One of the biggest challenges in training a medical professional is having a live patient for the procedural instructions. As a result, simulation has become a key tool for training staff at leading medical facilities, including Stamford Health.
“We used to say with physicians ‘see one, do one, teach one,'” said Dr. Suzanne J. Rose, executive director of research at Stamford Health. “That’s what we’re really trying to get away from in this day and age of advanced learning because there are so many different ways you could make a mistake with a real person without intending it. But if we can provide the scenarios in a very low risk environment that’s safe, then everyone feels a lot more adept when they get to an actual patient.”
The latest advanced learning tool in Stamford Health’s toolbox is a virtual reality (VR) platform produced by Oxford Medical Simulation (OMS) and used by students as well as doctors and nurses.
“There’s a wealth of research and evidence that supports simulation-based education,” said Michelle Saglimbene, the manager of Stamford Health’s Center for Simulation and Learning. “It really gets back down to the basics ”” we don’t want our practitioners practicing in real time on real people.”
“While that’s traditionally how healthcare workers have been trained in that preceptorship, apprenticeship model, we felt that as an organization and as the Department of Research and Discovery that it’s our duty to go out there and see what newer technologies are available to support our staff,” Saglimbene added.
According to Saglimbene, the decision to use OMS became increasingly appealing as a result of the pandemic because the platform allows training wherever students have a stable internet connection.
The program can be used without a headset, providing access to all the same scenarios, but mouse and keyboard navigation is not quite the same as being able to walk around the virtual patient and feel fully immersed in the realistic rendering of an emergency room bay.
Stamford Health is in the process of acquiring more VR headsets which provide a fully immersive experience. OMS also provides networked options so that several people can work on the same virtual patient, whether they are in the same room or separated.
But VR technology has some limits. Many aspects of medicine require tactile information and practice with fine motions that are still not easy to replicate, in even the most advanced virtual spaces. For the time being, OMS is supplemented with advanced animatronics, mannequins, and mock-ups.
“In our neonatal intensive care, we have a high-fidelity baby simulator,” noted Rose. “If there is a procedure that they know they’re going to be doing they can practice it on that neonatal simulator and have familiarity with a procedure that they might only do once every few months.”
Rose pointed to applying tape to a baby’s skin as a key skill to practice.
“When you have a baby who is born prematurely the tape can rip their skin off and cause an infection and so many different types of issues,” she said. “But they can practice their taping skills on the simulator so that they’re comfortable where that tape needs to be placed and where it can be without causing the skin to break. We want them to say, ‘I’m so confident in my skills that I’m ready for that.'”
According to Saglimbene, early trials with the virtual reality component have not only been positive but generated considerable excitement.
“I scheduled a meeting today with the entire risk and regulatory team for March 7, that’ll be about 10 to 12 learners, I think we are going to need a third headset. The educators who helped facilitate the orientation all asked to put the headset on, and the residents have been emailing me individually to put them on,” Saglimbene said. “This isn’t a slow roll out, everybody is very excited about it.”
