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Trevena W, Zhong X, Lal A, Rovati L, Cubro E, Dong Y, Schulte P, Gajic O. Model-driven engineering for digital twins: a graph model-based patient simulation application. Front Physiol 2024; 15:1424931. [PMID: 39189027 PMCID: PMC11345177 DOI: 10.3389/fphys.2024.1424931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/19/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction Digital twins of patients are virtual models that can create a digital patient replica to test clinical interventions in silico without exposing real patients to risk. With the increasing availability of electronic health records and sensor-derived patient data, digital twins offer significant potential for applications in the healthcare sector. Methods This article presents a scalable full-stack architecture for a patient simulation application driven by graph-based models. This patient simulation application enables medical practitioners and trainees to simulate the trajectory of critically ill patients with sepsis. Directed acyclic graphs are utilized to model the complex underlying causal pathways that focus on the physiological interactions and medication effects relevant to the first 6 h of critical illness. To realize the sepsis patient simulation at scale, we propose an application architecture with three core components, a cross-platform frontend application that clinicians and trainees use to run the simulation, a simulation engine hosted in the cloud on a serverless function that performs all of the computations, and a graph database that hosts the graph model utilized by the simulation engine to determine the progression of each simulation. Results A short case study is presented to demonstrate the viability of the proposed simulation architecture. Discussion The proposed patient simulation application could help train future generations of healthcare professionals and could be used to facilitate clinicians' bedside decision-making.
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Affiliation(s)
- William Trevena
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, United States
| | - Xiang Zhong
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, United States
| | - Amos Lal
- Mayo Clinic, Rochester, MN, United States
| | | | - Edin Cubro
- Mayo Clinic, Rochester, MN, United States
| | - Yue Dong
- Mayo Clinic, Rochester, MN, United States
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Zhu S, Li Z, Sun Y, Kong L, Yin M, Yong Q, Gao Y. A Serious Game for Enhancing Rescue Reasoning Skills in Tactical Combat Casualty Care: Development and Deployment Study. JMIR Form Res 2024; 8:e50817. [PMID: 39133911 PMCID: PMC11347892 DOI: 10.2196/50817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/15/2023] [Accepted: 05/31/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Serious games (SGs) have emerged as engaging and instructional digital simulation tools that are increasingly being used for military medical training. SGs are often compared with traditional media in terms of learning outcomes, but it remains unclear which of the 2 options is more efficient and better accepted in the process of knowledge acquisition. OBJECTIVE This study aimed to create and test a scenario-based system suitable for enhancing rescue reasoning skills in tactical combat casualty care. METHODS To evaluate the effectiveness of the SGs, a randomized, observational, comparative trial was conducted. A total of 148 members from mobile medical logistics teams were recruited for training. Pre- and posttraining assessments were conducted using 2 different formats: a video-based online course (n=78) and a game simulation (n=70). We designed 3 evaluation instruments based on the first 2 levels of the Kirkpatrick model (reaction and learning) to measure trainees' satisfaction, knowledge proficiency, and self-confidence. RESULTS There were 4 elements that made up the learning path for the SGs: microcourses (video-based online courses), self-test, game simulation, and record query. The knowledge test scores in both groups were significantly higher after the intervention (t154=-6.010 and t138=-7.867, respectively; P<.001). For 5 simulation cases, the average operation time was 13.6 (SD 3.3) minutes, and the average case score was 279.0 (SD 57.6) points (from a possible total of 500 points), with a score rate of only 44% (222/500 points) to 67% (336/500 points). The results indicated no significant difference in trainees' satisfaction between the 2 training methods (P=.04). However, the game simulation method outperformed the video-based online course in terms of learning proficiency (t146=-2.324, P=.02) and self-perception (t146=-5.492, P<.001). CONCLUSIONS Despite the high satisfaction reported by trainees for both training methods, the game simulation approach demonstrated superior efficiency and acceptance in terms of knowledge acquisition, self-perception, and overall performance. The developed SG holds significant potential as an essential assessment tool for evaluating frontline rescue skills and rescue reasoning in mobile medical logistics teams.
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Affiliation(s)
- Siyue Zhu
- Medical School of Chinese People's Liberation Army, Department of Emergency Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zenan Li
- Garrison Veteran Cadres Activity Center, Beijing, China
| | - Ying Sun
- Department of Emergency Medicine, the Third Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Linghui Kong
- Health Service Training Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ming Yin
- Department of Emergency Medicine, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qinge Yong
- Department of Nursing, the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yuan Gao
- Department of Nursing, the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
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Dawidziuk A, Miller G, Malawana J. Visualisation Approaches in Technology-Enhanced Medical Simulation Learning: Current Evidence and Future Directions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:175-190. [PMID: 37524988 DOI: 10.1007/978-3-031-30379-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Technology-enhanced learning (TEL) has been proposed as an approach to minimise the healthcare workforce shortage preventing universal healthcare coverage. Simulation-based medical education is a well-established teaching method. Little is known about effective strategies to translate in-person medical simulation teaching into a virtual world. This work aimed to review the literature on approaches to visualisation in technology-enhanced medical simulation. A systematic search strategy was optimised using three databases: Embase, MEDLINE, and APA PsycInfo. Additional papers were identified through cross-referencing. The last date of this search was 3 January 2022. The articles were analysed qualitatively. The risk of bias was assessed using ROBINS-I and RoB 2 tools. The search yielded 656 results with 9 additional papers identified through cross-referencing. Following deduplication and exclusions, 23 articles were included in a qualitative synthesis of evidence. Offline and online computer-based modules with virtual patient cases or practical skills simulations were identified as the most prevalent clinical simulation teaching modalities. Visualisation approaches included text, images, animations, videos, and 3D environments. Significant heterogeneity of study designs with a moderate risk of bias was established. Based on the current data, the virtual patient scenarios should use natural language input interfaces enriched with video and voice recordings, 3D animations, and short text descriptions to make the patient management experience more lifelike and increase knowledge retention. However, there is no agreed framework for assessing the pedagogical value of these innovations. High-quality randomised controlled trials of TEL-based clinical simulation are essential to advance the field.
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Affiliation(s)
- Aleksander Dawidziuk
- The Healthcare Leadership Academy Research Collaborative, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - George Miller
- The Healthcare Leadership Academy Research Collaborative, London, UK
- University of Central Lancashire, Preston, UK
| | - Johann Malawana
- The Healthcare Leadership Academy Research Collaborative, London, UK.
- University of Central Lancashire, Preston, UK.
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Levy AR, Khalil E, Chandramohan M, Whitfill TM, Cicero MX. Efficacy of Computer-Based Simulation as a Modality for Learning Pediatric Disaster Triage for Pediatric Emergency Nurses. Simul Healthc 2022; 17:329-335. [PMID: 34652326 DOI: 10.1097/sih.0000000000000616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
SUMMARY STATEMENT Pediatric disaster triage (PDT) is challenging for healthcare personnel. Mistriage can lead to poor resource utilization. In contrast to live simulation, screen-based simulation is more reproducible and less costly. We hypothesized that the screen-based simulation "60 Seconds to Survival" (60S) to learning PDT will be associated with improved triage accuracy for pediatric emergency nursing personnel.During this prospective observational study, 138 nurse participants at 2 tertiary care emergency departments were required to play 60S at least 5 times over 13 weeks. Efficacy was assessed by measuring the learners' triage accuracy, mistriage, and simulated patient outcomes using JumpStart.Triage accuracy improved from a median of 61.1 [interquartile range (IQR) = 48.5-72.0] to 91.7 (IQR = 60.4-95.8, P < 0.0001), whereas mistriage decreased from 38.9 (IQR = 28.0-51.5) to 8.3 (IQR = 4.2-39.6, P < 0.0001), demonstrating a significant improvement in accuracy and decrease in mistriage. Screen-based simulation 60S is an effective modality for learning PDT by pediatric emergency nurses.
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Affiliation(s)
- Arielle R Levy
- From the Departments of Pediatrics and Emergency Medicine (A.R.L.), Sainte-Justine Hospital University Center, University of Montreal; Department of Pediatrics (E.K., M.C.), McGill University, Montreal, Canada; and Section of Pediatric Emergency Medicine (T.M.W., M.X.C.), Departments of Pediatrics and Emergency Medicine, Yale University School of Medicine, New Haven, CT
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Alhejaili A, Wharrad H, Windle R. A Pilot Study Conducting Online Think Aloud Qualitative Method during Social Distancing: Benefits and Challenges. Healthcare (Basel) 2022; 10:healthcare10091700. [PMID: 36141311 PMCID: PMC9498622 DOI: 10.3390/healthcare10091700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
COVID-19 social distancing restrictions provided unprecedented insights into online research methodologies and approaches for both participants and researchers. Field research traditionally conducted face-to-face had to be transferred online, highlighting the great strides made in communication technologies (particularly live video streaming) over the last two decades for online qualitative research. However, dedicated research on these phenomena is tentative, including with regard to specific methods such as Think Aloud. This paper contributes to literature on online Think Aloud in qualitative research, evaluating new insights on its adoption online. It draws on findings from an online piloting study of Think Aloud tasks to explore the implications of using real-time internet video calls via SoIP applications by MS Teams. To assess the online Think Aloud process, this review called upon some of the comments made by participants during the semi-structured interview or comments made during the Think Aloud process, when they were relevant to the online process itself. It focuses on different dimensions of benefits, rapport in the session’s encounter, challenges, and ethical concerns. Overall, the findings indicate that online Think Aloud sessions cannot completely replace in-person sessions for some particular and highly in-depth research areas, but they can greatly facilitate qualitative data collection in most conventional contexts. It is necessary to carry out further studies exploring the use of this and other online approaches and instructions.
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Affiliation(s)
- Asim Alhejaili
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- College of Nursing, Taibah University, Medina 42353, Saudi Arabia
- Correspondence:
| | - Heather Wharrad
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
| | - Richard Windle
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
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Trevena W, Lal A, Zec S, Cubro E, Zhong X, Dong Y, Gajic O. Modeling of Critically Ill Patient Pathways to Support Intensive Care Delivery. IEEE Robot Autom Lett 2022; 7:7287-7294. [DOI: 10.1109/lra.2022.3183253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Affiliation(s)
- William Trevena
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA
| | | | | | | | - Xiang Zhong
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA
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The Role of Game-Based Learning in Experiential Education: Tool Validation, Motivation Assessment, and Outcomes Evaluation among a Sample of Pharmacy Students. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12070434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
(1) Background: There is a scarcity of data regarding game-based learning (GBL) in experiential pharmacy education; in addition, the impact of educational games on the attainment of intended learning outcomes and students’ motivation to actively learn and practice through non-traditional pedagogical tools are yet to be explored. (2) Methods: This was a prospective quasi-experimental study that introduced GBL into the Pharmacy Practice Experience course of the Bachelor of Pharmacy (BPharm) program at the Lebanese International University in Lebanon. Data collection took place between July and September 2021. The study objectives were to assess the impact of GBL on attaining intended learning outcomes, determine students’ motivation to engage in GBL, and assess the impact of this motivation on the attainment of learning outcomes. (3) Results: GBL was associated with a significantly higher exam average (mean difference = 7.152, p < 0.001). Moreover, an active learning motivation assessment scale (ALMAS) was constructed and validated; it was found to have good reliability as well as high sensitivity and specificity, and it determined a good level of motivation to engage in GBL. Game-based learners with higher motivation scores had significantly higher exam averages compared to those with lower scores (Beta = 0.296, 95% CI 0.110–0.545, p = 0.004). (4) Conclusion: GBL was associated with better attainment of intended learning outcomes. Students appear to be motivated to learn by this style of active learning, and motivation is prognostic of the attainment of learning outcomes.
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Bawazeer G, Sales I, Albogami H, Aldemerdash A, Mahmoud M, Aljohani MA, Alhammad A. Crossword puzzle as a learning tool to enhance learning about anticoagulant therapeutics. BMC MEDICAL EDUCATION 2022; 22:267. [PMID: 35410242 PMCID: PMC8995885 DOI: 10.1186/s12909-022-03348-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Educational games make the learning process more enjoyable, fun, and create a competitive classroom environment that can positively affect learning. The purpose of this study was to evaluate pharmacy students' perceptions of crossword puzzles (CWPs) as a learning tool in the pharmacotherapy cardiovascular module focusing on anticoagulants' therapeutics and assessing if students' preference of learning style influenced their perception. METHODS Clues for the puzzle were developed, validated, and piloted by course faculty. A free internet puzzle generator was used to create puzzles with 10 to 20 clues. Students were given 30 min to solve the puzzle following six hours of didactic lectures about the topic. An 8-item survey instrument and Pharmacists' Inventory of Learning Styles (PILS) questionnaire were administered to examine students' perceptions of the game and their learning style preference, respectively. RESULTS Two hundred sixty-seven students participated in the activity from both undergraduate programs (BPharm and PharmD) over three consecutive course offerings. Most students expressed favorable perceptions of the puzzle. Female and BPharm students had significantly more favorable perceptions than male and PharmD students on several perception items. The dominant preferred learning style (PLS) was converger (35.6%), followed by assimilator (25.3%), while 15.1% had mixed learning styles. The study did not find a significant association between PLS and students' perceptions toward the CWP. CONCLUSIONS The CWP game presented an innovative, creative, and easy active learning tool to enhance information recall, retention, and class engagement while accommodating all learning style preferences.
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Affiliation(s)
- Ghada Bawazeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Ibrahim Sales
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Huda Albogami
- Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed Aldemerdash
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Mansour Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Abdullah Alhammad
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
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Game-Based Learning in Pharmacy Education. PHARMACY 2022; 10:pharmacy10010011. [PMID: 35076609 PMCID: PMC8788493 DOI: 10.3390/pharmacy10010011] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 02/04/2023] Open
Abstract
Game-based learning (GBL) involves adding game elements to non-game activities to encourage engagement. Pharmacy curricula are required to incorporate active learning to meet accreditation standards. The literature supports that well-designed GBL holds the attention of students and improves knowledge in some instances. Furthermore, these adaptable experiences can be leveraged for a variety of content areas in pharmacy education. Some activities utilized by educators require large amounts of technological expertise, while others involve minimal use of technology. The incorporation of technology can create highly immersive experiences for learners; however, there are barriers (e.g., financial and technology prowess) to implementation compared to simpler designs. One area of GBL that is not well defined in the literature is how to adequately assess student learning outcomes. Most current studies describe subjective attitudes and confidence or assess content knowledge through objective pre- and post-tests. In the future, more defined and connected methods for assessment—such as active demonstrations within the game—will be needed to better incorporate GBL into pharmacy curricula. Based on the collective evidence in the literature, some GBL activities may serve as useful tools to improve pharmacy student engagement and learning.
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van Steen T, Deeleman JRA. Successful Gamification of Cybersecurity Training. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2021; 24:593-598. [PMID: 34491845 DOI: 10.1089/cyber.2020.0526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The behavioral aspect of cybersecurity has gained more attention in recent years. By their actions, people can improve the security of their devices and organizations, but also hinder the successful implementation of security in these areas. As awareness campaigns where information is merely distributed are not effective, we designed a cybersecurity serious game applicable for cybersecurity training. The effectiveness of this game was experimentally tested against a noncybersecurity game that did or did not contain cybersecurity information, through measures of the theory of planned behavior. Results showed that the cybersecurity game resulted in higher self-reported scores on attitudes, perceived behavioral control, intentions, and behavior compared with both noncybersecurity games. For subjective norms, we only found an effect in the comparison between the cybersecurity game and the noncybersecurity game without additional information.
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Affiliation(s)
- Tommy van Steen
- Institute of Security and Global Affairs, Leiden University, The Hague, The Netherlands
| | - Julia R A Deeleman
- Institute of Security and Global Affairs, Leiden University, The Hague, The Netherlands.,L.I.B. Businessgames, Breda, The Netherlands
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Lavallée A, Lavoie P, Mailhot T, Deschênes MF. Efficacy of Serious Games in Healthcare Professions Education: A Systematic Review and Meta-analysis. Simul Healthc 2021; 16:199-212. [PMID: 33196609 DOI: 10.1097/sih.0000000000000512] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
SUMMARY STATEMENT Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = -1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = -0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = -0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = -0.78 to 0.87)], attitude change [SMD = -0.09 (95% CI = -0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = -0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- From the Faculty of Nursing of the Université de Montréal (S.C., V.D., G.F., A.L., P.L., M.-F.D.); Montreal Heart Institute Research Center (S.C., P.L., T.M.); Research Center of the Université de Montréal Hospital Center (V.D.); CHU Ste-Justine Research Center (AL), Montreal, Quebec, Canada; Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences (T.M.), Boston, MA; and Center for Innovation in Nursing Education (M.-F.D.), Montreal, Quebec, Canada
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Thompson J, White S, Chapman S. Interactive Clinical Avatar Use in Pharmacist Preregistration Training: Design and Review. J Med Internet Res 2020; 22:e17146. [PMID: 33155983 PMCID: PMC7679212 DOI: 10.2196/17146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Virtual patients are interactive computer-based simulations that are being increasingly used in modern health care education. They have been identified as tools that can provide experiential learning and assessment in a standardized and safe environment. However, the study of high-fidelity virtual patients such as interactive clinical avatars within pharmacy is limited. OBJECTIVE The aim of this paper is to describe the design and review of three interactive clinical avatar simulations as part of pharmacist preregistration training. METHODS A multistep design approach was taken to create interactive clinical avatar simulations on the topics of emergency hormonal contraception (EHC), calculation of renal function, and childhood illnesses. All case studies were reviewed by registered pharmacists to establish content and face validity. The EHC case study and data collection questionnaire were also reviewed by a purposive sample of preregistration trainees and newly qualified pharmacists. The questionnaire used Likert ranking statements and open-ended questions to obtain users' feedback on the design, usability, and usefulness of the interactive clinical avatars as learning tools. Descriptive statistics and content analysis were undertaken on the data. RESULTS Ten preregistration trainees and newly qualified pharmacists reviewed the EHC interactive clinical avatars and data collection questionnaire. The data collection questionnaire was associated with a Cronbach alpha=.95, demonstrating good reliability. All three interactive clinical avatar simulations were reported as usable and appropriately designed for preregistration training. Users perceived they were developing skills and knowledge from the simulations. The high-fidelity nature of the avatars and relevance of the simulations to real-life practice were reported as aspects that encouraged the application of theory to practice. Improvements were suggested to ensure the simulations were more user-friendly. CONCLUSIONS The design and creation of the interactive clinical avatar simulations was successful. The multistep review process ensured validity and reliability of the simulations and data collection questionnaire. The in-depth explanation of the design process and provision of a questionnaire may help widen the use and evaluation of interactive clinical avatars or other simulation tools in pharmacy education. The interactive clinical avatars were reported as novel learning tools that promoted experiential learning and allowed users to feel like they were engaging in real-life scenarios, thus developing transferable knowledge and skills. This may be potentially beneficial for many health care training courses as a way to provide standardized experiences promoting active learning and reflection.
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Affiliation(s)
- Jessica Thompson
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Simon White
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Stephen Chapman
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
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Arruzza E, Chau M. A scoping review of randomised controlled trials to assess the value of gamification in the higher education of health science students. J Med Imaging Radiat Sci 2020; 52:137-146. [PMID: 33153931 DOI: 10.1016/j.jmir.2020.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In today's ever-changing technological landscape, novel pedagogical methods are very attractive for medical radiation educators trying to enhance their students' educational experience. This scoping review aimed to assess the evidence regarding the value of gamification as part of health science undergraduate education, in comparison to conventional teaching curriculum. METHODS A comprehensive systematic literature search was conducted in MEDLINE, EMC are and Cochrane databases. Articles were eligible if they were randomised controlled trials comparing the use of gamification for undergraduate health profession students, with conventional teaching methods. Outcomes included knowledge (ie., information acquisition), skills (ie., knowledge application) and perceived benefit. Screening, data extraction and critical appraisal was conducted by two reviewers independently. RESULTS Eleven RCT studies were included (n = 997). Three of eight reporting studies discovered significant findings for knowledge acquisition scores favouring the intervention group. Varying results were demonstrated in the skills domain across six studies. Perceived benefits including student motivation and satisfaction levels demonstrated positive findings in all but one of six reporting studies. DISCUSSION Educators should supplement methods with gamified learning rather than replace them, consider group-based gamification, and employ methods at irregular intervals. CONCLUSION The findings of this review suggest that gamification may be advantageous for health science undergraduates. Gamification positively impacts student satisfaction and motivation, though its capacity to enhance students' knowledge acquisition and application necessitates further research.
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Affiliation(s)
- Elio Arruzza
- UniSA Allied Health & Human Performance, University of South Australia, South Australia, Australia.
| | - Minh Chau
- UniSA Allied Health & Human Performance, University of South Australia, South Australia, Australia
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Yap KYL, Tan SIBH, Yap KZ, Yap JYG. Students’ perceptions of an in-house developed pharmacy serious game for professional skills training. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:293-296. [DOI: 10.1136/bmjstel-2019-000547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 02/19/2020] [Accepted: 03/05/2020] [Indexed: 11/03/2022]
Abstract
BackgroundAn in-house three-dimensional (3D) multiplayer online role-playing game was developed for professional skills training of pharmacy students. Students play the game in a post-apocalyptic world to save humankind from zombies. They solve virtual patient encounters through visual and motion-capture technologies. Their gaming perceptions and experiences were investigated.MethodA self-administered questionnaire obtained participants’ demographics, gaming interests, perceptions of game effectiveness, preferences on gaming elements and gameplay experience through the Game Engagement Questionnaire (GEQ). Pre-gameplay and post-gameplay assessments were tracked to assess student learning. Descriptive statistics and paired sample t-tests were used for analysis.ResultsFifty-five students were recruited. Two-thirds of the gameplay group (67.9%) liked the post-apocalyptic fantasy settings and heroic storyline (66.0%). Three quarters liked the modern setting (73.1%), authentic plots (73.5%) and plot animations (72.3%). Participants felt the game was effective in training health communication and patient history-taking skills (81.8%). Participants’ test scores for counselling increased from 66.1%±7.6% (pre-gameplay) to 70.3%±8.0% (post-gameplay, p=0.004). The highest scoring GEQ dimension was sensory and imaginative immersion (2.92±0.74).ConclusionStudents found the game useful for pharmacy professional skills training. With proper implementation, this game can become a useful tool to enhance student learning and gear them towards clinical practices.
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Blanié A, Amorim MA, Benhamou D. Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students. BMC MEDICAL EDUCATION 2020; 20:53. [PMID: 32075641 PMCID: PMC7031947 DOI: 10.1186/s12909-020-1939-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/16/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. METHODS In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming "SG": the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;Traditional Teaching "TT": the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0-100) immediately after the session (primary outcome) and on month later. Other outcomes included students' satisfaction, motivation and professional impact. RESULTS One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. CONCLUSIONS In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. TRIAL REGISTRATION ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France.
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France.
- CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - Michel-Ange Amorim
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
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Seybert AL, Smithburger PL, Benedict NJ, Kobulinsky LR, Kane‐Gill SL, Coons JC. Evidence for simulation in pharmacy education. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1167] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Amy L. Seybert
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - Pamela L. Smithburger
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - Neal J. Benedict
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - Lawrence R. Kobulinsky
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - Sandra L. Kane‐Gill
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - James C. Coons
- Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
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Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, Tudor Car L, Carlstedt-Duke J, Car J, Zary N. Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e14676. [PMID: 31267981 PMCID: PMC6632099 DOI: 10.2196/14676] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/29/2022] Open
Abstract
Background Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education. Objective The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction. Methods We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models. Results A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI −0.17 to 0.39, I2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence. Conclusions Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low- and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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Affiliation(s)
- Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
| | - Luke A Woodham
- Institute of Medical and Biomedical Education, St George's, University of London, London, United Kingdom.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Samuel Edelbring
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Learning and Professional Development Group, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David Davies
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nakul Saxena
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jan Carlstedt-Duke
- President's Office, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Nabil Zary
- Games for Health Innovations Centre, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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