Tag Archives: simulation

Advancing Simulation Beyond Education

Written on December 15, 2016 at 9:10 am, by

Simulation in health care has powerful potential. For years, it’s been utilized to educate and train those seeking a career in medicine. It’s also been leveraged as a way to provide insights into latent health system flaws such as communication issues among clinicians or whether a medical facility has all the essential tools it needs to provide the best care possible.

u-of-i-innovation-space OSF HealthCare, through Jump Simulation and the University of Illinois, is expanding its use of simulation even further by leveraging it to design novel solutions in health care. The idea is to simulate problems discovered throughout the health care system so that engineers and clinicians can observe and brainstorm ways to fix these issues.

Using simulation as a design tool is still fairly new to health care systems around the U.S. But Jump Simulation and U of I have been collaborating on this type of work since the opening of Jump Trading Simulation & Education Center, so much so that there are now dedicated labs for these collaborative efforts in the newly minted space within Jump called OSF Innovation.

Four Labs, One Purpose

All four labs are located on the fourth floor of the Jump facility. Two will be dedicated to the ongoing work Jump Sim has established with the University of Illinois’ Colleges of Medicine and Engineering through Jump Applied Research for Community Health through Engineering and Simulation (ARCHES). The other two rooms are committed to projects in Advanced Imaging and Modeling.

All four assignments pair clinicians and engineers to develop medical education technology that will advance the clinical agenda at OSF. This is part of a larger effort by the University of Illinois re-thinking how it innovates around curriculum.

Two of the projects utilizing innovation lab space were recently awarded a continuation of Jump ARCHES funding. One team of individuals from OSF HealthCare, U of I, Illinois Neurological Institute, and Bradley University is creating a device to teach young health care professionals to practice feeling and identifying abnormal muscle behaviors in patients with brain lesions. The goal is to expand training to more than just neurologists so that OSF can increase the number of patients served.

The second development is focused on producing an avatar-based system to communicate with patients at the time of discharge so they fully understand their medical instructions before going home. The system could also be used to train medical students to communicate with patients in a simulated environment. The
dikshant-pradhan-working-on-orthopedic-trainerultimate goal of the project led by clinicians and engineers from U of I and OSF is to reduce readmission rates at area hospitals.

The two labs devoted to work in Advanced Imaging and Modeling are leveraging virtual and augmented reality technologies like the Oculus Rift and HTC Vive to revolutionize how clinicians and radiologists view anatomy and advance how human anatomy is taught to medical students.

Nurture, Validate and Disseminate

The intention of committing space for collaborative work among clinicians and engineers is to support teams with great ideas and provide technical and clinical expertise to advance their projects. Each of the teams selected to use the lab space within Jump will get to do so for up to a year. From there, these ventures can be validated within the simulation space at Jump and throughout the OSF Healthcare System.

Completed projects could eventually find a home within the University of Illinois’ curriculum and disseminated to its various medical campuses. It’s this ongoing collaboration between OSF and U of I that makes Jump Simulation a one-of-a-kind facility.

A Champion for Medical Simulation

Written on October 18, 2016 at 7:20 am, by

There’s a model in higher education used to describe different levels of assessment called Miller’s Pyramid. The idea is that educational objectives should go beyond recalling and understanding facts and basic concepts, giving learners the ability to apply knowledge; analyze and evaluate processes, procedures and principles; and eventually create new or original work.

Medical simulation fits in the higher levels of this pyramid because it allows physicians and nurses-in-training to take what they learned in the classroom and apply it in a realistic, but safe wprismay. To me, it’s an essential part of medical education. And even now as an emergency medicine physician at OSF Saint Francis Medical Center, I strive to learn more about simulation to not only demonstrate its benefits but create new ways to utilize simulation to improve health care.

I recently joined Jump Simulation as part of a two-year fellowship where I will learn to be a health educator and how to make simulation a productive tool. It’s my future goal to understand how to make a unique environment such as Jump Sim work and apply that knowledge in rural areas that aren’t typically exposed to centers like these.

Finding My Path

My mother was a nurse, but getting into the health care industry was never a given for me. In fact, I initially resisted the field because I wanted to pave my own career path. A couple of mission service trips overseas opened my eyes to the importance of medicine. I was exposed to so many people who don’t have access to health care and were unable to live normal lives. I knew I had to go to medical school to change that.

voz-podolejWhat I learned in medical school is that the emergency room is a great place to master the art of taking care of very sick people. It’s a place where decisions matter and time is of the essence. Learning life-saving procedures at the bedside isn’t the best option. It was in the ER where I came to discover the benefits of training for medical emergencies in a simulated environment, so we don’t put patients at risk.

I gained much more experiential knowledge through various simulation cases than I ever did reading a textbook, doing homework or taking a test because those cases were so formative for me.  An internship with Dr. John “Voz” Vozenilek during his time with Northwestern University’s Simulation Center peaked my interest even future.

It was Voz who taught me that deliberate practice makes technically competent doctors. Working with him helped me understand how using simulation to repetitively do something until you get it right makes you comfortable and safe dealing with patients, leading to fewer complications and better health care delivery.

Gaining Simulation Expertise

As part of my Fellowship here at Jump, I am working with various departments to identify gaps in knowledge among medical students and residents. The goal is to create well-thought-out educational interventions that could include classroom or simulation work. I’m also learning to create and implement simulations and assess learners.Simulation-3

One case I’m partnering with OSF Saint Francis Medical Center nurses on is to produce simulations around new American Heart Association guidelines for maternal cardiac arrest. Sometimes a C-section is needed if a soon-to-be mother goes into cardiac arrest. We are generating scenarios that will train residents and nurses to work as a team as they deal with that situation. I’m also working to make simulation scenarios for pediatric and behavioral health cases.

As someone who’s gone through medical school and residency, I understand why teaching hospitals and universities around the world are pushing to make simulation a rite of passage for anyone entering the field. There’s certainly a place in education for classroom learning, but there’s nothing like actually performing medical procedures or dealing with critically ill patients in a realistic, safe environment. The ability to practice until you achieve your educational goals instills learner confidence.

That’s why I’m excited that my simulation fellowship is taking place at Jump. It’s a unique space, especially with its connection to OSF HealthCare and the University of Illinois College of Medicine at Peoria.  I believe Jump Sim is poised to make a big difference in health care, and I can’t conceive of a better place to learn the trade than right here. I’m really fortunate to be a part of this experience, learn from leaders in the medical education field, and put my ideas into use.

 

The Potential of Virtual Reality in Simulation

Written on May 13, 2016 at 7:03 am, by

Just as the healthcare industry continues to evolve, so too does the training of novice and experienced physicians and other clinicians. Jump is a leader in offering hands-on experiences in a variety of simulated environments: beginner and more seasoned surgeons can practice life-saving procedures they rarely encounter on a cadaver perfusion model, fledgling nurses and residents can rehearse working as a team for the first time to save a patient’s life, and advanced care planners can practice discussing end-of-life care decisions using standardized participants.

In-person simulation has become a right-of-passage for medical and nursing students around the world, allowing them to practice life-saving procedures before contact with real patients. To some extent, that will always be the case. But in the future, more simulation scenarios will occur in the immersive virtual reality space.

Virtual Reality

The fact is, physical simulation and physically reproduced environments are expensive and require people to travel. This makes frequent or repetitive practice difficult. Offering virtual reality simulations opens up participation for medical professionals who are too far away to utilize a simulation center. It provides the opportunity to create interprofessional teams with staff members who have never worked together before. Virtual reality simulation will allow participants to prepare for in-person simulations and do follow-up repeat practice after they’ve completed hands-on learning opportunities.

There is much as yet untapped potential with virtual reality. I was recently part of a team, consisting of educators from Lehigh Valley Health Network (LVHN), that published an online paper demonstrating that it was possible to create an outpatient virtual reality simulation in a first-person-perspective environment. The pilot revealed it’s an opportunity we, as simulation centers, should continue to explore.

Utilizing Virtual Reality Technology for Medical Simulation

Virtual and augmented reality technology is exploding today with products like Oculus Rift and the Microsoft HoloLens becoming part of mainstream culture. But virtual reality has been utilized in the medical industry, to some extent, for years. It just hasn’t evolved enough to provide real immersive experiences for clinicians in different healthcare environments.

Our research worked to design a user-friendly interface for interprofessional teams to practice outpatient-based emergency scenarios. We used AvayaLive™ Engage to create a computer-generated replica of an LVHN outpatient facility, and built three simulation cases centered on common office-based emergencies: chest pain, respiratory distress/allergic reaction, and suicidal risk. We chose to focus on office-based emergencies because there aren’t a lot of simulation opportunities for this environment, and outpatient care is expanding to include more complex cases.

18 individuals representative of an outpatient interprofessional care team participated in the study. Up to five clinicians performed simulation exercises at a time as if they were playing a video game. They controlled their own avatars and utilized Voice over IP to communicate with each other. Some were also in the same room, so they could talk to each other as they went through the scenarios. Actors played the patients within the virtual clinic room and controlled their own avatars and voice controls. Orientation was provided to all subjects before the simulations took place.

Using a design-based research approach, we were able to continually improve the simulation process, virtual environment, and scenarios based on feedback from participants during debrief. Learners provided reactions to everything from whether the sounds in the outpatient room were realistic to whether the virtual environment was easy to navigate.

A post-activity survey revealed participants were accepting of the learning method and environment. A majority also felt they met the learning objectives of office-based emergencies using virtual reality simulation. The next step will be to test this method out on a larger scale.

The Future of Simulation

A major advantage of using a virtual world for medical simulation is that the cost of distributing content to a wide audience is very low. However, there are upfront costs associated with creating the curriculum and medical environment. In many cases, educators would likely prefer a pre-made virtual environment they could write cases for. There aren’t many faculty members with the time or resources to build an interface from the ground up as our research team did.

However, there are an increasing number of technology companies developing more opportunities for virtual reality-based simulation. I envision that students in healthcare will eventually be able to wear a 3D viewing apparatus to fully immerse themselves in a virtual space that allows them to practice procedures or interact with patients.

At this point, I think we are still at an early stage. I imagine the things we are unable to simulate today, we’ll be able to simulate easily in the next five to ten years.