Jeffrey Wiseman Emmanuel G. Blanchard Susanne Lajoie The Deteriorating Patient Smartphone App How Can Achievement Emotions Guide the Design of a Medical TRE? Jeffrey Wiseman Emmanuel G. Blanchard Susanne Lajoie LEADS 2nd Annual Team Meeting May 2, 2013 San Francisco

Outline Rationale Research Questions Methods Data to be analyzed Deliverables Implications + Conclusion

Rationale Emergencies = emotionally challenging situations ABCDEFG algorithm guides emergency care & helps with some emotional challenges Medical Simulations: Role of debrief; “Hi Fi” versus “Low Fi” Deliberate practice with feedback (Ericsson, 2004)

Rationale The Deteriorating Patient Simulation (DPS) Human tutors (Wiseman, Lajoie, Lu, Blanchard 2006, 2010, 2012) Human tutors Small groups of learners + few tutors Digital tutors Large numbers of learners + digital tutor TRE (Smartphone App: Authoring + Case tools) Community of live & digital learners and tutors Deliberate practice with feedback anywhere, anytime Serious games

Emotions?

From the Live Tutor Deteriorating Patient Simulation… (Wiseman, Snell, 2008; Lu, Lajoie, Wiseman, 2010) Patient Scenario Listen to Learner Your approach Learner’s approach Important differences or weaknesses Patient deteriorates by a small increment specific to the weakness Learner corrects doesn’t correct Hints & Humor Prompt to consult Listen to next learner E

…To the Digital Deteriorating Patient Application (Blanchard, Wiseman, Naismith, Hong, Lajoie, 2010; Blanchard, Wiseman, Naismith, Lajoie, 2012) Action categories Information panel Vital signs Choice of actions in the selected category

Research Questions What types of achievement emotions (Pekrun, 2006) occur in the setting of medical learners attempting to solve an emergency case simulation presented by a human tutor? Are similar achievement emotions induced by a smartphone-based TRE presenting the same case? If not, what additional adjustments in the TRE are needed to bring the TRE-induced achievement emotions closer to those induced by a human tutor?

Methods User-centred design iterative approach (Lai et al 2010) DP app developers interact with 5 target users to test and adjust TRE design choices Modules for collecting user data embedded into the TRE Compare + adjust TRE to human Tutor with using an isometric case for 10 medical learners

Data to be Analyzed Technical Cognitive Emotional Self-report measures, log files Cognitive Process: use of ABCDEFG algorithm to guide diagnostic and management choices; response to changes in vital signs & hints; persistence Outcome: Diagnosis, Management, Timing of help-seeking Emotional AEQ (Pre? During? As part of Debrief to guide recall?), Task value + control

Deliverables A new version of the DDPA running on smartphones A first version of the DDPA authoring tool running on smartphones A paper submission to ECTEL2014 An advanced draft of a paper to be submitted to a peer-reviewed international journal in late 2014 A grant proposal submission to the Royal College of Physicians and Surgeons of Canada for additional evaluations on the emotional and cognitive impacts of DDPA for medical learners

Implications + Conclusions Role of learner emotions in medical simulations are relatively unexplored in TRE design is new for medical contexts DPA Smartphone App promises to Support further adaptation + application of the AEQ to a medical education context Provide a TRE designed for learners’ emotions Permit tracking of learner development over time Provide links with Empathy/Giving Bad News/Cultural Differences/Bioworld

Thank You! Thank You