Simulation Lab

Collaboration between Transtechnology Research and Torbay Hospital

A current funded collaboration between Transtechnology Research and Clinicians at Torbay Hospital Trust investigates strategies for developing appropriate levels of professional empathy in clinical training. This collaboration includes multiple workstreams which collectively aim to develop alternative approaches to care and treatment of the human holistically by reviewing the tools, methodologies and approaches in the teaching and training of healthcare professionals.

How we increase non-technical skills, teaching and understanding in education is approached from two directions; one develops a methodology in medical simulation training that includes props and apparatus in the environment that might provide cues to elicit empathetic responses.Another intervention advances the work already started at Torbay, by critically examining the use of VR and finding low fidelity approaches that are cost effective but have capability of being adopted across the healthcare workforce digital literacy.

Another research strand addresses the recent trend in which clinicians are creating film materials from their clinical practice, recognising the value of moving image to recover certain aspects of practice for training and debriefing purposes. Moving image can bring to attention some aspects of professional practice or environmental context dynamics that may have been overlooked whilst absorbed in the moment.

Simulated baby in a woman's arms

Simulated baby

Simulated patient in hospital training room

Simulated patient in hospital training room

As filmmakers with documentary and experimental film backgrounds we are able to offer guidance to clinicians in becoming their own content designers. Through a series of workshops, we aim to design a filmmaking toolkit and visual methodology that could provide clinicians with methods for reading and developing moving image documentation. The tool kit will develop skills and understanding of using moving image as a discursive tool to engage in critical evaluation of events, interactions and procedures to make appropriate and informed judgements,use moving image to show up and challenge the boundaries of knowledge within the field and inform innovative and creative solutions to problems, offer new insights that are informed by critical evaluation of current research or professional practice. The tool kit will demonstrate how to read and evaluate moving image content, engage clinicians in confident discussion of filming concepts through learning a visual language. It will also propose appropriate techniques, methods and editing strategies, create an awareness ofthe limits, affordances and ambiguities of media representation and simulation, facilitate a series of open ended questions to encourage close reading, analysis and reflexivity

Trainee health care staff wearing 3D headsets

Trainee health-care staff wearing 3D headsets

Additionally, this collaboration draws on researchers curatorial and practical experience in the arts to assist Torbay Hospital Trust in developing the The HeArTs Gallery program. Creative activity has long been known to have tangible effects on health and quality of life. The creative arts help make sense of the complexity of our human condition. They encourage active engagement with the world around us, help us to keep learning, connect with each other and contribute to our communities. The arts, creativity and the imagination are agents of wellness: they help keep the individual resilient, aid recovery and foster a flourishing society. The gallery program aims to develop opportunities for both users and providers of healthcare—across Torbay and South Devon—to engage more fully with a wide range of arts and creative activity that can benefit health and wellbeing. Our collaboration will assist in facilitating a range of art projects in a variety of health care and community settings for expressive, restorative, educational and therapeutic purposes. Some projects work preventively, some enhance recovery, others improve the quality of life for people with long-term or terminal conditions.

Another research strand aim to tackle a delivery problem in clinical training. A series of workshops using the Digital Horizons Torbay Laboratoryaims to investigate strategies for developing appropriate levels of professional empathy in clinical training through a comparative study using simulator technologies. It addresses the way in which an uncritical equivalence is drawn between the apparent realism of the medical manikin and the human factors, such as empathy, that need to be developed in training. This results in manikin technologies becoming increasingly expensive, as animatronic simulation functions become standard, without enhancing the necessary empathic skills of the clinicians. The resulting impact on the cost of simulation-based medical training is particularly problematic in the context of community healthcare applications. Current manikins are very heavy, immobile, require technical input and increasingly are designed to only support specific pre-specified training scenarios because of their elaborate design. In addition, little consideration has been given to important, culturally-dependent, features that might engage trainees and elicit professional empathy. We address these issues by using co-design principles to further two lines of investigation: a) proof of concept prototyping of low-cost locally configurable manikin simulators, and b) novel 360o filming and VR technologies, that will flexibly support an expandable range of training scenarios as required. Underlying both is the goal of cultivating empathic skills in trainee clinicians without expensive animatronics.

Another contribution connected to this research is a humanities perspective literature review, to complement Peres’s systematic review, which proposes a transdisciplinary methodology for evaluating subjectivity, compassion and professional empathy in clinical training. This annotated bibliography begins by analysing definitions of empathy and extends this into thinking about how apparatus, materials, technology, design and simulation methods can be used to elicit empathic responses in a professional context.

 

Nick Peres