Info Virtual Med School

About: Introduction VirtualMedSchool and abcdeSIM solutions

ABCDE training in acute medicine for residents, nurses and medical students

Reference: VMS-2015-001-INT

From: Carmen de Witt, International Marketing Director VirtualMedSchool

Stephanie Klein Nagelvoort-Schuit, MD, MSc, PhD, internist acute medicine-intensivist, Head Department of

Emergency Medicine, Erasmus University Medical Center, Rotterdam

Ronald Nanninga, McScBA, CEO VirtualMedSchool

Training doctors and nurses for emergency situations is a vital part in medical education. Using latest online gaming

technology and a proprietary physiological model of the human body, we created a new and innovative program to

teach emergency skills to doctors and nurses according to the internationally known and used ABCDE-method:

abcdeSIM.

This prize winning serious game has since seen the introduction of additional programs

(e.g. severe burns treatment) and is used in hospitals in Europe and the US. Together with Erasmus Medical Centre the

game will be further developed to become the medical flight simulator for training emergency departments.

Summary AbcdeSIM is an online simulated emergency department with

virtual patients. In an online realistic and immersive emergency

department environment doctors and nurses are challenged to

care for the sickest patients. Mistakes made in online patients

are not fatal as in real-life, but important learning points,

thereby improving everyday patient care. Doctors learn to

accurately assess the medical condition of each patient,

recognize life threatening illnesses and injuries, and resuscitate

and stabilize in ordered priority.

VirtualMedSchool Statenlaan 71 3051HM Rotterdam

m +31 62 859 9991 e [email protected] i www.abcdesim.nl | www.virtualmedschool.com t @abcdesim | @VirtMedSchool w

facebook.com/ABCDEsim | facebook.com/VirtualMedSchool u linkedin.com/company/abcdesim | linkedin.com/company/virtualmedschool AbcdeSIM includes a high-fidelity physiological model that contains more than 200 parameters for circulation, respiration

and consciousness. This model creates a very realistic and immersive experience in which the trainee can see the direct

results of their chosen diagnostics and treatment. Just like flight-simulators have increased airline safety, abcdeSIM aims to

cost-effectively increase patient safety.

The following versions of abcdeSIM are currently available:

• abcdeSIM for emergency physicians

• abcdeSIM for emergency department nursing

• abcdeSIM for pre-hospital primary care

• abcdeSIM for severe burn victims

• abcdeSIM for paediatrics (in development, planned release Q2 2015)

AbcdeSIM was developed by and on initiative of Erasmus University Medical Center. The initial idea came from dr. Stephanie

Klein Nagelvoort-Schuit, currently head of Emergency Medicine at Erasmus MC.

For any additional information please contact:

Carmen de Witt

[email protected]

+31 62607 6206

VirtualMedSchool Statenlaan 71 3051HM Rotterdam m +31 6207 6206 e [email protected] i www.abcdesim.nl | www.virtualmedschool.com t @abcdesim | @VirtMedSchool w

facebook.com/ABCDEsim | facebook.com/VirtualMedSchool u linkedin.com/company/abcdesim | linkedin.com/company/virtualmedschool

What is abcdeSIM?

Training in emergency medicine is an essential part of medical education. Around the world every doctor

and nurse working in a hospital or primary care is required to be trained in emergency skills. Expertise

usually comes with experience. However, doctors and nurses must be prepared for all types of medical

emergencies even when they lack extensive experience.

Using gaming and simulation technology and a high fidelity model of human physiology abcdeSIM,

Erasmus University Medical Center, Technical University of Twente, IJsfontein and the Dutch national

primary care residency program are improving training in emergency medicine in a cost-efficient

manner.

In an online realistic and immersive emergency department environment doctors are challenged to

care for the sickest patients. Mistakes made in online patients are not fatal as in real-life, but important

learning points, thereby improving everyday patient care. By using the program doctors learn to

accurately assess the medical condition of each patient, recognize life threatening illnesses and

injuries, and to resuscitate and stabilize in ordered priority. They can train lifelike patient scenarios

without putting patients at unnecessary risk. Just like flight-simulators have increased airline safety,

abcdeSIM aims to increase patient safety.

As of September 2012 abcdeSIM is a mandatory part of training for residents and medical students at

Erasmus University and has already reduced costs while improving skills. Since the implantation of

abcdeSIM within standard ABCDE training for residents, the face-to-face training time has been reduced

by 50% while maintaining the same learning objectives.

What is included in abcdeSIM? As an example the abcdeSIM Emergency Physician module consists of 3 parts:

1. T he e-learning consisting of 7 chapters (the ABCDE-method, communication and in-hospital transportation of

critically ill patients)

2. A test for which the student must receive a score of 75% or higher to be able to enter the

Virtual Emergency Department (the game part of the module)

3. T he Virtual Emergency Department where the student must attend to 6 seriously ill patients.

Four patients are treated separately and the 5th and 6th patient are treated at the same time

(the learning objective here is triaging the severely of illness) The

other abcdeSIM versions are built up in a similar manner.

Learning Management System The abcdeSIM modules include a learning management system (LMS) where the student and teacher can

track progress and scores.

Online High-score leaderboard

The abcdeSIM website includes a high-score server where the top 10 scores are placed.

CME credit

AbcdeSIM has recently become the first

serious game in The Netherlands to be

accredited

with 7 hours of Continuing Medical

Education (CME) credit by a number of

medical specialist organizations such as

the Dutch Societies of

Internal Medicine, Anaesthesiology, Neurology,

Pulmonology and Family Practice.

Prize winning solution

AbcdeSIM has received very enthusiastic reviews from users and experts in-

and outside the field of emergency medicine. In 2013 abcdeSIM won the

Dutch national E-learning Award.

The jury was highly impressed by

• the strong didactic concept

• the realism of the game (largely due to the high-fidelity physiological

model in combination with excellent graphics)

• the detailed feedback

• the team dedicated to researching the effectiveness as an educational tool

In 2014, AbcdeSIM won the Accenture Innovation award in the section Health after a competition

between 100 innovative health ventures.

The total list of awards includes:

• First serious game in NL to receive CME credit

• Nomination Games for Health Europe Award

• Winner Smarter eLearning Award

• Winner Valid game award

• Winner Accenture Innovation Award

abcdeSIM versions

Currently the following versions are available online:

• abcdeSIM for emergency physicians

• abcdeSIM for emergency department nursing

• abcdeSIM for pre-hospital primary care

• abcdeSIM for severe burn victims

• abcdeSIM for paediatrics (in development, planning release Q2 2015)Additional (abcdeSIM) serious games are

currently being developed.

National and International AbcdeSIM has users in over 35 hospitals in The Netherlands, including all academic centers. Furthermore

abcdeSIM joined a partnership with the British Royal College of Physicians to use abcdeSIM in 60 training

centers in the UK.

What makes abcdeSIM so innovative?

There are many considerations when deciding on which training methods to use for Emergency Medicine

education. This paragraph will provide some of the educational advantages of serious gaming in emergency

medicine and abcdeSIM in particular.

Immersive emergency department environment for minimal cost

For the optimal training efficacy it is essential that the students feel the stress and time pressure that is an

important part of real-life patient care. Serious gaming technology not only gives us the tools to create such an

immersive environment, it also allows us to train various clinical situations in a relatively short period of time.

To ensure the highest quality learning experience, skilled clinicians at Erasmus University Medical Center and

other institutions worked together with serious game developers at abcdeSIM and Dutch software developer

IJsfontein. To allow students to take on the roles of doctors and nurses a number of key elements in the

simulated emergency department must be extremely lifelike. Panels of experienced clinicians, end-users and

educationalists worked together to this end with game developers in order to obtain the feeling of immersion

for minimal costs.

High fidelity proprietary model of human physiology never

before used in an online simulation

To aid in creating a realistic and immersive experience the

Technical Medicine department at the University of

Twente worked with Erasmus University Medical Center

to develop a high-fidelity physiological model that is

based on years of extensive research. This physiological

model

contains more than 200 parameters for circulation, respiration and consciousness. An extensive

physiological model of this kind has never been part of an online simulation. Implementation of this

extremely complex model required teamwork between programmers, clinicians and researchers. This

collaboration resulted in a virtual emergency department where clinical parameters react to illnesses,

injuries, medication, infusion and other therapies the way that real life patients would. Learning

objectives are obtained by the virtual patients’ reaction to medical treatments and therapies and a

complex scoring and feedback system.

Tailor made scenarios The physiological model that sits at the core of abcdeSIM allows for a very flexible platform on which

an endless variety of clinical scenarios, also outside the emergency room, can be played out. At the

moment a simulation specifically tailored to nursing skills, one featuring patients in a primary care

(home/ambulance) setting and another one with paediatric patients (including a paediatric

physiological model) are being developed. Additionally the graphics of abcdeSIM can be adjusted to

correspond with local medication names and dosages, as

well as medical equipment if needed.

Significant financial and educational gain

Low operating costs and easy online access with minimal computer hardware requirements mean that

there are significant (financial) advantages for the user. But even more important is the increase in

knowledge and skills for doctors and nurses treating patients. This way healthcare workers can now train

emergency skills on a computer connected to the internet from anywhere in the world without exposing

real patients to unnecessary risks.

Making learning FUN! Doctors and nurses are naturally

competitive individuals. The serious

game element in abcdeSIM makes it

fun to learn and gain skills. Game

competitions with doctors and nurses

at 4 national healthcare conferences

in The Netherlands showed abcdeSIM

to be highly engaging.

Strengthening existing training courses in emergency medicine Using gaming technology students can learn specific skills online prior to the training course. Students are

therefore better prepared and the existing training time can be used to teach additional skills.

Furthermore, acquired skills can be better maintained by the ability to continuously train online, even

months or years after the training course.

In conclusion

AbcdeSIM is a realistic online simulated emergency department and is proven to have a positive effect

on emergency medicine education, while reducing costs at the same time. Thanks to an innovative high-

fidelity physiological model that contains more than 200 parameters it provides a flexible platform for

medical education that can be tailored to different learning objectives. This allows students and medical

professionals to acquire new, or hone existing skills by treating different patients in a virtual

environment thereby helping to improve overall patient safety.