This study was designed to test the hypothesis that simulator-based transesophageal echocardiographic training was a more effective method of training anesthesia residents with no prior experience in echocardiography as compared with conventional methods of training (books, articles, and web-based resources).
A prospective randomized study.
An academic medical center (teaching hospital).
The participants consisted of first-year anesthesia residents.
The study design was composed of 2 groups: a control group (group 1, conventional group) and a study group (group 2, simulator group). The residents belonging to group 2 (simulator group) received a 90-minute simulator-based teaching session moderated by a faculty experienced in transesophageal echocardiography. Residents belonging to group 1 (conventional group) were asked to review the guidelines of the comprehensive intraoperative transesophageal echocardiographic examination published by the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. They also were encouraged to use other learning resources (eg, textbooks, electronic media, and web-based resources) to understand the underlying concepts of echocardiography. Written pre- and post-test was administered to both groups.
The groups were compared for the pretest scores by the nonparametric Mann-Whitney U test. Pre- and post-test scores were compared with a Wilcoxon paired test in the individual groups. The results showed a statistically significant difference between the scores of the 2 groups with better scores in the simulation group in the post-training test.
The simulator-based teaching model for transesophageal echocardiography is a better method of teaching the basic concepts of transesophageal echocardiography like anatomic correlation, structure identification, and image acquisition.
"However, these studies have primarily focussed on image interpretation and not on the technical image quality. Digital simulation has also received some attention, but primarily in the field of trans-oesophageal echocardiography and with focus on technical skills [12,13]. "
[Show abstract][Hide abstract] ABSTRACT: Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation.
Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed.
At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9).
Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.
BMC Medical Education 08/2012; 12(1):65. DOI:10.1186/1472-6920-12-65 · 1.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this paper, a new identification method, called learning identification algorithm, of the model parameters of robot dynamics is proposed. This method has the following features: it does not require the exciting trajectory, and the measurements of joint accelerations and velocities. The method is demonstrated experimentally by estimating the dynamic parameters of a shaped glass cutting robot
Industrial Technology, 1996. (ICIT '96), Proceedings of The IEEE International Conference on; 01/1997
[Show abstract][Hide abstract] ABSTRACT: The authors have been developing humanoid robots in order to develop new mechanisms and functions for a humanoid robot that has the ability to communicate naturally with a human by expressing human-like emotion. We considered that human hands play an important role in communication because human hands have grasping, sensing and emotional expression abilities. Then, we developed the emotion expression humanoid robot WE-4RII (Waseda Eye No.4 Refined II) by integrating the new humanoid robot hands RCH-1 (RoboCasa Hand No.1) into the emotion expression humanoid robot WE-4R. Furthermore, we confirmed that RCH-1 and WE-4RII had effective emotional expression ability because the correct recognition rate of WE-4RII's emotional expressions was higher than the WE-4R's one. In this paper, we describe the mechanical features of WE-4RII.
Intelligent Robots and Systems, 2004. (IROS 2004). Proceedings. 2004 IEEE/RSJ International Conference on; 01/2004
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