Board 518 - Technology Innovations Abstract The Use of the iPhone and iPad in the High-Fidelity Simulation of an Operating Room Fire (Submission #78)
Oren T. Guttman, Ravi Bhoja · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · 2013
Introduction/Background The goal of High Fidelity Simulation (HFS) is to convince the participant they are immersed in a real situation. To enable HFS, we employ “Realism” in three parts; first, that the problem being simulated is believable (conceptual); second, that the physical simulation space appears compellingly real (physical); and finally, that the simulation is conducted in a fashion which is reflective of the event being modeled (emotionally contextual).1 Fidelity is the degree to which simulation achieves the objective of “Realism”. Realism seems to be the critical quality that enables effectiveness of High Fidelity Simulation, over other types, at encoding episodic memory and transformational learning.2-4 Hence, any contribution that enhances Realism—be it conceptual, physical, or contextual—is of high value at increasing the probability of HFS to occur and therefore, client learning to be effective. We present a variety of novel utilization’s for the iPad and iPhone to improve physical realism in the simulation of an operating room fire. Given the expense often associated with creating realism in simulation, using an easily accessible product for such as the iPhone/iPad may enable an increase in realism for many simulation centers on a limited resource budget. Methods ‘Alarm’ Ring Tone and OR Fire: the iPhone comes with a variety of ring tones installed, and many other apps that easily add hundreds of others. The standard “alarm” tone can be utilized to imitate a real OR fire alarm. Similarly, other tones can mimic such things like the Line Isolation Monitor. ‘iStrobe’ application: The iStrobe app is a free program on the Apple app store, which turns the iPhone into a strobe light, mimicking the fire alarm flashing strobe light. ‘Fire’ image with an iPad/iPhone projector: we utilize an iPad, hidden in the field wrapped in surgical drapes to simulate drapes on fire. The fire video is easily on youtube under “fire and smoke”. As an aside, the smoke seen in the attached image enshrouding the iPad is created by mixing boiling water and dry ice in an apparatus hidden under the drapes. Other utilities we have for the iPad is to project different hospital backgrounds (i.e. L&D floor, ICU bed, CT scanner, etc) onto a wall via a small projector made by Brookstone to increase contextual realism. Creation of two-way communication: Place one iPhone behind the neck of the manikin and call it with a second iPhone, placing the call on speaker. You now have two way communication system. Creation of Live Video: with a wall mounted iPhone holder, entering face time with another iPhone is an easy way to create a video stream live. Results: Conclusion The creation of a HFS lab that enables realism is an expensive task. We present a low budget approach to enhancing physical and contextual realism with the use of the iPhone/iPad. Although not inexpensive items, the ingenuity and open ended utility has made the iPhone/iPad an indispensable item in our simulation practice, often without any further investment in software. References 1. Rudolph J, Simon R, Raemer D. Which Reality Matters? Questions on the Path to High Engagement in Healthcare Simulation. Simulation in Healthcare 2[3], 161-163. 2007. 2. Dieckmann P, Gaba DM, Rall M. Deepening the theoretical foundations of patient simulation as social practice. Simulation in Healthcare 2[3], 183-193. 2007. 3. Saus ER, Johnsen BH, Eid J. Perceived learning outcome: the relationship between experience, realism and situation awareness during simulator training. International Maritime Health 62[4], 258-264. 2010. 4. Reader, British Journal of Anaesthesia 107 (4): 483–7. 2011. Disclosures None.