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.

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Healthcare Training with SImulation

  1. 1. Online Virtual Environments for Healthcare Professionals’ Training<br />Parvati Dev, PhD<br />CEO, CliniSpace<br />
  2. 2. Virtual Environments<br />3D<br /> Networked<br /> Multi-person<br />World of Warcraft<br /> Second Life<br /> Open Sim, Avaya, OLIVE, VastPark ……..<br />CliniSpace<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />2<br />
  3. 3. The problem we want to address<br />Issues of Patient Safety and Healthcare Quality<br />which increase Healthcare costs<br />Method<br />Immersive Training<br />
  4. 4. Example: Training for patient safety<br />The cost of medical errors is huge<br />$22-38B (source: AHRQ)<br />Prevention requires systemic change through training<br />An example – Septicemia<br />2% of hospital discharges in the U.S. include septicemia<br />Average charge is > $60,000 per case<br />One case prevented can pay for the training<br />This training is difficult, requires emotional engagement<br />Role playing is emotionally engaging<br />Virtual medical spaces are very effective role playing environments<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />4<br />
  5. 5. Training is expensive<br />Onboarding a new hire - $60,000 and 6 months<br />Cost of lost supervisory time<br />Cost of inefficient trainee time<br />Training is apprentice-based and opportunistic<br />What if training was like being in a live hospital<br /><ul><li>But every case gave useful learning
  6. 6. And training was completed in 2 months</li></ul>Potential savings<br /> $40,000 and 4 months per trainee<br />
  7. 7. CliniSpace<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />6<br />Virtual Learning Environments<br />
  8. 8. CliniSpace<br />An immersive, collaborative, online environment that represents authentic medical spaces<br />Dynamic patient and interactive medical objects in a navigable 3D space<br />Enables team training in a simulated ED or ICU<br />Remote collaboration with team members in-world<br />Creates safe and effective learning opportunities for critical events AND routine care<br />Clinical decision making (minimize cognitive error)<br />Communication skills (error prevention strategies)<br />Medical protocols (ACLS, BLS)<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />7<br />
  9. 9. What makes up amulti-uservirtual environment?<br />
  10. 10. Tracking and Performance Assessment<br /> from database<br />Manual Assessment<br />Mentor / Guide<br />Scenarios based on Curriculum<br />Virtual Patients w physiology<br />3D Building<br />ED, ward, exam room, clinic<br />Medical Objects with functionality<br />Virtual Role Players<br />Real Role Players<br />Virtual World Platform<br />
  11. 11. The Components<br />Virtual Patients w physiology<br />3D Building<br />ED, ward, exam room, clinic<br />Medical Objects with functionality<br />Virtual Role Players<br />Real Role Players<br />Virtual World Platform<br />
  12. 12. CliniSpace Environments<br />CliniSpace™<br />Conference Room<br />Reception<br />Intensive Care<br />Emergency Care<br />Urgent Care<br />Ward<br />Medical Clinic<br />
  13. 13. We can represent any space<br />
  14. 14. The patient and environment interact<br />Some variables are observed <br /> monitor, hematology report <br />Some variables are affected by actions in the environment <br />saline drip replenishes blood fluid volume<br />antibiotic reduces circulating cytokines and causes the body temperature to drop<br />Variables also affect the patient <br />patient appearance (bleeding, pallor, rash) <br />actions (vomiting, coughing)<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />13<br />
  15. 15. Medical objects<br />
  16. 16. Medical objects<br />
  17. 17.
  18. 18. Blood<br />volume<br />Blood<br />pressure<br />Heart<br />rate<br />Oxygen<br />saturation<br />Respiratory<br />rate<br />Bleeding<br />
  19. 19.
  20. 20. Virtual Role Players<br />
  21. 21. Real Role Player<br />
  22. 22. Scenarios based on Curriculum<br />Mentor / Guide<br />Virtual Patients w physiology<br />3D Building<br />ED, ward, exam room, clinic<br />Medical Objects with functionality<br />Virtual Role Players<br />Real Role Players<br />Virtual World Platform<br />
  23. 23. Scenario<br />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.<br />[RN: I think you should come and see this guy pretty soon]<br />MD: Yes, I would like you to give Mr. Appleberry 1-2 of Morphine and order the following: CBC, Chem 8, UA and KUB<br />[Note: MD/confederate can prompt or just give the order to the learner if no recommendation is given]<br />RN: Dr. Smith let me repeat and clarify your orders.<br />
  24. 24. Mentor / Guide<br />
  25. 25. Tracking and Performance Assessment<br /> from database<br />Manual Assessment<br />Scenarios based on Curriculum<br />Mentor / Guide<br />Virtual Patients w physiology<br />3D Building<br />ED, ward, exam room, clinic<br />Medical Objects with functionality<br />Virtual Role Players<br />Real Role Players<br />Virtual World Platform<br />
  26. 26.
  27. 27. Assessing Behavior<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />26<br />
  28. 28. Protocols and Checklists<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />27<br />
  29. 29. What can you do with avirtual environment?<br />
  30. 30. Patient Assessment in Nursing<br />Patient, post-op, after fracture has been set<br />Review the chart<br />Speak with patient<br />Do assessment<br />Decide on interventions<br />Physician orders (medications, other)<br />Patient safety issues<br />Patient comfort issues<br />Write up notes<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />29<br />– with feedback layer<br />– with game layer<br />
  31. 31. Advanced Nursing Scenarios<br />Procedure scenarios<br />Multi-tasking<br />Dealing with distractions<br />Communication scenarios<br />Based on accepted guidelines – TeamSTEPPS<br />Close the communication loop; use names<br />Clarification and check back<br />Raising concerns through a hierarchy<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />30<br />
  32. 32. IHI – Learning safety ‘bundles’<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />31<br />Technology<br />Assessment<br />
  33. 33. Learning rules for patient safety<br />Number of safety items checked<br />Number identified accurately as correct or incorrect implementation<br />Understanding of safety issues as identified through discussion<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />32<br />
  34. 34. Assessment items<br />Multi-player<br />Learner<br />Rest of team<br />Discussion of evidence<br />30+ bundles<br />Game?<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />33<br />
  35. 35. Faculty authoring<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />34<br />
  36. 36. Learning medical billing codes<br />Number of accurately coded notes<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />35<br />
  37. 37. HPS VED<br /> HPS VED<br />The Data Show . . . <br />Pre-test Values Post-test Values<br />60<br />50<br />40<br />30<br />20<br />10<br /> 0<br />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<br />
  38. 38. Current and near future uses<br />Virtual Medical Center<br />In negotiation<br />Practising communication<br />Nurse to physician<br />Practising assessment of patient<br />Nursing<br />Managing sepsis<br />Under development<br />Learning billing codes<br />100,000 members in organization<br />Learning safety protocols<br />Under evaluation<br />Learning medical Spanish<br />Research project<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />37<br />
  39. 39. Thank you & questions<br />IIL slides are on SlideShare.<br /> Search for ‘parvatidev’ or ‘clinispace’<br />Emailmeat<br />parvati@clinispace.com<br />© 2011 IIL Inc.<br />GameTech 2011 at Orlando<br />38<br />

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