Drexel University’s College of Medicine has collaborated with Education Management Solutions to develop new interactive training software that hopes to significantly reduce clinician error and create better patient outcomes. The concept for the program was presented by Dr. Richard Hamilton, professor and chair of the Department of Emergency Medicine at Drexel, with the goal of giving clinicians the opportunity to practice a wide variety of challenging cases in a short period of time on virtual patients.
According to the Institute of Medicine’s journal in 1999, at least 44,000 to 98,000 people die every year in U.S. hospitals due to medical errors that could have been prevented; this is higher than deaths that occur due to car accidents, breast cancer or . Some of the faults that occur include an error or delay in diagnosis, error or delay in administering treatment, inadequate monitoring of treatment, and failure to communicate. While the goal of the health care system is to cure patients, systemic failures and limited attention on the prevention of medical errors during training in medical school have made it difficult to resolve these issues.
The program, called SIMULATIONiQ CaseMaster, is similar in nature to a flight simulator that pilots in training use to practice. It aims to solve several faults by allowing learners to rerun different types of teaching cases multiple times, which helps them achieve mastery through deliberate practice. Just as the process of learning to play a sport or an instrument requires hours of practice, monitoring of progress, and feedback, patient care can be improved in a similar manner, Hamilton claims.
“If you think about it, you can learn to play a complex game like chess using a computer,” he said. “One of the ways you learn to play chess better using a computer is by getting to play over and over again using different moves and the computer reacts according to your strategy. Over time with practice, you become a better chess player.”
Just as the computer changes strategies based on the player’s moves, each case in SIMULATIONiQ has numerous variations (authored by a clinician) which means different events occur in an altered sequence each time the case is run. The cases are modeled after real patients whom doctors have treated and deemed to be excellent teaching examples. Variations of the same case gives learners different perspectives on the same condition and trains them to react quickly to a variety of situations, improving their cognitive skills and helping prevent rote memorization.
Users can choose from a variety of cases in the online service. Once they select a case, they are presented with the symptoms and vital signs of the patient— then it is up to them to order the correct medical tests, manage, and treat the patient. The program gives prompts along the way if the virtual doctors are on the right track or veer off course.
In addition, the program also provides spontaneous changes in vital signs or physicals based on the orders placed. Each case lasts about 10 to 15 minutes and once the case is completed, the users are given the correct diagnosis and it’s revealed which tests should’ve been conducted and in what order.
SIMULATIONiQ is targeted to all clinicians involved in patient care—including paramedics, technicians, nurses, and doctors — but the most important audience is medical students. According to the Institute of Medicine, many providers also perceive the medical malpractice system as a serious barrier to efforts to uncover and learn from errors, and medical schools focus limited attention on preventing medical errors.
Hamilton’s hope is that the program will be adopted into medical school curricula in order to provide students the opportunity to practice a wide variety of challenging cases on virtual patients in the short period of time before their residencies during which they will be treating real patients.
“One of the problems with health care is, you get to see a fair number of patients, but not enough of a certain type of patient with different symptoms but the same condition [to] help learn about them,” Hamilton said. “Another problem with simulation and simulation centers is you do even less encounters in simulation centers because it requires a lot of people and support, so there had to be software that would create the cognitive challenges that physicians face when taking care of patients.”
SIMULATIONiQ currently includes cases in emergency medicine, primary care, trauma as well as several other areas of medicine, but are mostly geared towards physicians. EMS plans to include simulations targeted towards nurses and paramedics as well as add several more cases in other areas of medicine over the next two years.
The largest planned undertaking over the next few years is a project to create simulations in which multiple nurses and physicians from different medical schools in the U.S. or globally can collaborate on a single case. This type of simulation better portrays real-world conditions of a hospital in which difficult cases may require consultation with other physicians and specialists.
While this particular software program is aimed at the healthcare industry, the concept can be applied to other professions that require rapid decisions, such as firefighters and police officers. The new program is unlike any other available today and it adds to Drexel’s growing list of contributions in the medical field. By collaborating with EMS, Drexel aims to reach medical schools across the globe and significantly reduce patient deaths due to errors in a health care system that should be treating and saving patients.