The Deteriorating Patient Smartphone App How Can Achievement Emotions Guide the Design of a Medical TRE? Jeffrey Wiseman Emmanuel G. Blanchard Susanne Lajoie 1 LEADS 2 nd Annual Team Meeting May 2, 2013 San Francisco
Dec 13, 2015
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The Deteriorating Patient Smartphone App How Can Achievement Emotions Guide the Design of
a Medical TRE?
Jeffrey Wiseman Emmanuel G. Blanchard
Susanne Lajoie
LEADS 2nd Annual Team MeetingMay 2, 2013 San Francisco
Outline
• Rationale• Research Questions• Methods• Data to be analyzed• Deliverables• Implications +
Conclusion
Rationale
• Emergencies = emotionally challenging situations
• ABCDEFG algorithm guides emergency care & helps with some emotional challenges
• Medical Simulations: Role of debrief; “Hi Fi” versus “Low Fi”
• Deliberate practice with feedback (Ericsson, 2004)
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Rationale
The Deteriorating Patient Simulation (DPS) (Wiseman, Lajoie, Lu, Blanchard 2006, 2010, 2012)
• Human tutors– Small groups of learners + few tutors
• Digital tutors– Large numbers of learners + digital tutor
• TRE (Smartphone App: Authoring + Case tools)– Community of live & digital learners and tutors– Deliberate practice with feedback anywhere, anytime– Serious games
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Emotions?
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From the Live Tutor Deteriorating Patient Simulation…
(Wiseman, Snell, 2008; Lu, Lajoie, Wiseman, 2010)
Patient Scenario
Listen to Learner
Your approach Learner’s approach
Important differences or weaknesses
Patient deteriorates by a small increment
specific to the weakness
Learner
corrects
Learnerdoesn’t correct
Hints & Humor
Prompt to consult
Listen to next
learner
E E
EE
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…To the Digital Deteriorating Patient Application(Blanchard, Wiseman, Naismith, Hong, Lajoie, 2010; Blanchard, Wiseman,
Naismith, Lajoie, 2012)
Action categories
Information panelVital signs
Choice of actions in the selected category
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Research Questions
• What types of achievement emotions (Pekrun, 2006) occur in the setting of medical learners attempting to solve an emergency case simulation presented by a human tutor?
• Are similar achievement emotions induced by a smartphone-based TRE presenting the same case?
• If not, what additional adjustments in the TRE are needed to bring the TRE-induced achievement emotions closer to those induced by a human tutor?
Methods
• User-centred design iterative approach (Lai et al 2010)
– DP app developers interact with 5 target users to test and adjust TRE design choices
– Modules for collecting user data embedded into the TRE
• Compare + adjust TRE to human Tutor with using an isometric case for 10 medical learners
Data to be Analyzed
• Technical – Self-report measures, log files
• Cognitive– Process: use of ABCDEFG algorithm to guide diagnostic and
management choices; response to changes in vital signs & hints; persistence
– Outcome: Diagnosis, Management, Timing of help-seeking• Emotional– AEQ (Pre? During? As part of Debrief to guide recall?), Task
value + control
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Deliverables
• A new version of the DDPA running on smartphones• A first version of the DDPA authoring tool running on
smartphones• A paper submission to ECTEL2014 • An advanced draft of a paper to be submitted to a
peer-reviewed international journal in late 2014• A grant proposal submission to the Royal College of
Physicians and Surgeons of Canada for additional evaluations on the emotional and cognitive impacts of DDPA for medical learners
Implications + Conclusions
• Role of learner emotions– in medical simulations are relatively unexplored– in TRE design is new for medical contexts
• DPA Smartphone App promises to– Support further adaptation + application of the AEQ to
a medical education context– Provide a TRE designed for learners’ emotions– Permit tracking of learner development over time– Provide links with Empathy/Giving Bad News/Cultural
Differences/Bioworld
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Thank YouThank You!