Introduction The brevity of training for soldiers and combat medics to learn how to provide treatment on the battlefield may restrict optimal performance for treating chest and airway injuries, particularly when treating female soldiers. The present study tested treatment performance on patient simulators by battlefield medic trainees to determine whether there is a need for more extensive training on chest and airway procedures on female soldiers. Materials and Methods Battlefield medic trainees treated male and female patient simulators in counterbalanced order. The assessment considered the effects of patient gender and order on procedures performed, particularly critical chest and airway interventions such as needle chest decompression (NCD), and considered the appropriate order of treatment tasks. Four coders rated video footage of three simulated procedures, i.e., tourniquet, chest seal (front and back application), and NCD, using a binary coding system to determine completeness and order correctness according to the Massive hemorrhage, Airway, Respiration, Circulation, and Head injury/Hypothermia (MARCH) mnemonic. Results Results from analysis of variance showed that when presented with a female patient first, trainees performed significantly fewer total procedures on both the female and male simulators. More experienced trainees completed significantly more procedures compared to trainees with minimal experience. Results from the binary logistic regression showed that trainees with more experience and trainees presented with the male patient simulator first performed significantly more procedures in the correct order. Finally, an examination of the NCD procedure found that trainees presented with the female patient simulator first had more errors and that trainees with less experience were less likely to perform the procedure adequately. Conclusions The findings suggest that treating a female patient first may lead to undertreatment of both patients. Furthermore, the observed differences in treating sensitive areas of the body (e.g., near female breasts) suggest providing greater opportunities for trainees to practice often missed or incorrectly performed procedures. Treating a female patient remains a novel experience for many trainees, such that trainees are less likely to fully treat a female patient and are less likely to treat female soldiers for the most life-threatening injuries. In fact, the initial presentation of the female patient simulator appeared to affect experienced trainees, suggesting that removing the experience of novelty and stress requires more extensive exposure and alternative training. The study’s small sample size with a wide range of trainee experience may limit the findings, which may fail to capture some study effects. Finally, the study did not request trainees’ experience treating female soldiers, so future studies should examine the extent to which experience is predictive of performance. There is a need for more interactive approaches in patient simulations to provide opportunities for practice, especially those that require the treatment of sensitive areas.
Visual hallucinations, illusions, and distortions have been observed in individuals undergoing severe periods of extended wakefulness. However, the incidence of these perceptual phenomena occurring during applied domains such as driving have been underreported. This study investigates effects of a 30-hour period of extended wakefulness during which participants abstained from stimulants and were not allowed to sleep or nap. Participants drove every 4 hours during this period on an uneventful 30-minute driving route in a fullcab high fidelity driving simulator. At the end of the study, participants reported whether they experienced significant visual illusions or distortions, and when the events occurred. Participants reported visual distortions and illusions during drives comprising a time period between 22 and 30 hours awake. Furthermore, self-reported mental workload and extroversion predicted the likelihood of experiencing the visual phenomena. Potential mechanisms for this relationship and possible consequences for safe driving performance during significant sleep deprivation are discussed.
Restricted Crossing U-turns (RCUTs) show reduction in severe and fatal crashes compared to traditional stop-controlled intersections in rural and suburban areas, but poor community acceptance of these relatively novel road designs can lead to costly delays in installation or cessation of the project. One way to increase road user acceptance of RCUTs and other novel road designs is through the use of persuasive technologies such as virtual environments and simulation. Three studies employing different forms of simulated virtual environments with the same RCUT design were conducted, with participants providing pre- and post-exposure self-report attitudes toward the RCUTs. The results indicated that acceptance towards RCUTs generally improved for two of the three studies that provided a virtual experience driving through an RCUT, but attitudes did not improve for the virtual environment utilizing a highly immersive full-cab simulator. The results have implications for the use of persuasive technologies for novel roadway designs.
Bicycling has become an increasingly popular and environmentally friendly active transportation modality for many commuters across the nation. Consequently, as ridership increases so does the rate of bicycle–motor vehicle crashes, many of which are caused by reduced bicycle visibility and driver inattention. Therefore, one effective solution to improve bicyclist safety may be through the use of an audible bicycle alarm system to alert both the driver and the rider. A study was conducted to determine whether a unique auditory alert would be effective at reducing crash rates and whether a localized alert (i.e., an alert presented from the driver’s perspective) would improve the driver’s responsiveness in avoiding a potential collision. A driving simulator study tested car horn sounds, an experimental bike alert, and no auditory alert in different potential collision scenarios to measure collision rates and other collision avoidance metrics. Findings indicated that the experimental bike alert contributed to fewer relative crashes than the horn sound and no sound on bicycles, motor vehicles were struck more frequently than bicycles, collisions were more likely to occur from the front than the sides, and collisions were more likely for drivers going straight than when making turns. Taken together, the findings suggest that an alarm designed to be specifically compatible with bicycles is more effective than auditory alerts from other sources.
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