Shock Skills Critical Care Simulations Scenarios A software development project

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Shock Skills An educational technology project
into Critical Care Simulation Scenarios

• Ian Cole
• Lecturer in ICT
• Department of Health Sciences
• University of York

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Background
Alison

• TIDC funded project (2500).
• Project Team
• Content provider (Alison Foster - nursing
  expert).
• Content developer (myself software designer).
• Researcher (Carl Thompson Clinical Judgement
  Analyst).

Ian
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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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Project Plan

• 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.

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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

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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.

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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).

Alison
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Research Study Initial Results

• 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.

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Phase 2 Shock Skills

• Involved the content expert developer.
• Used Parsons 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 Early 2005

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 Shneidermans
• usability scale criteria.
• 1 member performing
• a Cognitive Walkthrough
• Experiment.

Ian
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Shock Skills Usability Results

• Criteria
• Images
• Readability
• Colour
• Navigation
• Interactivity
• Reactions
•  

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Shock Skills Methodologies

• System Design Life Cycle
• Normans 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.

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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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What's Next?

• Finish the software proof reading.
• Install on network
• Another group of nursing students. (April 05)
• Undertake the pre-test /Shock Skills /post test
• Analyse and compare differences.
• Publish final results

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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!!!!
• Dont underestimate the amount of time money
  software development takes.
• Dont only have one content expert.
• Everybody needs protected time to work on
  e-learning projects.

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Any Questions?
Anyone wishing to have a closer look at Shock
Skills see me after the session.