healthcare training with simulation

Online Virtual Environments for Healthcare Professionals’ Training

Parvati Dev, PhDCEO, CliniSpace

Virtual Environments

3DNetworked

Multi-person

World of WarcraftSecond 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 Qualitywhich 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 engagingVirtual medical spaces are very effective role playing

environments

© 2011 IIL Inc. GameTech 2011 at Orlando 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


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)


What makes up amulti-user

virtual environment?

Virtual World Platform

Virtual Patients w physiology

3D BuildingED, ward,

exam room, clinic

Medical Objects with functionality

Tracking and Performance Assessment

from database

Virtual Role Players

Real Role Players

Manual Assessment

Scenarios based on Curriculum Mentor / Guide




exam room, clinic



Real Role Players

The Components

CliniSpace Environments

CliniSpace™

Reception Conference Room

WardMedical Clinic Urgent Care

Intensive Care Emergency Care

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)


Medical objects

Bloodvolume

Bloodpressure

Heartrate

Oxygensaturation

Respiratoryrate

Bleeding

Real Role Player




exam room, clinic


Scenarios based on Curriculum


Real Role Players

Mentor / Guide

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




exam room, clinic


Scenarios based on Curriculum

Tracking and Performance Assessment

from database


Real Role Players

Manual Assessment

Mentor / Guide

Assessing Behavior


Protocols and Checklists


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


– with fe

edback layer

– with game la

yer

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


IHI – Learning safety ‘bundles’


Technology

Assessment

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


Assessment items

Multi-player– Learner– Rest of team

Discussion of evidence

30+ bundles– Game?


Faculty authoring


Learning medical billing codes

Number of accurately coded notes


Pre-test Values Post-test Values

60

50

40

30

20

10

0

HPS VED

HPS VED

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

The Data Show . . .

GameTech 2011 at Orlando 37

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.

THANK YOU & QUESTIONS

IIL slides are on SlideShare.Search for ‘parvatidev’ or ‘clinispace’

Email me [email protected]


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