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Healthcare Training with SImulation

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We need "flight simulators" for training in healthcare. This talk was presented to the Bio2Device group in the Silicon Valley / San Francisco Bay Area in August 2011.

We need "flight simulators" for training in healthcare. This talk was presented to the Bio2Device group in the Silicon Valley / San Francisco Bay Area in August 2011.

Published in: Health & Medicine, Business

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Transcript

  • 1. Online Virtual Environments for Healthcare Professionals’ Training
    Parvati Dev, PhD
    CEO, CliniSpace
  • 2. 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
  • 3. The problem we want to address
    Issues of Patient Safety and Healthcare Quality
    which increase Healthcare costs
    Method
    Immersive Training
  • 4. 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.
    GameTech 2011 at Orlando
    4
  • 5. 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
    • 6. And training was completed in 2 months
    Potential savings
    $40,000 and 4 months per trainee
  • 7. CliniSpace
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    6
    Virtual Learning Environments
  • 8. 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.
    GameTech 2011 at Orlando
    7
  • 9. What makes up amulti-uservirtual environment?
  • 10. 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
  • 11. The Components
    Virtual Patients w physiology
    3D Building
    ED, ward, exam room, clinic
    Medical Objects with functionality
    Virtual Role Players
    Real Role Players
    Virtual World Platform
  • 12. CliniSpace Environments
    CliniSpace™
    Conference Room
    Reception
    Intensive Care
    Emergency Care
    Urgent Care
    Ward
    Medical Clinic
  • 13. We can represent any space
  • 14. 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.
    GameTech 2011 at Orlando
    13
  • 15. Medical objects
  • 16. Medical objects
  • 17.
  • 18. Blood
    volume
    Blood
    pressure
    Heart
    rate
    Oxygen
    saturation
    Respiratory
    rate
    Bleeding
  • 19.
  • 20. Virtual Role Players
  • 21. Real Role Player
  • 22. Scenarios based on Curriculum
    Mentor / Guide
    Virtual Patients w physiology
    3D Building
    ED, ward, exam room, clinic
    Medical Objects with functionality
    Virtual Role Players
    Real Role Players
    Virtual World Platform
  • 23. 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.
  • 24. Mentor / Guide
  • 25. Tracking and Performance Assessment
    from database
    Manual Assessment
    Scenarios based on Curriculum
    Mentor / Guide
    Virtual Patients w physiology
    3D Building
    ED, ward, exam room, clinic
    Medical Objects with functionality
    Virtual Role Players
    Real Role Players
    Virtual World Platform
  • 26.
  • 27. Assessing Behavior
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    26
  • 28. Protocols and Checklists
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    27
  • 29. What can you do with avirtual environment?
  • 30. 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.
    GameTech 2011 at Orlando
    29
    – with feedback layer
    – with game layer
  • 31. 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.
    GameTech 2011 at Orlando
    30
  • 32. IHI – Learning safety ‘bundles’
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    31
    Technology
    Assessment
  • 33. 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.
    GameTech 2011 at Orlando
    32
  • 34. Assessment items
    Multi-player
    Learner
    Rest of team
    Discussion of evidence
    30+ bundles
    Game?
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    33
  • 35. Faculty authoring
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    34
  • 36. Learning medical billing codes
    Number of accurately coded notes
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    35
  • 37. 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
  • 38. 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.
    GameTech 2011 at Orlando
    37
  • 39. Thank you & questions
    IIL slides are on SlideShare.
    Search for ‘parvatidev’ or ‘clinispace’
    Emailmeat
    parvati@clinispace.com
    © 2011 IIL Inc.
    GameTech 2011 at Orlando
    38