1. 2 Shock Skills Critical Care Simulations Scenarios A software development project Ian Cole Lecturer in ICT Department of Health Sciences University.

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Shock Skills Critical Care Simulations

Scenarios A software development project

Ian ColeLecturer in ICT

Department of Health Sciences

University of York

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Background

TIDC funded project (£2500).

Project Team Content provider (Alison

Foster - nursing expert). Content developer (myself –

software designer). Researcher (Carl Thompson –

Clinical Judgement Analyst).

Alison

Ian

Carl

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Project Outline The Proposal

Combine a piece of networked e-learning software.

With web based simulation scenarios. To teach nursing students the principals of

dealing with clinical shock. Research Aims

To develop an effective means of capturing the judgment policies of (student) nurses.

To determine what changes are made by a educational intervention (lecture / software)

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Phase 1 = Research study using web based simulation scenarios.

Phase 2 = Creation of the piece of learning technology (Shock Skills)

Phase 3 = Replacement of a Lecture with Shock Skills.

Analyse results.

Project Plan

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Phase 1 - Research Study

The social judgement approach Attach varying weights to associated

‘cues’. Examine these weights to see how

people make a judgement. Research Method

Judgment of diagnosing someone in hypovolaemic shock.

Judgment based on 6 clinical cues. These cues presented as 20 online

scenarios. 3 levels – abnormal, normal & equivocal

Carl

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Web based scenarios method Web pages created and linked to

Macromedia Coldfusion platform. Created a database of results. Exported as a text file into SPSS.

Carl

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Research Study – Phase 1 A group of 2nd year nursing

students (23). Asked to judge if a fictitious

patient was in shock (pre-test). Students then given a lecture.

(this would be replaced in phase 3 by a piece of learning technology – Shock Skills)

After lecture, students come back and retake the test (post-test).

Carl

Alison

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We Wanted: To know if the lecture make a difference? Compare results with a future student group when

the lecture is replaced with Shock Skills.We Found: A greater variability in the use of some cues than

others. A wide variety of judgements. Pre test = similar importance to all cues except

GCS. Post test = respiratory rate was the most

important factor.

Research Study – Initial Results

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Phase 2 – Shock Skills Involved the content expert

& developer. Used Parson’s & Oja System

Development Life Cycle. Network Software /CD-Rom. Internet limited

for video use. Limited by 650Mb

CD-Rom.

Alison

Ian

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Phase 2 – Shock Skills SDLC

Analysis - Lots of interactivity

Mini Quizzes & Click ’n’ Drag exercises.

Video of clinical procedures. Animations. Lots of images.

Planning. Project Plan. Macromedia Director / Flash. Spent the money (Software /

video camera). Usability Evaluation Team (12)

Ian

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Phase 2 – Shock Skills SDLC

Design. Storyboarded the lecture in

PowerPoint. Navigation model designed. Design metaphor.

Ian

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Phase 2 – Shock Skills SDLC

Implementation. Prototype Implementation Aug

2003 Planned for April 2004 –

SLIPPED!!!! Planned for September 2004

Ian

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Phase 2 – Shock Skills SDLC

Testing. Usability Evaluation Dec 2003 to Jan

2004. Team of 12 evaluators (Staff &

Students). 58 Question Questionnaire. Based on Shneiderman’s

usability scale & criteria. 1 member performing

a Cognitive WalkthroughExperiment.

Ian

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Shock Skills Usability Results

Criteria: Images Readability Colour Navigation Interactivity Reactions

No: Questions Descriptors (0 to 9) Mean

Q8 Navigating from this screen is?

Hard to Easy 8.4

Q55 Overall Reactions Terrible to Wonderful 7.5

Q55 Overall Reactions Dull to Stimulating

7.7

Q55 Overall Reactions Difficult to Easy 7.2

Q55 Overall Reactions Frustrating to Satisfying 7.2

Q55 Overall Reactions Rigid to Flexible 6.5

Q56 Learning to use the software is?

Difficult to Easy 7.7

Q57 The ‘TC’ character image is?

Pointless to Excellent 6.0

Q58 Educational content is? Poor to Excellent 7.5

Q59 Software usability is? Poor to Excellent 7.6

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System Design Life Cycle Norman’s Seven principles of User-Centered Design

1: Use both knowledge in the world and knowledge in the head.

2: Simplify the structure of tasks. 3: Make things visible: bridge the gulfs of Execution &

Evaluation. 4: Get the mappings right. 5: Exploit the power of constrains, both natural and artificial 6: Design for error. 7: When all else fails, standardize.

Shock Skills Methodologies

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Phase 3 – The end is in sight!

Project started in Summer 2002.

Phase 3 should have started April 2004

Project should be finished now.

Underestimated the time needed.

Underestimated the funding.

No protected time. For content expert.

Should have held back some money to buy in a proof reader. 80 screens to proof

read.

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August 04: Finish the software proof reading.

September 04: Install on network October 04: Another group of nursing

students. Undertake the pre-test /Shock Skills /post test

Analyse and compare differences. Publish end of the year (we hope!!!). Regardless the project will be completed.

What's Next?

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Conclusions:

We have an effective method of analysing judgement policies. But more research is needed.

We used a clearly defined development path.BUT!!!! Don’t underestimate the amount of time &

money software development takes. Don’t only have one content expert. Everybody needs protected time to work on e-

learning projects.

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