"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012
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Pavarti Dav speaks about "Virtual Environments for Healthcare" at the 2102 Serious Play Conference ABSTRACTS: Healthcare training is an apprenticeship when so many other professions have incorporated simulations and virtual environments for their training. Flight simulation for pilots is so powerful that a pilot trained on a simulation of a new plane is considered competent to fly the real plane for the first time with a full load of passengers and cargo. What should virtual environments for healthcare look like, be capable of, encourage, constrain? What are the barriers to use? We will explore these questions and examine the current status of healthcare virtual environments.
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"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012
- 1. Virtual Environments for Healthcare Parvati Dev, PhD CEO, CliniSpace www.InnovationInLearning.com www.clinispace.com
- 2. My co-pilot has … but I have flown 200 never flown this hours on the simulator model of plane and am certified for this before … model © 2012 IIL Inc. Serious Play, August 21, 2012 2
- 3. My resident has … but my chief is never done this watching me very surgical procedure carefully as I do it. before … © 2012 IIL Inc. Serious Play, August 21, 2012 3
- 4. WHY DOES THIS MATTER ? © 2012 IIL Inc. Serious Play, August 21, 2012 4
- 5. The Cost in Life and Money The cost of medical errors is huge – $22-38B (source: AHRQ) An example – Septicemia – 2% of hospital discharges in the U.S. include septicemia – Average charge is > $60,000 per case Prevention requires systemic change through training – One case prevented can pay for the training Prevention training is difficult Knowledge, Skills, ATTITUDE requires emotional engagement Learning through Role playing is emotionally engaging © 2012 IIL Inc. Serious Play, August 21, 2012 5
- 6. WHY VIRTUAL ENVIRONMENTS MAY BE THE BEST APPROACH TO ENGAGEMENT © 2012 IIL Inc. Serious Play, August 21, 2012 6
- 7. Medical Training Current approach: – Classes, e-learning, manikins, standardized patients – Problems in scalability, expense, lack of engagement © 2012 IIL Inc. Serious Play, August 21, 2012 7
- 8. Virtual Environments are immersive And immersive experiential learning Is DISRUPTIVE © 2012 IIL Inc. Serious Play, August 21, 2012 8
- 9. So immersive that it’s real © 2012 IIL Inc. Serious Play, August 21, 2012 Comm. of the ACM 9
- 10. Virtual Emergency Room Environment © 2012 IIL Inc. Serious Play, August 21, 2012 10
- 11. HOW EFFECTIVE ARE VIRTUAL ENVIRONMENTS ? © 2012 IIL Inc. Serious Play, August 21, 2012 11
- 12. The Data Show . . . Comparison of Team Leadership Before and After Practicing Four Resuscitation Scenarios on a Human Patient Simulator (HPS) or in an Online Virtual Emergency Department (VED) with Virtual Patients
- 13. WHAT ARE VIRTUAL ENVIRONMENTS ? © 2012 IIL Inc. Serious Play, August 21, 2012 13
- 14. Scientific meeting in World of Warcraft (May 2008) © 2012 IIL Inc. Serious Play, August 21, 2012 14
- 15. Azeroth © 2012 IIL Inc. Serious Play, August 21, 2012 15
- 16. Scientific meeting in World of Warcraft (May 2008) 20 JUNE 2008, VOL 320, SCIENCE, www.sciencemag.org © 2012 IIL Inc. Serious Play, August 21, 2012 16
- 17. ‘Congressional Hearing’ in Second Life © 2012 IIL Inc. Serious Play, August 21, 2012 17
- 18. PROTOTYPE VIRTUAL ENVIRONMENT Forterra, 2005 Multi- casualty Incident Multi- Training player, Event Online @ Game Stanford Technology – by 2005 Forterra – 2005 © 2012 IIL Inc. Serious Play, August 21, 2012 18
- 19. CliniSpace Virtual Emergency Department © 2012 IIL Inc. Serious Play, August 21, 2012 19
- 20. COMPONENTS OF A MEDICAL VIRTUAL ENVIRONMENT © 2012 IIL Inc. Serious Play, August 21, 2012 20
- 21. REALISTIC CLINICAL SPACES, INCLUDING IN BATTLEFIEL © 2012 IIL Inc. Serious Play, August 21, 2012 21
- 22. CIAN, NURSE, THERAPIST, PATIENT, SOLDIER, BABY AVA © 2012 IIL Inc. Serious Play, August 21, 2012 22
- 23. VIRTUAL PATIENTS, DYNAMIC PHYSIOLOGY AND ACTION © 2012 IIL Inc. Serious Play, August 21, 2012 23
- 24. VIRTUAL OBJECTS THAT INTERACT WITH PATIENT AND EACH OTHER © 2012 IIL Inc. Serious Play, August 21, 2012 24
- 25. CASE AUTHORING, USER ACTION TRACKING AND ASSESSMENT © 2012 IIL Inc. Serious Play, August 21, 2012 25
- 26. Example of use http://vimeo.com/41082428 © 2012 IIL Inc. Serious Play, August 21, 2012 26
- 27. INTERMEDIATE QUESTIONS © 2012 IIL Inc. Serious Play, August 21, 2012 27
- 28. ANOTHER WAY OF LOOKING AT VIRTUAL ENVIRONMENTS © 2012 IIL Inc. Serious Play, August 21, 2012 28
- 29. The Virtual Environment is the ‘System’ around the Virtual Patient Protocols, policies, rules People/ Team (real, computer) Devices, supplies, meds Virtual Patient © 2012 IIL Inc. Serious Play, August 21, 2012 29
- 30. The Virtual Environment is the ‘System’ around the Virtual Patient It is the “theater” -- environment -- within which you can “role Protocols, policies, rules play” The “virtual patient” may People/ Team play a Key or a (real, computer) Supporting Role Virtual environments Devices, supplies, meds extend the usability of Virtual virtual patient Patient © 2012 IIL Inc. Serious Play, August 21, 2012 30
- 31. THE ‘SANDBOX’ AND THE ‘CAMPAIGN’ © 2012 IIL Inc. Serious Play, August 21, 2012 31
- 32. Which one to build? Sandbox Campaign Explore the environment Trigger actions cause game to Unguided ‘play’ advance – the ‘narrative’ Automated responsiveness to player input Reward is in advancement – Levels, side missions Play has its own rewards – Earn badges and promotion – Engaging - Save the patient – Compete with self, others, teams Environment rich enough to Carefully crafted ‘story’ satisfy http://www.gamasutra.com/view/feature/4081/the_history_and_theory_of_sandbox_.php?print=1 © 2012 IIL Inc. Serious Play, August 21, 2012 32
- 33. Our experience: Which one to build? Sandbox Campaign Unguided ‘play’ Trigger actions cause game to Environment must be rich advance – the ‘narrative’ enough to be satisfying Carefully crafted ‘story’ This is CliniSpace today CS BattleCare, etc Need much more content Sub-goals, overall goal are liked And still need specified goals But want some exploration ! © 2012 IIL Inc. Serious Play, August 21, 2012 33
- 34. BUSINESS MODELS FOR VIRTUAL ENVIRONMENTS © 2012 IIL Inc. Serious Play, August 21, 2012 34
- 35. System Overview Users Content Applications Platform © 2012 IIL Inc. Serious Play, August 21, 2012 35
- 36. Platform businesses Integration with other Trainers, Customization technologies Users curriculum (branding, layout, (Characters with AI, Natural developers language) language processing) Further specialization Specialized worlds Third Party (Equipment testing in (medical, kids, adult entertainment) developers virtual OR) - Simulations of disease, equipment Platforms Custom New platforms (Second Life, OLIVE, Unity) development © 2012 IIL Inc. Serious Play, August 21, 2012 36
- 37. CliniSpace: A Medical Platform © 2012 IIL Inc. Serious Play, August 21, 2012 37
- 38. Platform businesses Integration with other Trainers, Customization technologies Users curriculum (branding, layout, (Characters with AI, Natural developers language) language processing) Further specialization Specialized worlds Third Party (Equipment testing in (medical, kids, adult entertainment) developers virtual OR) - Simulations of disease, equipment Platforms Custom New platforms (Second Life, OLIVE, Unity) development © 2012 IIL Inc. Serious Play, August 21, 2012 38
- 39. BUSINESS ECOSYSTEMS © 2012 IIL Inc. Serious Play, August 21, 2012 39
- 40. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Dynamic “Normalize” very Embedded 3D virtual different people and pathophysiolog knowledge Face models Resell spaces sets for activities so that they y (nursing, customization – branded or machinima can exercise together Fitness medical) white label Behavior support Animations therapy Virtual Therapy Behavior 3D actors Increase sessions alteration medical engagement through avatar avatars Standardized of traditional Curriculum association role players interactive development Designing content game or Virtual Greeters, Experience competition patients, sales Actors for dynamic goods machinima designer person Product Automatic movies design using Medical User- assessment VR/AR of furniture generated performance Adding sensor content Medical networks to Platform worlds © 2012 IIL Inc. Serious Play, August 21, 2012 40
- 41. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Resell spaces 3D virtual – branded or Standardized sets for white label role players machinima Dynamic pathophysiolog Virtual y models actors Actors for Animations machinima 3D movies medical avatars Greeters, Virtual patients, sales goods person Experience Medical designer furniture Medical Platform © 2012 IIL Inc. Serious Play, August 21, 2012 41
- 42. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Increase Face engagement Embedded customization of traditional knowledge interactive (nursing, content medical) Automatic Designing assessment game or Curriculum of competition development performance dynamic User- Product generated Adding sensor design using content networks to VR/AR worlds Medical Platform © 2012 IIL Inc. Serious Play, August 21, 2012 42
- 43. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Behavior Therapy Fitness therapy sessions support “Normalize” very Behavior different people and alteration activities so that they through avatar can exercise together association Medical Platform © 2012 IIL Inc. Serious Play, August 21, 2012 43
- 44. Distribution/Revenue Models Resell spaces – branded or courses Certification Grants and white label federal Per virtual funding patient per Per clinical subscriptions session per year patient e.g. License for therapy bundle of seats Per actor- Link with music and per year hour movie assets to drive Virtual serious uses goods Freemium Loss of federal reimbursement Rent a Medical (Medicare / seat or Platform Medicaid) space © 2012 IIL Inc. Serious Play, August 21, 2012 44
- 45. In conclusion …... Virtual environments can impact the cost of healthcare - By changing attitudes by training with role playing A virtual environment is an entire ‘system’ around a virtual patient (or patients) To succeed, virtual environments must scale up to include multiple business models and a business eco- system © 2012 IIL Inc. Serious Play, August 21, 2012 45
- 46. www.clinispace.com © 2012, CLINISPACE, INC. parvati@clinispace.com © 2012 IIL Inc. Serious Play, August 21, 2012 46
- 47. THANK YOU & QUESTIONS Slides are on SlideShare. Search for ‘parvatidev’ or ‘clinispace’ Email us at info@clinispace.com parvati@clinispace.com © 2012 IIL Inc. Serious Play, August 21, 2012 47
Notas do Editor
- Multi-player virtual worlds are well-suited to training teams to work together.
- My favorite is a scientific meeting in which I participated in the World of Warcraft. We all assembled in this great hall – both humans and non-humans
- Then we all rushed across the countryside to the quiet remote spot for our discussion I would surely have dies many grisly deaths if I had nothad the protection of my staffer an experienced level-60 witch
- We ended the session with this quest on top of a hill The meeting itself went on fro two days And was reported in Science magazine
- Does anyone remember … Those were the wild and woolly days of virtual environments, in 2008 When everyone jumped in, and then they all jumped out.
- But we had been building medical virtual environments since 2004
- Sandbox is actually very difficult to do well. If these are at two ends of a balance scale,build something that is mostly Campaign, with a little Sandbox. Much more likely to be successful and to satisfy. Of course, the end goal is a richly detailed Virtual Hospital, a Sandbox, in which the stories and the learning are emergent.
- There were so many ideas they did not fit on a slide.
- Direct additions to a medical virtual environment
- Ways of increasing the richness of the environment