McGill University Developing Deteriorating Patient Simulation App

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Dr. Jeff Wiseman, an Internal Medicine physician at the Royal Victoria Hospital of the McGill University Health Centre (RVH-MUHC), and an assistant professor of Medicine at McGill University in Montreal, Canada, is developing a serious medical smartphone-based game called Deteriorating Patient to help medical students learn how to stabilize severely ill patients.

A core member of the McGill Centre for Medical Education, Wiseman is using a simulation in the Early Recognition of and Response to Acute Deterioration (ERRAD) course given to fourth-year medical students who are about to become residents. In the Deteriorating Patient simulation, students take on roles, perform tasks and face the consequences of their decisions and actions and Wiseman says to his students "Imagine you are the physician on first call during the night shift on an in-patient ward. You are called by the ward nurse because Mr. Smith looks terrible, with a blood pressure of 80/60. What do you do?”

Students have to take a series of steps to treat the patient as successfully and as quickly as possible – if they make mistakes, the patient can worsen and even die. Weisman adjusts the game according to the learners’ level, coaches them and records their actions for debriefing. He says “The idea is to offer students a safe, relevant challenge in a way that’s supportive, inspiring and mutually trusting.”

Turning this simulation into an app means students can practice on a patient’s case over and over again – on their own – until they get things right and save the patient’s life. Then, a teacher analyzes the results and gives students feedback on their recorded performances.

Wiseman’s students suggested he add a scoreboard and develop an online community, so now he’s working with experts in educational psychology, learner’s emotions and computer science – and hopes to be able to implement the app into the ERRAD course by 2017. Once the app works for medical students, he says he would like use it to teach nurses at the school and, ultimately, transform the Deteriorating Patient app into an interprofessional educational tool.

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