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Virtually a Reality: The Future of Neonatology Simulation-based Education with Dr. Ryan M. McAdams

Dr. Ryan M. McAdams is a neonatologist in Madison, Wisconsin an Associate Professor and Division Chief for the University of Wisconsin Department of Pediatrics’ Division of Neonatology & Newborn Nursery, and a faculty member in the Division of Global Pediatrics.  Through research, scholarship, and clinical work, he is committed to providing the best care to every baby everywhere so they can survive and thrive.  Watch the full video here (link).

  • Dr. McAdams is interested in using art as a way to help kids pay for school, medical services, and food
  • Didn’t grow up as a gamer, but as an educator, he sees a lot of gaps in the way we teach, and the effectiveness of it.
  • VR is a contemporary approach that could memorable learning – help lock information into the memory.
  • Traditional neonatal simulations are quickly forgotten, but he can remember real life resuscitations he was at.
  • VR experiences can be easily remembered later
  • Plastic baby mannequin doesn’t seem real, so they’re very aware of it, people have a hard time absorbing the learning experience
  • 3D scan of delivery room at hospital, operating room – used to develop the virtual reality scene in high definition – side-by-side comparison of photo vs. virtual scene
  • Your brain thinks it’s real – important to trigger memory, allows for better learning, doesn’t feel as artificial
  • VR scene can’t be too empty – needs details to improve immersion
  • Importance of audio – conversations, noise, alarms.  If you don’t have that, it doesn’t seem as real.  Where is the threshold?  Otherwise you focus on what’s not there.
  • Simulating life, not simulation.
  • VR simulation can be tailored to the learner.  This sim is geared toward people with a little more experience, but it could be oriented toward someone newer.
  • Patients and family members can be manipulated with the Simulation Manager.
  • The focus is on the activity, not just how I look as an avatar – I’m wearing a spiffy hat, etc. doesn’t matter.  It’s more about the patient, family members.
  • Demo of ambient sound boards, assets, environment, stethoscope, PIP/PEP adjustments, mask position, bp cuff
  • Visualizing the airway, using the laryngoscope – when you intubate, you can see the vocal cords
  • Not focused on haptic touch, but knowing what to do – situational awareness, communication skills, critical thinking.
  • Can quiz participants on what size endotracheal tube to pick?  How far would you put it in?  What size blade would you use?  How would you know that it’s in correctly?
  • It’s about the dialogue and conversation about it – when the alarms are on, and the sounds are crazy, it’s good that it stresses you out so you can practice it, and get used to the sequence, and develop a comfort level.
  • If you have an expert who really wants to challenge a participant, you can increase the complexity
  • Family members in VR.  You would often have the partner waiting to hear how things went.  These are often unexpected, urgent / crash sections.  Bewildered parent is waiting, and you need to communicate to them – simulate with really good actors, really stressed out people, or someone who doesn’t speak English, to practice and make mistakes so when you have the same conversation in real life, you can communicate in a good way.
  • Dad’s stressed out, he’s worried, the baby isn’t doing well or dies – how do you explain that?  It can be traumatic for the health provider, not just the parent.
  • Prenatal counselling, pre-delivery consult, then post-delivery, then in the NICU, discussions there – when they’re discharged home and have follow-ups.  So many opportunities to say, “What would the learning experience be now?”
  • Diversity, equity and inclusion – why not train and become aware in a safe environment, with actors who are from different backgrounds, and play that role.  What opportunities are there for learning?
  • VR could be a very powerful tool to practice these things, and absolutely affects a person’s experience in the hospital.
  • So many surreal juxtapositions in medicine that are very difficult to simulate but could be done virtually

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