W21C was featured in Avenue Magazine’s Big Idea 2013 as one of five advances in health simulation in Calgary. Dr. John Conly, Medical Director, and Greg Hallihan, Research Associate, Human Factors, were interviewed for the article.
5 Advances in Health Simulation
October 16, 2013
JULIA WILLIAMS and GREG BENETEAU
Advances in medical simulation and medical technologies are drastically changing how students learn in the classroom — and improving the health care that Calgarians receive.
W21C
The Ward of the 21st Century is trying to improve the way health care is delivered.
The program was originally envisioned as a model ward at the Foothills Medical Centre and allowed health care professionals to test ideas and products. Five years after W21C opened its clinical test environment in 2004, it added a technology test environment called the Research and Innovation Centre. The program’s research team — including medical practitioners, computer scientists, biomedical engineers, nurses, sociologists and anthropologists, to name a few — have access to a laboratory, clinical space and a simulation room.
Dr. John Conly, an expert on infectious disease and one of W21C’s founders, says the multi-disciplinary team is one of the program’s greatest strengths. “When you’re doing a study, if you start looking at it from multiple angles, it enriches the issue,” he says.
W21C has worked on projects to prevent emergency room overcrowding, testing tablet technology and working with doctors to consider their wellness in relation to nutrition and scheduling. It’s currently looking into ambulance design, a subject that has not been investigated in depth in Canada before.
Greg Hallihan is a research associate specializing in human factors at W21C, a field that combines psychology and engineering. He and his team have travelled across Alberta conducting interviews and studies and performing tests in a donated ambulance.
“We actually drove it on a closed test track and had EMS providing care to a patient who was having an anaphylactic reaction to a bee sting,” Hallihan explains. “We recorded everything. We used an eye-tracking camera to see where they were looking, plus five cameras mounted in the unit.” The goal was to find out what factors, if any, were hampering the delivery of care.
Conly says W21C’s next move will be to take on the challenge of delivering health care in the home, working with the University of Calgary’s faculty of environmental design to create a versatile testing environment simulating different types of home environments.
“The patient exists after the hospital and before they arrive,” says Hallihan. “We’re going to create the environment that actually tracks from the home to the hospital to whatever environment you want to simulate.” (w21c.org)
Peter Lougheed eSIM Centre
The eSIM facility at the Peter Lougheed Centre is an on-site simulation-training centre. Using a “family” of responsive mannequins, the eSIM centre presents aspiring health care workers with symptoms and situations that mimic the complexity and unpredictability of a real clinical environment. For example, patients may have confusing combinations of symptoms, they may not be lucid, they may be very young or very old or they may have a language barrier. The goal of the eSIM centre (which stands for Educate, Simulate, Innovate, Motivate) is to give students the opportunity to practice routine procedures in controlled environments. Peter Lougheed Hospital is the first to have simulation centres of this kind in Calgary, but eventually there will be seven eSIM centres in Calgary, including one that is mobile. (albertahealthservices.ca)
Clinical Simulation Learning Centre
Since 2009, nursing students at the University of Calgary have developed their skills in highly realistic scenarios created at the Clinical Simulation Learning Centre. Here, the patients are responsive mannequins that breathe, speak, respond to treatments — even give birth. Teaching takes place in nine multi-purpose rooms that transform from seminar spaces into classrooms or simulated wards, and three “high-fidelity” rooms are equipped with observation technology essential to the debriefing process. Director Pat Morgan says the Centre is designed to enable students to transition successfully from school to actual clinical environments. “It’s a safe learning environment where students are provided with a variety of learning opportunities which help them transition from classroom to clinical practice,” Morgan says. (ucalgary.ca)
LINDSAY
Meet LINDSAY: a virtual human body that lets students see its inner workings. The LINDSAY Virtual Human Project is an interactive 3D computer model that allows users to explore dynamic functions of the human body, from the flexing of muscles to the inner workings of blood cells, in staggering detail. The program was developed by researchers at the University of Calgary and was named after Dr. Lindsay Kimmett, a U of C medical student who died in a car crash in 2008. (ucalgary.ca)
KidSIM Patient Simulation Ward
Dr. Vincent Grant’s early experiences with patient simulation were less than ideal, to say the least. “When I did my practicum in medical school, I performed CPR on a pillow and pretended it was a child,” he says.
Grant, an emergency physician at the Alberta Children’s Hospital and an associate professor of pediatrics at the University of Calgary, took that experience to heart. Recruited from the Children’s Hospital of Eastern Ontario in Ottawa in 2005, Grant has spent much of the past decade developing a program to train health care professionals in team-based responses to pediatric care.
Funded through private donations, with support from Alberta Health Services’ provincial eSIM patient simulation program, KidSIM has grown from a small group of educators operating out of a crowded basement suite to a fully staffed, 3,600-square-foot teaching space on the fourth floor of ACH, which opened this fall.
“We’ve set up debriefing rooms where educators and the team can go over the simulation and provide feedback in an open and non-judgmental environmen.” Dr Vincent Grant
The program has a collection of 10 “high fidelity” patient mannequins, which can be programmed to simulate conditions ranging from cardio-respiratory problems and altered levels of consciousness to seizures.
To make the training scenarios as realistic as possible, each of the ward’s four simulation rooms is decked out to mimic a hospital working environment, complete with diagnostic equipment and terminals that show patient readouts. From an adjacent control room, instructors monitor the exercise and can alter the parameters of the program by, for example, having a patient go into shock.
But the real key to the learning process is the reflection period that follows each simulation, Grant says. “We’ve set up debriefing rooms where educators and the team can go over the simulation and provide feedback in an open and non-judgmental environment,” he explains.
Additionally, the simulation and debriefing rooms are equipped with audio-visual recording software, allowing instructors to do a play-by-play analysis of the scenario and ensure quality control for instructor training.
In 2012, more than 3,500 health care professionals trained with KidSIM. Participants in the program range from first-year med students to “doctors with decades of hospital experience,” Grant says.
Each year Avenue chooses one topic as its Big Idea to delve a little deeper in. The Big Idea is also the theme of the October print issue. This year Avenue is studying education, health care and design as the three cornerstones of a successful city.