Dissertation Results Example: Cloud-based ECG Simulation Tool for Educational Purpose

ABSTRACT: Sudden Cardiac Death (SCD) considerably attributed to sustained ventricular arrhythmias, is one of the leading causes of death for both men and women globally. Electrocardiogram (ECG) is believed to play a pivotal role in saving lives and remains an essential clinical tool and a symbol of cardiac electrophysiology for the detection of dangerous heart conditions and various cardiac diseases. From an educational perspective, the experience required for students and participants to learn and interpret ECG signals demands the adoption of learning styles that goes beyond traditional didactic teaching. A well-designed simulation relies heavily on interactive, multiple intelligences and learner-centred approach, in contrast to traditional teaching which depends on rote memorization. We developed an interactive ECG Simulation tool supported by a social network for educational purposes. It is an extend to our previous work in this direction and to the best of our knowledge, none of the previous studies gave a similar view about how to take advantage of Cloud Computing and Social Network techniques to enhance the education of ECG for healthcare students and participants. In order to achieve the overall aim of this work, we carried out three studies, in which quantitative and qualitative methods were used. The first study targeted the healthcare instructors, practitioners. The second study targeted ECG students. In the third study, an online social network was designed to share and transfer knowledge between instructors and students, the direct feedback was received from the users and many comments were taken for future enhancement.

KEYWORDS: ECG simulation, Education tool, Cloud computing, Social network

Study Design

In order to achieve the overall aim of this project, we carried out three studies, in which quantitative and qualitative methods were used. The first study targeted the healthcare instructors, practitioners. The second study targeted ECG students. Two questioners were designed and used to investigate how the instructors, practitioners and students experienced the developed simulation tool fidelity and usability levels and whether this tool could influence their perceptions and educational level. In the third study, an online social network were designed to share and transfer knowledge between instructors and students , the direct feedback was received from the users and many comments were taken for future enhancement. Overview of designs and methods are shown in Table 1.

Table 1 Overview of study design

Study Design

Participants

Data collection

I Quantitative study

11 instructors and practitioners Questionnaires

II Quantitative study 17 healthcare students Questionnaires

III Evaluation study 30 users Participant feedback

ParticipantsInstructors and practitioner

The sample (N = 11) consisted of questioner completed by instructors and practitioner at King Saud University in the Kingdom of Saudi Arabia. Data were collected in the period from May to June 2016. Participants were either Instructors or practitioner were asked to evaluate the tool and answer to the online Questionnaire. The inclusion criteria for the answers were: 1) participation should indicate their educational level as a way to divide them according to degree held, and 2) participants should be 25 years or older.

Students

The participant students in this project were invited to participate in our study. All the students (N=17) are from bachelor healthcare program at King Saud University in Kingdom of Saudi Arabia.

Study I: Instructor/Practitioner Questionnaire (IPQ)A total of 16 items (Table 2) assess the specialists attitudes and opinion toward the developed simulation tool and the educational social network for learning and teaching ECG. The Simulation Accuracy subscale contains four items measuring the correctness, accuracy, quality and benefits of the developed tool. The Attention subscale contains six items measuring the overall characteristics of our tool that help the user keep attention and continuously use the simulation tool and the social network for educational proposes. The Relevance subscale contains three items to indicate whether the content of the simulation tool is related to the participants knowledge and skills. And finally, the Confidence subscale contains three items measuring the overall confidence of the user and the easiness of the developed tool.

For each item, participants indicated their personal feelings about a statement that described their own attitudes or beliefs. Response options were 1) strongly disagree, 2) disagree, 3) undecided, 4) agree, and 5) strongly agree using a five-point Likert-style scale. Cronbach's alpha is used to test the internal consistency of the questionnaires, it has been reported as 0.89 for the simulation accuracy subscale, 0.84 for attention subscale, 0.84 for relevance subscale and 0.86 for confidence subscale. Scores are calculated by summing responses; higher scores indicate simulation accuracy and confidence, respectively. Instructors and practitioners questioner items and their associated mean and standard deviation are shown in Table 2.

Table 2 Instructors and practitioners questioner No. Items Mean SD

1. Simulation accuracy

1.1. ECG Simulation tool are with high quality and provide a enough description 4.36 .674

1.2. ECG social network is with high benefit and provide a good communication chances 4.64 .674

1.3. The simulation tool offered a variety of ways in which to learn ECG 3.82 .874

1.4. ECG signals are clear and valid compared with real signal 4.36 .505

2. Attention

2.1. The interface design of the simulation tool and the social network is eye-catching 4.36 .674

2.2. The quality of the ECG waveforms helped to hold my attention 4.36 .674

2.3. I enjoyed using the tool and social network so much that I would like to continue using it to learn ECGF interpretation 4.36 .809

2.4. The way the information is arranged in the tool helped keep my attention 4.00 .775

2.5. I really enjoyed learning with the simulation tool and the social network 4.45 .688

2.6. I could relate the content of the tool to things I have seen in my real ECG interpretation 4.36 .674

3. Relevance

3.1. It is clear to me how the content of the simulation tool is related to what I already know 4.27 .786

3.2. There were examples that showed me how the simulation tool and the social network could be important to students in the learning setting 3.82 .874

3.3. The content of the tool is relevant to my interests 4.36 .809

4. Confidence

4.1. The simulation tool and social network were more easy to understand than I expect it 4.64 .505

4.2. The simulation tool had enough information to be understood and remembered for the important points 3.91 .539

4.3. The examples in the simulation tool and the social network were fair enough 3.82 1.250

Study II: Student Questionnaire (SQ)A total of 20 items assess students perceptions of Validity, Motivation, Educational experience and Usability in the developed ECG simulation and its social network. The Validity subscale contains four items measuring the simulation quality, educational benefit and the level of descriptions and learning methods of the developed simulation system. The Motivation subscale contains three items measuring the motivation of student for using the simulation tool and its social network and how this tool could enhance their learning. The Educational experience subscale contains four items to indicate whether the simulation tool was a valuable learning experience, helpful and more productive for students, it also measure how the students feel that their interpretation skills are improved using this tool. Finally, the Usability subscale contains four items measuring the overall usability of the simulation tool and the developed social network. The response scale used is a five-point Likert-type rating scale, response options were 1) strongly disagree, 2) disagree, 3) undecided, 4) agree, and 5) strongly agree. The Cronbach's alpha revealed as 0.91 for validity subscale, 0.805 for motivation subscale, 0.874 for educational experience subscale and 0.850 for usability subscale. Scores are calculated by summing responses; higher scores indicate validity and educational experience, respectively. Students questioner items and their associated mean and standard deviation are shown in Table 3.

Table 3 Student Questionnaire No. Items Mean SD

1. Validity

1.1. ECG Simulation tool are with high quality and provide a enough description 4.765 .4372

1.2. ECG social network is with high benefit and provide a good communication chances 4.471 .5145

1.3. The simulation tool offered a variety of ways in which to learn ECG 4.294 .6860

1.4. ECG signals are clear and valid compared with real signal 4.588 .6183

2. Motivation

2.1. I was motived while using the ECG simulator and the social network 4.824 .3930

2.2. The objectives for the simulation experience were clear and easy to understand 4.412 .7952

2.3. The simulation tool and the social network would enhance my learning 4.471 .5145

3. Educational experience

3.1. Using the simulation tool was a valuable learning experience 4.588 .6183

3.2. ECG social network information are helpful and provide a complete description for the shared cases 4.353 .6063

3.3. The simulation tool and the social network developed my interpretation skills 4.412 .8703

3.4. Using simulation tool and the social network made my learning time more productive 4.588 1.0037

4. Usability 4.1. The simulation tool and the social network were easy to use for studying ECG interpretation 4.765 .5623

4.2. the simulation tool and the social network load time was fast 4.529 .7998

4.3. The simulation Tool and the social network overall navigation was easy 4.647 .4926

4.4. ECG simulation tool and the social network design colors were acceptable and made my interpretation easier 4.294 .9852

Study III: Online Social network feedbackAll the Participants were asked to use and create accounts in online social networks designed specifically to share and transfer knowledge between different users (Fig. 6). This network is complement addition to the ECG simulation tool. Seeking simplicity, we build the social network to be similar to Facebook site. Signing up is designed to be as easy as possible, where registration requires only the email address, name and password. About (30) accounts were created during the period from May to June 2016 and many posts were published by each user to test the system and its ability as a knowledge sharing environment. The social network offered a possibility to receive feedback and comments from the users.

Some of notable comments were as following: Very excellent tool for visual and social learners, Students must use this tool to facilitate learning ECG basics, my suggestion is to develop a mobile app that can provide the same benefits, more efforts are required to draw attention for the simulation tool, this could allow a wide range of students to use the system, using social network concept is a great idea due to its stimulation and attractions on people daily life.

RESULTS

We used commercially available statistical software SPSS to perform psychometric testing on the IPQ and SQ. Fig. 2 and 3 summarizes all the responses of Instructors, practitioners and students, which represents all the items in terms of responses frequencies.

The study sought to establish the various effect and impact Cloud-based ECG simulation tool for educational purpose. The respondents were asked to rate their levels of agreement with various statements on a scale of 1 5 where 1 was strongly disagree and 5 was strongly agree. The summary statistics o...