January 19, 2022By Lance Baily

IMSH 2022: Healthcare Simulation Conference Roundup

The final day of 2022 International Meeting for Simulation in Healthcare (IMSH) has come! Hosted by the Society for Simulation in Healthcare (SSiH), this year’s event provided an opportunity for healthcare simulation champions from around the world to come together. IMSH 2022 remained a hybrid event as planned, taking place in person and virtually from January 15 to January 19, 2022, in Los Angeles, California at the Los Angeles Convention Center. This year, SSH welcomed more than 90 exhibitors and more than 1,200 registered simulationists! This HealthySimulation.com article shares recaps of each day’s session, as reported by Elizabeth Wells-Beede, Ph.D., RN, C-EFM, CNE, CHSE-A, as well as several clinical simulation vendor updates.

IMSH 2022 Session Recaps

Sunday, January 16

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The SSH SimVentors Showcase: Serious Games, Virtual Environments and AR/VR and the Research Abstract Professor Rounds were well attended and had a lot of innovative ideas created by some aspiring researchers and inventors. Today’s session of SimVentors included High Tech & Government Projects; Low-Cost & Low Resource Innovations; Novel Simulation Platforms; Serious Games, Virtual Environments, and AR/VR; and Sim modifications. As expected, there were several options being presented on the mixed reality continuum and ranged from Augmented Reality and resuscitation with a newborn, to the exploration of haptics with Leopold’s within the Oculus Quest 2 headset.

In addition to the virtual and augmented platforms being presented, a few apps & QR codes were demonstrated to showcase a multitude of patient safety options. It was apparent with both the posters and the inventions displayed that cardiopulmonary resuscitation and clinical judgment were well represented during this session. After presenting and beginning their research during the last in-person IMSH session at San Diego, the research study conducted by Dr. Paige, Ms. Lindsey Graham, & Dr. Stiner explored faculty development available via a poster presentation. Their recommendations were not surprising in the need for a greater reward & support system to develop and sustain a quality program where needed. There also appeared to be a great connection with some of the SimVentors projects and the poster presentations.

Monday, January 17

Key Note & Awards: The morning began with the Presidential citations where Dr. Maxworthy presented heartfelt awards to two people that have been instrumental in her growth and leadership. First, her father whose service to the community was instrumental during the pandemic in providing fresh food and resources to food banks. Second, was Dr. Bob Armstrong, former president of SSiH. Additionally, Dr. Maxworthy presented the inaugural Pioneering Award for Simulationists to Dr. Debra Spunt. Dr. Pam Jeffries and Dr. Mary Ann Rizzolo accepted the award on behalf of Dr. Spunt. Their beautiful account of Dr. Spunt and her legacy was apparent in why she was chosen for this inaugural award.

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In the morning, the keynote Dr. Lou Oberndorf lecturer was Erica Dhawan. This lecturer may possibly have provided paramount resources and ideas to help leaders with the idea of the digital shift that is occurring now due to the global pandemic. She asked, “How will we create a BETTER normal?”

As innovators in the industry, it is our moment to begin taking the lead in what Dhawan describes as Connectional Intelligence. It is important to take these opportunities placed in front of us now and begin to design new ways of generating ideas through innovation and collaboration. It was a reminder to all the attendees during trying times that much of what we do in healthcare simulation can be translated once again to our everyday interactions with our peers, learners, and community of interest.

There were also a number of points to her discussion that rang similar to the Basic Assumption and how we can learn to “trust-totally” during trying times. Dhawan shared a toolkit to learn more and practice digital body language. A toolkit was shared with those present at the keynote and is available by texting Dhawan to 66866.

Morning Session:

Case Study: Three Schools of Nursing begin the journey of assessing and evaluating competence through the curriculum with presenters from three institutions of higher education in undergraduate nursing programs conducted a panel discussion with Q&A from the moderator. This case study discussed their experience in developing a model for evaluation utilizing the sim capture and incorporating different modalities of evaluation for educators, facilitators, and learners. Some of the tools discussed that are validated include the Creighton Tool and DASH.

Each spoke to the significance of adequately utilizing the data longitudinally for a demonstration of “competency” with both the learner and the facilitators within the clinical simulation. How the tools can be incorporated to help with professional development and remediation. The presentation has provided lessons learned and identified gaps in the process that are instrumental with the ongoing development and seeing inter-rater reliability and some of the technology concerns. This will be a journey to follow to gain further insight as nursing moves toward competency in hopes of providing clarification of what is expected with what they define as competency.

Afternoon Sessions:

Augmented Reality Training: Education to Save Maternal-Child Lives: A study exploring the utilization of an augmented reality simulation was conducted with undergraduate nursing students with the CAE LucinaAR (CAE Healthcare, n.d.) during the Maternal-Child rotations with over 121 students. The AR simulation was delivery and postpartum hemorrhage. As with many programs, some learners may or may not have had theory prior to the healthcare simulation, so the presenters worked to help mitigate any problems that may occur. This particular study identifies some much-needed data to help facilitators navigate side effects that could occur with using AR/VR technology.

General discomfort, eye strain, and some dizziness were the most common responses. The tool utilized was the VRSQ which is currently a tool under its own analysis by the authors. As we continue to navigate where the future will be in AR/VR technology within healthcare measurement tools and assess whether the learners are gaining a reciprocal experience as they would with a high-fidelity simulation. The presenters also shared their experience with debriefing the clinical simulation and expressed concern regarding the inability to “see” what the learner is viewing in time and space. This was a limitation that would benefit from further investigation.

It was refreshing for them to share their experiences and the “oops’ ‘ moments to help those that may want to explore the virtual environment. You can explore more about this study and stay tuned for their future publications. Q&A was limited, indicating that this area is growing and the research coming out with this upcoming new technology is going to be needed.

Final Session (3 PM): The final session for Day 2 was a look at mastery learning through deliberate practice. The presenters went through their definition based on the interpretation from studies conducted regarding mastery learning. As their definition, they described what is considered the best standard of practice that is necessary to meet safe patient goals. They provided several active learning modalities to help the audience gain insight into what they believe to be deliberate practice.

Both Drs. Barsuk and Salzman have been working together for over a decade and it was noticeable during the presentation. It was apparent they practice what they preach per se and their expertise in the content was shared throughout their presentation. The discussion with the audience was engaging throughout and with the number of attendees, both the first time and the second time, it was evident that they felt comfortable sharing their knowledge on the mastery model of education.

This particular topic has been one of interest for some time and is important for practitioners at all levels regardless of their own expertise due not only to the fact that healthcare is iterative and changing at a speed that leaves practitioners at a loss to keep up, but also stagnation of skill requisition. They pointed out on several instances the significance and importance of continued practice and ongoing mastery through deliberate practice to ensure safe patient outcomes. In addition, they provided how important the feedback is for this model of teaching, which is similar to coaching with formative feedback throughout and at appropriate times.

Tuesday, January 18

Today’s plenary started with a recap and Presidential citation awards. Dr. Maxworthy recognized the CEO from Zoom Eric Yuan for his grace and contributions during the global pandemic. Additionally, Dr. Maxworthy recognized the editing team for the second edition of Defining Excellence in Simulation Programs. Drs Palaganas, Okuda, and Mancinni were all present to receive their award and Dr. Maxworthy will present the award to Dr. Chad Epps’ family at a later time.

After Dr. Maxworthy recognized her final awards, the research committee shared updates and acknowledged the scholarly work being conducted at this time. An update was also provided regarding the 2023 Research Summit. This particular work is significant to the healthcare simulation committee to ensure we are staying abreast with evidence-based practice.

The keynote speaker for today’s plenary session was Yassmin Abdel-Magied, sharing a significant message regarding unconscious and implicit bias. In light of the current climate and the ongoing challenges with flaws in the system surrounding diversity, equity, and inclusion, her message was important to hear. There are so many thoughts that are ingrained in our cultures that continue to impact society as a whole.

These thoughts are significant in exploring deeper as healthcare providers that are charged with ensuring safe patient practice. Looking beyond our first impression, as suggested by Abdel-Magied, to minimize and hopefully remove bias are important. Challenging where the idea that initially “pops” in our heads when viewing a patient, student, peer or stranger may help us realize the thought maybe untrue or perpetuated by negative media and/or faulty thoughts.

She challenged the audience to focus on patient-centered communication that ensures the patient is “seen” and “heard” as an individual. She left the audience with her final thoughts in sharing that “one simple conversation can have a life-changing impact”. Today is all about connecting and remembering that as small as being kind might be, it could help someone through the day.

10 AM Session

Lots of Little Conversations: Mentoring Simulation Facilitators through Best Practices was presented by members of the team at the Carolinas Simulation Center. The Carolinas Simulation Center has dual accreditation. The mentorship program they have established, MentorSim, has been peer-reviewed by SSiH creditors. This four-tier system to develop facilitators helps this program appropriately follow the Healthcare Simulation Standards of Best Practice.

During the session, they described how they incorporate the Professional Development, Professional Integrity, Simulation Design, and Facilitation standards into their training process. During the workshop they had the attendees interact in the “mentor” role with role-played scenarios that presented as somewhat difficult situations. This session helped all the attendees gain knowledge on the significance of taking baby steps and having lots of little conversations as they move the needle in professional development.

There were a number of conversations within the groups regarding the difficulty associated with providing appropriate feedback with facilitators and also ensuring they are current with best practices. The process established by the presenters provides continuous feedback and mentorship for the facilitators, providing them resources to ensure they are meeting the needs of the tier they would like to meet.

The program is asynchronous and allows the facilitators to move the bar to higher tiers past the basic at their own comfort level. In line with the multiple sessions during the conference, it was reiterated that professional development is fluid and ever-changing, requiring healthcare simulationists to stay up to date with the literature to ensure they are providing safe educational practices as well.

3 PM Session

Rapid Cycle Debriefing Process, the final session of the day was an interactive session that asked the participants to take place in several debriefing sessions. After receiving a prebrief on the objectives of the session the facilitators led the participants through what they call a rapid cycle debriefing process where the participants rotate through multiple sessions of role-playing and debriefing activities.

During the session, the participants had the opportunity to practice debriefing a difficult scenario utilizing the Advocacy Inquiry and the DASH model to debrief the debriefer. Once all participants rotated and were at the limited time the group as a whole was debriefed. The debrief explored the methods utilized and shared personal experiences.

Wednesday, January 19

The Extended Reality in Curricula: Setbacks and Success was presented by a multidisciplinary nursing panel from 3 separate institutions. They shared several views on how integrating extended reality into a curriculum can be both exciting and challenging. First, they presented on the utilization in an undergraduate program followed by graduate programs. It was wonderful to hear firsthand the challenges and successes for those that haven’t started working with extended reality in their institutions and to also share experiences with those that have begun working with these new modalities.

Of significant importance, which was also a common theme for the conference, is ensuring our own bias isn’t projected into the experience. As Dr. Diaz shared and identified her own assumptions or bias in thinking that the male learners in her program would be more familiar with the Oculus Quest 2 headsets and their functionality. On the contrary, she discussed with the audience that she spent more time than expected helping them understand how to just find the simulation in the headset. With this knowledge, she adapted the format and had an instructional video that provided step by step on how to use the headsets.

As with any healthcare simulation ensuring faculty have buy-in so the modality continues to be used within the course, this was a barrier to overcome and they are working through professional development to help. With all the programs created they discussed the perceived motion sickness and suggested if you’re using these modalities to try to have an alternate delivery modality. Not only for those learners that may not be able to be immersed but also if technology doesn’t work as intended. There appeared to be a great number of sessions discussing the experience of either starting your own VR work or utilizing companies to help meet the need. This was exciting and it exemplifies the wonderful community of simulation that would like to share their knowledge and help other simulationists.

IMSH 2022 Vendor Updates

1) Echo Healthcare Inc. has once again advanced the landscape of medical simulation by launching the industry’s first service and support mobile application. The Master Level Service Agreement (MeLiSA) app provides users with immediate access to the revolutionary MeLiSA program. This is an important milestone for healthcare simulation as many other industries have fully adopted mobile phone technical support tools to the benefit of customers and service providers alike! The power lies in the app’s ability to quickly bring an advanced technical support person “on scene” even though they are thousands of miles away.

“Immediate connectivity and live technical response time have never been done before in our industry. The MeLiSA mobile app was created to streamline the service and support needs of medical simulationists around the world. It also gives our clients instantaneous access to our Emergency Simulator Network via chat, video call, or phone call. Providing simplicity and efficiency of support during a stressful time is the key foundation of the MeLiSA app,” said Peter Ford, Director of Technology at Echo Healthcare.

2) Remedy Simulation released the company’s first FRS Dome (Fundamental Robotic Surgery). This was developed and produced in partnership with a non-profit institution to provide devices for neurological robotic surgery training. Training exercise diagrams are cast into the silicone outer skin, and multiple tissue layers offer an authentic feel and surgical experience. Further, incorporated vessels provide a more realistic training scenario, and 3D printed inserts with wire connectors challenge trainees’ dexterity.

FRS is a multi-specialty, proficiency-based curriculum of basic technical skills to train and assess surgeons to safely and efficiently perform robotic-assisted surgery. It was developed by over 80 national/international robotic surgery experts, behavioral psychologists, medical educators, statisticians, and psychometricians. The clinical robotic surgery subject matter experts represented all of the major surgical specialties in the United States that currently perform robotic-assisted surgical procedures, the Department of Defense and the Veterans Administration (VA).

The goals and objectives of the basic skills and tasks for robotic surgery are to train and assess the proficiency of the psychomotor robotic skills of the surgeon. This will ensure that only the surgeons who are skilled and well trained in robotic surgery perform such complex procedures, making the patient the ultimate benefactor. The FRS Dome is ultimately designed for seven tasks:

Task 1: Docking and Instrument Insertion Subjects will realize the docking task introducing the trocars for the camera and instruments into in the white-box trainer. The dome will be in the closed box.
Task 2: Ring Tower Transfer Four towers with an S-wire are positioned on the dome, two towers on the center cap and two on the lower part (one on the left side and one on the right side). There is an 8 mm ring on the base of each tower located at the upper part of the dome. Using both hands, subjects will transfer the ring from the S-tower on the cap to the S-tower on the skin surface, twice.
Task 3: Knot Tying Subjects will tie a surgeon’s knot to approximate the two eyelets of the “I” towers such that they touch each other and back up the knot with a square knot (two throws).
Task 4: Railroad Task Horizontal mattress suture will be made through the target points to approximate the tissue.
Task 5: 4th Arm Cutting Subjects will pick up and stretch the elastic band with the first and third arms and use a second arm instrument to cut at the marks. Place the cut sections in the bowl on top.
Task 6: Puzzle Piece Dissection – Subjects will cut out and dissect the shape marked on the skin.
Task 7: Vessel Dissection Subjects will dissect through the fat layer to expose the vessel, cauterize and cut the vessel.

3) Ingmar Medical invites IMSH 2022 attendees to visit the company at Booth #707. Here are 3 reasons to stop by:

  1. Add the company’s Learning Lab, “Scenario Building 1o1 with RespiSim,” to your schedule on Monday, 1/17 @ 4:30 PM EST. This free session can be beneficial for RespiSim users as well as any educator interested in scenario-building strategy. Walk away with the confidence and resources to build your own scenarios from scratch!
  2. See the brand NEW RespiPro in action! Watch live patient-ventilator interactions with this all-in-one respiratory simulation solution.
  3. Chat with friendly Product Specialists and RTs and pick up some cool swag

4) Strategic Operations will be exhibiting and holding hyper-realistic trauma surgery simulations using the company’s Cut Suit at the IMSH 2022. The Cut Suit is the only open surgery simulator that is Hyper-Realistic, repairable, and thus cost-effective, the subject of numerous peer-reviewed scientific papers, and is part of curricula for both medical students and surgeons. The surgical Cut Suit has been used by military and civilian surgeons, emergency room doctors, and other medical providers extensively over the last few years. Designed by surgeons, for surgeons, to teach surgeons, Advanced Surgical Skills Packages (ASSPs) allow Hyper-Realistic simulated surgical procedures that replicate various trauma and pathology scenarios. The ASSPs are rented, shipped in pre-paid returnable containers, repaired at STOPS, and placed back into rental inventory, effectively becoming Medical Simulation as a Service (MSaaS).

5) Avkin has released Avbirth, a wearable simulator packed with all of the technology needed to transform childbirth education. This wearable simulator is designed to transform childbirth education from an observation and shadowing experience to a fully immersed, patient care erience. Users can now include objectives such as closed-looped communication with an interprofessional team and therapeutic communication with the patient and their significant other through all phases of labor and delivery.

Avbirth pairs with the Avkin App to control the release of a variety of natal fluids, haptically cue the wearer during a contraction, progress the labor at the desired rate, and include additional challenges for the development of critical thinking such as shoulder dystocia or postpartum hemorrhage.

6) MedVision will have an updated Arthur (a pediatric simulator) on exhibit at IMSH 2022. He will have the lifelike look, feel, hair, etc that Leo has. Arthur was created to bring pediatric patient care to a whole new level. The simulator comes with realistic chest compressions, including depth, frequency, hands placement assessment, ventilation volume, and a detailed activity log. MedVision’s design has resulted in Arthur’s conformity to all pediatric care requirements and standards.

7) Echo Healthcare Inc., a global leader in high-reality simulation, disrupts the healthcare simulation industry once again with the announcement of SecondSkin. Designed to dramatically transform human patient simulators, SecondSkin provides a high level of realism and diversity that has never been seen before.

Designed to be fitted over top of existing patient simulators, SecondSkin allows for the functionality and full range of motion of the simulator it is outfitted for. Created from scans of real human beings, SecondSkin provides extreme realism, down to the finite physical and anatomical details of an actual human. SecondSkin effortlessly changes a patient simulator’s age, gender, and ethnicity, increasing diversity in simulation training.

“The suspension of disbelief that we believe is so critical in healthcare simulation has driven us towards innovation. Today I am proud to announce SecondSkin. SecondSkin delivers an unmatched level of realism in the industry. SecondSkin is a project we have been incredibly passionate about. Everything we do is guided by our mission to help save lives and improve patient outcomes. Increasing diversity in healthcare simulation is one way we are doing that. Most patient simulators being used in training are Caucasian middle-aged males. With SecondSkin, you can now train your learners on patient simulators that represent the population they serve. Everyone deserves to be represented in healthcare simulation,” said Kevin King, CEO of Echo Healthcare.

8) Oxford Medical Simulation is known for scenario quality, breadth of content, and freedom for learners – who can access with or without faculty in a headset or on screen. These abilities have led to the incredible uptake of OMS, which has allowed us to continue to push the boundaries of what VR can offer.

In 2022, the OMS team has three big releases planned. This includes OMS Create, a full-stack authoring platform that allows users to create VR simulation scenarios without coding or VR development experience. OMS Create will enable users to adapt existing content – such as changing labs, radiology, conversation – all the way to envisaging and building scenarios entirely from scratch. Next, a new voice control functionality is made possible through OMS Communicate. Driven by Natural Language Processing (NLP) and machine learning algorithms, OMS Communicate allows learners to speak naturally with virtual patients as they would do in real life.

Lastly, OMS Touch – hand control functionality from OMS – allows learners to manipulate objects within OMS scenarios just like in real life using Touch controllers with vibrotactile feedback and procedural grip. Using Touch controllers with vibrotactile feedback and procedural grip, OMS Touch allows learners to manipulate objects within OMS scenarios just like in real life. This lets you take clinical skills and task training to a whole new level, with learners practicing flexibly, as many times as they like, before they ever get near the patient.

9) Guamard unveiled the company’s brand new HAL S5301 simulator at IMSH 2022. From emergency care to ICU and med-surg training, HAL is engineered to fulfill educational objectives across clinical disciplines and blur the lines between simulation and real life. New conversational speech, lifelike motor movement, next-gen simulated physiology, UNI® 3, and many more industry-first capabilities usher in the next revolutionary leap in simulation.

10) The new TCS Pro Series from Operative Experience, is a revolutionary, fully modular portfolio of tactical trauma care simulators featuring groundbreaking, on-the-fly interchangeable wounds, and trauma configurations; fully-integrated patient monitoring, and all-new advanced software capabilities and scenarios. With TCS Pro’s interchangeable wound capability, each simulator can be quickly and easily modified to support a uniquely diverse range of scenarios and training possibilities.

Daily Event Coverage

Here’s what some attendees had to say about this year’s event:

More About IMSH

The Society for Simulation in Healthcare (SSH) hosts IMSH annually and offers over 250 sessions encompassing interactive and immersive courses and plenary sessions. The IMSH meeting is aligned with the SSH’s mission to “provide hands-on learning in leading-edge medical simulation trends and technology, networking and collaboration.” Furthermore, the programs are all peer-reviewed and are selected to serve the needs of novices to experts.

“Every year, professionals from all experience levels and from more than 50 countries attend IMSH,” Kathy Adams, Director of Continuing Education, SSH, said. “Any professional interested in or currently working in healthcare simulation will find value in the healthcare simulation conference; the range of learning formats — from small, interactive workshops, to large, inspiring plenaries – and the breadth of topics presented by global experts ensures that there is something for every learning style, interest and experience level.”

At IMSH meetings, key areas of discussion are often new ideas, leadership development, new processes, and research findings, innovative approaches, design strategies, return on investment, and improved communication techniques. As a catalyst for advancement and evolution in healthcare simulation technology, the IMSH brings together and connects industry professionals to learn. The event is considered to be one of the top educational and networking events for the healthcare simulation world, especially for those with interests in IPE.

Learn More About IMSH 2022

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