• http://slurl.com/secondlife/Medical%20School/48/133/26 (private sim - please request rights with avatar names)

Despite inherent benefits to healthcare, implementation of widespread simulated experience-based training programmes in medical education has been slow. This has been ascribed to the high cost of dedicated simulators and the scale of the simulated clinical environments needed to provide realistic training. Virtual World Environments, and especially Second Life can provide cost effective, widespread access to training scenarios that have the capability to enhance general or specialist healthcare training. Medical devices are common technologies that the majority of healthcare professionals must be familiar with, and yet device associated incidents account for a significant proportion of medical errors. Widespread medical device training can be difficult to provide and where provided it often lacks the appropriate clinical context. This project set out to demonstrate how Second Life as a new and cost effective disruptive simulation technology could be used to effectively overcome these obstacles to improve patient safety across the UK’s National Health Service.

In consultation with the user community represented by a multidisciplinary group from different NHS specialities we evaluated existing training practices and presented iterative designs for a robust clinically relevant scenario (environment and sequence of events).

In this way we created a fully interactive scenario around an IV infusion pump which had been badly mismanaged just prior to the user entering the simulated ward. Participants were to undertake routine safety tasks, engage with other (automated) members of staff and interact with an (automated) patient as well as the medical device during the scenario. The scenario was then piloted with a cohort of experienced nurses from a London teaching hospital (St Mary’s Hospital). The results of this pilot were extremely positive and will be presented at several international conferences during the coming months.

Scenarios such as this can present a more realistic training environment and enable the participant to see the consequences of their actions in a clinically safe environment that does not endanger the real patient, and can help reduce real life medical errors. There is significant potential for the development of this technology in medical education to improve existing training and quality of patient care.

The other members of staff and patients were played by bots, but we are now experimenting with training entire teams together who may be based in different locations whilst training. In fact this project has already improved the ways that interdisciplinary teams within the medical profession are able to work and function. With much of the work done remotely, people and cohorts that would normally never have met, were able to collaborate and refine their ideas as if they were all in the same building. Working virtually has brought departments and experts together that previously would not be able to afford to meet face to face so often. By continuing this work we will not only reduce medical errors but bring medical departments, authorities and the general population together in a dynamic collaboration that will improve the livelihoods of all mentioned above. The pilot was funded by NHS Training for Innovation. Further research is now being undertaken at the Medical Media and Design Lab in the Department of Biosurgery and Surgical Education at Imperial College London with a larger cohort of nurses and in several related fields..