A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB) on student learning

BACKGROUND: High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. OBJECTIVES: To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. DESIGN AND SETTING: Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. PARTICIPANTS: A population of 489 final-year nursing students in programs of study leading to license to practice. METHODS: Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation. Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. RESULTS: Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation. Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R(2)=0.090, F(7, 352)=4.962, p<0.001. DISCUSSION: The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. CONCLUSION: The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students.

iPrevent®: a tailored, web-based, decision support tool for breast cancer risk assessment and management

We aimed to develop a user-centered, web-based, decision support tool for breast cancer risk assessment and personalized risk management. Using a novel model choice algorithm, iPrevent(®) selects one of two validated breast cancer risk estimation models (IBIS or BOADICEA), based on risk factor data entered by the user. Resulting risk estimates are presented in simple language and graphic formats for easy comprehension. iPrevent(®) then presents risk-adapted, evidence-based, guideline-endorsed management options. Development was an iterative process with regular feedback from multidisciplinary experts and consumers. To verify iPrevent(®), risk factor data for 127 cases derived from the Australian Breast Cancer Family Study were entered into iPrevent(®), IBIS (v7.02), and BOADICEA (v3.0). Consistency of the model chosen by iPrevent(®) (i.e., IBIS or BOADICEA) with the programmed iPrevent(®) model choice algorithm was assessed. Estimated breast cancer risks from iPrevent(®) were compared with those attained directly from the chosen risk assessment model (IBIS or BOADICEA). Risk management interventions displayed by iPrevent(®) were assessed for appropriateness. Risk estimation model choice was 100 % consistent with the programmed iPrevent(®) logic. Discrepant 10-year and residual lifetime risk estimates of >1 % were found for 1 and 4 cases, respectively, none was clinically significant (maximal variation 1.4 %). Risk management interventions suggested by iPrevent(®) were 100 % appropriate. iPrevent(®) successfully integrates the IBIS and BOADICEA risk assessment models into a decision support tool that provides evidence-based, risk-adapted risk management advice. This may help to facilitate precision breast cancer prevention discussions between women and their healthcare providers.

Requirements engineering for web-based information systems

This chapter overviews the existing methods of requirements analysis as prescribed by some of the best-known web-development methods. It also discusses the pre-eminent importance of stakeholder analysis, identification of stakeholder views and concerns, and the processes governing elicitation of web systems requirements. The chapter finally derives a model of concern-driven requirements evolution from several case studies undertaken in the area of web-enabled employee service systems.

Towards an interactive architecture for web-based databases

World Wide Web has brought us a lot of challenges, such as infinite contents, resource diversity, and maintenance and update of contents. Web-based database (WBDB) is one of the answers to these challenges. Currently the most commonly used WBDB architecture is three-tier architecture, which is still somehow lack of flexibility to adapt to frequently changed user requirements. In this paper, we propose a hybrid interactive architecture for WBDB based on the reactive system concepts. In this architecture, we use sensors to catch users frequently changed requirements and use a decision making manager agent to process them and generate SQL commands dynamically. Hence the efficiency and flexibility are gained from this architecture, and the performance of WBDB is enhanced accordingly.

A load balancing algorithm for web based server grids

Load balance is a critical issue in distributed systems, such as server grids. In this paper, we propose a Balanced Load Queue (BLQ) model, which combines the queuing theory and hydro-dynamic theory, to model load balance in server grids. Base on the BLQ model, we claim that if the system is in the state of global fairness, then the performance of the whole system is the best. We propose a load balanced algorithm based on the model: the algorithm tries its best to keep the system in the global fairness status using job deviation. We present three strategies: best node, best neighbour, and random selection, for job deviation. A number of experiments are conducted for the comparison of the three strategies, and the results show that the best neighbour strategy is the best among the proposed strategies. Furthermore, the proposed algorithm with best neighbour strategy is better than the traditional round robin algorithm in term of processing delay, and the proposed algorithm needs very limited system information and is robust.

Knowledge transfer in enterprise information technology support using web-based self-service systems

This paper explores Critical Success Factors (CSFs) in the transfer
of after-sales support-oriented knowledge from Information Technology (IT)
support organisations to enterprise customers, using Web-based self-service Systems (WSS). As it appears that best-in-class companies are ahead of the academic work in this area, we approached the topic through an exploratory CSF study of a best-in-class multinational IT services firm and identified 26 CSFs. Key findings from the study indicate that best-in-class IT service organisations may be cognisant of a range of factors relating to supporting customers, but are less aware of what is needed to support their own frontline support agents. Such organisations also lack an understanding of what is needed to provide enterprise support in the later stages of knowledge transfer, where enterprise customers can experience problems attempting to integrate resolutions. The study further showed that many aspects that might be characterised as encompassing socio-technical issues relating to the provision of web-based self-service are still poorly understood.

Development of a web-based information system for cascading utilisation of construction materials

This paper presents a Web-based information system for promoting the cascading utilisation of construction materials in order to mitigate the increasing environmental pressure by the construction industry. First, this paper points out me weaknesses of current waste material exchange systems. Then, a new approach is introduced to reuse demolished materials, by which the utilisation of demolished materials may be ascertained before the demolition is actually produced.. Information technologies, including web-based intelligent and distributed systems, are applied to actua1ise this approach. Finally, the development and implementation of the system is described in detail.

Quality-of-service routing for web-based multimedia servers

Quality-of-Service is an important issue in multimedia applications; so far most of the research focuses on bandwidth guarantee, few pays attention to the server performance guarantee. In this paper we pay more attention to the server performance guarantee under the prerequisite of guaranteed bandwidth quality. We take advantage of anycast to find the "best" multimedia server among a distributed server group in terms of bandwidth, the request will be submitted to the selected server, moreover, the selected server's neighbours' (all the servers with feasible paths) addresses are delivered to the selected server simultaneously. If the selected server can not guarantee the QoS for the request in terms of server performance, then a proposed QoS-Aware Server Load Deviation (QASLD) mechanism wiII be employed, which will deliver the request to one of its neighbours until there exists a suitable server that can guarantee the server performance for the request. Our experiments show that the proposed QASLD algorithm works well.

End-user control in web-based electronic services : a case study

This paper reports a case study of end-user control in delivery of Web-based electronic services. The case study concentrates the adoption of a Web-based electronic system being implemented in processing student’s admission applications on a Web site. The end-user’s control interface provides information on the detail existing in the Web-based electronic service. This insight into end-user synthesis in developing effective control in Web service environment relates to ease of use in doing the task. To assume the leverage of end-user control strictly on the basis of the Web service usage would limit the purpose of understanding. Rather it is suggested that it would be better to develop an approach to study the end-user ease of use interface in doing the task with the user’s perception towards Web-based interactivity.

End-user experience with information in Web-based electronic service : a case study

End-user experience with information presumably considered as one of the prominent factors shaping the adoption of web-based electronic services. User interfacing with large amount of information the rationale is to deduce the effect in the current web-based task environment. Understanding user’s perception on the basis of the prior experience with information may provide insights into what constitutes in driving those perceptions and their effect in the current and future task in web-based electronic services. The paper lays the theoretical context of end-user experience with information and proceeds further in an attempt to distinguish the role in web-based electronic services.