Level 3 Healthcare Shares Impressive Portfolio of Simulation Center A/V Integration Projects

sim lab av integrators

Level 3 Healthcare, who were the platinum sponsors of the 2014 SimGHOSTS USA event, have updated their new website with some amazing shots of their impressive A/V integration portfolio. Having worked with them closely this year for SimGHOSTS and after touring their impressive integration work at the Cedars-Sinai Women’s Guild Simulation Center, I would highly recommend you add them to your contact list for all major sim lab A/V integration plans!

Zero Hour: First Responder Disaster Training ‘Serious Game’ Now Free

free ems disaster response training

Just received word that Zero Hour: America’s Medic Disaster Response Training Video game has been released free for download (PC only)!

About Zero Hour:

Released in May 2009, Zero Hour: America’s Medic is a first-person video game designed to train and exercise first responders to respond to mass casualty incidents such as earthquakes and terrorist attacks. Zero Hour was designed by George Washington University’s Office of Homeland Security and Virtual Heroes, Inc. on a grant from the Department of Homeland Security. Zero Hour is developed using Unreal Engine 3.

Zero Hour is intended for training and exercising of EMS response, but will also serve the EMS community as a recruiting tool. The scope of practice of the tools in the game are geared toward pre-hospital emergency medical service practitioners, especially paramedics.

Taking place in the fictional city of St. Lillo, the player begins each mission in an ambulance and receives calls from the EMS dispatcher. As the ambulance approaches the scene, the player sees the chaotic scene unfolding. The player chooses which equipment to bring and then acts in accordance with the unique requirements of the situation.

About Virtual Heroes From Their Website:

Virtual Heroes creates blended learning courseware by combining educationally sound and scientifically validated approaches in a robust, proven, production process. We create interactive learning architectures and content based on interoperable industry system standards.

We focus on delivering content in three formats:

  • Simulations for Learning: Representations of real life that accurately demonstrate a physical or simulated process or phenomenon.
  • Serious Games: Game technology used for other than purely entertainment purposes including education, training, strategic messaging, mission planning and rehearsal, marketing, scientific visualization etc.
  • Virtual Worlds: Computer-based, simulated 3D environments intended for many users to inhabit and interact with via avatars.

Our Advanced Learning Technologies leverage simulation and digital game-based learning paradigms to accelerate learning, increase user proficiency and reduce training costs. Powered by the award-winning Unreal Technology, our applications provide self-paced learning and instructor facilitated team training via our browser based GO platform and mobile devices.

Products Available:

  • Skins: Critical Thinking Assessment, Prevention and Treatment
  • HumanSim: Blast Prehospital Disaster Triage
  • HumanSim: Sedation & Airway
  • HumanSim: Zero Hour
  • HumanSim: Biotech
  • HumanSim: Combat Medic
  • Medical Team-based Training
  • Other military, space and anatomy games also available

Train with Zero Hour for Free here and learn more about Virtual Heroes and their many other simulation training games here!


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‘Hemoulage’ – A Review of TrueClot Blood Simulant by Will Enfinger

luna inc

With Halloween just around the corner we thought now would be a great time to review Luna Inc. ‘s TrueClot’s Blood Simulant. Simulation Technology Specialist Will Enfinger wrote this wonderful breakdown of this amazing product!

Let There Be… Simulated… Blood:

Welcome to the inaugural simulated blood-product series! My name is Will Enfinger, and I will be your guide on this magical journey through the myriad of products available to us as Simulation Professionals. I have a unique understanding of blood products, as my experience in simulation has required me to bring realism to combat medical training, OR scenarios, and traumatic mass casualty events. I have spilled many a gallon of blood in my quest to illicit realistic stares and flustering amongst participants.

Whether we call it “blood simulant”, “simulated blood”, or just “fake blood”, we all have a need for it at some point during simulation. We fill IV arms with it, pump it through the manikin, or create a trauma wound or scene. And let’s be honest: “concentrated blood” from the majority of manikin manufacturers looks like, well, Kool‑Aid.

While some simulation programs have great success with food coloring or manufacturer’s concentrated mixtures, others feel the need to step it up just a notch. Raise the bar. Add the next level of realism. Give students and learners a memorable experience. That’s where good fake blood comes into play. Hemoulage!

For the sake of this series, we are going to refer to these products as “simulated blood products” since the majority of sim programs will use them for bleeding wounds, scene creation, or realistic IV training and these events involve human whole blood (one of the blood products as recognized by the Red Cross). I will review four Key Elements for these products: Color; Viscosity; Washability; Bonus Traits.

The first product on our testing block is TrueClot™ Blood Simulant by Luna Inc. As you can imagine, the focus of simulated blood products is going to be trauma training and hemorrhage control. This is where realism plays a vital role in the development of skills and intestinal fortitude. According to the Luna website their product

“. . . is the most realistic blood simulant available today. Developed for training first responders in traumatic hemorrhage control, wound packing and the use of advanced hemostatic dressings, TrueClot™ Blood Simulant will form realistic simulated blood clots when used together with TrueClot™ Simulated Hemostatic Dressings and a suitable task trainer or manikin-based wound simulator. Moulage clots can also be created instantly by mixing TrueClot™ with our liquid Clotting Solution.

TrueClot™ accurately matches the color, opacity and flow characteristics of human blood. It is non-biological and non-hazardous, washes from skin and clothing with soap and water and is shelf-stable for six to twelve months. TrueClot™ Blood Simulant is available as a pre-mixed solution or as a concentrate designed to be diluted in water by the end user.”

I believe that is a challenge!

In the sample package I found instruction pages, a large bottle of TrueClot ™ Blood Simulant, a roll of TrueClot ™Simulated Hemostatic Gauze, and TrueClot ™Clotting Solution. The last two bits are intriguing, as shops are beginning to focus on ultra-fidelity with blood. Other than color and viscosity, what makes human blood so special? It clots. Interest piqued.

trueclot

COLOR: Red water is not realistic. Appearance is everything in simulated blood. Appearance consists of a combination of color and viscosity. If the color is wrong, we know it right away and the believability suffers.

The first thing I noticed about TrueClot ™ is the color. It is surprisingly realistic. Kind of like that shade of red just this side of I-stole-it-from-a-blood-bank. So far, off to a good start! Luna actually has an image online comparing TrueClot ™ with human blood for color. I was hard-pressed to tell the difference.

I opened the bottle and immediately poured some in my hand. It looked like I really hurt myself. I was impressed. It was extremely life-like and I immediately had a flashback to one of any number of times I have sliced my hand/finger open while cooking, carving things, or just being a boy.

Then I poured some onto our Testing Surface to see how it would fare in the next test . . .

trueclot2

VISCOSITY: Blood is not water-thin. Neither is it syrup-thick. On a smooth surface blood runs, but slowly. It splatters, but uniformly. Have you ever rubbed it between your fingers? It’s sticky. All of this is viscosity at work.

On the fingers, TrueClot ™ feels like water. On our Testing Surface (a laminated sheet) it beaded up and ran when tilted, just like water would. This is not a deal-breaker, but I began to have my doubts. Deduct one point from TrueClot ™. According to Luna Inc, TrueClot ™ can be used in a manikin. I haven’t gotten to that point yet, but I’ll update as soon as I do. With this thin viscosity it may be just fine. Spattered on the floor or manikin, it looked realistic despite the thinness of it.

Maybe some other properties will raise the score. . .

simulated blood clotting

WASHABILITY: This is The Number One Simulation Concern. I suppose the proper word here is “cleanability”, but the idea remains the same: will it wash off? Not just from skin (ours and our learners) but from clothing (again, ours and learners) and, most importantly, from the manikin. A little known fact: the color red stains more persistently than any other (we could debate about black Sharpie on a manikin’s skin or Red Dye #5 which is probably of the devil). My general rule: If it stains me, it will never come off the manikin.

I left the sample on the Testing Surface to dry for 24hrs, a sample on the manikin for 12hrs, and my skin for about 5 minutes. The interesting thing about TrueClot ™is that it doesn’t actually dry. This is a little strange to me. Luna sells a concentrated TrueClot ™product that reconstitutes with water and I can only assume this is the case here. Once the water evaporates we are left with a concentrate.

simulated blood stain

A purple, slimy concentrate.  All traces of “human blood” are now gone (See Image 3) on the Testing Surface.  On my skin, I actually had staining right away (when I first opened it I spilled some and washed up immediately).  But at the 5 minute mark, I was concerned.  Even with soap and warm water, per instructions, I had staining (Image 4).  It easily rinsed off of the Testing Surface with water alone, and I could see that it was reconstituted when the water touched the “dry” sample.  On the manikin, it was a nightmare.  Purple, deep-set stains that I couldn’t remove with soap, acetone, elbow grease — which was not a good sign for cleanup.

CLOTTING:

TrueClot ™ does clotting! The namesake of this product is one of the most incredible aspects of human blood. Our clotting factor keeps us from leaking like a sieve. Anyone who’s dealt with traumatic amputations, childbirth, or just simple lacerations can attest to the miracle of a little direct pressure (or a few shakes of a coagulant).

With the included TrueClot Simulated Hemostatic Gauze, a flow of TrueClot Blood Simulant will actually begin to clot in 30-60 seconds to facilitate the experience of hemorrhage control in a trauma or surgical setting. The addition of a Clotting Solution is even more impressive and more than makes up for the viscosity and washability issues. A ration of 5:1 Blood Simulant to Clotting Solution yields incredibly life-like, almost-instant, clots. So realistic, my co-worker (an experienced trauma/advanced care certified Paramedic) walked into my experiments and just stared. Pale. He turned around and walked out. Luna has a few amazing videos on their site demonstrating the clotting factor, and I really think it’s absolutely brilliant. The possibilities are frightening . . .

CONCLUSION:

So, in conclusion and in summary, Luna Inc.’s TrueClot ™Blood Simulant is a life-like simulated blood product with qualities that far surpass dyed water especially when it comes to educating about clotting, but there’s still a few things to be desired. If the staining isn’t a concern to you, be my guest and try it out.  But for the clotting factor, that is absolutely awesome! The price for this, and other simulated blood products, is not cheap.  You truly get what you pay for (about $50/gal of the pre-made solution), and while tempra paint can do in a pinch, it’s just not the same.

To learn more visit Luna’s TrueClot Webpage!

Stay tuned, my Hardcore Hemoulage Heads! More to come next month… If you have any questions or would like to know how a simulated blood product (can we call these things SBPs?) acts in certain situations, email me!

GoPro Unveils 4K Resolution Camera: Hero4

simulation cameras

GoPro, the makers of the world’s most popular HD personal camera, recently unveiled their Hero4 which records at an incredible 4K resolution. Why is this so important? Well, as we all know technology continues to evolve at a rapid pace and at this point, none of us would be comfortable watching our favorite shows on a black and white 6″ TV screen. Think about the resolution quality of DVDs at 720 pixels by 480 pixels which are almost phased out being replaced by BluRay. Contrast that with the resolution of 4K which is at an astounding 4096 pixels x 2160 pixels.

Look at the breakdown below at the difference between pixel ratios between various types of media. Our current high “standard” is 1080p HD which you will find on most new TV flatscreen TVs. Imagine four of those 1080p TVs together and then some packed into the same size screen – thats 4K!

4k-resolution simulation(Click photo for on-screen example)

What does this mean for healthcare simulation?

Consider being able to read the label on the simulated medication, or the tick mark on the syringe with the amount of medication to be administered. Or consider the level of detail surgeons will be able to work through with higher resolution screens for training. As advanced simulation attempts to mimic real experiences with the highest level of fidelity, recording and presenting those engagements to learners in the highest quality possible will always been an important element towards success. While this level of technology is not required to run medical simulations effectively, the trend to utilize the latest in a/v technologies will eventually make 4K the standard in healthcare — and that we can now do that with a personal camera like the GoPro Hero4 is a huge shift towards mass adoption of such technologies, which previously were extremely cost-prohibitive. Just like the first clinical manikins were!

About the Hero4 Black:

Introducing HERO4 Black, the most advanced GoPro ever. Featuring improved image quality and a 2x more powerful processor with 2x faster video frame rates,1 HERO4 Black takes Emmy® Award-winning GoPro performance to a whole new level. Incredible high-resolution 4K30 and 2.7K50 video and high frame rate 1080p120 video enable stunning, immersive footage of you and your world. New Protune™ settings for both photos and video unlock manual control of Color, ISO Limit, Exposure and more. Waterproof to 131’ (40m) with 12MP photos at a blistering 30 frames per second and improved audio,1 HERO4 Black is the ultimate life-capture solution.

Check out the latest GoPro video to see 4K in action. Note: To see the true potential of 4K, I suggest loading this video full screen and making sure the playback quality is set to 4K in the settings options located on the gear lowered right.


(Load this video in full screen and set 4K as the Quality)

Since the holidays are coming up, I know what’s going to be on my list for this year! Get your GoPro Hero4 Black through amazon today:

Does your sim program already utilize GoPro cameras? Email us and let us know all about it!


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New Adult Simulation Room Orientation for Clinical Simulation Center of Las Vegas Learners

video lab orientation

Looks like the wonderful team from my old stomping grounds, the Clinical Simulation Center of Las Vegas, have put together an updated orientation video for new learners to one of the adult simulation lab spaces. The tour was provided by Simulation Program Coordinator Rowena Saba and produced by Simulation Technology Specialist Jonathan Sturak. The CSCLV, which is a partnership of Nevada System of Higher Education schools including University of Nevada: Las Vegas School of Nursing, University of Nevada School of Medicine, and Nevada State College School of Nursing recently celebrated its 5-year anniversary! I hear the 31,000 sq.ft. facility is available to host events and is also providing simulation-based training activities for educators!

Such orientations are great ways to introduce the space to visual or auditory learners before they receive their physical orientation. This provides learners with additional opportunities to orient themselves to the process of simulation either remotely or before entering the lab — so that when simulation starts — they spend less time trying to remember where the oxygen masks are and more time focusing on patient care.

The CSCLV has produced many of such wonderful orientations and promotional videos for a variety of spaces and programs which have already been viewed over 110,000 times! Think about the cost savings of one-time productions vs providing all those tours with staff time! Learn more by reading our post on “Why Video Production Saves Your Sim Program Time & Money“.

Visit the CSCLV website media page for more great examples of simulation videos!

Looking to create your own video orientations? Check out my 2-part comprehensive post on “Basic Video Production Techniques”

Medical Simulation News From Around the World

simulation news

Here’s the latest news from Simulation Champions around the world:

Stay up to date with all the best medical simulation news and resources with our
FREE monthly newsletter!


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Training Situational Awareness Through Simulation Valid to Reduce Surgical Errors in the Operating Room

surgery-training-situ-awareness

Dr. Marlies Schijven, Past President of the Dutch Society for Simulation in Healthcare & Surgeon at Academic Medical Center Amsterdam just shared this great British Journal of Surgery Article entitled “Training situational awareness to reduce surgical errors in the operating room” M. Graafland, J. M. C. Schraagen, M. A. Boermeester, W. A. Bemelman and M. P. Schijven. The paper speaks to the need to train OR staff in the process of maintaining situational awareness, and found that medical simulation is a key methodology for accomplishing this training goal. Stress causes tunnel vision which leads to errors, but nonjudgemental communication practices and simulation training can open up our field of view for better patient outcomes. Recap of the study:

Background

Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim of this review was to assess the validity of methods for improving situational awareness in the surgical theatre.

Results

Nine articles were considered eligible. These evaluated surgical team crisis training in simulated environments for minimally invasive surgery (4) and open surgery (3), and training courses focused at training non-technical skills (2). Two studies showed that simulation-based surgical team crisis training has construct validity for assessing situational awareness in surgical trainees in minimally invasive surgery. None of the studies showed effectiveness of surgical crisis training on situational awareness in open surgery, whereas one showed face validity of a 2-day non-technical skills training course.

Conclusion

To improve safety in the operating theatre, more attention to situational awareness is needed in surgical training. Few structured curricula have been developed and validation research remains limited. Strategies to improve situational awareness can be adopted from other industries.

What Needs to Happen?

Situational awareness is a key factor in Aviation Simulation training which is accomplished through CRM communication practices, where team members are taught to work together as a team to provide more comprehensive perspective during critical situations. The failure of healthcare communication is in the toxicity of work environments to be able to speak up without harsh criticism for doing so. Here’s an example of medical student having to go against his better judgement and speak up to save a patient’s life. For more of such reading check out Suzanne Gordon’s book “Beyond the Checklist: What Else Healthcare Can Learn from Aviation Teamwork & Safety“. Clearly, the research above continues to add to the enormous benefit of training opportunities simulation has to offer the healthcare community.

Read the full BJS Article on the Wiley website

Konsiderate & SimGHOSTS Presented to EMS SimulationIQ HQ

rocky-philly

Last week, Education Management Solutions brought myself and Konsiderate CEO Jackie Morck out to their Exton Pennsylvania HQ just outside Philly to present about SimGHOSTS.Org and Konsiderate.com to their international team. Of course, we had to stop by the Rocky steps to do our best impersonation.

Jackie shared how the world has evolved through user generated content in Business to Consumer (B2C) spaces through websites like Yelp, Amazon, TripAdvisor, RottenTomatoes, and more. Ten years ago customers had no way to know if a restaurant, book, or device was worth their dollar unless by reading expert opinion. But in today’s world, with websites like those and online social media outlets like twitter, facebook and LinkedIn — companies that acknowledge that customers own their brand can engage more powerfully to build better outcomes for everyone. Now with Konsiderate.com, medical simulation champions can have that same beneficial dialogue regarding hundred-thousand dollar A/V system purchases.

I shared about the interesting story that brought me to healthcare simulation by going back in time, demonstrating how all simulation champions have unique backgrounds which can contribute to the advancement of our field. Since there are only limited professional education opportunities in simulation (like the NYIT and Drexel Simulation Masters programs), most individuals have sidestepped into this field from careers in healthcare, IT and A/V, they have an enormous amount of experience to share! SimGHOSTS.Org events are specifically designed to showcase such experiences to those operating medical simulation technology labs.

There I also received a tour of their redesigned space about to become their non-profit Global Institute for Simulation Learning, which will be working with local healthcare partners to provide simulation training and sales demonstrations. Learn more about the GISL in my previous article here.

I also had a wonderful opportunity to sit down with Product Manager Marco Angeli, to learn more about the amazing features his team has been developing on the past year for SimulationIQ Enterprise. The ability to use their Enterprise cloud system to track room utilization, scheduling, equipment, as well as launch student recordings, rendering options, and edit video playlists was mind blowing! Stay tuned for a future EMS webinar on the topic to learn a great deal more. Following my presentation, Gaumard representatives introduced the many features of their new Victoria birthing simulator and latest HAL 3201

For now, visit EMS’ SimulationIQ website to learn more about the original A/V recording company in medical simulation!


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Presenting Today at EMS International Sales Meeting

simulationiq

Today I was invited out to the international HQ of Education Management Solutions (EMS) in Exton Pennsylvania to present about the history of SimGHOSTS.Org and HealthySimulation.com at their international sales team meeting! Konsiderate.com‘s co-founder and CEO Jackie Morck was also out to speak about the new home for online ratings and reviews of simulation products and services.

I will be connecting my presentation to the work of Malcolm Gladwell’s “Outliers”, which points out that our careers are a lot more connected to the circumstances of our upbringing than we may previously have imagined. I know my story towards medical simulation was unique — just as I am sure your story is as well!

I’d love to hear how you started working in medical simulation, so please share with me and your community on the HealthySim Linkedin Group page.

Serious Fun: Video Gamer Group Simulates Military Engagements

simulated military

Check out this recent Polygon article by Charlie Hall entitled “Why We Fight: Inside Shack Tactical, The Elite Military Simulation Group” about an online clan of gamers that by the name of Shack Tactical and play ARMA III. One of the players, “Gluck” is a real life veteran who has 116,00 youtube followers that have watched his simulated military engagements more than 18,000,000 times.

Excerpt from the Polygon Article: 

Flying low above a pine forest, the two U.S. Army Blackhawk helicopters suddenly broke formation. From my seat at the open door, the view tipped straight down for a moment before we leveled off. In the distance, backlit by a sky purpling with the dawn, I could see Alpha squad beginning to descend, their rotors kicking up a huge cloud of dust.

Our pilot pulled us into a shallow valley and I lost sight of both the other chopper and the sunrise. In the darkness I began to notice that my palms were sweating.

I’d played Arma, the complex military simulation series, before. I had plenty of experience in how to use the various small arms in the game, how to aim and reload and adjust them for range. I’d spent hundreds of hours learning to navigate across its environments on foot; through jungles with a map, over deserts by compass and once, while at sea, by using only the stars. Over the years I’d struggled with, and mastered, its bizarre user interface.

I was in Shack Tactical now, an elite Arma gaming group, embedded with them as a new recruit. To keep the experience pure I withheld my true identity as a writer. I was there to document a kind of role playing experience that can’t be found anywhere else, and I didn’t need someone showing off or holding back because I was there to observe them.

The way ShackTac plays is different from the military. Those differences have a lot to do with the weapons they choose to fight with (usually Cold War era, analogue weapons), but also the missions they create and play (like traditional meeting engagements, but also highly thematic scenarios like hostage rescues that require acting skills). There are rules and hierarchies; all of the players in ShackTac have a rank — from pFNG (pre-Fucking New Guy) to NCO (Non Commissioned Officer). But unlike the military, ShackTac doesn’t have fixed units — players can fight alongside whoever they like from night to night. Certain roles, however, are off limits to all but senior members. Pilot slots are reserved for only the most skilled players in the group.

But what makes ShackTac truly unique are the length of their games. Whether fighting against computer-controlled opponents or other members of the group, games are grueling, hours-long affairs. Sessions can last five hours or more, and each individual mission often ends only when the last member of ShackTac has died.

McFarlin fulfills an intangible role at ShackTac, and not just because he’s an officer in the U.S. Army. While he once had a dangerous firefight in Iraq, he’s had hundreds in Arma over the years. And because of that he’s a great in-game leader. He’s the the kind of player you want in your foxhole late on a Saturday night.

The group’s popularity is a big reason why Gluck now works with the company that makes Arma, Bohemia Interactive, as a consultant and video designer. He’s the author of an extensive series of freely available written and video tutorials for Arma products, all of which grew out of his experiences leading ShackTac. Called the Tips, Tactics and Procedures Manual, much of that content was bundled together to create the authoritative guidebook sold alongside Arma 3.

Read the full Polygon Coverage of this Simulated Battle Group here.