The document describes a validation study conducted to evaluate avatar-based animations for portraying different levels of pain intensity in a nursing simulation. 10 nursing professionals rated 9 animated patient scenarios on a visual analog scale. Their ratings showed that the animations were generally perceived as portraying moderate pain levels and were consistent with the intended pain levels of 3, 6, and 9 on the scale. The participants' comments provided insight into the pain level ratings for each animation.

1. Valida&on
of
Avatar-­‐Based
Anima&ons
for
the
Development
of
a
Nursing
Simula&on

2. Authors
Enilda
Romero-­‐Hall,
Ph.D.
(@RomeroEnilda)
Assistant
Professor
The
University
of
Tampa
Ginger
S.
Watson,
Ph.D.
Associate
Professor
Old
Dominion
University
Yiannis
Papelis,
Ph.D.
Research
Professor
Virginia
Modeling,
Analysis
and
Simula@on
Center

3. Introduc&on
A
valida@on
study
was
conducted
to
corroborate
the
pain
rendering
of
animated
agents
in
a
3D
simula@on
focusing
on
pain
management.
Pain
Rendering
=
Emo&on
Intensity
• body
movement
• verbal
communica@on
• behaviors

4. Visual
Analog
Scale

5. Pain
in
Pa&ents
Low
Emo@on
Intensity
-­‐ Pain
Score
3
The
behaviors:
-­‐ neutral
expression
-­‐ able
to
talk
normally

6. Pain
in
Pa&ents
Moderate
Emo@on
Intensity
-­‐ Pain
Score
6
The
behaviors:
-­‐ protec&ve
of
affected
area
-­‐ less
movement
-­‐ complaining
of
pain.

7. Pain
in
Pa&ents
High
Emo@on
Intensity
-­‐ Pain
Score
9
The
behaviors:
-­‐ restless
unseRled
-­‐ complains
about
lots
of
pain
-­‐ cries
inconsolably.

8. Forma&ve
Evalua&on
Research
The
valida@on
study
was
part
of
a
forma@ve
evalua@on
to
assess
the
effec@veness
of
the
scenarios
prior
to
the
use
of
the
nursing
simula@on.
Since
the
simula@on
was
available
through
web-­‐
based
3D
soMware,
the
valida@on
process
was
conducted
using
the
Internet.

9. METHODS

10. Par&cipants
Total
of
10
nursing
professionals
20%
80%
Gender
Males
Females

11. Par&cipants
10%
10%
50%
30%
Age
Groups
Age
(25
-­‐
34)
Age
(35
-­‐
44)
Age
(45
-­‐
54)
Age
(55
-­‐
64)
Total
of
10
nursing
professionals

12. Par&cipants
70%
30%
Status
Full-­‐Time
Part-­‐Time
Total
of
10
nursing
professionals

13. Par&cipants
30%
50%
10%
10%
Rank
Registered
Nurse
Advance
Prac@ce
Nurse
Pain
Consultant
Graduate
Nursing
Student
Total
of
10
nursing
professionals

14. Par&cipants
90%
10%
Years
of
Clinical
Experience
Years
(3
or
more)
Years
(1to
2)
Total
of
10
nursing
professionals

15. Par&cipants
90%
10%
Experience
with
Pain
Assessment
and
Management
Experts
Novice
Total
of
10
nursing
professionals

16. Materials
Nine
simulated
pa@ent
anima@ons
with
different
pain
intensity
levels
were
presented
through
a
web-­‐based
interface.

17. Instruments
A
visual
analog
scale
was
used
to
rate
the
pain
level
portrayed
by
the
animated
agent
in
each
anima@on
and
to
explain
the
observed
cues
that
lead
to
this
ra@ng.

18. Procedure
The
email
included:
• detailed
instruc@ons
• a
link
to
the
anima@ons
• a
link
to
the
visual
analog
scale
(VAS)
instrument
Par@cipants
were
asked
to:
• Read
the
instruc@ons
provided
in
the
email
• Interact
with
the
nine
simulated
pa@ent
anima@ons
• Select
the
VAS
ra@ng
the
observed
pain
• Answer
the
open-­‐ended
ques@on

19. Procedure
Web
Interface:
Nursing
Scenario
Valida@on

20. Results
The
ra@ngs
for
each
anima@on
were
evaluated
using
the
average
ra@ng
across
all
responses.

21. Results
Scene1
6.30
Scene2
5.60
Scene3
6.00
Three
videos
with
an
animated
agent
portraying
a
pain
level
equal
to
3
(VAS)
Average
for
the
Videos
=
5.97

22. Results
Scene4
4.71
Scene5
5.33
Scene6
6.33
Three
videos
with
an
animated
agent
portraying
a
pain
level
equal
to
6
(VAS)
Average
for
the
Videos
=
5.45

23. Results
Scene7
6.13
Scene8
6.13
Scene9
5.89
Three
videos
with
an
animated
agent
portraying
a
pain
level
equal
to
9
(VAS)
Average
for
the
Videos
=
6.05

24. Results
Videos:
• None
were
given
very
low
or
high
pain
level
ra@ng
• In
their
majority
were
rated
as
moderate
pain
level
The
comments
provided
by
the
par@cipants
shed
light
on
the
results
for
each
video
anima@on

25. Comments
(Pain
Level
3)
“If
this
was
a
non-­‐verbal/non-­‐English
speaking
pa@ent
and
you
were
looking
for
facial
cues-­‐
I
would
need
to
see
facial
grimace.”
“Very
short
scene!
only
6
seconds!”
“Very
difficult
to
say.
He
is
clearly
uncomfortable.
I
would
need
to
ask
the
pa&ent
a
few
more
ques&ons.”

26. Comments
(Pain
Level
6)
“Unable
to
assess-­‐
‘no
not
really’
means
what?
Is
it
an
answer
to
a
ques&on?”
“Too
short
scene,
it
is
not
realis&c.
For
pain
observa@on
you
do
have
more
than
6
seconds!
I
rated
a
7
but
I
should
not
know
why”

27. Comments
(Pain
Level
9)
“Frustra&on
expressed
but
he
s@ll
has
guarding
body
movements”
“Looking
for
service
-­‐
But
difficult
to
assess
pain”
“Again
a
too
short
scene,
not
as
in
prac&ce!”

28. Discussion
Modifica@ons
and
improvements
were
made
to
the
nursing
simula@on
based
on
the
input
from
the
nursing
professionals.

29. QUESTIONS
OR
COMMENTS
Email:
eromerohall@ut.edu
TwiRer:
@RomeroEnilda