Year: 2011
Type: book-chapter
Abstract: IntroductionCardiovascular disease is the leading cause of death in the United States with over 696,000 cases recorded by the Center for Disease Control (CDC) in 2002 (National Center for Health Statistics, 2002).In particular, Sudden Cardiac Arrest (SCA) claims 300,000 to 400,000 American lives annually (AHA, 2005, Huikuri, Castellanos & Myerburd, 2001, Zipes & Wellens, 1998).Ventricular fibrillation is believed to be the insidious perpetrator associated with the majority of these heart maladies (AHA, 2005, Cummins & Hazinski, 2000).Unfortunately, most victims that experience SCA have only a small chance of survival (Stiell, Nichol, Wells, De Maio, Nesbitt, Blackburn, & Spaite, 2003;Zipes & Wellens, 1998).Increasing the probability of survival of SCA victims requires skilled and knowledgeable responders.Usually the task falls to EMTs, firefighters, police officers, or other highly trained responders.Unfortunately, these experts are not always available on site which means that critical time is lost by moving responders to the victim.An alternative approach to provide rapid access to responders is to develop and provide supportive technology that guides a novice through the procedure of resuscitating the victim by presenting information and feedback at the time when it is needed.However, such approach needs methodologically and conceptually to be rooted in cognitive psychology and human factors since these fields can direct work that aims at the robust improvement of human performance of novices.The successful application of this approach has the potential to improve usability of medical devices for non-experts, beyond the design of defibrillators.Below we will outline the elements that need to be included in the development of a system that allows an untrained responder to deal with a SCA by providing elementary cardiopulmonary resuscitation (CPR).This approach is based on the idea of Just-in-Time Support (JITS).First, we will outline the tradition into which such JITS falls conceptually.Then, we will describe the differences between current architectures of Intelligent Tutorial Systems (ITS) and the constraints under which a true JITS has to operate.In the following section we provide a conceptual framework that allows analysis of human performance in the context of complex procedural tasks.Next, we will describe a JITS developed for the purpose of evaluating the feasibility and effectiveness of this approach, and report the results of an experimental study that evaluated a JITS.Finally, we will discuss the findings in the context of future developments of defibrillators and other systems that require guidance of novice users when using these advanced medical technologies in emergency situations. www.intechopen.com Cardiac Defibrillation -Prediction, Prevention and Management of Cardiovascular Arrhythmic Events 1061.1 Intelligent Tutorial Systems (ITS) 1.1.1Description of ITS Intelligent Tutoring Systems (ITS) have been developed over the last decades.Early systems focused on supporting students in acquiring knowledge, thus these systems were similar to flash cards but were also capable of analyzing a student's responses (Uhr, 1969).The next generation systems were more sophisticated because they moved from a scripted hierarchical structure of knowledge towards systems that were able to deal with potentially all requests that a student would submit to the system.For example SCHOLAR (Carbonell, 1970) tutored students in South American geography and was designed to deal with a variety of questions that might be asked by a student learner.The next important step in the development of ITS was embodied in the work of Collins (1977).Earlier that decade Craik & Lockhart (1972) demonstrated that deeper, more elaborate processing improved learning and retention.In application of this line of reasoning, Collins (1977) implemented a Socratic method of exploration for his system.What was remarkable about this approach was that it allowed the student to "discover" knowledge, empowering the student to acquire knowledge from experience and individual cases, through self-directed exploration of the knowledge base.Despite the wide range of ITS there are a number of basic elements that all of these systems have in common.These elements will be outlined next.Many ITS projects share a basic architecture consisting of the same components.Perhaps the most basic components as described by Burns and Capps (1988) are the "Expert Model", the "Student Model" and the "Tutor".These modules are essential to the development of the JITS framework and will be discussed in depth.Expert Model.The expert model is designed to encapsulate all available knowledge for a particular domain.Domains for which ITS's have been developed included arithmetic -BUGGY (Brown & Burton, 1978), programming language -LISPIT (Anderson, 1988), and electronic troubleshooting -SOPHIE (Brown, Burton, and deKleer, 1982).Clearly, it is a challenge to develop an expert model for an ITS and the difficulty is a function of how well defined a domain is.For example, when dealing with technical procedures like maintaining an aircraft, the problem space is well understood, i.e., the steps involved in performing a procedure are clearly structured and the means to perform the task are well defined.Clearly less well understood domains provide a significantly higher challenge for the designer of the expert model, and with Anderson (1988) one has to emphasize that, ". . .a great deal of effort needs to be expended to discover and codify the domain knowledge" (p.22).The information contained in the expert model is usually assembled by experts in specific fields and serves as the standard to which the student's actions and knowledge is compared.Student Model.The student (or user) model is the system's representation of a specific learner's abilities and knowledge concerning the domain under consideration.Because of the dynamic nature of learning, a single or a static student model is not sufficient in an ITS.This is because overall the student acquires knowledge during the use of the system and progesses towards the development of expertise, but this track is not linear and perturbations of the user's proficiency across and even within a training session need to be accommodated.A critical function of ITS is to properly diagnose the user and identify when and what type of assistance is needed.If students perform below their normal baselines, the system must respond according.For the system to accurately gauge a student, it must go beyond a simple comparison to the expert model.One issue of current diagnostic functions implemented in ITS's is that they evaluate response accuracy by comparison with the knowledge base (Linn, 1990;Marshall, 1990).This allows for the categorization of a student, www.intechopen.com How to referenceIn order to correctly reference this scholarly work, feel free to copy and paste the following: Frank A. Drews and Paul M.
Source: InTech eBooks
DOI: 10.5772/20403
Authors: Frank A., Paul M.
Institutions: University of Utah, Aptima (United States)
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W1509747563