Virtual Medical Worlds for Team Training (updated)
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Transcript of Virtual Medical Worlds for Team Training (updated)
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Virtual Reality for Team Training
Parvati Dev, PhD, President
Wm LeRoy Heinrichs, MD PhD, Exec Medical Officer
Innovation in Learning Inc.http://www.InnovationinLearning.com/
Virtual world images and movies from our technology partner, Forterra Systems, unless noted otherwise.
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
What is a Virtual World?
• It is an online environment, usually 3D• A ‘player’ is represented by an ‘avatar’ in the world
– You see other people as their avatars. Use voice or text chat
• It is immersive– You have a sense of ‘presence’ or ‘being there’
• It is social.– You talk with others and interact with them.
• It is populated with interactive objects– Objects include drugs, devices, computers, furniture.
• It may include simulations– Such as virtual patients, with dynamic models of physiology
• It may be game-like, have goal-oriented activities• Building and customization is a popular activity
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
‘Avatars’ in a 3D world
Second Life
Qwaq
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Avatars controlled by learners or role players
• Navigation in world is through the keypad or mouse• Headset supports in-world conversation
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Avatar interaction
A soldier returns home virtually to meet his family Physician/nurse consoling an injured child
A movie icon indicates that the movie will be played on the next slide
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Virtual Hospital(Begun at Stanford University SUMMIT, and continued as a collaboration between Innovation in Learning and Forterra Systems)
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Urban and Emergency Scenes
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Photo-inspired Virtual 3D
Environment – – –
Photos taken in Adult ED at Stanford University
Medical Center
July 2006
In-hospital multi-bay Emergency Department room
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Residents practicing triage
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Nurse shift change
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
High school students practicing CPR scenarios
A collaboration of the Karolinska Institutet, Stockholm, Forterra Systems Inc, and Stanford University
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
The Virtual Medical Environmentand its user interface
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Avatar Health Visualization
Graphical User Interface Diagnostic Display
Images and Text 3D Patient Avatar
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Virtual Trauma Patient – under the hood
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
A Dynamic Model of Patient Physiology
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Virtual Patients currently available from IIL
Trauma, hemorrhage and hypovolemic shock– Dynamic model of physiology
• Implemented as licensable software module and as a web demo• Generates almost an infinite variety of patients
– 12 specific scenarios developed by us using this physiology
• Implemented by Forterra Systems in a Virtual Hospital
Aphyxiation, nerve toxins, anaphylactic shock– Dynamic model of physiology
• Available as a written set of rules– 10 specific scenarios developed by us using this physiology
• Implemented by Forterra Systems in a Virtual Hospital
Infection, sepsis– Dynamic model of physiology
• Available as a written set of rules
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Controlled Trial Study of Learning Efficacy
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Study design and subjects
Explain interface and goals
Pre-test with trauma scenario (no debrief)– Score with EMCRM rating sheet
Four learning scenarios (trauma), with debrief
Post-test with trauma scenario– Score with EMCRM rating sheet
4th year medical students or 1st year residents
Control group learnt with HPS manikin– N=15
Intervention group used Virtual ED– N = 16
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Managing trauma with HPS manikinQuickTime™ and aTIFF (Uncompressed) decompressorare needed to see this picture.
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Managing Trauma in the Virtual Emergency Room
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Clinical Scenarios for Virtual ED
1. Male: pneumothorax and femur fracture after auto collision2. Male; bicycle rider falls from bike path, suffers spleen rupture3. Male; car driver, hypoglycemia and femur fracture4. Male; ethanol induced fall, with head injury, obstructed airway5. Female;(2nd trimester pregnancy); with renal laceration after
auto collision6. Male; construction worker fall, liver rupture, fracture of femur7. Male: construction worker, flail chest and dislocated shoulder8. Male: bicycle rider with severe hand and abdominal injury after
auto collision and being ‘run-over’ 9. Female; elderly pedestrian with facial fractures and
unconsciousness after auto collision.10. Female (3rd trimester pregnancy); auto collision with femoral
neck fracture, and vaginal bleeding (placental abruption)
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Roles
Role player Learner
Facilitator
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Performance measurement using principles of EMCRM
(Emergency Medicine Crew Resource Management)
1. Know your environment
2. Anticipate and plan for crises
3. Assume a leadership role
4. Communicate effectively with other team members
5. Call for help early enough
6. Distribute workload optimally
7. Allocate attention wisely
8. Utilize all available resources
9. Utilize all available information
10. Maintain a professional behavior
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
A debrief sessionQuickTime™ and aTIFF (Uncompressed) decompressorare needed to see this picture.
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
EMCRM Performance scores
0.00
10.00
20.00
30.00
40.00
50.00
HPS Group
Pretest Sum Scores
Posttest Sum Scores
Pretest Sum Scores
Posttest Sum Scores
Virtual ED GroupN=15 N=16
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
P o s i t i o n s / R o l e s o f P a r t i c i p a n t s
1 2
32
1
3
1
0
5
1 0
1 5
2 0
ED RNED
Physician
EM
Resident
Chief
Resident-Surgery Surgery
Resident
Surgery
Intern
# Participants
P r i o r T r a i n i n g i n C B R N E
3
6
8
5
0
5
1 0
1 5
2 0
N o Y e s
# Participants
S t a n f o r d
S a n M a t e o
F e e l i n g I m m e r s e d
1 1
6
11
31
6
2
0
5
1 0
1 5
2 0
N o t a t a l l S o m e o f t h e
t i m e
N o t s u r e M u c h o f t h e
t i m e
A l l o f t h e
t i m e
# Participants
S t a n f o r d
S a n M a t e o
C o n f i d e n c e P r i o r t o E x e r c i s e s
7
23
8
1
10
5
1 0
1 5
2 0
N o t
C o n f i d e n t
S o m e w h a t
C o n f i d e n t
C o n f i d e n t V e r y
C o n f i d e n t
E x t r e m e l y
C o n f i d e n t
# Participants
S t a n f o r d
S a n M a t e o
C o n f i d e n c e A f t e r E x e r c i s e s
9
12
5
5
0
5
1 0
1 5
2 0
N o t
C o n f i d e n t
S o m e w h a t
C o n f i d e n t
C o n f i d e n t V e r y
C o n f i d e n t
E x t r e m e l y
C o n f i d e n t
# Participants
S t a n f o r d
S a n M a t e o
U s e f u l n e s s f o r T e a m S k i l l s T r a i n i n g
1
5
3
1
4
5
3
0
2
4
6
8
1 0
1 2
N o t U s e f u l S o m e w h a t
U s e f u l
U s e f u l V e r y U s e f u l E x t r e m e l y
U s e f u l
# Participants
S t a n f o r d
S a n M a t e o
Results of our other studies using Virtual Worlds
(Stanford Hospital and San Mateo General Hospital)
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Lessons from our studies
• Multiplayer virtual worlds are effective learning environments for individuals in a team.
• They are also effective in teaching confidence in dealing with unexpected situations such as CBRNE.
• The studies applied to trauma management. They should be extended to other medical situations.
• Individual performance assessment instruments need to be augmented to include team performance.
• Learners like these simulated but authentic learning scenarios and would welcome their inclusion in their curricula.
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Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
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Innovation in Learning
• We build individual and team expertise– through Immersive Role-playing Experiences– in Virtual Worlds
• Products:– Virtual Patients with Medical Models– Virtual Hospitals and Clinics
• Services:– Training & Workshops– Curriculum & Content
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
Thank you for your attention !
http://www.InnovationInLearning.com/
Innovation in Learning Inc.12600 Roble Ladera RdLos Altos Hills, CA [email protected]
Research and prototype development funded by:TATRC (USAMRMC)Wallenberg FoundationForterra Systems Inc.Innovation in Learning Inc.
Team Training in Virtual Worlds
© 2008, Innovation in Learning Inc. Overview Presentation
QuickTime™ and aTIFF (Uncompressed) decompressorare needed to see this picture.QuickTime™ and aTIFF (Uncompressed) decompressorare needed to see this picture.
Innovation in Learning Inc.12600 Roble Ladera RdLos Altos Hills, CA [email protected]