Wednesday, August 29, 2012

VHA's Simulation Activities

The VHA’s “Simulation Learning, Education, and Research Network” (SimLEARN), program used for healthcare training is involved in new efforts to improve training. The simulation program is developing a national simulation center, establishing the IT infrastructure, and collaborating with DOD, academic affiliates, and other non-VHA entities to advance mutual interests in simulation.

According to an article appearing in the summer 2012 SimLEARN newsletter, Jeffrey Cluver, M.D, Staff Psychiatrist at the Ralph H. Johnson VA Medical is finding ways to use simulation training to treat veterans who have delirium.

When the Medical University of South Carolina (MUSC) opened their state-of-the-art simulation center, a call went out to develop a module to treat delirium. Students are working to treat the simulated patient that they call “SimMan” who acts incoherent and sometimes shouts abrasively or even sometimes acts somewhat normal. So far, several modules have been developed using “SimMan” to treat the causes for delirium.

To add realism, “SimMan” will become agitated if not treated appropriately. Additionally, if the students do not manage the case effectively “SimMan” may have a seizure, develop an arrhythmia, or become unresponsive. So far, the students using the simulated patient have said they feel more confident in their ability to recognize and treat delirium.

In another effort to improve the simulation experience, the Boise VA Medical Center (BVAMC) was looking for a way to enhance and increase realism in-situ simulation experiences. They simulated monitoring babies in the hospital units during mock code using wireless transmitters for voice but found there still wasn’t an acceptable way to hear or see what was happening in the room without physically being at the bedside.

Some facilities have tried using standard operating baby monitors during simulation so that the mannequin operator could hear what was happening and respond appropriately. The simulation education team however, decided to use a color video and audio baby monitor instead which makes it possible to see as well as hear what is happening in real-time during the simulation.

Since both the mannequin and the baby monitor were wireless, the operator was able to control the simulation and respond to the learner’s actions from two rooms away. Being able to remotely run in-situ scenarios without an immediate physical presence at the bedside opens up many options and increases the realism of training without incurring a big price tag.

Additional benefits to using this particular baby monitor is the ability to see in the dark since using infrared light allows for continuous monitoring during power outages and has the ability to record and capture images and sounds from the monitor onto an attached computer.

Also, VHA is addressing the simulation needs of women veterans by training thousands of VHA providers in women’s health care partly by using state-of-the-art simulation equipment. The simulator is a tactually accurate breast model placed on a pressure-sensitive tablet. The simulator gives trainees feedback on proper palpation methods and how to examine the breast in a thorough systematic manner. Women’s Health in partnership with SimLEARN has purchased MammaCare® Clinical Breast Exam Simulators for all of the VHA’s 21 VISNs.