Education Management Solutions (EMS) congratulates Virginia’s Centra Health and Lynchburg College (LC) on the recent dedication of  the Central Virginia Center for Simulation and Virtual Learning, which will be managed jointly by the two institutions.

“Simulation is the latest and most effective type of education in which students can intervene, make decisions, and take actions in a highly controlled environment,” says Patti McCue, Sc.D., R.N., MSN, NEA-BC, Centra senior vice president of patient care services and chief nursing officer. “The process allows the creation of clinical situations that could not be created in a hospital setting. It also is an excellent way to teach and promote patient safety. Students can practice in a controlled environment before working with actual patients. In addition to students, current health professionals have the opportunity to use the center for advanced technical skill development and to improve communication and collaboration skills as part of a team.”

Phase 1, which occupies about half of the more than 15,000 square-foot center has been completed and consists of five acute care inpatient rooms, one critical care inpatient room, one labor and delivery birthing suite, two primary care exam rooms, one home health apartment, and an ambulance venue.

EMS’ Orion solution, the most technologically advanced simulation management and audio-video system for capturing simulation activities, debriefing, and skills evaluation is integrated into the simulation areas of the first phase.  Johanna Derrenbacker, director, Central Virginia Center for Simulation and Virtual Learning, states, “We are really excited to start working with our system. We wanted to make sure we had a state-of-the-art, most up to date system. EMS’ Orion really fits that description.”

Derrenbacker continues, “I am amazed by the flexibility Orion has to offer faculty and learners. They can really use the system as little or as much as needed based on their need. If there is a need, Orion can fulfill it.”

Computerized simulation manikins will also be used as part of the overall training. The manikins simulate human actions such as breathing, heart and lung sounds, speaking, crying and other specialized functions.

The Healthcare/Medical Simulation Market has experienced extensive growth over the past few years, mainly attributed to various advancements in technologies. The increasing focus on training of medical practitioners, rising healthcare costs, growing focus on patient safety, and availability of funds has helped increase the purchasing power of academic institutes, thereby driving the growth of the market.

The Medical Simulation Market mainly consists of simulation products and services that are used to train students and healthcare practitioners. The high fidelity mannequin/patient simulators market is lucrative for companies to invest in, as it is a major contributor to the market and is forecast to grow at a healthy CAGR from 2012 to 2017. Academics, hospitals, and military are the major end-users of medical simulation products. Academics accounted for the largest market share in 2012 primarily due to increased focus on training of medical students and availability of government funds.

North America is the Major Market for Medical Simulation, followed by Europe. This is attributed mainly to the presence of major players in these regions and availability of funds. Growth in the Asian Market, especially China and India, is likely to be propelled by the increasing awareness of advanced technologies and focus of major players.

Among the prominent players mentioned in the healthcare/medical simulation market study by MarketWatch is Education Management Solutions (EMS).

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(Image at right) A high-fidelity manikin-based simulation event as seen from the control room at Samuel Merritt University’s (SMU) Health Sciences Simulation Center. Education Management Solutions’ (EMS) leading simulation center management software and audio video technology helps to run SMU’s simulation training program.

Mark your Calendar!

RSVP to Simulation@PNWHSC.org to reserve your seat to this free educational series!

Light snacks and beverages will be available for purchase.

Presented by Casey Schroeder, M.A. and Andrew Gross, B.A., Mt. Sinai Skills and Simulation Center, Case Western Reserve University School of Medicine.

We had a great response to today's webinar. Feel free to post your questions/comments for Andrew and Casey in the comments box below.

Abstract: This webinar will define debriefing and its purpose as well as describe various elements of and methods for debriefing. It will also explain ways to evaluate simulation experiences via the debrief. This information will then be applied to debriefing the debrief. The webinar will also consider the importance of debriefing the debrief, as it can improve debriefing methods, and thus contribute to overall simulation program improvement.

About the presenters: Andrew Gross, B.A., is the Medical Simulation Manager at the Mt. Sinai Skills and Simulation Center (MSSSC) and serves as the primary resource for our simulation technology. Since 2006, Drew has been responsible for maintaining the high fidelity manikins, surgical simulators, task trainers and the video-on-demand (VOD) audiovisual recording system. His extensive experience assists clients with designing just about any simulation possible. Drew’s simulation experience with several critical care airlift medical teams combines his love of simulation with his enthusiasm for aviation.

Casey Schroeder, M.A., has been a Standardized Patient Trainer/Coordinator at MSSSC since 2010. Casey has a M.A. in medical sociology from Case Western University and is currently pursuing her PhD in medical sociology from CWRU with a focus on doctor-patient communication. One of Casey’s goals is to train standardized patients to provide the most constructive learner feedback.

How interns and residents spend their time has been of interest to academic researchers for more than 50 years, but in the late 1980s, as training programs came under increasing pressure to limit the work hours of young doctors, one study in particular raised concerns. The researchers trailed 15 doctors-in-training over five nights and found that residents spent only about 20 percent of their time with patients, with the bulk of their nights at the hospital devoted to paperwork, tasks that did not have to be done by a doctor like drawing blood and inserting intravenous catheters, and frequently interrupted attempts at sleep.

Medical educators were distressed by the findings, and over the next 20 years, residency programs and academic medical centers instituted a series of changes meant to remedy them. Hospitals hired trained nonphysician teams to draw blood and start I.V.’s. They eagerly adopted electronic medical records in order to streamline documentation.

Finally in 2003, under increasing pressure from politicians, unions and sleep experts, the Accreditation Council for Graduate Medical Education issued a mandate that limited an intern’s time at the hospital to 80 hours per week. Then two years ago, they restricted duty hours even further, requiring interns to work according to a complicated algorithm of 16-hour days at most, with mandatory naps and days off.

Now, the largest study on intern work to date, published in The Journal of General Internal Medicine, reveals that while the initiatives of the last two decades were implemented with the best of intentions, the result has been a perfect storm of unintended consequences.

Researchers from Johns Hopkins University and the University of Maryland shadowed interns at two different internal medicine training programs over the course of almost 900 hours. They recorded the time the interns spent talking with and examining patients, meeting with families, attending educational conferences, discussing treatment plans with other doctors, sleeping, eating and even walking around the hospital.

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Young adults, in a period of transition, are often reluctant to seek treatment for mental health problems because of the stigma, inadequate insurance coverage and difficulty finding a mental health care provider.

But a new preliminary study by researchers at Case Western Reserve University suggests that depression symptoms may be significantly reduced when 18- to 25-year-olds interact with computerized avatars—virtual 3D images of a healthcare provider like a nurse practitioner or physician —as a way to rehearse office visits ahead of time and learn self-management skills.

Study results were published in the current Applied Nursing Research journal article (http://www.appliednursingresearch.org/), "Avatar-based depression self-management technology: promising approach to improve depression symptoms among young adults."

Melissa Pinto, PhD, RN, a KL2 Clinical Research Scholar and instructor at Case Western Reserve's Frances Payne Bolton School of Nursing, collaborated with developers of the Electronic Self-Management Resource Training (eSMART) team: Ronald Hickman Jr., PhD, ACNP-BC, and John Clochesy, PhD, RN, FAAN (now at University of Southern Florida) from the nursing school, and Marc Buchner, PhD, from the Virtual Gaming Lab at Case Western Reserve's engineering school.

Pinto said the study was the first to her knowledge to use an avatar-based intervention for this age group to improve depressive symptoms.

The researcher used a Case Western Reserve-designed virtual program, called eSMART-MH. eSMART-MH was adapted from a previous platform (eSMART-HD) designed by the team to help adults with chronic health problems manage their health.

The interactive avatar program, eSMART-MH, was designed in Buchner's Virtual Gaming Lab and tailored for young adults with depressive symptoms. eSMART-MH walks young adults through healthcare appointments with an avatar healthcare provider in virtual primary care office setting. During these visits, young adults practice talking about depression, ask avatar healthcare providers questions and learn self-managements skills to help manage depressive symptoms.

At this age, a majority of young people do not make contact with mental health providers until years after they first experience depressive symptoms. And those who do seek professional help may go to their first few appointments, but stop going soon after, said Pinto, who has studied mental health interventions in adolescents and young adults for six years.

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At North Shore University Hospital on Long Island, motion sensors, like those used for burglar alarms, go off every time someone enters an intensive care room. The sensor triggers a video camera, which transmits its images halfway around the world to India, where workers are checking to see if doctors and nurses are performing a critical procedure: washing their hands.

This Big Brother-ish approach is one of a panoply of efforts to promote a basic tenet of infection prevention, hand-washing, or as it is more clinically known in the hospital industry, hand-hygiene. With drug-resistant superbugs on the rise, according to a recent report by the federal Centers for Disease Control and Prevention, and with hospital-acquired infections costing $30 billion and leading to nearly 100,000 patient deaths a year, hospitals are willing to try almost anything to reduce the risk of transmission.

Studies have shown that without encouragement, hospital workers wash their hands as little as 30 percent of the time that they interact with patients. So in addition to the video snooping, hospitals across the country are training hand-washing coaches, handing out rewards like free pizza and coffee coupons, and admonishing with “red cards.” They are using radio-frequency ID chips that note when a doctor has passed by a sink, and undercover monitors, who blend in with the other white coats, to watch whether their colleagues are washing their hands for the requisite 15 seconds, as long as it takes to sing the “Happy Birthday” song.

All this effort is to coax workers into using more soap and water, or alcohol-based sanitizers like Purell.

“This is not a quick fix; this is a war,” said Dr. Bruce Farber, chief of infectious disease at North Shore.

But the incentive to do something is strong: under new federal rules, hospitals will lose Medicare money when patients get preventable infections.

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