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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
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TIDC funded project (£2500).
Project Team
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Alison
Content provider (Alison Foster nursing expert).
Content developer (myself –
software designer).
Researcher (Carl Thompson –
Clinical Judgement Analyst).
Ian
Carl
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Project Outline
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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) 4
Project Plan
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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
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The social judgement approach
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Attach varying weights to associated ‘cues’.
Examine these weights to see how people
make a judgement.
Research Method
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Judgment of diagnosing someone in
hypovolaemic shock.
Judgment based on 6 clinical cues.
These cues presented as 20 online
scenarios.
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Carl
3 levels – abnormal, normal & equivocal
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Web based scenarios method
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Web pages created and linked to
Macromedia Coldfusion platform.
Created a database of results.
Exported as a text file into SPSS.
Carl
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Research Study – Phase 1
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Carl
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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.
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Alison
(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).
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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
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Involved the content expert &
developer.
Used Parson’s & 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
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Analysis - Lots of interactivity
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Mini Quizzes & Click ’n’ Drag
exercises.
Video of clinical procedures.
Animations.
Lots of images.
Ian
Planning.
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Project Plan.
Macromedia Director / Flash.
Spent the money (software /
video camera).
Usability Evaluation Team (12)
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Phase 2 – Shock Skills SDLC
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Design.
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Storyboarded the lecture in
PowerPoint.
Navigation model designed.
Design metaphor.
Ian
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Phase 2 – Shock Skills SDLC
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Implementation.
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Prototype Implementation Aug 2003
Planned for April 2004 – SLIPPED!!!!
Planned for Early 2005
Ian
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Phase 2 – Shock Skills SDLC
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Testing.
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Usability Evaluation Dec 2003 to Jan 2004.
Team of 12 evaluators (Staff & Students).
58 Question Questionnaire.
Based on Shneiderman’s
usability scale & criteria.
1 member performing
a Cognitive Walkthrough
Experiment.
Ian
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Shock Skills Usability Results
No:
Criteria:
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Images
Readability
Colour
Navigation
Interactivity
Reactions
Questions
Descriptors (0 to 9)
Mean
Q8
Navigating from this
screen is?
Hard to Easy
8.4
Q55
Overall Reactions
Terrible to Wonderful
7.5
Q55
Overall Reactions
Dull to
Stimulating
7.7
Q55
Overall Reactions
Difficult to Easy
7.2
Q55
Overall Reactions
Frustrating to Satisfying
7.2
Q55
Overall Reactions
Rigid to Flexible
6.5
Q56
Learning to use the
software is?
Difficult to Easy
7.7
Q57
The ‘TC’ character image
is?
Pointless to Excellent
6.0
Q58
Educational content is?
Poor to Excellent
7.5
Q59
Software usability is?
Poor to Excellent
7.6
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Shock Skills Methodologies
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System Design Life Cycle
Norman’s Seven principles of User-Centered Design
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1:
2:
3:
4:
5:
6:
7:
Use both knowledge in the world and knowledge in the head.
Simplify the structure of tasks.
Make things visible: bridge the gulfs of Execution & Evaluation.
Get the mappings right.
Exploit the power of constrains, both natural and artificial
Design for error.
When all else fails, standardize.
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Phase 3 – The end is in sight!
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Project started in
Summer 2002.
Phase 3 should have
started April 2004
Project should be
finished now.
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Underestimated the time
needed.
Underestimated the
funding.
No protected time.
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For content expert.
Should have held back
some money to buy in a
proof reader.
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80 screens to proof read.
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What's Next?
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Finish the software proof reading.
Install on network
Another group of nursing students.
(April 05)
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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!!!!
 Don’t underestimate the amount of time & money
software development takes.
 Don’t only have one content expert.
 Everybody needs protected time to work on elearning projects.
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Any Questions?
Anyone wishing to have a closer look at Shock Skills
– see me after the session.
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