Healthcare Training with SImulation

Online Virtual Environments for Healthcare Professionals’ Training
Parvati Dev, PhD
CEO, CliniSpace

Virtual Environments
3D
Networked
Multi-person
World of Warcraft
Second Life
Open Sim, Avaya, OLIVE, VastPark ……..
CliniSpace
© 2011 IIL Inc.
GameTech 2011 at Orlando
2

The problem we want to address
Issues of Patient Safety and Healthcare Quality
which increase Healthcare costs
Method
Immersive Training

Example: Training for patient safety
The cost of medical errors is huge
$22-38B (source: AHRQ)
Prevention requires systemic change through training
An example – Septicemia
2% of hospital discharges in the U.S. include septicemia
Average charge is > $60,000 per case
One case prevented can pay for the training
This training is difficult, requires emotional engagement
Role playing is emotionally engaging
Virtual medical spaces are very effective role playing environments
© 2011 IIL Inc.
4

Training is expensive
Onboarding a new hire - $60,000 and 6 months
Cost of lost supervisory time
Cost of inefficient trainee time
Training is apprentice-based and opportunistic
What if training was like being in a live hospital
But every case gave useful learning
And training was completed in 2 months
Potential savings
$40,000 and 4 months per trainee

CliniSpace
© 2011 IIL Inc.
6
Virtual Learning Environments

CliniSpace
An immersive, collaborative, online environment that represents authentic medical spaces
Dynamic patient and interactive medical objects in a navigable 3D space
Enables team training in a simulated ED or ICU
Remote collaboration with team members in-world
Creates safe and effective learning opportunities for critical events AND routine care
Clinical decision making (minimize cognitive error)
Communication skills (error prevention strategies)
Medical protocols (ACLS, BLS)
© 2011 IIL Inc.
7

What makes up amulti-uservirtual environment?

Tracking and Performance Assessment
from database
Manual Assessment
Mentor / Guide
Scenarios based on Curriculum
Virtual Patients w physiology
3D Building
ED, ward, exam room, clinic
Medical Objects with functionality
Virtual Role Players
Real Role Players
Virtual World Platform

The Components
3D Building
Real Role Players

CliniSpace Environments
CliniSpace™
Conference Room
Reception
Intensive Care
Emergency Care
Urgent Care
Ward
Medical Clinic

We can represent any space

The patient and environment interact
Some variables are observed
monitor, hematology report
Some variables are affected by actions in the environment
saline drip replenishes blood fluid volume
antibiotic reduces circulating cytokines and causes the body temperature to drop
Variables also affect the patient
patient appearance (bleeding, pallor, rash)
actions (vomiting, coughing)
© 2011 IIL Inc.
13

Medical objects

Blood
volume
Blood
pressure
Heart
rate
Oxygen
saturation
Respiratory
rate
Bleeding

Real Role Player

Mentor / Guide
3D Building
Real Role Players

Scenario
RN: Dr. Smith, do you think it would be appropriate to give Mr. Appleberry some pain medication and put in orders for labs and diagnostics.
[RN: I think you should come and see this guy pretty soon]
MD: Yes, I would like you to give Mr. Appleberry 1-2 of Morphine and order the following: CBC, Chem 8, UA and KUB
[Note: MD/confederate can prompt or just give the order to the learner if no recommendation is given]
RN: Dr. Smith let me repeat and clarify your orders.

Mentor / Guide

Tracking and Performance Assessment
from database
Manual Assessment
Mentor / Guide
3D Building
Real Role Players

Assessing Behavior
© 2011 IIL Inc.
26

Protocols and Checklists
© 2011 IIL Inc.
27

What can you do with avirtual environment?

Patient Assessment in Nursing
Patient, post-op, after fracture has been set
Review the chart
Speak with patient
Do assessment
Decide on interventions
Physician orders (medications, other)
Patient safety issues
Patient comfort issues
Write up notes
© 2011 IIL Inc.
29
– with feedback layer
– with game layer

Advanced Nursing Scenarios
Procedure scenarios
Multi-tasking
Dealing with distractions
Communication scenarios
Based on accepted guidelines – TeamSTEPPS
Close the communication loop; use names
Clarification and check back
Raising concerns through a hierarchy
© 2011 IIL Inc.
30

Learning rules for patient safety
Number of safety items checked
Number identified accurately as correct or incorrect implementation
Understanding of safety issues as identified through discussion
© 2011 IIL Inc.
32

HPS VED
HPS VED
The Data Show . . .
Pre-test Values Post-test Values
60
50
40
30
20
10
0
Comparison of Team Leadership Before and After Practicing Four Resuscitation Scenarios on a Human Patient Simulator (HPS) or in an Online, Virtual Emergency Department (VED) with Virtual Patients

Current and near future uses
Virtual Medical Center
In negotiation
Practising communication
Nurse to physician
Practising assessment of patient
Nursing
Managing sepsis
Under development
Learning billing codes
100,000 members in organization
Learning safety protocols
Under evaluation
Learning medical Spanish
Research project
© 2011 IIL Inc.
37

Thank you & questions
IIL slides are on SlideShare.
Search for ‘parvatidev’ or ‘clinispace’
Emailmeat
parvati@clinispace.com
© 2011 IIL Inc.
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Healthcare Training with SImulation

by Parvati Dev

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