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Medical Models for Virtual Patients in Virtual Worlds

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Virtual patients are an integral part of virtual medical environments. Here we describe how we simulate the pathophysiology of our virtual patients. These physiology models are available for licensing as plug-in software.

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Page 1: Medical Models for Virtual Patients in Virtual Worlds

INNOVATION IN LEARNING, INC. SERIOUS VIRTUAL WORLDS WITH DYNAMIC MEDICAL MODELS

Medical ModelsRepresentations of Human Physiology at Work

Dynamic Changes in Vital Signs

Backstory: Patient # 12. A 42 year old female suffered an open fracture of the upper arm in a bomb blast. She is bleeding copiously, and will probably lose 2500ml in 30 minutes from a lacerated brachial artery. The Vital Signs illustrate the decaying functions from normal levels, if untreated:

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1:42 1:45 1:50 1:55 2:00 2:05 2:10 2:15 2:20 2:25

Time in minutes

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Sa02%

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One can recognize the heart rate (red curve) increasing to 200 beats/minute, when fibrillation occurs, and cardiac arrest soon thereafter; the mean arterial blood pressure (green curve) decreases to zero; the blood oxygenation (blue curve) decreases from 98%, and the respiratory rate (yellow curve) increases, from 14 breaths/minute, up to 40. This set of time-dependent values is determined by rules interrelating these functions:Loss of blood

⇒ reduced blood volume ⇒ reduced blood pressure ⇒ increased heart rate. Reduced

blood volume also ⇒ reduced blood oxygenation ⇒ increased respiratory rate

Effect of TreatmentPrompt diagnosis, and administration of appropriate remedial care, can restore the

Vital Signs to near normal values as seen in the next graph:

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Compressionbandage

IV Nacl Dolbutamide

Trendelenberg

Transfuse

Send tosurgery

Note the starting position is the same for all of the functions, and they proceed in the same trajectory until interventions are introduced. These are to: 1. apply a pressure dressing, 2. begin fluid replacement, 3. lower the head of the patient by

tilting the bed, 4. administer a vaso-active drug, 5. transfuse blood.When the vital signs are stabilized, the person can safely go to surgery for repair of the vessel and the arm. Medical Models WorkThese graphs demonstrate how the medical model for this virtual patient reflects her patho-physiology before, during, and after appropriate diagnosis and treatment. In the first illustration, the model determines the fate of the patient –fibrillation and death in about 35 minutes. The second illustration demonstrates that the model recognizes timely interventions, and the restored vital signs after treatment – this patient had surgery, and went home in 36 hrs.

PATIENTS ALIVE

# 1VIRTUAL PATIENTSFor making ‘best use’ of Virtual Worlds for medical education, simulating medical environments as closely as possible is essential. Virtual patients are an integral part of virtual medical facilities.

# 2VIRTUAL WORLDSSerious Virtual Worlds afford spaces, medical–surgical tools, and virtual patients for learning how to conduct initial profession- al interactions. These worlds may be a clinic’s patient examination room, an emergency department or a field surgical tent.

# 3 SAVING HUMAN LIVESThe Hippocratic Oath to which physicians subscribe is ‘doing no harm’, and doing one’s utmost to relieve pain and suffering of patients in their charge.

# 4MEDICAL MODELSSerious Virtual Worlds for teaching and practicing patient care are complete only when patient avatars have dynamic patho-physiological models.

PRODUCT BRIEF N° 2 WINTER 2009

Page 2: Medical Models for Virtual Patients in Virtual Worlds

INNOVATION IN LEARNING, INC. SERIOUS VIRTUAL WORLDS WITH DYNAMIC MEDICAL MODELS

About Innovation in Learning Inc.

Innovation in Learning, Inc., is a California-based corporation organized for designing, developing, and commercializing leading-edge learning technologies for the healthcare market, to meet the training and capacity building needs of health care institutions and enterprises anywhere in the world.

Our ApproachOur approach is to build key

technologies and content collections for medical learning, and to customize them through collaboration with our clients and our network of medical experts around the world. We use cutting edge simulation, virtual reality, games and 3D technologies to create immersive medical experiences. Through our collaboration with international medical leaders, we bring state-of-the-art knowledge to our learners.

Immersive Learning ExperiencesOur three-dimensional virtual

clinics, emergency departments, and city scenes are online virtual spaces that replicate familiar medical environments. Learners move and explore, interact with team members or other personnel, and manage medically relevant encounters with virtual patients.

With surgical and medical simulations, they hone existing skills and practice new ones. For those learning the structure of the human body and its pathologies, they view richly detailed views of the human body. Through high performance networks, they collaborate with peers. Exploration, learning, patient management, and team exercises are all capabilities of the products that we offer.

Our Products and Services

• Virtual patients

• Virtual 3D medical spaces

• Medical scenarios of crises and of chronic conditions for teaching using virtual patients

• Patient education using virtual medical environments

• Virtual patients for marketing support

• Virtual anatomy in 3D models

• Virtual anatomy dissection collections

• Internet tools for collaborative learning

• High bandwidth network access to hosted collections and simulations

• Training workshops in teaching with simulations and virtual patients

Our ManagementThe principals in Innovation in

Learning bring many decades of experience in designing, implementing and evaluating technology-enabled learning as leaders and members of the SUMMIT lab at Stanford University, California. Parvati Dev, PhD, President, has over 30 years of university and corporate experience linking medicine and technology to create solutions for surgical planning, medical imaging and health care education. Wm. LeRoy Heinrichs, MD, PhD., Executive Medical Officer, completed a first career as an gynecologic surgeon and endocrine researcher before turning to simulation as an essential new mode of learning for surgeons. Products developed by them, at the SUMMIT lab in Stanford University, include the Curriculum Web for delivery of all content for the medical school courses, numerous web and CD-based rich media courses, technical development of hardware and software for surgical and virtual patient simulations, and the application of game technology to innovations in learning.

RECENT NEWSIIL is a member of winning teams for contracts to deliver a commercial strength mass casualty training system for medics on the front line, and to create a health sciences virtual organization operating over a high performance optical network.

IIL members have participated as advisors to develop the strategic plan for Internet2, to create a feasibility study for a South Asia network, to organize and implement surgical teaching events across the Pacific using high resolution multi-point videoconference, and to create a new training tool for cardiopulmonary resuscitation (CPR) using physical manikins that can drive signals into virtual worlds to control avatars and vital sign monitors in the virtual environment.

CONTACT US:Innovation in Learning Inc.12600 Roble Ladera RdLos Altos Hills, CA [email protected]

PRODUCT BRIEF N° 2 WINTER 2009