193 research outputs found

    Virtual Maintenance, Reality, and Systems: A Review

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    Virtual Reality is a computer-generated, mock environment that can allow people to interact with it in a seemingly real way by using certain types of specialized equipment. It is mainly used for training or educational purposes and allows for “real-life” training in a safe and monitored environment. Virtual training can be used in many different fields such as medical, military, biomedical research, aviation, and many others. However, this paper reviews the most cited publications related to the application of virtual reality for training in the United States Military. As a result, researchers can find research venues based on the challenges, risk, and infrastructures

    Musicians’ perceptions and experiences of using simulation training to develop performance skills

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    Simulation has been applied as a tool for learning and training in sports, psychology and medicine for some time, but its current use and potential for training musicians is less well understood. The aim of this study was to explore musicians’ perceptions and experiences of using simulated performance environments. Nine conservatory students performed in two simulations, each with interactive virtual elements and vivid environmental cues: a recital with a virtual audience and an audition with virtual judges. Qualitative data were collected through a focus group interview and written reflective commentaries. Thematic analysis highlighted the musicians’ experiences in terms of (1) their anticipation of using the simulations, (2) the process of performing in the simulations, (3) the usefulness of simulation as a tool for developing performance skills and (4) ways of improving simulation training. The results show that while simulation was new to the musicians and individual levels of immersion differed, the musicians saw benefits in the approach for developing, experimenting with and enhancing their performance skills. Specifically, the musicians emphasised the importance of framing the simulation experience with plausible procedures leading to and following on from the performance, and they recognised the potential for combining simulation with complementary training techniques

    The simulated ocular surgery (SOS) trials: randomised-controlled trials comparing intense simulation-based surgical edication for cataract and glaucoma surgery to conventional training alone in East and Southern Africa

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    Cataract remains the most common cause of blindness globally, and glaucoma is the third after uncorrected refractive error. Surgical management remains a priority, yet surgical training of ophthalmologists continues in the outdated apprentice model. Simulation-based surgical education is yet to be tested to the level of a randomised-controlled trial in ophthalmology. We designed two separate and independent multi-centre multi-country investigator-masked randomised controlled educational-intervention parallel group efficacy trials. Post-graduate doctors in ophthalmology training programmes at collaborating institutions in five East and Southern African countries were assessed for eligibility for inclusion (not having performed the procedure as primary surgeon) into either the OLIMPICS (ophthalmic learning and improvement initiative in cataract surgery) or GLASS (glaucoma simulated surgery) trials. Fifty-one surgical trainees were recruited into the GLASS trial, and 50 into the OLIMPICS trial. Surgical competency was assessed by video recordings, which were double marked by independent experts who were masked to group assignment and timing of the assessment. The intervention was an intense simulation-based cataract or glaucoma surgical training course over 5 days. Primary outcome measure was surgical competency at three-months assessed with validated simulated surgical competency assessment rubrics, the Sim-OSSCARs (ophthalmic simulation surgical competency assessment rubric), for both trials. The trials were registered in March 2017 on the Pan-African Clinical Trial Registry (PACTR201803002159198) and are currently closed to recruitment. Baseline characteristics of age, sex, year of training, baseline knowledge and competency scores were balanced between both arms, for both trials. In total 1,361 surgical videos from across different time-points were independently graded by two separate graders in both trials. In the OLIMPICS trial, 50 participants were recruited between November 2017 and May 2018 and 49 included in the final intention-to-treat analysis with one dropout from the control group. Intervention group participants increased mean simulated surgical competence scores from a baseline of 10.8 of 40 points (27.0%) to 33.7 (84.2%) at 3-months after the training intervention, an increase of 212%. Control group participants’ mean baseline scores were 12.8 (31.9%) and 3-month scores 17.9 (44.7%). We found strong evidence (linear regression p<0.0001) that those in the intervention arm were estimated to have higher scores at three months than those in the control arm, after adjusting for baseline score. Among individuals with the same baseline score, those who received the training were estimated to have scores 16.6 points higher (95%CI 14.5 to 18.8) at three months, compared to those who had not received the training. Intervention participants performed a mean of 22 cataract surgeries as primary surgeon in the one year following the training intervention, compared to 9 by control participants (Poisson regression p<0.0001). Surgical complications were reported for the one year period, and posterior capsule rupture (PCR) rates were 7.4% for the intervention group compared to 26.2% for controls (p<0.0001). Confidence rating scores were assessed using a ten-point Likert scale anchored at 1=’not confident at all’, and 10=’very confident’. Confidence as cataract surgeons increased from 2.2 (of 10) to 6.3 at three-months in the intervention group, compared to 3.4 at baseline to 4.2 for the control group. Among individuals with the same baseline confidence score, those receiving the training were estimated to have scores 2.7 points higher (95%CI 1.6 to 3.7) (p<0.001). In the GLASS trial, 53 trainee ophthalmologists were assessed for eligibility, and 51 were enrolled and randomised. Forty-nine participants were included in the final intention-to-treat analysis: 23 intervention and 26 control, following two drop outs from the intervention group. Baseline surgical competency scores for intervention were a mean of 9.1/40 (22.6%) [median 7.3, IQR 5.4-12.1]; and for control: 8.7/40 (21.8%) [median 8.2, IQR 6.3-12.0] participants. Mean Sim-OSSCAR scores at three-months were 30.4 (76.1%) [median 30.3 IQR 27.8-33.5] and 9.8 (24.4%) [median 9.2 IQR 7.5-11.7] for intervention and control groups respectively. We found strong evidence (linear regression p<0.0001) that those in the intervention arm were estimated to have higher scores at three months than those in the control arm, after adjusting for baseline score as a fixed effect. Among individuals with the same baseline score, those who received the training were estimated to have scores 20.5 points (of 40) higher (95%CI 18.4 to 22.6) at three months, compared to those who had not received the training (linear regression p<0.0001). Baseline mean self-reported confidence in glaucoma surgical skills was 3.0/10 for intervention and 3.2 for control participants. This increased to mean 6.4 and 3.7 at three months respectively (p=0.002). Trainee participants in the intervention group performed a mean of 3.1 live surgical trabeculectomies as primary surgeon over one year following training (median 2, range 0-15, IQR 0-4). Over the same period (and before their simulation training) the control group performed a mean of 0.15 (only one of the 26 control participants performed any glaucoma surgery, compared to 14 of the 23 intervention participants). These are the first multi-centre ophthalmic simulation surgery educational-intervention randomised controlled trials ever conducted. Intense simulation training affords a rapid and sustained increase in surgical competence, confidence as a surgeon, and impacts the number of live surgeries performed. Simulation education in cataract surgery affords a striking benefit in terms of patient safety

    Health technology assessment of online eLearning for post-registration health professionals’ education

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    Aim: The overall aim of this thesis was to undertake and report the findings of a health technology assessment (HTA) on the effectiveness, cost-effectiveness and acceptability of online and LAN-based eLearning, and blended learning, among post-registration healthcare professionals. Methods: This HTA comprised three studies. The first study was a systematic review of 93 randomised controlled trials evaluating the effectiveness of online and LAN-based eLearning on physicians' knowledge, skills, attitude and satisfaction. The second study compared the cost, cost-savings and return on investment between a blended and a face-to-face advanced cardiac life support course for physicians in Singapore. The third study was an online survey that assessed the acceptability of the technology among a sample of optometrists and opticians in Singapore and their scope of practice, primary eye care knowledge, views on extended roles in primary eye care, preferred mode of learning for continuing professional education, and referral behaviour. Results: The systematic review showed that online and LAN-based eLearning or blended learning compared with self-directed or face-to-face learning resulted in higher post-intervention knowledge scores (21 studies; small to large effect size; very poor quality); higher post-intervention skills scores (seven studies; large effect size; low quality); higher attitude scores (one study; very low quality); higher post-intervention satisfaction (four studies; large effect size; low quality); and higher post-intervention practice or behaviour changes (eight studies; large effect size; low quality) among physicians in the intervention groups. Fourteen studies compared eLearning with other forms of eLearning. Among these, four studies reported higher post-intervention knowledge scores (large effect size; very low quality) for participants in the intervention group. Unintended or adverse effects of the intervention were not reported among the included studies. Ninety-three studies (N=16,895) were included of which seventy-six studies compared ODE (including blended) vs self-directed/face-to-face learning. Overall the effect of ODE (including blended) on post-intervention knowledge, skills, attitude, satisfaction, practice or behaviour change and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher post-intervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge score (small to large effect size; very low quality) for the intervention while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size; low quality) while thirteen studies reported no difference in skill score between the groups. One study reported higher attitude score for the intervention (very low quality), while 4 studies reported no difference in attitude score between the groups. Four studies reported higher post-intervention physician satisfaction with the intervention (large effect size; low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher post-intervention practice or behaviour change for the ODE group (small to moderate effect size; low quality) while five studies reported no difference in practice or behaviour change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects, cost-effectiveness of the interventions. Although the review only focused on post-registration medical doctors, the technology could be used for the interprofessional education of post-registration medical doctors and other healthcare professionals. Such an initiative would encourage collaborative learning and facilitate task-shifting, which could address the problem of fragmentation in health care. Although eLearning and blended learning technology interventions have been implemented, primary studies have not assessed their cost-effectiveness. Hence, to ascertain the technology’s cost-saving potential, we used a blended advanced cardiac life support (B-ACLS) course as an exemplar and compared its cost to face-to-face advanced life support (F-ACLS) training. The analysis showed that the annual cost of F-ACLS training (USD72,793)was1.7timeshigherthanBACLStraining(USD72,793) was 1.7 times higher than B-ACLS training (USD43,467). The discounted total cost of training over the life of the course (5-years) was SGD 107,960forBACLSandS107,960 for B-ACLS and S280,162 for F-ACLS. The cost of productivity loss accounted for 52% and 23% of the costs for F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested, yielding $1.60 for every dollar spent. There would be a 61% saving for course providers if they delivered a B-ACLS instead of F-ACLS course. The effectiveness component of the HTA showed that online eLearning and blended learning is as effective as traditional learning and has cost-saving potential. We also sought to determine if this technology could be used to train and equip optometrists and opticians in Singapore to take on an extended role in primary care, which would allow some simple primary eye care tasks to be shifted from ophthalmologists to optometrists and ease healthcare access issues at specialist hospital outpatient clinics. The survey of optometrists showed that the current roles of opticians and optometrists in Singapore were limited to diagnostic refraction (92%); colour vision assessment (65%); contact lens fitting and dispensing (62%) amongst others. The average self-rated primary eye care knowledge score was 8.2 ± 1.4; (score range 1-10; 1 = very poor, 10 = excellent). Average self-rated confidence scores for screening for cataract, diabetic retinopathy, chronic glaucoma and age-related macular degeneration were 2.7 ± 1.5; 3.7 ± 1.9; 4.0 ± 1.0 and 2.7 ± 1.5, respectively. Three fourths of the optometrists surveyed felt that they should undertake regular continuing professional education (CPE) to improve their primary eye care knowledge. Blended learning (eLearning and traditional face-to-face lectures) was the most preferred mode (46.8%) for CPE delivery. Conclusions: Overall, the findings from the HTA provide evidence of effectiveness, cost-saving of online eLearning and blended learning for training medical doctors and the acceptance of the technology in a local context to facilitate its wider adoption for training post-registration healthcare professionals’. These research outputs would have direct impact on the adoption of online eLearning, blended learning technologies in universities and educational institutes across the region with consequent impacts on post-registration health professionals’ education and policy. The results of learning will serve as a guide for policy makers to decide on investment in the learning technology and to learn about the associated factors, which would influence its adoption. This thesis resulted in three papers, of which one has been accepted for publication, the two other papers are under review.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 201

    A comparison of computer aided learning and traditional didactic lectures for teaching clinical decision making skills to optometry undergraduates

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    This study was designed to compare computer aided learning (CAL), in the form of a Virtual Patient (VP), and traditional didactic lectures as methods of teaching clinical decision making (CDM) skills to second year Optometry undergraduates. Comparisons were based on performance in multiple-choice examinations testing CDM skills (actual mastery), student feedback relating to confidence in CDM skills (perceived mastery or self-efficacy) and student satisfaction. The influence of sex, learning style and academic ability was also investigated. This is the first time that these aspects of teaching pedagogy have been studied together. Current literature informed development of didactic lectures and an online VP. Both teaching methods were designed to ensure that the same clinical content was included. This content was aimed at training students to perform problem-orientated eye examinations. A cohort of 102 students was taught using the traditional didactic lectures in academic year 2010-11 and 93 students using the online VP in academic year 2011-12. An established Index of Learning Styles instrument was used to classify students according to their preference in four learning style dimensions. Both teaching methods were designed to cater for both poles of each learning style dimension. Most students had no strong learning preferences but those that did had a tendency towards the active-sensing-visual-sequential profile. Actual and perceived mastery were scored for five key learning objectives; question selection, critical symptom recognition, test selection, critical sign recognition and referral urgency selection. The influence of academic ability and teaching method differed for each learning objective; didactic lectures favouring some, the VP others. Learning style and sex had no influence, indicating that both teaching methods catered equally for males and females with all learning styles. Comparisons between perceived and actual mastery revealed poor self-assessment accuracy. Student satisfaction, rated on a five point Likert scale, was equally high for both teaching methods. Sex was the only influential variable, with males favouring one aspect of VP training. Overall, the findings suggest that CAL should be used to supplement traditional teaching rather than replace it in order to ensure that all students benefit equally. Future research may wish to focus on self-assessment accuracy as a means of improving academic performance

    Immersive Horizons: Exploring the Transformative Power of Virtual Reality Across Economic Sectors

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    open access articleThe scholarly discourse surrounding the manifold advantages, applications, and limitations of implementing Virtual Reality (VR) in the contemporary milieu has burgeoned over time. VR holds immense potential, attracting fervent interest from governmental and private entities alike. Nevertheless, the existing body of literature pertaining to the expanding utilization of VR in diverse economic sectors remains scant. Therefore, the primary objective of this study is to furnish a comprehensive literature review encompassing VR applications across various economic domains while elucidating concerns surrounding its integration within engineering education. A total of 108 publications were extracted from prominent databases such as Scopus, Elsevier, Science Direct, and Google Scholar, with a subsequent review of 51 relevant works. These scrutinized journals were published between 2015 and 2022 and were predominantly authored in English. The reviewed publications encompassed VR applications in education, robotics, healthcare, transportation, sports, agriculture, governance, security, and media. The study’s findings unveiled significant advancements in VR implementation within engineering education, medical training, cognitive augmentation, aircraft assembly, governance, and diverse other spheres. Notwithstanding these achievements, impediments to VR deployment were identified, stemming from financial exigencies, cultural and conventional norms, with scant evidence of VR’s prevalence in underdeveloped nations, given that all the assessed research originated from developed economies. Additionally, the limitations of this review encompassed a small sample size and a narrowly focused demographic in the examined articles. Nevertheless, despite these constraints, the research highlights substantial progress in VR utilization over the preceding decade

    Haptic-Enhanced Learning in Preclinical Operative Dentistry

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    Background: Virtual reality haptic simulators represent a new paradigm in dental education that may potentially impact the rate and efficiency of basic skill acquisition, as well as pedagogically influence the various aspects of students’ preclinical experience. However, the evidence to support their efficiency and inform their implementation is still limited. Objectives: This thesis set out to empirically examine how haptic VR simulator (Simodont®) can enhance the preclinical dental education experience particularly in the context of operative dentistry. We specify 4 distinct research themes to explore, namely: simulator validity (face, content and predictive), human factors in 3D stereoscopic display, motor skill acquisition, and curriculum integration. Methods: Chapter 3 explores the face and content validity of Simodont® haptic dental simulator among a group of postgraduate dental students. Chapter 4 examines the predictive utility of Simodont® in predicting subsequent preclinical and clinical performance. The results indicate the potential utility of the simulator in predicting future clinical dental performance among undergraduate students. Chapter 5 investigates the role of stereopsis in dentistry from two different perspectives via two studies. Chapter 6 explores the effect of qualitatively different types of pedagogical feedback on the training, transfer and retention of basic manual dexterity dental skills. The results indicate that the acquisition and retention of basic dental motor skills in novice trainees is best optimised through a combination of instructor and visualdisplay VR-driven feedback. A pedagogical model for integration of haptic dental simulator into the dental curriculum has been proposed in Chapter 7. Conclusion: The findings from this thesis provide new insights into the utility of the haptic virtual reality simulator in undergraduate preclinical dental education. Haptic simulators have promising potential as a pedagogical tool in undergraduate dentistry that complements the existing simulation methods. Integration of haptic VR simulators into the dental curriculum has to be informed by sound pedagogical principles and mapped into specific learning objectives

    Craniofacial Growth Series Volume 56

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    https://deepblue.lib.umich.edu/bitstream/2027.42/153991/1/56th volume CF growth series FINAL 02262020.pdfDescription of 56th volume CF growth series FINAL 02262020.pdf : Proceedings of the 46th Annual Moyers Symposium and 44th Moyers Presymposiu

    The Lived Experience of Older Adults with Visual Impairments and Their Integration Into Social and Recreational Activities in the Long-Term Care Setting: A Phenomenological Study

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    The prevalence of vision loss in the elderly is high. Visual impairment in long-term care (LTC) settings may be a barrier to fully interacting in therapeutic recreational and social activities. Living with visual barriers may hamper safety (i.e., fear of falling and navigating in unfamiliar settings); cognitive ability; and participation in activities leading to isolation, depression, and loss of self-esteem. Decreased stimulation may affect one’s overall happiness and quality of life. A qualitative phenomenological design was followed to capture the lived experience of older adults with visual impairments living in LTC settings and their integration into social and recreational activities in the LTC setting. Seventeen participants (12 women, 5 men) aged 69 to 100, were recruited through purposive sampling. Interviews were conducted from May 2021 through July 2021 by telephone and/or in person. The interviews were audio-recorded, transcribed, coded, and aggregated, which assured trustworthiness in the data analysis. NVivo 12® software was used to organize and code the data. The six-step approach of van Manen was followed through data collection and analysis. Five essential themes with sub-themes were identified: (1) Life Interrupted; (2) The Impact of Vision Loss; (3) Adaptation to the New Normal; (4) Embracing Relationships; and (5) Transcendence into the Future. This study resulted in a greater understanding of the lived experience of older adults with a visual impairment and their integration into social and recreational activities in a LTC facility. The participants conveyed the challenges they experienced from the time of diagnosis to the present and how they adapted to remain engaged in social and recreational activities

    HSLIC Annual Report FY2005-06

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    https://digitalrepository.unm.edu/hslic-annual-reports/1016/thumbnail.jp
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