A Graduatte Level Immersive-Simulattion Program for Teaching and Assessing Fundamental Skills in Entry Level Clinical Perfusionists.

Background: The clinical perfusionist is a member of the open-heart-surgery team and responsible for operating the life support equipment that replaces the function of the patient\u27s heart and lungs and arrests and restarts the patient\u27s heart in the course of a Cardiopulmonary Bypass (CPB) procedure. In the perfusionists scope of practice, the consequence of unskilled actions, inaccurate understanding or delayed decision making may result in significant patient morbidity or even death. Historically, perfusion students have learned and practiced their skills within a clinical preceptorship program in which an experienced clinician allows the novice student to operate the life support equipment under their direct supervision and consultation. While there is clinical evidence from numerous surgical specialties which establishes that learning curve associated errors have a negative effect on patient outcomes, this has not been researched for clinical perfusionists. Despite this evidence gap, the professions leaders have been instrumental in driving educational innovation and the development of medical simulation models that may reduce the patient\u27s exposure to learning curve associated morbidity by developing competence with high-risk clinical skills prior to patient contact. The purpose of this research is to develop, validate and apply novel medical simulation techniques and technologies to the preparation of entry level clinical perfusionists and demonstrate pre-clinical competence with the fundamental perfusion skills.Methods and Results: To inform the development of a skills curriculum we conducted two national surveys using online survey tools. Through these surveys we validated a list of fundamental skills, and the deconstructed sub-elements involved in the conduct of these skills. Additionally, we identified the typical ranges of physiologic and technical parameters that clinicians maintain during clinical procedures. With this foundational benchmark data we validated the performance of a simulated patient to establish that the patient surrogate generates data that is substantially similar to the physiologic and technical data that a perfusionist would manage during a live clinical procedure. This validated simulation technology was then incorporated into a high-fidelity simulation suite and applied to an innovative immersive curriculum which included hands on repetitive practice, live and video supported self, peer and expert observation and feedback as well as a battery of high-stakes assessments. The validity and fidelity of the simulated experience was established through analysis of over 800 opinions generated over 10 years by novice and expert perfusionists after performing simulated cases. Finally, the efficacy of the simulation curriculum was assessed by comparing our simulation trained students to a national pool of their peers from other schools and expert clinicians. Through this process we generated the first measurements of the typical learning curve for the fundamental skills of CPB, the first estimates of error rates for students navigating the learning curve and the first benchmark measures of competent performance in a simulated environment. This data establishes that students learning in traditional clinical training programs conduct three-fold more errors than experts and will have approximately 99 high-risk patient encounters prior to developing competence with fundamental skills. By comparison, simulation trained students demonstrated competence with fundamental skills that was similar to the experts with almost no high-risk patient encounters. Discussion: The implications to patient safety are clearly implied. These studies establish that there is a high level of agreement among clinicians regarding the skills that are necessary to operate perfusion equipment and that realistic simulation environments can be designed and applied to the development of student\u27s fundamental perfusion skills without exposing patients to the threat of students learning curve associated errors. This data may catalyze a larger national dialog regarding Entrustable Professional Activities for perfusionists and influence national accreditation standards for educational programs

DECISION SUPPORT MODEL IN FAILURE-BASED COMPUTERIZED MAINTENANCE MANAGEMENT SYSTEM FOR SMALL AND MEDIUM INDUSTRIES

Maintenance decision support system is crucial to ensure maintainability and reliability of equipments in production lines. This thesis investigates a few decision support models to aid maintenance management activities in small and medium industries. In order to improve the reliability of resources in production lines, this study introduces a conceptual framework to be used in failure-based maintenance. Maintenance strategies are identified using the Decision-Making Grid model, based on two important factors, including the machines’ downtimes and their frequency of failures. The machines are categorized into three downtime criterions and frequency of failures, which are high, medium and low. This research derived a formula based on maintenance cost, to re-position the machines prior to Decision-Making Grid analysis. Subsequently, the formula on clustering analysis in the Decision-Making Grid model is improved to solve multiple-criteria problem. This research work also introduced a formula to estimate contractor’s response and repair time. The estimates are used as input parameters in the Analytical Hierarchy Process model. The decisions were synthesized using models based on the contractors’ technical skills such as experience in maintenance, skill to diagnose machines and ability to take prompt action during troubleshooting activities. Another important criteria considered in the Analytical Hierarchy Process is the business principles of the contractors, which includes the maintenance quality, tools, equipments and enthusiasm in problem-solving. The raw data collected through observation, interviews and surveys in the case studies to understand some risk factors in small and medium food processing industries. The risk factors are analysed with the Ishikawa Fishbone diagram to reveal delay time in machinery maintenance. The experimental studies are conducted using maintenance records in food processing industries. The Decision Making Grid model can detect the top ten worst production machines on the production lines. The Analytical Hierarchy Process model is used to rank the contractors and their best maintenance practice. This research recommends displaying the results on the production’s indicator boards and implements the strategies on the production shop floor. The proposed models can be used by decision makers to identify maintenance strategies and enhance competitiveness among contractors in failure-based maintenance. The models can be programmed as decision support sub-procedures in computerized maintenance management systems

A novel approach for No Fault Found decision making

Within aerospace and defence sectors, organisations are adding value to their core corporate offerings through services. These services tend to emphasise the potential to maintain future revenue streams and improved profitability and hence require the establishment of cost effective strategies that can manage uncertainties within value led services e.g. maintenance activities. In large organisations, decision-making is often supported by information processing and decision aiding systems; it is not always apparent whose decision affects the outcome the most. Often, accountability moves away from the designated organisation personnel in unforeseen ways, and depending on the decisions of individual decision makers, the structure of the organisation, or unregulated operating procedures may change. This can have far more effect on the overall system reliability – leading to inadequate troubleshooting, repeated down-time, reduced availability and increased burden on Through-life Engineering Services. This paper focuses on outlining current industrial attitudes regarding the No Fault Found (NFF) phenomena and identifies the drivers that influence the NFF decision-making process. It articulates the contents of tacit knowledge and addresses a knowledge gap by developing NFF management policies. The paper further classifies the NFF phenomenon into five key processes that must be controlled by using the developed policies. In addition to the theoretical developments, a Petri net model is also outlined and discussed based on the captured information regarding NFF decision-making in organisations. Since NFF decision-making is influenced by several factors, Petri nets are sought as a powerful tool to realise a meta-model capability to understand the complexity of situations. Its potential managerial implications can help describe decision problems under conditions of uncertainty. Finally, the conclusions indicate that engineering processes, which allow decision-making at various maintenance echelons, can often obfuscate problems that then require a systems approach to illustrate the impact of the issue

Usability analysis of the FDT standard Device Type Manager (DTM) in the plant life cycle

Abstract. Fast development and complexity of modern automation has brought many challenges to automation solutions providers. One important part of modern automation is Plant Asset Management (PAM) tool, especially in field devices business where Company X is market leader. The communication between the field device and PAM tool is done via Device Type Manager (DTM). DTM is a Human Machine Interface (HMI) which provides the high sophisticated parameters of the device to a one interface. HMI or SCADA (Supervisory Control and Data Access) systems developers are facing serious problems to give users needed information in a package which is usable. This research will concentrate to clarify and improve current DTM usability for Company X (CX). First, the thesis will go through CX DTMs user types. User type’s clarification will be the basis information for usability benchmarking tests with the biggest competitors of CX. Benchmarking tests will concentrate on commissioning, because it is the most time spending and that is why the most money consuming, regular task in a field device plant life cycle. In the end, master thesis will provide a clarified user types with the user needs and goals towards the DTM. Plus the main thing, to a have an improvement proposals for DTM usability for today and future. Tests showed that CX is way behind in the efficiency and also in the satisfaction towards competitors. In usability satisfaction, CX was competing against Company M from the last place when Company V and Company E are fighting of the first place. Quite describing is the average rate of satisfaction, for Company E it was 6.05, Company V 5.71 and then comes CX with average rate 4.56. Only Company M had worse users’ satisfaction rate with 3.91. In the efficiency the situation was similar, CX where competing of the last place when Company M and Company E were almost twice faster. According to the benchmarking tests, in effectiveness CX where only one who had DTM where users made faults. In other issues, tasks performers asked help if there were problems. Fast development and complexity of modern automation has influenced also to CX DTM usability, making DTMs huge and complex from the usability and structure. It is shown in the test that DTM usability hasn’t been the focus of CX by this far. Anyway, now it should become one of the tasks to make a serious improve.FDT standardisoidun Device Type Managerin (DTM) käytettävyys analyysi elinkaaren aikana. Tiivistelmä. Automaatioteknologian nopea kehitys ja monimutkaisuus ovat tuoneet uudenlaisia haasteita automaatioratkaisuja tarjoaville yrityksille. Kenttälaitteita tarjoavassa liiketoiminnassa, jossa Yritys X (CX) on markkinajohtaja, laitostenhallintatyökalut ovat yksi tärkeä osa modernia automaatiota. Laitostenhallintatyökalujen ja kenttälaitteiden välillä Device Type Manager (DTM) on puuttuva kommunikoinnin palanen. DTM on ihmisille kehitetty käyttöliittymä (Human Machine Interface — HMI), joka tarjoaa laadullisesti tarkkoja mittalaiteparametrejä yhdelle näyttöpäätteelle. HMI ja SCADA eli käytön ja tiedonsiirron ohjauksen hallinta työkalu (Supervisory Control and Data Access) systeemin kehittäjät ovat kohdanneet todellisia haasteita yrittäessään tarjota tarpeellisen tiedon, joka olisi samalla myös käytettävyydessä toimiva. Diplomityö tulee keskittymään Yritys X:n DTM:n käytettävyyden analysointiin ja kehitykseen. Ensiksi diplomityössä tarkennetaan jo standardisoituja CX:n käyttäjätyyppejä, jonka jälkeen saatu tieto tullaan käyttämään alustavana tietona CX:n suurimpien kilpailijoiden vertailututkimukselle. Vertailututkimus tulee keskittymään käyttöönottoon, koska tämä on eniten aikaa vievä vaihe ja täten myös kallein normaalisti tehtävä työvaihe kenttälaitteiden elinkaaren aikana. Diplomityö tulee tarjoamaan tarkennetut käyttäjätyypit ja niiden tehtävät sekä tavoitteet DTM:lle. Lopuksi diplomityö esittää parannusehdotuksia DTM:n tämän hetkiselle ja tulevaisuuden käytettävyydelle. Testit osoittivat että CX:lla on paljon parannettavaa käytettävyyden suhteen. Sekä suorituskyvyssä että tyytyväisyydessä, CX oli vasta kolmannella sijalla, selvällä erolla kärkikaksikkoon. Myös tehokkuudessa huomattiin selkeitä puutteita CX:n DTM:ssä. Kuvaava tieto CX:n heikohkosta menestyksestä käytettävyystesteissä kertoo käytettävyys tyytyväisyyden keskiarvot. Yritys E:n keskiarvo oli 6.05 ja kakkosena olevan Yritys V:n 5.71. Seuraavaksi tuli CX selkeällä erolla keskiarvoin 4.56. Ainoastaan Yritys M:n DTM sai huonomman keskiarvon 3.91. Nopea kehitys ja monimutkaisuus automaatioliiketoiminnassa ovat vaikuttaneet myös CX:n käytettävyyteen, tehden siittä valtavan ja monimutkaisen rakenteeltaan että käytettävyydeltään. Testit osoittivat että CX ei ole keskittynyt DTM:n käytettävyyden parantamiseen, joten nyt olisi aika alkaa tekemään todellisia uudistuksia käytettävyydenkin suhteen

The Use of Microprocessor Trace Infrastructures for Radiation-Induced Fault Diagnosis

This work proposes a methodology to diagnoseradiation-induced faults in a microprocessor using the hardwaretrace infrastructure. The diagnosis capabilities of this approachare demonstrated for an ARM microprocessor under neutronand proton irradiation campaigns. The experimental resultsdemonstrate that the execution status in the precise moment thatthe error occurred can be reconstructed, so that error diagnosiscan be achieved

An investigation into the use of B-Nodes and state models for computer network technology and education

This thesis consists of a series of internationally published, peer reviewed, conference research papers and one journal paper. The papers evaluate and further develop two modelling methods for use in Information Technology (IT) design and for the educational and training needs of students within the area of computer and network technology. The IT age requires technical talent to fill positions such as network managers, web administrators, e-commerce consultants and network security experts as IT is changing rapidly, and this is placing considerable demands on higher educational institutions, both within Australia and internationally, to respond to these changes