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October 17, 2007
1:30 PM - 3:30 PM
Room Room 123
3DiTeams – Healthcare Team Training in a Virtual Environment
Jeffrey Taekman, M.D., Noa Segall, Ph.D., Eugene Hobbs, C.H.T., Melanie Wright, Ph.D.
Department of Anesthesiology, Duke University, Durham, North Carolina
Introduction: Teamwork and communication lapses are the number one cause of iatrogenic injury in medicine. Effective team coordination is critical for the safe delivery of healthcare. Development of these skills requires training and practice in an interactive team-based environment.

High-fidelity simulation is sometimes used to train teamwork and communication skills. High-fidelity simulation is less useful when training large groups of learners due to issues of cost, portability, scalability, and supporting infrastructure.

The military leads the way in the use of gaming technology for training. America's Army, initially developed as a recruiting tool, was rapidly adapted for mission rehearsal. Gaming technology is now used regularly to train American soldiers throughout the world.

Three-dimensional immersive computer environment provide an engaging and cost-effective alternative to other interactive training solutions. We are developing an interactive healthcare team trainer in collaboration with the United States Army (Department of Defense / Telemedicine and Advanced Technology Research Center) and a state-of-the-art gaming studio. The new training platform is called 3DiTeams.

Methods: 3DiTeams is being built with commercial gaming technology (Epic's Unreal Engine 3) and includes an embedded physiology engine (Body.dll). 3DiTeams will run on any network-connected personal computer.

3DiTeams has three phases:

1. Independent Learning Phase– Individuals learn the principles of teamwork and communication by observing expert virtual teams perform in the virtual world while categorizing behaviors.

2. Collaboration / Team Coordination Phase – Multiple learners enter a virtual world together. Team members can be in the same room or spread throughout the world. Team members apply the principles they learned in the Independent Learning Phase while caring for virtual patients. Team members, instructors, and non-participant observers comment and rate the interactions they witness.

3. Debrief / After Action Review - Video and voice recording of the Collaborative Phase is played back live or over the internet. A facilitator-lead debrief allows the learners to observe their behaviors, reflect on their actions, and discuss the positive and negative interactions that took place during the challenging scenario.

Results: The 3DiTeams platform will be completed in September of 2007. Anticipated users include medical students, residents, nurses and faculty in a large academic health system. Wider distribution is anticipated.

3DiTeams platform will be compared to traditional forms of teamwork training using metrics that include knowledge, skills, attitudes, learning efficiency, learner satisfaction, and cost.

Conclusions: We believe advanced learning technology platforms such as 3DiTeams will have a prominent place in the future of healthcare training and evaluation do to their interactivity, flexibility, scalability, portability, and reduced infrastructure costs.

Acknowledgments: This work is funded by the US Army Telemedicine and Advanced Technology Research Center, (W81XWH-06-1-0720) and the NIH Agency for Healthcare Research and Quality, (U18 HS016653-01 and K02 HS015704-01).

Anesthesiology 2007; 107: A2145