Effectiveness analysis of traditional and mixed reality simulations in medical training: a methodological approach for the assessment of stress, cognitive load and performance

La simulazione nell'educazione in medicina è considerata un metodo di formazione in grado di migliorare le competenze cliniche e il comportamento degli operatori sanitari e, di conseguenza, la qualità dell'assistenza per il paziente. Inoltre, l'utilizzo di nuove tecnologie come la Realtà Aumentata, offre ai discenti l'opportunità di esercitarsi in un ambiente immersivo. L'opportunità di sperimentare questo innovativo metodo didattico è efficace non solo nel ridurre il rischio di errori e approcci sbagliati ma anche nel provare ansia e stress simili a quelli avvertiti nella pratica reale. La sfida sta nel trovare il giusto equilibrio. I discenti devono infatti provare lo stesso stress che avvertirebbero lavorando ad un vero caso clinico ma, allo stesso tempo, devono essere controllati ed evitati possibili disturbi da stress post-traumatico, verificabili soprattutto nel campo della gestione delle emergenze (pronto soccorso). Inoltre, è fondamentale anche ottenere alte prestazioni e un apprendimento adeguato, evitando sovraccarichi cognitivi che influenzerebbero negativamente l’apprendimento. Tuttavia, ad oggi mancano ancora studi approfonditi sull'impatto che le simulazioni mediche hanno su stress, frustrazione, carico cognitivo e apprendimento dei discenti. Per questo motivo, l'obiettivo principale di questo studio è valutare l'efficacia del training tramite simulazione, analizzando prestazioni, ansia, stress e carico cognitivo durante simulazioni cliniche tradizionali (con manichino) ed avanzate (in realtà mista). A questo scopo, è stato sviluppato un approccio metodologico strutturato e completo per valutare le prestazioni, le condizioni emotive e cognitive degli studenti. Questo comprende l'acquisizione e l'analisi di parametri psicologici (valutazione soggettiva), segnali biometrici (valutazione oggettiva) e prestazioni. Questa indagine consente di evidenziare i punti deboli delle simulazioni e offre l'opportunità di definire utili linee guida per la riprogettazione e l'ottimizzazione delle stesse. La metodologia è stata applicata su tre casi studio: il primo si riferisce a simulazioni ad alta fedeltà per la gestione del paziente in pronto soccorso, il secondo si riferisce a simulazioni a bassa fedeltà per la pratica della rachicentesi. Per il terzo caso studio, è stato progettato e sviluppato un prototipo di simulatore in realtà mista per la rachicentesi, con l'obiettivo di migliorare il senso di realismo e immersione della simulazione a bassa fedeltà. 148 studenti sono stati coinvolti nei primi due casi studio osservazionali, mentre soltanto 36 studenti hanno preso parte allo studio pilota sulla simulazione in realtà mista. In tutti i casi di studio sono state effettuate analisi descrittive delle prestazioni, degli stati cognitivi ed emotivi. Per le simulazioni ad alta e bassa fedeltà, le analisi di regressione statistica hanno evidenziato quali variabili influenzano le prestazioni, lo stress e il carico cognitivo degli studenti. Per lo studio pilota sulla realtà mista, l'analisi della user experience ha sottolineato i limiti tecnici della nuova tecnologia.Simulation in medical education is considered a training method capable of improving clinical competence and practitioners’ behaviour, and, consequently quality of care and patient’s outcome. Moreover, the use of new technologies, such as augmented reality, offers to the learners the opportunity to engage themselves in an immersive environment. The opportunity to experiment with this innovative instructional method is effective not only in reducing the risk of errors and wrong approaches but also in experiencing anxiety and stress as in real practice. The challenge is to find the right stress balance: learners have to feel as if they were practicing in the real stressful clinical case, and, at the same time, post-traumatic stress disorders, verifiable especially in the emergency field, must be controlled and avoided. Moreover, it is fundamental also to obtain high performance and learning, thus avoiding cognitive overloads. However, extensive researches about the impact of medical simulations on students’ stress, frustration, cognitive load, and learning are still lacking. For this reason, the main objective of this study is to assess simulation training effectiveness by analysing performance, anxiety, stress, and cognitive load during traditional (with manikin) and advanced (with augmented reality) clinical simulations. A structured and comprehensive methodological approach to assess performance, emotional and cognitive conditions of students has been developed. It includes the acquisition and analysis of psychological parameters (subjective assessment), biometric signals (objective assessment), and task performance. This investigation allows to point out simulations’ weaknesses and offers the opportunity to define useful optimisation guidelines. The methodology has been applied to three case studies: the first one refers to high-fidelity simulations, for the patient management in the emergency room, the second one refers to low-fidelity simulation for rachicentesis. For the third case study, a prototype of a mixed reality simulator for the rachicentesis practice has been designed and developed aiming at improving the sense of realism and immersion of the low-fidelity simulation. While 148 students have been enrolled in the first two case studies, only 36 students have taken part in the pilot study about mixed reality simulation. Descriptive analysis about performance, cognitive and emotional states have been done in all the case studies. For the high-fidelity and low-fidelity simulations, the statistical regression analysis has pointed out which variables affect students’ performance, stress, and cognitive load. For the pilot study about mixed reality, the user experience analysis highlighted the technical limitations of the new technology

Harnessing Technology: new modes of technology-enhanced learning: a case study series

This report presents the outcomes and conclusions from a series of 18 case studies exploring the innovative use of technology for learning and teaching using new modes of technology

The written production of argumentative and dissertation text: a didactic project based on Bakhtin's philosophy

This article is characterized as a theoretical and practical research related to a project developed during the year 2015 in two schools - one public, the other private- , in the city of Birigui, State of São Paulo, Brazil. The main goal of the study was to analyze: the pedagogical project and the teachers’ activities oriented towards teaching and learning of argumentative and dissertation texts. The methodology used in this research comprised: (i) visiting both schools, (ii) producing a description of ongoing school practices, with focus on the teaching of argumentative and dissertation texts, (iii) suggesting a teacher’s activity to improve this apprenticeship, (iv) putting this activity into practice and (v) analyzing obtained results. The theoretical framework used for this study was the Bakhtinian philosophy (BAKHTIN, 2013; 2006a; 2006b; 2006c; 2006d; 2010; 2013; VOLOSHINOV, 1986). This theoretical approach was chosen due to the importance of comprehension of the text not just as an amalgamated set of words, phrases and paragraphs; other than that, we understand it as a structure of meaning, in which we encounter linguistic forms, ideologies and discursive stance. At last, we can say the results show that the argumentative texts render assistance to the development of the students’ argumentative competence and skill, that is, in their ability to argue and organize ideas in a communicative situation

MIRACLE Handbook : Guidelines for Mixed Reality Applications for Culture and Learning Experiences

Siirretty Doriast

ADEPT:Exploring the Design, Pedagogy, and Analysis of a Mixed Reality Application for Piano Training

(Abstract to follow

Journeying into darkness: spatializing Latinx students’ literacy narratives in the in-between

This study utilized a narrative inquiry model to explore the narratives-in-construction of seven Latinx students’ lived experiences in a ninth-grade social studies class. Layered and parallel narratives constructed around critical incidents and as told by the student participants, their teacher, and the researcher were used to examine the co-constitutive nature of spaces related to literacy and history teaching and learning. Data were collected over the course of the semester-long course and included class observations, artifact collection, and critical incident think-aloud protocol interviews conducted with students three times a week. An adapted positioning analysis framework was used to examine narratives at three levels, moving from the level of participant talk to that of broader sociocultural discourses. Four storylines emerged from the data that illustrated (a) the ways in which the teacher’s instruction informed student decision-making about learning; (b) how the teacher’s positioning of students determined legitimization of that decision; (c) students’ agentive actions in response to the teacher’s positioning; and (d) the conceptualizations of personhood that emerged. These storylines were then deconstructed using a spatial framework to examine the ways in which the Latinx students’ learning spaces were expanded or constricted. Observed shifts in the borders and boundaries of spaces informed implications drawn for teaching and learning

Smart glasses for 3D multimodal composition

Extended reality technologies – mixed, augmented, and virtual reality, and future-related technologies – are rapidly expanding in many fields, with underexplored potentials for multimodal composition in digital media environments. This research generates new knowledge about the novel wearable technology – smart glasses – to support elementary students’ multimodal story authoring with 3D virtual objects or holograms. The researchers and teachers implemented learning experiences with upper elementary students from three classrooms to compose and illustrate written narratives before retelling the story with Microsoft HoloLens 2 smart glasses, selecting 3D holograms to illustrate the settings, characters, and events from the 3D Viewer software. The findings analyse how smart glasses supported students’ multimodal composition, and relatedly, the new modal resources available to students wearing smart glasses to compose 3D stories. The findings have significance for educators and researchers to understand and utilise the multimodal affordances of augmented and mixed reality environments for composing and storytelling

Games, Simulations, Immersive Environments, and Emerging Technologies

International audienceThis entry presents an overview of advanced technologies to support teaching and learning. The use of innovative interactive systems for education has never been higher. Far from being just a trend, the objective is to use the current technology to cover educational needs and create relevant pedagogical situations. The arguments in their favor are generally their positive effects on learners’ motivation and the necessity to provide learning methods adapted to our growing digital culture. The new learning technologies and emerging trends are first reviewed hereunder. We thus define and discuss learning games, gamification, simulation, immersive environments and other emerging technologies. Then, the current limits and remaining scientific challenges are highlighted

An Activity-Based Approach to Technology Integration in the Mathematics Classroom

Becoming a mathematics teacher today can be a challenging endeavor, requiring teachers to learn difficult content and specialized pedagogies, as well as new technological tools and techniques. How do we help teachers not to become so learned in mathematical concepts, yet so ignorant in modern mathematics instruction, that they essentially buy a cow to ride on and thus poorly combine content, pedagogy, and technology to form classroom activities that are instructionally unsound