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.


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“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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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.

Hospital Simulations Inspire Student Engineering Innovators at Stanford

Hospital simulations inspire student innovators

The trend to combine bio-engineering departments with or within an institution’s healthcare simulation program is contiuing to grow. All around the world, engineering departments are recognizing the growing opportunities for product development within healthcare through simulated innovations.

Today we share another such story out of Stanford from the School of Medicine website:

In order to invent new medical devices to address problems in health care, the doctors and engineers in Stanford Biodesign ’s year-long fellowship program spend up to six weeks immersed in the hospital or other health-care facilities, watching procedures and asking questions. For undergraduate and graduate students in Biodesign’s introductory classes, firsthand observation is much harder to accomplish because of time constraints and privacy issues.

To solve this problem, Lyn Denend , Biodesign’s director for academic programs, teamed up with emergency room doctor Alexei Wagner , MD, to develop a new approach for an introductory Biodesign Innovation class, which I describe in a recent Stanford News article . Drawing on the resources at the School of Medicine’s Center for Immersive and Simulation-Based Learning , Wagner developed three realistic scenarios around the class’s focus on health care needs related to aging. The scenarios included a chaotic, five-bed ER; a quiet palliative care room where an elderly woman lay dying; and a physical therapy consultation with an older fall victim and his wife.

The goal was to expose students to real problems in health care, an essential part of the Biodesign process for developing medical devices and other technology-based solutions. On the first night of the class, students were randomly assigned roles as patients, caregivers, or observers, and plunged into these scenarios. Each one featured real doctors and nurses, high-tech mannequin patients with voices controlled by simulation staff, standardized patients (actors trained to play specific roles) and, most importantly, real problems in care delivery. As each simulation played out, the students struggled to offer appropriate care and make critical medical decisions against a frustrating backdrop of financial limitations, overburdened providers and conflicting family wishes.


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New Realistic ‘Mikoto’ 3D Printed Medical Simulator Robot Developed in Japan

Realistic 'Mikoto' 3D printed medical training robot developed in Tottori, Japan

Another new healthcare simulation manikin, this time out of Japan, as reported by 3D printer and 3D printing news website 3ders.org, which focuses primarily on endotracheal intubation, gastrointestinal endoscopy, and sputum suctioning. The new device was a collaborative project between Tmsuk R&D Inc., a medical venture firm based in Tottori Prefecture and the Tottori University Hospital in Japan.

Mikoto, which is the Japanese word for “life,” is an extremely lifelike medical simulation robot that was specifically developed to help train young doctors, medical students, and emergency care workers. Not only does the 3D printed robot look and feel real, it is also equipped with special sensors that allow it to give real-time feedback to trainees—in the form of saying “ouch” and gagging. At first glance, it’s easy to mistake the robot for a real boy, as all of its features are uncannily lifelike. Even its interiors are anatomically accurate, as its tongue, esophagus, and windpipe were all based on a patient’s actual organs. In making the simulation robot, the Tmsuk team transformed digital images of the patient’s organs into 3D printed models.

As we’ve seen, the medical sector is turning increasingly towards realistic 3D printed models to train surgeons and simulate medical procedures. In Japan, where most medical learning is still done through textbooks, simulations are also gaining in popularity, as they offer hands-on experience and training, though the simulation models are still relatively limited in their scope. That is, while many medical schools and hospitals are equipped with simulation centers, many of the current training devices and “dolls” are much more rigid than real patients, which creates a discrepancy between what doctors are trained to do and what they actually do when they encounter a real patient.

Dr. Toshiya Nakano, a neurologist at the University of Tottori’s faculty of medicine, added: “Young doctors used to learn the ropes gradually by observing senior doctors at work and then trying their hand at operating on actual patients. Such styles of training are no longer acceptable. Ensuring patient safety is a top concern.”

The new Mikoto robot thus marks a remarkable step forward for medical simulation equipment. Mikoto is not designed for all types of simulations, however, but is built for three main procedures: endotracheal intubation (a process wherein a patient’s airway is forced open by a tube in the windpipe), gastrointestinal endoscopy (where internal organs are checked using a flexible fiber-optic camera tube), and sputum suctioning. As mentioned, Mikoto is equipped with various sensors which can alert users if they are putting too much pressure on the robot, or if they are choking it. At the end of the simulation, the 3D printed robot also issues a score for the simulation, which is based on data obtained through the sensors as well as the length of the procedure.

UW’s CREST Utilizes DOD Grant to Build Modular Manikin Simulator

Fake it ‘til you make it

Looks like there is a new manikin on the horizon from the team at CREST! The Daily UW recently reported about the manikin’s development, which while initially seems to have combat medics in mind, will also have lasting civilian opportunities with the industries first “open source” programming interface.

Named after Frankenstein, the roughly 6-foot manikin is part of an ambitious project by the UW Center for Research in Education and Simulation Technologies (CREST) to create an intelligent, customizable model patient that can fit the needs of any medical scenario. The finished manikin will have interchangeable limbs, an internal computer system, and a network of sensors that monitor how a simulation is progressing in real time. “[Frank] is kind of the logical conclusion,” said CREST director David Hananel. “We’ve been trying to develop these high-tech medical simulators for 25 years, but we haven’t made a lot of progress. It’s really the last three to four years where it’s starting to take off.”

The team won a competitive grant from the Department of Defense (DOD) last September as part of the Advanced Modular Manikin project, securing $7.7 million over the next three years to further develop Frank into a multipurpose training tool. They plan to equip Frank with realistic features like warm skin, a wet tongue, a working system of fluid-filled veins, and a network of sensors that relay information back to the computer core in real time.

Much of the DOD’s interest in medical simulation stems from its goal to improve training procedures for combat medics, but the CREST grant specifies that the manikin platform should have both military and civilian applications. This technology could also allow the U.S. military to end its current practice of using live animals, such as pigs and goats, to train combat medics on invasive procedures.

The U.S. military uses over 8,500 live animals every year for training purposes, according to a house bill filed in February. The DOD wants to move away from animal models but is hesitant to do so until researchers have demonstrated that medical simulations are equally effective training tools, according to Speich. As part of the DOD’s grant, the final manikin platform will be open source, meaning the software and design information will be available for free. While it’s unusual for the DOD to be this transparent with its research, Hananel said that they see the benefits of many companies collaborating on a common platform. “For too long simulation has been silos where everyone is pretty protective of their technology,” Speich said. “The way we’re approaching this from the start is letting everyone know that what we’re creating will be shared with everyone. It’s been a long time coming.”

I’m sure we will see Frank at a SimGHOSTS healthcare simulation technology conference in the near future!

Read the full article on the Daily UW website


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Latest Healthcare Simulation News Articles From Around the World!

medical simulation news

Here’s the latest recap of healthcare simulation topics found from the global news stream:

Special Operations Medics Refine Tactical Combat Casualty CareAs a 10th Special Forces Group (Airborne) battalion surgeon, Maj. Hunter Winegarner assists in the planning and execution of medical training across the Group. On April 6th, Winegarner led a group of medics through some of the most realistic training Fort Carson has to offer. To help close that gap as much as possible, Group medics use the Medical Simulation Training Center (MSTC) to provide realistic scenarios that they can work through. The MSTC provides training aids that simulate casualties who can bleed from their extremities, have difficulty breathing, and have eyes that are unresponsive to light.

WSU Provides Simulated Training to Enhance Medical Education Program: In August, Washington State University’s Elson S. Floyd College of Medicine will debut its medical education program, which leads to a Doctor of Medicine (M.D.) degree. The program will welcome 60 students to its charter class. “By integrating clinical, simulation, and case-based learning experiences, the College prepares graduates to lead health care teams,” says Dr. Ann Poznanski, pathologist and Associate Dean for Curriculum. “They learn to coordinate resources in new ways to improve patient care and the health of their communities.”

El Paso EMT Students Receive Grant for Simulated Ambulance

EPCC EMT Students have New Tool for Simulated Training, Echoing Real-Life Experience

Has your EMS program considered a simulated ambulance? We’ve heard of sponsored vehicles and this awesome classroom simulated environment. My only question is — does it move and vibrate like a real ambulance? The El Paso Herald recently reported on the grant purchase of one such classroom simulator: El Paso Community College (EPCC) Emergency Medical Technician (EMT) and Paramedic students have a new tool for “real-life” training.

As part of a $123,000 grant from the Texas Association of Community Colleges– Texas Success Center, EPCC has installed a $40,000 state-of- the-art Ambulance Simulator in its classrooms at the Mission del Paso Campus. “The EMT and Paramedic program is required to train and educate students in a variety of lifesaving treatments and assessment techniques,” said Tony Ayub, Program Coordinator Emergency Medical Services Paramedic. “Simulation has been used successfully in a variety of healthcare related training programs as it allows students to practice and test in a realistic environment.” Practice with “real-life” simulators enriches the student’s training experience.

Accreditation entities recognize and allow the use of medium and high fidelity simulation for clinical training. Paramedic student Kenya Martinez says the simulator training really enhances the program, “I like to help people; I know I can make a difference in their lives.” Ambulance simulators allow the student to practice treatment of critical patients while in transport with all of the restrictions that are associated with working in small, enclosed environments.


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Healthcare Learning Innovations Provides Enhanced Urban Simulation for Public and Community Health Courses

Enhanced Urban Simulation for Public and Community Health Courses

Simulation will continue to expand its educational and training opportunities for healthcare in all disciplines. Healthcare Learning Innovations has announced the planned development of a simulated world for community and public health nursing courses, aptly titled Sentinel World. The first phase of the three-phase project is the urban expansion, Sentinel City 3.0, which will be released April 24, 2017. This phase of development will expand on the company’s already successful Sentinel City Community Health Simulation 2.3, which is currently used by nursing schools across the country. Sentinel City 3.0 will vastly increase the amount of interactive elements and course-based student activity within the simulation, as well as ease the faculty challenge of managing clinical practice hours.

“We’re excited to incorporate new, highly-interactive elements like the Mayor and the home assessment exercise which will allow students to think critically and investigate at their own speed,” says Trevor Rasmusson, the Learning Innovation Manager for Healthcare Learning Innovations. “This type of educational gamification helps increase student engagement and new skill retention,” states Rasmusson.

Healthcare Learning Innovations provides simulation technologies, digital learning tools and interactive courses for healthcare professionals and educators. In partnership with American Sentinel University, it has over 10 years of experience in online, healthcare-focused education.

How Health Sciences North Sim Lab is Fundraising for Their Program!

HSN Foundation event to support simulation learning

Dr. Rob Anderson, left, medical lead of Health Sciences North Simulation Laboratory, introduces simulation technician Tyler Montroy at the launch of Health Sciences North Foundation Taste St. Beach Party fundraiser in Sudbury, Ont. on Wednesday February 22, 2017. Montroy wore a cut suit used in simulation training.

About the Program and the Fundraising Event:

The Ontario Ministry of Health and Long-Term Care committed a few years ago to provide 90 per cent of funding for a new centre where health professionals and students at the Northern Ontario School of Medicine can take part in multidisciplinary simulation-based education and build on HSN’s work at the current simulation lab at the Sudbury Outpatient Centre on Regent Street.

“We’re able to create really realistic educational programs and now we have grown, year after year, to the point that we are busting at the seams,” Anderson said during a press conference at the sim lab on Wednesday. “We are a first-class educational institution, we are leaders in Northern Ontario with respect to simulation-based education, we do outstanding educational research and we’re actually booking time in our sim lab 18 months in advance and having to turn people down, which is great, considering we don’t even have a learners’ centre yet. When we have the learners’ centre, the lights will be on all the time and that’s the most important thing we can do.”

To make the new centre a reality, the HSN Foundation has committed to provide the other 10 per cent of the capital costs of the facility, as well as much of the equipment used to build the programs, with a total funding target of $5.4 million. Taste St. Beach Party will be a key fundraiser in helping the foundation meet that target. Held at the Caruso Club on March 31, the event is billed as “the first beach party of the year” and features hors d’oeuvres, desserts, wine, beer, and other speciality food and drinks donated by supporters of the HSN Foundation, as well as an auction with items donated by artists, actors and other celebrities. All funds raised will support the building of the new learners’ centre and the purchase of teaching equipment.”

Read the Sudbury and the Sudbury Star to learn more!
Have you successfully held a fundraiser for your Simulation Program? Leave us a comment and tell us how!

University of Tennessee, BlueCross BlueShield, and B-Line Medical Team Up to Improve Patient Safety Through Healthcare Simulation

simulation grant tennessee

Last Week Newswise shared how The University of Tennessee Health Science Center (UTHSC) will soon be putting a BlueCross BlueShield (BCBS) grant of $2.9M to work promoting patient safety and healthcare education through an interdisciplinary healthcare simulation center!

HTHSC’s healthcare simulation center will be one of the largest in the world, and it will be interdisciplinary, accommodating training programs for Medicine, Nursing, Allied Health, Pharmacy and Dentistry within the center. Students from these different programs will be working together in a safe, immersive, and simulated healthcare environment that teaches them to tackle today’s biggest healthcare challenges in a risk-free setting.

B-Line Medical’s SimCapture platform was selected by HTHSC to manage and operate the simulation center. Over three hundred coordinated and centralized video streams throughout the center incorporate multiple camera angles and medical devices for comprehensive event capture. UTHSC faculty will use SimCapture to record, analyze, and evaluate the performance of interdisciplinary healthcare teams. SimCapture will also allow faculty to provide students with robust, web-based portfolios and a firm understanding of their simulation outcomes.

President of B-Line Medical, Hartley Thompson says, “UTHSC’s and BCBS’ commitment to healthcare simulation and patient safety aligns perfectly with our company’s mission and vision. We’re honored to have been chosen for such an important and progressive project. The scope and interdisciplinary approach taken by UTHSC will be a model for other institutions to follow.”