Development and usability testing of a patient digital twin for critical care education: a mixed methods study

Abstract

BackgroundDigital twins are computerized patient replicas that allow clinical interventions testing in silico to minimize preventable patient harm. Our group has developed a novel application software utilizing a digital twin patient model based on electronic health record (EHR) variables to simulate clinical trajectories during the initial 6 h of critical illness. This study aimed to assess the usability, workload, and acceptance of the digital twin application as an educational tool in critical care.MethodsA mixed methods study was conducted during seven user testing sessions of the digital twin application with thirty-five first-year internal medicine residents. Qualitative data were collected using a think-aloud and semi-structured interview format, while quantitative measurements included the System Usability Scale (SUS), NASA Task Load Index (NASA-TLX), and a short survey.ResultsMedian SUS scores and NASA-TLX were 70 (IQR 62.5–82.5) and 29.2 (IQR 22.5–34.2), consistent with good software usability and low to moderate workload, respectively. Residents expressed interest in using the digital twin application for ICU rotations and identified five themes for software improvement: clinical fidelity, interface organization, learning experience, serious gaming, and implementation strategies.ConclusionA digital twin application based on EHR clinical variables showed good usability and high acceptance for critical care education.

Residency training programs in anesthesiology, intensive care and emergency medicine: from curriculum to practice

“…Students and trainees are more committed and have better performance when they can see the explicit connection between the educational activities or requirements and their future professional expertise ( 30 , 32 , 34 ). Lower rating for the quality of theoretical education in anesthesiology residency was reported when compared to other educational activities ( 30 – 32 , 35 – 37 ). Several possible explanations have been considered, such as absence of comprehensive training programs and even mentors' qualifications ( 35 ).…”

“…They provide actual experiences that are highly effective in retaining knowledge and have the potential to generate behavioral changes, such as in leadership, communication, and resource management. This, in turn, enhances patient safety ( 37 , 42 ), and can bridge theoretical lessons with real-world clinical practice, particularly in helping junior doctors handle emergency situations ( 43 ). Simulation programs positively impact non-technical and behavioral issues, influencing the learning process in both EM and anesthesiology ( 31 , 44 – 46 ).…”