Trainee Actions Research Articles

Using data clustering to reveal trainees’ behavior in cybersecurity education

AbstractIn cyber security education, hands-on training is a common type of exercise to help raise awareness and competence, and improve students’ cybersecurity skills. To be able to measure the impact of the design of the particular courses, the designers need methods that can reveal hidden patterns in trainee behavior. However, the support of the designers in performing such analytic and evaluation tasks is ad-hoc and insufficient. With unsupervised machine learning methods, we designed a tool for clustering the trainee actions that can exhibit their strategies or help pinpoint flaws in the training design. By using a k-means++ algorithm, we explore clusters of trainees that unveil their specific behavior within the training sessions. The final visualization tool consists of views with scatter plots and radar charts. The former provides a two-dimensional correlation of selected trainee actions and displays their clusters. In contrast, the radar chart displays distinct clusters of trainees based on their more specific strategies or approaches when solving tasks. Through iterative training redesign, the tool can help designers identify improper training parameters and improve the quality of the courses accordingly. To evaluate the tool, we performed a qualitative evaluation of its outcomes with cybersecurity experts. The results confirm the usability of the selected methods in discovering significant trainee behavior. Our insights and recommendations can be beneficial for the design of tools for educators, even beyond cyber security.

Trainee Uncertainty around Intervening When Patients Decompensate.

BackgroundTrainees in acute care specialties often grapple with the decision to perform an invasive procedure in a rapidly decompensating patient, for whom the benefits and risks are inherently uncertain. The difference between trainees who know when to act and when to seek supervision and those who do not is often linked to individual trainee psychological and cultural perceptions of uncertainty. But how much comfort with uncertainty relates to the situational context rather than the trainee traits is underexplored.ObjectiveThe objective of this study was to explore trainee actions around decompensating patients and assess the degree to which invasive intervention and supervision seeking depend on situational certainty or individual trait-based perceptions of uncertainty.MethodsA total of 41 internal medicine residents completed a survey to measure anxiety related to uncertainty using the Physicians’ Reactions to Uncertainty (PRU) tool and to measure uncertainty avoidance using the Values Survey Module (VSM) before responding to 14 written emergency situations. Half of the scenarios contain sufficient diagnostic certainty to warrant aggressive intervention, and half lack sufficient diagnostic clarity to offset the risk of intervention. Mixed multivariable modeling was used to identify the relationship between planned invasive intervention, situational uncertainty, and trait-based perceptions of uncertainty measured in the PRU and VSM.ResultsTrainees’ first actions were appropriate in 60% of cases. Multivariable modeling suggested that situational certainty was more predictive of upfront intervention (odds ratio [OR], 30.5; P < 0.0001) than trait-based PRU (OR, 1.22; P = 0.05) and VSM (OR, 1.73; P < 0.0001). Similarly, situational certainty was more predictive of reduced supervision seeking (OR, 0.20; P < 0.0001) than trait-based PRU (OR, 2.03; P < 0.001) and VSM (P = not significant).ConclusionsSituation-specific certainty was more strongly correlated with invasive intervention in cases of decompensated patients than individual trainee traits. Focusing on trainee contextual understanding of procedural risk–benefit ratios in decompensating patients holds more promise for improving trainee actions and supervision seeking than tackling their perceptions around uncertainty.

Real-Time 3D Tracking of Laparoscopy Training Instruments for Assessment and Feedback.

Assessment of minimally invasive surgical skills is a non-trivial task, usually requiring the presence and time of expert observers, including subjectivity and requiring special and expensive equipment and software. Although there are virtual simulators that provide self-assessment features, they are limited as the trainee loses the immediate feedback from realistic physical interaction. The physical training boxes, on the other hand, preserve the immediate physical feedback, but lack the automated self-assessment facilities. This study develops an algorithm for real-time tracking of laparoscopy instruments in the video cues of a standard physical laparoscopy training box with a single fisheye camera. The developed visual tracking algorithm recovers the 3D positions of the laparoscopic instrument tips, to which simple colored tapes (markers) are attached. With such system, the extracted instrument trajectories can be digitally processed, and automated self-assessment feedback can be provided. In this way, both the physical interaction feedback would be preserved and the need for the observance of an expert would be overcome. Real-time instrument tracking with a suitable assessment criterion would constitute a significant step towards provision of real-time (immediate) feedback to correct trainee actions and show them how the action should be performed. This study is a step towards achieving this with a low cost, automated, and widely applicable laparoscopy training and assessment system using a standard physical training box equipped with a fisheye camera.

Архитектура тренажерной системы подготовки операторов радиационно стойких манипуляторов

Nowadays Industrial robots of different kinematic structures and functionality are widely used nowadays in different areas of industry and most of them function autonomously with preprogrammed set of actions or typical trajectories. Some special purposes mobile and stationary robots are human-controlled and in most cases require qualified operator skills. For example, in nuclear industry the mechanical and electro-mechanical “master arm – slave arm” manipulators are widely used. Modern approaches of control systems and human machine interfaces designs allow to eliminate direct copy of kinematic configuration of manipulator arms, add semi-automatic and automated control modes. Key feature of such manipulator systems is a presence of human in control loop, by reason of variety and complexity of manipulations and, in some cases, non-deterministic environment. Due to these factors, it is very desirable to form operator sustainable skills to control such manipulators, including learning process using training systems. This article describes general approaches and practical aspects of the operator training and qualification system for arm-based special purpose manipulators. The set of training system functions include: general manipulator control (basic motion) and grasping actions, manipulator operations in restricted working areas, operator actions using virtual reality helms and multi-monitor visualization, etc. The hardware and software architecture of training system should allow effective training process and teamwork of trainee and instructor to reach good results. The paper proposes ROS-based software part of training system with description of inter-process communication messages, data formats, integration with database and following analysis of trainee action.

What trainees grapple with: a study of threshold concepts on the medicine ward.

Socialisation theories of professional identity formation (PIF) consider clinical rotations to be critically intense transformative experiences. However, few studies have explored what trainees grapple with during these transformative experiences or their influence on performance. Applying a threshold concepts (TCs) lens, this study investigates and documents 'troublesome' and 'transformative' concepts that junior trainees may encounter during a clinical rotation. Insights gained are essential for supporting trainee development. Constructivist grounded theory was used to guide the collection and analysis of data for this two-phase study. Phase 1 involved direct observation and field interviews with 17 junior trainees over two observation periods and phase 2 involved in-depth interviews with 13 attending physicians. The theory of TCs was used as a sensitising concept. In total, nine TCs were identified and thematically grouped under the headings: Developing as a Professional, Providing Patient Care and Working Collectively. Across the interviewed attending physicians, there appeared to be a shared understanding of TCs strong trainees had crossed and weaker trainees struggled with. Observational and field interview data suggested that individual trainee actions were strongly influenced by the identified TC and whether or not the trainee appeared to have crossed any given threshold. Moreover, individual clinical practices could be influenced by more than one TC. Trainees were also observed to vary in the thresholds they had already crossed or struggled with. The identified TCs offer important insights into the relationship between trainee actions and how they conceptualise practice. At their heart, many appeared to represent ideals of practice that trainees should incorporate into their developing identities as they explore what it means to be a physician. Future research should explore how to incorporate TCs into assessment and the support of trainee development.

Методы оценки действий обучаемого в компьютерных тренажерных комплексах для подготовки диспетчеров в транспорте нефти и газа

Методы оценки действий обучаемого в компьютерных тренажерных комплексах для подготовки диспетчеров в транспорте нефти и газа

Interactive plant simulation modeling for developing an operator training system in a natural gas pressure-regulating station

This study proposes a method of interactive plant simulation modeling which delivers the online simulated results to the field operators and induces them to take proper actions in the case of pre-identified accident scenarios in a chemical plant. The developed model integrates the real-time process dynamic simulation with 3D-CFD accident simulation in a designed interface using object linking and embedding technology so that it can convey to trainees the online information of the accident which is not available in existing operator training systems. The model encompasses the whole process of data transfer till the end of the training at which a trainee operates an emergency shutdown system in a programmed model. In this work, an overall scenario is simulated which is from an abnormal increase in the main valve discharge (second) pressure due to valve malfunction to accidental gas release through the crack of a pressure recorder, and the magnitude of the accident with respect to the lead time of each trainee’s emergency response is analyzed. The model can improve the effectiveness of the operator training system through interactively linking the trainee actions with the simulation model resulting in different accident scenarios with respect to each trainee’s competence when facing an accident.

Leadership in Pediatric Surgery from a Trainee's Perspective.

AbstractRole models are fundamental for anyone entering the field of medicine. Proper leadership is especially essential in surgical subspecialties to guide young doctors through their training, ensure surgical experience and skill development, and teach the values of professional and ethical behavior and team management. In the complex field of pediatric surgery, which is composed of a unique patient clientele and age-dependent conditions, specialization, experience, and a strong executive are vital for patient care. Leaders in pediatric surgery are required to find a suitable balance between guidance and controlling a trainee's actions to ensure correct medical and surgical treatment and provide young doctors with the opportunity to grow and gain independent experience. When teaching the present generation of trainees, current leaders need to consider the specific characteristics of the so-called “Millennials” to avoid tension and frustration due to generation diversity. This article aims to assess leadership qualities, character traits, challenges, and expectations in pediatric surgery from a trainee's perspective.

Examining efficient instructional methods for computer-aided brush coating skill training system in elementary and secondary education

In recent Japan, many elementary and secondary school children strongly feel an awareness of resistance toward manufacturing class. It is considered as one of the aversion causes to science and engineering. We suspect that the shortage of teacher's manufacturing experience is related to this background. So, the authors previously have developed a brush coating skill training system with a haptic device to improve the ability. In the skill training, historically, the instruction method while reproducing the video of trainee's action has been considered to be effective. Thus, our developed system includes a software system to visualize the brush coating motion. This software system can record trainee's brush coating motion and visualize the data in virtual three-dimensional space, so the advisor and the trainee can share his/her skill level and the wrong motion such as extra shaking and tilt by reproducing his/her past training data on a computer screen. In this paper, to improve the learning effectiveness of our brush coating skill training system, some kinds of instructional methods are designed, and the difference of the instructional methods is analyzed based on the proposed criteria. This paper performed some experiments with 10 college students who have less experience of brush coating. From the analysis results, the most effective instruction method was clarified.

Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers.

BackgroundCompetency-based medical education increasingly recognizes the importance of observation, feedback, and reflection for trainee development. Although bedside rounds provide opportunities for authentic workplace-based implementation of feedback and team-based reflection strategies, this relationship has not been well described. The authors sought to understand the content and timing of feedback and team-based reflection provided by bedside teachers in the context of patient-centered bedside rounds.MethodsThe authors conducted a thematic analysis qualitative study using transcripts from audio-recorded, semi-structured telephone interviews with internal medicine attending physicians (n= 34) identified as respected bedside teachers from 10 academic US institutions (2010–2011).ResultsHalf of the respondents (50%) were associate/full professors, with an average of 14 years of academic experience. In the context of bedside encounters, bedside teachers reported providing feedback on history-taking, physical-examination, and case-presentation skills, patient-centered communication, clinical decision-making, leadership, teaching skills, and professionalism. Positive feedback about physical-exam skills or clinical decision-making occurred during encounters, positive or constructive team-based feedback occurred immediately following encounters, and individualized constructive feedback occurred in one-on-one settings following rounding sessions. Compared to less frequent, emotionally-charged events, bedside teachers initiated team-based reflection on commonplace “teachable moments” related to patient characteristics or emotions, trainee actions and emotions, and attending physician role modeling.ConclusionsBedside teachers use bedside rounds as a workplace-based method to provide assessment, feedback, and reflection, which are aligned with the goals of competency-based medical education. Embedded in patient-centered activities, clinical teachers should be encouraged to incorporate these content- and timing-related feedback and reflection strategies into their bedside teaching.

Gynaecological surgical training in the operating room: an exploratory study

Objective One of the challenging goals of gynaecological education is preparing trainees for independent practice of surgery. Research, however, on how to acquire surgical skills in the operating room safely, effectively and efficiently is scarce. We performed this study to explore trainers’ and trainees’ mutual expectations concerning operative training, to identify key aspects for improving learning and teaching in the operating theatre. Study design We conducted a focus group study in different teaching hospitals in The Netherlands. Three focus groups were composed of gynaecology consultants representing over half of the training hospitals in The Netherlands. Four groups were composed of gynaecology trainees at different stages of training, from university and non-university hospitals and of both sexes. The interviews were recorded, transcribed verbatim and entered into qualitative data analysis software and two researchers performed a thematic analysis. Results Teaching and learning in the operating theatre are complicated by the dynamics of trainer–trainee interaction, which are fraught with potentially conflicting interests. Trainer and trainee have to consider each other's interests, while their primary concern must be patient safety. Trainers want to feel in control and trainees want to be given a free hand within a safe atmosphere. Structuring of the teaching and learning process appears to hold the key to creating positive dynamics between trainer, trainee and their responsibility towards the patient. Structuring can be achieved before, during and after an operation. Before the operation both trainer and trainee can take the initiative to talk about learning objectives, plan of action, and task allocation. During the operation, the trainee can verbalise actions before actually performing them. This makes trainee actions predictable, enhances trainer confidence and thus may increase the trainee's chance of actually performing (a portion of) a procedure. After the operation, both trainer and trainee can initiate an evaluation the trainee's performance. Conclusion Interaction between trainer and trainee is complicated by their shared responsibility towards the patient. Structured interactions before, during and after operations appear to offer opportunities for improving learning and teaching in the operating theatre.

A novel and practicable ERCP training system with simulated fluoroscopy

Simulators facilitate the acquisition of technical skills for endoscopy. Here, we describe the development, introduction, and first evaluation of a novel generation of mechanical endoscopic retrograde cholangiopancreatography (ERCP) simulation models with simulated fluoroscopy, the X-Vision ERCP Training System. A custom-made modular ERCP simulation system was built with the use of universally obtainable materials and tools. The trainee controls ERCP activities on two screens: the aspect of the papilla and duodenum is shown on the conventional endoscopy monitor, and the trainee's actions in the equivalents of the pancreaticobiliary ducts are shown on the viewing screen of the model. Thereby, the latter screen serves as a substitute for fluoroscopy. Currently, four different models are available, allowing simulation of selective cannulation of the pancreatic or bile duct, intubation of differently arranged papillae, stent placement, and sphincterotomy of a biopapilla. The X-Vision ERCP Training System was first used during an ERCP course attended by 26 endoscopists. Trainees were supervised by an ERCP expert and an experienced ERCP nurse at each training model. The training system was evaluated by the participants and experts using a specific questionnaire. During the course there were no technical problems related to the X-Vision ERCP Training System. After sphincterotomy the organic papillae could easily be exchanged within less than 15 seconds. Overall, the X-Vision ERCP Training System achieved favorable results in all categories assessed. The new X-Vision ERCP Training System is simple and effective. A first evaluation in the context of an ERCP course showed impressive results.

Thereʼs No Such Thing as “Nonjudgmental” Debriefing: A Theory and Method for Debriefing with Good Judgment

We report on our experience with an approach to debriefing that emphasizes disclosing instructors' judgments and eliciting trainees' assumptions about the situation and their reasons for acting as they did. To highlight the importance of instructors disclosing their judgment skillfully, we call the approach "debriefing with good judgment." The approach draws on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through "reflective practice." This approach specifies a rigorous self-reflection process that helps trainees recognize and resolve pressing clinical and behavioral dilemmas raised by the simulation and the judgment of the instructor. The "debriefing with good judgment" approach is comprised of three elements. The first element is a conceptual model drawn from cognitive science. It stipulates that the trainees' "frames"--comprised of such things as knowledge, assumptions, and feelings--drive their actions. The actions, in turn, produce clinical results in a scenario. By uncovering the trainee's internal frame, the instructor can help the learner reframe internal assumptions and feelings and take action to achieve better results in the future. The second element is a stance of genuine curiosity about the trainee's frames. Presuming that the trainee's actions are an inevitable result of their frames, the instructor's job is that of a "cognitive detective" who tries to discover, through inquiry, what those frames are. The instructor establishes a "stance of curiosity" in which the trainees' mistakes are puzzles to be solved rather than simply erroneous. Finally, the approach includes a conversational technique designed to bring the judgment of the instructor and the frames of the trainee to light. The technique pairs advocacy and inquiry. Advocacy is a type of speech that includes an objective observation about and subjective judgment of the trainees' actions. Inquiry is a genuinely curious question that attempts to illuminate the trainee's frame in relation to the action described in the instructor's advocacy. We find that the approach helps instructors manage the apparent tension between sharing critical, evaluative judgments while maintaining a trusting relationship with trainees.

On the Development of Typhoon Avoidance Simulation System with the Evaluating Method by Seakeeping Performance of Ship

A simulation system is needed to train students and mariners in order that they can take suitable actions to evade typhoon's strike promptly and sufficiently. In order to make such kind of system, three kinds of models about the typhoon are necessary, typhoon prediction model to generate typhoon's track, wind & wave-field model to make sea conditions around the typhoon and evaluation model of trainee's action whether their actions were suitable or not during simulation. We have developed the prediction and wind & wave-field models of typhoon, but the evaluation model has not been developed yet. In this paper, after making a method for evaluating trainee's actions by seakeeping performance, we propose an typhoon avoidance simulation system for training mariners so that they can promote their abilities to evade the typhoons at sea.

Using the Plastic Framework to Augment Scenario-Based Training Systems with Instructional Agents

This paper describes the Prolog-Like Agent Specification &amp; Tutor Implementation Calculus (PLASTIC) framework. PLASTIC is an intelligent tutor authoring system in which instructional agents based on models of human decision making, communication, action, and unit task execution are specified and deployed. To help non-programmers develop agent-based intelligent tutoring systems, PLASTIC includes GUI-based agent specification and performance visualization tools. PLASTIC agents provide instructional scaffolding by offering helpful hints that highlight task-relevant aspects of problems, help trainees think about tasks appropriately, guide trainees through unfamiliar problems, and encourage new strategy formation. To demonstrate how PLASTIC is used to implement agent-based instructional systems, a tutor incorporated into an Anti-Air Warfare Coordinator (AAWC) scenariobased training system is discussed. The technology through which PLASTIC tracks AAWC trainee actions and produces instructional scaffolding is discussed. The instructional impact of the PLASTIC tutor incorporated into the AAWC scenario-based trainer is illustrated with a discussion of training effectiveness data.

The Use of Executable Cognitive Models in Simulation-Based Intelligent Embedded Training

This paper defines a new role for expert models in intelligent embedded training — guiding practice. The integration of problem-based practice with focused, automated instruction has long proven elusive in training systems for complex real-world domains. The training strategy of ‘guided practice’ offers a way to merge the approaches of traditional simulation-based practice and intelligent tutoring's knowledge tracing. The performance of the trainee is dynamically assessed against scenario-specific expectations and performance standards, which are generated during the simulation by embedded models of expert operators. This research developed an executable cognitive model capable of solving realistic simulation scenarios in an expert-level manner, identified and implemented modifications and extensions to this baseline model needed to generate dynamic and adaptive expectations of future trainee actions, and developed means of providing cognitive state information for use in (separate) diagnostic processes, without resorting to full-scale knowledge tracing methods.

Human Factors Considerations in the Design of Displays and Switches for a Flight Simulator's Onboard Instructor/Operator Station (IOS)

The MV-22A training device suite Operational Flight Trainer (OFT) and Aircrew System Trainer (AST) specification requirements provide for an instructor work environment that focuses on integrating the instructor's position with the training environment. This paper will describe the process to refine a display/switch design dedicated to over-the-shoulder instruction at the IOS. The time frame encompasses the period from the mockup through the IOS-specific design reviews which addresses a mature IOS display/switch design. This new IOS display/switch design mirrors the aircraft's Multi-Function Displays (MFDs) which provide the pilots rapid and efficient access to aircraft systems and environmental data, while allowing for primary focus on flying the aircraft. Correspondingly, the IOS display/switch design for control and monitor of the training scenario, allows the instructor to focus on trainee actions, the aircraft instrument panel, and the visual system's forward field of view. Since the mockup, there has been a refinement process leading to some significant design initiatives. An analysis of this refinement process points out some key issues in designing for this new type of IOS display.