The Six Second ECG Simulator
Why a web-based cardiac rhythm simulator?
What assumptions are made on who is the learner?
Is learning theory used in the design and development of the Six
Second ECG?
What
design principles were used as foundations to the development of
the Six second ECG?
How does the Cardiac
Simulator work?
Why a web-based cardiac rhythm simulator?
The rhythm simulator results from feedback received
over many years of seminar workshops in dysrhythmia interpretation. Many
participants found that using a cardiac rhythm simulator with a cardiac
monitor was a very effective learning tool - most closely approximating
the experience in the field. While many cardiac simulators exist in acute
health care settings, most nurses and paramedics do not have access to
the $3000 - $5000 simulation hardware, not to mention the $10,000 - $40,000
cardiac monitors.
The web already
offers several sites that specialize in text based ECG tutorials. Only
recently, with the arrival of recent versions of Flash can a simulator
be created on the web that satisfies certain criteria:
-rapid download (less than 400k in size);
-advanced interactivity without the large file size;
-cross platform capability (Flash is available to Windows, Mac,
and UNIX);
-ability to build once, play anywhere - even Java hasn't lived
up to this promise;
-streaming ability to allow playing the application before a
full download
These criteria along with the improved user base
for hardware and browser software provide firm footing for a cardiac
rhythm simulator -especially a simulator offered for free with a download
size of less than 400k.
The Six Second ECG is a learning module and
an ECG interpretation game that facilitate learning experiences that
are fast, fun and effective. In fact, the module is designed to promote
basic ECG interpretation in 6 seconds or less!
What assumptions are made on who is the learner?
Nursecom designed the cardiac rhythm simulator
after close consultation with physicians, nurses and paramedics who
comprise our target group of learners - players - users. From this consultation,
we believe that health professionals:
-are exceptionally time conscious. Time has become
one of the rarest of resources in our increasingly hectic lives;
-learn usually by observing and by doing on the job;
-are keenly interested in being and becoming competent in all
aspects of their professional lives;
-have access to the Internet or at least plan to soon;
-are disappointed by the quality of educational experiences
on the Internet while at the same time are impressed by the
breadth of information;
-find the pace of change accelerating...with it the speed where
information and knowledge becomes obsolete; and
-want to learn and expect to learn throughout their lives.
The design of the Six Second ECG reflects our assumptions
of who is the learner.
Is
learning theory used in the design and development of the Six Second
ECG?
The Six Second ECG was developed
with attention to the learning theories of Albert Bandura (Self-Efficacy),
John Dewey, and Paolo Friere. The cardiac rhythm simulator promotes a
positive experience reading ECGs. The immediate feedback to the learner
reinforces the skill of correctly and quickly reading ECGs. We believe
that the health professionals are self-motivated learners (Dewey,
) intent on empowering themselves and their community (Friere). The close
similarity between interpreting ECGs online (Six Second ECG) and in the
clinical area fosters the carry-over of skills learned online to the
work setting (Bandura).In short, a simulator promotes a sense of self-efficacy.
What design principles were used as foundations to the development
of the Six second ECG?
The cardiac rhythm simulator was designed with the concepts of time
and game theory as primary design parameters. Of course the constraints
of the Internet (bandwidth, multiple platform, multiple hardware configurations,
range in user profile) are significant factors when designing any application
for the web.
Beside the primary parameters and the constraints mentioned, usability
also has a significant role in design. For example, the use of color
to group rhythms into categories, the use of prominent colors and larger
fonts for the main buttons, and the grouping of support documents under
menu titles all help increase ease of use.
The
learner remains the center of design and development. The first cardiac
rhythm simulator released on the web was version 45 after each earlier
version was prototyped and tested. This process
is endless. Within the next quarter, the Six Second ECG simulator
will evolve into a full featured application, designed to systematically
facilitate ECG interpretation skills for health professionals.
How does the Cardiac Simulator work?
The cardiac rhythm simulator begins with an introductory
screen where the participant is prompted to enter their name or nickname
and then click 'Start'. This introduction displays the progress of downloading
and also makes the experience more personal with feedback that uses your
name in the message.
Upon clicking on 'Start', the next screen is displayed. This default
screen is the learning mode of the simulator. You can access either the
'Learn' mode or the 'Game' mode by choosing the button of the same name.
The 'Freeze' button stops the rhythm and places a grid under the rhythm
for reference. Once frozen, the rhythm's intervals and rate can be quickly
determined. For a closer look, right click the mouse on the screen in
the area you want magnified and choose 'Zoom In'. To return to the original
screen magnification right-click again and choose either 'Zoom Out' or
'Show All'.
Each rhythm label is a button that once clicked begins an animated cardiac
rhythm of its namesake. Note the window at the bottom of the screen.
This is a reference window, providing brief details on the characteristics
and significance of each rhythm.
The 'Settings' button opens a small window to allows you to change default
settings. Choose whether you want the sound to be on or off (button sounds
are not affected). Choose whether you want the ECG rhythms to remain
static or dynamic (rhythm is animated). The time settings are for the
length of the ECG Challenge in game mode.
Choosing 'Game' mode adds a few extra features to the interface. A time
clock and various scores present.Find a 'Reset' button that begins the
game anew with each click.
The objective of the game or challenge is to correctly identify as many
rhythms as possible within a certain time frame. The ECG Challenge game
defaults to one minute (choose a different timeframe with the 'Settings'
window).
In 'Game' mode, the 'Freeze' button
will stop the rhythm and make visible the reference grid (like 'Learn'
mode) but the time clock does not stop. Upon clicking 'Start', animated
rhythms are generated randomly. Click on the appropriate rhythm name
to identify the rhythm. If your choice is correct, you will see a "Correct" below
the rhythm names and center.
A 'Correct' stops the clock. Click on 'Next' to continue the game and
the clock. If the rhythm name chosen does not fit the cardiac rhythm
displayed, a 'Try Again' will be displayed - the clock will continue.
Continue choosing rhythm names until a 'Correct' appears.
The game concludes at the end of the respective time period. At the
conclusion of the game, personal feedback is provided on total attempts
tried, percent correct, and the average time taken to correctly identify
cardiac rhythms - along with a little personalized encouragement in the
form of a text and audio message. Choosing 'Reset' and then 'Start' begins
a new game.
We hope you enjoy the cardiac simulator, a kernel of
the Six Second ECG learning series. If you have comments, suggestions,
or would like to just drop us a 'hi', please email
us. We would love
to hear from you.
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