1. 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

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

3. 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)

4. 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

5. Emotions?

6. 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

7. …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

8. 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?

9. 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

10. 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

11. 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

12. 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

13. Thank You!
Thank You