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Simulating Human Pleura Performance in Medical Training Using Measured Tissue Mechanical Properties
Title
Simulating Human Pleura Performance in Medical Training Using Measured Tissue Mechanical Properties.
Creator
Norfleet, Jack, Bai, Yuanli, Kassab, Alain, Metcalf, David, Cendan, Juan, University of Central Florida
Abstract / Description
Medical simulations provide hands-on training at various levels of medical expertise. Yet these simulators fail to accurately mimic the look, feel and behavior of human tissue. Applying measured mechanical properties from human cadaver tissues promises to improve the fidelity of simulated tissue behaviors when subjected to medical procedures. Samples of human parietal pleura were tested under uniaxial tension to failure and measured characteristics were replicated in synthetic pleura. Context...
Show moreMedical simulations provide hands-on training at various levels of medical expertise. Yet these simulators fail to accurately mimic the look, feel and behavior of human tissue. Applying measured mechanical properties from human cadaver tissues promises to improve the fidelity of simulated tissue behaviors when subjected to medical procedures. Samples of human parietal pleura were tested under uniaxial tension to failure and measured characteristics were replicated in synthetic pleura. Context specific parameters were then collected and compared between human pleura and the new synthetics. These comparisons tested the hypothesis; H1 Gaps exist between synthetic and human pleura performance, H2: Human tissue fracture mechanics define desired performance of synthetic tissues, H3: Synthetic and human tissues with similar stress/strain parameters will behave similarly when blunt punctured. The results promote the future development of high fidelity tissue simulants for medical training.The studied tissue is parietal pleura which contributes the critical haptic (")pop(") indicating access to the proper anatomic space during the tube thoracostomy procedure. Once accessed through blunt puncture, tube is then inserted to drain air and fluid from around the lungs.Stress/strain based hyper-elastic and fracture properties calibrated from fresh human cadaver pleura were used to define performance requirements. Synthetic pleura were then prototyped and their mechanical properties were characterized. Commercial pleura simulants were puncture tested and compared to compliant custom and off-the-shelf formulations. A non-compliant but commonly used pleura substitute was also tested. Blunt puncture force and displacement were compared for each of the materials to test the stated hypotheses.
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Date Issued
2018
Identifier
CFE0007065, ucf:52023
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007065
Physical-Virtual Patient Simulators: Bringing Tangible Humanity to Simulated Patients
Title
Physical-Virtual Patient Simulators: Bringing Tangible Humanity to Simulated Patients.
Creator
Daher, Salam, Welch, Gregory, Gonzalez, Laura, Cendan, Juan, Proctor, Michael, University of Central Florida
Abstract / Description
In lieu of real patients, healthcare educators frequently use simulated patients. Simulated patients can be realized in physical form, such as mannequins and trained human actors, or virtual form, such as via computer graphics presented on two-dimensional screens or head-mounted displays. Each of these alone has its strengths and weaknesses. I introduce a new class of physical-virtual patient (PVP) simulators that combine strengths of both forms by combining the flexibility and richness of...
Show moreIn lieu of real patients, healthcare educators frequently use simulated patients. Simulated patients can be realized in physical form, such as mannequins and trained human actors, or virtual form, such as via computer graphics presented on two-dimensional screens or head-mounted displays. Each of these alone has its strengths and weaknesses. I introduce a new class of physical-virtual patient (PVP) simulators that combine strengths of both forms by combining the flexibility and richness of virtual patients with tangible characteristics of a human-shaped physical form that can also exhibit a range of multi-sensory cues, including visual cues (e.g., capillary refill and facial expressions), auditory cues (e.g., verbal responses and heart sounds), and tactile cues (e.g., localized temperature and pulse). This novel combination of integrated capabilities can improve patient simulation outcomes. In my Ph.D. work I focus on three primary areas of related research. First, I describe the realization of the technology for PVPs and results from two user-studies to evaluate the importance of dynamic visuals and human-shaped physical form in terms of perception, behavior, cognition, emotions, and learning.Second, I present a general method to numerically evaluate the compatibility of any simulator-scenario pair in terms of importance and fidelity of cues. This method has the potential to make logistical, economic, and educational impacts on the choices of utilizing existing simulators.Finally, I describe a method for increasing human perception of simulated humans by exposing participants to the simulated human taking part in a short, engaging conversation prior to the simulation.
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Date Issued
2018
Identifier
CFE0007750, ucf:52402
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007750
The Effect of Videogame Play on Robotic Surgery Skill Acquisition
Title
The Effect of Videogame Play on Robotic Surgery Skill Acquisition.
Creator
Tanaka, Alyssa, Hughes, Charles, Kincaid, John, Cendan, Juan, Smith, Roger, University of Central Florida
Abstract / Description
Robotic surgery uses innovative technology to transcend a surgeon's skills when performing complex procedures. Currently, the only FDA approved robotic system is Intuitive's da Vinci Surgical System. While this system offers many advantages over other minimally invasive techniques, it also introduces a need for specialized training. Virtual reality simulators have emerged as valuable tools for standardized and objective robotic surgery skill training and assessments. In recent years, the idea...
Show moreRobotic surgery uses innovative technology to transcend a surgeon's skills when performing complex procedures. Currently, the only FDA approved robotic system is Intuitive's da Vinci Surgical System. While this system offers many advantages over other minimally invasive techniques, it also introduces a need for specialized training. Virtual reality simulators have emerged as valuable tools for standardized and objective robotic surgery skill training and assessments. In recent years, the idea of using video game technology in surgical education for laparoscopy has also been explored; however few have attempted to make a connection between video game experience and robotic surgical skills. Thus, the current study aims to examine the performance of video gamers in a virtual reality robotic surgery simulator. Furthermore, the video gamers' performance was compared to that of medical students, expert robotic surgeons, and (")laypeople.(") The purpose of this study is to examine the hypothesis that video gamers acquire perceptual and psychomotor skills through video game play, similar to those used by robotic surgeons.Subjects completed a demographic questionnaire and performed three computer-based perceptual tests: a Flanker compatibility task, a subsidizing task, and a Multiple Object Tracking test. Participants then performed two warm-up exercises on the Mimic dV-Trainer to familiarize themselves with the system and eight trials of two core exercises to test their skills. After completing all trials, participants completed a post-questionnaire regarding their experience with the system.Expert video gamers (n=40), medical students (n=24), laypeople (n=42) and expert robotic surgeons (n=16) were recruited. Medical students and gamers were significantly faster than experts in the Flanker Task. The experts were significantly slower than the all other groups in the subsidizing task. Experts scored significantly higher, were significantly more efficient, and were significantly faster than laypeople, medical students, and gamers in the first trial of Ring (&) Rail 1 and Suture Sponge. In trial eight of Ring (&) Rail 1, experts scored significantly higher and were more efficient than laypeople. Experts were also significantly faster than all other groups. Experts scored significantly higher than laypeople and gamers in trial Suture Sponge. Experts were significantly more efficient and significantly faster than all other groups. Contrary to prior literature in laparoscopy, this study was unable to validate enhanced abilities of video gamers in a robotic surgery simulator. This study does further demonstrate that the transfer of skills developed through video game play is relevant to the surgical technique. This may be due to the differences of the systems and how the users interact within them. In a society where video games have become an integral past time, it is important to determine the role that video games play in the perceptual and psychomotor development of users. These findings can be generalized to domains outside of medicine that utilize robotic and computer-controlled systems, speaking to the scope of the gamers' abilities and pointing to the capacity within these systems.
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Date Issued
2015
Identifier
CFE0006010, ucf:51002
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006010
Assessment of Tattoo and Silicone Wounds in Terms of Time of Treatment and Perceived Treatment Quality
Title
Assessment of Tattoo and Silicone Wounds in Terms of Time of Treatment and Perceived Treatment Quality.
Creator
Pettitt, M, Karwowski, Waldemar, Shumaker, Randall, Cendan, Juan, Sottilare, Robert, University of Central Florida
Abstract / Description
At the point of injury, critical medical tasks include locating and identifying an injury as well as applying the appropriate initial care. Over the past decade, to increase the fidelity of wound representation and ultimately the quality of medical care, a considerable amount of research and development has occurred to improve simulated wounds during training, primarily at the point of injury. As material and techniques mature and as more relevant data is collected on tissue properties,...
Show moreAt the point of injury, critical medical tasks include locating and identifying an injury as well as applying the appropriate initial care. Over the past decade, to increase the fidelity of wound representation and ultimately the quality of medical care, a considerable amount of research and development has occurred to improve simulated wounds during training, primarily at the point of injury. As material and techniques mature and as more relevant data is collected on tissue properties, examining what fidelity is required for training at the point of injury is crucial. The main objective of this effort was to assess a three dimensional silicone wound versus a two dimensional tattoo wound for training and to examine differences in user perceptions and treatment time. This was accomplished with a test population of 158 City of Orlando Fire Department First Responders which were randomly assigned to each group (three dimensional silicone wound group versus a two dimensional tattoo wound group). The data analyses incorporated the use of non-parametric statistics (Mann-Whitney U Test) to compare the differences between the two groups on depth perception, sense of urgency, immersion, and time on task. Other factors that were examined included the costs for the average tattoo wound and silicone wound as well as the number of uses before the synthetic wound is visibly damaged. The data results indicated that at the point of injury, there were relatively few statistically significant differences in the survey data or time on task between the silicone and tattoo wounds. Additionally, the cost analysis revealed that the silicone wound is significantly more expensive than the tattoo wound. Supporting the military and civilian first responder communities, the results of this study provides statistically reliable data on the use of trauma tattoos as a tool for mastering point of injury treatment during training exercises.
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Date Issued
2017
Identifier
CFE0006904, ucf:51733
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006904
An Empirical Evaluation of an Instrument to Determine the Relationship Between Second-Year Medical Students' Perceptions of NERVE VP Design Effectiveness and Students' Ability to Learn and Transfer Skills from NERVE
Title
An Empirical Evaluation of an Instrument to Determine the Relationship Between Second-Year Medical Students' Perceptions of NERVE VP Design Effectiveness and Students' Ability to Learn and Transfer Skills from NERVE.
Creator
Reyes, Ramsamooj, Hirumi, Atsusi, Sivo, Stephen, Campbell, Laurie, Cendan, Juan, University of Central Florida
Abstract / Description
Meta-analyses and systematic reviews of literature comparing the use of virtual patients (VPs) to traditional educational methods support the efficacy of VPs (Cook, Erwin, (&) Triola, 2010; Cook (&) Triola, 2009; McGaghie, Issenberg, Cohen, Barsuk, (&) Wayne, 2011). However, VP design research has produced a variety of design features (Bateman, Allen, Samani, Kidd, (&) Davies, 2013; Botezatu, Hult, (&) Fors, 2010a; Huwendiek (&) De Leng, 2010), frameworks (Huwendiek et al., 2009b) and...
Show moreMeta-analyses and systematic reviews of literature comparing the use of virtual patients (VPs) to traditional educational methods support the efficacy of VPs (Cook, Erwin, (&) Triola, 2010; Cook (&) Triola, 2009; McGaghie, Issenberg, Cohen, Barsuk, (&) Wayne, 2011). However, VP design research has produced a variety of design features (Bateman, Allen, Samani, Kidd, (&) Davies, 2013; Botezatu, Hult, (&) Fors, 2010a; Huwendiek (&) De Leng, 2010), frameworks (Huwendiek et al., 2009b) and principles (Huwendiek et al., 2009a) that are similar in nature, but appear to lack consensus. Consequently, researchers are not sure which VP design principles to apply and few validated guidelines are available. To address this situation, Huwendiek et al. (2014) validated an instrument to evaluate the design of VP simulations that focuses on fostering clinical reasoning. This dissertation examines the predictive validity of one instrument proposed by Huwendiek et al. (2014) that examines VP design features. Empirical research provides evidence for the reliability and validity of the VP design effectiveness measure. However, the relationship between the design features evaluated by the instrument to criterion-referenced measures of student learning and performance remains to be examined. This study examines the predictive validity of Huwendiek et al.'s (2014) VP design effectiveness measurement instrument by determining if the design factors evaluated by the instrument are correlated to medical students' performance in: (a) quizzes and VP cases embedded in Neurological Examination Rehearsal Virtual Environment (NERVE), and (b) NERVE-assisted virtual patient/standardized patient (VP/SP) differential diagnosis and SP checklists. It was hypothesized that students' perceptions of effectiveness of NERVE VP design are significantly correlated to the achievement of higher student learning and transfer outcomes in NERVE.The confirmatory factor analyses revealed the effectiveness of NERVE VP design was significantly correlated to student learning and transfer. Significant correlations were found between key design features evaluated by the instrument and students' performance on quizzes and VP cases embedded in NERVE. In addition, significant correlations were found between the NERVE VP design factors evaluated by Huwendiek et al.'s (2014) instrument and students' performance in SP checklists. Findings provided empirical evidence supporting the reliability and predictive validity of Huwendiek et al.'s (2014) instrument.Future research should examine additional sources of validity for Huwendiek et al.'s (2014) VP design effectiveness instrument using larger samples and from other socio-cultural backgrounds and continue to examine the predictive validity of Huwendiek et al.'s (2014) instrument at Level 2 (Learning) and Level 3 (Application) of Kirkpatrick's (1975) four-level model of training evaluation.
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Date Issued
2016
Identifier
CFE0006166, ucf:51150
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006166
Examining the Impact of Error Encouragement on Training Outcomes
Title
Examining the Impact of Error Encouragement on Training Outcomes.
Creator
Lyons, Rebecca, Salas, Eduardo, Jentsch, Florian, Joseph, Dana, Cendan, Juan, Burke, Shawn, University of Central Florida
Abstract / Description
Error management training has been praised as an effective strategy for facilitating adaptive transfer. However, potential variations have not yet been examined to determine if an alternative format may be equally or more effective. As standard practice, error-related instructions in error management training encourage learners to make errors and to view these errors as learning opportunities. Also, an overwhelming majority of research on this topic has focused learner development of...
Show moreError management training has been praised as an effective strategy for facilitating adaptive transfer. However, potential variations have not yet been examined to determine if an alternative format may be equally or more effective. As standard practice, error-related instructions in error management training encourage learners to make errors and to view these errors as learning opportunities. Also, an overwhelming majority of research on this topic has focused learner development of procedural computer software skills. The empirical literature provides little guidance in terms of the boundaries within which error management training is an effective training approach. The purpose of this research was to examine the relative effectiveness of a modified error management training approach for influencing adaptive transfer in contrast to both standard error management training and error avoidant training. The modified error management approach encouraged learners to do their best to avoid errors, but maintained traditional instructions to learn from errors. The effectiveness of these three training conditions for promoting adaptive transfer was examined in two studies. The first study applied the error strategies to a complex decision-making task, and the second study compared the strategies relative effectiveness for a fine motor skills task. Study 1 results indicated that both error management training approaches were associated with higher adaptive learning compared to an error avoidant training approach. Error management and the modified error management did not significantly differ. In Study 2, error management training and error avoidant training both demonstrated greater adaptive transfer than did the modified approach. The mediating roles of metacognition and emotion regulation were examined, but unsupported, in both studies. Implications for future research and organizational practice are discussed.
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Date Issued
2014
Identifier
CFE0005372, ucf:50444
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005372