Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-18T14:22:59.441Z Has data issue: false hasContentIssue false
  • English
  • Français

A Virtual Reality Patient Simulation System for Teaching Emergency Response Skills to U.S. Navy Medical Providers

Published online by Cambridge University Press:  28 June 2012

Karen M. Freeman ,
Scott F. Thompson ,
Eric B. Allely ,
Annette L. Sobel ,
Sharon A. Stansfield  and
William M. Pugh
Karen M. Freeman*
Affiliation:
Anteon Corporation, under contract to Naval Health Research Center, San Diego, California, USA
Scott F. Thompson
Affiliation:
Tekamah Corporation, Vienna, Virginia, USA
Eric B. Allely
Affiliation:
Tekamah Corporation, Vienna, Virginia, USA
Annette L. Sobel
Affiliation:
Sandia National Laboratories, Albuquerque, New Mexico, USA
Sharon A. Stansfield
Affiliation:
Ithaca College, Ithaca, New York, USA
William M. Pugh
Affiliation:
Naval Health Research Center, San Diego, California, USA
*
Naval Health Research Center, P.O. Box 85122, San Diego, California, 92186-5122, USA, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Rapid and effective medical intervention in response to civil and military-related disasters is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties not generally encountered in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multimodal data. In this project, collaborators adapted and merged existing technologies to produce a flexible, modular patient simulation system with both three-dimensional virtual reality and two-dimensional flat screen user interfaces for teaching cognitive assessment and treatment skills. This experiential, problem-based training approach engages the user in a stress-filled, high fidelity world, providing multiple learning opportunities within a compressed period of time and without risk. The system simulates both the dynamic state of the patient and the results of user intervention, enabling trainees to watch the virtual patient deteriorate or stabilize as a result of their decision-making speed and accuracy. Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired. This paper describes the technologies and the process used to develop the trainers, the clinical algorithms, and the incorporation of teaching points. We also characterize aspects of the actual simulation exercise through the lens of the trainee.

Resumen

Intervenciones médicas rápidas y efectivas como respuesta a desastres civiles o militares, son cruciales para salvar vidas y limitar incapacidades. Proveedores sin experiencia sufren en llevarlas a cabo cuando se encuentran limitados de recursos frente a las demandas de poder estabilizar a la víctima, como cuando se encuentran comparativamente en un hospital con una posición más rica en recursos. El trauma de cráneo y los politraumatizados son particularmente complejos para diagnosticar y tratar, requiriendo de procesar e integrar información multimodal compleja. En este proyecto, los colaboradores adaptaron y fusionaron tecnologias existentes para producir un sistema simulador de paciente modular flexible, tanto con realidad virtual tridimensional y bidimensional para su uso en pantalla plana con interfase para la enseñanza de conocimientos y la evaluación de habilidades. Este acceso de entrenamiento basado en problemas, atrae al usuario a un mundo de alta fidelidad lleno de estrés, proporcionándole oportunidades de aprendizaje dentro de un período de tiempo comprimido y sin riesgo. El sistema Simula tanto el estado dinámico del paciente como los resultados de la intervención del usuario, permitiendo a los entrenadores observar el virtual deterioro o estabilización del paciente como resultado de la decisión tomada con rapidez y precisión. Los sistemas pueden ser desplegados en el campo, permitiendo a los entrenadores practicar repetidamente hasta que las destrezas sean dominadas, y para mantener aquellas ya adquiridas. Este documento describe las tecnologías y el proceso utilizado para desarrollar a los entrenadores los algoritmos clínicos y la incorporación de puntos de enseñanza. Nosotros también caracterizamos aspectos de los ejercicios actuales de simulación a través de los objetivos del período de práctica.

Keywords

disaster preparednessemergency responseexperiential learninghead injurymedical educationpatient simulationproblem-based learningsimulation trainingvirtual reality
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 1 , March 2001 , pp. 3 - 8
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Home, GE, Carey, NB, Rattelman, CR: Future challenges for operational medicine: care of the echelons. Navy Med 1996;Sept-Oct:8–13.Google Scholar
2.Kizakevich, PN, McCartney, ML, Nissman, DB, Starko, K, Smith, NT: Virtual medical trainer: Patient assessment and trauma care simulator. Stud Health Technol Inform 1998;50:309–315.Google ScholarPubMed
3.Helling, TS, McNabney, WK, Whittaker, CK, Schultz, CC, Watkins, M: The role of early surgical intervention in civilian gunshot wounds to the head. J Trauma 1992;32:398–400.CrossRefGoogle ScholarPubMed
4. Memorandum Number: No. 169-M: Memorandum For Correspondents. 27 Jul 199S. (11 paragraphs) Defense Link: U.S. Department of Defense. http://www.defenselink.mil/news/Jul1995/m072795_m-169-95.html (Nov 2000).Google Scholar
5.Stansfield, S, Shawver, D, Sobel, A: MediSim: A prototype Virtual Reality system for training medical first responders. Proceedings of the Virtual Reality Annual International Symposium, Atlanta, GA, Mar 1998.Google Scholar
6.Stansfield, S, Sobel, A, Shawver, D: BioSimMER: A virtual reality simulator for training first responders in a BW scenario. Proceedings of the 1998 Scientific Conference on Chemical and Biological Defense Research, Aberdeen Proving Ground, MD. Nov 1998.Google Scholar
7.Barton, ED: Tension pneumothorax. Curr Of in Pulm Med 1999;5:269–274.CrossRefGoogle ScholarPubMed
8.Stansfield, SA: A distributed virtual reality simulation system for situational training. Presence: Teleoperators and Virtual Environment. 1994;3:360–366.CrossRefGoogle Scholar
9.Kolb, DA: Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs, NJ: Prentice Hall Inc., 1984.Google Scholar
10.Albanese, M, Mitchell, S: Problem-based learning: A review of literature on its outcomes and implementation issues. Acad Med 1993;68:52–81. Review.CrossRefGoogle ScholarPubMed
11.Vernon, DT, Blake, RL: Does problem-based learning work? A meta-analysis of evaluative research. Acad Med 1993;68:550–563. Review.CrossRefGoogle Scholar
12.Norman, G, Schmidt, HG: Psychological basis of problem-based learning. Acad Med 1992;67:557–565.CrossRefGoogle ScholarPubMed
13.Berkson, L: Problem-based learning: Have the expectations been met? Acad Med 1993;68:s79–s88. Review.CrossRefGoogle ScholarPubMed
14.Bordage, G, Sinacore, JM, Gecht, MR, Chang, RW, Connell, KJ: Assessing the semantic content of clinical case presentations: Studies of reliability and concurrent validity. Acad Med 1997;72:s37–s39.CrossRefGoogle ScholarPubMed
15.Small, SD, Wuerz, RC, Simon, R, Shapiro, N, Conn, A, Setnik, G: Demonstration of high-fidelity simulation team training for emergency medicine. Acad Emerg Med 1999;6:312–323.CrossRefGoogle ScholarPubMed
16.Christie, PM, Levary, RR: The use of simulation in planning the transportation of patients to hospitals following a disaster. J Med Syst 1998;22:289–300.CrossRefGoogle ScholarPubMed
17.Willy, C, Sterk, J, Schwarz, W, Gerngross, H: Computer-assisted training program for simulation of triage, resuscitation, and evacuation of casualties. Mil Med 1998;163:234–238.CrossRefGoogle ScholarPubMed
18.Gaba, DM, Howard, SK, Flanagan, B, Smith, BE, Fish, KJ, Botney, R: Assessment of clinical performance during simulated crises using both technical and behavioral ratings. Anesthesiology 1998;89:8–18.CrossRefGoogle ScholarPubMed
19.Sica, GT, Barren, DM, Blum, R, Frenna, TH, Raemer, DB: Computerized realistic simulation: A teaching module for crisis management in radiology. AJR Am J Roentgenol 1999;172:301–304.CrossRefGoogle ScholarPubMed
20.Cavanaugh, S: Computerized simulation technology for clinical teaching and testing. Acad Emerg Med 1997;4:939–943.CrossRefGoogle ScholarPubMed
21.Ackerman, MJ: The Visible Human Project: A resource for education. Acad Med 1999;74:667–670.CrossRefGoogle ScholarPubMed
22.Nani, FK, Oguztoreli, MN: Modelling and simulation of chemotherapy of haematological and gynaecological cancers. IMA J Math Appl Med Biol 1999;16:39–91.CrossRefGoogle ScholarPubMed
23.Pentecost, JO, Icardo, J, Thornburg, KL: 3D computer modeling of human cardiogenesis. Comput Med Imaging Graph 1999;23:45–49.CrossRefGoogle ScholarPubMed
24. Federation of State Medical Boards. United States Medical Licensing Exam (USMLE)™. http://www.fsmb.org See USMLE, Step 3 link, Computer-based Case Simulations (CCS). (Nov 2000).Google Scholar
25.Funk, D: He's No Dummy—Med school mannequin makes for ‘live theater.’ The Navy Times 13 Dec 1999, p24.Google Scholar