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Many engineering staff in the Health Service, from craftsmen to professional engineers, enter from outside the service at varying stages in their careers and from a variety of previous employments. Whilst more is now being done in the way of basic training via a substantial craft apprenticeship scheme and an honours degree studentship scheme, it is likely that substantial outside recruitment will continue for the foreseeable future. The Health Service is not primarily an engineering organisation, engineering staff total only 10 000 out of a total of 800 000 employees and the main training effort is of course in the medical, para medical, and nursing fields. Thus the engineering side of the Health Service contains numbers of staff trained in their basic trade or profession, but lacking knowledge of areas specialised to the Health Service. Because of their diversity of backgrounds and the breadth of knowledge required in the Health Service there are also gaps in more basic knowledge. Also, given the pace of change in some technologies, updating is necessary for all staff.

Learner-centered interactions determine the look and feel of online courses, influencing the way learners experience them. In this chapter we investigate considerations related to three types of interactions: learner–content, learner–instructor, and learner–learner. Learners interact with content through the course structure and layout. They also interact with peers who may be cast in the role of community members, there to provide social support, or they may be more prominently cast as information providers and/or collaborators. The learner is at the center of both content and peer interactions. Instructor interactions set expectations for learners and facilitate learner interactions with content and peers. Instructors are instrumental forces in bringing about connections between learners, enabling the social presence necessary for collaboration. Instructor interaction may also be relational, enabling individualized connections between learners and the instructor. Redesign decisions center on creating a course structure that fits the learner and content and results in a satisfying course experience. We use the power of metaphor to bring into focus the most relevant considerations. In the end, we illustrate the redesign of a single course through the lens of three separate metaphors to demonstrate how metaphor shapes the process, bringing together design and interaction decisions to create unique and elegant course designs.

Incidents requiring command and control require all personnel from firefighters (FFs) to the incident commander (IC) to make continuous decisions often with limited information and under acute time-pressure. Therefore, the purpose of this paper is to explore the stress reactivity of specific roles during the command and control of an immersive, computer-based incident.

Experienced firefighting personnel undergoing incident command training participated in this study. Participants completed measures of state anxiety and stress immediately before and after taking part in a computer-based simulation of a large-scale incident run in real time. During the simulation personnel assumed one of four roles: IC, sector commander, entry control officer (ECO), and command support officer. Following the simulation personnel then completed measures of perceived workload.

No significant changes in state anxiety were observed, but levels of stress and perceived workload were related to task roles. Specifically, ICs reported the greatest levels of mental and temporal demands and stress when compared with ECOs.

Limitations include the lack of environmental factors (such as rain, darkness, and noise), a relatively small sample size, and the use of self-reported questionnaires.

The application of immersive training environments as a method of developing FFs experience of incident command roles and skills pertinent to high-acuity, low-frequency events.

The paper represents one of the first attempts to identify the self-reported anxiety, stress, and perceived workload of specific role demands during the command and control of simulated incidents.