When Dr. Haru Okuda trained as an emergency physician over two decades ago, he learned to perform procedures for the first time by practicing on patients.
“There were so many instances when I was a resident in training and a medical student that I was terrified. I felt like I was causing harm,” said Okuda, now president of the Society for Simulation in Healthcare.
Okuda and other researchers, doctors and leaders in simulation have worked since then to ensure that the next generation of medical professionals isn’t using patients as test subjects. They have developed increasingly realistic clinical simulators for students to try out before they encounter a real life-or-death scenario.
From Sunday to Thursday, the 2023 International Meeting on Simulation in Healthcare brought Hollywood-level special effects, artificial intelligence, virtual reality, actors and robots to the Orange County Convention Center in Orlando, widely recognized as the modeling and simulation capital of the world.
“Whether it be simulation through Disney, whether it be simulation through NASA … we often say [Orlando] is probably the best-kept secret out there,” said Jarrod Young, one of the meeting’s planning team co-chairs and director of operations technology and business development at the Center for Healthcare Improvement and Patient Simulation at the University of Tennessee Health Science Center.
The conference’s exhibit hall housed millions of dollars of technology from over 140 companies, attracting a record-breaking 4,200 attendees, according to Okuda.
The exhibited technology included Lifecast Body Simulation Global’s hyper-realistic training model of a child with Down syndrome, crafted based on a 3D scan of a real-life 7-year-old.
The model allows doctors to practice treating the 1 in 700 people in the U.S. born with Down syndrome every year, including many who have unique physical features that make care different from care for children without the genetic disorder.
Recently, more and more companies have pivoted beyond physical simulations to newer technologies such as virtual reality, mixed reality and artificial intelligence.
“This year, in mainstream media, and in our industry, AI is taking hold. So I think a lot of VR applications are becoming more integrated into our work,” said Sean Cavanaugh, a planning team co-chair and associate director of simulation education at the New York University Long Island School of Medicine.
Gaumard Scientific Company showcased a robot, the Victoria S2200, that simulates labor and delivery complications by birthing a robot baby.
In 2021, Gaumard unveiled a mixed-reality system that allows students to put on a virtual reality headset and see what happens inside a woman in real-time, projected onto the body of the Victoria robot while she gives birth.
Labor simulators like this one can come with a price tag of about $70,000 and are a staple in many Florida nursing and medical schools.
Given such hefty price tags on simulation technology, hundreds of studies have taken place to determine whether medical simulations work.
The U.S. Agency for Healthcare Research and Quality’s Patient Safety Network notes that clinical simulations significantly improve students’ knowledge and skills, and, to a smaller extent, improve patient outcomes.
Their rise was largely born out of a need to reduce mistakes. Johns Hopkins researchers in 2016 calculated that over 250,000 U.S. deaths annually are due to medical errors.
The University of Central Florida, like many places in the state, has embraced this growing trend. Simulation is commonplace in training nurses and doctors at the university.
For the past 16 months, professors have beamed lifelike holograms of patients and speakers into classrooms, both in prerecorded content and in live video chats, said Bari Hoffman, associate dean for clinical affairs at the College of Health Professions and Sciences.
This tech, widely used in the entertainment industry, overcomes geographic and practical barriers in medical training and allows students to more deeply examine patients, Hoffman said.
Last month, Howie Mandel was beamed in from L.A. to discuss his experiences with ADHD, OCD and anxiety.
An interdisciplinary team of researchers at UCF is studying how this simulation technology impacts students’ learning through special glasses that track their focus, attention and eye movements.
“Just like any new digital tool, it has a lot of shine to it,” Hoffman said. “But the most impactful piece of it is how it elevates the learning experience and the learning outcomes.”
Simulation in and of itself, without a deliberate, evidence-based training curriculum, won’t necessarily improve a patient’s quality of care, said meeting co-chair Young.
“You can do it with high-tech or low-tech as long as that educational session was set up intentionally and delivered in the appropriate way,” Young said.
In the coming years, practice via simulation is likely to become a mandatory step before treating patients, predicted a 2022 mini-review article published in Frontiers in Public Health.
As simulation grows, however, it needs to become accessible to schools and healthcare facilities with smaller budgets, said SSH President Okuda.
“We’re starting to utilize simulation for really critical topics like health equity, diversity,” Okuda said. “The disparities between folks that are getting trained are getting bigger and bigger. And in hospitals and health care systems, disparities in quality and safety are getting bigger and bigger as well.”
Some companies are already working toward this goal.
The largest cleft lip and palate organization in the world, Smile Train, is attempting to level the playing field for doctors in low-resource areas through a partnership with Biodigital, Inc.
The companies have created a platform to train surgeons in low and middle-income countries to perform medical procedures via virtual reality headsets that give learners a chance to practice procedures step-by-step and troubleshoot when things go wrong.
“When you experience it live, you may panic. It’s much better to experience it outside the operating room first,” said Aaron Oliker, co-founder and chief innovation officer at BioDigital.
Ccatherman@orlandosentinel.com; @CECatherman Twitter
