Development and evaluation of two 3D-simulated practice learning environments

This paper discusses the evaluation of two 3D simulated practice learning environments, Tiny Oaks and Play2Do, focused on supporting people working with children, families, and vulnerable people in special educational settings. Pre-test/post-test evaluation methodology was employed consisting of a questionnaire with 16 questions covering knowledge and understanding, professional practice, and transferable skills. Tiny Oaks had 530 participants pre-test and 423 post-test from six European countries, and results show a significant increase in learning across all questions. Play2Do had 318 participants pre-test and 301 participants post-test from the UK and Bulgaria, and again results show a significant increase in learning across all questions. The system usability scale (SUS) questionnaire was also used to measure the usability of the two environments, and usability was found to be excellent. Findings suggest that 3D simulated practice environments can provide a valuable learning experience and can provide practice learning scenarios that may be difficult to encounter in real-life

A systematic review of technologies and standards used in the development of rule-based clinical decision support systems

A Clinical Decision Support System (CDSS) is a technology platform that uses medical knowledge with clinical data to provide customized advice for an individual patient's care. CDSSs use rules to encapsulate expert knowledge and rules engines to infer logic by evaluating rules according to a patient's specific information and related medical facts. However, CDSSs are by nature complex with a plethora of different technologies, standards and methods used to implement them and it can be difficult for practitioners to determine an appropriate solution for a specific scenario. This study's main goal is to provide a better understanding of different technical aspects of a CDSS, identify gaps in CDSS development and ultimately provide some guidelines to assist their translation into practice. We focus on issues related to knowledge representation including use of clinical ontologies, interoperability with EHRs, technology standards, CDSS architecture and mobile/cloud access. This study performs a systematic literature review of rule-based CDSSs that discuss the underlying technologies used and have evaluated clinical outcomes. From a search that yielded an initial set of 1731 papers, only 15 included an evaluation of clinical outcomes. This study has found that a large majority of papers did not include any form of evaluation and, for many that did include an evaluation, the methodology was not sufficiently rigorous to provide statistically significant results. From the 15 papers shortlisted, there were no RCT or quasi-experimental studies, only 6 used ontologies to represent domain knowledge, only 2 integrated with an EHR system, only 5 supported mobile use and only 3 used recognised healthcare technology standards (and all these were HL7 standards). Based on these findings, the paper provides some recommendations for future CDSS development that should be of interest to software developers of CDSSs and also health practitioners involved in commissioning or development