A 3D Virtual Hospital World using Multi-player Online Simulation (MOS)

1. A 3D Virtual Hospital World using Multi-player Online Simulation (MOS) Wm. LeRoy Heinrichs, MD, PhD, Professor (Emeritus, Active) and Past Chair, Dept/ Ob/Gyn Associate Director, SUMMIT. Stanford University School of Medicine Stanford, CA

2. Virtual Emergency Department A Virtual Patient with a Splinted Leg, and Pneumothorax, Vital signs deteriorate in 12-15min, requires immediate Rx • Windows-based PC with graphics card • Connection to the Internet • Mouse or Game Controller • Headsets Six Avatars selected and operated by trainees (role-players)

3. Why VideogameTechnology? • 1–Virtual Environments are engaging – you can • • Go places you’ve never been – • • Be a person you’ve never known – • • Do things you’ve never done before – • – that’s why they’re FUN • 2–And they • • Afford situational learningbetter retention • • Teach what to do, and what NOT to do • • Prepare users for advanced, higher stakes, • more costly simulations, or real experiences • 3–AND, our students are leading us there • • •

4. ED Multi-bay Treatment Room Photo-inspired Virtual 3D Environment – – – Adult ED at Stanford University Medical Center July 2006

5. ED Isolation Treatment Room Photo-inspired Virtual 3D Environment – – – Adult ED at Stanford University Medical Center July 2006 July 2006

6. Robotar programmed to die from asphyxia in 3-30min, depending on dose of nerve toxin – sarin Nerve Gas Treatment at Adult ED at Stanford University Medical Center Dec 2006

7. Virtual World for CPR Training Peninsula High School – CA & Stockholm April 2006

8. Cognitive Skills of CPR Guidelines for Healthcare Professionals: OLD method: Check carotid pulse during initial assessment NEW: Just . . Repeat Give 15 chest compressions. Do two rescue breaths

9. Mr. Brooks, Are You OK? August 2006

10. OLIVE: On- Line Interactive Virtual Environment

11. Progress and Plans On-Line Interactive Virtual Environments: • Downtown buildings & streets – Peninsula City • Emergency Department – Stanford • High School – Peninsula City & Stockholm • Global Bank – Peninsula City – disaster training What’s needed – • All critical care facilities - OR’s, ICU’s, CCU’s, DR’s for adults and pediatrics . . . and • Clinics, pharmacies, radiology, & administration, too – the ENTIRE Virtual Hospital!

12. An International, Multi-disciplinary Team Colleagues@Karolinska Institutet, Stockholm, Sweden: • Li-Fellander Tsai, MD,PhD, Director, Simulation Center, • Johan Creutzfield, MD, Anesthesiologist, • Karl Stengard, PhD, Teacher, Huddinge Gymnasium & Umea University, Umea, Sweden: • Leif Hedman, PhD, Dept. Psychology, Colleagues@Stanford University School of Medicine: • Pat Youngblood, PhD (Ed), Director of Evaluation, SUMMIT • Sakti Srivastava, MD, SUMMIT & Hand Surgery (New Delhi) • Parvati Dev, PhD (EE), Director, SUMMIT, IRT • Robert Cheng, MEng, Technical Support, SUMMIT • KimMarie Hansen, MA., Teacher, Redwood High School Thank you! Colleagues@Forterra Systems, Inc., San Mateo, CA • Laura Kusumoto, VP Forterra Studios • Arnold Hendrick, Senior Project Designer Partial funding by TATRC and WGLN

13. Virtual 3D World Hospital 1– How difficult is learning to navigate and role-play in a 3D World? Ans: Learning the interface functions for choosing desired actions and movements takes between 30min and an hour for first timer’s – videogame players ‘get-it’ faster; • role-playing is an art akin to drama, verbal and gesturing skills are very helpful. Questions?? 2– What’s the evidence that this learning technology works? Ans: Use in military & fire-fighter instruction has proven to be life-saving. SUMMIT’s & Karolinska’s formative research in Med-- icine suggests that team training in a Virtual ED is as immersive & effective for learning as high-fidelity manikin scenarios. Interns diagnosed, treated and ‘saved’ six robotars ‘programmed to die’. No intern had ever had this responsibility or experience before!