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The Virtual Anesthesia Machine: An Experiment in Sustainable Philanthropic Education over the Web
Samsun Lampotang, Ph.D., Edwin B. Liem, M.D., David Lizdas, B.S.M.E., Michael E. Nyland, M.B.A., Nikolaus Gravenstein, M.D.
Anesthesiology, University of Florida, Gainesville, Florida.
Introduction: Charging a fee for educational simulations limits their accessibility and intended benefits, especially in developing countries. On the other hand, free access generates no income to fund a core team for continued development and updates. Thus lack of funding may limit the availability, quality and currentness of free simulations, especially for topics ineligible for grants, like anesthesia equipment. We investigated whether free access can be reconciled with financial self-sufficiency in disseminating an anesthesia machine simulation. Our hypothesis was that (a) within 3 years, with departmental seed funding, our web site would achieve high-volume traffic and visibility by hosting free, high quality educational simulations and (b) leverage the traffic and goodwill into corporate and institutional sponsorship and individual donations to attain financial autonomy for the core team.

Methods. Using Macromedia Director (San Francisco, CA), we implemented the Virtual Anesthesia Machine (VAM) simulation (1,2), For wider audience appeal, we added simulation legends in 13 languages, US/ISO gas color codes, a discussion list and a 50-page anesthesia machine workbook developed with APSF funding. We monitored traffic and compiled statistics to assess traffic growth and user demographics and interests.

Results: For the period 7/1/02-3/30/03, the VAM web site received > 100,000 hits/month, has 9,200 registered users and is used in > 287 programs worldwide. For the last year VAM has maintained without interruption the top listing on a Google Internet search on "anesthesia machine" and received unanimously positive user feedback. To date, donations total just $10 and corporate sponsorship amounts to $11,000, a fraction of annual team payroll.

Conclusions: A free Web-based simulation seems to be a widely accessed and popular learning medium based on traffic and user feedback respectively. Whether VAM's popularity is due to its format, free access or both is undetermined. Corporate sponsorship has not materialized to the expected degree in spite of VAM achieving international prominence. We had thought that contacted manufacturers would perceive sponsorship as an appropriate use of their public relations (PR) funds along with traditional activities like sponsored lunches and journal advertising. Our vision is that VAM will help instigate a fresh PR outlook where corporations routinely spend a fraction of their PR funds to sponsor free, peer-reviewed Web simulations developed by independent academic institutions. The current economic downturn may partly explain VAM's short-term failure to attain financial autonomy via sponsorship. As primary beneficiaries, end users must play a more active and vocal role in convincing industry that it benefits from sponsoring free, high-quality web simulations. In collaboration with PR experts and industry, we may need to conduct studies to compare customer goodwill resulting from different PR activities. Based on VAM's experience, seed funding may be required for 5 years to establish a philanthropic and continually updated web simulation and keep its core team intact.


1. Doyle DJ: The Virtual Anesthesia Machine (v 8.32). Can J Anaesth, 50:206-7, 2003

2. Olympio MA: The virtual anesthesia machine. Anesthesiology 96:1281, 2002.

Anesthesiology 2003; 99: A1319