Oxford Medical Simulation is offering online VR training to help busy hospitals and medical facilities as they are being crushed by large numbers of patients during the coronavirus pandemic.

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A virtual reality (VR) medical training system built by Oxford Medical Simulation (OMS) is now being offered for free during the COVID-19 pandemic to help hospitals and medical schools bring in badly-needed additional staffers to provide patient care. OMS is providing the free use of its VR training system to health care facilities in the US, Canada and the UK so retired doctors and nurses can get back up to speed on patient care quickly. The hope is that these doctors and nurses can return to help treat a steady stream of patients with other more typical medical emergencies, such as heart attacks, strokes, and broken bones while specialists are assisting coronavirus patients.

"At the moment, during the COVID-19 pandemic, hospitals are beginning to recruit more doctors and nurses, but they are also bringing doctors and nurses back into practice who have left previously" due to retirements or going into other fields, said Dr. Jack Pottle, a physician in acute and internal medicine and the chief medical officer for OMS.

"There is this huge need to train people up quickly, whether they are in the profession or whether they are coming back to the profession to help during the pandemic," he said. Thousands of doctors and nurses are returning to the medical field now in response to the crisis, he added.

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So far, some 50 hospitals and medical schools have accepted the company's free simulation training offer since March 16, said Pottle. That means that about 17,000 additional medical professionals and students have signed up to gain the ability to boost and increase their patient care skills so they can help in medical facilities that are being hard-hit with COVID-19 cases. The company had already been working with about 50 hospitals and medical schools to provide its virtual medical training since its platform hit the market about 18 months ago.

"While COVID-19 is occurring, all the other medical issues are still happening as well in the background," said Pottle. "Many doctors and nurses are being drafted to manage COVID-19 and many other people who are not specialists are now being asked to take care for the more general patients–those with heart attacks, strokes, gastrointestinal bleeding and other emergencies."

That's where the company's medical simulation training can help, by giving knowledge and experience to clinicians who may not have treated these kinds of things for a while and who may have been drafted to help deal with the crisis today, said Pottle. "That is currently the situation we are in with the pandemic."

The OMS simulation systems provide animated, web-based patient training scenarios for doctors, nurses, and teams through the use of a laptop or desktop computer using a display screen and/or a VR headset for a fully-immersive experience. The training can be done anywhere, meaning that it can be done at home, which helps users comply with social distancing rules that have been laid out in communities around the world.

To use the system, participants log in to a web-based portal and are given a patient care scenario based on a wide selection of some 100 medical cases preloaded by the hospitals, medical facilities, or medical schools that are using the platform. The user won't know what kind of case they will be facing, which mirrors what they would experience when a patient arrives in an emergency room or doctor's office.

"So, they go in knowing they are seeing a patient with chest pain, for instance, but they don't know anything else about that case," said Pottle. "It is not guided. They don't need to do specific things at different points. They can do everything they normally would do when they are going to see a sick patient. Like in real life, they do not know the diagnosis going in."

The trainee then has to work out what is going on by taking a patient history, performing a physical examination, doing investigative work and consulting with colleagues to determine what is happening, said Pottle. The simulation scenarios are completely variable and provide a wide range of illness nuances and changes in reaction to the steps taken by the person undergoing the training, making them even more realistic.

"It all adapts in real-time, so the patient will begin to look unwell if you don't treat them," said Pottle. "They will get pale or sweaty or clammy, their breathing rate will increase over time, their pulse will increase, their blood pressure will drop, and when you begin doing the right treatment, that gradually improves over time and they'll begin to tell you they are feeling better. As you speak to colleagues on the phone about the patient, they'll begin to tell you different things depending on what you've done in the scenario. It is all completely adaptable."

Image: Oxford Medical Simulation

Traditional medical scenario training has typically been done using mannequins and actors who participate in pretend medical situations to provide treatment experiences for doctors, nurses, and students. The doctors and nurses go through those training experiences and then talk to their colleagues about them and gain insights and knowledge, said Pottle. And though such training has worked well in the past, they are very expensive and they can only train a small group of people at once.

Using OMS's virtual training system, hospitals and medical schools can make such training available to more people in realistic and repeatable ways whenever it is needed, said Pottle. "That really is what this is designed to do. It's about providing people with clinical experiences on demand."

At New York University's Langone Medical Center, Dr. Carol DerSarkissian, a clinical assistant professor of emergency medicine, said the school has been using the OMS system for some time to train its students. "OMS is a great assessment tool for figuring out what you really know or don't know when it comes to taking care of patients. That way you can focus more efficiently and become an adaptive learner."

Before the pandemic, the school had about 12-15 students a month rotating through the emergency medicine rotation training using the VR platform for each of the last six months. "We are now planning on using it to train the medical students that are graduating early to start internships and help take care of patients," she said. "We have around 50 interns that will go through the training post-COVID-19 as part of their internship orientations."

The students continue to have an overwhelmingly positive response to the OMS training, said DerSarkissian. "They feel that it is real and they like that they can independently make decisions on how to take care of patients. Medical students never do that."

And just as important, the students are not afraid to make mistakes in the simulations and they are able to learn from their mistakes, she said.

Image: Oxford Medical Simulation

During the current pandemic crisis, the simulation system is definitely helping the school to boost student skills so they can help with other medical cases as front-line doctors and nurses combat COVID-19, she said. "That is the objective. Part of becoming a good doctor is the experience of taking care of similar cases over and over and learning from each case. OMS allows that opportunity without putting anyone at risk."

Natalya Pasklinsky, the executive director of simulation learning at the Clinical Simulation Learning Center at New York University's Rory Meyers College of Nursing, said the OMS system has been helping students there by strengthening their critical thinking and decision-making skills, while providing useful individualized feedback. "OMS helps students identify their weaknesses and improve upon them with practice," she said. "This knowledge base that students develop and strengthen through VR will help the students make those critical decisions in critical times."

The simulation system is even more helpful today due to the need for social distancing, said Pasklinsky. "Virtual simulation, especially during a crisis as COVID-19 where everyone is so distant, can bring students together into a virtual environment for continued high-quality training that stimulates and challenges students to think critically, advocate for patients, and make the right decisions for the right patient at the right time."

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