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Rovati L, Gary PJ, Cubro E, Dong Y, Kilickaya O, Schulte PJ, Zhong X, Wörster M, Kelm DJ, Gajic O, Niven AS, Lal A. Development and usability testing of a patient digital twin for critical care education: a mixed methods study. Front Med (Lausanne) 2024; 10:1336897. [PMID: 38274456 PMCID: PMC10808677 DOI: 10.3389/fmed.2023.1336897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background Digital twins are computerized patient replicas that allow clinical interventions testing in silico to minimize preventable patient harm. Our group has developed a novel application software utilizing a digital twin patient model based on electronic health record (EHR) variables to simulate clinical trajectories during the initial 6 h of critical illness. This study aimed to assess the usability, workload, and acceptance of the digital twin application as an educational tool in critical care. Methods A mixed methods study was conducted during seven user testing sessions of the digital twin application with thirty-five first-year internal medicine residents. Qualitative data were collected using a think-aloud and semi-structured interview format, while quantitative measurements included the System Usability Scale (SUS), NASA Task Load Index (NASA-TLX), and a short survey. Results Median SUS scores and NASA-TLX were 70 (IQR 62.5-82.5) and 29.2 (IQR 22.5-34.2), consistent with good software usability and low to moderate workload, respectively. Residents expressed interest in using the digital twin application for ICU rotations and identified five themes for software improvement: clinical fidelity, interface organization, learning experience, serious gaming, and implementation strategies. Conclusion A digital twin application based on EHR clinical variables showed good usability and high acceptance for critical care education.
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Affiliation(s)
- Lucrezia Rovati
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Phillip J. Gary
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Edin Cubro
- Department of Information Technology, Mayo Clinic, Rochester, MN, United States
| | - Yue Dong
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Oguz Kilickaya
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Phillip J. Schulte
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
| | - Xiang Zhong
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, United States
| | - Malin Wörster
- Center for Anesthesiology and Intensive Care Medicine, Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Diana J. Kelm
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ognjen Gajic
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Alexander S. Niven
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Amos Lal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
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