Alan Liu: The World of Medical Simulators

Our fourth interviewee is Dr. Alan Liu who is the Director of the Virtual Medical Environments Laboratory at the National Capital Area Medical Simulation Center (SimCen). He is involved in defining the SimCen’s strategic research goals, and directing the development of the SimCen’s computer-based medical training systems.

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Click here to see how Dr. Liu answered these questions:

  • 1) What do you consider the indicators of “success” in the development of medical simulator?
  • 2) What types of communication between engineers, educators, and physicians increase success in simulator development?
  • 3) What role does patient opinion or experience have in the development of simulators?
  • 4) Please tell us more about the workshop you will organize at the MMVR 17 conference.
  • 5) What are the major mistakes one can make while building medical simulators?
  • 6) Which medical specialties will benefit the most from medical simulators in the near future?

1) What do you consider the indicators of “success” in the development of medical simulator?

A “successful” medical simulator goes beyond technical excellence. It’s difficult to pin down exactly what constitutes a successful trainer, but there are common elements that are generally regarded as necessary. First, the simulation system should address real-world training requirements. Second, it should focus on the essentials of the task being trained. Third, to be effective, it’s use should be formalized as part of the teaching curriculum. Finally, it should demonstrate that it is effective at accomplishing its objective (i.e., there should be demonstrable training transfer).

2) What types of communication between engineers, educators, and physicians increase success in simulator development?

The stakeholders (physicians, engineers, and educators) need to arrive at a common understanding of the lessons/skills/knowledge that need to be taught. They also need to agree on what constitutes a successful training event in measurable terms (number of minutes, accuracy, etc.). It is also equally important to understand what is *not* required or unessential to the simulation.

For example, very precise biomechanical tissue models are frequently overkill in a training simulator. These models are complex, and can be difficult to run in real-time. In many cases, the data necessary to tune these models must be derived from in-vivo tissue measurements. Unfortunately, they cannot be done for ethical or practical reasons. As a result, physiologically plausible models that are simpler and more efficient, but less precise are often preferred.

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Pericardiocentesis

3) What role does patient opinion or experience have in the development of simulators?

Simulators can have an effect on patient outcomes, in terms of the reduction of errors, and the quality of treatment. Patient feedback can affect the way clinical skills are taught, so to that extent, patient opinion or experience will affect how simulators are developed to support training.

4) Please tell us more about the workshop you will organize at the MMVR 17 conference.

The workshop will be highlight advanced techniques in medical simulation development. It is intended to be a practical introduction to methods, tools, and procedures. The workshop will focus on three main areas: requirements analysis, engineering, and 3D model development. Throughout the course of the workshop, we’ll be highlighting our discussion with case studies taken from successful initiatives, or those currently underway.

5) What are the major mistakes one can make while building medical simulators?

A major error is to let technology drive the development. It is possible to over-engineer the simulator. The result is a device that either does not accomplish its teaching objectives, or is excessively complex/costly/difficult to operate. In both cases, the end result is the same: the simulator gets ignored in favor of lower cost, more effective teaching tools.

6) Which medical specialties will benefit the most from medical simulators in the near future?

Medical simulation has (to date) focused mainly on individual skills training. However, the practice of medicine is a team effort. I would expect future simulation initiatives to focus on team training instead of the “one patient, one clinician” approach currently used. To that end, networked simulators, immersive virtual environments, and multi-player/multi-user platforms will become more prevalent.

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