Background: Providing comprehensive emergency preparedness training (EPT) for patient care providers is important to the future success of emergency preparedness operations in the United States. Disasters are rare, complex events involving many patients and environmental factors that are difficult to reproduce in a training environment. Few EPT programs possess both competency-driven goals and metrics to measure life-saving performance during a multiactor simulated disaster.Methods: The development of an EPT curriculum for patient care providers—provided first to medical students, then to a group of experienced disaster medical providers—that recreates a simulated clinical disaster using a combination of up to 15 live actors and six high-fidelity human simulators is described. Specifically, the authors detail the Center for Health Professional Training and Emergency Response’s (CHPTER’s) 1-day clinical EPT course including its organization, core competency development, medical student self-evaluation, and course assessment.Results: Two 1-day courses hosted by CHPTER were conducted in a university simulation center. Students who completed the course improved their overall knowledge and comfort level with EPT skills.Conclusions: The authors believe this is the first published description of a curriculum method that combines high-fidelity, multiactor scenarios to measure the life-saving performance of patient care providers utilizing a clinical disaster scenario with 10 patients at once. A larger scale study, or preferably a multicenter trial, is needed to further study the impact of this curriculum and its potential to protect provider and patient lives.
This paper describes the implementation ofNeVIS, a local network system that establishes communication between individual performers, as well as between laptop and performers. Specifically, this is achieved by making use of vibrotactile feedback as a signalling tool within an improvisational setting. A discussion of the current developments regarding the use of networks within improvisation is presented, followed by an outline of the benefits of utilising the haptic feedback channel as a further sensory information pathway when performing digital music. We describe a case study of the system within the context of our computer-mediated improvisational duo Můstek, involving piano, percussion and live electronics. Here, a cueing system or framework is imposed over the improvisation and is transmitted directly to the skin of the performers via tiny vibrations. Additionally, performers may make use of simple vibrotactile signals to enhance traditional visual cues that are often employed within performance. A new work,Socks and Ammo, was created using NeVIS, and was presented at various international conferences and festivals. We also tested the system itself within a group of postgraduate researchers and composers. Qualitative evaluation of the musical outcomes as experienced both by the performers and by the listeners at these events is offered, as well as implications about the nature of collaborative music-making.
Cochlear implant (CI) users’ poor speech recognition in noise and music perception may be both due to their limited access to pitch cues such as the fundamental frequency (F0). Recent studies showed that similar to residual low-frequency acoustic hearing, vibrotactile presentation of the F0 significantly improved speech recognition in noise of CI users. The present study tested whether F0-based vibrotactile stimulation can improve melodic contour identification (MCI) of normal-hearing listeners with acoustically simulated CI processing. Each melodic contour consisted of five musical notes with one of nine contour patterns (rising, falling, or flat in each half of the contour). The F0 of the middle note was 220 or 880 Hz, and the frequency intervals between adjacent notes were 1, 3, or 5 semitones. The F0 of each note was extracted in real time and transposed to a vibration frequency centered around 110 Hz at the right forearm top. MCI was tested in five experimental conditions (with a 4- or 8-channel CI simulation alone, vibrotactile stimulation alone, and 4- or 8-channel CI simulation plus vibrotactile stimulation), each after the same amount of brief training was provided. Results showed that discrimination of vibrotactile stimuli significantly improved from chance to near perfect as the vibration frequency interval increased from 0.25 to 3 semitones. The MCI performance with vibrotactile stimulation alone was similar to that with the 4-channel CI simulation alone, but was significantly worse than that with the 8-channel CI simulation alone. Significant improvement in MCI performance with the addition of vibrotactile stimulation was only found with the 4-channel CI simulation when the middle F0 was 880 Hz and when the frequency intervals were 3 or 5 semitones. The improvement in MCI performance with than without vibrotactile stimulation was significantly correlated with the baseline MCI performance with 4-channel CI simulation alone or with the MCI performance difference between vibrotactile stimulation and 8-channel CI simulation. Therefore, when the simulated or real CI performance is relatively poor, vibrotactile stimulation based on the F0 may improve MCI with acoustic CI simulations and perhaps in real CI users as well.
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