Immersive Composition for Sensory Rehabilitation: 3D Visualisation, Surround Sound, and Synthesised Music to Provoke Catharsis and Healing

There is a wide range of sensory therapies using sound, music and visual stimuli. Some focus on soothing or distracting stimuli such as natural sounds or classical music as analgesic, while other approaches emphasize the active performance of producing music as therapy. This paper proposes an immersive multi-sensory Exposure Therapy for people suffering from anxiety disorders, based on a rich, detailed surround-soundscape. This soundscape is composed to include the users’ own idiosyncratic anxiety triggers as a form of habituation, and to provoke psychological catharsis, as a non-verbal, visceral and enveloping exposure. To accurately pinpoint the most effective sounds and to optimally compose the soundscape we will monitor the participants’ physiological responses such as electroencephalography, respiration, electromyography, and heart rate during exposure. We hypothesize that such physiologically optimized sensory landscapes will aid the development of future immersive therapies for various psychological conditions, Sound is a major trigger of anxiety, and auditory hypersensitivity is an extremely problematic symptom. Exposure to stress-inducing sounds can free anxiety sufferers from entrenched avoidance behaviors, teaching physiological coping strategies and encouraging resolution of the psychological issues agitated by the sound

The Effects of Simulation-Based Training on Critical Thinking

The purpose of this study was to examine the effects of a simulation-based training on the critical thinking skills of 10 graduate medical education trainees to understand the potential of simulation-based training as an innovative tool to improve medical competencies among trainees in a graduate medical training program. The theoretical framework incorporated in this study focused on the Five-Stage Model of Adult Skill Acquisition by Dreyfus and Dreyfus and the Theory of Andragogy by Malcolm Knowles to examine how adults learn in a medical simulation-based training setting. This study utilized a pre-and posttest, the AAC&U VALUE Critical Thinking Rubric, and individual interviews with trainees after the simulation. In analyzing pre/posttest scores, a paired samples t-test revealed that all 10 trainees showed a small growth in critical thinking regarding the management of a patient with cardiogenic shock based on hemodynamics by 0.30. A summary of the rubric study findings reported that third-year trainees received the highest critical thinking scores, while first-year trainees received the lowest critical thinking scores. Participant mean scores on the rubric also showed a correlation in the progression of training year to increased critical thinking in their use of hemodynamics to manage patient with cardiogenic shock. Post-simulation interviews with study participants reflected four major themes that included: (a) discrepancies in frequency and classification of simulation training, (b) the simulation learning environment, (c) from theory to practice, and (d) the impact of simulation training on clinical practice. The results of this study indicated the amount of prior exposure a trainee has to the medical competency that is being addressed in the simulation may have an influence on how the trainee perceives the value of the training. This study also found the amount of interaction that a rater has with the trainee may cultivate a bias in how they evaluate the trainee’s procedural and theoretical knowledge. The researcher recommends the implementation of a cohesive simulation curriculum for graduate medical education training programs. The researcher also recommends providing trainees with adequate exposure to simulation that is meaningful, practical, and relevant to their training to elevate the trainees overall learning experienc

Focal Spot, Spring 1996

https://digitalcommons.wustl.edu/focal_spot_archives/1072/thumbnail.jp

Cultivating a Culture of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited to cultivate and sustain a competent and compassionate nursing workforce? This evidence-based quality improvement project is built on existing findings from Simulation-Based Education (SBE), as an effective pedagogy, to enhance professional nursing practice. A smartphone mobile education application (app) was developed, implemented, and evaluated for a cohort of newly graduated registered nurses to improve their transition to practice experiences in a nurse residency program at a large integrated healthcare system in Southern California. By incorporating the science of caring, experiential learning, mindfulness practice, self-reflection, and peer-to-peer feedback, through the use of a state-of-the-art mobile app, into an existing simulation-based nurse residency program, participants reported an increase in clinical competency, communication skills, reflective practice, and self-compassion

Instructional *simulations and the concepts of shared cognition

Graduates of registered nurse educational programs are expected to bring some degree of preparedness for intervening in emergency situations. However, within the clinical portion of the curricula a student may not have the opportunity to observe and or participate in patient respiratory or cardiac resuscitation. Volunteer participants, student nurses, engaged in practice with a human simulator (SimMan) and teacher guided dialogue to assist in the construction of nursing knowledge in a safe, supportive environment. SimMan was programmed with eight scenarios depicting common patient emergency situations. Simulations and debriefings were videotaped and transcribed. Post employment interviews were audio taped and transcribed. Discourse analysis was utilized to determine if the simulations assisted the students to incorporate the language used in verbal communication within the usual discourse of the setting and the discipline, as well as incorporating previous and new information; Participants demonstrated acquisition of meaning of selected scientific concepts and constructed a personal scaffold of learning. Employed graduates, reported that simulation and debriefing, was consequential in their progress as a student, as well as a new nurse employee. It accelerated their confidence in assuming the appropriate role responsibilities, hastened participation, and lessened hesitancy in acting

Development of Evidence-Based Scenario with High Fidelity Simulation to Improve Nursing Care of Chest Pain Patients

Cardiovascular disease remains the leading cause of mortality in the United States, and a primary educational objective is to develop professional competency among nurses to ensure the provision of safe and effective care to the cardiac patient. Benner\u27s theory of novice-to-expert led to the development of an evidence-based scenario for the care of the patient with chest pain using risk-free high-fidelity simulation environments that focused on assessment, history taking, and communication, while evaluating improvements in the competency of nurses providing care to chest pain patients. Thirty-six nurses volunteered in the study. Feedback from nurse educators, which led to modifications to the scenario, preceptor evaluation of participants during simulation, and post simulation feedback of participants, were analyzed using an inductive and exploratory theme analysis. Participants reported they learned meaningful information but felt somewhat confused regarding the correct course of action when multiple events occurred simultaneously. Preceptors\u27 feedback identified participant failure to meet stated scenario expectations. Quantitative analysis of data, using one sample t test, compared the pre- and post-test scores measuring participant knowledge on assessment, history taking, and communication. Although knowledge scores increased, the difference was not clinically significant based on the negative feedback from both preceptor and participants. Accurate appraisal of nurses\u27 competency in assessment, history-taking, and communication skills is needed prior to exposure to simulation. Simulation scenarios may be more clinically significant when tailored to an individual participant\u27s competency levels

Perceptions of Integrating Immersive Virtual Reality Simulation as a Teaching Methodology in a Hospital Setting

Introduction As newly licensed nurses enter the workforce with limited experience and limited clinical reasoning skills, nursing educators must employ innovative strategies to teach graduate nurses how to identify and manage clinical deterioration – skills which are vital to saving lives and improving outcomes. Fully immersive Virtual Reality (VR), (also defined as Immersive VR) is one effective educational strategy available for hospital educators to use for preparing newly licensed nurses to recognize and manage clinical deterioration. Objective The purpose of this study was to explore perceptions of hospital-based nurse educators, simulation specialists, and nursing leaders with respect to integrating immersive VR to teach management of clinical deterioration to newly licensed nurses. The primary goal of this study was to assess the facilitators and barriers associated with integrating immersive VR. Methods A generic qualitative descriptive approach employing group and individual interviews was undertaken using purposive sampling of experienced hospital nursing educators, nurse simulation specialists and education department administrators. Data were analyzed using thematic analysis. Results Fifteen individual and one group interview were conducted using semi structured interviews. Participants indicated that use of immersive VR for educating newly licensed nurses could prove successful in their organizations if they had the proper resources, time to learn and develop the training modalities, create scenarios that were relevant to the learner’s needs, and financial/logistical support from the organization’s stakeholders. Conclusion Immersive VR may be an effective pedagogy for educating newly licensed nurses on managing clinical deterioration if sufficient resources are in place for its’ support

A Framework for Measuring Return on Investment for Healthcare Simulation-Based Training

In the healthcare sector, providing high-quality service in a safe environment for both patient and staff is an obvious and ultimate major objective. Training is an essential component for achieving this important objective. Most organizations acknowledge that employee simulation-based training programs are an important part of the human capital strategy, yet few have effectively succeeded in quantifying the real and precise ROI of this type of investment. Therefore, if the training is perceived as a waste of resources and its ROI is not clearly recognized, it will be the first option to cut when the budget cut is needed. The various intangible benefits of healthcare simulation-based training are very difficult to quantify. In addition, there was not a unified way to count for the different cost and benefits to provide a justifiable ROI. Quantifying the qualitative and intangible benefits of medical training simulator needed a framework that helps to identify and convert qualitative and intangible benefits into monetary value so it can be considered in the ROI evaluation. This research is a response to the highlighted importance of developing a comprehensive framework that has the capability to take into consideration the wide range of benefits that simulation-based training can bring to the healthcare system taking into consideration the characteristics of this specific field of investment. The major characteristics of investment in this field include the uncertainty, the qualitative nature of the major benefits, and the diversity and the wide range of applications. This comprehensive framework is an integration of several methodologies and tools. It consists of three parts. The first part of the framework is the benefits and cost structure, which pays special attention to the qualitative and intangible benefits by considering the Value Measurement methodology (VMM) and other previously existing models. The second part of the framework is important to deal with the uncertainty associated with this type of investment. Monte Carlo simulation is a tool that considered multiple scenarios of input sets instead of a single set of inputs. The third part of the framework considers an advanced value analysis of the investment. It goes beyond the discounted cash flow (DCF) methodologies like net present value (NPV) that consider a single scenario for the cash flow to Real Options Analysis that consider the flexibility over the lifetime of the investment when evaluating the value of the investment. This framework has been validated through case studies

Data-driven modelling of biological multi-scale processes

Biological processes involve a variety of spatial and temporal scales. A holistic understanding of many biological processes therefore requires multi-scale models which capture the relevant properties on all these scales. In this manuscript we review mathematical modelling approaches used to describe the individual spatial scales and how they are integrated into holistic models. We discuss the relation between spatial and temporal scales and the implication of that on multi-scale modelling. Based upon this overview over state-of-the-art modelling approaches, we formulate key challenges in mathematical and computational modelling of biological multi-scale and multi-physics processes. In particular, we considered the availability of analysis tools for multi-scale models and model-based multi-scale data integration. We provide a compact review of methods for model-based data integration and model-based hypothesis testing. Furthermore, novel approaches and recent trends are discussed, including computation time reduction using reduced order and surrogate models, which contribute to the solution of inference problems. We conclude the manuscript by providing a few ideas for the development of tailored multi-scale inference methods.Comment: This manuscript will appear in the Journal of Coupled Systems and Multiscale Dynamics (American Scientific Publishers

Walking in a patient’s shoes: an evaluation study of immersive learning using a digital training intervention

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention ‘In Their Shoes’ which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and ‘kit’ items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre–post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided ‘eye opening’ insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings align with other literature evaluating immersive learning and the potential for increasing knowledge, empathy and motivation. The present study offers opportunities to extend this outside of the body of work focussing on healthcare practitioners and explores the benefits of using this type of learning experience within an organizational setting