Learning in a virtual hospital

When a physician is treating a patient in an intensive care unit, nurses are more than partners. They’re also human safety checklists. Are the right medicines and equipment on hand? Has the patient consented to the procedure? Did the doctor wash his hands?

Purdue nursing students are testing a new way to learn and practice their future duties using a virtual intensive care unit, an immersive 3-D environment created at Purdue’s Envision Center for Data Perceptualization.

The virtual ICU not only looks like the real thing, it comes complete with an interactive virtual doctor, one who isn’t shy about letting his nurses know, among other things, that he’s in a hurry to get done.

The virtual ICU is part of a collaboration between nursing professor Polly Royal, civil engineering professor Phillip Dunston, and building construction management professor Gregory Lasker with funding from Purdue’s Regenstrief Center for Healthcare Engineering. All three researchers share one focus: applying technology to reduce the incidence of hospital acquired infections, which can be deadly to patients and costly to hospitals.

Royal is using the virtual ICU in a study examining whether interactive technology helps senior nursing students better learn and communicate a standard checklist of procedures proven to reduce the number of hospital infections, in comparison with the traditional method of learning by paper assignments and lab sessions.

Besides the checklist, Royal says the virtual ICU also exposes nursing students to a concept called the “authority gradient.” The idea is that nurses, working with doctors as fellow health care professionals, should feel comfortable making suggestions and expressing concerns where necessary, even to a doctor in a hurry.

Meanwhile, Dunston, who directs Purdue’s Advanced Construction Systems Lab, is interested in how such virtual environments might be employed to identify desired design changes earlier in the building design and construction process when it is easier — and less costly — to do something like moving a wall to improve workflow.

Royal thinks a virtual ICU could also be used in accreditation renewal of ICU nurses. A nurse might practice on the version that runs on desktop or laptop computers, which the students use before working in the Envision Center’s multiwall immersive environment. The nurse would then visit a facility similar to the center’s, set up at a hospital or nursing conference for instance, to validate competencies in high-risk procedures.

At the Envision Center, Purdue’s data visualization and virtual reality facility, nursing students wearing 3-D glasses and surgical masks are surrounded by a life-sized ICU projected on three walls, including blinking medical monitors and a whiteboard containing notations about the treatment of the patient. The student stands on one side of a real hospital bed placed in the middle of the immersive environment with a physical 'patient' on it — in this case, a mannequin.

The virtual doctor is projected on the other side of the bed. As he goes through a series of steps for treating the patient, the student nurses are supposed to respond with relevant portions of the safety checklist they’ve been learning.

The 3-D animation for the virtual ICU was created by Eric Palmer and Scott Schroeder, Purdue computer graphics technology students working for the Envision Center. Schroeder and Palmer began by using images and models of real-world intensive care units. Then they created and animated the 3-D environments and virtual people using 3ds Max and the Vizard software program. David Braun, a Purdue research computing specialist who directs the Envision Center, Purdue staff members Steve Dunlop, and the coordinator for the Center for Nursing Education and Simulation, Susan Fisher, were also part of the effort.

The virtual ICU is not the Envision Center's first foray into the realm of virtual hospital rooms. Steven Abel, associate dean for clinical programs in the College of Pharmacy, worked with the center to create a virtual pharmacy clean room that is already in use by Purdue pharmacy students.

There also is a virtual operating room, a virtual community pharmacy, and a virtual hospital room; the latter was created in collaboration with James McGlothlin, a health sciences professor and technical director of the Regenstrief Center for Healthcare Engineering,

According to Braun, these projects are part of a suite of virtual environments that educators and researchers can use to better design and train people to work in and understand the operation of complex health care facilities. Someday, the virtual environment may grow to include an entire virtual hospital.