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Lawrence E. M. Grierson - One of the best experts on this subject based on the ideXlab platform.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:CONTEXT: High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a 'no-intervention' control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. OBJECTIVES: This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. METHODS: Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. RESULTS: Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. DISCUSSION: The factors influencing learning, and the reasons for this surprising finding, are discussed.
Geoff Norman - One of the best experts on this subject based on the ideXlab platform.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:CONTEXT: High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a 'no-intervention' control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. OBJECTIVES: This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. METHODS: Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. RESULTS: Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. DISCUSSION: The factors influencing learning, and the reasons for this surprising finding, are discussed.
Kelly Dore - One of the best experts on this subject based on the ideXlab platform.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:Medical Education 2012 Context High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a ‘no-intervention’ control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.
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the minimal relationship between simulation Fidelity and transfer of learning
Medical Education, 2012Co-Authors: Geoff Norman, Kelly Dore, Lawrence E. M. GriersonAbstract:CONTEXT: High-Fidelity Simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that Simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a Simulator is compared with learning in a 'no-intervention' control group. This fails to clarify the relationship between Simulator Fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. OBJECTIVES: This analysis was conducted to review studies that compare learning from high-Fidelity simulation (HFS) with learning from low-Fidelity simulation (LFS) based on measures of clinical performance. METHODS: Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. RESULTS: Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. DISCUSSION: The factors influencing learning, and the reasons for this surprising finding, are discussed.
Ronald A Hess - One of the best experts on this subject based on the ideXlab platform.
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analytical assessment of flight Simulator Fidelity using pilot models
Journal of Guidance Control and Dynamics, 2009Co-Authors: Ronald A Hess, Federico MarchesiAbstract:A simplified approach for modeling pilot pursuit control behavior is adopted for use in assessing the Fidelity of flight Simulators. The model includes proprioceptive, visual, and vestibular cueing. The model differs from previous Simulator Fidelity applications in that pursuit, as opposed to compensatory pilot behavior, is modeled. In approximate fashion, the model can account for the effects of task interference, degraded motion and visual cues, vehicle modeling errors, differing levels of pilot control aggressiveness, and to a limited extent, pilot skill level. A Fidelity metric similar to one previously discussed in the literature is exercised with three vehicles and tasks: a fighter aircraft in a tail-chase tracking task, a small rotorcraft in a near-hover repositioning task, and a large rotorcraft in acceleration/deceleration and departure/abort tasks. The Fidelity assessment procedure is shown to be sensitive to changes in vehicles, tasks, and Simulator limitations in these disparate examples.
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computer aided assessment of flight Simulator Fidelity
AIAA Modeling and Simulation Technologies Conference and Exhibit, 2002Co-Authors: Yasser Zeyada, Ronald A HessAbstract:A technique for computer-aided assessment of e ight Simulator e delity is presented. The assessment procedure utilizes a mathematical model of the human pilot that includes proprioceptive, visual, and vestibular cues. The quality ofthelattertwo cuescanbevariedtocapturetheeffectsofe ightSimulatorlimitationsassociatedwithvisual and motion cueing. A MATLAB ® -based tool that automatesthe selection of the majority of parameters in the pilot model and the generation of a e delity metric is described. In addition, a prediction of the task-dependent handling qualities of the nominal e ight vehicle can be obtained. The assessment procedure is exercised in a hypothetical example involving the six-degree-of-freedom control of a rotorcraft completing a vertical remask maneuver. It is demonstrated that by varying the quality of the visual and vestibular cues in the pilot/vehicle model the effects of Simulator limitations upon e delity can be systematically addressed.
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assessment of flight Simulator Fidelity in multiaxis tasks including visual cue quality
Journal of Aircraft, 2001Co-Authors: Ronald A Hess, W SiwakositAbstract:A technique for analytical assessment of flight Simulator Fidelity is presented as an extension of a methodology previously introduced in the literature. The assessment is based on a computer simulation of the pilot and vehicle and is inherently task dependent. A simple model of visual cue quality is introduced that is based on the classical concept of human operator visual remnant. The complete assessment procedure now includes proprioceptive, vestibular, and visual cue modeling. Inverse dynamic analysis is employed that allows the use of compensatory models of the human pilot in multiaxis tasks. The methodology is exercised by considering a simple rotorcraft lateral and vertical repositioning task in which visual and motion cue quality is varied.
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modeling human pilot cue utilization with applications to Simulator Fidelity assessment
Journal of Aircraft, 2000Co-Authors: Yasser Zeyada, Ronald A HessAbstract:An analytical investigation to model the manner in which pilots perceive and utilize visual, proprioceptive, and vestibular cues in a ground-based flight Simulator was undertaken. Data from a NASA Ames Research Center vertical motion Simulator study of a simple, single-degree-of-freedom rotorcraft bob-up/down maneuver were employed in the investigation. The study was part of a larger research effort that has the creation of a methodology for determining flight Simulator Fidelity requirements as its ultimate goal. The study utilized a closed-loop feedback structure of the pilot/Simulator system that included the pilot, the cockpit inceptor, the dynamics of the simulated vehicle, and the motion system. With the exception of time delays that accrued in visual scene production in the Simulator, visual scene effects were not included in this study. Pilot/vehicle analysis and fuzzy-inference identification were employed to study the changes in Fidelity that occurred as the characteristics of the motion system were varied over five configurations. The data from three of the five pilots who participated in the experimental study were analyzed in the fuzzy-inference identification. Results indicate that both the analytical pilot/vehicle analysis and the fuzzy-inference identification can be used to identify changes in Simulator Fidelity for the task examined.
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flight Simulator Fidelity assessment in a rotorcraft lateral translation maneuver
AIAA Atmospheric Flight Mechanics Conference, 1992Co-Authors: Ronald A Hess, T Malsbury, A AtencioAbstract:A model-based methodology for assessing flight Simulator Fidelity in closed-loop fashion is exercised in analyzing a rotorcraft low-altitude maneuver for which flight test and simulation results were available. The addition of a handling qualities sensitivity function to a previously developed model-based assessment criteria allows an analytical comparison of both performance and handling qualities between simulation and flight test. Model predictions regarding the existence of Simulator Fidelity problems are corroborated by experiment. The modeling approach is used to assess analytically the effects of modifying Simulator characteristics on Simulator Fidelity.
Robert E Sedlack - One of the best experts on this subject based on the ideXlab platform.
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validation of computer simulation training for esophagogastroduodenoscopy pilot study
Journal of Gastroenterology and Hepatology, 2007Co-Authors: Robert E SedlackAbstract:Background: Little is known regarding the value of esophagogastroduodenoscopy (EGD) Simulators in education. The purpose of the present paper was to validate the use of computer simulation in novice EGD training. Methods: In phase 1, expert endoscopists evaluated various aspects of simulation Fidelity as compared to live endoscopy. Additionally, computer-recorded performance metrics were assessed by comparing the recorded scores from users of three different experience levels. In phase 2, the transfer of simulation-acquired skills to the clinical setting was assessed in a two-group, randomized pilot study. The setting was a large gastroenterology (GI) Fellowship training program; in phase 1, 21 subjects (seven expert, intermediate and novice endoscopist), made up the three experience groups. In phase 2, eight novice GI fellows were involved in the two-group, randomized portion of the study examining the transfer of simulation skills to the clinical setting. During the initial validation phase, each of the 21 subjects completed two standardized EDG scenarios on a computer Simulator and their performance scores were recorded for seven parameters. Following this, staff participants completed a questionnaire evaluating various aspects of the Simulator's Fidelity. Finally, four novice GI fellows were randomly assigned to receive 6 h of Simulator-augmented training (SAT group) in EGD prior to beginning 1 month of patient-based EGD training. The remaining fellows experienced 1 month of patient-based training alone (PBT group). Results of the seven measured performance parameters were compared between three groups of varying experience using a Wilcoxon ranked sum test. The staffs' Simulator Fidelity survey used a 7-point Likert scale (1, very unrealistic; 4, neutral; 7, very realistic) for each of the parameters examined. During the second phase of this study, supervising staff rated both SAT and PBT fellows' patient-based performance daily. Scoring in each skill was completed using a 7-point Likert scale (1, strongly disagree; 4, neutral; 7, strongly agree). Median scores were compared between groups using the Wilcoxon ranked sum test. Results: Staff evaluations of Fidelity found that only two of the parameters examined (anatomy and scope maneuverability) had a significant degree of realism. The remaining areas were felt to be limited in their Fidelity. Of the computer-recorded performance scores, only the novice group could be reliably identified from the other two experience groups. In the clinical application phase, the median Patient Discomfort ratings were superior in the PBT group (6; interquartile range [IQR], 5–6) as compared to the SAT group (5; IQR, 4–6; P = 0.015). PBT fellows' ratings were also superior in Sedation, Patient Discomfort, Independence and Competence during various phases of the evaluation. At no point were SAT fellows rated higher than the PBT group in any of the parameters examined. Conclusion: This EGD Simulator has limitations to the degree of Fidelity and can differentiate only novice endoscopists from other levels of experience. Finally, skills learned during EGD simulation training do not appear to translate well into patient-based endoscopy skills. These findings suggest against a key element of validity for the use of this computer Simulator in novice EGD training.