Virtual Medical Worlds for Team Training (updated)

Virtual Reality for Team Training Parvati Dev, PhD, President Wm LeRoy Heinrichs, MD PhD, Exec Medical Officer Innovation in Learning Inc. http://www.InnovationinLearning.com/ Virtual world images and movies from our technology partner, Forterra Systems, unless noted otherwise.

What is a Virtual World?
It is an online environment, usually 3D
A ‘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 is populated with interactive objects
Objects include drugs, devices, computers, furniture.
It may include simulations
Such as virtual patients, with dynamic models of physiology
It may be game-like, have goal-oriented activities
Building and customization is a popular activity

‘Avatars’ in a 3D world Second Life Qwaq

Avatars controlled by learners or role players
Navigation in world is through the keypad or mouse
Headset supports in-world conversation

Avatar interaction A soldier returns home virtually to meet his family Physician/nurse consoling an injured child A movie icon indicates that the movie will be played on the next slide

Virtual Hospital (Begun at Stanford University SUMMIT, and continued as a collaboration between Innovation in Learning and Forterra Systems)

Urban and Emergency Scenes

In-hospital multi-bay Emergency Department room Photo-inspired Virtual 3D Environment – – – Photos taken in Adult ED at Stanford University Medical Center July 2006

Residents practicing triage

Nurse shift change

High school students practicing CPR scenarios A collaboration of the Karolinska Institutet, Stockholm, Forterra Systems Inc, and Stanford University

The Virtual Medical Environment and its user interface

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

Virtual Trauma Patient – under the hood

A Dynamic Model of Patient Physiology

Virtual Patients currently available from IIL
Trauma, hemorrhage and hypovolemic shock
Dynamic model of physiology
Implemented as licensable software module and as a web demo
Generates almost an infinite variety of patients
12 specific scenarios developed by us using this physiology
Implemented by Forterra Systems in a Virtual Hospital
Aphyxiation, nerve toxins, anaphylactic shock
Available as a written set of rules
10 specific scenarios developed by us using this physiology
Implemented by Forterra Systems in a Virtual Hospital
Infection, sepsis
Available as a written set of rules

Controlled Trial Study of Learning Efficacy

Study design and subjects
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
4th year medical students or 1st year residents
Control group learnt with HPS manikin
N=15
Intervention group used Virtual ED
N = 16

Managing trauma with HPS manikin

Managing Trauma in the Virtual Emergency Room

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)

Roles Role player Learner Facilitator

Performance measurement using principles of EMCRM (Emergency Medicine Crew 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

A debrief session

EMCRM 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

Results of our other studies using Virtual Worlds (Stanford Hospital and San Mateo General Hospital)

Lessons from our studies
Multiplayer virtual worlds are effective learning environments for individuals in a team.
They are also effective in teaching confidence in dealing with unexpected situations such as CBRNE.
The studies applied to trauma management. They should be extended to other medical situations.
Individual performance assessment instruments need to be augmented to include team performance.
Learners like these simulated but authentic learning scenarios and would welcome their inclusion in their curricula.

Innovation in Learning
We build individual and team expertise
through Immersive Role-playing Experiences
in Virtual Worlds
Products:
Virtual Patients with Medical Models
Virtual Hospitals and Clinics
Services:
Training & Workshops
Curriculum & Content

Thank you for your attention ! http://www.InnovationInLearning.com/ Innovation in Learning Inc. 12600 Roble Ladera Rd Los Altos Hills, CA 94022 [email_address] 650-208-8142
Research and prototype development funded by:
TATRC (USAMRMC)
Wallenberg Foundation
Forterra Systems Inc.
Innovation in Learning Inc.

Innovation in Learning Inc. 12600 Roble Ladera Rd Los Altos Hills, CA 94022 [email_address] 650-208-8142

Virtual Medical Worlds for Team Training (updated)

by Parvati Dev on Jul 24, 2009

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