자료유형  

 학위논문

Control Number  

0017162916

International Standard Book Number  

9798384231936

Dewey Decimal Classification Number  

612

Main Entry-Personal Name  

Tzamaras, Haroula M.

Publication, Distribution, etc. (Imprint  

[S.l.] : The Pennsylvania State University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

130 p.

General Note  

Source: Dissertations Abstracts International, Volume: 86-03, Section: B.

General Note  

Advisor: Miller, Scarlett R.

Dissertation Note  

Thesis (Ph.D.)--The Pennsylvania State University, 2024.

Summary, Etc.  

요약Central Venous Catheterization (CVC) is a commonly performed medical procedure used for medication delivery to the heart. While CVC is conducted over 5 million times annually it is plagued with high complication rates, resulting in adverse effects on patients, and in the worst cases, death. These complications are directly related to the experience level of the performing physician. A physician who has conducted less than 50 CVCs, is twice as likelyto incur complications than a physician with more experience, reiterating the need for robust training of CVC for new medical residents. To better train physicians in complex procedures like CVC, many residency programs utilize simulation-based training (SBT). SBT is an imitation of a procedure or environment that allows trainees to practice hands-on medical procedures risk-free to a predefined mastery level of performance before conducting the procedure on patients. When determining the effectiveness of SBT, instructors will sometimes employ self-assessment to gauge trainee knowledge gains. Self-assessment can be useful; however, when using self-assessment for measuring learning success, other factors like gender can potentially cause trainees to rate themselves lower even if their learning and performance is equivalent. This gender-gap is not widely researched in SBT, but is important to understand in the context of learning. Additionally, most SBT methods require residents to already know how to conduct the steps of the procedure on their first usage, without checking for understanding. In this way, many simulators are designed for practicing procedures, but not for effective learning, indicating a need for innovative training methods that can do both. For CVC SBT, manikin trainers are commonly utilized and are useful because they provide hands-on practice but are limited in that they only provide practice on one anatomy and do not provide automated feedback to the trainee. The Dynamic Haptic Robotic Trainer (DHRT) addresses these deficits of manikin training for CVC by providing force tissue profiles to simulate multiple patient anatomies, along with providing automated, personalized feedback on performance to help the trainee learn and improve. While the DHRT has been shown to train residents as effectively as manikin trainers without the need of a trained preceptor, it only teaches part of the mechanical portionsof CVC residents need to know to be proficient in the clinical environment. In addition, while DHRT has been validated for its educational effectiveness, it lacks clinical validation. Considering these gaps in medical training for CVC SBT, the objective of this dissertation was to transform CVC education through assessment of current training methods, development of new training methods, and validation of new training methods. Specifically, this dissertation focused on: (1) evaluating the impact of sequential learning on initial skill gain and learning over time, (2) assessing DHRT training for differences in self-efficacy between men and women, (3) developing and analyzing the impact of a novel comprehensive simulator on resident self-efficacy and proficiency, and (4) validating the comprehensive simulator through eye gaze in the operating room and on the simulator with novice and expert physicians. The results of this dissertation indicate that sequential learning significantly increased initial skill gain, decreased the number of trials required to complete training, and reduced learning curves, women rate their self-efficacy significantly lower than men despite no performance differences for SBT and neither men nor women are able to accurately self-assess performance, comprehensive simulation is more effective than the original DHRT training for resident performance and self-efficacy, and the comprehensive simulator exhibits both predictive validity by aligning expert gaze between the simulator and the operating room and construct validity by distinguishing between expert and novices. This dissertation also provides novel methodology for conducting validity studies in the clinical environment.

Subject Added Entry-Topical Term  

Gender differences.

Subject Added Entry-Topical Term  

Carotid arteries.

Subject Added Entry-Topical Term  

Intubation.

Subject Added Entry-Topical Term  

Infections.

Subject Added Entry-Topical Term  

Medical education.

Subject Added Entry-Topical Term  

Funding.

Subject Added Entry-Topical Term  

Catheters.

Subject Added Entry-Topical Term  

Clinical outcomes.

Subject Added Entry-Topical Term  

Skills.

Subject Added Entry-Topical Term  

User interface.

Subject Added Entry-Topical Term  

Patients.

Subject Added Entry-Topical Term  

Human performance.

Subject Added Entry-Topical Term  

Medical research.

Subject Added Entry-Topical Term  

Veins & arteries.

Subject Added Entry-Topical Term  

Design.

Subject Added Entry-Topical Term  

Venous access.

Subject Added Entry-Topical Term  

Role models.

Subject Added Entry-Topical Term  

Self-efficacy.

Subject Added Entry-Topical Term  

Trainers.

Subject Added Entry-Topical Term  

Drug administration.

Subject Added Entry-Topical Term  

Gender studies.

Subject Added Entry-Topical Term  

Health education.

Subject Added Entry-Topical Term  

Higher education.

Subject Added Entry-Topical Term  

Medical personnel.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Pharmaceutical sciences.

Added Entry-Corporate Name  

The Pennsylvania State University.

Host Item Entry  

Dissertations Abstracts International. 86-03B.

Electronic Location and Access  

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Control Number  

joongbu:657748