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CURATOR
A pinboard by
Diana Sanchez

I am completing my doctoral program at Colorado State University and plan to transition into a research position in Academia.

My research focuses on how organizations can integrate technology to improve their management of human capital. In recent years my studies have focused on virtual teams, game-based simulations, and training/learning management systems.

PINBOARD SUMMARY

Exploring the research behind high fidelity training simulations and virtual environments.

For decades organizations have used computer simulations (i.e., realistic virtual environments) to develop employee skills. These simulations allow employees to practice work related tasks in a safe and controlled environment. The use of these simulations can mitigate the potential harm of practicing new skills on the job (e.g., new medical procedures).

10 ITEMS PINNED

Simulation-based education: understanding the socio-cultural complexity of a surgical training 'boot camp'.

Abstract: The focus of simulation-based education (SBE) research has been limited to outcome and effectiveness studies. The effect of social and cultural influences on SBE is unclear and empirical work is lacking. Our objective in this study was to explore and understand the complexity of context and social factors at a surgical boot camp (BC).A rapid ethnographic study, employing the theoretical lenses of complexity and activity theory and Bourdieu's concept of 'capital', to better understand the socio-cultural influences acting upon, and during, two surgical BCs, and their implications for SBE. Over two 4-day BCs held in Scotland, UK, an observer and two preceptors conducted 81 hours of observations, 14 field interviews and 11 formal interviews with faculty members (n = 10, including the lead faculty member, session leaders and junior faculty members) and participants (n = 19 core surgical trainees and early-stage residents).Data collection and inductive analysis for emergent themes proceeded iteratively. This paper focuses on three analytical themes. First, the complexity of the surgical training system and wider health care education context, and how this influenced the development of the BC. Second, participants' views of the BC as a vehicle not just for learning skills but for gaining 'insider information' on how best to progress in surgical training. Finally, the explicit aim of faculty members to use the Scottish Surgical Bootcamp to welcome trainees and residents into the world of surgery, and how this occurred.To the best of our knowledge, this is the first empirical study of a surgical BC that takes a socio-cultural approach to exploring and understanding context, complexities, uncertainties and learning associated with one example of SBE. Our findings suggest that a BC is as much about social and cultural processes as it is about individual, cognitive and acquisitive learning. Acknowledging this explicitly will help those planning similar enterprises and open up a new perspective on SBE research.

Pub.: 13 Jul '16, Pinned: 30 Jun '17

Changing the Learning Curve in Novice Laparoscopists: Incorporating Direct Visualization into the Simulation Training Program.

Abstract: A major challenge in laparoscopic surgery is the lack of depth perception. With the development and continued improvement of 3D video technology, the potential benefit of restoring 3D vision to laparoscopy has received substantial attention from the surgical community. Despite this, procedures conducted under 2D vision remain the standard of care, and trainees must become proficient in 2D laparoscopy. This study aims to determine whether incorporating 3D vision into a 2D laparoscopic simulation curriculum accelerates skill acquisition in novices.Postgraduate year-1 surgical specialty residents (n = 15) at the Schulich School of Medicine and Dentistry, at Western University were randomized into 1 of 2 groups. The control group practiced the Fundamentals of Laparoscopic Surgery peg-transfer task to proficiency exclusively under standard 2D laparoscopy conditions. The experimental group first practiced peg transfer under 3D direct visualization, with direct visualization of the working field. Upon reaching proficiency, this group underwent a perceptual switch, changing to standard 2D laparoscopy conditions, and once again trained to proficiency.Incorporating 3D direct visualization before training under standard 2D conditions significantly (p < 0.0.5) reduced the total training time to proficiency by 10.9 minutes or 32.4%. There was no difference in total number of repetitions to proficiency. Data were also used to generate learning curves for each respective training protocol.An adaptive learning approach, which incorporates 3D direct visualization into a 2D laparoscopic simulation curriculum, accelerates skill acquisition. This is in contrast to previous work, possibly owing to the proficiency-based methodology employed, and has implications for resource savings in surgical training.

Pub.: 09 Oct '16, Pinned: 30 Jun '17

Development of an interprofessional student teaching simulation in team communication skills

Abstract: Interprofessional education (IPE) has become increasingly the object of focus in undergraduate medical education. Evidence supports the promotion of teamwork and effective communication to improve patient safety and outcomes. Educators are challenged to find meaningful ways to teach these skills to students and there are several barriers that must be addressed to meet this challenge. Educators must work outside of well-established silos within the medical education community to bring learners from various disciplines together. In addition, they must create curriculum that engages all participants and is relevant to the modern learner. Simulation creates a safe, low stress environment in which participants may practice communication and teamwork without risk to themselves or, more importantly, patients. By practicing a high stress, high stakes scenario in the low risk environment of the simulator, learners from various disciplines are able practice these skills in a meaningful way. Cardiac arrest is an example of a common, high impact occurrence that is particularly amenable to interprofessional team based simulation training exercises. We describe the development of an interprofessional student course teaching communication and teamwork culminating in a team run cardiac arrest simulation exercise. This course was designed to use a blended learning model utilizing both pre-course online materials available to participants, a team training exercise utilizing high-fidelity simulation and team debrief with formative assessment. This blended model addressed the challenge of coordinating multiple learners from multiple colleges and schedules.

Pub.: 17 Oct '16, Pinned: 30 Jun '17

From cockpit to operating theatre to drilling rig floor: five principles for improving safety using simulator-based exercises to enhance team cognition

Abstract: Abstract For over 30 years, aviation has conducted training courses to enhance team performance and improve safety involving simulation with observation and directed feedback. Participants’ performance is observed by trained and experienced observers who then provide feedback using behaviour-based evidence noted during the simulator exercise. More recently, in healthcare, operating theatre personnel have adopted simulator-based training (SBT), observation and feedback for learning and practice to reduce the potential for human errors and improve safety. Maritime and nuclear power also incorporate high-fidelity simulators and feedback in team training interventions including technical and non-technical skills. The design and development of drilling rig simulators means that drill crews can now practise and test out their decision-making and receive feedback from observers, with the aim of improving team non-technical skills and consequently reducing the potential for errors. This paper presents five principles gleaned from research and the experiences of both aviation and healthcare to be applied to the development of simulator-based exercising for drilling teams. The principles include: (a) developing learning objectives and expected performance standards; (b) training the team as a whole; (c) using a structured observation tool; (d) providing feedback during a structured debrief; (e) repeat the SBT regularly to enhance expertise and retain performance standards. It is anticipated that these principles can be generalised for simulator-based exercising to benefit team social and cognitive competences in other high-hazard or process industries.AbstractFor over 30 years, aviation has conducted training courses to enhance team performance and improve safety involving simulation with observation and directed feedback. Participants’ performance is observed by trained and experienced observers who then provide feedback using behaviour-based evidence noted during the simulator exercise. More recently, in healthcare, operating theatre personnel have adopted simulator-based training (SBT), observation and feedback for learning and practice to reduce the potential for human errors and improve safety. Maritime and nuclear power also incorporate high-fidelity simulators and feedback in team training interventions including technical and non-technical skills. The design and development of drilling rig simulators means that drill crews can now practise and test out their decision-making and receive feedback from observers, with the aim of improving team non-technical skills and consequently reducing the potential for errors. This paper presents five principles gleaned from research and the experiences of both aviation and healthcare to be applied to the development of simulator-based exercising for drilling teams. The principles include: (a) developing learning objectives and expected performance standards; (b) training the team as a whole; (c) using a structured observation tool; (d) providing feedback during a structured debrief; (e) repeat the SBT regularly to enhance expertise and retain performance standards. It is anticipated that these principles can be generalised for simulator-based exercising to benefit team social and cognitive competences in other high-hazard or process industries.

Pub.: 04 Nov '16, Pinned: 30 Jun '17

MO-DE-BRA-02: SIMAC: A Simulation Tool for Teaching Linear Accelerator Physics.

Abstract: The first goal of this work is to develop software that can simulate the physics of linear accelerators (linac). The second goal is to show that this simulation tool is effective in teaching linac physics to medical physicists and linac service engineers.Linacs were modeled using analytical expressions that can correctly describe the physical response of a linac to parameter changes in real time. These expressions were programmed with a graphical user interface in order to produce an environment similar to that of linac service mode. The software, "SIMAC", has been used as a learning aid in a professional development course 3 times (2014 - 2016) as well as in a physics graduate program. Exercises were developed to supplement the didactic components of the courses consisting of activites designed to reinforce the concepts of beam loading; the effect of steering coil currents on beam symmetry; and the relationship between beam energy and flatness.SIMAC was used to teach 35 professionals (medical physicists; regulators; service engineers; 1 week course) as well as 20 graduate students (1 month project). In the student evaluations, 85% of the students rated the effectiveness of SIMAC as very good or outstanding, and 70% rated the software as the most effective part of the courses. Exercise results were collected showing that 100% of the students were able to use the software correctly. In exercises involving gross changes to linac operating points (i.e. energy changes) the majority of students were able to correctly perform these beam adjustments.Software simulation(SIMAC), can be used to effectively teach linac physics. In short courses, students were able to correctly make gross parameter adjustments that typically require much longer training times using conventional training methods.

Pub.: 04 Jan '17, Pinned: 30 Jun '17

Using simulation to prepare for clinical practice

Abstract: A significant proportion of medical students feel underprepared for clinical practice, especially in skills such as decision making, prioritisation and prescribing. Changes to medical curricula, including assistantships and shadowing, provide supervised practise, but students remain unable to fully take responsibility for patient care. Simulation may assist in addressing this deficit. A simulation course entitled ‘Simulated ward round and professional skills’ (SWAPS) was developed to improve student preparation for clinical practice. Preliminary work surveyed 22 foundation doctors to identify perceived areas of weakness and to guide the learning outcomes of the course. Following the design and development of the course, 133 final-year medical students were observed completing a 60-minute simulation scenario aimed at providing experiential learning in a ward environment, reflecting professional practice. Students received structured feedback and completed pre- and post-course questionnaires to evaluate changes in confidence over the learning domains. Qualitative feedback was also collected.A significant proportion of medical students feel underprepared for clinical practiceThe p values were significant in all assessed domains, indicating a perceived improvement in confidence following the SWAPS course. Qualitative feedback highlighted the perceived utility of the course in exposing students to clinical ward-based scenarios infrequently encountered in their medical curriculum. Students praised the personal feedback received and realism of the simulation.This paper contributes to the growing body of literature supporting the use of simulation to replicate a ward round and the daily roles of a junior doctor. The SWAPS course seems to empower students to take responsibility for clinical decision making and experience some of the realities of foundation training in a simulated setting.

Pub.: 30 Mar '17, Pinned: 30 Jun '17

Organizational culture and development: Testing the structural path of factors affecting employees’ work performance in an organization

Abstract: In the world of business skills training, employees' skills can be generally divided into two main categories: hard skills and soft skills. For organization to wax stronger and competitive in the business environment today, employees need to possess soft skills in addition to hard skills. The purpose of this study is twofold: first, to examine the direct influence of both training methodology and trainers' effectiveness on soft skills acquisition, followed by identifying soft skill competencies and their influence on employees' work performance. The study was designed to use a survey research method in studying the effects of soft skills on employee work performance. The units of analysis were the selected managers and executives of a few Malaysian-based companies. Random sampling procedures were carried out in 10 different Malaysian companies, which consisted of about 1200 soft skills trainees, from which 260 participants were selected. The findings revealed that the model of trainer effectiveness and training methodology factors have provided a reasonable explanation for the influence of soft skill acquisition which is the latent variables. The model also revealed that soft skill acquisition positively influenced employees' work performance. The authors recommend need for employers to restructure the methodology for training employees on soft-skills. It is also recommend that, corporate institutions need to adopt ‘time-spaced learning’ training method in order to circumvent the hindrances associated with training transfer.

Pub.: 21 Feb '17, Pinned: 30 Jun '17

Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: a modified Delphi consultation.

Abstract: To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce BACKGROUND: The nursing workforce experiences rates of ill health above that of other workforces yet there is little investment in workplace health promotion.The study used a modified Delphi design conducted between September - November 2015.Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility.Mental health strategies were prioritised as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups.Study findings prompt consideration of health promotion opportunities to support nurses' health and wellbeing. Findings identified key workplace health promotion priorities and provide direction for policy-makers and managers to promote nursing and midwifery workforce health. This article is protected by copyright. All rights reserved.

Pub.: 26 May '17, Pinned: 30 Jun '17

An experimental study on the effects of a simulation game on students' clinical cognitive skills and motivation.

Abstract: Simulation games are becoming increasingly popular in education, but more insight in their critical design features is needed. This study investigated the effects of fidelity of open patient cases in adjunct to an instructional e-module on students' cognitive skills and motivation. We set up a three-group randomized post-test-only design: a control group working on an e-module; a cases group, combining the e-module with low-fidelity text-based patient cases, and a game group, combining the e-module with a high-fidelity simulation game with the same cases. Participants completed questionnaires on cognitive load and motivation. After a 4-week study period, blinded assessors rated students' cognitive emergency care skills in two mannequin-based scenarios. In total 61 students participated and were assessed; 16 control group students, 20 cases students and 25 game students. Learning time was 2 h longer for the cases and game groups than for the control group. Acquired cognitive skills did not differ between groups. The game group experienced higher intrinsic and germane cognitive load than the cases group (p = 0.03 and 0.01) and felt more engaged (p < 0.001). Students did not profit from working on open cases (in adjunct to an e-module), which nonetheless challenged them to study longer. The e-module appeared to be very effective, while the high-fidelity game, although engaging, probably distracted students and impeded learning. Medical educators designing motivating and effective skills training for novices should align case complexity and fidelity with students' proficiency level. The relation between case-fidelity, motivation and skills development is an important field for further study.

Pub.: 05 Oct '15, Pinned: 29 Jun '17