Enhanced Reality to Improve Teamwork and Event Management During a Simulated Obstetrical Crisis

Fernando Salvetti
Roxane Gardner

Session Overview:
After decades’ worth of dedicated simulation education, teamwork experts at the Center for Medical Simulation in Boston, MA, USA (CMS) developed cognitive aids to help facilitate learning of this mnemonic and an “Event Manager” checklist was created to facilitate designating roles effectively. The “Name-Claim-Aim” mnemonic and the “Event Manager” checklist have been adopted by the Massachusetts General Hospital (MGH) for inclusion on the latest version of their Emergency Manuals.

After 2 years of experimentation of the enhanced reality system (e-REAL) designed by the experts from Logosnet (Turin, Italy; Lugano, Switzerland; Houston, TX, USA) during the Labor & Delivery Programs at CMS in Boston, findings and evidence from applied research and field experiments have interesting implications for healthcare simulation: improved cognitive retention of the key principles about crisis resource management and a better team performance are among the observed outputs. So far, findings show that immersive visualization, if linked in interactive ways to the learners within an enhanced reality setting, allows for better neural processes related to learning and behavior change.

Effective team management during a crisis is a core element of expert practice: e-REAL reproduces a variety of different emergent situations, enabling learners to interact with multimedia scenarios and practice using the mnemonic called Name-Claim-Aim. Clinicians are shown on average 6 videos in a 25 minute time-span and they are challenged to recognize a situation requiring rapid intervention, communication, knowledge sharing, decision-making and management of unforeseen events—taking into consideration critical contextual factors such as a lack of time, scarcity of resources and tools, and a multitude of impactful factors.

Learners rapidly circle between deliberate practice and direct feedback within a simulation scenario until mastery is achieved. The learning setting is based on enhanced reality for immersive simulation (e-REAL), that is the merging of real and virtual worlds: a mixed reality (MR) environment for hybrid simulation where physical and digital objects co-exist and interact in real time, in a real place and not within a headset. e-REAL allows for a simulation within a multisensory scenario, based on challenging situations (short interactive videos) developed by visual storytelling techniques.

Learning Objectives: 

By the end of this information session, participants will be able to:

  1. Sharing knowledge about how to enhance teamwork during a simulated obstetrical crisis, fostering situational awareness and contextual intelligence, as well as cognitive retention of essential steps and procedures to be performed during an ongoing crisis.
  2. Making clear how a crisis management organizational approach known as “Name-Claim-Aim” is being used to facilitate crisis management and decision making.