A Virtual University Infrastructure For Orthopaedic Surgical Training With Integrated Simulation

This thesis pivots around the fulcrum of surgical, educational and technological factors. Whilst there is no single conclusion drawn, it is a multidisciplinary thesis exploring the juxtaposition of different academic domains that have a significant influence upon each other. The relationship centres on the engineering and computer science factors in learning technologies for surgery. Following a brief introduction to previous efforts developing surgical simulation, this thesis considers education and learning in orthopaedics, the design and building of a simulator for shoulder surgery. The thesis considers the assessment of such tools and embedding into a virtual learning environment. It explains how the performed experiments clarified issues and their actual significance. This leads to discussion of the work and conclusions are drawn regarding the progress of integration of distributed simulation within the healthcare environment, suggesting how future work can proceed

Lessons Learned about the Design and Active Characterization of On-Body Antennas in the 2.4 GHz Frequency Band

This work addresses the design and experimental characterization of on-body antennas, which play an essential role within Body Sensor Networks. Four antenna designs were selected from a set of eighteen antenna choices and finally implemented for both passive and active measurements. The issues raised during the process of this work (requirements study, technology selection, development and optimization of antennas, impedance matching, unbalanced to balanced transformation, passive and active characterization, off-body and on-body configurations, etc.) were studied and solved, driving a methodology for the characterization of on-body antennas, including transceiver effects. Despite the influence of the body, the antennas showed appropriate results for an in-door environment. Another novelty is the proposal and validation of a phantom to emulate human experimentation. The differences between experimental and simulated results highlight a set of circumstances to be taken into account during the design process of an on-body antenna: more comprehensive simulation schemes to take into account the hardware effects and a custom design process that considers the application for which the device will be used, as well as the effects that can be caused by the human body.Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15/00306Junta de Andalucía PIN-0394-2017Unión Europea "FRAIL

Computer Assisted Learning in Obstetric Ultrasound

Ultrasound is a dynamic, real-time imaging modality that is widely used in clinical obstetrics. Simulation has been proposed as a training method, but how learners performance translates from the simulator to the clinic is poorly understood. Widely accepted, validated and objective measures of ultrasound competency have not been established for clinical practice. These are important because previous works have noted that some individuals do not achieve expert-like performance despite daily usage of obstetric ultrasound. Underlying foundation training in ultrasound was thought to be sub-optimal in these cases. Given the widespread use of ultrasound and the importance of accurately estimating the fetal weight for the management of high-risk pregnancies and the potential morbidity associated with iatrogenic prematurity or unrecognised growth restriction, reproducible skill minimising variability is of great importance. In this thesis, I will investigate two methods with the aim of improving training in obstetric ultrasound. The initial work will focus on quantifying operational performance. I collect data in the simulated and clinical environment to compare operator performance between novice and expert performance. In the later work I developed a mixed reality trainer to enhance trainee’s visualisation of how the ultrasound beam interacts with the anatomy being scanned. Mixed reality devices offer potential for trainees because they combine real-world items with items in the virtual world. In the training environment this allows for instructions, 3-dimensional visualisations or workflow instructions to be overlaid on physical models. The work is important because the techniques developed for the qualification of operator skill could be combined in future work with a training programme designed around educational theory to give trainee sonographers consistent feedback and instruction throughout their training

Scoping a vision for formative e-assessment: a project report for JISC

Assessment is an integral part of teaching and learning. If the relationship between teaching and learning were causal, i. e. if students always mastered the intended learning outcomes of a particular sequence of instruction, assessment would be superfluous. Experience and research suggest this is not the case: what is learnt can often be quite different from what is taught. Formative assessment is motivated by a concern with the elicitation of relevant information about student understanding and / or achievement, its interpretation and an exploration of how it can lead to actions that result in better learning. In the context of a policy drive towards technology-enhanced approaches to teaching and learning, the question of the role of digital technologies is key and it is the latter on which this project particularly focuses. The project and its deliverables have been informed by recent and relevant literature, in particular recent work by Black andIn this work, they put forward a framework which suggests that assessment for learning their term for formative assessment can be conceptualised as consisting of a number of aspects and five keystrategies. The key aspects revolve around the where the learner is going, where the learner is right now and how she can get there and examines the role played by the teacher, peers and the learner. Language: English Keywords: assessments, case studies, design patterns, e-assessmen

A Tablet-based Virtual Environment for Neurosurgery Training

Published in Presence: Teleoperators and Virtual Environments, Spring 2015No. 2, Pages 155-162 Posted Online October 15, 2015. doi:10.1162/PRES_a_00224The requirement for training surgical procedures without exposing the patient to additional risk is well accepted and is part of a national drive in the UK and internationally. Computer-based simulations are important in this context, including neurosurgical resident training. The objective of this study is to evaluate the effectiveness of a custom built virtual environment in assisting training of a ventriculostomy procedure. The training tool (called VCath) has been developed as an app for a tablet platform to provide easy access and availability to trainees. The study was conducted at the first boot camp organized for all year one trainees in neurosurgery in the UK. The attendees were randomly distributed between the VCath training group and the Control group. Efficacy of performing ventriculostomy for both groups was assessed at the beginning and end of the study using a simulated insertion task. Statistically significant changes in performance of selecting the burr hole entry point, the trajectory length and duration metrics for the VCath group, together with a good indicator of improved normalized jerk (representing the speed and smoothness of arm motion), all suggest that there has been a higher level cognitive benefit to using VCath. The app is successful as it is focused on the cognitive task of ventriculostomy, encouraging the trainee to rehearse the entry point and use anatomical landmarks to create a trajectory to the target. In straight-line trajectory procedures such as ventriculostomy, cognitive task based education is a useful adjunct to traditional methods and may reduce the learning curve and ultimately improve patient safety

Contextualising simulation: the use of patient-focused hybrid simulation for clinical skills education

This thesis documents a research programme into the use of Patient-Focused Hybrid Simulation (PFHS) for clinical skills education. PFHS is an approach to simulating clinical skills that combines a simulated patient (SP) with a part-task trainer (PTT) embedding the simulation of procedural skills within a more holistic clinical context, potentially overcoming some of the shortcomings of single modality simulation. Although promising, there remains limited evidence supporting its use. Two studies were conducted using a mixed-method approach. The first study was based on the simulation of the management of a traumatic skin laceration and consisted of two parts: 1) investigating the use of PFHS as a means of introducing clinical challenge by modifying the clinical context in which a procedure is performed; 2) exploring clinician’s perception of the use of PFHS and PTT for assessing of clinical competence. These findings suggest that by changing the clinical context in which a procedure is performed, PFHS can potentially be used to objectively simulate challenge. It also demonstrated that PFHS when compared to PTT simulations was better able to induce authentic clinical behaviour within the simulation. Central to this is the presence of a human being (SP). The second study compared the use of PFHS to patients for the training and assessment of cardiovascular examination skills. Within the limitations of this study, no significant difference was observed between PFHS and real patient-trained students in terms of their post-training performance of cardiovascular examination on real patients. There also appeared to be degree of concurrent validity between assessment of competency with PFHS and with real patients when conducted as an Objective Structured Clinical Examination (OSCE). The work presented provides additional evidence to the existing literature to support the use of PFHS in clinical skills education. However, it also raises a multitude of questions particularly of how PFHS as well as simulation in general should be used and future directions for simulation research.Open Acces

Monte Carlo simulation software for realistic SPECT studies

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2022-2023. Tutor/Director: Niñerola Baizán, Aida, Tudela Fernández, Raú

Sensitivity Analysis of Optimum Tutor Staffing Schedule Using Discrete Event Simulation

This study utilized the discrete-event simulation (DES) approach to optimize the daily tutor cost for the Unified Tutoring Center, located at the Daytona Beach campus of Embry-Riddle Aeronautical University. The simulation model was built using Arena version 12, and the objective of the study was to determine an optimum tutor staffing schedule to minimize operating costs, while also servicing as many students as possible and with the students experiencing a minimal wait time. Data was collected by videotaping four weeks (or 20 nights) worth of evening tutoring sessions, held Sunday through Thursday between 6-9pm. Two models, the General Study Room and the Physics & Chemistry Lab, were validated by comparing the observed tutor utilization with the model\u27s output utilization. A sensitivity analysis was conducted on both models using constrained optimization, based on average wait time, maximum wait time and maximum tutor utilization. A more practical tutor staffing schedule was found for the General Study Room and the Physics & Chemistry Lab, yielding an overall decrease in the weekly operational cost of tutors by $204.00. These results are discussed and conclusions are given at the end of this paper

Effects of Metacognitive Monitoring on Academic Achievement in an Ill-Structured Problem-Solving Environment

Higher education courses are increasingly moving online while educational approaches are concurrently shifting their focus toward student-centered approaches to learning. These approaches promote critical thinking by asking students to solve a range of ill-structured problems that exist in the real world. Researchers have found that student-centered online learning environments require students to have self-regulated learning skills, including metacognitive skills to regulate their own learning processes. Much of the research suggests that externally supporting students while they are learning online, either directly or indirectly, helps them to succeed academically. However, few empirical studies have investigated what levels of support are most effective for promoting students\u27 self-regulated learning behaviors. Additionally, these studies reported conflicting results – some found maximum support to be most effective while others found no significant difference. The purpose of this study was to investigate the effectiveness of different levels of support for self-regulated learning during a complex learning activity to solve an ill-structured problem-solving situation in an online learning environment. In addition, the role of students\u27 self-efficacy on their academic achievement was examined. A total of 101 undergraduate students from three international studies courses offered at a large urban Southeastern public university in the United States participated in the study. The students were randomly assigned to treatment (minimum support, maximum support) and control groups. Students\u27 academic achievement scores were measured using a conceptual knowledge test created by the professor teaching the courses. O\u27Neil\u27s (1997) Trait Self-Regulation Questionnaire measured students\u27 self-efficacy. Analysis of Co-Variance (ANCOVA) was conducted to analyze the data. The ANCOVA results indicated significant improvement of the academic achievement of the minimum support group versus both the maximum support and control groups. Additionally, self-efficacy as a co-variable did not significantly impact students\u27 achievement scores in any of the groups. The overall results indicated that it is important to consider the level of self-regulated learning support when designing online learning environments promoting students\u27 critical thinking skills. Promoting students\u27 self-regulated learning skills is vital when designing online higher education courses