Category Archives: Virtual Reality Medical Training

OMS for Interprofessional Team Building

VR scenario manual pulse
VR scenario manual pulse

Building a safe space for a working environment is imperative to interdisciplinary team success in healthcare settings. 

Team building exercises are often done in person, and as scheduling across multiple disciplines is difficult, it can be few and far between for everyone on the team to come together at the same time for team-focused activities. 

VR can be used as a way to connect the interprofessional team from any space, providing similar benefits to that of in-person team building simulations. 

OMS Interprofessional Scenarios

OMS offers a suite of multidisciplinary scenarios that encourage teamwork, communication, and collaboration for safe and effective patient care. 

No matter where your learners are, they can enter the same simulation with their colleagues to exchange ideas, learn about other roles, and gain a deeper understanding of the intricacies of interprofessional teamwork. 

Together, learners examine, diagnose, and come to decisions on how best to treat patients who are acutely unwell.

These scenarios have a direct focus on team-oriented decision making, critical thinking, communication, and clinical reasoning through acute situations including (but not limited to): 

  • Advanced cardiovascular life support (ACLS)
  • Diabetic ketoacidosis
  • Pulmonary edema
  • Anaphylaxis
ACLS virtual simulation

Beyond what is completed in the scenario itself, learners also get the opportunity to debrief as a group, opening up a dialogue on where the team performed well and which areas have room for improvement. 

Interprofessional roles in scenarios

There are two main types of roles that both learners and trainers or faculty can take on in the simulation – active and observer. 

Active roles include the lead role and the assisting role, who both play active parts in the progression of the scenario. These learners directly communicate with one another to gather relevant information, perform tests and measures, interpret results, and conduct interventions. 

In order to complete the scenario and effectively manage the care of the patient, learners must collaborate to distribute tasks and maintain open communication throughout the simulation. 

This delineation of roles allows for one learner to take on a leadership role within their team, practicing delegation, just as interprofessional teams work together in clinical settings.  Denoting roles can also be beneficial in the understanding of roles and responsibilities of healthcare professionals from other disciplines. 

Observers, on the other hand, have the opportunity to get a view, from any angle, of how the scenario is unfolding and how the team is working together. This can inform and provide greater context for debriefing discussions amongst the team following the simulation. 

Learners or faculty can take on any role, depending on the goal of the scenario and learning objectives, and with OMS Create, faculty can control the patient’s actions, speech, or vitals just as they can in physical simulation. 

If for any reason, planned or unplanned, one participant exits the scenario, roles can be changed mid-simulation. For example, if you’d like to have one learner begin in the assist role and later take on the lead role, that can be planned for prior to entering the simulation. 

In OMS Interprofessional scenarios, learners have the opportunity to come together from across a wide range of disciplines to work as a team with a focus on crisis resource management, teamwork, and communication skills with their colleagues, reflecting the everyday work done by interprofessional teams across healthcare systems.

Team-based feedback

Similarly to single player scenarios, OMS Interprofessional simulations automatically populate with feedback upon completion of the scenario and self-guided reflective questions. 

However, the feedback provided for multiple participants is team-based, so learners can continue working as a group as they debrief. 

virtual debriefing room with feedback and learners

As expected, feedback details areas that went well during the scenario and where there is room for improvement of future performance. This evidence-based feedback also provides learners with rationale, giving a more robust explanation of why certain actions are important and how those concepts relate to practice. 

Additionally, a scenario timeline is constructed and shown to the learners. This timeline contains timestamps for actions taken during the simulation, as well as identifiers for who took which action, providing a visual representation of how the scenario unfolded. 

Finally, learners can go back to review reports that were conducted during the simulation. This may include any imaging, lab results, or guidelines that were relevant for the context of the scenario. 

How one university encouraged interprofessional collaboration with OMS

NOVA Southeastern University Health Professions Division created an Interprofessional Education Day utilizing OMS Interprofessional scenarios. 

They brought together over 2,000 students, faculty, and staff from over 16 disciplines as a part of this day to encourage collaboration and deeper understanding of the interdisciplinary team. 

Prior to the IPE day, faculty recorded a scenario that brought together one student each from pharmacy, medicine, and physician assistant programs. Together, they entered an OMS Interprofessional scenario and collaborated on the treatment of an acutely unwell patient.

Their entire experience was recorded, and on the IPE day, groups of learners were able to view the recorded simulation and debrief on what they observed. 

This particular experience made for rich debriefing discussions, as an incorrect medication was administered during the scenario. This not only brought about discussions on checks and balances for medication administration, but it also encouraged a meaningful discussion on psychological safety at work and speaking up within a cross-functional team to ensure patient safety at every stop.  

Interprofessional scenarios can accommodate multiple learners in each scenario, and for some, that can mean having a classroom of learners participate in the same simulation, at the same time. From three to 300 to 2000 – there’s a way for everyone to get involved and benefit from interdisciplinary team-building simulations. 

With OMS Interprofessional scenarios, learners enter the scenario together, and they exit the scenario together. As a group, they are responsible for the outcome of the simulation, and they are able to take time following the scenario to engage and discuss with one another about how they performed as a unit to positively impact the patient. 

These scenarios foster interprofessional communication and collaboration in a psychologically safe environment, encouraging learners from all healthcare disciplines to come together and build the foundation for interprofessional care. 

To learn more about the ways in which you can use interprofessional scenarios to foster collaborative interdisciplinary teams, set up a time for a demo here.

Interested in trying VR sim? Arrange a free demo with us today.

OMS named as finalists at the VR Awards

OMS Interprofessional makes the finals of the 2020 VR Awards

We are honored and excited to have been nominated as a finalist for the 2020 VR Awards for OMS Interprofessional.

OMS Interprofessional is the multiplayer virtual reality platform from Oxford Medical Simulation. Designed to provide immersive training opportunities for doctors, nurses and allied healthcare professionals, OMS Interprofessional lets clinicians work together wherever they are in the world. 

A doctor in California can now work with a nurse in Oxford and a facilitator in Baltimore to treat virtual patients. Participants can speak to the virtual patient and each other in real time, carry out examinations, make diagnoses and provide treatments just like in real life.

They can then learn from personalized feedback and repeat as often as they need in order to provide the best care for patients in real life. Using OMS Interprofessional can optimize quality of training while freeing up time, space and money to help hospitals provide optimal patient care.

Winners will be announced in November – until then we’ve got our fingers and toes crossed! 

LEARN MORE about OMS Interprofessional LEARN MORE

Video: VR Simulation at Oxford University

VR medical simulation

Dr Sally Shiels discusses the value of VR simulation at the OxSTaR simulation centre in the Oxford University Hospital Trust

VR simulation

Dr. Sally Shiels is an anaesthetist at OxSTaR (Oxford Simulation, Teaching and Research), the purpose-built, state-of-the-art medical simulation teaching and research facility in Oxford University Hospital.

Sally discusses virtual reality’s impact on training for medical students and clinicians, how immersive technology is supporting patient safety, and the types of programs the OxSTaR center are developing.

“Providing our students with virtual patients has been an absolute sea change in terms of medical education” 

Using OMS has allowed OxSTaR to expand their training capabilities, preparing medical students more fully for clinical practice, in order to improve patient safety.

“We’re taking our students into a virtual world where they can learn safely, and that is really important, because then they feel safe to make mistakes.”

Learn more about the work Oxford University are doing with OMS using the link below, or see PharmaComms TV for the original content.

OxSTAR and VIRTUAL REALITY

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Virtual Reality World Tech Magazine: Informed Immersion

Immersive technology is making significant strides in training medical professionals and as a treatment in health and wellness.

There are many ways that virtual reality (VR) can be applied in healthcare – from training medical professionals to aiding surgeons through visualisation or even robotics. But where is immersive tech really excelling right now, and what is it achieving for patients and medical professionals alike?

In the article below, Dr Jack Pottle, Chief Medical Officer at Oxford Medical Simulation, speaks to VR World Tech – discussing the views and often misconceptions that institutions have about immersive tech…

Read the full interview here

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The Importance of Simulation

Types of simulation

This week is Healthcare Simulation week and as part of the celebrations we take a look at five reasons to salute the wonderful practice of simulation…

 

 

1. Simulation improves patient care 

By far the most compelling benefit of simulation in healthcare is the positive impact that it can have on patients. After all, a drive to  improve patient outcomes and the quality of their care is at the basis of healthcare education systems worldwide…

Providing future healthcare workers with the resources to optimize patient care – be that through effective clinical acumen, time management, communication and everything else in between – is the bedrock of a successful healthcare system.

Essentially, simulation sets trainee doctors and nurses up to effectively make people better when they come to practice in real life. In 2012, Benjamin Zendejas (Mayo Medical School, Rochester) set out to prove how far simulation training promotes positive results for patients. The findings were powerful; simulation-based education was shown to be directly linked to patient benefits when compared to both non-simulation-based training and instances where no intervention was given at all. 

Linked to this is the propensity for simulation to reduce patient harm. No clinician wants to inadvertently complicate or worsen a patient’s condition but medical error is the third leading cause of death in hospitals worldwide. With simulation, we are able to reproduce patient care sequences with all the clinical complexities of real life scenarios allowing clinicians to cover all the bases when treating real people. 

Ultimately, simulation-based training produces more competent healthcare professionals which can only be beneficial in improving the quality and safety of patient care. 

 

2. Simulation inspires confidence

Few on-boarding periods of a new job can be as daunting as starting out as a junior doctor or nurse. Fetching coffees, navigating the intricacies of a Kafkaesque office bureaucracy, whilst remembering not to raid Belinda from Accounts’ personal HobNob stash seem like a walk in the park compared to a 12-hour shift filled with hundreds of patients with complaints ranging from the utterly absurd to the genuinely life-threatening. 

To make matters worse, strained resources, overcrowded hospitals and staff shortages mean that most junior healthcare professionals face much of this without the necessary support.   With simulation, clinicians are able to practice managing acutely unwell patients without causing real patient harm if it goes wrong. In this way, practicing emergency care during training can take the edge off the intimidating world of real life practice.

This is something we’ve been made directly aware of at Oxford Medical Simulation through the roll-out of our virtual reality simulation platform at Oxford University. There, learners told us that, “it’s really good to get the experience of being put in the driver’s seat, of making the decisions…I think it will give me more confidence to make those decisions [in real life]”.

 

What is more, simulation-based training as been shown to improve junior clincian’s confidence in pushing for improved patient outcomes within real life treatment. Healthcare training is inherently hierarchical and this can often mean that trainees are afraid to speak up when they think a senior colleague is not administering the right kind of treatment. 

In a study carried out by the University of Harvard and Massachusetts General Hospital, simulation was shown to increase the frequency and quality of interventions by Residents in the care suggested by their seniors. 

Simulation can therefore be seen to not only improve patient care by bolstering the doctor or nurses confidence in their individual practice, but also promoting appropriate assertion in challenging a treatment plan when they think there might be a better way. 

 

3. Simulation lets us learn from our mistakes 

In our personal and professional lives we learn best from the mistakes we make. Cultivating an attitude that embraces mistakes as an inevitable part of life that can be mined for valuable lessons is an effective way to successfully avoid making mistakes in the future. Within the context of healthcare however – where the price of our mistakes can be fatal – this kind of philosophy can be hard to accept. 

In practicing simulation a safe-space is created in which healthcare professionals can refine their clinical skills without the risk of harming real patients. When effective debrief is built into simulation, the learnings taken from this form of training  are invaluable. With learners identifying strengths and areas for improvement in a supportive atmosphere. This is a powerful combination that mitigates against these mistakes being made in real life. 

Further, the emphasis on debrief engenders good habits of self-reflection for trainees to take through their entire professional careers. When clinicians are used to assessing their own practice regularly they are personally assuring the quality of the care they provide. 

 

4. Simulation works across all healthcare disciplines 

Simulation works effectively across all healthcare domains including; medicine, nursing, paediatrics, mental health, surgery, emergency care, life-saving and more. What is more, simulation surpasses all other training mechanisms in touching the most comprehensive set of skills ranging from specific procedures to communication and teamwork. 

The controlled nature of simulation means that institutions can ensure learners are exposed to as wide a range of clinical presentations as possible to build up depth of knowledge. Stress conditions can be put in place to mirror real life scenarios and test trainees ability to cope under pressure. The debrief that follows these experiences means that learnings are not lost or left open to individual interpretation. 

Simulation is also deliverable across multiple platforms. Mannequin-based simulation has long been used to produce life-like conditions in which learners can practice patient management. Similarly, the use of standardized patients in simulation is effective in creating a true-to-life environment where learners are able to interact with a real person. Increasingly, virtual reality is being used to deliver repeatable, immersive simulation at scale. 

 

5. Simulation is widely practiced worldwide

We’ve often heard it said that – if you do not work in healthcare – simulation is probably the biggest industry that you’ve never heard of. When you stop to think about it – it makes sense. You wouldn’t expect pilots to fly planes without practicing in simulators first – so why should we expect the people taking care of our health not to do so as well? 

There are hundreds of organisations, institutions and individuals doing wonderful things in simulation across the world.  Organisations such as SSH and ASPiH organise renowned international events like the International Meeting on Simulation in Healthcare (IMSH) to encourage knowledge sharing and best practice. 

As part of Healthcare Simulation Week, Boston Children’s Hospital hosted a Facebook Live event to give the community insights into how its state-of-the-art paediatric simulation center works. Having run an immeasurably impactful simulation programme for over a decade, BCH has now taken is simulation capabilities on the road. Offering over 50 courses at nine institutions across eastern Massachusetts – its SIM Network initiative shows that simulation best practice can be distributed at scale. 

In the UK, the NHS Diabetes Programme is using simulation to directly impact the treatment of people with Type 1 diabetes. Using the OMS virtual reality simulation platform, doctors are able to practice treatment before they see real life patients. Diabetes treatment can be notoriously tricky and for many doctors the first time they have to manage diabetes-related cases is in real life. Using simulation, the NHS is able to train doctors on the specific complexities to look out for, without compromising the quality of patient care. 

The healthcare team at St Luke’s University, Pennsylvania, have customised a freight truck to serve as a mobile simulation suite. Offering training opportunities across disciplines, people that live in remote areas that once may have been unable to access a healthcare education are now able to access valuable resources to further their careers. In this way, St Luke’s mobile simulation operation is promoting diversity and social mobility in healthcare and beyond.

These are just a few examples of the ways in which simulation is being leveraged to improve healthcare training and education, and in turn, our healthcare systems and standards of patient care. 

Happy Healthcare Simulation Week! 

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Oxford University Partners with Oxford Medical Simulation to Transform Medical Education

The world’s leading medical schools are embracing state of the art virtual reality software to push student’s learning to new heights.

Oxford University has partnered with Oxford Medical Simulation to train medical students using virtual reality. Students can now practice medical emergencies using true to life virtual scenarios without risking patients’ lives.

The technology, developed by Oxford Medical Simulation (OMS), allows medical students to practice treating acutely unwell patients in a simulated, virtual environment as often as they like. Training in this way improves patient care in real life by allowing repeated practice in simulation to build competence and confidence.

Why VR?

Oxford University decided to employ this innovative technology as a way to get more students through simulation. Simulation – where trainees practice medical emergencies as they would present in real life – is widely regarded as one of the most effective ways of training healthcare professionals. Simulation is traditionally practiced with high fidelity plastic mannequins in mocked up hospital wards. However, this form of simulation is time, space and budget consuming meaning medical students may only get to experience one physical simulation in an academic year. With virtual reality simulation, students are now able to practice simulated scenarios as often as they like.

The system is being used at the OxSTaR centre based at the John Radcliffe Hospital in Oxford – the main teaching hospital for Oxford University Medical School.

Rosemary Warren, Centre Manager at OxSTaR commented,

“As a world-leading institution, it is important for us to remain at the forefront of changes in the types of learning opportunities we offer our students. Embedding virtual reality simulation into what we do has enabled us to give a far greater number of learners access to simulation in a shorter space of time. It’s encouraging to see how quickly our students have adopted the technology. I’m excited to see how they progress clinically as they use it more and more. Simulation is a vital part of medical education and students just don’t get to do it enough. The OMS virtual reality platform allows learners to enter simulation as often as they like to transfer their knowledge to practice.”

The OMS system works by providing students access to libraries of medical emergencies that allows them to simulate the treatment of a range of conditions such as sepsis, diabetes, cardiac failure, pancreatitis and many more. Students enter the interactive virtual scenario using an Oculus headset and are greeted by a virtual nursing assistant and their patient. Learners are able to question, comfort, examine and treat the patient as they would in real life. Every action the learner takes up to – and including – diagnosis and resolution is recorded and fed into the system’s inbuilt feedback engine. Once the scenario is complete, the learner is taken through this feedback to understand what went well and what they need to improve on.

The emphasis is on training effective decision making, critical thinking and clinical reasoning. Healthcare learners have a safe space where they can apply their knowledge and learn from their mistakes.

Dr Jack Pottle, Founder and Chief Medical Officer at OMS said:

“We’re delighted to be working with world leading institutions like Oxford to bring our platform to medical students. We have developed OMS out of a belief that training healthcare professionals in a flexible, zero-risk environment will transform patient care around the world. We learn best when learning from experience and our system allows users to do just that – without putting patient’s lives at risk.”

OMS are currently providing free trial access to the platfrom to healthcare institutions – use the form below to contact the team. 

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Oculus Rift S Updates: what do they mean for Virtual Reality simulation? 

Healthcare professional trying out virtual reality medical simulation on the Rift S

For the past few weeks we’ve been avidly testing out the latest Oculus Rift S kit.

The new hardware’s inside-out tracking shows the progression of VR technology and can only mean better, more exciting things for the world of healthcare simulation. 

So, what’s changed? 

The most significant difference between the new Rift S model and its predecessor, the Rift, is that it using inside-out tracking. This means that the sensors now sit inside the headset rather than using a separate desk-mounted sensor as with the original Rift. It has simpler halo-style headband making it easier to put on and the original over ear headphones have been replaced with directional speakers embedded into the headband. 

The screen resolution on the Rift S is slightly higher than previous models and they way the user sets up their guardian fields (ie the area in which you can “play” in VR) has changed. Now operated from entirely within VR, you draw a line to mark out your play area to map it out more precisely. New outward facing cameras on the Rift S headset mean you switch to seeing your real-world surroundings if you move outside of the physical space you’re meant to be in. It’s a clever feature that means you no longer have to worry about bumping into anything or anyone whilst your immersed in the virtual space. 

What do these changes mean for virtual reality simulation? 

In terms of how learners use the OMS simulation platform, the move to the Rift S won’t require you to change anything at all. Whether you’re using a Rift S or and original Rift model, you can still train healthcare professionals using fully immersive VR medical and nursing scenarios as before, and there are some added benefits. 

Firstly, freeing the headset from the external sensors means that the setup is even easier and quicker and the Rift S is smaller, making it even easier to store and transport. Particularly if you are looking for simulation suite that can be used across multiple sites then the Rift S is perfect.

The new guardian set up allows users to take full advantage of the six degrees of freedom (how your movement in the real world matches your movement in the virtual world) in a much simpler format. The guardian system allows you to more easily avoid any fixtures and fittings that might otherwise get in the way and interrupt your immersive experience. Because users can now view their surroundings without coming out of VR – health and safety is assured and the capacity for independent learning of VR simulation is further enhanced. 

In conclusion, in terms of learning outcomes and visual experience, the Rift S offers much the same experience as the original Rift – ie excellent. The improvements made on the Rift S tend to make the practical experience of setting up and implementing simulation simpler with fewer pieces of hardware and the smaller, more transportable kit. All of this means the Rift S continues to allow VR to provide simulation at scale, to deliver all the benefits of OMS VR simulation. 

If you want to try out the OMS VR medical or nursing simulation platform on the Rift S get in touch with one of our Educational Specialists today.

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Is Embracing Human Error the Future of Healthcare?

It’s a good job Frank Sinatra wasn’t a clinician…

Crooning “Regrets, I’ve had a few, but then again… I can never mention them because there’s an inherent denial of error in healthcare,” doesn’t exactly have the same ring to it, does it?

Ol’ Blue Eyes aside, I’ve been thinking a lot about mistakes recently. I’ve been thinking about the mistakes that we make as doctors and nurses and how they have irreversible effects on the lives of our patients. And I’ve been thinking about my own mistakes. How I have missed diagnoses, delayed treatments, discussed plans insufficiently and how this has impacted the lives of the patients who trusted me with their care.

And as well as reflecting on these errors and how they forever change the lives of our patients, I’ve been thinking about how they affect us as clinicians and how best to learn from them. And, paradoxically, how we never speak about them.

Humans make mistakes. Outside hospital we admit these mistakes, own up to them with people we trust and try not to repeat them again. Yet what is taken as normal in everyday life doesn’t work in healthcare.

Why don’t we discuss our mistakes?

Firstly, litigation. There’s an understandable sensitivity around talking about what’s gone wrong as it leaves us open to malpractice cases. Cases like that of Hazida Bawa-Garba – a doctor struck off for missing sepsis – does little to dispel this. There is a feeling that the legal vultures are just waiting to close in after every slip-up.

Then there is shame. There is a deep personal shame in making mistakes. We are taught that only juniors make mistakes and we grow out of them as they become more senior. There is therefore an inherent unwillingness to admit we make mistakes as we become more senior; we should be above this.

And in addition to the personal threat of shame is the societal threat of ridicule. Healthcare is a competitive field where we only show the best side of ourselves to our peers. In opening ourselves up to become ‘the guy who made that mistake’ there is a vulnerability we’re not prepared to accept.

The organisation threat of litigation, the personal threat of shame and the societal threat of ridicule by our peers is a powerful combination. And a combination that coalesces to form a more general fear – if we do admit our mistakes we will be alone.

The fear of ridicule distances us from our peers. We fear the institution we work in will distance itself from us in litigation. And the removal of these two vital supports – colleagues and organisation – leaves us alone and adrift when we are least prepared to deal with it.

Does discussing mistakes matter?

In short, yes. If we don’t discuss our mistakes, it is impossible to learn effectively from them. There is a wealth of evidence that debriefing on mistakes improves future performance. This effect comes not only from learning from our own mistakes, but learning from our colleagues’ errors. In not discussing our mistakes as a group we are depriving our colleagues of the knowledge they could have gleaned from our mistake and the rich vein of potential for broader error reduction has been lost.

This error reduction is not just in relation to other clinicians avoiding specific mistakes. Most errors are not due to a ‘bad clinician’, rather the same or similar medical errors have been made many times before in many different ways by many different clinicians. And errors are rarely due to one clinician happening to make a mistake. They are a combination of a huge number of factors that align to make an error. Therefore in not discussing as a group we are not only depriving our colleagues of knowledge, but we are leaving the system open to ongoing failures by not identifying system-wide faults.

Brian Goldman discusses the culture of mistake denial in medicine in his 2010 TEDX Talk: Doctors Make Mistakes. Can we talk about that? Goldman talks about his own experiences of making mistakes and argues we need to find a way to embrace that in a more constructive way.

Goldman closed his TED Talk with a call to action for the medical community to redefine its attitude to mistakes, to find ways to openly and sympathetically discuss them in order to better learn from them. That was almost ten years ago and I’m not sure we’ve answered his rallying cry yet.

So what can we do?

There is still hope, and it starts in medical and nursing school.

We must teach medical and nursing students that mistakes are inevitable in a high pressure field with exponentially increasing complexity and pressure. Only in doing this from the start, in teaching students to be comfortable with uncertainty and that mistakes are inevitable in an uncertain world, will we begin to change the tide.

Companies such as Oxford Medical Simulation are actively trying to create a safe space in which to consider clinical mistakes that Goldman so rightly encouraged us to cultivate.

OMS builds lifelike but non-judgemental virtual reality scenarios in which students can see and treat patients like in real life. This allows learners to make mistakes in the virtual world rather than in real life, without any sense of reprisal.

Reflection and debrief on performance is built into the system, guiding learners to discuss errors, before providing structured feedback on performance. In this way, learners are in control of building a culture of supportive discussion of error.

While it is key to embed a culture of discussing errors at medical or nursing school, this is not enough. Once clinicians have been taught that making mistakes is normal, that discussing them is vital, and that this can improve patient care, we need to have systems that support reporting of these errors, to disseminate knowledge.

Reporting of mistakes, reporting of near-misses, reporting of anything that might compromise patient care should be the norm. And this should be true from the porters through the clinicians to the CEO.

To do that, we have to extricate the shame loaded into such discussions of error. Though a broad culture change to make error reporting the norm will take time, one simple way to help this is anonymisation. Building simple, anonymised reporting systems into hospital infrastructure – where an error is reported to the patient safety team, a collaborative action plan is formed and reported back to the clinical team without fear of reprisal – is vital. None of this is difficult, and it will surprise many people outside healthcare that this is not the norm in more hospitals, but all will help create a system that helps identify and supports rather than punishes.

Finally, the systems above are worth nothing if not supported by patients. It is imperative that patients and the public support and can contribute to the structure of such systems – what clinicians and hospital managers feel is important can be very different from the patient voice.

Alongside this, patients and the public must begin to accept that in a complex system, doctors will make mistakes. Healthcare is an imperfect science – many of the decisions we make are based on little or no evidence. In a world where new treatments are being invented daily and conflicting evidence is produced at the rate of 1,000 papers per day, clinicians cannot know what the ‘correct’ course of action is in many cases.

Often the ‘correct’ course does not even exist so we make 50:50 calls.

Combine this with a workforce that is understaffed, overworked and burned out and there is no surprise that mistakes are made so frequently. That is not to accept mistakes – it is to accept what we cannot change, identify what we can change, and target this actively.

In summary…

Like the patients we harm, we carry our mistakes with us for the rest of our lives.

Arming our clinicians with the resources to acknowledge, reflect on and learn from their mistakes is crucial to identifying areas for growth and improving patient care.


Dr Jack Pottle is a practicing doctor, member of the Royal College of Physicians and Chief Medical Officer at Oxford Medical Simulation

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The Joy of VR: what we learned when the leading virtual reality healthcare minds gathered in Los Angeles

We attended the Virtual Medicine conference at Cedars Sinai Medical Centre in Los Angeles where we joined leaders in the virtual reality healthcare space to discuss the latest developments – and applications – of VR in patient care and medical education.

Oxford Medical Simulation (OMS) was proud to join other leading thinkers excited about the potential of virtual reality in healthcare. The Virtual Medicine conference (vMed) brought together not only healthcare professionals, but also researchers, technical developers, business leaders and patients. This made showcasing our virtual reality scenarios for healthcare training during the event all the more special.

As always, we loved getting VR newbies into the system to demo how intuitive VR can be, and it was even more encouraging to get the endorsement of VR experts who live and breath virtual reality in healthcare.

We were excited that when healthcare professionals entered our scenarios for a quick taste they quickly became so immersed that they were determined to save the patient, or delve into the details to find out more. Surprised at the level of realism in one of our virtual patient’s histories, one user at vMed19 announced;

“Whoa! I’m going to ask about his social history! I want to know what kind of recreational drugs he uses.”

Only in Los Angeles!

Besides the kind words about our own platform, we received a fascinating update into the other ways in which VR is impacting healthcare for the better. From helping to manage pain associated with Crohn’s Disease, to facilitating reminiscence therapy in people with dementia, the applications of therapeutic VR just keep growing. Dr David Rhew (Chief Medical Officer at Samsung Electronics America) gave a compelling talk on the effects of VR on people with dementia, loneliness and concussion amongst a host of other applications. In the case of concussions, VR is now proving to be as effective as sleep, exercise and education. Former Cedars Sinai patient Harmon Clarke recalled how meditating and travelling in VR during his hospital stay, instead of relying solely on pain medication, accelerated his recovery from Crohn’s disease.

The Patient Panel on Day 2 was another highlight: the moving accounts of four patients who had experienced therapeutic VR really brought home the positive results that this technology can have.

Research on the efficacy and optimal methods of delivering VR therapy remains in its infancy and is a fascinating topic. The groundbreaking work done by Skip Rizzo on the applications of VR to treat PTSD and anxiety in particular and Mel Slater on VR in cognitive neuroscience and body-swapping keep us pushing the boundaries of what VR can do and how it can deeply affect individuals perceptions and abilities to learn.

Despite the excitement of the forefront on the technology, the ongoing message of matching appropriate immersive content and delivery to the individual’s needs remains central to all VR design. At OMS we couldn’t agree more. We often ask ourselves and others considering virtual reality “what are your learning objectives?” and ensure that everything we design meets a specific need.

Cedars Sinai Medical Centre proved to be a compelling setting for the event, too. Set against the backdrop of one of the largest academic health centres in the US, the discussions, revelations and real life stories felt even more relevant. It almost felt like we – as a global VR in healthcare community – were more galvanised, united and inspired by physically locating us within the system we’re seeking to change.

It was this collective feeling of inspiration and celebration that made vMed19 such an impactful conference. The world’s leading thinkers and innovators in VR medicine came together in one place to share new developments and celebrate success stories, and we left with a boosted motivation to continue our work in the space. Brennan Spiegel, Director of Health Research at Cedars Sinai and the driving force behind the vMed conference summed up this feeling best when he offered some uplifting advice in his closing remarks:

“VR offers joy. Leverage that like crazy.”

We couldn’t agree more!

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Oxford University uses virtual reality to power blended learning and boost medical student education

Students at Oxford University use virtual reality simulation to augment medical student education.

Blended learning combines traditional learning techniques with interactive, digital resources to optimise student engagement. This practice can be particularly effective within the context of medical education – where students are required to absorb vast amounts of complex practical and conceptual knowledge. With this in mind, Oxford Medical Simulation’s platform has been designed to complement in-classroom teaching methods with cutting edge virtual reality simulation to take medical students’ learning to the next level.

Medical students at Oxford University have been using our simulation software at the OxSTaR centre to effectively combine learning techniques. Blending the use of our platform with conventional lectures, learners have followed in-classroom study by cementing their practical and clinical skills in VR. Users at Oxford told us that:

“As a learning experience, pairing the VR with a lecture beforehand worked well – the VR was an opportunity to consolidate and put the learning into practice.”

Differentiated learning is not a radically new concept in medical training and education – students have traditionally supported their theoretical studies with physical, mannequin-based simulation. However, it’s not uncommon for medical students to get access to a physical simulation session as little as once in an academic year. What is exciting about how Oxford University is using our virtual reality simulation platform is the immediate nature of learning theory in the lecture hall and then instantly – and seamlessly – applying that learning within a simulated scenario.

The upshot of embedding virtual reality simulation into medical training is improved learner confidence and transfer of learning to practice. Because the simulation software is readily accessible, students can repeat scenarios as many times as they need to build confidence. This is crucial to priming learners to enter the hospital environment. The medical students at Oxford University recognise how VR simulation will help them prepare for real-life situations:

“It’s really good to get the experience of being put in the driver’s seat, making the decisions and then following through with the management. As a medical student, there is a lot of standing around watching people do things. You tell yourself that you would make those decisions, but it’s nice to actually practice making the decisions. I think it will give me more confidence to make those decisions in real life.”

It’s encouraging to see students responding to virtual reality simulation with virtual patients in such a positive way. Providing readily available, scalable and accessible learning content that transforms learning and, ultimately, real-life practice, is built into the design of our platform. Oxford Medical Simulation will be keeping up the good work with Oxford University and leading institutions to bring this experience to learners around the world.

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NHS doctors train using virtual reality to improve care for people with diabetes

The NHS England diabetes team has partnered with Oxford Medical Simulation to train doctors using virtual reality. Doctors can now practice in virtual reality medical emergencies, to improve care for patients with diabetes in the real world. Combining clinical expertise from the NHS, volunteer patient input and world leading virtual reality software, doctors can now put on virtual reality headsets and practice taking care of patients as often as they want, without risking lives. The system is being piloted through Health Education England in a multicentre trial in the South of England, with development funded by Novo Nordisk. If supported by evidence from the pilot there are plans for further roll-outs nationwide throughout 2019.

People with Type 1 diabetes have more chance of developing life-threatening complications when in hospital than outside it. For people with diabetes, extreme highs and lows in blood sugar can be fatal. These emergencies can be difficult for doctors and nurses to recognise but can be fatal if not treated quickly. High quality training for frontline staff is vital to improve patient care in these situations. “When I was in training we’d learn on the wards. It was called ‘see one, do one, teach one’, commented Dr Jack Pottle, an NHS clinical entrepreneur and co-founder of Oxford Medical Simulation, a virtual reality medical training company based in London. “I had never practiced managing a diabetic emergency until I had to do it in real life. You wouldn’t expect a pilot to fly a plane full of passengers without having practiced first. Why do we think that’s acceptable for doctors and nurses?”

Dr Partha Kar, NHS England Clinical Director of Diabetes said: “Embracing technology is at the heart of the NHS Long Term Plan and training doctors using virtual reality is another example of modernising the NHS to help improve care for patients with diabetes.” Individuals who helped to develop this project included Dr Mayank Patel, Dr Ritwika Mallik and Mr Neil Sweeney.

Margot James, Minister of State for Digital and Creative Industries said: “Oxford Medical Simulation is a great example of the ground-breaking digital companies that the UK is constantly producing, I was hugely impressed when I met the company and tried their technology earlier this year and it’s great that it will now provide training for doctors across the NHS as they treat patients with diabetes.”

For more information please contact: Dr Jack Pottle, Oxford Medical Simulation Tel UK: 07515 281397 Phone international: +44 7515 281397 Email: [email protected]

Oxford Medical Simulation delivers virtual reality medical training. Using Oculus Rift VR headsets, learners can practice in immersive, fully-interactive clinical scenarios as if in real life. They then receive personalised feedback and can repeat as often as they like to improve performance. These scenarios deliver consistently excellent, standardised clinical training for students, doctors, nurses and other healthcare professionals. The focus is on clinical decision-making under pressure, crisis resource management, team interaction and patient engagement. Oxford Medical Simulation allows healthcare professionals to learn through practice, without risking patient lives, to improve patient care.