173 results found
Granados A, Low-Beer N, Higham J, et al., 2018, Real-time Visualisation and Analysis of Clinicians' Performance during Palpation in Physical Examinations., IEEE Trans Biomed Eng
OBJECTIVE: Motivated by the fact that palpation skills are challenging to learn and teach, particularly during Digital Rectal Examinations (DRE), and the lack of understanding of what constitutes adequate performance, we present a visualisation and analysis system that uses small position and pressure sensors located on the examining finger, allowing the quantitative analysis of duration, steps and pressure applied. METHODS: The system is first described, followed by an experimental study of twenty experts from four clinical specialties performing ten DREs each on a benchtop model using the proposed system. Analysis of the constitutive steps was conducted to improve understanding of the examination. A Markov model representing executed tasks and analysis of pressure applied is also introduced. RESULTS: The proposed system successfully allowed the visualisation and analysis during the experimental study. General Practitioners and Nurses were found to execute more tasks compared to Urologists and Colorectal Surgeons. Urologists executed the least number of tasks and were the most consistent group compared to others. CONCLUSION: The ability to "see through" allowed us to better characterise the performance of experts when conducting a DRE on a benchtop model, comparing the performance of relevant specialties, and studying executed tasks and the pressure applied. The Markov model presented summarises task execution of experts and could be used to compare performance of novices against that of experts. SIGNIFICANCE: This approach allows for the analysis of performance based on continuous sensor data recording that can be easily extended to real subjects and other types of physical examinations.
Granados A, Maréchal L, Barrow A, et al., 2018, Relax and tighten—a haptics-based approach to simulate sphincter tone assessment, Asia Haptics 2016, Pages: 327-333, ISSN: 1876-1100
© Springer Nature Singapore Pte Ltd. 2018. Digital Rectal Examination (DRE) is a physical examination performed by clinicians to diagnose anorectal and prostate abnormalities. Amongst these, sphincter tone assessment is a crucial task where a clinician asks the patient to relax or squeeze, whilst measuring its function by the amount of pressure felt on the examining finger. DRE is difficult to learn and current models fail to reproduce the dynamic function of anorectal abnormalities. We propose a haptics-based approach to incorporate sphincter tone into our current simulator by motor-controlled pulling and releasing of cables that are coiled around a silicone model of the sphincters. A range of healthy and abnormal sphincter tone cases can be modelled by controlling the motors symmetrically and asymmetrically.
Korzeniowski P, White RJ, Bello F, 2018, VCSim3: a VR simulator for cardiovascular interventions, INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY, Vol: 13, Pages: 135-149, ISSN: 1861-6410
Naveed H, Hudson R, Khatib M, et al., 2018, Basic skin surgery interactive simulation: system description and randomised educational trial., Adv Simul (Lond), Vol: 3
Background: Learning the skills required for open surgery is essential for trainee progression towards more advanced technical procedures. Simulation supports skill enhancement at a time when exposure to actual surgical procedures and traditional apprentice-based teaching has declined. The proliferation of smartphone and tablet devices with rich, touch sensitive displays and increasing processing power makes a compelling argument for expanding accessibility further by development of mobile virtual simulations for training on demand in any setting, at any time.We present a tablet-based mobile simulation App for educating surgical trainees in the planning and surgical procedures involved in facial lesion resection and local skin flap surgery. Methods: Novel algorithms were developed and modules included in a mobile simulation App to teach concepts required for three defect reconstruction techniques: elliptical closure, bilateral advancement (H flap) and the semi-circular rotation flap, with additional resources such as videos and formal guidelines made available at relevant points in the simulation. A randomised educational trial was conducted using the mobile simulation App with 18 medical students that were divided equally into two groups: the intervention group learning using the new mobile simulation App, and a control group, undergoing traditional text-based self-study. The students were then assessed on knowledge and skills' acquisition through an MCQ and a task analysis score. Results: There was a statistically significant difference between the scores of students in the intervention group and the students in the non-intervention group in both forms of assessment, with an average multiple-choice assessment score of 62.95% points versus 56.73%, respectively (p = 0.0285), and an average task analysis score of 3.53 versus 2.58, respectively (p = 0.0139). Conclusions: Touch-based simulation provided an efficient and superior method of learni
Weldon SM, Kelay T, Ako E, et al., 2018, Sequential simulation used as a novel educational tool aimed at healthcare managers: a patient-centred approach, BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING, Vol: 4, Pages: 13-18, ISSN: 2056-6697
Weldon SM, Kronfli M, Bello F, et al., 2018, Using a Variety of Research Methods and Angles to Understand a New Approach That Explores Health-Care Services, Publisher: SAGE PUBLICATIONS INC, Pages: 57-57, ISSN: 1609-4069
Kelay T, Chan KL, Ako E, et al., 2017, Distributed Simulation as a modelling tool for the development of a simulation-based training programme for cardiovascular specialties., Adv Simul (Lond), Vol: 2, ISSN: 2059-0628
Aims and background: Distributed Simulation is the concept of portable, high-fidelity immersive simulation. Here, it is used for the development of a simulation-based training programme for cardiovascular specialities. We present an evidence base for how accessible, portable and self-contained simulated environments can be effectively utilised for the modelling, development and testing of a complex training framework and assessment methodology. Iterative user feedback through mixed-methods evaluation techniques resulted in the implementation of the training programme. Approach: Four phases were involved in the development of our immersive simulation-based training programme: (1) initial conceptual stage for mapping structural criteria and parameters of the simulation training framework and scenario development (n = 16), (2) training facility design using Distributed Simulation, (3) test cases with clinicians (n = 8) and collaborative design, where evaluation and user feedback involved a mixed-methods approach featuring (a) quantitative surveys to evaluate the realism and perceived educational relevance of the simulation format and framework for training and (b) qualitative semi-structured interviews to capture detailed feedback including changes and scope for development. Refinements were made iteratively to the simulation framework based on user feedback, resulting in (4) transition towards implementation of the simulation training framework, involving consistent quantitative evaluation techniques for clinicians (n = 62). For comparative purposes, clinicians' initial quantitative mean evaluation scores for realism of the simulation training framework, realism of the training facility and relevance for training (n = 8) are presented longitudinally, alongside feedback throughout the development stages from concept to delivery, including the implementation stage (n = 62). Findings: Initially, mean evaluation scores flu
Kneebone RL, Nestel D, Bello F, 2017, Learning in a simulated environment, A Practical Guide for Medical Teachers, Editors: Dent, Harden, Hunt, Hodges, Publisher: Elsevier, Pages: 92-100, ISBN: 9780702068911
This highly regarded book recognises the importance of educational skills in the delivery of quality teaching in medicine. The contents offer valuable insights into all important aspects of medical education today.
Korzeniowski P, Brown DC, Sodergren MH, et al., 2017, Validation of NOViSE: A Novel Natural Orifice Virtual Surgery Simulator, SURGICAL INNOVATION, Vol: 24, Pages: 55-65, ISSN: 1553-3506
Marechal L, Granados A, Ethapemi L, et al., 2017, Modelling of Anal Sphincter Tone based on Pneumatic and Cabledriven Mechanisms, IEEE World Haptics Conference (WHC), Publisher: IEEE, Pages: 376-381
Plumptre I, Mulki O, Granados A, et al., 2017, Standardizing bimanual vaginal examination using cognitive task analysis, INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, Vol: 139, Pages: 114-119, ISSN: 0020-7292
Bello F, Kajimoto H, Visell Y, 2016, Preface, ISBN: 9783319423203
Bello F, Kajimoto H, Visell Y, 2016, Preface, ISBN: 9783319423234
Huddy JR, Weldon S-M, Ralhan S, et al., 2016, Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics, BMJ OPEN, Vol: 6, ISSN: 2044-6055
Kneebone R, Weldon S-M, Bello F, 2016, Engaging patients and clinicians through simulation: rebalancing the dynamics of care., Adv Simul (Lond), Vol: 1, ISSN: 2059-0628
This paper proposes simulation-based enactment of care as an innovative and fruitful means of engaging patients and clinicians to create collaborative solutions to healthcare issues. This use of simulation is a radical departure from traditional transmission models of education and training. Instead, we frame simulation as co-development, through which professionals, patients and publics share their equally (though differently) expert perspectives. The paper argues that a process of participatory design can bring about new insights and that simulation offers understandings that cannot easily be expressed in words. Drawing on more than a decade of our group's research on simulation and engagement, the paper summarises findings from studies relating to clinician-patient collaboration and proposes a novel approach to address the current need. The paper outlines a mechanism whereby pathways of care are jointly created, shaped, tested and refined by professionals, patients, carers and others who are affected and concerned by clinical care.
Korzeniowski P, Barrow A, Sodergren MH, et al., 2016, NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator, INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY, Vol: 11, Pages: 2303-2315, ISSN: 1861-6410
Loisillier A, Granados A, Barrow A, et al., 2016, Thimble End Effector for Palpation Skills Training, 10th International Conference on Haptics - Perception, Devices, Control, and Applications (EuroHaptics), Publisher: SPRINGER INT PUBLISHING AG, Pages: 86-96, ISSN: 0302-9743
Mulki O, Plumptre I, Granados A, et al., 2016, Bimanual vaginal examination: Using innovation through cognitive task analysis to standardise practise and enhance teaching, Publisher: WILEY-BLACKWELL, Pages: 205-205, ISSN: 1470-0328
Weldon S-M, Kneebone R, Bello F, 2016, Collaborative healthcare remodelling through sequential simulation: a patient and front-line staff perspective, BMJ Simulation and Technology Enhanced Learning, Vol: 2, Pages: 78-86
Brenton H, Woodward P, Gillies M, et al., 2015, Linking Aetiology with Social Communication in a Virtual Stroke Patient, 15th International Conference on Intelligent Virtual Agents (IVA), Publisher: SPRINGER-VERLAG BERLIN, Pages: 270-274, ISSN: 0302-9743
Brewin J, Tang J, Dasgupta P, et al., 2015, Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology, BJU INTERNATIONAL, Vol: 116, Pages: 156-162, ISSN: 1464-4096
Brunckhorst O, Shahid S, Aydin A, et al., 2015, The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment, JOURNAL OF SURGICAL EDUCATION, Vol: 72, Pages: 1039-1044, ISSN: 1931-7204
Brunckhorst O, Shahid S, Aydin A, et al., 2015, DEVELOPMENT AND VALIDATION OF AN INTEGRATED SKILLS CURRICULUM WITHIN URETEROSCOPY - A RANDOMISED CONTROLLED TRIAL, Annual Meeting of the American-Urological-Association (AUA), Publisher: ELSEVIER SCIENCE INC, Pages: E244-E245, ISSN: 0022-5347
Brunckhorst O, Shahid S, Aydin A, et al., 2015, Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 29, Pages: 2728-2735, ISSN: 0930-2794
Brunckhorst O, Shahid S, Aydin A, et al., 2015, IS THERE A CORRELATION BETWEEN TECHNICAL SKILLS AND NON-TECHNICAL SKILLS PERFORMANCE WITHIN URETEROSCOPY?, Annual Meeting of the American-Urological-Association (AUA), Publisher: ELSEVIER SCIENCE INC, Pages: E268-E269, ISSN: 0022-5347
Brunckhorst O, Shahid S, Aydin A, et al., 2015, Training and assessing technical and non-technical skills for uretersocopy within a simulation-based curriculum - a randomised control trial, Annual Meeting of the Society-of-Academic-and-Research-Surgery (SARS(, Publisher: WILEY-BLACKWELL, Pages: 39-39, ISSN: 0007-1323
Coates L, Weldon S-M, Rodrigues A, et al., 2015, Simulation as a public engagement: Engaging children in medicine and science in some surprising places, International Pediatric Simulation Symposia and Workshops
Costopoulos C, Kelay T, Ako E, et al., 2015, NOVEL SIMULATION-BASED TRAINING IN CARDIOLOGY: TRAINEE FEEDBACK AND EVALUATION OF A PILOT STUDY, CARDIOLOGY, Vol: 131, Pages: 70-70, ISSN: 0008-6312
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