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Military-Specific Augmented Reality Patient Simulation: Interview with Dr. Kevin King, CEO of MedCognition

May 24th, 2019 Conn Hastings Education, Emergency Medicine, Exclusive, Medicine, Military Medicine

MedCognition, a Texas-based startup, has been awarded a contract to develop military-specific augmented reality patient simulations for the US army, in conjunction with Chenega Healthcare Services. The technology is based on an existing patient simulator, the PerSim system, which uses Microsoft HoloLens Mixed reality to project simulations of patients into real working environments to allow for a more realistic training experience.

To date, the PerSim system has been conceived as a training aid for pre-hospital workers, such as paramedics. The patient simulations involve realistic scenarios, such as stroke, trauma, and respiratory distress, to help staff to accustom themselves with how such patients look and act.

Currently, staff can use the simulator to hone their decision making and enhance their critical thinking. In addition, the simulator allows more senior staff to assess how trainees are progressing. As the simulator is small and portable (weighing approximately 30 pounds), it can be used in the field, such as aboard an ambulance.

This latest contract will see the range of available simulations expand to cover military medicine and battlefield care, including battlefield injuries and mass casualty incident injuries.

See a video of the system below.

Medgadget had the opportunity to ask Dr. Kevin King, CEO of MedCognition some questions about the technology.

Conn Hastings, Medgadget: How are pre-hospital staff such as paramedics traditionally trained? Presumably this doesn’t typically involve augmented reality?

Kevin King, MedCognition: Historically, first responders and paramedics have been trained in a classroom setting using manikins and typical teaching styles – lectures, power point presentations, etc. The experience is largely theoretical. A manikin does NOT look like a person. It does not offer the trainee verbal or non-verbal cues. And the trainee has to imagine that the patient/manikin is deteriorating in front of him or her. Oftentimes, the educator will tell the person in training something like, “OK, pretend that your patient/manikin can’t breathe – what do you do?” and the trainee has to perceptualize that scenario.

There is no element of true experiential learning, and the first time a human patient presents in distress might be the very first time that responder sees what a sick patient looks like. Our product provides an accurate representation of clinical conditions so that first responders can effectively train for those critical moments.

There are a limited number of virtual reality training platforms available to address this problem, but they do not offer portability or the ability to deploy the training module in the actual environment in which the trainee will be working such as an ambulance or ER.

 

Medgadget: How was the PerSim system conceived? Was there a lack of similar training devices available for pre-hospital staff?

Kevin King: I’m an Emergency Medicine physician, and an educator for emergency medicine and pre-hospital professionals. Over the years, I’ve been frustrated with the limitations of traditional simulation technology (manikins). They’re prohibitively expensive, often topping $100,000, and weigh 80 pounds or more, largely limiting them to classrooms or simulation labs and, let’s be honest, they don’t look like real people. They certainly can’t move, change colors or do the things that sick people do or look like. It occurred to me that augmented reality might be a way to shift the educational paradigm. Since I was already working with John Quarles, our CTO, on an unrelated project, I asked him if he knew anyone who might be able to brainstorm and collaborate with me on how augmented reality could be applied to medical training to solve this problem. He responded, “I can do this. My lab is called, “San Antonio Virtual Environments.” That’s how it got started.

 

Medgadget: Please give us an overview of the system hardware and the virtual scenarios available for training.

Kevin King: The PerSim augmented reality patient simulator system is a combination of high-end hardware combined with our specialized, medical training software that allows us to project our highly realistic holographic models of patients into nearly any environment. PerSim allows participants to view realistic patient simulations with a number of clinical presentations including respiratory distress, stroke and minor trauma. We have adult male and infant models right now, and are developing several additional patient types.

 

Medgadget: What are the advantages of the system as a training tool?

Kevin King: Traditional, manikin-based simulation requires that the instructor “paint the picture” for the student. That is, tell the student what the simulated patient is doing, what they look like and how they react to treatments. Not only does this diminish the realism of the simulation, but it does not challenge the student’s decision-making. By telling the student that something is changing, the instructor is, in essence, telling them the change is significant. The student does not learn how to recognize what the patient is telling them through their appearance and actions.

With PerSim, the student is engaged with a simulation that can display the patient’s condition with dynamic realism. What I mean by that is that we can start with a patient who is having trouble breathing and depending on the student’s actions, we can increase the respiratory distress, make the patient diaphoretic or cyanotic, all without saying a word to the student. They must exercise their skills in rapid, accurate visual assessment of the patient’s condition and incorporate that into their decision-making.

Medgadget: How have staff responded to using the system? Has it made training easier?

Kevin King: Our system is in use in several colleges today and the response has been overwhelmingly positive. It is being used to teach paramedics clinical assessment skills, emergency medicine residents critical decision-making and to train interprofessional teams better collaborative skills.

 

Medgadget: Please give us an overview of the future military medicine training applications for PerSim, as per the new contract with the US army, and relevant new training simulations.

Kevin King: This contract expands our capabilities into military medicine and battlefield care. The modules we are developing under this contract will simulate typical battlefield and mass casualty injuries – extremity injuries, blood loss, bullet wounds and more. In addition, the modules could present multiple patients in one module – an essential cognitive training element that will help soldiers be prepared if they are presented with a mass-casualty scenario. Our intent is to empower our soldiers with the cognitive tools they need so they are better prepared to care for wounded comrades on the battlefield.

Link: MedCognition homepage…

Conn Hastings

Conn Hastings received a PhD from the Royal College of Surgeons in Ireland for his work in drug delivery, investigating the potential of injectable hydrogels to deliver cells, drugs and nanoparticles in the treatment of cancer and cardiovascular diseases. After achieving his PhD and completing a year of postdoctoral research, Conn pursued a career in academic publishing, before becoming a full-time science writer and editor, combining his experience within the biomedical sciences with his passion for written communication.

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