Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

Objectives: To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences.

Methods: A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE).

Categorizing Fetal Heart Rate Variability with and without Visual Aids.

 This study examined the ability of clinicians to correctly categorize images of fetal heart rate (FHR) variability with and without the use of exemplars.  A sample of 33 labor and delivery clinicians inspected static FHR images and categorized them into one of four categories defined by the National Institute of Child Health and Human Development (NICHD) based on the amount of variability within absent, minimal, moderate, or marked ranges. Participants took part in three conditions: two in which they used exemplars representing FHR variability near the center or near the boundaries of each range, and a third control condition with no exemplars.

The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals.

Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008).

Time and number of displays impact critical signal detection in fetal heart rate tracings.

Interest in centralized monitoring in labor and delivery units is growing because it affords the opportunity to monitor multiple patients simultaneously. However, a long history of research on sustained attention reveals these types of monitoring tasks can be problematic. The goal of the present experiment was to examine the ability of individuals to detect critical signals in fetal heart rate (FHR) tracings in one or more displays over an extended period of time.

Monitoring simulated maternal-fetal heart rate signals.

The present study represents the first in a series aimed at examining how individuals monitor maternal-fetal heart rate signals over an extended period of time. Seventy-two undergraduate students monitored simulated maternal-fetal heart rate signals for late decelerations of either high or low amplitude for 48 minutes. The results showed that the ability to detect late decelerations was quite good and did not decline over time.