Adding humans into clinical simulation scenarios is not a new thing. Standardized patients (SPs), or standardized participants, can be volunteers, fellow students, or trained actors. With the introduction of virtual reality (VR), students will even start to interact with holographic SPs.
Dr. Howard S. Barrows, a neurologist and medical educator, trained the first standardized patient in 1963 (source) to participate in his third-year neurology clerkship. Dr. Barrows taught at the University of Southern California.
He and a physician watched medical students interact with a patient, doing a work-up from beginning to end. They realized a number of skills were being incorrectly performed because students were unaware of the inaccuracy. Dr. Barrows realized that some skills practices could be simulated, and he came up with the idea for an SP. His first SP was a person who simulated the history and examination findings of a paraplegic multiple sclerosis patient.
Like Dr. Barrows, the need to innovate to solve a problem was the driver behind the creation of ReaLifeSim.
“Train the Way You Treat”
Books, lectures, and time in the classroom and simulation lab provide essential knowledge and good practice. But practicing in a realistic environment is different. Following high-quality clinical simulation experiences, learners report increased knowledge and improved performance, which leads to increased confidence.
Elizabeth Benson, RN, co-inventor of wearable hybrid simulation ReaLifeSim IV trainers shared, “During our end-of-semester IPE we were simulating an emergency room scenario. A communications professor volunteering as a standardized patient let out a loud ‘OUCH! What are you doing?’ when the student nurse inserted a catheter to start an IV into a fake arm at the bedside. The ‘a-ha’ moment was realizing the student had been so focused on the task, he failed to communicate with the patient.” This resulted in a negative interaction for the patient.
Benson, along with friend and colleague, simulation educator Linda Goodman, RN, decided to create a device that would enhance the simulation experience by closing the gap between a separate IV arm trainer and an SP.
Wearable Training Technology
The ReaLifeSim Adult IV Task Trainer with RLSimApp is a wearable training tool designed by clinicians to “train the way we treat.” This realistic trainer is worn by real people during a simulation scenario to add the human factor and encourage provider-patient communication. The trainers can be used on manikins, as well, for enhanced function and extended sustainability. The app provides the opportunity for self- and peer-assessment, and traditional instructor guidance and evaluation.
ReaLifeSim’s patented product design is lean and high-functioning without being over-engineered.
Success at ASPE
ReaLifeSim made its inaugural appearance at the Association of Standardized Participant Educators (ASPE) 2018 Conference in Kansas City, Missouri. Conference attendees were able to engage in live practice or observed demonstrations with the ReaLifeSim wearable IV task trainers, which provided physical fidelity for safe, repeated practice.
Educators and clinicians provided positive and affirming feedback.
“This is great,” said a nurse and SP educator at ASPE. “Our devices are so bulky… not practical to put on an SP. The arms and manikins we use don’t really simulate an actual patient, so this [wearable solution] is fantastic.”
Another SP educator and conference attendee left feedback that said, “We’re looking for [simulation devices] that can incorporate the human factor. This device does that beautifully. I love it!”
“The enthusiastic encouragement and support for the IV trainer has been very gratifying,” says Benson. “We’re providing an affordable product that improves clinical training, creating competent, confident clinicians and leading to better patient outcomes.”
This is a guest post by Jim Benson, Chief Communications Officer of B & G Educational Innovations, LLC, and the SP and communications professor referenced in the article. BGEI designs affordable, durable, wearable human-centered simulation products for developing clinical hands-on skills and provider/patient interactions.