The goal of this clinical simulation study is to learn if a "Digital Twin" graphical lung display reduce the mental workload of clinicians. The study also evaluates if this helps physicians diagnose and manage ventilator-related crises more effectively than standard ventilator screens.
The main questions it aims to answer are:
Does the Digital Twin display lower the cognitive stress (mental workload) experienced by clinicians during a crisis? Does the Digital Twin display reduce the time it takes for clinicians to identify specific respiratory complications? Does the use of real-time physiological visualization improve the accuracy of clinical decision-making? Researchers will compare the performance of clinicians using a standard ventilator display (the "Black Box" condition) to their performance when provided with an additional synchronized 3D lung and advanced waveform display (the "Digital Twin" condition).
Participants will:
Complete four randomized mechanical ventilation crisis scenarios using a high-fidelity lung simulator (ASL 5000).
Manage scenarios involving high airway resistance, low lung compliance, auto-PEEP, and patient-ventilator asynchrony.
Undergo a 14-day "washout" period between sessions to ensure no memory bias between the control and intervention groups.
Complete a NASA-TLX survey after each scenario to measure their perceived mental, physical, and temporal demand.
Licensed physicians currently practicing in intensive care units (ICU), neuro-intensive care units (NICU), or respiratory departments.
For the Junior Stratum: Physicians currently in a standardized residency training program or in their first two years of a sub-specialty fellowship. For the Senior Stratum: Senior attending physicians or senior fellows with more than 5 years of experience in intensive care medicine.
Basic proficiency in operating the mechanical ventilators used in the study (e.g., Hamilton, Dräger, or Puritan Bennett).
Willingness to participate in two simulation sessions separated by a 14-day interval.
Prior formal training or significant experience using the ASL 5000 / RespiSim "Digital Twin" or Aurora interface.
Physical limitations that prevent the operation of a mechanical ventilator or the viewing of a digital monitor.
Refusal to provide informed consent for video recording of the simulation session for data adjudication.
Crossover
Real-time Graphical Lung Function Visualization (Digital Twin)
DeviceThis intervention consists of a high-fidelity graphical display that translates raw simulator data into synchronized 3D animations and advanced physiological waveforms. It provides continuous visualization of, Muscle Pressure (Pmus), and the Equation of Motion components (Resistive vs. Elastic pressure) to assist in clinical diagnosis.
Standard Ventilator Waveform Monitoring
Other interventionThis intervention represents the current standard of care in mechanical ventilation monitoring. Clinicians are limited to the pressure-time and flow-time waveforms provided by the mechanical ventilator interface. Diagnostic assessments of lung mechanics (Resistance and Compliance) must be performed using manual ventilator maneuvers, such as inspiratory and expiratory holds.
Perceived Mental Workload (NASA Task Load Index)
The total workload score as measured by the NASA Task Load Index (NASA-TLX). This validated tool assesses six dimensions: mental demand, physical demand, temporal demand, performance, effort, and frustration level. Each dimension is scored on a scale of 0 to 100. The weighted average provides a "Global Workload Score." Higher scores represent a higher perceived cognitive burden.
Time to Correct Diagnosis (Diagnostic Latency)
The duration (in seconds) from the initiation of a respiratory crisis (T=120s) until the participant accurately identifies the underlying pathophysiology (e.g., Bronchospasm, Atelectasis, Auto-PEEP, or Double Triggering). This is measured by an independent observer using a synchronized stopwatch. Lower times indicate higher diagnostic efficiency.
Diagnostic Accuracy Rate
The percentage of participants who correctly identify the respiratory complication within the allotted 10-minute scenario time. A diagnosis is marked "Correct" or "Incorrect" based on pre-defined criteria for each of the four scenarios.
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