A Comprehensive Review of Serious Games in Health Professions

Education of healthcare professionals is of primary importance for patient safety. In some health related professions, education and training have to be practiced during the entire working period and not only limited to school years. The use of new technology such as virtual reality and e-learning brings new possibilities with significant improvement in learning outcomes. Serious gaming describes a technology that can educate and train while entertaining users. This type of training can be very useful for health professions because it improves learning outcomes creating a learner oriented approach and providing a stealth mode of teaching. In some fields it represents an ideal instrument for continuous health professions education also in terms of costs because it is cheaper than traditional training methods that use cadavers or mannequins. In this paper we make a scoping review of serious games developed for health professions and health related fields in order to understand if they are useful tools for health related fields training. Many papers confirmed that serious gaming is a useful technology that improves learning and skills development for health professionals

Jeanetta Hudson, Administratrix of the Estate of Jack B. Hudson v. Surgical Specialists, Inc., Dr. Crile Crisler and Norfolk General Hospital

Supreme Court of Virginiahttps://scholarlycommons.law.wlu.edu/va-supreme-court-records-vol239/1006/thumbnail.jp

Volume 22, issue 2

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1160/thumbnail.jp

Hemodynamic interventions and -monitoring in critically ill patients

Hemodynamic interventions and - monitoring are daily practices in the Intensive Care Unit (ICU); usually initiated on the basis of (supposed) pathophysiological mechanisms or expert opinion. The available evidence for inotropics in critically ill patients with cardiac dysfunction is hampered by systematic and random errors and does not support contemporary practice. It leaves the clinician with many questions. The only logical conclusion is that if inotropy is given, we should measure the one parameter it is supposed to have a direct effect on: the cardiac output. It probably doesn't matter much which device/instrument is used to measure the cardiac output, although ultrasound has an advantage over other hemodynamic monitoring techniques as it gives a direct impression of the cardiac function and can give possible origins of cardiac dysfunction. Ultrasound will most likely be used more and more in the ICU, as it can quickly provide answers to (binary) questions. For example, it seems to be better able to assess whether there is pulmonary edema compared to a physical examination. However, one should be aware of the operator dependence of ultrasonography and the operator of the ultrasound machine should be aware of the pitfalls of ultrasonography. Hopefully in the near future there will be evidence on patient-relevant outcomes for the use of ultrasound in the ICU

Healthy You

https://scholarlyworks.lvhn.org/healthy-you/1047/thumbnail.jp

Effectiveness of virtual reality therapy upon anxiety and blood pressure among patients undergoing CABG

An Experimental Study to Assess the Effectiveness of Virtual Reality Therapy upon Anxiety and Blood Pressure among Patients undergoing Coronary Artery Bypass Grafting at Selected Hospital, Chennai. OBJECTIVES: 1. To assess the level of anxiety and blood pressure among control and experimental group of patients undergoing CABG in pretest and posttest. 2. To determine the effectiveness of virtual reality therapy by comparing the pre and posttest scores of anxiety and blood pressure in control and experimental group of patients undergoing CABG. 3. To assess the level of acceptability of experimental group patients undergoing CABG regarding virtual reality therapy. 4. To determine the correlation between level of anxiety and blood pressure scores among patients undergoing CABG in pretest and posttest. 5. To find out the association between selected demographic variables and level of anxiety and blood pressure among control and experimental group of patients undergoing CABG in pretest and posttest. 6. To find out the association between selected clinical variables and level of anxiety and blood pressure among control and experimental group of patients undergoing CABG in pretest and posttest. A conceptual framework is a group of concepts and a set of propositions that spell out the relationship between them. The purpose of conceptual framework is to make scientific findings meaningful and generalized. A conceptual framework deals with the interrelated concepts on abstractions that are assembled together in some rational scheme by virtue of their relevance to a common theme. It helps to stimulate research and extension of knowledge by providing both direction and impetus. A framework may serve as a spring board for scientific advancement (Polit, 2008). The conceptual framework for this study is based on Modified Kings Goal Attainment Model (1981). According to Imogene King, nursing is defined as a process of action, reaction and interaction where by nurses and clients share information about their perception in nursing education. Through perceptions and communications, they identify the problem through which they set goals and take necessary action. Modified Kings Goal Attainment model is based on the interpersonal and social system including perception, judgement, action, reaction, interaction, transaction and feedback. Data was collected through the self-administration method by using instruments (Demographic variable Proforma, Beck Anxiety Inventory, Proforma to record B.P and level of acceptability scale). The study was conducted in Apollo Main Hospital, Nungambakkam from January 28th 2018 to April 5, 2018. The patients were randomized using systematic Simple Random Technique on the basis of selection criteria. The purpose and duration of the study was explained to the samples to obtain their cooperation and informed consent was taken from participants. Pretest was done by using Beck Anxiety scale and Proforma to record B.P from both group. The patient was made to sit on the bed and asked to wear Cardboard glasses and then VR meditation sceneries were played through mobile application. They were followed the scenes one by one where the natural sceneries and boating were displayed. The music’s and the solar system gives audio effect to get more interest towards the relaxation. During preoperative period, virtual reality therapy was given in the morning at 8 am and evening at 4 pm before taking routine medications consecutively for 2 days. It was continued in their postoperative period for 2 days till they were shifted to ward. No intervention was provided to the control group. Posttest was done on 5th POD by using Beck anxiety scale and Proforma to record B.P from both groups respectively. Level of acceptability was obtained from experimental group of patients undergoing CABG. MAJOR FINDINGS OF THE STUDY: Majority of patients were males (93.33%, 80%) and their income was above 40000/month (76.67%, 66.67%) in control and experimental group respectively. With regard to other variables, they were aged between 61yrs to 71 yrs (23.33%, 46.67%), had higher secondary education (33.33%, 36.67%) and involved in business (33.33%, 40%) in control and experimental group respectively. • Majority of patients had illness for less than 5 years (100%, 90%), no history of smoking (93.33%, 76.67%), had no history of alcoholism (86.66%, 80%), hospitalized for 5- 10 days (90%, 93.33%) in control and experimental group respectively. Around half of them, had hypertension (53.33%, 53.33%), not taking antihypertensive drugs (46.47%, 56.67%), body mass index was between 25- 29 (43.33%, 56.67%) and involved in moderate physical activity (46.47%, 46.67%), were vegetarian (66.67%, 53.33%) in control and experimental group respectively. • Majority of patients had mild level of anxiety in control (86.66%, 90%) and experimental group (86.67%, 96.66%) in pretest and posttest. • Majority of patients had normal diastolic B.P (83.33%, 83.33%) and had prehypertension in systolic B.P (46.67%, 50%) in experimental group in pretest and posttest. However, less than half of patients had prehypertension in systolic B.P (43.33%, 40%), had prehypertension in diastolic B.P (43.33%, 43.33%) in control group in pretest and posttest. • Mean and the standard deviation of pre-test and post-test anxiety scores of control group of patients (M= 19.7& SD= 2.7, M= 19.17& SD= 2.33) is higher than the experimental group (M= 17.37 & SD= 3.99, M= 14.83 & SD= 3.29) which is statistically significant with a‘t’ value of 5.59 at p<0.001. This can be attributed to the effectiveness of virtual reality therapy upon anxiety. Hence the null hypothesis (Ho1) “There will be no significant difference between pretest and posttest anxiety scores in control and experimental group of patients undergoing CABG” was rejected. • Mean and standard deviation of systolic B.P in control group did not show any significant reduction in posttest (M121.33, SD 13.32), when compared with pretest (M121.3, SD 12.95). In experimental group also mean and standard deviation of systolic B.P did not show any significant reduction in posttest (M 122.66, SD 12.26), when compared with pretest (M 123.66, SD 12.63). • Mean and standard deviation of diastolic B.P in control group did not show any significant reduction in posttest (M 76.3, SD 8.89), when compared with pretest (M 76, SD 8.55). In experimental group also mean and standard deviation of diastolic B.P did not show any significant reduction in posttest (M 65.33, SD 8.40), when compared with pretest (M 65.66, SD 8.20). Hence the null hypothesis (Ho2) “There will be no significant difference between pretest and posttest B.P scores in control and experimental group of patients undergoing CABG” was retained. • There was no correlation between variables such as anxiety, systolic B.P and diastolic B.P among patients undergoing CABG in control and experimental group in pretest and posttest (p>0.05). Hence the null hypothesis (Ho3) “There will be no significant correlation between anxiety and B.P scores in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected demographic variables of control group and level of anxiety in pretest and posttest (p > 0.05). Hence, the null hypothesis (Ho4) “There will be no significant association between the selected demographic variables and level of Anxiety in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected demographic variables of experimental group and level of anxiety in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho4) “There will be no significant association between selected demographic variables and level of Anxiety in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected demographic variables of control group and level of B.P in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho5) “There will be no significant association between selected demographic variables and level of B.P in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected demographic variables of experimental group and level of B.P in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho5) “There will be no significant association between selected demographic variables and level of B.P in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected clinical variables of control group and level of Anxiety in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho6) “There will be no significant association between selected clinical variables and level of anxiety in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected clinical variables of experimental group and level of anxiety in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho6) “There will be no significant association between selected clinical variables and level of anxiety in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected clinical variables of control group and level of B.P in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho7) “There will be no significant association between selected clinical variables and level of B.P in pretest and posttest of patients undergoing CABG” was retained. • There was no significant association between selected clinical variables of experimental group and level of B.P in pretest and posttest (p > 0.05). Hence the null hypothesis (Ho7) “There will be no significant association between selected clinical variables and level of B.P in pretest and posttest of patients undergoing CABG” was retained. RECOMMENDATIONS: The study may be conducted with larger samples for generalization of the results. • The study can be replicated in different settings. • The same study can be conducted using other different forms of virtual goggle or oculus rift. • A comparative study can be done using usual relaxation techniques and virtual reality therapy to assess the anxiety among various groups. • A comparative study can be done to assess the effectiveness among various psychosocial intervention including Virtual Reality Therapy. • A comparative study can be conducted between private and government settings