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  • 1. Ahlborg, Liv
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Murkes, Daniel
    Westman, Bo
    Kjellin, Ann
    Fellander-Tsai, Li
    Enochsson, Lars
    Visuospatial ability correlates with performance in simulated gynecological laparoscopy2011In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 157, no 1, p. 73-77Article in journal (Refereed)
    Abstract [en]

    Objective: To analyze the relationship between visuospatial ability and simulated laparoscopy performed by consultants in obstetrics and gynecology (OBGYN). Study design: This was a prospective cohort study carried out at two community hospitals in Sweden. Thirteen consultants in obstetrics and gynecology were included. They had previously independently performed 10-100 advanced laparoscopies. Participants were tested for visuospatial ability by the Mental Rotations Test version A (MRT-A). After a familiarization session and standardized instruction, all participants subsequently conducted three consecutive virtual tubal occlusions followed by three virtual salpingectomies. Performance in the simulator was measured by Total Time, Score and Ovarian Diathermy Damage. Linear regression was used to analyze the relationship between visuospatial ability and simulated laparoscopic performance. The learning curves in the simulator were assessed in order to interpret the relationship with the visuospatial ability. Results: Visuospatial ability correlated with Total Time (r = -0.62; p = 0.03) and Score (r = 0.57; p = 0.05) in the medium level of the virtual tubal occlusion. In the technically more advanced virtual salpingectomy the visuospatial ability correlated with Total Time (r = -0.64; p = 0.02), Ovarian Diathermy Damage (r = -0.65; p = 0.02) and with overall Score (r = 0.64; p = 0.02). Conclusions: Visuospatial ability appears to be related to the performance of gynecological laparoscopic procedures in a simulator. Testing visuospatial ability might be helpful when designing individual training programs.

  • 2.
    Ahlqvist, Jan B
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nilsson, Tore A
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hedman, Leif R
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Desser, Terry S
    Dev, Parvati
    Johansson, Magnus
    Umeå University, Faculty of Medicine, Department of Odontology.
    Youngblood, Patricia L
    Cheng, Robert P
    Gold, Garry E
    A randomized controlled trial on 2 simulation-based training methods in radiology: effects on radiologic technology student skill in assessing image quality.2013In: Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, ISSN 1559-2332, E-ISSN 1559-713X, Vol. 8, no 6, p. 382-387Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: A simulator for virtual radiographic examinations was developed. In the virtual environment, the user can perform and analyze radiographic examinations of patient models without the use of ionizing radiation. We investigated if this simulation technique could improve education of radiology technology students. We compared student performance in the assessment of radiographic image quality after training with a conventional manikin or with the virtual radiography simulator.

    METHODS: A randomized controlled experimental study involving 31 first-year radiology technology students was performed. It was organized in 4 phases as follows: (I) randomization to control or experimental group based on the results of an anatomy examination; (II) proficiency testing before training; (III) intervention (control group, exposure and analysis of radiographic images of the cervical spine of a manikin; experimental group, exposure and analysis of the cervical spine images in the virtual radiography simulator); and (IV) proficiency testing after training.

    RESULTS: The experimental group showed significantly higher scores after training compared with those before training (P < 0.01). A linear mixed-effect analysis revealed a significant difference between the control and experimental groups regarding proficiency change (P = 0.01).

    CONCLUSIONS: Virtual radiographic simulation is an effective tool for learning image quality assessment. Simulation can therefore be a valuable adjunct to traditional educational methods and reduce exposure to x-rays and tutoring time.

  • 3.
    Andersson, Pehr
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Center for Surgical Sciences, Karolinska Institutet at Huddinge University Hospital.
    Enochsson, Lars
    Ström, Pär
    Kjellin, Ann
    Westman, Bo
    Felländer-Tsai, Li
    Working memory and virtual endoscopy simulation2004In: Proceedings of the twenty-sixth annual conference of the cognitive science society / [ed] Forbus, K; Gentner, D; Regier, T, Mahwah: Lawrence Erlbaum Associates, 2004, p. 1519-1519Conference paper (Refereed)
  • 4. Courteille, Olivier
    et al.
    Fahlstedt, Madelen
    Ho, Johnson
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fors, Uno
    Von Holst, Hans
    Felländer-Tsai, Li
    Möller, Hans
    Learning through a virtual patient vs. recorded lecture: a comparison of knowledge retention in a trauma case2018In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 9, p. 86-92Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare medical students' and residents' knowledge retention of assessment, diagnosis and treatment procedures, as well as a learning experience, of patients with spinal trauma after training with either a Virtual Patient case or a video-recorded traditional lecture. Methods: A total of 170 volunteers (85 medical students and 85 residents in orthopedic surgery) were randomly allocated (stratified for student/resident and gender) to either a video-recorded standard lecture or a Virtual Patient-based training session where they interactively assessed a clinical case portraying a motorcycle accident. The knowledge retention was assessed by a test immediately following the educational intervention and repeated after a minimum of 2 months. Participants' learning experiences were evaluated with exit questionnaires. A repeated-measures analysis of variance was applied on knowledge scores. A total of 81% (n = 138) of the participants completed both tests. Results: There was a small but significant decline in first and second test results for both groups (F-(1,F-135) = 18.154, p = 0.00). However, no significant differences in short-term and long-term knowledge retention were observed between the two teaching methods. The Virtual Patient group reported higher learning experience levels in engagement, stimulation, general perception, and expectations. Conclusions: Participants' levels engagement were reported in favor of the VP format. Similar knowledge retention was achieved through either a Virtual Patient or a recorded lecture.

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  • 5. Creutzfeldt, Johan
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Fellander-Tsai, Li
    Cardiopulmonary Resuscitation Training by Avatars: A Qualitative Study of Medical Students' Experiences Using a Multiplayer Virtual World2016In: JMIR Serious Games, E-ISSN 2291-9279, Vol. 4, no 2, article id e22Article in journal (Refereed)
    Abstract [en]

    Background: Emergency medical practices are often team efforts. Training for various tasks and collaborations may be carried out in virtual environments. Although promising results exist from studies of serious games, little is known about the subjective reactions of learners when using multiplayer virtual world (MVW) training in medicine.

    Objective: The objective of this study was to reach a better understanding of the learners’ reactions and experiences when using an MVW for team training of cardiopulmonary resuscitation (CPR).

    Methods: Twelve Swedish medical students participated in semistructured focus group discussions after CPR training in an MVW with partially preset options. The students’ perceptions and feelings related to use of this educational tool were investigated. Using qualitative methodology, discussions were analyzed by a phenomenological data-driven approach. Quality measures included negotiations, back-and-forth reading, triangulation, and validation with the informants.

    Results: Four categories characterizing the students’ experiences could be defined: (1) Focused Mental Training, (2) Interface Diverting Focus From Training, (3) Benefits of Practicing in a Group, and (4) Easy Loss of Focus When Passive. We interpreted the results, compared them to findings of others, and propose advantages and risks of using virtual worlds for learning.

    Conclusions: Beneficial aspects of learning CPR in a virtual world were confirmed. To achieve high participant engagement and create good conditions for training, well-established procedures should be practiced. Furthermore, students should be kept in an active mode and frequent feedback should be utilized. It cannot be completely ruled out that the use of virtual training may contribute to erroneous self-beliefs that can affect later clinical performance.

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  • 6. Creutzfeldt, Johan
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fellander-Tsai, Li
    Effects of pre-training using serious game technology on CPR performance: an exploratory quasi-experimental transfer study2012In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 20, p. 79-Article in journal (Refereed)
    Abstract [en]

    Background: Multiplayer virtual world (MVW) technology creates opportunities to practice medical procedures and team interactions using serious game software. This study aims to explore medical students' retention of knowledge and skills as well as their proficiency gain after pre-training using a MVW with avatars for cardio-pulmonary resuscitation (CPR) team training. Methods: Three groups of pre-clinical medical students, n = 30, were assessed and further trained using a high fidelity full-scale medical simulator: Two groups were pre-trained 6 and 18 months before assessment. A reference control group consisting of matched peers had no MVW pre-training. The groups consisted of 8, 12 and 10 subjects, respectively. The session started and ended with assessment scenarios, with 3 training scenarios in between. All scenarios were video-recorded for analysis of CPR performance. Results: The 6 months group displayed greater CPR-related knowledge than the control group, 93 (+/- 11)% compared to 65 (+/- 28)% (p < 0.05), the 18 months group scored in between (73 (+/- 23)%). At start the pre-trained groups adhered better to guidelines than the control group; mean violations 0.2 (+/- 0.5), 1.5 (+/- 1.0) and 4.5 (+/- 1.0) for the 6 months, 18 months and control group respectively. Likewise, in the 6 months group no chest compression cycles were delivered at incorrect frequencies whereas 54 (+/- 44)% in the control group (p < 0.05) and 44 (+/- 49)% in 18 months group where incorrectly paced; differences that disappeared during training. Conclusions: This study supports the beneficial effects of MVW-CPR team training with avatars as a method for pre-training, or repetitive training, on CPR-skills among medical students.

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  • 7.
    Creutzfeldt, Johan
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol, S-14186 Stockholm, Sweden.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Heinrichs, LeRoy
    Innovat Learning Inc, Los Altos Hills, CA USA.
    Youngblood, Patricia
    Stanford Univ, Sch Med, Dept Surg, Div Clin Anat, Palo Alto, CA 94304 USA.
    Fellander-Tsai, Li
    Karolinska Inst, Dept Clin Sci Intervent & Technol, S-14186 Stockholm, Sweden.
    Cardiopulmonary resuscitation training in High School using Avatars in Virtual Worlds: An International Feasibility Study2013In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 15, no 1, p. doi-10.2196/jmir.1715Article in journal (Refereed)
    Abstract [en]

    Background: Approximately 300,000 people suffer sudden cardiac arrest (SCA) annually in the United States. Less than 30% of out-of-hospital victims receive cardiopulmonary resuscitation (CPR) despite the American Heart Association training over 12 million laypersons annually to conduct CPR. New engaging learning methods are needed for CPR education, especially in schools. Massively multiplayer virtual worlds (MMVW) offer platforms for serious games that are promising learning methods that take advantage of the computer capabilities of today's youth (ie, the digital native generation). Objective: Our main aim was to assess the feasibility of cardiopulmonary resuscitation training in high school students by using avatars in MMVM. We also analyzed experiences, self-efficacy, and concentration in response to training. Methods: In this prospective international collaborative study, an e-learning method was used with high school students in Sweden and the United States. A software game platform was modified for use as a serious game to train in emergency medical situations. Using MMVW technology, participants in teams of 3 were engaged in virtual-world scenarios to learn how to treat victims suffering cardiac arrest. Short debriefings were carried out after each scenario. A total of 36 high school students (Sweden, n=12; United States, n=24) participated. Their self-efficacy and concentration (task motivation) were assessed. An exit questionnaire was used to solicit experiences and attitudes toward this type of training. Among the Swedish students, a follow-up was carried out after 6 months. Depending on the distributions, t tests or Mann-Whitney tests were used. Correlation between variables was assessed by using Spearman rank correlation. Regression analyses were used for time-dependent variables. Results: The participants enjoyed the training and reported a self-perceived benefit as a consequence of training. The mean rating for self-efficacy increased from 5.8/7 (SD 0.72) to 6.5/7 (SD 0.57, P<.001). In the Swedish follow-up, it subsequently increased from 5.7/7 (SD 0.56) to 6.3/7 (SD 0.38, P=.006). In the Swedish group, the mean concentration value increased from 52.4/100 (SD 9.8) to 62.7/100 (SD 8.9, P=.05); in the US group, the concentration value increased from 70.8/100 (SD 7.9) to 82.5/100 (SD 4.7, P<.001). We found a significant positive correlation (P<.001) between self-efficacy and concentration scores. Overall, the participants were moderately or highly immersed and the software was easy to use. Conclusions: By using online MMVWs, team training in CPR is feasible and reliable for this international group of high school students (Sweden and United States). A high level of appreciation was reported among these adolescents and their self-efficacy increased significantly. The described training is a novel and interesting way to learn CPR teamwork, and in the future could be combined with psychomotor skills training.

  • 8.
    Creutzfeldt, Johan
    et al.
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden and Center for Advanced Medical Simulation, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden .
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Center for Advanced Medical Simulation, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Medin, Christopher
    Center for Advanced Medical Simulation, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden and Department of Biomedical Engineering, Karolinska University Hospital, Stockholm, Sweden.
    Heinrichs, LeRoy
    Stanford University Medical Media and Information Technology, Stanford University, Palo Alto, United States.
    Felländer-Tsai, Li
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden and Center for Advanced Medical Simulation, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden .
    Exploring Virtual Worlds for Scenario-Based Repeated Team Training of Cardiopulmonary Resuscitation in Medical Students2010In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 12, no 3, p. e38-Article in journal (Refereed)
    Abstract [en]

    Background

    Contemporary learning technologies, such as massively multiplayer virtual worlds (MMVW), create new means for teaching and training. However, knowledge about the effectiveness of such training is incomplete, and there are no data regarding how students experience it. Cardiopulmonary resuscitation (CPR) is a field within medicine in high demand for new and effective training modalities.

    Objective

    In addition to finding a feasible way to implement CPR training, our aim was to investigate how a serious game setting in a virtual world using avatars would influence medical students’ subjective experiences as well as their retention of knowledge.

    Methods

    An MMVW was refined and used in a study to train 12 medical students in CPR in 3-person teams in a repeated fashion 6 months apart. An exit questionnaire solicited reflections over their experiences. As the subjects trained in 4 CPR scenarios, measurements of self-efficacy, concentration, and mental strain were made in addition to measuring knowledge. Engagement modes and coping strategies were also studied. Parametric and nonparametric statistical analyses were carried out according to distribution of the data.

    Results

    The majority of the subjects reported that they had enjoyed the training, had found it to be suitable, and had learned something new, although several asked for more difficult and complex scenarios as well as a richer virtual environment. The mean values for knowledge dropped during the 6 months from 8.0/10 to 6.25/10 (P = .002). Self-efficacy increased from before to after each of the two training sessions, from 5.9/7 to 6.5/7 (P = .01) after the first and from 6.0/7 to 6.7/7 (P = .03) after the second. The mean perceived concentration value increased from 54.2/100 to 66.6/100 (P = .006), and in general the mental strain was found to be low to moderate (mean = 2.6/10).

    Conclusions

    Using scenario-based virtual world team training with avatars to train medical students in multi-person CPR was feasible and showed promising results. Although we found no evidence of stimulated recall of CPR procedures in our test-retest study, the subjects were enthusiastic and reported increased concentration during the training. We also found that subjects’ self-efficacy had increased after the training. Despite the need for further studies, these findings imply several possible uses of MMVW technology for future emergency medical training.

  • 9. Enochsson, L
    et al.
    Isaksson, B
    Tour, R
    Kjellin, A
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Psychology.
    Wredmark, T
    Tsai-Fellander, L
    Visuospatial skills and computer game experience influence the performance of virtual endoscopy2004In: JOURNAL OF GASTROINTESTINAL SURGERY, ISSN 1091-255X, Vol. 8, no 7, p. 876-882Article in journal (Refereed)
  • 10. Enochsson, L
    et al.
    Westman, B
    Ritter, EM
    Hedman, L
    Umeå University, Faculty of Social Sciences, Psychology.
    Kjellin, A
    Wredmark, T
    Fellander-Tsai, L
    Objective assessment of visuospatial and psychomotor ability an flow of residents and senior endoscopists in simulated gastroscopy2006In: SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, ISSN 0930-2794, Vol. 20, no 6, p. 895-899Article in journal (Refereed)
  • 11. Escher, Cecilia
    et al.
    Creutzfeldt, Johan
    Meurling, Lisbet
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
    Kjellin, Ann
    Fellaender-Tsai, Li
    Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety2017In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, article id 37Article in journal (Refereed)
    Abstract [en]

    Background: Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training.

    Methods: In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ).

    Results: We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples.

    Conclusion: In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.

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  • 12. Felländer-Tsai, Li
    et al.
    Kjellin, Ann
    Wredmark, Torsten
    Ahlberg, Gunnar
    Anderberg, Bo
    Enochsson, Lars
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Johnson, Erica
    Mäkinen, Kai
    Ramel, Stig
    Ström, Pär
    Särnå, Lars
    Westman, Bo
    Basic accreditation for invasive image-guided intervention: a shift of paradigm in high technology education, embedding performance criterion levels in advanced medical simulators in a modern educational curriculum2004In: The Journal on Information technology in Healthcare, ISSN 1479-649X, Vol. 3, no 2, p. 165-173Article in journal (Refereed)
  • 13.
    Hedman, L
    et al.
    Umeå University, Faculty of Social Sciences, Psychology.
    Ström, P
    Andersson, P
    Kjellin, A
    Wredmark, T
    Fellander-Tsai, L
    High-level visual-spatial ability for novices correlates with performance in a visual-spatial complex surgical simulator task2006In: SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, ISSN 0930-2794, Vol. 20, no 8, p. 1275-1280Article in journal (Refereed)
  • 14.
    Hedman, Leif
    et al.
    Umeå University, Faculty of Social Sciences, Psychology.
    Klingberg, T
    Enochsson, L
    Kjellin, A
    Fellander-Tsai, L
    Visual working memory influences the performance in virtual image-guided surgical intervention2007In: Surg. Endosc., ISSN 0930-2794, Vol. 21, no 11Article in journal (Refereed)
  • 15.
    Hedman, Leif
    et al.
    Umeå University, Faculty of Social Sciences, Psychology.
    Sharafi, P
    Early use of Internet-based educational resources: effects on students' engagement modes and flow experience2004In: BEHAVIOUR & INFORMATION TECHNOLOGY, ISSN 0144-929X, Vol. 23, no 2, p. 137-146Article in journal (Refereed)
  • 16. Kjellin, A.
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Escher, C.
    Fellander-Tsai, L.
    Hybrid simulation: bringing motivation to the art of teamwork training in the operating room2014In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 103, no 4, p. 232-236Article in journal (Refereed)
    Abstract [en]

    Background and Aims: Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Material and Methods: Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). Results and Conclusions: The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence.

  • 17.
    Meurling, Lisbet
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Orthopaed & Biotechnol, SE-14186 Stockholm, Sweden.
    Lidefelt, Karl-Johan
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Paediat, SE-14186 Stockholm, Sweden.
    Escher, Cecilia
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Fellander-Tsai, Li
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Orthopaed & Biotechnol, SE-14186 Stockholm, Sweden.
    Wallin, Carl-Johan
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Anaesthesia & Intens Care, SE-14186 Stockholm, Sweden.
    Comparison of high- and low equipment fidelity during paediatric simulation team training: a case control study2014In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 14, p. 221-Article in journal (Refereed)
    Abstract [en]

    Background: High-fidelity patient simulators in team training are becoming popular, though research showing benefits of the training process compared to low-fidelity models is rare. We explored in situ training for paediatric teams in an emergency department using a low-fidelity model (plastic doll) and a high-fidelity paediatric simulator, keeping other contextual factors constant. The goal was to study differences in trainees' and trainers' performance along with their individual experiences, during in situ training, using either a low-fidelity model or a high-fidelity paediatric simulator.

    Methods: During a two-year period, teams involved in paediatric emergency care were trained in groups of five to nine. Each team performed one video-recorded paediatric emergency scenario. A case control study was undertaken in which 34 teams used either a low-fidelity model (n = 17) or a high-fidelity paediatric simulator (n = 17). The teams' clinical performances during the scenarios were measured as the time elapsed to prescribe as well as deliver oxygen. The trainers were monitored regarding frequency of their interventions. We also registered trainees' and trainers' mental strain and flow experience.

    Results: Of 225 trainees' occasions during 34 sessions, 34 trainer questionnaires, 163 trainee questionnaires, and 28 videos, could be analyzed. Time to deliver oxygen was significantly longer (p = 0.014) when a high-fidelity simulator was used. The trainees' mental strain and flow did not differ between the two types of training. The frequency of trainers interventions was lower (p < 0.001) when trainees used a high-fidelity simulator; trainers' perceived mental strain was lower (< 0.001) and their flow experience higher (p = 0.004) when using high-fidelity simulator.

    Conclusions: Levels of equipment fidelity affect measurable performance variables in simulation-based team training, but trainee s' individual experiences are similar. We also note a reduction in the frequency of trainers' interventions in the scenarios as well as their mental strain, when trainees used a high-fidelity simulator.

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  • 18. Montgomery, Henry
    et al.
    Sharafi, Parvaneh
    Hedman, Leif R
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Engaging in activities involving information technology: dimensions, modes, and flow2004In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 46, no 2, p. 334-348Article in journal (Refereed)
    Abstract [en]

    An engagement mode involves a subject (e.g., a user of information technology, or IT) who is engaged in an activity with an object in a certain manner (the mode). The purpose of this study is to develop a general model of engagement modes that may be used for understanding how IT-related activities are shaped by properties of the user and the IT object. A questionnaire involving items on IT engagement and the experience of flow was administered to 300 participants. The results supported an engagement mode (EM) model involving 5 different engagement modes (enjoying/acceptance, ambition/curiosity, avoidance/hesitation, frustration/anxiety, and efficiency/productivity) characterized on 3 dimensions (evaluation of object, locus of control between subject and object, and intrinsic or extrinsic focus of motivation). The flow experience follows from a balance between enjoying/acceptance and efficiency/productivity propelled by ambition/curiosity. The EM model could provide a platform for considering how IT users, IT applications, and IT environments should work together to yield both enjoyment and efficiency. Actual or potential applications of this research include designing IT training programs on different levels of specificity.

  • 19.
    Nilsson, Tore A
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Radiology.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Ahlqvist, Jan B
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Radiology.
    A Randomized Trial of Simulation-Based Versus Conventional Training of Dental Student Skill at Interpreting Spatial Information in Radiographs.2007In: The Journal of the Society for Simulation in Healthcare.: Simulation in Healthcare:, ISSN 1559-2332, Vol. 2, no 3, p. 164-169Article in journal (Refereed)
    Abstract [en]

    Abstract Introduction: A radiology simulator has been developed. We tested the simulator with students in an oral radiology program for training interpretation of spatial relations in radiographs utilizing parallax. The aim of the study was to compare learning outcome regarding interpretative skill after training in the simulator vs. after conventional training.

    Methods: Fifty-seven dental students voluntarily participated in a randomized experimental study. The participants' proficiency in interpretation of spatial information in radiographs and their visual-spatial ability was assessed. Proficiency was assessed by a test instrument designed by the authors and visual-spatial ability with the Mental Rotations Test, version A (MRT-A). Randomization to training group was based on pre-training proficiency test results. The experimental group trained in the simulator and the control group received conventional training. Training lasted for 90 minutes for both groups. Immediately after training a second proficiency test was performed.

    Results: The proficiency test results were significantly higher after training for the experimental group (P <= 0.01), but not for the control group. Univariate variance analysis of difference in proficiency test score revealed a significant interaction effect (P = 0.03) between training group and MRT-A category; in the experimental group there was a stronger training effect among students with low level of MRT-A.

    Conclusions: Training in the simulator improved skill in interpreting spatial information in radiographs when evaluated immediately after training. For individuals with low visual-spatial ability simulator based training seems to be more beneficial than conventional training.

  • 20.
    Nilsson, Tore A.
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Univ Hosp, Oral & Maxillofacial Radiol Clin, SE-90185 Umea, Sweden.
    Hedman, Leif R
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Ahlqvist, Jan B
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Dental student skill retention eight months after simulator-supported training in oral radiology2011In: Journal of dental education, ISSN 1930-7837, Vol. 75, no 5, p. 679-684Article in journal (Refereed)
    Abstract [en]

    The purpose of this project was to investigate the long-term effects on skill to interpret spatial information in radiographs after conventional and simulator-supported training. The study was a follow-up of a previously reported randomized experimental study. The original study population was comprised of fifty-seven dental students. Forty-five individuals agreed to participate in a follow-up study eight months after completion of the original study. During the time interval between completion of the previous study and the follow-up study, the participants underwent an examination in oral radiology and had theoretical and clinical training in other topics than oral radiology. Skill at interpreting spatial information in radiographs was assessed with a previously used test instrument. The test instrument was identical with the instrument used for baseline assessment in the original study. The results showed that the skill to interpret spatial relations in radiographs eight months after completion of simulator-supported training was significantly better (p=0.01) than before training. The conventional training showed almost the same pattern, but the difference was smaller and not statistically significant (p=0.11). It is concluded that simulator-supported training is a valuable adjunct to conventional educational methods in oral radiology.

  • 21.
    Nilsson, Tore
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hedman, Leif
    Ahlqvist, Jan
    Retention of dental student skill at interpreting spatial information in radiographs after radiology simulator trainingManuscript (preprint) (Other (popular science, discussion, etc.))
  • 22.
    Nilsson, Tore
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Ahlqvist, Jan
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Radiology. Oral diagnostisk radiologi.
    Visual-spatial ability and interpretation of three-dimensional information in radiographs2007In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 36, p. 86-91Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate whether skill in the interpretation of three-dimensional (3D) information in radiographs utilizing the parallax phenomenon is associated with visual-spatial ability and whether development of this skill is related to visual-spatial ability.

    Methods: Eighty-six individuals with a median age of 25 years participated in the study. It was organized into three parts: (1) assessment before training, (2) training in object depth localization utilizing parallax and (3) assessment after training. Before training, visual-spatial ability was assessed with a mental rotation test, MRT-A; skill in interpreting 3D information was assessed with two specifically designed proficiency tests: a radiography test, which assessed the ability to interpret 3D information in radiographs utilizing motion parallax and a principle test which assessed understanding of the principles of motion parallax. After training, skill in interpreting 3D information was reassessed. Improvement was defined as the difference between test scores after training and before training. Multiple linear regression was used to analyse the effect of student and training characteristics on proficiency test results and improvement.

    Results: Radiography test results after training and improvement of radiography test results were significantly associated with MRT-A scores (P<0.001 and P=0.020, respectively). Principle test results were high before training and did not improve after training. The test results were associated with MRT-A both before (P=0.009) and after training (P=0.003).

    Conclusions: Understanding of the parallax phenomenon is associated with visual-spatial ability. Development of the skill to interpret 3D information in radiographs utilizing parallax is facilitated for individuals with high visual-spatial ability.

  • 23.
    Salovaara, Antti
    et al.
    Helsinki Institute for Information Technology HIIT, University of Helsinki and Aalto University, Finland.
    Lehmuskallio, Asko
    Helsinki Institute for Information Technology HIIT, University of Helsinki and Aalto University, Finland.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Valkonen, Paula
    Idean Enterprises, Inc., Kauppaneuvoksentie 8, Helsinki, Finland.
    Näsänen, Jaana
    Helsinki Institute for Information Technology HIIT, University of Helsinki and Aalto University, Finland.
    Information technologies and transitions in the lives of 55–65-year-olds: The case of colliding life interests2010In: International journal of human-computer studies, ISSN 1071-5819, E-ISSN 1095-9300, Vol. 68, no 11, p. 803-821Article in journal (Refereed)
    Abstract [en]

    More and more people entering the stage of retirement at around age 55–65 are healthy, active, and also very computer-literate. This trend is rapidly changing the common image of late-midlife technology users, which rests on the assumption that they find it difficult to embrace new technologies and also that their main interests are health related. Although technology use and lifestyles are changing, however, many other aspects of life remain the same. One of these aspects is that of the transitions, or life changes, that generally take place in these years. Besides retirement, these transitions include changes in health, housing, social interaction, work life, and personal finance. People develop different ways of coping with these transitions, which brings up interesting issues related to the late midlife stage. This paper presents a diary-aided interview study of late middle-age adults (N=24) in Finland and Sweden with a focus on the interplay between technologies and transitions. Transitions were found to play a part in how the life interests of late middle-aged persons are often conflictive, forcing them to choose from among various ‘possible selves’. At its best, technology can help alleviate these tensions. This finding is exemplified in the paper’s discussion of two design implications associated  with particular clashes of interests, related to how daily activities are organized and how contact is maintained with one’s friends and family.

  • 24.
    Salé, Hanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Isberg, Annika
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Accuracy of patients' recall of temporomandibular joint pain and dysfunction after experiencing whiplash trauma: a prospective study2010In: The Journal of the American Dental Association (1939), ISSN 0002-8177, E-ISSN 1943-4723, Vol. 141, no 7, p. 879-886Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Researchers have conducted studies regarding whiplash-induced temporomandibular joint (TMJ) pain and dysfunction mainly under the presumption that patients' memory of symptoms remains accurate across time. In this prospective study, the authors aimed to determine the frequency of patients' inaccurate retrospective reports of TMJ pain and dysfunction after whiplash trauma.

    METHODS: The authors assessed TMJ pain and dysfunction in 60 patients consecutively seen in a hospital emergency department directly after the patients experienced whiplash trauma in rear-end automobile accidents. They followed up with 59 patients one year later. The participants completed a self-administered questionnaire followed by a comprehensive interview during both examinations. The study group consisted of the 40 patients who reported previous or current TMJ pain, dysfunction or both at either examination or at both examinations.

    RESULTS: The agreement between each patient's inceptive and retrospective reports of TMJ pain and dysfunction yielded a kappa value of 0.41 (95 percent confidence interval [CI] 0.18-0.64). Sixteen patients (40 percent, 95 percent CI 25-57 percent) had inaccurate recall. Recollection errors were addition, omission, and forward and backward telescoping. Seven patients incorrectly referred symptom onset to the accident.

    CONCLUSIONS: The high frequency of inaccurate recall of TMJ pain and dysfunction one year after whiplash trauma implies that clinicians and researchers should interpret with caution the results of previous studies that relied on retrospective data regarding whiplash-induced TMJ pain and dysfunction.

    CLINICAL IMPLICATIONS: To achieve valid long-term evaluations in clinical research, the patient's TMJ status should be established at the time of an accident.

  • 25.
    Schlickum, Marcus
    et al.
    Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
    Fellander-Tsai, Li
    Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Henningsohn, Lars
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Endourological simulator performance in female but not male medical students predicts written examination results in basic surgery2013In: Scandinavian Journal of Urology, ISSN 2168-1805, Vol. 47, no 1, p. 38-42Article in journal (Refereed)
    Abstract [en]

    Objective. The objective of this study was to examine the correlation between endourological simulator performance and demonstrated theoretical knowledge in the basic surgical sciences. Material and methods. In total, 158 fourth year medical students participated in the study, 83 females and 75 males, all surgical novices. All students performed the flexible endoscopic task Hall of Fame in the urological simulator URO Mentor (TM). Later during the same semester all students took the final theoretical examination in surgery. Results. In female medical students a significant correlation was found between surgical simulator performance and the examination results (r = -0.22, p = 0.04). There was no statistically significant correlation when looking at the total study population (r = -0.04, p = 0.58) or when looking at male medical students (r = 0.01, p = 0.9). Conclusion. Female medical students completing an endourological simulator task more efficiently passed the theoretical examination in the basic surgical sciences with significantly higher scores than females with low efficiency in the urological simulator. There are likely to be several explanations for this correlation, such as motivation and a lower amount of current video gaming experience.

  • 26. Schlickum, Marcus
    et al.
    Hedman, Leif
    Enochsson, Lars
    Henningsohn, Lars
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Kjellin, Ann
    Fellander-Tsai, Li
    Surgical Simulation Tasks Challenge Visual Working Memory and Visual-Spatial Ability Differently2011In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 35, no 4, p. 710-715Article in journal (Refereed)
    Abstract [en]

    Background New strategies for selection and training of physicians are emerging. Previous studies have demonstrated a correlation between visual-spatial ability and visual working memory with surgical simulator performance. The aim of this study was to perform a detailed analysis on how these abilities are associated with metrics in simulator performance with different task content. The hypothesis is that the importance of visual-spatial ability and visual working memory varies with different task contents.

    Methods Twenty-five medical students participated in the study that involved testing visual-spatial ability using the MRT-A test and visual working memory using the RoboMemo computer program. Subjects were also trained and tested for performance in three different surgical simulators. The scores from the psychometric tests and the performance metrics were then correlated using multivariate analysis.

    Results MRT-A score correlated significantly with the performance metrics Efficiency of screening (p = 0.006) and Total time (p = 0.01) in the GI Mentor II task and Total score (p = 0.02) in the MIST-VR simulator task. In the Uro Mentor task, both the MRT-A score and the visual working memory 3-D cube test score as presented in the RoboMemo program (p = 0.02) correlated with Total score (p = 0.004).

    Conclusions In this study we have shown that some differences exist regarding the impact of visual abilities and task content on simulator performance. When designing future cognitive training programs and testing regimes, one might have to consider that the design must be adjusted in accordance with the specific surgical task to be trained in mind.

  • 27. Schlickum, Marcus
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fellander-Tsai, Li
    Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study2016In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 7, p. 56-61Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Methods: Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. Results: A good result in the first simulator trial correlated with higher self-determination index (r = -0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). Conclusions: This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

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  • 28. Schlickum, Marcus Kolga
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Center for Advanced Medical Simulation, Karolinska University Hospital, 141 86, Stockholm, Sweden .
    Enochsson, Lars
    Kjellin, Ann
    Fellander-Tsai, Li
    Systematic video game training in surgical novices improves performance in virtual reality endoscopic surgical simulators: a prospective randomized study2009In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 33, no 11, p. 2360-2367Article in journal (Refereed)
    Abstract [en]

    Background Previous studies have shown a correlation between previous video game experience and performance in minimally invasive surgical simulators. The hypothesis is that systematic video game training with high visual-spatial demands and visual similarity to endoscopy would show a transfer effect on performance in virtual reality endoscopic surgical simulation.

    Methods A prospective randomized study was performed. Thirty surgical novices were matched and randomized to five weeks of systematic video game training in either a first-person shooter game (Half Life) with high visual-spatial demands and visual similarities to endoscopy or a video game with mainly cognitive demands (Chessmaster). A matched control group (n = 10) performed no video game training during five weeks. Performance in two virtual reality endoscopic surgical simulators (MIST-VR and GI Mentor II) was measured pre- and post-training. Before simulator training we also controlled for students' visual-spatial ability, visual working memory, age, and previous video game experience.

    Results The group training with Half Life showed significant improvement in two GI Mentor II variables and the MIST-VR task MD level medium. The group training with Chessmaster only showed an improvement in the MIST-VR task. No effect was observed in the control group. As recently shown in other studies, current and previous video game experience was important for simulator performance.

    Conclusions Systematic video game training improved surgical performance in advanced virtual reality endoscopic simulators. The transfer effect increased when increasing visual similarity. The performance in intense, visual-spatially challenging video games might be a predictive factor for the outcome in surgical simulation.

  • 29.
    Schéle, Ingrid A.
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hedman, Leif R.
    Umeå University, Faculty of Social Sciences, Department of Psychology. Center for Advanced Medical Simulation and Training, Karolinska Institutet, Stockholm.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    A model of psychosocial work environment, stress, and satisfaction among dental students in Sweden2012In: Journal of Dental Education, ISSN 0022-0337, E-ISSN 1930-7837, Vol. 76, no 9, p. 1206-1217Article in journal (Refereed)
    Abstract [en]

    Dental students are often described as stressed. The stress has, among other things, been connected to stressors in their psychosocial environment and inconsistent feedback. The hypothesis of this study was that the psychosocial work environment in dental schools leads to stress and affects the satisfaction of dental students and that tolerance for ambiguity shields students from stress. A web-based survey was sent to the entire Swedish dental student population in clinical training (N=805); the response rate was 40 percent. Structural equation modeling used in the analyses contains four main constructs: psychosocial work environment, tolerance for ambiguity, perceived stress, and student satisfaction (χ2=267.437, d.f.=174, p<0.001, Normed χ2=1.537, RMSEA= 0.041, CFI=0.98). Psychosocial work environment influenced both perceived stress and satisfaction: it accounted for almost all of the explained variance in perceived stress for women, while about half of the variance for the men was explained by tolerance for ambiguity. This study concluded that about 40 percent of the total perceived stress of these female dental students was related to their psychosocial work environment. Tolerance for ambiguity shielded men but not women from stress. An improved psychosocial work environment in dental schools would decrease the stress of both male and female dental students.

  • 30.
    Schéle, Ingrid
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Shared ambiguity but different experiences and demands among dental students: a gender perspective2011In: Qualitative Research in Psychology, Vol. 8, no 1, p. 1-25Article in journal (Refereed)
    Abstract [en]

    This study explores how dental students experience their clinical semesters from a gender perspective.

    Twelve students (seven women and five men) and three teachers (two women and one man) at the Umeå dentistry programme participated in semi-structured interviews that were analysed with Grounded Theory methodology.

    The model we propose consists of the core category Experiencing ambiguity and the three categories Experiencing pressure and stress, Assessing your own performance, and Passing through the eye of the needle and also includes four subcategories. At the core of our findings lies ambiguity, captured in the student dilemmas What’s enough/When’s enough. The answers to these dilemmas are further complicated by the gendered dimension and the dimension of unequal treatment, which provide students with different and contradicting sets of rules and roles. A comparison with recent findings from the U.S. shows that their experiences are not unique.

    Our Experiencing ambiguity model constitutes a platform for future research on how students experience clinical education, as well as potential predictors and consequences in relation to performance and well-being.

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  • 31.
    Schéle, Ingrid
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hedman, Leif R
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    The Blurring between Strictand Fluid demands at theUmeå Dentistry Programme2008In: Abstracts of the XXIX International Congress of Psychology, July 21- 25, 2008, 2008Conference paper (Refereed)
    Abstract [en]

    The objective was to study elements forming students’ professional identity and experience ofdental education. Focus was on how students cope with conflicting demands and the interaction between a male dentist norm and predominantly female students. Semi-structured interviews were conducted with three teachers and ten students from the Umeå dentistry programme. The Grounded Theory method used generated a model centred on ‘‘Experiencing ambiguity’’ – ambiguity about actual effort needed and actual demands to be met. Also central were ‘‘Experiencing stress’’, time related as well as strain related, and ‘‘Demands lead to quality’’. The consequences of this ambiguity will be further explored.

  • 32.
    Sharafi, Parvaneh
    et al.
    Department of Psychology, Stockholm University, Stockholm 106-91, Sweden.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Montgomery, Henry
    Department of Psychology, Stockholm University, Stockholm 106-91, Sweden.
    Using information technology: engagement modes, flow experience, and personality orientations2006In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 22, no 5, p. 899-916Article in journal (Refereed)
    Abstract [en]

    The engagement mode (EM) model describes how an IT user (subject) engages in an activity with an object in a certain mode. The model specifies five engagement modes (Enjoying/Acceptance, Ambition/Curiosity, Avoidance/Hesitation, Frustration/Anxiety, and Efficiency/Productivity), which are characterized on three dimensions (evaluation of object, locus of control between subject and object, and intrinsic or extrinsic focus of motivation). Using questionnaire data from 290 participants, we extended previous empirical support for the model as well as described the model’s relationship to flow experience. In addition, it was found that autonomy, controlled and impersonal orientation in conjunction with socio-demographic variables differentiated among specific engagement modes and flow experience. We conclude that the EM-model, flow experience, and causality orientation theories provide a uniform framework for understanding how people adapt to information technology.

  • 33. Ström, P
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Psychology.
    Sarna, L
    Kjellin, A
    Wredmark, T
    Fellander-Tsai, L
    Early exposure to haptic feedback enhances performance in surgical simulator training: a prospective randomized crossover study in surgical residents2006In: SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, ISSN 0930-2794, Vol. 20, no 9, p. 1383-1388Article in journal (Refereed)
  • 34. Ström, P
    et al.
    Kjellin, A
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Psychology.
    Wredmark, T
    Fellander-Tsai, L
    Training in tasks with different visual-spatial components does not improve virtual arthroscopy performance2004In: SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol. 18, no 1, p. 115-120Article in journal (Refereed)
  • 35. Wallin, Carl-Johan
    et al.
    Meurling, Lisbet
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Psychology.
    Hedegård, Jan
    Felländer-Tsai, Li
    Target-focused medical emergency team training using a human patient simulator: effects on behaviour and attitude2007In: Medical education, ISSN 0308-0110, Vol. 41, p. 173-180Article in journal (Refereed)
  • 36. Westfelt, Petter
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet.
    Lindkvist, Mikael Axelsson
    Enochsson, Lars
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Fellander-Tsai, Li
    Schmidt, Peter Thelin
    Training nonanesthetist administration of propofol for gastrointestinal endoscopy in scenario-based full-scale hybrid simulation - a pilot study2013In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 48, no 11, p. 1354-1358Article in journal (Refereed)
    Abstract [en]

    Objective. The use of nonanesthetist-administered propofol (NAAP) in GI endoscopy has long been controversial. In the setting of NAAP, acute situations can develop during endoscopy and thus training before starting with NAAPs is considered crucial. The aim was to evaluate a pilot study on crew resource management (CRM)-based training of teams of endoscopists and endoscopy nurses in NAAP in a full-scale hybrid simulation consisting of a full-scale human patient simulator and an endoscopy simulator. Our hypothesis was that the training would increase the self-efficacy of the participants. Material and methods. Four scenarios were created, each with typical side effects of propofol administration. All scenarios included the need for prompt decision-making and treatment. Colonoscopy, gastroscopy or endoscopic retrograde cholangiopancreatography (ERCP) cases were assigned to the course participants in coherence with their main clinical expertise in order to facilitate situated and contextualized training. Twenty-one participants (ten doctors and eleven nurses) completed a questionnaire on self-efficacy before and after the course. A questionnaire regarding the quality and yield of the course was also completed. Results. For all participants, the self-efficacy score was 26.0 (24.0-28.0; interquartile range) before training and 30.0 (27.0-30.5) after training (p = 0.0003). The ten doctors had a self-efficacy score before training of 26.5 (25.0-29.5) and 30.0 (29.0-33.0) after (p = 0.0078). The eleven nurses scored 24.0 (22.0-26.0) before and 28.0 (27.0-30.0) after training (p = 0.0098). Conclusions. Systematic target focused scenario-based training with hybrid simulation of NAAP in endoscopy resulted in increased self-efficacy in both nurses and physicians.

  • 37.
    Winberg, Mikael
    et al.
    Umeå University, Faculty of Teacher Education, Mathematics, Technology and Science Education.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Student attitudes toward learning, level of pre-knowledge and instruction type in a computer-simulation: effects on flow experiences and perceived learning outcomes2008In: Instructional science, ISSN 0020-4277, E-ISSN 1573-1952, Vol. 36, no 4, p. 269-287Article in journal (Refereed)
    Abstract [en]

    Attitudes toward learning (ATL) have been shown to influence students’ learning outcomes. However, there is a lack of knowledge about the ways in which the interaction between ATL, the learning situation, and the level of students’ prior knowledge influence affective reactions and conceptual change. In this study, a simulation of acid-base titrations was examined to assess the impact of instruction format, level of prior knowledge and students’ ATL on university-level students, with respect to flow experiences (Csikszentmihalyi, 1990) and perceived conceptual change. Results show that the use of guiding instructions was correlated with a perceived conceptual change and high levels of “Challenge,” “Enjoyment,” and “Concentration,” but low sense of control during the exercise. Students who used the open instructions scored highly on the “Control flow” component, but their perceived learning score was lower than that for the students who used the guiding instructions. In neither case did students’ ATL or their pre-test results contribute strongly to students’ flow experiences or their perceived learning in the two different learning situations.

  • 38.
    Winberg, Mikael
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Taube, Fabian
    Hedman, Leif
    A comparative analysis of discussion quality in Face-to-Face and threaded discussion groupsManuscript (preprint) (Other academic)
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