Elizabeth Benson is an engineer, nurse, and educator. As CEO of B & G Educational Innovations, LLC, and subsidiary ReaLifeSim, LLC, she’s also an inventor and entrepreneur on a mission to improve health and wellness worldwide by improving clinical skills education. Regardless of the environment, Ms. Benson has one goal – improved patient safety and care in our ever-changing healthcare environment.

Ms. Benson blends aspects of nearly 40 years’ experience as a RN and education specialist into designing/developing disruptively innovative products that focus on human factor realism to improve patient outcomes. Her clinical experience includes EMS, Emergency, Critical Care, and Faith Community Nursing.

Elizabeth Benson
Elizabeth Benson

She was recently recognized with the Nightingale Innovative Nurses Award and was featured in MedTech Boston and “Babes Who Hustle,” for innovations in healthcare and encouraging girls to enter STEM programs.

The RealLifeSim nomination: “They have developed a unique and beneficial training product that helps to aid in training while working on live patients. Their product is beneficial to many fields, such as training nurses, doctors, vets, vet tech, firemen and many more.”

Train the Way You Treat = Improved Patient Safety

Doctors. Nurses. Medics. All ordinary people - called to do extraordinary things. One moment we’re in the market or at the movies – and the next we could be delivering a baby, stopping a bleed or performing CPR. On a busy day, we might be doing all those tasks - multiple times.

We all see and feel these events differently and none of us were prepared for this experience during our training.

Problem - The Disconnect

There’s a disconnect between what we prepare emergency responders, nurses, and doctors to do - and what they will experience. We need to provide more realism in their training, so they recognize the influence human factors have on patient safety.

Medical errors cause thousands of deaths each year. Clinicians are caring people, committed to providing their best care, but they’re human and humans make mistakes. Learners and providers need more realistic experiences in clinical skills practice to improve patient safety. Improving the realism of clinical simulation education is an effective way to improve patient safety - now and for the future.

Solution – Reconnect

BGEI’s unique solution is the wearable ReaLifeSim hybrid simulation product. It is a hybrid IV trainer designed by nurses to provide realistic, risk-free, immersive learning experiences working under the pressure of practicing on real people. Learners experience the influence of human factors on hands-on and interactive communication skills, while developing situational awareness.

Books, lectures and lab time provide essential knowledge and good practice. But, practicing in a realistic environment is different. After working with ReaLifeSim, learners and providers reported improved competency, better communication, confidence, and deeper empathy - which contribute to fewer preventable errors, reduced time to treatment, and fewer human factor mishaps.

Ten key human factors topics for patient safety identified as most relevant for patient safety:

Benson

Human Factor Mishaps

Human factors analysis is an essential step to designing equipment, procedures, tasks, and work environments. Research shows that human failures cause 80% to 90% of errors. The most common root causes of sentinel events are the human factors of leadership and communication as referenced in “Human Factors Analysis in Patient Safety Systems”.

In healthcare, training, related to the influence of human factors, is not routinely provided, unlike other safety-critical industries like aviation. In 2007, an airline pilot whose wife died due to an anesthetic accident with human factor causes established the first Clinical Human Factors Group in the UK, comprised of clinical and human factors specialists. As a pilot, coming from an industry that incorporated a human-factors approach into all aspects of safety management, he was surprised to find there was little awareness of the role of human factors in patient safety. (www.chfg.org)

The World Health Organization, in their report “Human Factors in Patient Safety - Review of Topics and Tools” defined situation awareness (SA) as the continuous monitoring of the task environment to understand what is going on and what might happen next. Clinical simulation task training and scenarios can be used to measure situation awareness, since activities can be stopped without risk. They defined decision making as a critical component of workplace safety in relation to minimizing errors. Increasing use is being made of clinical simulators to train individuals and teams in decision making, especially under high pressure conditions.

Communication & Patient Safety

As clinicians, we’re committed to promote a revitalized focus on the human element of patient-centric care and clinical training.

Effective provider/patient communication is essential to empower patients to see themselves as part of the process, building a sense of trust with patient and provider and improving patient outcomes. A look, a tone of voice, a touch - all can communicate competence and caring.

Patient safety experts agree communication and teamwork skills are essential for providing quality care. “When all clinical and non-clinical staff collaborate effectively, health care teams can improve patient outcomes, prevent medical errors, improve efficiency and increase patient satisfaction. Health care teams that communicate effectively and work collaboratively reduce the potential for error, resulting in enhanced patient safety and improved clinical performance.”

Yet, studies continue to show technical and communication errors are the root cause of most of the morbidity and mortality statistics reported annually. An analysis of 2455 sentinel events reported to the Joint Commission for Hospital Accreditation in the USA (JCAHO, 2008) revealed that the primary root cause in over 70% was communication failure.

The wearable design of ReaLifeSim products replicate real-life clinical skills training. Learners safely practice hands-on clinical skills working with a live person, relating to them as in real life, promoting a heightened sense of “presence” and emotional connection. The improved communication skills also improve clinical team communication.

“The closer we can get the students to a ‘real call’, the better we can transition them from students to practitioners. ReaLifeSim IV trainer added another level of realism to our scenarios. This tool really helps achieve that goal.” – Hector Martinez, EMS Faculty

Clinical team communicates with patient, shares assessment and monitoring responsibilities, and maintains situational awareness.
 Image credit: Emergency Nurse Association (ENA).
Clinical team communicates with patient, shares assessment and monitoring responsibilities, and maintains situational awareness.
Image credit: Emergency Nurse Association (ENA).

Why ReaLifeSim?

We designed ReaLifeSim because it was needed in our clinical education environments. We needed a better way to "train the way you treat".

For my colleague and business partner, Linda Goodman, RN, and me the tipping point came in 2015. One day in the simulation lab, a communications professor was participating as a “patient.” A student nurse was starting an IV using a fake arm next to the patient when the patient yelled ‘ouch’! Startled, the student stepped back saying, “It was just a fake arm, I didn’t touch you.” In that moment, we realized we needed to help our students become as competent in communication skills and situational awareness as they were in hands-on clinical skills. That’s when we decided - we can make the clinical simulation experience better.

Our ReaLifeSim products permit repeated, safe skills practice on real people for learning proper hand positioning, IV catheter manipulation, patient interaction, and situational awareness.

Many schools are substituting 25-50% of clinical experiences with simulation. Nursing educators can use simulation to provide exposure to challenging patient scenarios while optimizing a safe environment.

With up to 50% of clinical training on manikins and computer scenarios, extra emphasis needs to be placed on effective interpersonal communication as an equal partner with the latest technologies to provide the best treatment and care.

Experts in these national and international venues choose ReaLifeSim because their clinically challenging scenarios require added realism:

  • US&R Task Force Medical Specialist and Medical Team Managers Training with Disaster Medical Solutions (ongoing)
  • EMSWorld Clinical Challenge (10.2017, 10.2018) and Patient Safety Bootcamp (10.2018)
  • National EMS Clinical Competition (10.2018)
  • Emergency Nurses Association Advanced Skills Practice and SimWar (9.2018)
  • NAEMSE Scenario Challenge (8.2018)
  • JEMS EMS Today Hands-on Clinical Competition (2.2018)

“Real world training with Real patients wearing ReaLifeSim in Night Training - the best, high fidelity out-of-hospital training I’ve had!” - Dr. Ryan Jacobson, Johnson County, KS, EMS Medical Director

Our clients include healthcare training institutions, acute & long-term healthcare facilities, clinics, diagnostic centers, and home health agencies.

Those using our IV training products to develop and maintain skills, and demonstrate clinical competency include:

  • Emergency services (Firefighters, Paramedics/Corpsmen, Search & Rescue).
  • Nursing (RN, LPN, medical assistants, CNA, Home aides).
  • Medical (MD and Physician Assistants).
  • Phlebotomist.
  • Radiology (technicians and technologists).
  • Respiratory therapists.
  • Multiple levels of physical therapy professionals.

Reviewing plan of care with 'patient' and members of the interprofessional team promotes clear communication, helping to improve patient safety and outcomes.
Reviewing plan of care with 'patient' and members of the interprofessional team promotes clear communication, helping to improve patient safety and outcomes. Image credit: Emergency Nurse Association (ENA).

Product Specifics

As educators, we’re committed to provide competency-based training and assessment.

ReaLifeSim products provide high physical fidelity wearables with authentic haptic, visual, and interactive feedback to provide more realistic immersive "train the way you treat" learning opportunities.

  • Realistic - Haptic feedback: palpate rolling vessels, feel skin and vessel “pop”, auditory feedback: tone with deep IV catheter insertion, and visual feedback with flashback.
  • Quick & Easy Set-up - 5 minutes or less, from storage bag to IV catheter insertions.
  • Patient-focused – Combines human communication/interaction with hands-on skills practice.
  • Portable - Wearable, lightweight IV trainers used in classrooms, laboratories, scenarios, IPEs, and in the field exercises and drills, and close-space and austere environments.
  • Affordable - The cost is within the range of most clinical textbooks.
  • Durable - The adult size IV trainer maintains skin integrity for more than 250 insertion attempts
  • (w/20g). Simulated blood vessels (filled/refillable) in a variety of sizes, plus 2 types of continuous flow vessels.
  • Adaptable – Sizes for adults, pediatric and children. Use on a person or placed on a manikin or simulated arm to improve/expand existing resources and technologies.
  • Safe skills practice - Repeated safe practices learning to start an IV or draw blood while interacting with the patient and team.
  • RLSimApp - Goal Evaluation - The ReaLifeSim application (optional) provides secure access on mobile devices to record performance of hands-on IV training and communication skills. RLSimApp software runs on mobile devices for easy updates. Embedded sensors track skill performance with BLE technology and provide multiple sources of objective data. Working with RLSimApp, skills and communication (individual or team) performance are recoded, saved, and stored with remote access for review and feedback.

Conclusions

One of the best ways to positively effect patient experience is to decrease time to treatment. Instructors and facilitators report students show increased clinical competency, clear communication skills, confidence, empathy, and improved situational awareness - which contribute to reduced preventable medical errors, reduced time to treatment, and minimized human factor mishaps.

Wearable ReaLifeSim products bring together IoT, bleeding edge technology, and the equally important human element of patient-centric care for instructors to leverage the combined benefits in a coherent learner-centered approach. 

Originally published in Issue 1, 2019 of MT Magazine.