Virtual Reality Immerses Northwestern Medicine Clinicians in Realistic Training Simulations While Remaining Physically Distant

Hands-on training for clinicians usually requires the medical team to surround a patient. However, with COVID-19 recommendations encouraging physical distance as much as possible, the professional development team at Northwestern Medicine Central DuPage Hospital in Winfield, Ill. and Northwestern Medicine Delnor Hospital in Geneva, Ill., is using of a virtual reality (V/R) system for simulation training.

Teams of nurses, doctors and clinical staff are donning V/R headsets that immerse them in realistic treatment scenarios. Hand held controllers allow the team to perform assessments and interact with a virtual patient who can be programmed to have just about any medical condition and a full range of symptoms.

The system is wireless and participants can easily remain more than six-feet apart, while others can observe the training via computer screens and see exactly what the participants are seeing. The system is portable making it possible to turn any space into a simulation training center with just minutes of set-up. Systems can also be combined allowing players from different locations to work around the same virtual patient.

"We can replicate any scenery and develop a scenario that is very specific to our training objective," said Michelle J. Olech Smith, MSN, program director of the Clinical Simulation Labs at Northwestern Medicine Central DuPage Hospital and Delnor Hospital. "For example, we can simulate a post-surgical assessment to work on communication and patient interaction or practice a critical event that rarely happens such as a fire in an operating room. We are also working on creating a scenario for the care of a COVID-19 patient should we have resurgence and need to retrain others."

The high-definition 3D virtual patient can be customized by age, gender, size, and physical features. The environment is completely customizable as well allowing staff to recreate an inpatient patient room, operating room, outpatient clinic, emergency department or even an outside setting like a parking lot or sporting event.

The virtual reality system was purchased and piloted shortly before the COVID-19 pandemic hit thanks to a donation from the Harbaugh family of St. Charles. A previous donation from Kay L. and Earl K. Harbaugh seven years ago helped establish the Clinical Simulation Lab at Delnor Hospital. It is named in their honor.

During the pilot program, veteran nurses gasped as they tried out the simulations and a few couldn't help but giggle due to their excitement. They could fully interact with the patient, ask questions, listen to the heartbeat, place a central line, give medication, start an IV and more.

"This is great for a group dynamic," said Sharon Graunke, APN, a clinical nurse specialist at Northwestern Medicine Central DuPage Hospital. "We can freely walk around the environment, communicate with our team members and practice skills so that everyone knows what to do, especially in a high-pressure environment."

Northwestern Medicine has offered simulation training using sophisticated computerized mannequins and hired actors for many years. Olech Smith says the new virtual reality system enhances training by facilitating clinical learning and judgement in a new way.

"Virtual reality is a fully immersive experience that helps participants focus not only on the task, but also the decision making and prioritization," said Olech Smith. "The use of V/R can help improve inter-professional relationships among the healthcare team and help decrease medical errors that may occur when nontechnical skills are underdeveloped."

New graduate nurses were the first to participate in the V/R simulation. Olech Smith says it helped them gain confidence in communicating with providers and they were able to recognize a change in patient status more quickly.

"This innovative technology is a unique opportunity for community hospitals," said Olech Smith. "The capabilities of V/R are endless, making it an exceptional addition to our clinical simulation program. In the long term we hope to leverage the technology for patient education as well."

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