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Training emergency personnel on the clinical management of a mass-casualty incident (MCI) with prior chemical, biological, radioactive, nuclear, or explosives (CBRNE)-exposed patients is a component of hospital preparedness procedures.
Objective:
The objective of this research was to determine whether a Virtual Emergency Department (VED), designed after the Stanford University Medical Center's Emergency Department (ED) and populated with 10 virtual patient victims who suffered from a dirty bomb blast (radiological) and 10 who suffered from exposure to a nerve toxin (chemical), is an effective clinical environment for training ED physicians and nurses for such MCIs.
Methods:
Ten physicians with an average of four years of post-training experience, and 12 nurses with an average of 9.5 years of post-graduate experience at Stanford University Medical Center and San Mateo County Medical Center participated in this IRB-approved study. All individuals were provided electronic information about the clinical features of patients exposed to a nerve toxin or radioactive blast before the study date and an orientation to the “game” interface, including an opportunity to practice using it immediately prior to the study. An exit questionnaire was conducted using a Likert Scale test instrument.
Results:
Among these 22 trainees, two-thirds of whom had prior Code Triage (multiple casualty incident) training, and one-half had prior CBRNE training, about two-thirds felt immersed in the virtual world much or all of the time. Prior to the training, only four trainees (18%) were confident about managing CBRNE MCIs. After the training, 19 (86%) felt either “confident” or “very confident”, with 13 (59%) attributing this change to practicing in the virtual ED. Twenty-one (95%) of the trainees reported that the scenarios were useful for improving healthcare team skills training, the primary objective for creating them. Eighteen trainees (82%) believed that the cases also were instructive in learning about clinical skills management of such incidents. Conclusions: These data suggest that training healthcare teams in online, virtual environments with dynamic virtual patients is an effective method of training for management of MCIs, particularly for uncommonly occurring incidents.
Conclusions:
These data suggest that training healthcare teams in online, virtual environments with dynamic virtual patients is an effective method of training for management of MCIs, particularly for uncommonly occurring incidents.
Videoendoscopic surgery has changed everything! Surgeons don't operate on patients any more; they operate on (their) images.
Heinrichs, 2005
A variety of surgical simulators are available to assist surgeons in learning and practicing the technical skills needed for conducting laparoscopic surgery. Some are low-fidelity and others are high-fidelity systems that have been validated as effective surgical training systems for novice users. Proficiency and safety are unequivocally improved in the subsequent surgical performances of users.
Teaching and learning the basic technical skills required for performing laparoscopic procedures by surgical trainees has been greatly facilitated with today's surgical simulators. Published evaluation data on learning outcomes from the use of surgical simulators clearly indicate their value in surgical education. Simulators can be characterized by their fidelity to authentic surgical environments:
Box trainers using physical objects (such as cotton string, pegs, latex tubes, and rings, some with haptics)
Computer-based with either physical objects or virtual images of tubes, bands, balls, and so on, and instruments projected onto monitors/displays
Virtual three-dimensional (3D) models of simulated and real tissues and organs
Some devices provide authentic surgical instruments for manipulating real objects, and others have interfaces that provide touch sensations (haptics) for virtual objects; both afford practice of the basic skills, gestures, and instrument—tissue manipulations.
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