Virtual Reality for Team Training Parvati Dev Innovation in Learning Inc. http://www.InnovationinLearning.com/

What is a Virtual World? It is an online environment, usually 3D Each ‘player’ is represented by an ‘avatar’ in the world You see other people as their avatars. Use voice or text chat It is immersive You have a sense of ‘presence’ or ‘being there’ It is social. You talk with others and interact with them. It may be game-like, have goal-oriented activities, or not. Building and customization is a popular activity

It is an online environment, usually 3D

Each ‘player’ is represented by an ‘avatar’ in the world

You see other people as their avatars. Use voice or text chat

It is immersive

You have a sense of ‘presence’ or ‘being there’

It is social.

You talk with others and interact with them.

It may be game-like, have goal-oriented activities, or not.

Building and customization is a popular activity

My ‘Avatar’ in a 3D world

A conference in a Virtual World

Schizophrenic hallucination in Univ. of California, Davis, world

Hallucinating disappearance of the floor

Businesses open in Virtual Worlds

Hospital Emergency Department A Stanford University - Forterra Systems collaboration

Ambulance arrives

Patients to be triaged to - Immediate, Delayed and Minor

ED Multi-bay Treatment Room Photo-inspired Virtual 3D Environment – – – Photos taken in Adult ED at Stanford University Medical Center July 2006

Team managing patient in ED

Avatar Health Visualization Graphical User Interface Diagnostic Display Images and Text 3D Patient Avatar

Mr. Brooks, Are You OK? A Virtual World developed as a collaboration of the Karolinska Institutet, Stockholm, Forterra Systems Inc, and Stanford University See video at http://forterrainc.com/index.php/resources/screens-a-video/99-high-school-cpr-wm

Clinical Scenarios for Virtual ED Male: pneumothorax and femur fracture after auto collision Male; bicycle rider falls from bike path, suffers spleen rupture Male; car driver, hypoglycemia and femur fracture Male; ethanol induced fall, with head injury, obstructed airway Female;(2 nd trimester pregnancy); with renal laceration after auto collision Male; construction worker fall, liver rupture, fracture of femur Male: construction worker, flail chest and dislocated shoulder Male: bicycle rider with severe hand and abdominal injury after auto collision and being ‘run-over’ Female; elderly pedestrian with facial fractures and unconsciousness after auto collision. Female (3 rd trimester pregnancy); auto collision with femoral neck fracture, and vaginal bleeding (placental abruption)

Male: pneumothorax and femur fracture after auto collision

Male; bicycle rider falls from bike path, suffers spleen rupture

Male; car driver, hypoglycemia and femur fracture

Male; ethanol induced fall, with head injury, obstructed airway

Female;(2 nd trimester pregnancy); with renal laceration after auto collision

Male; construction worker fall, liver rupture, fracture of femur

Male: construction worker, flail chest and dislocated shoulder

Male: bicycle rider with severe hand and abdominal injury after auto collision and being ‘run-over’

Female; elderly pedestrian with facial fractures and unconsciousness after auto collision.

Female (3 rd trimester pregnancy); auto collision with femoral neck fracture, and vaginal bleeding (placental abruption)

In the Virtual Emergency Room

Roles Role player Learner Facilitator

Principles of EMCRM (Emergency Medicine Crisis Resource Management) Know your environment Anticipate and plan for crises Assume a leadership role Communicate effectively with other team members Call for help early enough Distribute workload optimally Allocate attention wisely Utilize all available resources Utilize all available information Maintain a professional behavior

Know your environment

Anticipate and plan for crises

Assume a leadership role

Communicate effectively with other team members

Call for help early enough

Distribute workload optimally

Allocate attention wisely

Utilize all available resources

Utilize all available information

Maintain a professional behavior

A debrief session

Team training study Explain interface and goals Pre-test with trauma scenario (no debrief) Score with EMCRM rating sheet Four learning scenarios (trauma), with debrief Post-test with trauma scenario Score with EMCRM rating sheet

Explain interface and goals

Pre-test with trauma scenario (no debrief)

Score with EMCRM rating sheet

Four learning scenarios (trauma), with debrief

Post-test with trauma scenario

Score with EMCRM rating sheet

Managing trauma with a manikin

Performance scores N=15 N=16 0.00 10.00 20.00 30.00 40.00 50.00 HPS Group Pretest Sum Scores Posttest Sum Scores Pretest Sum Scores Posttest Sum Scores Virtual ED Group

Conclusion Multiplayer virtual worlds are effective learning environments for individuals in a team. This study applied to trauma management. It should be extended to other medical situations. Scenarios and performance scores should be developed for individuals, teams, and departments with multiple interacting teams. We need to understand which knowledge, skills and attitudes are taught best in virtual environments, in physical simulations and in the real ward.

Multiplayer virtual worlds are effective learning environments for individuals in a team.

This study applied to trauma management. It should be extended to other medical situations.

Scenarios and performance scores should be developed for individuals, teams, and departments with multiple interacting teams.

We need to understand which knowledge, skills and attitudes are taught best in virtual environments, in physical simulations and in the real ward.

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