Joint Medical Simulation Technology (JMST) IPT June ‘09

1. Joint Medical Simulation Technology (JMST) IPT June ‘09 Army RDECOM/STTC 12423 Research Parkway Orlando, FL 32826 (407) 384-3934 FAX (407) 384-5440 CELL 321-287-5568 Beth.h.pettitt@us.army.mil M. Beth H. Pettitt Division Chief, Soldier Simulation Environments SFC Paul Ray Smith Simulation & Training Technology Center *UNCLASSIFIED/FOR OFFICIAL USE ONLY*

2. Mission – JMST IPT (JMSTRDC) The Joint Medical Simulation Technology Research and Development Center (JMSTRDC) will serve as the principal center and focal point for collaboration between the primary defense organizations conducting research and development activities in medical modeling and simulation for training, therapy, and rehabilitation. This will be a joint cooperative initiative that will support research projects, teamwork, and information sharing between the TATRC, USAMRMC; STTC, RDECOM; and other defense activities engaged in medical simulation RDT&E. The primary mission of the JMSTRDC will be to promote more rapid research, development, evaluation, acquisition, and fielding of military medical modeling and simulation technologies and products, including adaptation of commercial off-the-shelf products and technologies, where appropriate. The JMSTRDC will provide focused coordination of research activities, information sharing, rapid response, quick turn-around, and smooth transition to the field in response to pressing military operational and warfighter health, safety, and medical training needs.

3. JMST IPT Structureand Organization • Began as a Congressional Add in ‘08… • Convened representatives from all services and appropriate organizations in Sep ‘08: • Chair, USA RDECOM STTC • Vice-Chair, USA MRMC TATRC • Air Force Medical Community Representative (DIR AFMM&S) • Navy Medical Community Representative (MPT&E/CSAC) • Medical Acquisition Community Representative (PEO STRI) • Army Medical Community Representative (CSC) • Central FL Warfighter simulation community representative(s) • Central FL Academic community representative(s) • Joint Medical Training Community Representative (USUHS) • CSC Representative (Army Doctors) • AMEDD C&S, DCMT Representative (Dean) • Army EMS Representative OTSG

4. Accomplishments • Feedback from 09/29 meeting • Incorporated in proposed projects • Collaboration and Council Involvement • Refinement of 5 Topics for R&D • Plus One additional topic identified by committee reps… • FY 08 Funded Projects launched • FY 09 Funding in place • NCS providing Project Development Support • May 09 – 2nd Orlando meeting • Draft charter

5. R&D Use the ICT Virtual Human project as a research platform Explore visual and audio gestures and the development of an “intelligent” patient. Explore constructs for interventions as instructor, mentor or therapist Extend the environment to be used for additional screening, using diagnostic tools such as BP and HR monitoring. Communication with Physician Application Learning Objective-Screening/Diagnostic Skills Field hospital, sick bay or doctor office “sick call" accomplished by nurses/medics Mental Health Screening Re-use of Hospital Environment for other JMST IPT projects, such as trauma care, team training and rehearsal 1 - Medically Enhanced Virtual Human Research

6. R&D Evaluate alternative man/machine interfaces with virtual patients and their treatment protocols Consider deployed sites and home/ hospital environments and use of web-based delivery Improvements for Situational Awareness and Diagnosis Application Rehabilitation Outreach Care;Tele-Medicine Distance Learning Medical Mission Rehearsal Emergency Preparedness-First Response 2 - Low Cost Immersive Medical Synthetic Environment

7. R&D Evaluate existing technologies; consider unique needs for medical education, training and care-(Interventions) AI interfaces Integration with the Virtual Human Consider interfaces with Learning Mgt. Systems and courseware Application Outreach care and individually-paced learning Adaptive learning strategies and more effective use of real person mentor time and expertise Possible add-on to LVC architectures 3 - Intelligent Tutor for Medical Applications

8. R&D Explore anatomy visualization using hologram technology Research learning interface and advantages of this approach Application Medical Education Surgical Mission Rehearsal Robotic/assisted surgery New Trauma techniques and procedures Wound Visualization 4 – Medical 3D Holograms

9. R&D Evaluate applicability of existing technology and business models, such as CTPS, USAF Aircrew Training Concepts, Army FSXX1, Virtual World Platforms, and others Determine Technology Gaps Define a potential integrated architecture which can support the joint ops C of C, to include common synthetic environments, curriculum, medical models. Prioritize related to patient safety, team training and medical C2 Integration of new/existing technologies; e.g. avatars and manikins Application Medical Mission Rehearsal Team care, from battlespace thru VA and family;TC3 JORD Extension to the Army MSTC capability Providing industry with a common operating picture for medical education, training and care solutions Prototyping of new protocols, procedures and TTP’s to save development costs and promote rapid deployment 5 - Continuum of Care (CofC) WARFIGHTER SIM Point of Injury Casualty Collection Point Ground Evacuation CSH Battalion Aid Station Air Evacuation FST

10. Virtual Sick Call 3. Team Members Dr. Teresita Sotomayor & Bill Pike COR and ACOR for various contracts Tami Griffith & Christine Allen - STTC ICT, CMU, and Others (TBD) 4. Stakeholders AMEDD C&S PEOSTRI MSTC ACQ Program USUHS 2. Program Objectives 5. Partners Develop an immersive environment to support training of medical personnel in diagnosing a variety of ailments and medical conditions during sick call. The research will leverage existing virtual human, intelligent tutoring and immersive environments capabilities emerging and underway at STTC to develop a medically meaningful and accurate virtual patient in a relevant environment, along with an ITS-based training application. JMST IPT - Congressional Funding STTC mission funds – ITS piece 6. Maturity Research Development Transition

11. Virtual Sick Call: Scenarios • Three scenarios developed by STTC, NCS • Scenarios chosen to: • Include all services • Include various facilities • Include dependents as well as service members • Force the student to look beyond the obvious (PTSD, domestic violence, symptoms masking more dangerous disease.) • Testing at military and civilian locations

12. Virtual Sick Call: Scenario 1 • Student: USAF medic • Environment: CONUS base hospital • Patient: Spouse of service member • Complaint: Came in last week w/ bronchitis, reacted to meds • Other signs: Too much makeup, reluctant to allow visual inspection of rash on abdomen • Bottom line: Still has bronchitis, did react to antibiotics, but also a victim of domestic abuse (spouse is USAF SO, returned from theater & is not adjusting well)

13. Virtual Sick Call: Scenario 2 • Student: Army medic • Environment: Bn aid station in Afghanistan • Patient: 2LT, recently arrived 11B PL • Complaint: Cough, scratchy throat, stuffy nasal passages • Other signs: Agitated, pulls rank (even as 2LT to E5) • Bottom line: URI aggravated by plane flight, but PTSD potential. Lost 3 men in firefight on first patrol.

14. Virtual Sick Call: Scenario 3 • Student: Navy Independent Duty Corpsman • Environment: Navy destroyer underway • Patient: BMC from Deck Department • Complaint: Common cold symptoms • Other signs: None • Other issues: Ship just got underway from foreign port visit. Several Sailors came down with colds. First Lieutenant (“mustang” ensign in charge of Deck Division) just laid into you because you gave so many of his Sailors SIQ chits. • Bottom line: Viral meningitis

15. Combat Medic:The Card Game Combat Medic Card Game (“5+1”) 3. Team Members Bill Pike, Christine Allen – STTC Dr. David Metcalf, et al. – UCF IST Complication Tool Bleeding Antibiotic 4. Stakeholders -2 2 +2 3 AMEDD C&S PEOSTRI MSTC ACQ Program FMTB-E & W Description Description 2. Program Objectives 5. Partners Develop a low-cost, east-to-learn and easy-to-use card game for training combat medics and combat lifesavers. The game is targeted for schoolhouses and training sites to fill in training down time, and can be instructor-led or played by students with no instructors. It is also very low cost and can be mass-produced. JMST IPT - Congressional Funding PEO-STRI – Chief Scientist interest 6. Maturity Research Development Transition

16. Way Ahead • Started 3 of the five projects identified in Sept ‘09. • Initiating efforts on the remaining two by the end of Summer ‘09 • Align technology developments with: • Acting Assistant Secretary of Defense for Health Affairs… • OSD level group JTCG1 "Joint Technical Coordinating Group" Medical Information and Training Technologies • Continuous process – re-identify new and emerging technology needs across the Services

17. Joint Medical Simulation Technology (JMST) IPT June ‘09 Army RDECOM/STTC 12423 Research Parkway Orlando, FL 32826 (407) 384-3934 FAX (407) 384-5440 CELL 321-287-5568 Beth.h.pettitt@us.army.mil M. Beth H. Pettitt Division Chief, Soldier Simulation Environments SFC Paul Ray Smith Simulation & Training Technology Center *UNCLASSIFIED/FOR OFFICIAL USE ONLY*