ALS SIM

Non Linear Trainer

Flexible, accessible and self-directed Advanced Life Support team leader training

Overview

Many people are trained in Basic Life Support techniques, such as CPR, which are designed to maintain life until help is available. Hospital clinicians are trained in Advanced Life Support (ALS) techniques, which maintain life and also identify and resolve the cause of the cardiac arrest, so that a normal rhythm is restored.

Cardiac arrests don’t happen very often but are life or death events. Because the standard of care in hospitals is constantly improving, cardiac arrests are occurring less often. As a result, hospital clinicians are receiving less exposure to managing cardiac arrests but are still required to perform effectively as a team when they do occur.
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The ALS-SimVR application is designed to provide leader training for clinicians managing a patient in a cardiac arrest., which allows a clinician to take the headset home and practice managing a patient in a cardiac arrest in the location and time of their choosing. They do this by directing a virtual team in all the tasks required of a team managing a patient in this state. Rhythm interpretation, drug doses, pathology results, ABG results are all randomised to increase replicability for the user. Key skills of ALS management are also available as skills trainers within the application including handover practice, defibrillation, cardioversion and pacing and more in development.
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Creators, Partners & Contributors

Nathan Moore

Nursing Information Manager - DHS Western Sydney Local Health District FAIDH CHIA

I am an experienced Nursing leader currently focusing on ensuringclinician needs are considered and addressed in DHS projectsand rollouts. I have extensive experience in the implementation ofinnovative technologies into healthcare with a clinical backgroundin critical care nursing. I have worked for several years as a nurseeducator developing Simulation Based Learning for a range ofclinicians of all levels of experience.
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Martin Brown
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Project Manager Innovative Technologies at The University of Sydney
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Experienced educator with a demonstrated history of working in theentertainment industry. Producer of Moulin Rouge, Co-producerof Romeo+Juliet and Art Director of Strictly Ballroom. Strongprofessional with a Masters of Humanities focused in Literature fromUniversity of Tasmania.
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Philip Poronnik
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Professor of Biomedical Sciences (Educational Strategy) at The University of Sydney

Exploring User Needs in the Development of a Virtual Reality

DOI:10.2196/20797

Exploring User Needs in the Development of a Virtual Reality–Based Advanced Life Support Training Platform: Exploratory Usability Study

DOI:10.1145/3359996.3365051

ALS-SimVR: Advanced Life Support Virtual Reality Training Application
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Team Task Allocation

All members of the ALS team are present and able to have commonly required tasks allocated to them.

ALS algorithm Implementation

Decisions made within the application are graded against the Australian Resuscitation Council Advanced Life Support guidelines. Randomisation of the cardiac rhythms and other patient pathology allow for increased replay ability and variation in management strategies.

Systematic Patient Assessment

The user can allocate a team member to perform all common parts of a patient assessment, using the A-G and A-E assessment frameworks.

Cardiac Rhythm Interpretation

Randomisation of the cardiac rhythm and recording of user performance against key KPIs allows the user to practice the real time interpretation of cardiac rhythms in the setting of a cardiac arrest.

ALS Medication Administration

Common ALS medications are available for administration by the team and the medication administration is graded against the ARC council guidelines depending if the patient is on the shockable or non-shockable side of the algorithm.

Arterial Blood Gas Interpretation

Randomised arterial blood gasses are available for interpretation by the team leader, which will have an impact on which reversible causes of cardiac arrest are marked correct.

ECG Interpretation

Randomised ECGs are available for interpretation by the team leader, which will have an impact on which reversable causes of cardiac arrest are marked correct.

Scribe Nurse

All decisions made within the scenario are recorded in realtime and made available for review by the user by referring to the scribe nurses resuscitation chart.

Defibrillation Practice

The user can practice defibrillation using an interactive three-dimensional models of either the X Series or R series ZOLL defibrillator, being led through the COACHED defibrillation process.

ZOLL X and R series defibrillator operation

In the skill trainer section of ALS-SimVR interactive models of both the X Series or R series ZOLL defibrillators have been created to allow the user to familiarise themselves with their use.

Cardioversion practice

The user can practice performing a cardioversion on the virtual patient using an interactive three-dimensional models of either the X Series or R series ZOLL defibrillator.

Pacing practice

The user can practice commencing pacing on the virtual patient using an interactive three-dimensional models of either the X Series or R series ZOLL defibrillator.

Handover practice and reflection

Using a randomised set of patients and required clinical handovers the user can practice discerning the required information for the prescribed handover, verbally give the handover to a virtual clinician and then replay that handover back to themselves whilst reflecting on the provided information with the prompt of an ISBAR cognitive aide.

Learner Insights

All performance within the application is recorded including in-app time, number of playthroughs, user demographics and also key KPIs such as off chest time, defibrillation accuracy, medication accuracy and reversible causes.

This information is then made available to the user both at the completion of a scenario but also via their own personal dashboard on the FRLE website allowing review of individual playthroughs and performance change over time. Users can also be grouped into classrooms allowing instructors to have overviews of class performance prior or following face to face training.

Testimonials

" It is seldom in the realm of medical education do you come across a "game changer". The ALS-SimVR I believe is that rare beast. The realism and attention to detail means that even those only vaguely aware of the world of Virtual Reality can gain confidence and competence in team leading ALS scenarios."

Dr Alan GilesEmergency Physician, Medical educator

“I am of the generation that rarely uses this stuff, I am also of a generation that doesn’t play computer games, at all, ever. But that was good! What I can see that this is good at is making sure team leaders are getting sequences right.”

Dr Ken HarrisonSenior Staff Specialist
Anaesthetics

“This application has the potential to significantly improve the way we train and assess ALS team leaders. Being able to facilitate both individual and collaborative experiences really adds to it benefits.”

Richard Conway
Clinical Nurse Consultant
Clinical Emergency Response System

“I think this is a really cool thing. I think it would compliment the simulation training where you’ve got a lot of staff resources. You could potentially reinforce new learning without much supervision and the feedback is generated automatically in the program.”

Dr Andrew Coggins Staff Specialist
Emergency

"This has the potential to be an extremely effective educational tool.”

Sandra Warburton
Nurse Educator
Simulation

“That is the coolest thing I’ve seen in education for a long time”

Alyssa Clarke Senior ICU Nurse

Roadmap

Current Release