Safe Prescribing and Use of Opioids April 10-12, 2012 Walt Disney World Swan Resort
Accepted Learning Objectives:1. Analyze current professional educationprograms on safe use of opioids and newprograms under development.2. Explain a potentially transformative on-lineeducational tool for health professionals thatenable them to train by interacting with “virtualpatients.”3. Describe a Massachusetts program for trainingphysicians on safe opioid prescribing, and thecurriculum developed to teach residentsand faculty.
Disclosure Statement• Drs. Daniel P. Alford and Sarah Ball have disclosed no relevant, real or apparent personal or professional financial relationships.• Dr. Benjamin Lok has disclosed that he has a relationship with Shadow Health, Inc.
Simulation-based training for health care providers on prescription drug abuse Benjamin Lok, Ph.D. Computer and Information Sciences and Engineering University of FloridaNational Prescription Drug Abuse Summit April 10-12th, 2012
Overview of talk Existing approaches Level of integration Costs and benefits New approaches What s coming down the pike Defining the direction of simulation (what does simulation look like in 5 years?) Goals: Identifying how you can benefit from simulation today Identifying your part in shaping the future of education
Current Computer Simulation Efforts Computer-based learning case studies Passive – multimedia presentation of information Image from Harvard Medical School Choose your own adventure
Current state of simulation Simulation wings UF-Jacksonville has dedicated 24,000 sq. ft. UF-Jacksonville 55 simulators Basic understanding of integration into curriculums [Huang 2007] Virtual patients Ad-hoc (26 of 108 schools building cases) Still images and video (83% of virtual patients) Expensive (each case $10,000- $50,000, 1-2 years to develop) Known education potential Compliments classrooms Human Patient Simulator – image from Samsun Lampotang
Current approaches have difficulty providing:• Sufficient opportunities for practice• Exposure to infrequent – yet critical – scenarios• Tailoring for each student• Standardization• Patient variability• Team-based learning• Cultural competency• Feedback
Addiction Management Challenges• Large scale deployment (40k+ learners)• Solution: virtual human simulation• Effective training using simulation – Track progress – Provide feedback – Implement protocols
Serious Games• Interactive training exercises• Using computer game engines and the Internet Image from Breakaway Ltd.
Can interacting with a virtualhuman make you a better person?Dr. Gregory House Derek Shepherd Dr. Doug RossGood with medical knowledge Good with medical knowledgeNot so good with interacting with people Good with interacting with people
Virtualpatientsgroup.com• 6 universities, 35 researchers, 8 years of VP research• Technologies to: – Create virtual patients – Deploy virtual patients• Enable – Curricular building and integration of training scenarios – Teaching and training with • Variety of scenarios • Variety of patients • After-action review systems• Looking for: Research partners
Deployment - Continuum of Experiences Immersive Interaction Virtual WorldsImmersion Video Conference Chat Web Browser Instant Message Mobile Deployment Images from www.virtualpatientsgroup.com Fidelity, Learning efficacy
Virtual People Factory• www.virtualpeoplefactory.com• Web-based interface to virtual humans• Deployed Early 2008 – 56 active developers – 2700 users – 105,000 utterances Opiod patient
Mobile Distribution of Simulation Deploy simulations via mobile platforms Android app, released December 2010, over 4600 downloads In Android Market, search for Virtual Patient Image from www.virtualpatientsgroup.com
Repositories• MedEdPORTAL – Peer reviewed medical education resource• 400 institution downloads in 10 months
NERVE: The Neurological Examination Rehearsal Virtual• Environment Virtual multi-tool interface – Playstation Move controls multiple virtual tools – Gestural and tool input, in addition to speech• Medical students – Learn how to use neurological tests to diagnose a patient with a vision disorder – Receive additional exposure to patients with abnormal findings (Cranial Nerve 2,3,4,5,6,7,12)
After-Action Review by Students• IPSViz – Web-based interface – Students received email with link (automated) – Sample student (10158/00000) – Self-directed review of content, video, and feedback• Each student can review their performance and compare with experts
After-Action Review by Educators• IPSVizn – Web-based interface – Educators can review completed student interactions – Data from study – Filter based on user background • Level of expertise • Gender • Educator-defined metrics• Experts can – Identify trends (mean of class) – Identify outliers
Physical Examinations of Virtual Human Patients• Mixed reality humans – Passive-haptic interface to life-sized virtual human – Applications • Clinical breast exam • Prostate Exam• Students can – Practice physical examination and communication skill sets – Get real-time feedback of exam performance • Coverage • Pressure • Conversation topics
Getting Involved Now (<6 months) Use systems to create web-deployable cases Case study-based Adaptive raining – could branch depending on trainee s selections Example: http://www.md-inc.com/Products/product_details.cfm? mm=2&sm=4027&courseno=172 Near term (<2 years) Work with developers to create interactive virtual patients Different levels of fidelity Requires funding More interactive Long term (3 years+) Coordinated teaching/training/testing using simulation Valid and reliable training materials Work with professional, licensing, continuing education groups
Demo of Creating Virtual Patient• www.virtualpatientsgroup.com
Thank You!Build virtual patients: www.virtualpatientsgroup.comContact: firstname.lastname@example.orgSupport: National Science Foundation and National Institutes ofHealth