Preliminary Study: Learning the Impact of Simulation Time on Reentry Location and Morphology Induced by Personalized Cardiac Modeling

Personalized cardiac modeling is widely used for studying the mechanisms of cardiac arrythmias. Due to the high demanding of computational resource of modeling, the arrhythmias induced in the models are usually simulated for just a few seconds. In clinic, it is common that arrhythmias last for more than several minutes and the morphologies of reentries are not always stable, so it is not clear that whether the simulation of arrythmias for just a few seconds is long enough to match the arrhythmias detected in patients. This study aimed to observe how long simulation of the induced arrhythmias in the personalized cardiac models is sufficient to match the arrhythmias detected in patients. A total of 5 contrast enhanced MRI datasets of patient hearts with myocardial infarction were used in this study. Then, a classification method based on Gaussian mixture model was used to detect the infarct tissue. For each reentry, 3 s and 10 s were simulated. The characteristics of each reentry simulated for different duration were studied. Reentries were induced in all 5 ventricular models and sustained reentries were induced at 39 stimulation sites in the model. By analyzing the simulation results, we found that 41% of the sustained reentries in the 3 s simulation group terminated in the longer simulation groups (10 s). The second finding in our simulation was that only 23.1% of the sustained reentries in the 3 s simulation did not change location and morphology in the extended 10 s simulation. The third finding was that 35.9% reentries were stable in the 3 s simulation and should be extended for the simulation time. The fourth finding was that the simulation results in 10 s simulation matched better with the clinical measurements than the 3 s simulation. It was shown that 10 s simulation was sufficient to make simulation results stable. The findings of this study not only improve the simulation accuracy, but also reduce the unnecessary simulation time to achieve the optimal use of computer resources to improve the simulation efficiency and shorten the simulation time to meet the time node requirements of clinical operation on patients.

Effectiveness of mental simulations on the early mobilization of patients after cesarean section: a randomized controlled trial

We aimed to investigate whether psychological intervention (single mental simulation) among women after cesarean surgery (CC) can affect their willingness to verticalize, actual verticalization, and the duration of the first mobilization. In this prospective randomised, controlled study, 150 women after CC were divided into 3 groups: experimental group with process-simulation with elements of relaxation, experimental group with outcome-simulation with elements of relaxation and control group with elements of relaxation only. After a 5-h stay in the post-operative room, women listened to a recording with a stimulation. Pain and anxiety of verticalization were measured before and after listening to the recording and after verticalization. Almost 12% more patients verticalized in the process-simulation group than in the control group. Percentages of mobilized patients were: 39.4% the process-simulation group; 32.8% in the outcome-simulation group; 27.7% controls (p = 0.073). Mobilization was 5 min longer in the process-simulation group then in control (p < 0.01). Anxiety after the simulation was a significant covariate of the willingness to verticalize, actual verticalization and time spent in mobilization. We conclude that a single mental simulation can effectively motivate patients for their first verticalization after CC. Perceived anxiety before verticalization may affect the effectiveness of interventions, so we recommend to check it at the postoperative care.ClinicalTrials.gov Identifier: NCT04829266.

TP8.2.2 Surgical Escape Rooms: A Novel Approach to identifying and addressing Resilience and Academic Buoyancy

Introduction Traditional Simulation is useful practice for real life scenarios whilst Surgical Escape Rooms (ER) assess other elements. Resilience contributes to physical and emotional wellbeing as well as the development of coping strategies. Consistent short-term Academic Buoyancy levels can have an impact on long-term levels of Resilience. Method Two groups of 4th year medical students were given the validated Brief Resilience Scale (BRS) and the Academic Buoyancy Scale (ABS) before and after. The first group completed the Surgical ER whilst the second group completed a Surgical Simulation. During the ER session, participants were assessed by multiple, independent assessors on 4 parameters - participation, objective display of frustration/stress, interaction with the team and definitive decisions taken. These were then correlated with their initial self-assessments scores. Result The ER group ABS Scores improved (3.45 to 3.8; Range 0-4) whilst BRS scores decreased (4.5 to 3.9; Range 0-5). The Simulation group ABS scores decreased (3.4 to 2.9) whilst BRS scores improved (2.9 to 3.2). Scores became more polarised across all groups. Participants who scored low on the BRS/ABS displayed lower levels of participation, team interaction and fewer definitive actions taken but also displayed fewer indicators of overt stress in comparison to their higher scoring counterparts. Conclusion Escape Rooms are useful in challenging individuals to improve problem solving skills and encourage lateral thinking. It would be useful to incorporate ER’s in the early stages of training to build confidence and reduce the immediate negative impact of Simulation at later stages.

Pengaruh Pelatihan Balut Bidai terhadap Pengetahuan Penatalaksanaan Fraktur pada Anggota PMR di SMK Kota Makassar

Balut bidai training aims to minimize the impact that can occur so that every lay person can help if they find victims who have an accident.The research aimed to analyze to what extent the effect of the splint wrap training using the watching video method on the fracture management knowledge of the Youth Red Cross members. This was the qualitative research with the one group pretest posttest design method with the samples of 70 students of YRC members. The samples were selected using the non-probability sampling technique with the purposive sampling approach. The date were analyzed using T-Test. The research result indicates that there is no significant difference concerning the knowledge level between the simulation group and video group (? = 0.063), whereas on the skill level, there is the significant difference between the simulation group and video group (? = 0.000). Thus, it can be concluded that the training using the video method can improve the fracture management knowledge fester than the training using the simulation method, so that it is expected that the training using the video method can be utilized for almost all topics, and every cognitive, affective, psychomotoric and interpersonal domain.

Evaluating the effectiveness of a single-day simulation-based program in psychiatry for medical students: a controlled study

Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.

Using peer role-playing to improve students’ clinical skills for musculoskeletal physical examinations

Background The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX). Methods Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants’ performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis. Results The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters. Conclusions Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.

Modelling and Simulation as a Service – an Emergent Concept that Supports the Military Education and Training Process Continuity

In the last years, the NATO Modelling and Simulation Group (NMSG) has started to develop and put into practice an emergent concept named “Modelling and Simulation as a Service” (MSaaS) with the purpose to provide a permanent service and cloud-based modelling and simulation (M&S) ecosystem to be used by NATO and partner nations. The new M&S ecosystem will help to project and expand the ways of using M&S capabilities for achieving interoperability between participating simulation systems and ensuring credibility of results. This paper presents, on one hand, the development phases of MSaaS, the benefits and steps that have to be done in the future for its implementation at NATO level, and on the other hand, it makes an extrapolation between business continuity concept and MSaaS concept in terms of ensuring the military education and training process continuity when a crisis situation occurs.

Design and Implementation Of Blended Learning Approach For Simulation Education Among Undergraduate Nursing Students

The importance of undergraduate nursing education has never been higher due to the aging population and complexity of patients. The blended simulation combined two and more educational methods and is an effective strategy in nursing education. This study was to evaluate the effectiveness of blended simulation using standardized patients and patients simulation. Using a convenience sampling, a quasi-experimental study was conducted. Forty undergraduate nursing students enrolled and were allocated into the experimental group (n=20) or the control group (n=20). CPX (clinical performance examination) was used to evaluate physical assessment skills. Self-reporting questionnaires were used for communication skill and learning satisfaction. χ2-test/Fisher’s exact test and Mann-Whitney U test were conducted for statistical analysis. After completing the educational program, there were statistically significant higher levels of physical assessment and communication skills in the blended simulation group (p<.001) compared with the control group. Regarding learning satisfaction, there were also statistically significant differences with higher level of satisfaction among students in blended simulation group (p=.002). This blended simulation has high potential to successfully achieve learning outcomes in undergraduate nursing education. Providing students diverse educational methods ensures an optimal learning experience.

Using Imagination to Overcome Fear: How Mental Simulation Nudges Consumers’ Purchase Intentions for Upcycled Food

Upcycled food, a new kind of food, provides an effective solution to reduce the food waste from the source on the premise of food security for human beings. However, the commercial success of upcycled food and its contribution to environmental sustainability are determined by consumers’ purchase intentions. In order to overcome consumers’ unfamiliarity with upcycled food and fear of new technology, based on the cue utility theory, we adopted scenario simulation through online questionnaires in three experiments to explore how mental simulation can improve consumers’ product evaluation and purchase intentions for upcycled food. Through ANOVA, the t-test, and the Bootstrap methods, the results showed that, compared with the control group, consumers’ product evaluation and purchase intentions for upcycled food in the mental simulation group significantly increased. Among them, consumers’ inspiration played a mediation role. The consumers’ future self-continuity could moderate the effect of mental simulation on consumers’ purchase intentions for upcycled food. The higher the consumers’ future self-continuity, the stronger the effect of mental simulation. Based on the above results, in the marketing promotion of upcycled food, promotional methods, such as slogans and posters, could be used to stimulate consumers, especially the mental simulation thinking mode of consumer groups with high future self-continuity, thus improving consumers’ purchase intentions for upcycled food.