Simulation Equipment Research Articles

Development of a simulation technical competence curriculum for medical simulation fellows

Background and needsMedical educators with simulation fellowship training have a unique skill set. Simulation fellowship graduates have the ability to handle basic and common troubleshooting issues with simulation software, hardware, and equipment setup. Outside of formal training programs such as this, simulation skills are inconsistently taught and organically learned. This is important to address because there are high expectations of medical educators who complete simulation fellowships. To fill the gap, we offer one way of teaching and assessing simulation technical skills within a fellowship curriculum and reflect on lessons learned throughout the process. This report describes the instructional designs, implementation, and program evaluation of an educational intervention: a simulation technology curriculum for simulation fellows.Curriculum designThe current iteration of the simulation technical skill curriculum was introduced in 2018 and took approximately 8 months to develop under the guidance of expert simulation technology specialists, simulation fellowship-trained faculty, and simulation center administrators. Kern’s six steps to curriculum development was used as the guiding conceptual framework. The curriculum was categorized into four domains, which emerged from the outcome of a qualitative needs assessment. Instructional sessions occurred on 5 days spanning a 2-week block. The final session concluded with summative testing.Program evaluationFellows were administered summative objective structured exams at three stations. The performance was rated by instructors using station-specific checklists. Scores approached 100% accuracy/completion for all stations.ConclusionsThe development of an evidence-based educational intervention, a simulation technical skill curriculum, was highly regarded by participants and demonstrated effective training of the simulation fellows. This curriculum serves as a template for other simulationists to implement formal training in simulation technical skills.

КОНЦЕПЦІЯ МОДУЛЬНИХ ТРЕНАЖЕРНИХ СИСТЕМ ІЗ МОЖЛИВІСТЮ ШВИДКОЇ ЗМІНИ ФУНКЦІОНАЛЬНОГО ПРИЗНАЧЕННЯ

In the study, the author considers the concept of building simulator systems of vehicles based on theoretical justification, creation and construction of technical systems according to modular principles. The modern view of the process of creating training systems is based on the principles of strict compliance of each object of imitation to its purposefully created training system. The use of modular principles of creating training systems allows you to solve problems related to increasing their efficiency and reliability. This approach corresponds to the concept of creating universal, adaptive training systems: a limited number of training systems - the maximum number of simulation objects. The concept of modular training systems is a novelty, which is distinguished by the fact that in the presence of modules there is a possibility of quickly changing the functional purpose of the system, while the number of modifications of training systems is significantly reduced. The modern development of scientific and technical progress, modern equipment and technologies in the vast majority is carried out according to the principle of modular creation of various technical devices, which differ significantly from each other in the principle of operation, physical parameters and intended use. The "Trainer" module can be represented by any design solution and consists of a fixed support, a frame, a turning mechanism, a lifting mechanism, a balancing mechanism, a turning mechanism of the cab, which is an element of connection with the "Cabin" module through a universal base. The application of the principle of modular construction in exercise equipment will allow to create a single system of construction of exercise equipment and exercise equipment, which in turn provides an opportunity to establish uniform requirements for exercise complexes and methods of their evaluation and comparison. This modular approach to the construction of simulators will determine the maximum economic and technical result of the implementation of simulator equipment. Keywords: modular principle; operator's cabin; dynamic platform; simulator; simulator training; information subsystem.

Telesimulation to Improve Critical Decision-Making in Prehospital Airway Management: A Feasibility Study.

Telesimulation, in which learners and evaluators use technology to connect remotely to simulation-based learning activities, is effective for skills and decision-making review. Historical models in which learners are colocated with the simulation equipment have inherent issues, especially for emergency medical services (EMS) providers. This feasibility study placed the evaluators in the simulation center, whereas the learners were at a distance steering the scenario evolution through telehealth technologies. Volunteer EMS providers across South Carolina with varying levels of training and experience completed difficult airway management scenarios focused on clinical decision making. The program consisted of pre- and postexperience examinations, a lecture, and increasingly complicated simulations using high-fidelity mannequins that were facilitated by local trainers under the direction of remote trainees. Audio and video content, including vital signs and cardiac monitoring, were live streamed. Participants worked in two-person teams with lead providers on each scenario clinically assessing and managing cases of anaphylaxis. Data were collected from the simulations using Laerdal software, as well as examination and survey results. A total of 24 participants completed all of the elements of the training. Trends toward improvement in times to bag-mask ventilation and initial epinephrine administration were noted. Average cognitive test scores increased by 9.6%, and learners reported improved comfort with simulation (75%, P ≥ 0.0001) and videoconferencing (83%, P ≥ 0.0001). They also reported high degrees of comfort with intubation (73.3%) following the training. This method of telesimulation appears to be a viable addition to continuing EMS education and may address access issues for some providers.

Effect of the Internal Humidity of Concrete on Frost Resistance and Air Void Structure under Different Low Temperature Conditions.

From the perspective of combining macroscopic and microscopic properties, this paper simulates the freeze–thaw cycle process at different freezing low temperatures based on the climate simulation equipment and by setting the curing conditions with different temperatures and relative humidity to produce different moisture conditions in concrete. The frost resistance properties and microscopic air void performance of concrete with different internal water content under different freezing low temperatures in freeze–thaw cycles were systematically studied. The results show that the higher the internal water content of concrete, the more obvious the mass loss rate and dynamic elastic modulus loss of concrete in the freeze–thaw process, and the more serious the deterioration of the air void parameter performance of the air-entraining agent introduced into concrete, which is manifested as the average bubble diameter and bubble spacing factor become larger and the bubble specific surface area decreases. In addition, in the case of the same internal moisture content of concrete, the freezing temperature used in the freeze–thaw cycle also has an important impact on the frost resistance of concrete and air void parameters; the lower the freezing temperature used, the more significant the decline in the frost resistance of concrete, the more obvious the deterioration of air void parameters.

Improving the Efficiency of Mastering Professional Skills with the Help of Additional Devices for Simulation Equipment

The aim of the study is to determine the effectiveness of the author's device for objective control of the location of the ischial spines.

Establishment of Thermal Deformation Constitutive Equation of TA15 Titanium Alloy

The hot deformation of TA15 titanium alloy was studied by the hot compression test on the Gleeble-3800 thermal simulation equipment. The true stress-strain curves of TA15 titanium alloy at the temperature of 1123-1223K and the strain rate of 0.001-1s-1 were obtained.. The results show that the flow stress increases with decreasing temperature, and increases as the strain rate increases. And the deformation process is accompanied by work hardening and dynamic recovery and dynamic recrystallization. Based on the true stress-strain curves of TA15 titanium alloy, the Arrhenius-typed constitutive equation was established. The thermal deformation activation energy of TA15 titanium alloy with a strain of 0.2 is 746.27kJ/mol.

A Scoping Review of the Priority of Diversity, Inclusion, and Equity in Health Care Simulation

BackgroundDiversity, equity, and inclusion (DEI) in health care are recognized as valuable factors affecting health outcomes for historically underrepresented populations such as racial, ethnic, cultural, and gender minorities. Approaching diverse minority groups with cultural humility requires awareness and sensitivity. The level to which cultural competencies that address these factors have been integrated into nursing educational systems is unknown. MethodThis scoping review examines previous and current literature of simulation in nursing education that includes factors of diversity, equity, and inclusion. ResultsPrevious literature addressed the need for diversification of the educational environment with little discussion of health care simulation. Recent literature demonstrates an increasing use and incorporation of strategies for application of cultural humility to increase DEI in health care simulation. ConclusionsThe incorporation of DEI into simulation design, environments, and equipment provides an opportunity for health care educators and providers to create an environment capable of promoting and supporting cultural humility

Analysis of feedback questionnaires of 6th year interns who completed simulation training

Simulation training is a relatively new, but rather promising education technique that is rapidly developing and modifying. The article reflects the possibility of determining the quality of educational services through a survey of the 6th year interns in the context of integrating simulation training into the educational process of the Faculty of General Medicine, organized on the basis of the Simulation Center (SC). The article presents an analysis of feedback from the consumer of educational services trained on simulation equipment.

Experimental Study of the Plastic Zone and Stress Asymmetric Distribution in Roadway Layered Surrounding Rocks

A three-axis experimental simulation model was established for a roadway with layered surrounding rock by a 20 MPa true triaxial analog simulation equipment, and the corresponding layered surrounding rock numerical simulation model was established by discrete element software. The simulation results showed that the deformation of the roadway layered surrounding rock showed asynchronous deformation with time and asymmetric deformation in space. The measured results of the multipoint displacement meter inside the surrounding rock showed that the order of displacement of surrounding rock from the four corners of the roadway to the center of the roadway were upper right, lower left, upper left, and lower right. Under the influence of the surrounding rock bedding, the shape of the plastic zone of the roadway surrounding rock was irregular. In the area where the rock layer and the surface of the roadway were tangent and in the vertical area between the rock layer and the surface of the roadway, the plastic zone had a large development depth. In other regions, the development depth of the plastic zone was smaller. As a result, the stress values obtained at the monitoring points in the surrounding rock at the same distance from the roadway surface were different, and the stress increase value of the monitoring points in the plastic zone was not large (No. 929). With the expansion of the plastic zone, the monitoring point change from outside the plastic zone to inside the plastic zone, its stress first increased and then decreased (No. 2 and No. 872). The experimental results are of great significance for understanding and controlling the development law of the plastic zone of a layered inclined rock roadway and the deformation control of the roadway layered surrounding rock.

A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services.

ObjectiveCare of the critically ill child is a rare but stressful event for emergency medical services (EMS) providers. Simulation training can improve resuscitation care and prehospital outcomes but limited access to experts, simulation equipment, and cost have limited adoption by EMS systems. Our objective was to form a statewide collaboration to develop, deliver, and evaluate a pediatric critical care simulation curriculum for EMS providers.MethodsWe describe a statewide collaboration between five academic centers to develop a simulation curriculum and deliver it to EMS providers. Cases were developed by the collaborating PEM faculty, reviewed by EMS regional directors, and based on previously published EMS curricula, a statewide needs assessment, and updated state EMS protocols. The simulation curriculum was comprised of 3 scenarios requiring recognition and acute management of critically ill infants and children. The curriculum was implemented through 5 separate education sessions, led by a faculty lead at each site, over a 6 month time period. We evaluated curriculum effectiveness with a prospective, interventional, single-arm educational study using pre-post assessment design to assess the impact on EMS provider knowledge and confidence. To assess the intervention effect on knowledge scores while accounting for nested data, we estimated a mixed effects generalized regression model with random effects for region and participant. We assessed for knowledge retention and self-reported practice change at 6 months post-curriculum. Qualitative analysis of participants' written responses immediately following the curriculum and at 6 month follow-up was performed using the framework method.ResultsOverall, 78 emergency medical technicians (EMTs) and 109 paramedics participated in the curriculum over five separate sessions. Most participants were male (69%) and paramedics (58%). One third had over 15 years of clinical experience. In the regression analysis, mean pediatric knowledge scores increased by 9.8% (95% CI: 7.2%, 12.4%). Most (93% [95% CI: 87.2%, 96.5%]) participants reported improved confidence caring for pediatric patients. Though follow-up responses were limited, participants who completed follow up surveys reported they had used skills acquired during the curriculum in clinical practice.ConclusionThrough statewide collaboration, we delivered a pediatric critical care simulation curriculum for EMS providers that impacted participant knowledge and confidence caring for pediatric patients. Follow-up data suggest that knowledge and skills obtained as part of the curriculum was translated into practice. This strategy could be used in future efforts to integrate simulation into EMS practice.

Experimental Study on Proppant Transport within Complex Fractures

Summary The process of proppant filling within complex fractures is a key factor that determines the effects of volumetric fracturing operation in shale. To address the need of simulating proppant transport within the complex fractures, a large size visual simulation equipment of particle transport within complex fractures was built. The equipment considers roughness and fluid leakoff on the fracture wall and includes branched fractures of different angles. We ensured that the fluid flow and proppant flow were similar to those in the actual fracture and carried out experiments to obtain the influence of operation parameters and fracture parameters on proppant transport, also including injection of special proppants and channel fracturing. Then, we quantified proppant placement through standardized processing of dune shape pictures. The results show that under the influence of perforation, the near-wellbore dune is distributed in a slope shape, and an increase in the perforation density causes dune migration toward the wellbore and proppant accumulation to a certain height within the wellbore. The carrier fluid flow velocity change from 1.0 to 1.5 m/s within the fracture has the greatest effect on the dune equilibrium height (DEH). The dune height only varies slightly after the proppant concentration reaches 12%. Small size proppants have better transport capacity in the slickwater, and the large size proppants are likely to settle down. Combination injection of increasing proppant size improves the filling effect of complex fractures significantly. Pulse injection and stopping pump during fracturing operation have little effect on the transport of conventional proppants. Nevertheless, stopping pump leads to a significant increase in the dune height of the lower density proppants. An increase in the flow rate within the branched fracture leads to the transition in the dune shape from triangle to trapezoid and rectangle. The dune height within the major fracture determines those within the branched fracture, and the proppant volume flowing into the branched fracture determines the dune length. Proppant accumulation within the branched fracture enhances the difficulty in the diversion of carrier fluid to the branched fracture. The proppant tumble area increases within the inclined fracture, which is conductive to proppant transport. The proppants form the dune through bridging within the horizontal fracture, and the dune is less stable than that within the vertical fracture. A reduction in the proppant density and size leads to a significant increase in the proppant transport distance, and the convection effect by concentration difference of the ultralow-density (ULD) proppant is of great significance for propping of the microfractures. In channel fracturing, the proppant and fiber agglomerates are formed at the fracture point with the relatively large fluid leakoff and wall roughness, and the agglomerates grow laterally against the fracture fluid flow direction. A reasonable increase in the injection rate enhances the connectivity between the channels within the fracture. This study provides guidance for the optimization of volumetric fracturing parameters.

College Cross-Country Skiing Teaching and Sports Training Based on VR

As a kind of simulation equipment that can correctly simulate skiing actions, ski simulators are widely used in ski teaching and training in colleges. With the rapid development of VR, it has been widely used in the development of ski simulator systems. This article mainly talks about the research of college cross-country skiing teaching and sports training based on VR and intends to provide ideas and directions for combining VR with college cross-country skiing teaching and sports training. This article puts forward the research methods of cross-country skiing teaching and sports training in colleges based on VR, including the literature retrieval method, expert interview method, survey method, mathematical statistics method, logical analysis summary method, ski simulator algorithm, etc. At the same time, this paper also conducts experiments on cross-country skiing teaching and sports training in colleges and universities. The experimental results in this paper show that 96.67% of students believe that the college cross-country skiing teaching and sports training system based on VR can stimulate the enthusiasm of ski training.

Classifying Driving Fatigue by Using EEG Signals.

Fatigue driving is one of the main reasons for the occurrence of traffic accidents. Brain-computer interface, as a human-computer interaction method based on EEG signals, can communicate with the outside world and move freely through brain signals without relying on the peripheral neuromuscular system. In this paper, a simulation driving platform composed of driving simulation equipment and driving simulation software is used to simulate the real driving process. The EEG signals of the subjects are collected through simulated driving, and the EEG of five subjects is selected as the training sample, and the remaining one is the subject. As a test sample, perform feature extraction and classification experiments, select any set of normal signals and fatigue signals recorded in the driving fatigue experiment for data analysis, and then study the classification of driver fatigue levels. Experiments have proved that the PSO-H-ELM algorithm has only about 4% advantage compared with the average accuracy of the KNN algorithm and the SVM algorithm. The gap is not as big as expected, but as a new algorithm, it is applied to the detection of fatigue EEG. The two traditional algorithms are indeed more suitable. It shows that the driver fatigue level can be judged by detecting EEG, which will provide a basis for the development of on-board, real-time driving fatigue alarm devices. It will lay the foundation for traffic management departments to intervene in driving fatigue reasonably and provide a reliable basis for minimizing traffic accidents.

Special stereotactic radiotherapy techniques: procedures and equipment for treatment simulation and dose delivery.

Stereotactic radiotherapy (SRT ) is a multi-step procedure with each step requiring extreme accuracy. Physician-dependent accuracy includes appropriate disease staging, multi-disciplinary discussion with shared decision-making, choice of morphological and functional imaging methods to identify and delineate the tumor target and organs at risk, an image-guided patient set-up, active or passive management of intra-fraction movement, clinical and instrumental follow-up. Medical physicist-dependent accuracy includes use of advanced software for treatment planning and more advanced Quality Assurance procedures than required for conventional radiotherapy. Consequently, all the professionals require appropriate training in skills for high-quality SRT.Thanks to the technological advances, SRT has moved from a “frame-based” technique, i.e. the use of stereotactic coordinates which are identified by means of rigid localization frames, to the modern “frame-less” SRT which localizes the target volume directly, or by means of anatomical surrogates or fiducial markers that have previously been placed within or near the target. This review describes all the SRT steps in depth, from target simulation and delineation procedures to treatment delivery and image-guided radiation therapy. Target movement assessment and management are also described.

The Use of Patient Simulations to Teach and Assess Clinical Competencies in Colleges of Podiatric Medicine: A Survey of US Podiatric Medical Schools.

Human and mechanical simulations are used to teach and assess clinical competencies in medical education. In 2014, the National Board of Podiatric Medical Examiners implemented the Clinical Skills Patient Encounter, an examination using standardized patients. Similar clinical skills examinations already existed as part of medical and osteopathic licensure examinations. The purpose of this study was to assess the use of simulation-based education in the nine colleges of podiatric medicine in the United States to inform podiatric clinical faculty and other stakeholders about current trends within the podiatric education system. In 2019, the Clinical Skills Patient Encounter committee of the National Board of Podiatric Medical Examiners developed a survey and contacted each podiatric school to voluntarily participate. The mailed survey instrument gathered information on patient simulation modalities, years used, clinical content application, simulation program administration, facilities and equipment available, and the role of simulation educators. All nine schools participated anonymously. The survey showed that simulation modalities were used in all of the schools during the first 3 years, although there was considerable variance in their use.

Fault diagnosis of power grid based on variational mode decomposition and convolutional neural network

The distribution network has complex topological structure and many branches. So, the fault location is easy to be wrongly located. Therefore, a novel hybrid method of combining variational mode decomposition (VMD) and convolutional neural network (CNN) for fault location and fault type identification is proposed in power grid. A fault feature extraction method based on VMD and Hilbert-Huang transform (HHT) is designed. In this method, the VMD is used to analyze the characteristic features from fault transient signals of the positive sequence current. The fault features of the intrinsic mode function with more fault features are extracted through HHT. The extracted fault feature vector is used as the input of CNN to build fault diagnosis model. Finally, the fault diagnosis report is obtained by comparing and analyzing the output results of SoftMax layer. The experimental results show that this method can identify the fault location and type in the small current grounding power system model of relay protection dynamic simulation equipment. Meanwhile, the method is less influenced by fault resistance and fault distance and has good accuracy, thus having better accuracy and generalization ability than traditional methods.

Remote-facilitated mental simulation to bridge the theory-practice divide

Remote simulation in education predates the COVID-19 pandemic, and its more widespread contemporary use can help inform future teaching practices. This article outlines the development of a remote-facilitated mental simulation (RFMS) delivered to second-year paramedic science students at a UK university. This was created using Sprick et al's simulation design model: preparation, briefing, simulation activity, debriefing, reflection and evaluation. Mental simulation is a teaching modality where participants mentally rehearse processes rather than practical skills. Speaking thoughts aloud helps learners to reflect on their thought processes and decision-making. While studies on remote simulation involve a facilitator viewing participants interacting with a simulation, in this study the participants were observers and the facilitator interacted with the simulation equipment. This arrangement may increase access to simulation for learners who do not have access to such facilities. Participants were engaged through group activities and psychological fidelity was maintained by providing real-time streaming of patient observations. The RFMS was evaluated positively by respondents.

Improved Stable Drag Reduction of Controllable Laser-Patterned Superwetting Surfaces Containing Bioinspired Micro/Nanostructured Arrays.

Superwetting surfaces are widely used in many engineering fields for reducing energy and resistance loss. A facile and efficient method using laser etching has been used to fabricate and control superwettable drag reduction surfaces. Inspired by the self-cleaning theory of lotus leaves, we propose controllable patterned bionic superhydrophobic surfaces (BSSs) simulating the uneven micro/nanostructures of lotus leaves. The superhydrophobicity and drag reduction ratios at low velocities are highly improved using a laser ablation method on metal substrates. However, unstable air layers trapped on superhydrophobic surfaces are usually cut away by a high-velocity flow, which greatly reduces the drag reduction performance. The fabricated bionic superhydrophobic/hydrophilic surfaces (BSHSs) with alternated hydrophilic strips can build a large surface energy barrier to bind the three-phase contact line. It maintains the stable drag reduction by capturing the air bubbles attached to the hydrophilic strips at a high velocity. Three-dimensional simulation analysis and equipment to measure the weak friction of a self-assembled solid–liquid interface are used to explain the drag reduction mechanism and measure the drag reduction ratios at different flow speeds. BSSs achieve an improved drag reduction effect (maximum 52.76%) at a low velocity (maximum 1.5568 m/s). BSHSs maintain an improved and steady drag reduction effect at high speed. The drag reduction ratios can be maintained at about 30% at high speed, with a maximum value of 4.448 m/s. This research has broad application prospects in energy saving, liquid directional transportation, and shipping due to their robust superhydrophobic properties and stable drag reduction effect.

THE ROLE OF PROFESSIONAL ASSOCIATIONS IN THE SYSTEM OF CONTINUING PROFESSIONAL DEVELOPMENT OF PEDIATRICIANS AND FAMILY DOCTORS

The article is devoted to the role of the Odesa Association of Pediatricians and Neonatologists in the system of continuous professional development of pediatricians and family doctors. The history of the creation of the Odesa Association of Pediatricians and Neonatologists since 1849 and its current achievements are highlighted. The analysis of the formation of the system of continuous professional education in European countries is carried out. The system of continuous professional development of doctors in Ukraine is presented. Examples of formal training in the form of thematic improvement cycles, informal training in the form of seminars, trainings, including using simulation equipment, participation in scientific and practical conferences are shown. Methods and models of continuous professional development in the world and in Ukraine are described. Emphasis is placed on changing the methodology of postgraduate education aimed at mastering skills, mastering competencies in real professional activity instead of obtaining only theoretical knowledge. The role and responsibilities of providers in the continuous professional development of doctors are demonstrated. The active participation of the Odesa Association of Pediatricians and Neonatologists in the postgraduate professional development of pediatricians and family doctors, both in the Odesa region and throughout the country is shown. An opinion was expressed about the involvement of professional associations as providers in the system of continuous professional development of doctors in Ukraine. Key words: continuing professional development, medical professional associations, pediatricians, family doctors.

Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity.

Congenital heart surgery (CHS) is technically demanding, and its training is extremely complex and challenging. Training of the surgeon’s technical skills has relied on a preceptorship format in which the trainees are gradually exposed to patients in the operating room under the close tutelage of senior staff surgeons. Training in the operating room is an inefficient process and the concept of a learning curve is no longer acceptable in terms of patient outcomes. The benefits of surgical simulation in training of congenital heart surgeons are well known and appreciated. However, adequate surgical simulation models and equipment for training have been scarce until the recent development of three-dimensionally (3D) printed models. Using comprehensive 3D printing and silicone-molding techniques, realistic simulation training models for most congenital heart surgical procedures have been produced. Newly developed silicone-molded models allow efficient CHS training in a stress-free environment with instantaneous feedback from the proctors and avoids risk to patients. The time has arrived when all congenital heart surgeons should consider surgical simulation training before progressing to real-life operating in a similar fashion to the aviation industry where all pilots are required to complete simulation training before flying a real aircraft. It is argued here that simulation training is not an option anymore but should be a mandatory component of CHS training.