February 15, 2021By Lance Baily

How Healthcare Simulation Can Learn From the Aviation Industry’s ‘Black Box’

While the healthcare simulation industry continues to push for improved training and patient safety measures, more comprehensive video recording is in need of increased adoption. Much like in the aviation industry, where a “black box” is used, clinical simulation educators and administrators must find new ways to not only record all medical simulation experiences, but all patient engagements where permission is provided, so that we can begin systematically reviewing incidents of medical error. Recently, Caresyntax, University of Massachusetts Medical School (UMMS) and Massachusetts Digital Health Sandbox Network have teamed up to make this systematic review a reality.

In January 2021, the pioneer in surgical automation, analytics, and AI software and technologies, Caresyntax, was selected to join the Massachusetts Digital Health Sandbox Network. This was part of a joint project with UMMS to install a digital platform in operating rooms that can enable video-based assessments of a surgeon’s technical performance. This performance data can be used to provide a simulation debriefing to the learner, but also to establish much needed data for performance review of all learners.

Currently, the Massachusetts Digital Health Sandbox Network connects startups to cutting-edge research and development facilities and provides opportunities to test innovations in Network labs. Through collaboration with Caresyntax and UMMS, the Network will be able to collect and analyze this high-volume video data on surgical performance in a clinical simulation environment. The goal is to enable Caresyntax and the UMMS interprofessional Center for Experiential Learning and Simulation (iCELS) to use the data to identify predictive indicators of surgical risk. They also hope to identify any possible complications and use the healthcare simulation setting to improve patient safety.


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“Medical schools and teaching hospitals worldwide have been forced to reassess how they support training and learning opportunities during the pandemic,” Caresyntax CEO and co-founder, Dennis Kogan, said. “With access to a renowned medical school and labs dedicated to immersive education, UMass Medical School and the Digital Health Initiative are ideal partners for strengthening these programs, expanding the reach of our patient safety-focused technology to more facilities, and accelerating innovation across the industry.”

This partnership could prove especially advantageous as the COVID-19 pandemic continues and more healthcare simulation learning scenarios take place virtually. Being able to use video-based assessment is integral to closely reviewing a learner’s simulated surgical performance, and can yield areas of practice that need improvement. Without thorough assessment, many of these learners who have not yet been able to return to a clinical learning environment may experience a delay in their knowledge, understanding and retention of the principles, protocols and procedures required to deliver high-quality surgical treatment to patients in need, when they reenter the field.

“We’re always striving to improve surgical performance and we know that many of the answers are right in front of us, but in ways that can be challenging to apply,” said Demetrius Litwin, MD, chairman of the department of surgery at UMass Medical School. “With Caresyntax, we may have the tools to understand what works and what doesn’t work so that we can operate more safely.”

During this partnership, Caresyntax and UMass Medical School facilitators will also be able to apply the insights made possible through video data. This will be done to develop a fully remote and immersive virtual surgical simulation program to train residents. The mission is to use this leverage to modernize residency learning for the COVID-19 era and beyond. Furthermore, the project aims to develop a new approach to surgical simulation training that can be applied by other medical schools and hospitals to improve learning opportunities worldwide.


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“The interprofessional Center for Experiential Learning and Simulation is renowned for exemplary simulation development, programming, and research,” said Nathaniel Hafer, Ph.D., assistant professor of molecular medicine and Sandbox coordinator for the medical school. “We look forward to collaborating with Caresyntax to develop innovative training programs that advance clinical simulation development, programming, and research for this generation of medical professionals and the next one.”

While this is just one example of how healthcare simulation companies, institutions and organizations are working together to improve healthcare simulation development, others should take note. By considering how each individual simulation center or learning environment can also adopt seminar video-based assessments, the industry as a whole can better align with what is needed to achieve a new standard for learner evaluation and patient care. Just like a flight recorder facilitates the investigation of aviation accidents and incidents, advanced healthcare simulation recording systems can better identify where, when and how learner errors are occurring across the field of medicine. For more on this topic, see our other relevant articles:

More About Caresyntax

Caresyntax is working to make mission-critical healthcare settings such as surgery, interventional radiology, and obstetrics smarter and safer. The company’s proprietary solutions leverage IoT, analytics and AI technologies to automate clinical and operational decision support for surgical teams and support all outcome contributors in the delivery and management of risk-bearing contracts.

By integrating data from medical devices, electronic health records, and other sources inside the OR into a unified data platform, Caresyntax helps caregivers better identify and manage risk, increase workflow efficiency, reduce surgical variability and improve operational or clinical outcomes at the point of care. Today, Caresyntax technologies are used in more than 8,000 operating rooms worldwide and support surgical teams in over 13 million procedures per year.



More About the Massachusetts eHealth Institute

The Massachusetts eHealth Institute (MeHI) at the Massachusetts Technology Collaborative is the Commonwealth’s entity for healthcare innovation, technology, and competitiveness, and partners with industry, government, and healthcare organizations. This is to support the Massachusetts Digital Health Initiative on behalf of Gov. Charlie Baker. MeHI also helps all the Commonwealth’s providers harness the benefits of electronic health records and the Mass HIway, the statewide health information exchange.

More About the University of Massachusetts Medical School

The University of Massachusetts Medical School is one of five campuses of the university system, and comprises the School of Medicine, the Graduate School of Biomedical Sciences, the Graduate School of Nursing, a thriving research enterprise and an innovative public service initiative, Commonwealth Medicine. The university’s mission is to advance the health of the people of the Commonwealth through pioneering education, research, public service and healthcare delivery with its clinical partner, UMass Memorial Health Care. In doing so, the university has built a reputation as a world-class research institution and as a leader in primary care education.

The 2013 opening of the Albert Sherman Center ushered in a new era of biomedical research and education on campus. Designed to maximize collaboration across fields, the Sherman Center is home to scientists pursuing novel research in emerging scientific fields with the goal of translating new discoveries into innovative therapies for human diseases.

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