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G4H 2008: Serious Games For Effective Healthcare Team Coordination

Via: Games for Health 2008 - Early Content Preview
and Duke University (Human Simulation and Patient Safety Center) - 3DiTeams: Gaming Environment for Training Healthcare Team Coordination Skills

Games for Health Session - 3DiTeams: Team Training for Healthcare

Effective team coordination is critical for the safe delivery of care and a three-dimensional Serious Game environment provides an engaging and cost effective alternative to other interactive training solutions.

The session details the development, research evaluation, and rollout for 3DiTeams Healthcare Team Coordination Scenario Environment. This training environment was developed in conjunction with Duke's Human Simulation and Patient Safety Center, Durham, NC and Virtual Heroes Inc, also in Durham.

The project was funded by TATRC (Telemedicine and Advanced Technology Research Center) and AHRQ (Agency for Healthcare Research and Quality). The content is based on AHRQ and the Department of Defense's evidence-based healthcare team training curriculum called TeamSTEPPS.

An evaluation of this application is actually being carried out at Duke Medical Center. Its purpose is to provide a controlled and instructive environment for medical professionals to communicate using Situation, Background, Assessment, and Recommendation (SBAR) techniques and TeamSTEPPS protocols, resulting ultimately in better teamwork and cohesion in patient care.

The case study will focus on how the partnership between a commercial developer and Duke Medical worked, the challenges in building the system including the integrated virtual patient model, and the ongoing evaluation and rollout of the project for healthcare workers.

The Project Background

Teamwork and communication lapses are the number one cause of iatrogenic injury in medicine. Effective team coordination is critical for the safe delivery of healthcare. Development of these skills requires training and practice in an interactive team-based environment.

High-fidelity simulation is sometimes used to train teamwork and communication skills. High-fidelity simulation is less useful when training large groups of learners due to issues of cost, portability, scalability, and supporting infrastructure.

Three-dimensional immersive computer environment provide an engaging and cost-effective alternative to other interactive training solutions. The new training platform is called 3DiTeams.

3DiTeams is being built with commercial gaming technology (Epic's Unreal Engine 3) and includes an embedded physiology engine (Body.dll). 3DiTeams will run on any network-connected personal computer.

3DiTeams has three phases:

1. Independent Learning Phase– Individuals learn the principles of teamwork and communication by observing expert virtual teams perform in the virtual world while categorizing behaviors.
2. Collaboration / Team Coordination Phase – Multiple learners enter a virtual world together. Team members can be in the same room or spread throughout the world. Team members apply the principles they learned in the Independent Learning Phase while caring for virtual patients. Team members, instructors, and non-participant observers comment and rate the interactions they witness.
3. Debrief / After Action Review - Video and voice recording of the Collaborative Phase is played back live or over the Internet. A facilitator-lead debrief allows the learners to observe their behaviors, reflect on their actions, and discuss the positive and negative interactions that took place during the challenging scenario.

Anticipated users include medical students, residents, nurses and faculty in a large academic health system. Wider distribution is anticipated. 3DiTeams platform will be compared to traditional forms of teamwork training using metrics that include knowledge, skills, attitudes, learning efficiency, learner satisfaction, and cost.