Watch: Gardaí Simulate Terror Attack at Dublin’s Docklands

Watch: Gardaí test response to terror attack in simulation at Dublin's Docklands

The Irish-based Gardai engaged with a counter-terrorism exercise in Dublin recently to test their response in the event of a mass casualty terrorist attack. The simulation, codenamed ’Sciath’, involved a number of actors at the Docklands railway station in Dublin’s north inner city and the garda units involved today had not been told ahead of time what would be involved.

Does your simulation program work with local Civil Service Groups to provide simulated training opportunities? The promotional opportunities to develop new business opportunities and showcase your simulation program are clearly evident!


Sponsored Advertisement:


As part of the simulation, the men inside acted out assaulting a number of people inside the station. Armed officers used stun grenades and blank rounds, shooting one of the suspects and securing the scene. “Today has demonstrated the professionalism and the capability that we have,” Garda Commissioner Nóirín O’Sullivan told reporters after the training exercise was finished. “Incidents like this can happen. We have to make sure that we are ready to respond to those incidents. In the last few days we have given instructions to all of our members and I think we wanted to see how those instructions would work,” she said.

The Commissioner said simulations such as today’s operation are prioritised in high density areas like Dublin city, but she said further exercises will take place in other parts of the country to test response times outside the capital.


Sponsored Advertisement:


Mixed and Augmented Reality Can Facilitate Seamless Medical Communication

ar-healthcare-simulation

MedicalResearch.com recently interviewed Birmingham City University Associate Professor Dr. Ian Williams PhD about the work of the DMT lab on mixed and augmented reality for healthcare simulated training. Make no mistake, VR and AR are the future of healthcare simulated training:

Dr. Williams: Our work at the DMT Lab (dmtlab.bcu.ac.uk) focuses on developing a novel Mixed Reality (MR) medical presentation platform which allows practitioners to interact with patient data and virtual anatomical models in real time. The system enables the presentation of medical data, models and procedures to patients with the aim of educating them on pending procedures or the effects of lifestyle choices (for example the effects of smoking or excessive alcohol consumption).

The system employs an exocentric mixed reality environment which can be deployed in any room. It integrates a medical practitioner in real time with multimodal patient data and the corresponding result is a real time co-located visualisation of both the practitioner and the data, which they can interact with in real time.  We implement a natural interaction method into the system which improves a user’s level of direct interaction with the virtual models and provides a more realistic control of the data.

The system can also be used in a fun educational setting where patients, students, children or any naive user, can learn about medical anatomical information via a real-time interactive mixed reality “body scanner”. This fun system overlays the MR information onto their own body in real-time and shows them scaled and interactive virtual organs, anatomy and corresponding medical information. We are aiming for this system to be used not only in patient education but also in engaging and informing people on lifestyle choices.


Sponsored Advertisement:


MedicalResearch.com: What types of medical or surgical problems do you envision can be enhanced with the use of free hand gestures to manipulate patient data?

Dr. Williams: Mixed reality has enormous potential within the medical field, with healthcare being profoundly affected by some recent developments. Mixed reality technology can also provide the platform for facilitating a seamless doctor-patient communications in real time. The system we are developing can provide a real time augmented view of the patient’s data which can be overlaid onto the patient, or interacted with via freehand interaction without the use of complex wearable devices.

Many current mixed reality systems rely on bespoke sensors and cumbersome wearable devices (for example haptic gloves) whereas we work in freehand interaction without the need for a medical practitioner or patient to wear any complex wearable device. This interaction method enables a more natural virtual interface and via the use of naturally inspired physical interaction models (for example common real grasping types) we bridge the gap between users and technology. This form of natural interaction can also enable an interaction which can be perceived as more realistic to the observer.

Medical Group Readies Complaint Over Use of Live Pigs for Training Instead of Simulators

live animal training instead of simulators for healthcare

Last week the Physicians Committee for Responsible Medicine announced they will file a federal complaint against the University of Missouri School of Medicine, questioning the legality of the school’s use of live animals for emergency medicine residency training — as reported by the Columbia Tribune.

Consider that if enough healthcare groups complained about the abuse of animals for medical training, that simulators would grow in adoption and utilization, as this article clearly points out! Does your healthcare program have an animal rights group? Perhaps as a simulation center representative you should connect with them to explore collaborative options of mutually beneficial support!

In the complaint, which the committee emailed to the Tribune on Friday, the national not-for-profit organization of 12,000 physicians asserts that the training program does not meet the requirements of the Animal Welfare Act of 1966. Emergency residents practice several medical procedures on live pigs, and “this animal use is at odds with the current standards of practice in emergency medicine training,” the committee said in the complaint.

The committee conducted a survey of 168 emergency medicine programs nationwide and found that 150 of them, or 89 percent, did not use animals to train residents. Four of those 150 programs are in Missouri, including the University of Missouri-Kansas City, which is part of the UM System along with the Columbia campus. In the complaint, the committee said these 150 programs use only human-based simulation to practice the procedures that MU’s residents practice on pigs. 

Because the MU School of Medicine uses live animals despite the existence of alternative methods and has not provided “objective evidence to support” doing so, the school is breaking the law, the organization said in the complaint. However, Foundation for Biomedical Research President Matthew Bailey said in an email that nationwide, doctors do not have a general consensus that simulation can replace the use of animals in physician training.


Sponsored Advertisement:


“While simulators have become increasingly advanced in recent years, and make good adjuncts to training, many doctors do not agree that they provide an adequate level of training before operating on live people,” Bailey said. “They simply aren’t a full replacement in every case, yet.”

Human-based simulators “are not yet capable of replicating the human condition” in the case of some injuries, Bailey said. He gave the example of traumatic injuries that members of the military might suffer in combat. The Association of American Medical Colleges on its website says that the role of live animals in research is “irreplaceable” and that animals are “vital in the medical education continuum.”

The Physicians Committee for Responsible Medicine attributes its information about MU’s emergency medicine training program from a protocol document the committee obtained. According to the document, trainees cut into and open the throats and chests of the live pigs in order to insert needles and tubes and repair an injury to the pericardium, a sac surrounding the heart. The trainees continue the procedures even if the pig dies in the process, but if it survives, they kill it before they perform the final procedure.

The committee will send the complaint to the Animal and Plant Health Inspection Service’s Animal Care Unit, which is the division of the U.S. Department of Agriculture responsible for enforcing the Animal Welfare Act. The complaint asks APHIS to investigate MU’s medical school and enforce penalties for what the committee sees as breaches of federal law.


Sponsored Advertisement:


EMSWorld Interviews Moulage Concepts Founder Bobbie Merica About Simulation Realism Through Makeup

EMSWorld recently interviewed Moulage expert Bobbie Merica of MoulageConcepts.com to learn how moulage makeup can improve the educational outcomes of simulation by increasing the realism for learners. Here are a couple of excerpts from the EMSWorld article entitled The Importance of Accuracy in Moulage Trainingby Valeria Amato:

What advice would you give people who are looking to implement more realistic and effective moulage into training regimens?

It’s like anything else: You need to plan and prepare. When you develop your case scenarios, decide what the takeaway is going to be. Is it triage-specific? If so, then your wounds should accurately represent wounds related to triage. A lot of the time, people will throw in the moulage piece at the end without giving it any thought. They won’t collectively decide what the full-thickness burn is going to look like, what the pediatric patient will look like and how they’re going to present it. Locate an accurate picture on the Internet of an actual case. Practice creating moulage so that everyone in your training knows what these wounds will look like.

Mostly it’s about the planning. You’d never run your training scenarios without a great deal of planning. When you’re building those scenarios, start building in those moulage components. Understand what story you want to tell. Understand what the training outcome is. Is intubation with a full-thickness burn the outcome, or is it identifying the smoke inhalation? If the training outcome is smoke inhalation, then you don’t need a full-thickness burn. It’s not difficult to clarify that a full-thickness burn in the upper airway in the chest and neck has smoke inhalation. If you really want to know if someone has smoke inhalation, bring it back and test it in multiple areas. Create that eye-reddening, some tears coming down, the reddening in the back of the throat. That little bit of hoarseness. Break it out into multiple training avenues, unless intubating the patient with a full-thickness burn is the skill set.


Sponsored Advertisement:


That makes sense, especially going back to what you said about using moulage in less of a theatrical capacity and for mass-casualty incidents.

If it’s a mass-casualty incident, you’re going to have some people who look like those first-line-of-response people, but often a lot of those people look the same. Certainly you should assess the woman screaming and covered in blood, but you might also want to look at that person quietly dying right next to her. It’s about creating all those aspects and using this as a tool to define where those strengths are and, more important, where those weaknesses are so you know how to align future training dollars.

I think every person, every entity and every training site should have access to this level of training. Moulage doesn’t have to be expensive and time-consuming. You can have amazing moulage that tells the whole story, allowing you to spend the next six weeks accurately training your participants to meet outcomes, that will cost you pennies.

Do you have a copy of Bobbie’s Best Selling Moulage Recipe Book? Check out our review here!

Air Canada Almost in Deadliest Accident in Aviation History — CRM Training Saves Countless Lives

sfo near miss aviation simulation

Yesterday in San Francisco (July 10, 2017), Mercury News reporter MATTHIAS GAFNI wrote how Air Canada pilots almost landed an Airbus 320 onto the jetway where four other planes were waiting to take off. The incident provides a strong example of why Crew Resource Management (CRM) communication protocols allowed for everyone involved to create awareness, recommendations, and change. In this case that “must hear” communication helped save almost a thousand lives.

SAN FRANCISCO — In what one aviation expert called a near-miss of what could have been the largest aviation disaster ever, an Air Canada pilot on Friday narrowly avoided a tragic mistake: landing on the San Francisco International Airport taxiway instead of the runway.

Sitting on Taxiway C shortly before midnight were four airplanes full of passengers and fuel awaiting permission to take off, according to the Federal Aviation Administration, which is investigating the “rare” incident. An air traffic controller sent the descending Air Canada Airbus 320 on a “go-around” — an unusual event where pilots must pull up and circle around to try again — before the safe landing, according to the federal agency. FAA investigators are still trying to determine how close the Air Canada aircraft came to landing and potentially crashing into the four aircraft below, but the apparent pilot error already has the aviation industry buzzing.


Sponsored Advertisement:


“If it is true, what happened probably came close to the greatest aviation disaster in history,” said retired United Airlines Capt. Ross Aimer, CEO of Aero Consulting Experts. He said he’s been contacted by pilots from across the country about the incident. “If you could imagine an Airbus colliding with four passenger aircraft wide bodies, full of fuel and passengers, then you can imagine how horrific this could have been,” he said.

You can bet that this exact scenario conditions will be programmed into simulators around the world, especially for those pilots flying into San Francisco. As well, I am sure that the Ground Control teams at SFO will take a deep look at the lighting patterns for the runway to see what else could be  done to better indicate approaching flights.

In aviation, such near misses cause huge safety investigations from multiple agencies. When does that happen in healthcare for our near misses? — Why is TeamStepps training not mandatory for healthcare professionals like CRM is for aviation industry professionals? Possibly because the lives of the healthcare providers aren’t also on the line, only their patients. Harsh as that may sound, why else would healthcare not force adoption of the issue, like aviation did? Tell us your thoughts in the comments below.

Read the Whole Mercury News Story About the Never-Event here


Sponsored Advertisement:


A Sim Tech Shares Why You Should Come to SimGHOSTS 2017 USA

simghosts sim training

Simulation Operator Rachel Bailey  recently shared with the simulation community why she suggests attending SimGHOSTS.


There is still time to register for the 2017 USA Event
Next month at WakeMed in Raleigh, NC August 1st-4th

From Rachel: SimGHOSTS is a community of hard working technicians that adapt to any environment given to them.    As technicians we work over 8 hours a day, and when we are not working, we are thinking about what we can do better in the simulation community.  We volunteer for projects, we come in early and stay late.  You have to love the job in order to stay in the field.  The hours we work and the constant struggle to ensure things operate well, can weigh heavily.  Sometimes we are in a no- win situation but it never prevents us from thinking of how to improve simulations for educators and learners.


Sponsored Advertisement:


Being a sim tech is not the easiest job, nor the most rewarding, we do the job because we love it.  The demand of the job can leave us discouraged and burnt out, but when August comes around, we get to meet with people that are just like us and experience the same highs and lows of simulation operations.  I have attended several SimGHOSTS conferences, I get the pleasure of meeting new technicians, hearing their ideas, and seeing there fabrications.  The passion of this community is something to experience.  It is not about where you went to college, it is not about who you know, this conference is strictly about the job that we all love.

A fellow sim tech stated her experience at SimGHOSTS, as her “date night” with her job.  I couldn’t agree with her more.  This conference is more than educational, it is empowering.  When I thought I could not take one more reminder of what didn’t work , or how much time I spend at my job, that a select few really understand, I go to SimGHOSTS as a reminder that I really love what I do, and I love the community I am involved in.  I have attended SimGHOSTS as a presenter and a participant, and the community is the most inquisitive, intelligent, and involved in simulation technology that I have ever experienced.  People are proud and willing to share ideas and projects.  Every time I attend I am empowered to do my job for another year.

Whether you are tech, educator, coordinator, or director, the education you receive at SimGHOSTS is as unique as the people sharing what they have learned.  If you haven’t been to a conference, I urge you to try to persuade your leadership to invest in your education and your professional development.  See you in Carolina!

Learn more about joining Rachel at SimGHOSTS 2017 USA this Aug. 1-4!

Modern Healthcare Covers Growth of Healthcare Simulation Field

modern healthcare simulation

In the most recent addition of Modern Healthcare, the publisher covered the growing field of healthcare simulation with key interviews to help outsiders better understand the benefits of the emerging methodologies and technologies. This is a GREAT article to introduce others to the field of healthcare simulation, so be sure to share this link!

Simulation can save lives and limit patient harm by ensuring physicians young and old alike follow protocols and complete all the necessary steps in order to safely perform a procedure. In a study of 44 final-year medical students in Frankfurt, Germany, students who participated in a three-day simulation-based training course were found to have more thoroughly followed protocols for CPR and a trauma enactment in comparison to students who shadowed emergency physicians for three days. Students trained on simulators scored an average of 90% on their ability to complete steps required on a standard CPR checklist, while the other students scored 62%.

It’s not just students. Another study found that anesthesiologists who engaged in simulation-based training on how to properly wean patients from cardiopulmonary bypass performed better in real-life procedures than those who received traditional interactive seminars. Simulation-trained physicians scored over five percentage points higher when assessed two weeks later by senior staff on their ability to adequately complete necessary steps on a technical checklist. Similar results were shown five weeks after training. Researchers seeking to understand whether simulation could help improve training for ultrasound-guided central venous catheter cannulation found that 51% of simulation-trained residents were successful on the first try of cannulating a patient, as compared with the traditionally trained group’s success rate of 37%, according to a study published in the journal of the Association of American Medical Colleges.


Sponsored Advertisement:


Medical malpractice payouts have begun climbing upward since 2012, reaching $3.9 billion in 2016. Connecticut’s payout rate per capita is among the highest in the nation. In hopes of reversing this trend and reducing risk, Connecticut-based Hartford HealthCare sought to improve simulation-based training for obstetricians, who are at a particularly high risk for malpractice suits. The health system’s Center for Education, Simulation and Innovation (CESI) developed a simulation-based training program that evaluates physician effectiveness in preventing shoulder dystocia, a high-risk labor complication in which labor is obstructed by the infant’s shoulder. The project utilized technology that measures the amount of force being applied to a simulated baby, eliminating the subjectivity of a doctor-to-doctor evaluation. “Verdicts in the state of Connecticut have been steadily increasing, with some exceeding $20 million,” said CESI Director Stephen Donahue. The device has given physicians more confidence in their abilities, and protected them from preventable risk that can result in lawsuits.

Read the full Modern Healthcare Simulation Article here!


Supported Organization:


Simulaids Unveils Industry’s First Patient Communication Simulator ALEX

alex patient communication simulator simulaids

Recently we covered the innovative ‘Next Gen Geri’ as seen at IMSH 2017 — but even more recently Simulaids unveiled the industries first “Patient Communication Simulator (PCS)”! Newly launched, ALEX recognizes questions and responds with scripted answers related to his condition allowing simulation educators to use speech synthesis or your own voice for responses. Alex is also the first patient simulator with an HD camera streaming live, low latency video from his right eye. Debrief with a patient point-of-view experience! Check out this video below to see more:


Sponsored Advertisement:


  • Develop critical thinking, decision making and priority setting skills
  • Conduct initial patient assessments and clinical interviews
  • Acquire foundational nursing skills
  • Meet high-level simulation goals
  • Evaluate Nursing competencies in procedures such as injections, IV administration, and wound care
Core Features of Alex:
  • Breathing: Moving chest in sync with set respiratory rate. Set various respiratory profiles with varying depth of breath.
  • Airway: Oral, digital, and nasal intubation, as well as all other standard airway procedures.
  • BVM Ventilation: Rising chest measures and records airflow over time when done during CPR.
  • Circulation: Pulses (carotid x 2, brachial x 2, radial x 2 and pedal x 2): sensing touch and providing pulse sensation in sync with set heart rate and blood pressure.
  • CPR: CPR abilities with metrics of chest compression force/depth and timing. Automatic detection and logging of CPR procedures.
  • IV Injection Arm: Practice intravenous injections and positioning a butterfly catheter. Puncture veins and dorsal venous network of hand.
  • Patient Monitor: Direct control of HR, RR, SpO2 and TEMP to set target value and transition length.
  • Waveforms: Normal and abnormal simulated cardio, respiratory and SpO2 waveforms in virtual patient monitor.
  • Blood Pressure: Measure blood pressure with any sphygmomanometer attached to the included SmartCuff™, equipped with wireless pressure sensor.
  • IRISCAM: An HD camera built into the eye of ALEX, providing digital video for live streaming and recorded review. (patent pending)
  • SPEECH: Advanced speech recognition and speech synthesis to support fully automated medical interviewing exercises. (patent pending)
  • SOUNDS: Listen to normal or various abnormal lung/heart/bowel sounds and Korotkoff sounds using any stethoscope when attached to the included SmartScope™ accessory.

Simulaids began producing trauma moulage products in the town of Woodstock in 1963 and now operates out of an 83,000-square-foot facility in Saugerties New York.

Learn more about Simulaids Innovative Products on their website today!

Regional EMS Cadet Competition Utilizes Simulation For Recognition of Leading Students

South Orange Rescue Squad Cadets Bring Home Gold

Shouldnt all EMS programs utilize simulation for demonstration and training to new recruits on the lessons of first responding? Village Green NJ recently reported how last Saturday the South Orange Rescue Squad won the 5th Annual Bayshore EMS Cadet Competition in Keyport, New Jersey at the Keyport First Aid Squad. What a great way to utilize simulations to encourage healthcare professionals of tomorrow!

This event brought Emergency Medical Services cadet teams from New York and New Jersey together for a two day event that combines EMS skill competitions, educational experiences, training, and socializing with like-minded peers. Many volunteer ambulance squads across the state have cadet programs where teenagers train alongside adult members to provide emergency medical care to their community. Explained South Orange Rescue Squad President Troy Balog, “these cadet groups are valuable feeder programs to help critical volunteer shortages in squads.”


Sponsored Advertisement:


He added, “we’ve had our cadet program for three years and many former cadets are now active adult members, including our current 1st Lieutenant! We are all volunteer, do not charge for our services and exist on donations, so people who give so much of their time are highly valued.” Competing against 35 other cadet teams, the South Orange Rescue Squad team won both first place in the “Advanced Team” category as well as the “Grand Champion” award for highest all around score. This is the first time the South Orange squad has entered the competition. “I wasn’t sure what to expect.” said team member EMT Cole Fitzsimmons, “we train a lot at South Orange so I felt that we were ready for it.”

Cadet teams could enter the “Basic” level competition or the “Advanced” level. Basic teams consisted of CPR or first aid trained cadets and were evaluated in stations consisting of Vital Sign, CPR, and bleeding control. The “Advanced” teams had to have at least two Emergency Medical Technicians and their three stations consisted of a simulated fall down to flights of stairs with two broken legs, a Heart Attack/Cardiac Arrest simulation, and a serious car accident where two critical patients were entrapped in the vehicle. “For the car accident station we had to work with the fire department to use the Jaws of Life to remove doors from the vehicle,” shared EMT team member Victor Rothstein. The victims in each of the scenarios were either role played by a volunteer with medical make-up or a high-tech simulator mannequin. Cadets were evaluated in each station by Paramedics, EMT Instructors, or Physicians who provided detailed feedback to the teens after each test.

Summary of Product Demo Video Interviews from IMSH 2017 Trade Show Floor

imsh 2017

Hey Simulation Champions! Today we are sharing a comprehensive review of all the product demonstration interviews HealthySimulation produced exclusively from the International Meeting for Simulation in Healthcare 2017 Orlando Tradeshow floor! These videos will help you to catch up with the latest news and information about innovative new products and services entering the field of healthcare simulation, so be sure to watch them all!


Sponsored Advertisement:


Exclusive IMSH 2017 Exhibit Hall Video Interviews:

Finally, here is the HealthySim staff writeup about our favorite products from IMSH 2017!