Simulation for enhancing e-Learning environments: a software for teaching heart-lung interaction to medicine students

Heart-lung interaction must be analyzed while assisting patients with severe respiratory problems or with heart failure in intensive care unit. Such patients can be assisted by mechanical ventilatory assistance or by thoracic artificial lung. This paper presents an e-Learning environment aiming at teaching the interaction of cardiovascular and lung systems to medical students. Such an environment was experimented during a training course given to students of the School of Specialization in Cardiology at the Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences held at 'Sapienza' University in Rome. The training course employed CARDIOSIM©, the numerical simulator of the cardiovascular system. Such simulator is able to reproduce pathophysiological conditions of patients affected by cardiovascular and/or lung disease. The simulator implements several different cardiovascular pumps in order to assist one or both ventricles in parallel or in series. Thoracic artificial lung assistance was applied in parallel and hybrid mode to show the different effects produced on left (right) ventricular end diastolic (systolic)volume, cardiac output, mean pulmonary arterial pressure, mean left atrial pressure, mean systemic venous pressure and the value of the area of coronary blood flow-aortic pressure loop (CBP-AoP). The results presented here are consistent with those presented in the literature. Finally, the paper discusses the benefit of employing a software simulator to enhance the performances of an e-Learning environment. We also believe that not only a simulation software, but also an ontology-based modelling of the relevant concepts involved in the e-Learning domain is a valid approach in order to reuse an environment in other domains or for other students' profiles (e.g. general practitioners, anesthesiologists, nurses).