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Simulation of a virtual patient with cranial nerve injury augments physician-learner concern for patient safety

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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
We have created the Neurological Exam Rehearsal Virtual Environment (NERVE), a virtual patient based simulation targeted to train medical students in the diagnosis of abnormal findings in the neurological examination. In NERVE, a learner communicates with and performs a physical examination of a life-sized virtual character experiencing double vision as a result of a cranial nerve palsy. NERVE affords verbal communication through natural speech and gestures, and affords physical interaction through manipulation of virtual tools such as an ophthalmoscope. Creation of NERVE is motivated by the limited quantity and depth of current medical education and simulation approaches to providing learners with exposure to abnormal physical findings in the context of a doctor-patient interaction. NERVE not only provides an immersive and on-demand learning opportunity, but provides students with the opportunity to experience the patient’s double vision in the first person in a “Patient Vision Feedback” (PVF) session. PVF allows the learner to experience how the world looks to the virtual patient, providing an opportunity for enhanced perspective taking and empathy. Thirty-two medical students have examined a virtual patient in NERVE. Twenty-nine of these students were able to correctly diagnose the virtual patient’s cranial nerve palsy, demonstrating content validity of NERVE. A subset of eight medical students experienced Patient Vision and, as a result, demonstrated improved concern for the patient’s wellbeing. NERVE is able to augment a neurology curriculum by providing increased exposure to abnormal findings and providing students with a unique insight into how the disease affects the patient’s wellbeing.
Słowa kluczowe
Rocznik
Strony
25--34
Opis fizyczny
Bibliogr. 21 poz., rys.
Twórcy
autor
  • University of Florida Department of Computer and Information Science and Engineering
autor
  • University of Florida Department of Surgery
autor
  • University of Georgia, Faculty of Engineering
autor
  • University of Florida Department of Computer and Information Science and Engineering
Bibliografia
  • [1] B.J. Shingleton, M.W. O’Donoghue, “Blurred vision,” New England Journal of Medicine, vol. 343, no. 8, pp. 556-562, Aug. 2000.
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  • [3] D.J. Gelb, C.H. Gunderson, K.A. Henry, H.S. Kirshner, and R.F. Jozefowicz, “The neurology clerkship core curriculum,” Neurology, vol. 58, no. 6, pp. 849-852, Mar. 2002.
  • [4] L.E. Davis and M.K. King, “Assesment of medical student clinical competencies in the neurology clinic,” Neurology, vol. 68, pp. 597-599, 2007.
  • [5] E.S. van de Graaf, J. Felius, H. van Kempen-du Sar, C.W.N. Looman, J. Passchier, H. Kelderman, H.J. Simonsz, “Construct validation of the Amblyopia and Strabismus Questionnaire (A&SQ) by factor analysis,” Graufe’s Archive for Clinical and Experimental Opthalmology, vol. 247, no. 9, pp. 1263-1268, Sept 2009.
  • [6] R.M. Comer, E. Dawson, G. Plant, J.F. Acheson, and J.P. Lee, “Causes and outcomes for patients presenting with diplopia to an eye casualty department,” Eye, vol. 21, pp. 413-418, 2007.
  • [7] Diplopia: Follow-up [Internet]. eMedicine Ophthalmology; [updated 2008 Sept. 8; cited 2009 Sept. 15]. Available from: http://emedicine.medscape.com/article/1214490-followup
  • [8] F. Schon, P. Hart, and C. Fernandez, “Is clinical neurology really so difficult?” Journal of Neurology, Neurosurgery, and Psychiatry, vol. 72, pp. 557-559, 2002.
  • [9] F.G.A. Moore and C. Chalk, “The essential neurologic examination: What should medical students be taught?” Neurology, vol. 72, no. 23, pp. 2020-2023, June 2009.
  • [10] W.L. van Meurs, M.L. Good, and S. Lampotang, “Functional Anatomy of Full-scale Patient Simulators,” Journal of Clinical Monitoring and Computing, vol. 13, no. 5, pp. 317-324, Sept. 1997.
  • [11] Limbs and Things – Eye Examination Simulator [Internet]. Limbs and Things Co.; [cited 2009 Oct. 4]. Available from: http://www.limbsandthings.com/uk/products.php?id=96
  • [12] R. Lasslo, J. Keltner, and G. Henderson, “Virtual patient/eye simulator – Evolution of a futuristic teaching tool,” Proceedings of the AMIA 2002 Annual Symposium, p. 1074.
  • [13] M. Ramirez-Lassepas, C.E. Espinosa, J.J. Cicero, K.L. Johnston, R.J. Cipolle, and D.L. Barber, “Predictors of Intracranial Pathologic Findings in Patients Who Seek Emergency Care Because of Headache,” Archives of Neurology, vol. 54, no. 12, pp. 1506-1509, Dec. 1997.
  • [14] Bickerstaff’s Neurological Examination in Clinical Practice, 6th Edition, Ed: J.A. Spillane, Wiley-Blackwell, 1996.
  • [15] Managed Library for Nintendo's Wiimote [Internet]. Brian Peek; [updated 2007 Mar. 14; cited 2008 Oct. 31]. Available from: http://blogs.msdn.com/coding4fun/archive/2007/03/14/1879033.aspx
  • [16] J.C. Lee, "Hacking the Nintendo Wii Remote," IEEE Pervasive Computing, vol. 7, no. 3, pp. 39-45, Jul-Sept, 2008.
  • [17] H. Gehlbach, “A New Perspective on Perspective Taking: A Multidimensional Approach to Conceptualizing an Aptitude,” Educational Psychology Review, vol. 16, no. 3, pp. 207-234, Sept. 2004.
  • [18] A. Raij, A. Kotranza, D.S Lind, C.M. Pugh, and B. Lok, “Virtual Experiences for Social Perspective Taking,” Proceedings of IEEE Virtual Reality 2009, Lafayette, LA, Mar. 14-18, 2009, pp. 99-102.
  • [19] A. Kotranza, B. Lok, A. Deladisma, C.M. Pugh, and D. S. Lind, “Mixed Reality Humans: Evaluating Behavior, Usability, and Acceptability,” IEEE Transactions on Visualization and Computer Graphics, vol. 15, no. 3, pp. 369-382, May-June 2009.
  • [20] Williams, R (2004). “Have Standardized Patient Examinations Stood the Test of Time?”, Teaching and Learning in Medicine, 2004 spring: 16(2); 215-222.
  • [21] Liaison Committee on Medical Education. Website visited on September 19th, 2006. (http://www.lcme.org/functionslist.htm).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-0622dfdf-779c-4edd-b63c-c0573a1e1f16
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