Conference Recap: I/ITSEC 2009
Written by Judith Riess and Ted McKenna
MMT 2010 Volume: 14 Issue: 1 (February)
The most recent Interservice/Industry Training Simulation and Education Conference (I/ITSEC), held November 30-December 3, 2009, in Orlando, Fla., was the largest in the conference’s 26-year history, with 19,000 registered attendees and 607 exhibiting companies. Along with more than 50 exhibits on medical training products, the show also offered a number of presentations and panel discussions on medical simulation and technology.
One such discussion, “Medical Simulation: Solving Today’s Medical Needs With Promising Discussions,” included an overview of the role simulation technology can play in improving emergency medicine, as described by Dr. Mark Boyer, chief of trauma and combat care at the Uniformed Services University of the Health Sciences; a look at simulation as it relates to pandemic medicine, from Karen Ngowe of the Center for Disease Control’s training services division; and thoughts about the future of simulation for surgical procedures, from Dr. Richard Satava, a professor of surgery at the University of Washington Medical Center and a senior science advisor for U.S. Army Medical Research and Materiel Command.
Among the points made by each panelists was that war improves combat care as well as civilian medicine, but that there is still much that can be done to improve the quality of health care, lower overall costs and make better use of “lessons learned” from the defense simulation industry. Panelists noted that while the medical simulation industry is growing quickly, the medical community that uses the technology is still working to understand just how it can be used most effectively by different sorts of professionals.
Presentations at the conference also covered the use of simulation to improve the teamwork of military medical teams; training health care providers in diversity issues within clinical settings; the use of simulated static and dynamic battlefield injuries to help “inoculate” military medics against severe trauma stress; understanding how much fidelity within a particular simulation program is required for particular types of real life medical practices; and using simulation to improve the performance of critical care air transport teams.
As an example of how simulation is more and more becoming an integral part of medical training, and is viewed as a key way of improving patient safety and the overall quality of care, Dr. Deborah German, dean of the new University of Central Florida Medical School, which opened in August 2009, described in another panel discussion how students at her school are using simulation within their classes from day one.
Overall, exhibitors pointed to the growing presence of medical-related presentations as well as companies at I/ITSEC this year. “This was the largest presence we’ve seen in terms of people looking at what’s being done in the medical simulation arena,” said Engineering and Computer Simulations (ECS) President Waymon Armstrong, who noted the various military services in several cases are using modified versions of the same basic systems, as well as taking advantage of the Internet.
“The cost point in technology is coming down to where people can be looking at technologies and saying, ‘I don’t have to have a facility, I can be doing it online, virtually,’” he added.
ECS among other things highlighted its Tactical Combat Casualty Care Simulation, which allows users to rapidly develop scenarios based on various battlefield situations, as well as incorporate new casualty types and multiple wounds. ECS’ Armstrong also noted that his company’s Computer-Based Corpsman Training System won both government and “people’s choice” awards for best serious game. The following is a rundown of a number of other companies exhibiting medical-related products and services at the show:
► B-Line Medical displayed its SimBridge and SimCapture software products, which are used to capture information within simulators for debriefing and assessment. Data is aggregated and made available online. Along with civilian hospitals, medical schools and nursing programs within North America and Europe, the company’s products are also used at a number of U.S. military facilities, including the Uniformed Services University.
► CAE demonstrated a brief and debrief system that captures multiple camera feeds, records multiple monitor displays and integrates data for a range of medical simulators and medical devices. More broadly, CAE develops technology for medical simulation centers, including a new health care simulation training facility that opened in Toronto earlier in 2009, the CAEMichener Center for the Advancement of Simulation in Healthcare, which will be used to train more than 1,500 civilian medical students a year. “The aviation simulation-based training model is becoming universally recognized as one of the effective ways to prepare health care professionals to care for patients and respond to critical situations while reducing the overall risk to patients,” said CAE president and CEO Robert E. Brown in connection with the opening of the new center.
► Forterra Systems highlighted its products’ ability to use avatars as stand-ins for individuals seeking to rehearse for a variety of missions, including cultural and locale training, emergency preparedness training, collaboration and information sharing, tactical team training, virtual command and control, incident management, and public education and outreach.
► HaiVision Network Video exhibited its Video Furnace System 5, which is designed to encode and distribute live video to computers and set-top boxes for creating scheduled playback channels for enterprise TV and signage, and for recording content and delivering video on demand.
► Kforce Government Solutions demonstrated TraumaFX, training manikins developed with the U.S. Army Research, Development and Engineering Command’s Simulation and Training Technology Center that simulate severe trauma injuries as well as physiological response to treatment. The company’s Multiple Amputation Trauma Trainer replicates severe blast injuries and can be worn by human patient actors to provide realistic training for hemorrhage control, the company said.
► Laerdal, a maker of human body simulators for medical training, demonstrated among other things its SimMan 3G product, whose many attributes contributing to the realism and utility of the training process include secretions, arterial and venous bleeding, and drug recognition.
► Mymic demonstrated technology that it provides, along with other expertise, to a number of DoD organizations, including the Air Force Research Lab, the U.S. Army’s Telemedicine and Advanced Technology Research Center and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. Research by the company covers, among other things, the use of virtual environments for training emergency response teams and designing game-based training for combat medics. Systems Mymic is currently in the process of fielding include an avatar-based virtual training environment and the Complex Incident Response Training System-Combat Medic, which is used to support certification of combat medics and corpsmen for responding to incidents involving improvised explosive devices.
► Ngrain noted that military organizations face tighter budgets, with which they are under increased pressure to train personnel faster, including medical personal, and that simulation is seen as a way to improve training as well as save money. For instance,the United States faces a critical shortage in qualified nurses, the company noted, and that shortage of nursing manpower crisis is reflected in the challenges facing the USAF, which has a total nursing force of 19,000 men and women. Over 50 percent of new nurse recruits are novice nurses with less than six months of nursing experience. To help speed training, U.S. Air Force medical training teams use Ngrain's Producer software to create virtual surgical instruments for use by nurses, who because of supply limitations otherwise get only limited training time with real sets of surgical instruments. Ngrain's Viewer software lets the nurses interact with more than 80 virtual surgical tools spontaneously, learning as a result how to better handle and prepare instruments prior to surgery.
► Organic Motion demonstrated technology that can create instant, real-time virtual representations of people within a “scan area.” The company said the technology is already in use for studies related to, among other things, post-traumatic stress disorder (PTSD), children with cerebral palsy and the use of advanced prosthetics by amputees. For example, in a project supported by the Congressionally Directed Medical Research Programs, the technology is being used at the University of Florida Digital Worlds Institute to quickly create therapeutic scenarios for PTSD sufferers, including the prosaic yet potentially maddening grocery store checkout line. Organic Motion said its technology is also being used to train dismounted soldiers in various tactical responses.
► Polhemus demonstrated its motion tracking technology, which is used in simulator trainers such as MedSim’s mock ultrasound probe. The company said its technology has been used for more than 20 years for applications including training simulators, image-guided surgery and fabrication of orthotics and prosthetics. Accurate and low-latency tracking is key to the fidelity and realism of a simulator, the company notes. Too much “lag” time in the virtual representation of a head-mounted display can even cause motion sickness, Polhemus said. “One often overlooked attribute of training simulators is the objective, data driven feedback provided,” said Neil Schell, Polhemus’ director of business development, research and technology applications. “There is no guess work, or inconsistency from one instructor to another. Furthermore, the results of a training session can be recorded for later analysis and review by the instructor and student.”
► Projectiondesign showcased projectors that are used for color grading and editing, post production and other purposes in creating digital environments. The company said projectors have been used to create blockbuster films, but are affordable and flexible enough to be used in small design studios.
► Raydon highlighted its Virtual RX banner for use in assessing and treating traumatic brain injury (TBI) and PTSD. The company noted that DoD is using Raydon systems at the Blanchfield Army Community and Winn Army Community hospitals, while the Department of Veterans Affairs is using them at several of its medical centers, including Richmond, Va.; Boston and Brockton, Mass.; West Palm Beach, Fla.; Atlanta, Ga; and Ann Arbor, Mich. Raydon noted also the high potential for commercial applications for its TBI- and PTSD-related products, given the unfortunately widespread occurrence of vehicle collisions, sports injuries, and medical injuries resulting from strokes, trips and falls.
► SIMmersion emphasized its development of simulations for improving communications between doctors and patients. Poor communications about medical issues can lead to a number of bad things, the company noted, including misdiagnoses, unnecessary tests, lawsuits and even wrongful deaths. SIMmersion applications have been developed to allow medical professionals to practice alcohol and drug screening and intervention, medical history taking, differential diagnosis motivational interviewing and suicide prevention. Future applications may include conversations regarding chronic conditions, terminal illnesses and grief counseling, the company said. SIMmersion said its simulated characters respond realistically, so that users of the system don’t ever have the same conversation twice, even through repeated plays. The company’s systems use voice recognition to listen to the medical trainees, with video recordings by professional actors providing a response. ♦