Adapting the Gamified Educational Networking Online Learning Management System to Test a Decentralized Simulation-Based Education Model to Instruct Paramedics-in-Training on the Emergency Intraosseous Access and Infusion Skill

Abstract

Intraosseous (IO) access and infusion is a safe and rapid alternative to intravenous access in obtaining vascular access for administering fluids and drugs. Healthcare professionals, such as primary and advanced care paramedics, use IO access and infusion in emergency circumstances where peripheral intravenous routes are inaccessible. IO access skills require hands-on training, which can be done remotely if the participants have access to simulation, instructions, guidance, and feedback. For the purpose of moving the training outside of the simulation laboratories, we have developed (1) an inexpensive and scalable three-dimensional (3D) printed and silicone-based advanced adult proximal tibial IO access and infusion simulator and (2) a unique learning management system (LMS) for remote simulation-based training. The LMS was built using the Django platform and supports experiential learning by providing access to educational and instructional content (including virtual simulation and serious games), allowing peers to communicate among themselves and with subject-matter experts, provide and receive feedback asynchronously, and engage in learning using gamification elements. The aim of this technical report is to describe the process of development and the final product of the LMS as a research and educational tool to scaffold remote learning of emergency IO skills by paramedics-in-training.

Keywords: decentralized simulation-based education; emergency medical service; healthcare simulation; intraosseous access; paramedic training.

Figure 1. Model illustrating three phases of learning and the components adopted for the GEN IO.

GEN IO: Gamified Educational Network Intraosseous

Figure 2. Educational component with video and PowerPoint on learning the GEN IO1 Module.

Figure 3. Research component with tests and surveys on the GEN IO1 Module.

Figure 4. Physical setup of the GEN IO Module on a computer along with the simple IO, the advanced IO simulator, and the associated IO medical equipment.

GEN IO: Gamified Educational Network Intraosseous; IO: intraosseous

Figure 5. "Overview" section in the GEN IO1 Module.

Figure 6. "Instructions" section in the GEN IO1 Module.

Figure 7. "Overview" section in the GEN IO1 Module.

Figure 8. "Demographics Survey" section in the GEN IO1 Module.

Figure 9. "Self-Efficacy Survey" section in the GEN IO1 Module.

Figure 10. "Pretest" section in the GEN IO1 Module.

Figure 11. "Practice" section in the GEN IO1 Module.

Figure 12. "Posttest" section in the GEN IO1 Module.

Figure 13. "Self-Assessment" section in the GEN IO1 Module.

Figure 14. "Satisfaction Survey" section in the GEN IO1 Module.

Figure 15. "Book a Retention Test" section in the GEN IO1 Module.

Figure 16. "Stop Here" section in the GEN IO1 Module.

Figure 17. "Retention Test Upload" section in the GEN IO1 Module.

Figure 18. "Draw for an iPad" section in the GEN IO1 Module.

Figure 19. "Certificate of Completion" section in the GEN IO1 Module.

Figure 20. Responses of participants to 10 questions, relevant to the GEN IO Module, measured on a 5-point Likert scale translated into SUS scores.

Likert scale: 1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; 5 = strongly agree. Q1: I think that I would like to use this product frequently. Q2: I found the product unnecessarily complex. Q3: I thought the product was easy to use. Q4: I think that I would need the support of a technical person to be able to use this product. Q5: I found the various functions in the product were well integrated. Q6: I thought there was too much inconsistency in the product. Q7: I imagine that most people would learn to use this product very quickly. Q8: I found the product very awkward to use. Q9: I felt very confident using the product. Q10: I needed to learn a lot of things before I could get going with this product. SUS: system usability survey; GEN IO: Gamified Educational Network Intraosseous