Dabarash Albizu, M'S'SLP Student

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• Dabarash Albizu, M.S.-SLP Student
• Dr. Kristy Weissling, SLP.D, C.C.C

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Introduction

• Review of the literature
• The following review includes research from
  various authors who have used 3D simulations in
  their respective disciplines for patient and
  student education.
• Definition
• 3-Dimensional simulations are animations of
  models that have been created using a computer
  and specialized software Roos, (2008).

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Review of the Literature

• Scope Limited

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Katz et al. (2005)

• Katz, Ring, Naveh, Kizony, Feintuch, Weiss
  (2005)
• Occupational therapists used virtual interactive
  environments (VIE) to train people with
  unilateral spatial neglect to cross a street.
• Subjects
• Nineteen participants
• Divided in two groups
• Experimental group
• Eleven subjects with a mean age of 64 who had
  experienced a right hemisphere stroke within the
  past 12 months
• Control group
• Eight participants with a mean age of 63.5
• Nine hours of treatment were provided for four
  weeks

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• The VR group unilateral spatial neglect measure
  results equaled control group on conventional
  visual scanning tasks
• VR group improved more on the VR test
• VR group did better on some measures of the real
  street crossing (Katz et al., 2005)

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Bart et al. (2008)

• Bart, et al. (2008) utilized the methods of Katz,
  et al. (2005) and compared the abilities of
  normally developing children crossing the street.
  
• Eighty-six typically developing children between
  the age of 7 and 12 were in this experimental
  investigation.
• Children were tested in a virtual environment.
  The ones who failed the test were reassigned to
  the training and control groups. Baselines of
  street crossing skills were collected prior to
  the treatment

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• Treatment consisted of learning to cross the
  street traditionally and in a (VIE).
• All children increased their street crossing
  ability in both types of treatment. The children
  displayed no difference in skills between the
  real street crossing training or with (VIE) and
  the control group.

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Tichon et al. (2004)

• Tichon, Loh King (2004) investigated the
  opinions of psychology students about learning to
  identify schizophrenia using computer
  simulations.
• Ten second semester psychology students
  participated in a survey after receiving
  instruction using a computer simulation depicting
  a schizophrenic patient.

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• Sixty-two percent of the students strongly agreed
  that simulations can facilitate education.
• Thirty-seven percent agreed.
• Fifty percent agreed that their knowledge of
  schizophrenia increased as a result of viewing
  the simulation.
• The students reported that visuals of the
  simulation provided a better understanding of
  schizophrenia than explanations using words only
  (Tichon, et al., 2004).

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Initial Development of the Project
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Development

• The simulation was included as part of a project
  for an Augmentative Alternative Communication
  course.
• Approximately thirty-five hours were dedicated
  over a five day span to develop the initial
  simulation.
• Rendering times vary depending on the quality of
  the visuals the designer wants to achieve
• The final product was completed in a two months
  span with over forty hours of work including
• selection of the music loop
• recording the voice
• caption included in slides
• conversion to video
• completion of the CD covers.

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Development

• This simulation was developed by a Web Designer
  guided by the student clinician. It was created
  based on a fictitious case example.
• All the aids were designed using 3D simulation
  software from existing models currently available
  on the market.

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Rationale

• This simulation was developed based on the idea
  that different learning styles require varied
  presentation to reach all learners (Bell
  Fogler, 1995).
• Auditory, visual, and kinesthetic are the three
  major learning styles. As the terms imply
  learners use their hearing, vision, and body to
  learn. (Bell Fogler, 1995)
• Simulations include auditory, visual, and
  kinesthetic opportunities for the user enhancing
  the learning experience.

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Advantages of using 3D simulations

• Privacy concerns addressed by 3D simulation
• No consent forms needed
• HIPPA concerns may be eliminated by using
  simulations depicting fabricated but realistic
  case studies
• May lower liability risks associated with
  client/patient confidentiality.
• Simulations can be tailored to suit the needs of
  the audience
• Simulations can occur just in time when the
  learner needs them or has time to use them

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CEUs Applications

• Simulations may be effective study tools for
  clinical topics for CEU activities
• Simulations may provide educators visual examples
  of common therapy techniques to enhance lectures
• Simulations may provide a simulated scenario of a
  real situation that allows for practice by
  learners before they encounter real events
• Simulations may provide learners multiple
  opportunities to engage in training (as many
  times as needed)

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Client/Caregiver Applications

• May provide the person in therapy and the
  caregiver visual access of techniques or
  components of their treatment
• It may be tool for reviewing techniques learned
  during therapy
• A simulation may allow the person in therapy to
  share information about their method of
  communication with family, friends, and other
  caregivers.
• Simulations may allow for consistent caregiver
  training as staff changes

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StudentApplications

• May support training acquired through
  conventional methods
• May facilitate understanding of abstract concepts
• May benefit a variety of learning styles
• Rich combination of stimuli utilizing more than
  one sense at a time
• Provision of a simulated scenario of a real
  situation allows for practice (as much as is
  needed)
• May provide opportunities to encounter
  cases/situations not readily available at all
  university programs (low incidence populations)

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Methods
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Liaupsin(2003)Model adapted from Dick and Carey

• Critique of Methodology
• Software needs to be evaluated
• 2 phases
• Expert judgment phase
• Field trial phase
• This pilot study looked at the expert judgment
  phase
• Focus on
• Congruence analysis- does this type of
  instruction meet the needs of the organization
  which may adopt it
• Feasibility analysis-is such an endeavor feasible
  
• Did not include
• Design analysis
• Content analysis

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Survey

• 3 Goals
• To find CD specific information
• To find general 3-D simulation use information
• To allow for open ended thoughts on the topic

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Survey Construction

• Constructs of the survey
• Section one CD specific assessment
• Ease of use (3 questions)
• Visual Clarity/Suitability of visual presentation
  (4 questions)
• Instructional value (6 questions)
• Simulations in General
• Use/ Feasibility (one question each)
• CEU
• Student Training
• Caregiver Training
• Open ended responses (applications for
  caregivers, students, CEU events, and general
  comments)

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Scale

• 1 2 3 4 5
• Strongly Disagree Neither Agree Agree
  Strongly
• Disagree or Disagree Agree
• Five point scale
• Neutral center point to give distinct positive
  vs. negative scores

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Survey agreement

• Agreement Target for CD specific portion- 80
• 4/5 readers had 100 agreement with the authors
  intent
• The 5th reader had 85 agreement with the authors
  intent
• Construct agreement Data
• Ease of use- 100 (15/15)
• Visual Clarity/Suitability of visual presentation
  95 (19/20)
• Instructional value 97 (29/30)
• Did not obtain agreement ratings on imaginablity,
  feasibility, and usefulness-explicit statements
  were used

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Subjects

• Opinions from 20 Speech-Language Pathologists
  from the states of Florida and Nebraska were
  analyzed using a survey
• 20 subjects were recruited and 20 surveys were
  returned
• Average time in the profession was 22 years
• (range 2-39)
• 95 held a masters degree in speech Pathology
• 80 reported no experience with 3-D simulations
• 95 reported being somewhat comfortable or very
  comfortable with NEW technology
• 85 reported using the computer at least 6 hours
  per week

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Results
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Results

• For our 3-D simulation
• Ease of use (3 items looked at this)
• Mean rating was 4.43
• Instructional value (6 items looked at this)
• Mean rating was 4.04
• Visual Clarity (4 items looked at this)
• Mean rating was 4.37
• Ratings for all constructs for this simulation
  were above neutral and toward the positive end of
  the scale

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Results

• When asked about simulations in general
• Use in CEU
• mean4.3
• Use in Student training
• mean 4.3
• Use in Caregiver training
• mean 4.2
• Again all items were positively skewed above
  neutral
• All items ranged from at least 3 to 5 (neutral to
  strongly agree)
• Some items (4) items ranged from 1 to 5 (strongly
  disagree to strongly agree)

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Results

• When asked about simulations in general
• Feasibility
• mean 4.3 (range 2-5)
• Usefulness
• mean 4.3 (range 1-5)
• Imaginablity
• mean 4.27 (range 1-5)
• All ratings were above neutral and toward the
  positive end of the scale

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Selected comments regarding applications of this
technology

• May be helpful to include more narration
• Simulations such as this may replace repeated
  physical modeling and instruction
• Case scenarios for comps
• I dont think (in the form viewed) the
  simulation gave enough information for initial
  orientation
• Availability of being watched many times
• Easy onset in fluency
• Anatomy/physiology

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• 3-D simulations might also minimize the use of
  client videos which require permission and always
  run the risk of violating HIPAA guidelines
• The time, expertise, and expense required might
  impact the clinical utility of this strategy
• Training students in how to use devices
• Positioning of AAC devices or equipment
• Helps caregivers see options for their family
• Would have gained more with verbal or even
  written information

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Discussion

• Generally the people reviewing the simulation
  found it to be instructional, easy to use, and
  visually clear/pleasing
• People saw the potential use of 3-D simulations
  in/with CEU events, student training, and
  caregiver training
• People in general imagined using simulations,
  thought they were feasible, and thought they
  would be useful
• Production of trainings may be a group effort
  that benefits many consumers

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Future directions

• Current data may be analyzed more specifically
  for relationships between ratings and exposure to
  other 3-D simulations, years of experience,
  computer use, and other demographic factors
• Develop a 3-D simulation for training of a target
  group (i.e, CEU, student, caregiver) and use a
  group design to assess the outcome of 3-D
  simulation training compared to traditional
  models

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Simulation

• The following is a video of the actual simulation
  observed by the SLPs who answered to the survey.
  The simulation was based on a project created
  for an Augmentative Alternative Communication
  course at Nova Southeastern University.
• The project required creating a set of
  communication aids for a client who had been
  diagnosed with Guillain-Barre syndrome and had
  limited motor ability and dysarthria
• The three-D simulation was not a requirement to
  the project but was added as an enrichment tool
  and was meant for the education of the person
  with the disorder. and the caregiver.

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References

• Bart,O., Katz, N., Weiss, P., Josman, N. (2008)
  Street Crossing by Typically Developed
• Children in Real and Virtual Environments.
  OTJR Occupation Participation and \
• Health ,28 (2),89-96.
• Bell, John T., and H. Scott Fogler, "Virtual
  Reality in Chemical Engineering Education",
• Proceedings of the 1995 Illinois / Indiana
  ASEE Sectional Conference, March 16-18,
• 1995, Purdue University, West Lafayette,
  Indiana, http//fre.www.ecn.purdue.edu/asee/sect95
  .
• Katz, N., Ring, H., Naveh, Y., Kizony, R.,
  Feintuch, U., Weiss, P. L. (2005). Interactive
  virtual environment training for safe street
  crossing of right hemisphere stroke patients with
  unilateral spatial neglect. Disability and
  Rehabilitation, 27(20), 1235-1243. Retrieved from
  www.csa.com
• Liaupsin, C.J., (2003) The comprehensive
  Evaluation of Professional Development
• Software A Criteques of the methodology.
  Journal of special Education
• Technology,18(1),29-37.
• Roos, Dave. "How Computer Animation Works."
  Retrieved on
• September 13, 2008, from(http//www.HowSt
  uffWorks.com
• at http//entertainment.howstuffworks.com/
  computer-animation.htm

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References
continued

• Tichon, J., Loh, J., King,R. (2004) Psychology
  student opinion of virtual reality as a
• tool to educate about schizophrenia.
  International Journal on E-Learning,3(4),40-46.