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BEGIN:VEVENT
DTSTAMP:20240325T185835Z
LOCATION:Salon A-4
DTSTART;TZID=America/Chicago:20240326T085200
DTEND;TZID=America/Chicago:20240326T091500
UID:HFESHCS_2024 International Symposium on Human Factors and Ergonomics i
 n Health Care_sess137_INDLEC122@linklings.com
SUMMARY:Iterative use of Expert and Novice feedback on simulator design: A
  multi-stakeholder approach in central venous catheterization
DESCRIPTION:Oral Presentations\n\nHaroula Tzamaras, Jessica Gonzalez-Varga
 s, Jason Moore, and Scarlett Miller (Pennsylvania State University)\n\nMed
 ical simulation is an essential component of training physicians that has 
 facilitated the paradigm shift of medical training from “see one, do one, 
 teach one” to “see one, simulate many, do one, teach one”.  While simulato
 rs for many medical procedures are commercially available, there exists a 
 need for the continuous innovation of medical simulation to improve usabil
 ity and transferability to the clinical environment.  One procedure that c
 ould benefit from improved simulation training is central venous catheteri
 zation (CVC). CVC can be broken down into stages, needle insertion vessel 
 access, and post vessel access catheter insertion. The standard for CVC tr
 aining is manikin simulators that are useful for practicing needle inserti
 on. However, manikin simulators lack specific, personalized performance fe
 edback and durability, and only provide training on the needle insertion p
 ortion of the procedure, neglecting the remainder of the steps and medical
  tools. Based on the limitations of currently available training methods, 
 there is a need for the development of a whole procedure trainer that can 
 provide practice in all the steps of CVC with automated feedback. During t
 he design process, prototypes are often used to gain feedback from stakeho
 lders, defined as individuals who will be impacted by or exposed to the it
 em being design. The primary stakeholders for medical simulation training 
 are the system users, in this case, new residents (novices) and the physic
 ians in charge of their training (experts). To address the need for a whol
 e procedure trainer for CVC, we followed an iterative design cycle approac
 h.  For design cycle one, ten experts participated in a demonstration and 
 interview of a virtual prototype. This prototype was a simulated interface
  that was demonstrated to participants through pre-made videos.  The feedb
 ack from these ten expert interviews was used to inform design cycle two a
 nd create a low fidelity physical prototype which was used in a demonstrat
 ion and interview with three additional experts. The low fidelity physical
  prototype included an interface and a false vein channel to simulate the 
 vein that the catheter is inserted into during CVC. These interviews infor
 med design cycle three, which included a medium-fidelity physical prototyp
 e and a demonstration and interview with four additional experts. This pro
 totype included an updated interface, a false vein channel, a full CVC med
 ical tray with all equipment used for the procedure, and sensors to indica
 te successful catheter insertion and provide feedback to the trainee. Afte
 r design cycle three, NVivo was used to qualitatively analyze the overall 
 feedback given across all design cycles. In the final version of the simul
 ator to be used for new resident training, the interface was updated to in
 clude patient vitals. Computer vision was utilized in the physical system 
 to track the tools as they were moved in and out of the CVC medical tray t
 o practice mechanical steps and sensors were used to monitor the insertion
  of tools into the vein. Twenty-nine novices, the main users, trained on t
 he simulator and answered a Likert-scale survey and open-ended questions a
 bout the utility of the simulator and where it could be improved. Overall,
  both experts and novices indicated the utility of a whole procedural simu
 lator and its potential to positively impact resident training. Interestin
 gly, the expert feedback focused more on the aspects of CVC to include in 
 the training to ensure that it was teaching the most important skills, and
  the novice feedback focused on how the system could be best structured to
  help them learn. Both expert and the novice feedback are necessary to des
 ign the most usable training system.\n\nTrack: Simulation and Education\n\
 nSession Chair: Michael Schwartz (Cincinnati Children's Hospital)
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