PubMed

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

    2018-06-01

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

  7. Using Simulation for Launch Team Training and Evaluation

    NASA Technical Reports Server (NTRS)

    Peaden, Cary J.

    2005-01-01

    This document describes some of the histor y and uses of simulation systems and processes for the training and evaluation of Launch Processing, Mission Control, and Mission Management teams. It documents some of the types of simulations that are used at Kennedy Space Center (KSC) today and that could be utilized (and possibly enhanced) for future launch vehicles. This article is intended to provide an initial baseline for further research into simulation for launch team training in the near future.

  8. Training for teamwork through in situ simulations

    PubMed Central

    Sorensen, Asta; Poehlman, Jon; Bollenbacher, John; Riggan, Scott; Davis, Stan; Miller, Kristi; Ivester, Thomas; Kahwati, Leila

    2015-01-01

    In situ simulations allow healthcare teams to practice teamwork and communication as well as clinical management skills in a team's usual work setting with typically available resources and equipment. The purpose of this video is to demonstrate how to plan and conduct in situ simulation training sessions, with particular emphasis on how such training can be used to improve communication and teamwork. The video features an in situ simulation conducted at a labour and delivery unit in response to postpartum hemorrhage. PMID:26294962

  9. Laparoscopic Skills Are Improved With LapMentor™ Training

    PubMed Central

    Andreatta, Pamela B.; Woodrum, Derek T.; Birkmeyer, John D.; Yellamanchilli, Rajani K.; Doherty, Gerard M.; Gauger, Paul G.; Minter, Rebecca M.

    2006-01-01

    Objective: To determine if prior training on the LapMentor™ laparoscopic simulator leads to improved performance of basic laparoscopic skills in the animate operating room environment. Summary Background Data: Numerous influences have led to the development of computer-aided laparoscopic simulators: a need for greater efficiency in training, the unique and complex nature of laparoscopic surgery, and the increasing demand that surgeons demonstrate competence before proceeding to the operating room. The LapMentor™ simulator is expensive, however, and its use must be validated and justified prior to implementation into surgical training programs. Methods: Nineteen surgical interns were randomized to training on the LapMentor™ laparoscopic simulator (n = 10) or to a control group (no simulator training, n = 9). Subjects randomized to the LapMentor™ trained to expert criterion levels 2 consecutive times on 6 designated basic skills modules. All subjects then completed a series of laparoscopic exercises in a live porcine model, and performance was assessed independently by 2 blinded reviewers. Time, accuracy rates, and global assessments of performance were recorded with an interrater reliability between reviewers of 0.99. Results: LapMentor™ trained interns completed the 30° camera navigation exercise in significantly less time than control interns (166 ± 52 vs. 220 ± 39 seconds, P < 0.05); they also achieved higher accuracy rates in identifying the required objects with the laparoscope (96% ± 8% vs. 82% ± 15%, P < 0.05). Similarly, on the two-handed object transfer exercise, task completion time for LapMentor™ trained versus control interns was 130 ± 23 versus 184 ± 43 seconds (P < 0.01) with an accuracy rate of 98% ± 5% versus 80% ± 13% (P < 0.001). Additionally, LapMentor™ trained interns outperformed control subjects with regard to camera navigation skills, efficiency of motion, optimal instrument handling, perceptual ability, and performance of safe electrocautery. Conclusions: This study demonstrates that prior training on the LapMentor™ laparoscopic simulator leads to improved resident performance of basic skills in the animate operating room environment. This work marks the first prospective, randomized evaluation of the LapMentor™ simulator, and provides evidence that LapMentor™ training may lead to improved operating room performance. PMID:16772789

  10. 14 CFR 91.1089 - Qualifications: Check pilots (aircraft) and check pilots (simulator).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... simulator, or in a flight training device for a particular type aircraft. (2) A check pilot (simulator) is a person who is qualified to conduct flight checks, but only in a flight simulator, in a flight training... (simulator) must accomplish the following— (1) Fly at least two flight segments as a required crewmember for...

  11. 14 CFR 91.1089 - Qualifications: Check pilots (aircraft) and check pilots (simulator).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... simulator, or in a flight training device for a particular type aircraft. (2) A check pilot (simulator) is a person who is qualified to conduct flight checks, but only in a flight simulator, in a flight training... (simulator) must accomplish the following— (1) Fly at least two flight segments as a required crewmember for...

  12. 14 CFR 91.1089 - Qualifications: Check pilots (aircraft) and check pilots (simulator).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... simulator, or in a flight training device for a particular type aircraft. (2) A check pilot (simulator) is a person who is qualified to conduct flight checks, but only in a flight simulator, in a flight training... (simulator) must accomplish the following— (1) Fly at least two flight segments as a required crewmember for...

  13. Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training.

    PubMed

    Maxson, Pamela M; Dozois, Eric J; Holubar, Stefan D; Wrobleski, Diane M; Dube, Joyce A Overman; Klipfel, Janee M; Arnold, Jacqueline J

    2011-01-01

    To determine whether interdisciplinary simulation team training can positively affect registered nurse and/or physician perceptions of collaboration in clinical decision making. Between March 1 and April 21, 2009, a convenience sample of volunteer nurses and physicians was recruited to undergo simulation training consisting of a team response to 3 clinical scenarios. Participants completed the Collaboration and Satisfaction About Care Decisions (CSACD) survey before training and at 2 weeks and 2 months after training. Differences in CSACD summary scores between the time points were assessed with paired t tests. Twenty-eight health care professionals (19 nurses, 9 physicians) underwent simulation training. Nurses were of similar age to physicians (27.3 vs 34.5 years; p = .82), were more likely to be women (95.0% vs 12.5%; p < .001), and were less likely to have undergone prior simulation training (0% vs 37.5%; p = .02). The pretest showed that physicians were more likely to perceive that open communication exists between nurses and physicians (p = .04) and that both medical and nursing concerns influence the decision-making process (p = .02). Pretest CSACD analysis revealed that most participants were dissatisfied with the decision-making process. The CSACD summary score showed significant improvement from baseline to 2 weeks (4.2 to 5.1; p < .002), a trend that persisted at 2 months (p < .002). Team training using high-fidelity simulation scenarios promoted collaboration between nurses and physicians and enhanced the patient care decision-making process.

  14. Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

    PubMed Central

    Foell, Kirsten; Finelli, Antonio; Yasufuku, Kazuhiro; Bernardini, Marcus Q.; Waddell, Thomas K.; Pace, Kenneth T.; Honey, R. John D.’A.; Lee, Jason Y.

    2013-01-01

    Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices. Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed online-training modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional time-based training. Pre- and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC. Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity. Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills. PMID:24381662

  15. Training for shoulder dystocia: a trial of simulation using low-fidelity and high-fidelity mannequins.

    PubMed

    Crofts, Joanna F; Bartlett, Christine; Ellis, Denise; Hunt, Linda P; Fox, Robert; Draycott, Timothy J

    2006-12-01

    To evaluate the effectiveness of simulation training for shoulder dystocia management and compare training using a high-fidelity mannequin with that using traditional devices. Training was undertaken in six hospitals and a medical simulation center in the United Kingdom. Midwives and obstetricians working for participating hospitals were eligible for inclusion. One hundred forty participants (45 doctors, 95 midwives) were randomized to training with a high-fidelity training mannequin (incorporating force perception training) or traditional low-fidelity mannequins. Performance was assessed pre- and posttraining, using a videoed, standardized shoulder dystocia simulation. Outcome measures were delivery, head-to-body delivery time, use of appropriate and inappropriate actions, force applied, and communication. One hundred thirty-two participants completed the posttraining assessment. All training was associated with improved performance: use of basic maneuvers 114 of 140 (81.4%) to 125 of 132 (94.7%) (P=.002), successful deliveries 60 of 140 (42.9%) to 110 of 132 (83.3%) (P<.001), good communication with the patient 79 of 139 (56.8%) to 109 of 132 (82.6%) (P<.001), pre- and posttraining, respectively. Training with the high-fidelity mannequin was associated with a higher successful delivery rate than training with traditional devices: 94% compared with 72% (odds ratio 6.53, 95% confidence interval 2.05-20.81; P=.002). Total applied force was significantly lower for those who had undergone force training (2,030 Newton seconds versus 2,916 Newton seconds; P=.006) but there was no significant difference in the peak applied force 102 Newtons versus 112 Newtons (P=.242). This study verifies the need for shoulder dystocia training; before training only 43% participants could achieve delivery. All training with mannequins improved the management of simulated shoulder dystocia. Training on a high-fidelity mannequin, including force perception teaching, offered additional training benefits. I.

  16. Inter-professional in-situ simulated team and resuscitation training for patient safety: Description and impact of a programmatic approach.

    PubMed

    Zimmermann, Katja; Holzinger, Iris Bachmann; Ganassi, Lorena; Esslinger, Peter; Pilgrim, Sina; Allen, Meredith; Burmester, Margarita; Stocker, Martin

    2015-10-29

    Inter-professional teamwork is key for patient safety and team training is an effective strategy to improve patient outcome. In-situ simulation is a relatively new strategy with emerging efficacy, but best practices for the design, delivery and implementation have yet to be evaluated. Our aim is to describe and evaluate the implementation of an inter-professional in-situ simulated team and resuscitation training in a teaching hospital with a programmatic approach. We designed and implemented a team and resuscitation training program according to Kern's six steps approach for curriculum development. General and specific needs assessments were conducted as independent cross-sectional surveys. Teamwork, technical skills and detection of latent safety threats were defined as specific objectives. Inter-professional in-situ simulation was used as educational strategy. The training was embedded within the workdays of participants and implemented in our highest acuity wards (emergency department, intensive care unit, intermediate care unit). Self-perceived impact and self-efficacy were sampled with an anonymous evaluation questionnaire after every simulated training session. Assessment of team performance was done with the team-based self-assessment tool TeamMonitor applying Van der Vleuten's conceptual framework of longitudinal evaluation after experienced real events. Latent safety threats were reported during training sessions and after experienced real events. The general and specific needs assessments clearly identified the problems, revealed specific training needs and assisted with stakeholder engagement. Ninety-five interdisciplinary staff members of the Children's Hospital participated in 20 in-situ simulated training sessions within 2 years. Participant feedback showed a high effect and acceptance of training with reference to self-perceived impact and self-efficacy. Thirty-five team members experiencing 8 real critical events assessed team performance with TeamMonitor. Team performance assessment with TeamMonitor was feasible and identified specific areas to target future team training sessions. Training sessions as well as experienced real events revealed important latent safety threats that directed system changes. The programmatic approach of Kern's six steps for curriculum development helped to overcome barriers of design, implementation and assessment of an in-situ team and resuscitation training program. This approach may help improve effectiveness and impact of an in-situ simulated training program.

  17. Using cognitive task analysis to develop simulation-based training for medical tasks.

    PubMed

    Cannon-Bowers, Jan; Bowers, Clint; Stout, Renee; Ricci, Katrina; Hildabrand, Annette

    2013-10-01

    Pressures to increase the efficacy and effectiveness of medical training are causing the Department of Defense to investigate the use of simulation technologies. This article describes a comprehensive cognitive task analysis technique that can be used to simultaneously generate training requirements, performance metrics, scenario requirements, and simulator/simulation requirements for medical tasks. On the basis of a variety of existing techniques, we developed a scenario-based approach that asks experts to perform the targeted task multiple times, with each pass probing a different dimension of the training development process. In contrast to many cognitive task analysis approaches, we argue that our technique can be highly cost effective because it is designed to accomplish multiple goals. The technique was pilot tested with expert instructors from a large military medical training command. These instructors were employed to generate requirements for two selected combat casualty care tasks-cricothyroidotomy and hemorrhage control. Results indicated that the technique is feasible to use and generates usable data to inform simulation-based training system design. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  18. Desktop Modeling and Simulation: Parsimonious, yet Effective Discrete-Event Simulation Analysis

    NASA Technical Reports Server (NTRS)

    Bradley, James R.

    2012-01-01

    This paper evaluates how quickly students can be trained to construct useful discrete-event simulation models using Excel The typical supply chain used by many large national retailers is described, and an Excel-based simulation model is constructed of it The set of programming and simulation skills required for development of that model are then determined we conclude that six hours of training are required to teach the skills to MBA students . The simulation presented here contains all fundamental functionallty of a simulation model, and so our result holds for any discrete-event simulation model. We argue therefore that Industry workers with the same technical skill set as students having completed one year in an MBA program can be quickly trained to construct simulation models. This result gives credence to the efficacy of Desktop Modeling and Simulation whereby simulation analyses can be quickly developed, run, and analyzed with widely available software, namely Excel.

  19. Effect of train vibration on settlement of soil: A numerical analysis

    NASA Astrophysics Data System (ADS)

    Tiong, Kah-Yong; Ling, Felix Ngee-Leh; Talib, Zaihasra Abu

    2017-10-01

    The drastic development of transit system caused the influence of ground-borne vibrations induced by train on ground settlement became concern problem nowadays. The purpose of this study is to investigate soil settlement caused by train vibration. To facilitate this study, computer simulation of soil dynamic response using commercial finite element package - PLAXIS 2D was performed to simulate track-subgrade system together with dynamic train load under three different conditions. The results of simulation analysis established the facts that the soil deformation increased with raising in water level. This phenomenon happens because the increasing water level not only induced greater excess pore water pressure but also reduced stiffness of soil. Furthermore, the simulation analysis also deduced that the soil settlement was reduced by placing material with high stiffness between the subgrade and the ballast layer since material with high stiffness was able to dissipate energy efficiently due to its high bearing capacity, thus protecting the subgrade from deteriorating. The simulation analysis result also showed that the soil dynamic response increased with the increase in the speed of train and a noticeable amplification in soil deformation occurred as the train speed approaches the Rayleigh wave velocity of the track subgrade system. This is due to the fact that dynamic train load depend on both the self-weight of the train and the dynamic component due to inertial effects associated with the train speed. Thus, controlling the train speeds under critical velocity of track-subgrade system is able to ensure the safety of train operation as it prevents track-ground resonance and dramatic ground.

  20. Virtual Reality Compared with Bench-Top Simulation in the Acquisition of Arthroscopic Skill: A Randomized Controlled Trial.

    PubMed

    Banaszek, Daniel; You, Daniel; Chang, Justues; Pickell, Michael; Hesse, Daniel; Hopman, Wilma M; Borschneck, Daniel; Bardana, Davide

    2017-04-05

    Work-hour restrictions as set forth by the Accreditation Council for Graduate Medical Education (ACGME) and other governing bodies have forced training programs to seek out new learning tools to accelerate acquisition of both medical skills and knowledge. As a result, competency-based training has become an important part of residency training. The purpose of this study was to directly compare arthroscopic skill acquisition in both high-fidelity and low-fidelity simulator models and to assess skill transfer from either modality to a cadaveric specimen, simulating intraoperative conditions. Forty surgical novices (pre-clerkship-level medical students) voluntarily participated in this trial. Baseline demographic data, as well as data on arthroscopic knowledge and skill, were collected prior to training. Subjects were randomized to 5-week independent training sessions on a high-fidelity virtual reality arthroscopic simulator or on a bench-top arthroscopic setup, or to an untrained control group. Post-training, subjects were asked to perform a diagnostic arthroscopy on both simulators and in a simulated intraoperative environment on a cadaveric knee. A more difficult surprise task was also incorporated to evaluate skill transfer. Subjects were evaluated using the Global Rating Scale (GRS), the 14-point arthroscopic checklist, and a timer to determine procedural efficiency (time per task). Secondary outcomes focused on objective measures of virtual reality simulator motion analysis. Trainees on both simulators demonstrated a significant improvement (p < 0.05) in arthroscopic skills compared with baseline scores and untrained controls, both in and ex vivo. The virtual reality simulation group consistently outperformed the bench-top model group in the diagnostic arthroscopy crossover tests and in the simulated cadaveric setup. Furthermore, the virtual reality group demonstrated superior skill transfer in the surprise skill transfer task. Both high-fidelity and low-fidelity simulation trainings were effective in arthroscopic skill acquisition. High-fidelity virtual reality simulation was superior to bench-top simulation in the acquisition of arthroscopic skills, both in the laboratory and in vivo. Further clinical investigation is needed to interpret the importance of these results.

  1. JSC Shuttle Mission Simulator (SMS) visual system payload bay video image

    NASA Technical Reports Server (NTRS)

    1981-01-01

    This space shuttle orbiter payload bay (PLB) video image is used in JSC's Fixed Based (FB) Shuttle Mission Simulator (SMS). The image is projected inside the FB-SMS crew compartment during mission simulation training. The FB-SMS is located in the Mission Simulation and Training Facility Bldg 5.

  2. Medical simulation in interventional cardiology: "More research is needed".

    PubMed

    Tajti, Peter; Brilakis, Emmanouil S

    2018-05-01

    Medical simulation is being used for training fellows to perform coronary angiography. Medical simulation training was associated with 2 min less fluoroscopy time per case after adjustment. Whether medical simulation really works needs to be evaluated in additional, well-designed and executed clinical studies. © 2018 Wiley Periodicals, Inc.

  3. Some Current Problems in Simulator Design, Testing and Use.

    ERIC Educational Resources Information Center

    Caro, Paul W.

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

  4. Role of virtual reality simulation in endoscopy training

    PubMed Central

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-01-01

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed. PMID:26675895

  5. Role of virtual reality simulation in endoscopy training.

    PubMed

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-12-10

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed.

  6. Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

    PubMed

    Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V

    2017-03-01

    Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  7. 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.

  8. Longitudinal train dynamics model for a rail transit simulation system

    DOE PAGES

    Wang, Jinghui; Rakha, Hesham A.

    2018-01-01

    The paper develops a longitudinal train dynamics model in support of microscopic railway transportation simulation. The model can be calibrated without any mechanical data making it ideal for implementation in transportation simulators. The calibration and validation work is based on data collected from the Portland light rail train fleet. The calibration procedure is mathematically formulated as a constrained non-linear optimization problem. The validity of the model is assessed by comparing instantaneous model predictions against field observations, and also evaluated in the domains of acceleration/deceleration versus speed and acceleration/deceleration versus distance. A test is conducted to investigate the adequacy of themore » model in simulation implementation. The results demonstrate that the proposed model can adequately capture instantaneous train dynamics, and provides good performance in the simulation test. Thus, the model provides a simple theoretical foundation for microscopic simulators and will significantly support the planning, management and control of railway transportation systems.« less

  9. Longitudinal train dynamics model for a rail transit simulation system

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

    Wang, Jinghui; Rakha, Hesham A.

    The paper develops a longitudinal train dynamics model in support of microscopic railway transportation simulation. The model can be calibrated without any mechanical data making it ideal for implementation in transportation simulators. The calibration and validation work is based on data collected from the Portland light rail train fleet. The calibration procedure is mathematically formulated as a constrained non-linear optimization problem. The validity of the model is assessed by comparing instantaneous model predictions against field observations, and also evaluated in the domains of acceleration/deceleration versus speed and acceleration/deceleration versus distance. A test is conducted to investigate the adequacy of themore » model in simulation implementation. The results demonstrate that the proposed model can adequately capture instantaneous train dynamics, and provides good performance in the simulation test. Thus, the model provides a simple theoretical foundation for microscopic simulators and will significantly support the planning, management and control of railway transportation systems.« less

  10. Clinical experience does not correlate with the perceived need for cardiopulmonary resuscitation training.

    PubMed

    Lunz, Dirk; Brandl, Anita; Lang, Klaus; Weiss, Berthold; Haneya, Assad; Pühler, Thomas; Graf, Bernhard M; Zausig, York A

    2013-02-01

    The efficiency of cardiopulmonary resuscitation (CPR) training is dependent upon different influencing factors, such as the presented concepts, the participants' willingness to learn, and the interval between training sessions. However, the optimal interval for refreshing CPR training is less clear. We evaluated the perceived need of simulator-based CPR training for nurses and correlated it with their clinical experience. The 60 invited nurses were trained in simulator-based CPR. Knowledge about adult advanced life support was evaluated using a questionnaire after training, and participants rated their desired individual frequency of simulator-based training as well as the value of the presented training using a six-point Likert scale. The same questions were asked again after 1 year. All participants agreed about the usefulness of this type of simulator-based training. The average number of correct answers about typical facts in adult advanced life support showed an almost bell-shaped distribution, with the highest point at 6-15 years of clinical experience and the lowest points at≤5 and≥21 years. The desired training-frequency need was inversely correlated with clinical experience. There is a high interest in CPR training among nursing staff. Self-assessment about the training-frequency need was inversely correlated with clinical experience. However, the average number of correct answers on resuscitation questions decreased with clinical experience. Therefore, the training effectiveness seems to be extremely dependent on clinical experience, and therefore, training experienced senior nurses might be more challenging than training novice nurses. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. The ScanTrainer obstetrics and gynaecology ultrasound virtual reality training simulator: A cost model to determine the cost viability of replacing clinical training with simulation training.

    PubMed

    Carolan-Rees, G; Ray, A F

    2015-05-01

    The aim of this study was to produce an economic cost model comparing the use of the Medaphor ScanTrainer virtual reality training simulator for obstetrics and gynaecology ultrasound to achieve basic competence, with the traditional training method. A literature search and survey of expert opinion were used to identify resources used in training. An executable model was produced in Excel. The model showed a cost saving for a clinic using the ScanTrainer of £7114 per annum. The uncertainties of the model were explored and it was found to be robust. Threshold values for the key drivers of the model were identified. Using the ScanTrainer is cost saving for clinics with at least two trainees per year to train, if it would take at least six lists to train them using the traditional training method and if a traditional training list has at least two fewer patients than a standard list.

  12. Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

    PubMed

    Bartel, Billie J

    2014-08-01

    This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

  13. 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

  14. 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.

  15. 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.

  16. The effect of dyad versus individual simulation-based ultrasound training on skills transfer.

    PubMed

    Tolsgaard, Martin G; Madsen, Mette E; Ringsted, Charlotte; Oxlund, Birgitte S; Oldenburg, Anna; Sorensen, Jette L; Ottesen, Bent; Tabor, Ann

    2015-03-01

    Dyad practice may be as effective as individual practice during clinical skills training, improve students' confidence, and reduce costs of training. However, there is little evidence that dyad training is non-inferior to single-student practice in terms of skills transfer. This study was conducted to compare the effectiveness of simulation-based ultrasound training in pairs (dyad practice) with that of training alone (single-student practice) on skills transfer. In a non-inferiority trial, 30 ultrasound novices were randomised to dyad (n = 16) or single-student (n = 14) practice. All participants completed a 2-hour training programme on a transvaginal ultrasound simulator. Participants in the dyad group practised together and took turns as the active practitioner, whereas participants in the single group practised alone. Performance improvements were evaluated through pre-, post- and transfer tests. The transfer test involved the assessment of a transvaginal ultrasound scan by one of two clinicians using the Objective Structured Assessment of Ultrasound Skills (OSAUS). Thirty participants completed the simulation-based training and 24 of these completed the transfer test. Dyad training was found to be non-inferior to single-student training: transfer test OSAUS scores were significantly higher than the pre-specified non-inferiority margin (delta score 7.8%, 95% confidence interval -3.8-19.6%; p = 0.04). More dyad (71.4%) than single (30.0%) trainees achieved OSAUS scores above a pre-established pass/fail level in the transfer test (p = 0.05). There were significant differences in performance scores before and after training in both groups (pre- versus post-test, p < 0.01) with large effect sizes (Cohen's d = 3.85) and no significant interactions between training type and performance (p = 0.59). The dyad group demonstrated higher training efficiency in terms of simulator score per number of attempts compared with the single-student group (p = 0.03). Dyad practice improves the efficiency of simulation-based training and is non-inferior to individual practice in terms of skills transfer. © 2015 John Wiley & Sons Ltd.

  17. Effect of simulator training on driving after stroke: a randomized controlled trial.

    PubMed

    Akinwuntan, A E; De Weerdt, W; Feys, H; Pauwels, J; Baten, G; Arno, P; Kiekens, C

    2005-09-27

    Neurologically impaired persons seem to benefit from driving-training programs, but there is no convincing evidence to support this notion. The authors therefore investigated the effect of simulator-based training on driving after stroke. Eighty-three first-ever subacute stroke patients entered a 5-week 15-hour training program in which they were randomly allocated to either an experimental (simulator-based training) or control (driving-related cognitive tasks) group. Performance in off-road evaluations and an on-road test were used to assess the driving ability of subjects pre- and post-training. Outcome of an official predriving assessment administered 6 to 9 months poststroke was also considered. Both groups significantly improved in a visual and many neuropsychological evaluations and in the on-road test after training. There were no significant differences between both groups in improvements from pre- to post-training except in the "road sign recognition test" in which the experimental subjects improved more. Significant improvements in the three-class decision ("fit to drive," "temporarily unfit to drive," and "unfit to drive") were found in favor of the experimental group post-training. Academic qualification and overall disability together determined subjects that benefited most from the simulator-based driving training. Significantly more experimental subjects (73%) than control subjects (42%) passed the follow-up official predriving assessment and were legally allowed to resume driving. Simulator-based driving training improved driving ability, especially for well educated and less disabled stroke patients. However, the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training.

  18. Emergency obstetric simulation training: how do we know where we are going, if we don't know where we have been?

    PubMed

    Calvert, Katrina L; McGurgan, Paul M; Debenham, Edward M; Gratwick, Frances J; Maouris, Panos

    2013-12-01

    Obstetric emergencies contribute significantly to maternal morbidity and mortality. Current training in the management of obstetric emergencies in Australia and internationally focusses on utilising a multidisciplinary simulation-based model. Arguments for and against this type of training exist, using both economic and clinical reasoning. To identify the evidence base for the clinical impact of simulation training in obstetric emergencies and to address some of the concerns regarding appropriate delivery of obstetric emergency training in the Australian setting. A literature search was performed to identify research undertaken in the area of obstetric emergency training. The initial literature search using broad search terms identified 887 articles which were then reviewed and considered for inclusion if they provided original research with a specific emphasis on the impact of training on clinical outcomes. Ninety-two articles were identified, comprising evidence in the following clinical situations: eclampsia, shoulder dystocia, postpartum haemorrhage, maternal collapse, cord prolapse and teamwork training. Evidence exists for a benefit in knowledge or skills gained from simulation training and for the benefit of training in small units without access to high-fidelity equipment or facilities. Evidence exists for a positive impact of training in obstetric emergencies, although the majority of the available evidence applies to evaluation at the level of participants' confidence, knowledge or skills rather than at the level of impact on clinical outcomes. The model of simulation-based training is an appropriate one for the Australian setting and should be further utilised in rural and remote settings. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. Design and implementation of a proficiency-based, structured endoscopy course for medical students applying for a surgical specialty

    PubMed Central

    De Win, Gunter; Van Bruwaene, Siska; Allen, Christopher; De Ridder, Dirk

    2013-01-01

    Background Surgical simulation is becoming increasingly important in surgical education. Despite the important work done on simulators, simulator model development, and simulator assessment methodologies, there is a need for development of integrated simulators in the curriculum. In this paper, we describe the design of our evidence-based preclinical training program for medical students applying for a surgical career at the Centre for Surgical Technologies. Methods Twenty-two students participated in this training program. During their final months as medical students, they received structured, proficiency-based endoscopy training. The total amount of mentored training was 18 hours and the training was organized into three training blocks. The first block focused on psychomotor training, the second block focused on laparoscopic stitching and suturing, and the third block on laparoscopic dissection techniques and hemostasis. Deliberate practice was allowed and students had to show proficiency before proceeding to the next training block. Students’ psychomotor abilities were tested before the course and after each training block. At the beginning of their careers as surgical registrars, their performance on a laparoscopic suturing task was compared with that of registrars from the previous year who did not have this training course. Student opinions about this course were evaluated using a visual analog scale. Results All students rated the training course as useful and their psychomotor abilities improved markedly. All students performed deliberate practice, and those who participated in this course scored significantly (P < 0.0001) better on the laparoscopic suturing task than first year registrars who did not participate in this course. Conclusion Organization of a structured preclinical training program in laparoscopy for final year medical students is feasible, attractive, and successful. PMID:23901308

  20. SAGRAD: A Program for Neural Network Training with Simulated Annealing and the Conjugate Gradient Method.

    PubMed

    Bernal, Javier; Torres-Jimenez, Jose

    2015-01-01

    SAGRAD (Simulated Annealing GRADient), a Fortran 77 program for computing neural networks for classification using batch learning, is discussed. Neural network training in SAGRAD is based on a combination of simulated annealing and Møller's scaled conjugate gradient algorithm, the latter a variation of the traditional conjugate gradient method, better suited for the nonquadratic nature of neural networks. Different aspects of the implementation of the training process in SAGRAD are discussed, such as the efficient computation of gradients and multiplication of vectors by Hessian matrices that are required by Møller's algorithm; the (re)initialization of weights with simulated annealing required to (re)start Møller's algorithm the first time and each time thereafter that it shows insufficient progress in reaching a possibly local minimum; and the use of simulated annealing when Møller's algorithm, after possibly making considerable progress, becomes stuck at a local minimum or flat area of weight space. Outlines of the scaled conjugate gradient algorithm, the simulated annealing procedure and the training process used in SAGRAD are presented together with results from running SAGRAD on two examples of training data.

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