Holo-BLSD – A holographic tool for self-training and self-evaluation of emergency response skills

In case of cardiac arrest, prompt intervention of bystanders can be vital in saving lives. Basic Life Support and Defibrillation (BLSD) is a procedure designed to deliver a proficient emergency first response. Developing skills in BLSD in a large part of the population is a primary educational goal of resuscitation medicine. In this context, novel computer science technologies like Augmented Reality (AR) and Virtual Reality (VR) can alleviate some of the drawbacks of traditional instructor-led courses, especially concerning time and cost constraints. This paper presents Holo-BLSD, an AR system that allows users to learn and train the different operations involved in BLSD and receive an automatic assessment. The system uses a standard manikin which is quotes{augmented} by an interactive virtual environment that reproduces realistic emergency scenarios. The proposed approach has been validated through a user study. Subjective results confirmed the usability of the devised tool and its capability to stimulate learners' attention. Objective results indicated no statistical significance in the differences between the examiners' evaluation of users who underwent traditional and AR training; they also showed a close agreement between expert and automatic assessments, suggesting that Holo-BLSD can be regarded as an effective self-learning method and a reliable self-evaluation tool

The Multimodal Tutor: Adaptive Feedback from Multimodal Experiences

This doctoral thesis describes the journey of ideation, prototyping and empirical testing of the Multimodal Tutor, a system designed for providing digital feedback that supports psychomotor skills acquisition using learning and multimodal data capturing. The feedback is given in real-time with machine-driven assessment of the learner's task execution. The predictions are tailored by supervised machine learning models trained with human annotated samples. The main contributions of this thesis are: a literature survey on multimodal data for learning, a conceptual model (the Multimodal Learning Analytics Model), a technological framework (the Multimodal Pipeline), a data annotation tool (the Visual Inspection Tool) and a case study in Cardiopulmonary Resuscitation training (CPR Tutor). The CPR Tutor generates real-time, adaptive feedback using kinematic and myographic data and neural networks

A Simulation-Based Teaching Strategy to Achieve Competence in Learners

Background: Simulation-based education has become the mainstay of clinical education in health sciences and medical education. A simulation-based education is a result of work hour restriction placed on graduate learners, increased number of students requiring clinical experience, decreased number of clinical sites and lack of the availability to perform certain procedures by learners. Research has demonstrated that integration of a simulation-based educational teaching strategy in a curriculum and throughout continued learning achieves competence in learners. Methods: The review of the literature highlighted the following topics: (a) history of medical simulation, (b) fidelity used in simulation training, devices and equipment, (c) learning theories associated with simulation-based education, (d) role of simulation training in medical and health sciences education, e) advantages and disadvantages of simulation training, f) competence in simulation-based education, g) debriefing/reflection in simulation. Results: An extensive review of the literature supports the use of a simulation-based teaching strategy in health sciences and medical education. Learning theories associated with simulation-based education allow educators to provide teaching strategies that align with learner’s ability to achieve competence in learning clinical and procedural skills required for their profession. Conclusion: A simulation-based education integrated in all stages of learner education that provides deliberate/repetitive practice and feedback achieves competence in learners throughout a life-time of learning

Education, implementation, and teams : 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application

Education, implementation, and teams : 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application

Can a novel infant CPR retraining strategy result in longer skill retention?

The overall aim of this thesis was to create a novel, tailored, competence-based strategy to infant cardiopulmonary resuscitation (iCPR) retraining, with the ultimate goal of maximising retention of iCPR skills and potentially, improve survival rates after cardiac arrest. To interpret real changes in iCPR performance, consistency and variability of simulated iCPR skills were investigated through a within-day and between-day reliability study. Intraclass Correlation Coefficient, Standard Error of Measurement and Minimal Detectable Change were used. The results demonstrated that iCPR skills are highly repeatable and consistent, indicating that changes in performance after training can be considered real skill decay or improvement, and not variability in human performance. However, when the metrics are transformed in quality indices, large changes are required to be confident of real change. Differences in performance between dominant hand (DH) and non-dominant hand (NH) during simulated iCPR, and how perception of fatigue may affect performance, were also investigated. A randomised study was conducted, and the results indicated no significant differences in performance with DH versus NH for any iCPR metric. However, perception of fatigue is higher in NH and is related to compression rate and residual leaning, but with no effect on quality of performance. Based on the results, individuals performing iCPR can offer similar quality of infant chest compressions, regardless of the hand used. To investigate iCPR skill acquisition and retention, a prospective, longitudinal, interventional study with 118 participants was conducted. The results indicate that, despite individuals requiring different amounts of input and time (four to 28 minutes after initial training) to achieve iCPR competence, the retention of those skills was as high as 96% at follow-up. This suggests that the optimal reinforcement schedule is highly likely to vary depending on the individual achieving iCPR competence. It may be argued that this tailored, competence-based retraining model, can potentially reduce training costs overall, enhance iCPR performance, and in consequence, may improve the chances of survival after infant cardiac arrest

IMMERSIVE LEARNING IN EDUCATION FOR CPR SKILLS ACQUISITION

This quasi-experimental research study 1) explored the effectiveness of implementing a Virtual Reality CPR simulation for improving knowledge and skills on the Basic Life Support exam and 2) explored the favorability of using a CPR VR simulation for recertification as measured through a self-efficacy survey instrument. Participants included staff, faculty, or students at a small liberal arts college located in the southeast United States seeking re-certification in CPR. This study was conducted in the following steps; 1) conducted literature review that encompasses opportunities in CPR training, opportunities in VR, games and simulations in education, implementation challenges, and research opportunities and frameworks 2) applied for approval from the IRB at both Sam Houston State University and the participating college 3) acquired Oculus Go VR headsets and install the simulation software on each device 4) recruited an instructor and participants to participate in the study 5) scheduled classes and reserve facilities 6) conduct the study and analyze the data. This study provided evidence of the efficacy and favorability of using a CPR VR simulation as part of a CPR recertification course