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.


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“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.


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BuzzFeed Informs Public: Virtual Reality Is Medical Simulation Training’s Next Frontier

Virtual Reality Is Medical Training's Next Frontier

BuzzFeed recently reported on the new advances in VR technologies currently being utilized for medical training, a sign that our advanced methodologies are contiuning to interest mainstream media!

“There’s a baby boy on a stretcher in a children’s hospital emergency room. His mother is standing nearby, begging the doctors to do something, as her baby lies there. He is drooling and shaking; his diaper is soaked; he is making a disturbing snoring noise. An EMT comes in and says, “Doctor, this is a one-year-old male found by the mother at home, having a seizure. The seizure’s been lasting about seven minutes. Blood glucose on scene was 90.” The EMT leaves.

 

According to Dr. Joshua Sherman of CHLA and the USC Keck School of Medicine, VR helps solve several problems for medical training programs: expense, accessibility, and verisimilitude. (Sherman also helped develop the training.) Hands-on training for medical students and residents is time-consuming and expensive — mannequins run upwards of $50,000, plus maintenance and tech support — and also requires a room full of actual people to play the doctors and nurses. The other type of training currently used is screen-based training, but that doesn’t closely mimic a real-life situation. VR manages to replicate the atmosphere of an emergency room situation while also being accessible — a trainee can easily do it on his or her own time. Besides the simulated nature of the experience, the main drawbacks right now are lack of voice control and inability to have more than one person in the experience at the same time. There’s also currently only two training modules, so the applications are limited.

Sherman’s first VR experience was the Oculus Dreamdeck — which puts users at the top of a very tall building. Sherman, who is afraid of heights, felt his heart rate go up and his palms get sweaty. “I knew it was not real but I couldn’t get myself to jump,” he said. “When I felt that physiologic response and how similar it was to the real world, I immediately thought, why can’t we use this to simulate the response on resuscitations? We can train people who we can’t train in real life, up to an extent, so then when they face it in real life, it still will be very stressful but they will be able to select the correct items and protocols under pressure.”

I’m not a doctor, nor am I training to be one, but when I tried the simulation (or as it’s officially called, the “VR Pediatric Resuscitation Module 1: Status Epilepticus”), I found myself getting anxious about choosing the right protocol for this fake baby. Though I was guided through it by Clay Park VR founder and former Oculus developer relations specialist Shauna Heller, who produced the project, it was still nerve-racking to be inside this emergency room, responsible for saving the life of an infant.

Sherman said that’s entirely the point. “We compared the physiology of stress in real-life emergency situations to that of people going through VR — their heart rate, breathing rate, and salivary cortisol, which is a stress hormone. The preliminary data shows that the heart rates definitely correlate between the real world and VR world.”

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.

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!


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Global Network for Simulation Healthcare Annual Summit Meeting Brings Together Industry Leadership in Munich

GNSH logo

This week in Munich, Germany over 50 individuals representing more than 30 international organizations and 12 global corporate vendors came together for an annual summit to discuss and strategize for the improvement of the healthcare simulation industry. Member organizations included leading groups such as INACSL, SSH, IPSS, ASPiH, NPSF, NLN, SESAM, and ASPE who joined together with corporate members like Simulab, Laerdal, B-Line Medical, 3D Systems, CAE Healthcare, TellYes, and Simulaids to name a few. Halldale media (Medical Training Magazine) and HealthySimulation.com industry news reporting groups were also in attendance. This collaborative is designed to provide a dedicated space and time for these leading groups to sit down and focus not on their individual events but the global industry as a whole.

The organization presented a prototype of a healthcare simulation toolkit website, designed to help provide a how-to-guide for helping to make the business case for simulation with a searchable database of cases to help provide the evidence and resources necessary to be effective. The membership was enthusiastic about the prototype system and requested the continued developed with the hope for funded support from the commercial groups, with marketing and content creation support from the academic organizations.

Also delivered was a new branding, website, and marketing content by Lance Baily of SimGHOSTS.org & HealthySimulation.com with creative production support from Lynn Welch and Larry Boggs from EMS SimulationIQ as advised by Andy Smith from Halldale Media. This new website will launch next week so stay tuned.

Strategic industry messaging, collaborative partnerships with patient safety and other performance improvement organizations, as well as continued toolkit development content and development plans were the focus of the two and a half day event.

Stay tuned for the new GNSH website!

SWMI Sim Lab and VR Room Helps Prepare Students for Real World Patient Encounters

SWMI Sim Lab and VR Room Helps Prepare Students for Real World Patient Encounters

Petty Officer 1st Class Jermia Douglas of the Surface Warfare Medicine Institute recently shared how the US Navy program is utilizing advanced simulation training with his articles “Train like you fight, fight like you train.”, posted on the dvidshub.net website:

In an effort to align training and fighting, Surface Warfare Medical Institute opened its first Simulation Laboratory (Sim Lab) with one simulator in a small room in October 2009. The main purpose for the Sim Lab was to provide a realistic type of training environment for students to safely practice medicine through repetition and hands-on practice. It also provided the capability to better train Independent Duty Corpsmen (IDC) students through the use of advanced technology. This provided the students with the same opportunity that is offered to students of civilian medical fields such as nursing and allied health professional training programs.

A few years after the introduction of the Sim Lab, a Virtual Reality (VR) room was built in December 2013. The VR rooms provided the same experience as the Sim Lab while enhancing simulated environments of the Middle East and onboard ships. Currently the VR rooms are used by instructors and students at SWMI and have the ability to add physical stressors to enhance the experience for the students. Smoke, dim lighting, changes in sound, background videos, and various props can be introduced to heighten the experience. This type of capability is designed to bridge the gap between practical scenarios and real world patient encounters.

“It’s a controlled environment where students can get hands-on experience before they go out to the fleet,” said Lt. Hope Moore, physician supervisor for trauma at SWMI. “One of the most significant aids is the development of muscle memory, so that when it comes to treating an actual patient it’s a much smoother process.”

Muscle memory consolidates specific motor tasks into memory through repetition and many of the instructors believe that using the Sim Lab and VR room enrich classroom learning through hands-on practice. Students are able to practice procedures and scenarios in a safe and controlled environment as often as they need. This gives students the chance to practice before they are assessed on their abilities.


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23rd Annual SESAM Simulation Meeting Opens in Paris

simulation paris 2017

Yesterday in Paris at the Centre Universitaire des Saints-Pères, the 23rd annual Society in Europe for Simulation Applied to Medicine (SESAM), opened its exhibit floor and sessions to Europe’s medical simulation community. Tonight, attendees will be treated to a candlelight gala dinner on the top of the Eiffel Tower!

Today, François Taddei provided the opening address covering the history and state of education in healthcare. François Taddei is the Director of the CRI (Center for Research and Interdisciplinarity) in Paris, which offers dedicated facilities hosting visiting professors, a wide choice of courses and several student discussion clubs. CRI’s main role is to promote new pedagogies to help creative students take initiatives and develop their research projects, with the help of mentors, research institutions, private companies and foundations, such as the Bettencourt Foundation, which has supported many student-created activities. These activities range from the first French synthetic biology team (for the MIT-sponsored iGEM Competition) to the Paris-Montagne science festival and the Science Académie, an outreach program that allows high school students from deprived neighborhoods to discover the creativity of science.

SimGHOSTS, SoFraSimS and IPSS leadership helped provide additional session content, including a plenary session by Dr. Scott Crawford about the future of technology in healthcare.

Exhibit show highlights include SimCharacters Preterm Simulator Paul, SimforHealth’s VR learning platform MedicActiV, high-fidelity ventilation management with Laerdal’s SimMan 3G, new infant simulators from LifeCast Body, and SAM III from Cardionics.

The event continues through Friday afternoon with full days of keynotes, presentations and exhibit hall news — all of which you can follow along with the hashtag #SESAM2017.

Military Simulates for TeamSTEPPS: Communication Practice is Key

Communication is key for Army Reserve medical professionals

News worthy report today from “defense video imagery distribution systems” on how simulation is being utilized by the 807th Medical Command’s 228th Combat Support Hospital based out of San Antonio, Texas attend a three-day training exercise on 2-4 Jun. at the the Mayo Clinic Multidisciplinary Simulation Center located in Rochester, Minnesota.

ROCHESTER, MN — The medical facility is bustling. Patients are being received and then whisked away from the emergency room to the intensive care unit or operating room or treated and prepared for movement to other facilities. The loud sounds of a helicopter overhead are an audible sign that the medical teams need to prepare for new patients, even as they manage the patients currently in front of them.

Though this chaotic scenario sounds like something from a movie, this is a very realistic environment for military personnel serving overseas with Combat Support Hospitals and Forward Surgical Teams. This is an environment recreated at the Mayo Clinic Multi-disciplinary Simulation Center to provide Army Reserve medical units and healthcare providers the opportunity to work together in a realistic, theater-specific setting that replicates typical injuries and focuses on teaching and incorporating TeamSTEPPS into Army Reserve processes in an exercise environment.

TeamSTEPPS is the Department of the Army’s patient safety framework adopted by the Army Medical Command to enhance healthcare team performance and improve patient safety. The training audience for this particular exercise is the Soldiers from the 807th Medical Command’s 228th Combat Support Hospital based out of San Antonio, Texas. The exercise held 2-4 Jun. provides a crawl, walk, run format for the Soldiers. Col. Elizabeth Anderson, Medical Readiness and Training Command’s exercise director for the simulation center’s TeamSTEPPS exercise, explains why this training is so important.

“My favorite part of being an OC/T is making the experience interactive between the medical personnel and the patient. These are manikins, so we create noises and response to make it more realistic for Soldiers, to make them consider this as a real patient so that their stress level starts to go up, and then we can start to see the reactions we are looking to fine tune,’ said Elliott. The end-state is trained and ready Soldiers equipped with the knowledge and experience to utilize TeamSTEPPs during the delivery of care. “We are looking for the participating unit to apply the teamSTEPPS principles in a variety of combat casualty scenarios. One of the things we did at MRTC is we used some of the information in the joint trauma registry – patients that had actually been cared for and had been uploaded into the registry, and we used those to create scenarios that could be implemented here in the simulation center. We’ve got twenty of those scenarios with all the information that we need to treat the patients and move them through the hospital,” said Anderson.

Medical Training Magazine Interviews President of Simulab Doug Beighle Regarding Simulation & Patient Safety Industries

doug beighle healthcare training magazine

Recently our friends at Medical Training Magazine (formerly MedSim Magazine) interview Doug Beighle, President and COO of Simulab, regarding the current state of the simulation and patient safety industries. As a board member of key organizations between these industries like the Global Network for Simulation in Healthcare (GNSH), SSH, and NPSF — Doug sits in a unique position to share where the worlds of patient safety and simulation can collaborate to improve healthcare outcomes on an international level. Here below, are a few excerpts from the edition which you can read fully through the link below!

Medical Training Magazine: You are on a number of Boards and important committees at the SSIH, National Patient Safety Foundation and GNSH to name a few and you work very hard to get members of the different associations to work together to achieve common goals. Please discuss the importance of working together and what you would like to see accomplished.

Doug Beighle: At Simulab we have a very experienced management team, which gives me an opportunity to spend almost a third of my time focused on issues external to our company. Nearly five years ago we realized the Patient Safety and Medical Simulation movements were suffering from the same symptom – lack of resources. By this I mean a lack of adequate budget: allocated trainer time, learner time, and training facilities and equipment. The majority of my external work is an effort to support these movements by increasing awareness, working to break down silos, and building partnerships. Medical errors in the United States are a multi-billion dollar annual problem. Yet, two of the most powerful opportunities to reduce these errors, patient safety programs and simulation-based education are under-resourced. Bringing in a business perspective helps healthcare educators and patient safety professionals build a case to get their projects adequately funded. Ultimately, the first step towards reducing medical errors requires that educators, healthcare providers, patient safety experts, and financial officers break down their silos and work together using the same language.

MTM: How could the simulation industry help itself and the healthcare sector to improve training, patient care and results?

DB: There are many initiatives that can help speed up the process of improving patient care. One of the highest impact possibilities is integrating the simulator and curricula into one training system. In these settings learners would use a simulator and modules to self-direct learning. These systems create the ability to easily measure a learner’s path to mastery. This process would not only reduce the cost of educational interventions, but it might increase the likelihood of retention. Additionally, without the need for an instructor to be present, scheduling periodic assessments of adherence would be easier. There are examples of this today from the Resuscitation Quality Improvement (RQI) product from Laerdal, products from SonoSim and many other virtual reality training systems.

MTM: What effect do you think the merger between the Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation will have on patient safety and outcomes?

DB: As a member of one of the NPSF committees I do not know the behind the scenes but everyone believes it will be a very beneficial merger. The new group will continue under the IHI name and one of its goals is to revitalize the issue of patient safety. Derek Feeley, CEO and president of IHI, will lead the combined organization and Dr. Tejal Gandhi, president and CEO of NPSF, will lead the new organization’s patient safety teams. One goal of the new group is to draw greater attention to patient safety across the care continuum and not just in hospitals. It would be beneficial if they work with industry, academia and hospitals to bring innovation to medical education and work together by having state chapters or regional chapters.

Read the full interview with Doug in the latest edition of Medical Training Magazine

Operative Experience Expands Portfolio of Realistic Surgical and Team Training Simulators | IMSH 2017 Video Interview with CEO

realistic skin surgical simulator

At IMSH 2017, HealthySimulation.com had the opportunity to interview Mick Navin, CEO of Operative Experience Inc (OEI) about their expanded range of hyper-realistic surgical simulators with engaging anatomy, as well as to learn about the recent investments and support by Lou Oberndorf — who lead the growth of METI which was acquired by CAE Healthcare. Mick shared that OEI is on a mission to revolutionize surgical and medical team training using medical simulators with unprecedented anatomical and surgical fidelity within a rigorous experiential instructional paradigm. HealthySim provided a video interview about OEI during the 2012 IMSH event, suggesting it would only be a matter of time before the technology was expanded by investment support — and we are glad to see it was by one of our industries commercial pioneers!

OEI provides a range of simulation-based systems for surgery and pre-hospital training:

  • Fetal Extraction Simulator
  • Postpartum Hemorrhage Control Trainer
  • Emergency Hysterectomy Trainer
  • Emergency C-Section Delivery Simulator
  • C-Section Skills Trainer
  • Emergency Thoracotomy
  • Craniotomy
  • Fasciotomy
  • Disaster Legs
  • Surgical Legs
  • Various Tactical Casualty Care Simulator

HealthySim also spent some time learning from Mick about how the company has grown since our 2012 interview, following years of prototype development and testing, collaboration with materials expert Jeffrey Ellis led to the creation of the world’s first physical simulators upon which major surgical hands-in-the-body operations could be performed using standard surgical instruments. A series of SBIR grants from the U.S. Army Medical Research and Material Command capitalized the company and enabled Operative Experience Inc. to advance its product development.  OEI products offer a different type of simulator, providing unique surgical experiences that mimic combat or other trauma based emergencies with realistic anatomical feeling.

Learn more at the OEI website!

KbPort’s simCabRx Provides Realistic Medical Cart Simulated Training | IMSH 2017 Video Interview

med cart simulator from kbport

During the recent IMSH 2017, HealthySimulation.com learned more about the simCabRx med card simulator from Kbport which was located at the Pocket Nurse booth. KbPort’s Simplicity solution combines medication dispensation with the power of SimLabConnect and SimEMR to provide a more complete, more realistic simulation experience. The integration of medical simulation devices provides a critical context for the data generated, in the form of patient history and patient records, which form the foundation for support for future treatment. Improve bedside medication administration education with KbPort SimCartRx mobile medication cart solutions — which you can see in our video interview below!

SimCartRx works as part of the KbPort simplicity Solutions System!

Both SimCartRx, Kbport’s mobile medication dispensing solution, and SimCabRx their decentralized medication dispensing solution, integrate with SimEMR, allowing students to access patient records during simulations, which is a critical component of real patient care. The temporal capability of Simplicity, with SimLabConnect and SimEMR, adds an invaluable, true-to-life dimension to your simulation-based training, advancing your program’s effectiveness while promoting proper communication and patient safety.

Begin simulations with SimEMR for realistic med cart learning experiences:

  • Log in/out with student cart credentials (LDAP compatible)
  • Patient record lookup via barcode scan
  • Medication scanning

Control medication dispensation through SimEMR and view cart/cabinet events within SimEMR & ETC FusionHD

  • Log in/out
  • Patient lookup via barcode scan
  • Drawer open/close
  • Medication scanning
  • Administer via bedside with SimCartRx

Log simulator vitals into SimEMR patient record in real time

• Creates an accurate, complete and evolving patient history
• Improves critical thinking by presenting and integrating comprehensive patient data

Certainly those programs looking to integrate EMR, medcart, and patient charting into one system across the learning program should check out KbPort’s simplicity systems!

Learn more on the Kbport website today!