By: Victoria Brazil (@SocraticEM)
Healthcare simulation has a reputation for being complex and technical, but there are ways to simplify scenario delivery. Simplicity is especially useful for those of us running simulations in situ (in the real clinical environment), or those without specialised ‘sim -ops’ technical experts. Here’s a brief list of some ‘tech hacks for sim’ to consider: –
(N.B No disclosures. I use these Apps, but have no conflicts of interest)
1. Monitor emulators
Providing a set of vital signs that look like a patient monitor can add significant realism, especially for simulation scenarios that involve acutely unwell patients. Healthcare teams look for and respond to cues like heart rate and rhythm and oxygen saturations. A monitor emulator can be used with a simple mannikin, a simulated patient human actor or with a VEMS set up (laminated plastic patient)
Two simple App based options are SimpL and SimMON, both available on App store and Google Play for around $30. They work by displaying the ‘monitor’ on an iPad or tablet device, with the vitals ‘controlled’ by the same App on a phone or another tablet. The two devices are linked via a Wi-Fi network. Most of the commonly simulated cardiac rhythms are available, oxygen saturations can have the appearance of low perfusion, and there are optional waveforms for arterial lines or capnography. A defibrillator panel can be added to the monitor interface if desired. The process of defibrillation or cardiac pacing is surprisingly realistic, with the realistic sounds of defibrillator charging. If required, this process can be even simpler, with a single monitor display on the tablet and adjusts made directly via the touch screen on that device.
2. Ultrasound images
For scenarios that involve bedside ultrasound scanning, the Awesome Ultrasound App is a great choice (Available on iOS App store only for $15). This is another set up that involves a tablet for the display of the images at the bedside, paired with another device (phone or another tablet) to control the image displayed. The tablet displaying the images can be ‘attached’ to a 3D printed fake ultrasound probe and bedside stand for realism. There is a wide range of normal images and pathologies available – abdominal free fluid, pneumothorax, cardiac tamponade, aortic dissection, low ejection fraction, and pregnancy. Importantly these are shown as short, repeating video loops, rather than as static images. For experienced practitioners this is a significant leap in realism. I have seen learners actually spend time trying to optimise their view through subtle shifts on the probe in their hand! For some simulations, the information gleaned through interpreting the results of the ‘scan’ can be important in progressing the scenario and contributing to participant decision-making.
3. Making your mannikin ‘talk’
If you don’t have a fancy simulation suite, or you are going mobile with your simulation, this is a great option. The Microphone Live App (and many others like it) allows you to talk into your iPhone, connected to a Bluetooth speaker under the head of a mannikin. The ‘voice’ comes out of the speaker like the mannikin is talking. This allows you to be just far enough away to allow the participants to interact more realistically with the mannikin.
These are some of my simple tech adjuncts. For more on learning simulation technology, check back to last month’s post on “How do Simulation Educators learn the ‘tech stuff’.
Would love to hear of others experience and tips?
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