interfacing high fidelity mannequins with web- based training rachel ellaway, ph.d. 1,2, david topps...

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Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2 , David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s University of London

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Page 1: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Interfacing High Fidelity Mannequins with Web- Based Training

Rachel Ellaway, Ph.D.1,2, David Topps MD1

1Northern Ontario School of Medicine, 2St George’s University of London

Page 2: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Context

• Simulation in med-ed increasingly multi-modal and

multifaceted

• wealth of devices such as mannequins and task trainers

• actors play simulated patients

• increased use of screen-based simulations, ranging from

narratives to immersive worlds like Second Life

• Despite richness of simulation modes, each modality stands

alone, unable to connect or interoperate with any other

Page 3: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Reasons for doing this

• Limitations of independent modes

• Poor ROI, poor breadth of POV

• Needs, creativity, mash-up age

• Preparation for practice still arbitrary

Page 4: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Dimensions of the Continuum

• Continuum of experience – sequence and cluster

• Continuum of mechanics – physical integration

• Continuum of data – aggregate and exchange

• Continuum of modeling – parallax and triangulation

Page 5: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Dimensions of Integration

• Technical Integration – connectivity, exchange, control

• Presentational integration – real world, synthetic, hybrid

• Narrative integration

• Evaluation integration

• Rules systems

• Activity systems

Page 6: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Growing integration

• Simulation labs – integration by proximity

• Roger Kneebone – Part Task Sims + Std Patients

• SGUL &Daden – Second Life and MVP

• Mannequins + EHRs

• Jacobson imaging as simulation

Page 7: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

VERSE

VERSE (Virtual Educational Research Services Environment)

Remote telemetrics tracking and database

Second Life, haptics (Omni), OpenLabyrinth, Mitsubishi light surfaces

Requires generic data tracking model

Requires major storage and parsing

Creates new opportunities for metrics development and modeling

Page 8: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

VERSE

Page 9: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

HSVO (Health Services Virtual Organization)

NEPs: Network enabled platforms

CANARIE and HSVO

Edge services = device + wrapper

Heterogenous devices: virtual patients (OpenLabyrinth), mannequins (LaerdalSimMan 3G), light fields (virtualised cameras), 3D visualization (RSV and Volseg), multiple data sources (CMA, Medline)

Integrated service model for connecting, controlling and intertwining devices (physical, online, endpoint, model, source, renderer, aggregator)

Page 10: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Edge Infrastructure

shared control and messaging layer

edge devices are added to a shared environment as edge services

basis for the middleware layer is the SAVOIR control layer developed by NRC in Fredericton NB

SAVOIR: Service-oriented

Architecture for a Virtual Organization’s

Infrastructure and Resources

Page 11: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

SAVOIR2

Control: Eye (session manager, resource manager, threshold manager, user manager, credential manager, authoring, logging, runtime)

Transport: Bus – common connector for all aspects of the HSVO NEP – services, Eye – currently planning on using MULE (an open source light-weight Enterprise Service Bus (ESB))

SAVOIR: Service-oriented

Architecture for a Virtual Organization’s

Infrastructure and Resources

Page 12: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Scenarios and Activities

Activity: end user affordances of an edge device, may be active or passive

Scenario: HSVO aggregate of activities connected through Eye-based rules

Session: instance of a scenario

Page 13: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Eye: Author

Create scenario from:• available edge services, • activities on services• parameters within activities

Create rules to: • change focus; • exchange data; • start, pause, stop • based on parameter values

Save as (re)playableHSVO NEP scenario file

SAVOIR: Service-oriented

Architecture for a Virtual Organization’s

Infrastructure and Resources

Page 14: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Eye: Run

Create session context

Select and load scenario, check and load component services

Start, stop, pause

Receive and process messages from services

Send messages to services

Record all messages from the bus, tagged with session ID and timestamp

SAVOIR: Service-oriented

Architecture for a Virtual Organization’s

Infrastructure and Resources

Page 15: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Edge Wrapper

Edge Service = Edge Device + Wrapper

Wrappers have two sides:

Page 16: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Messaging

Service specification based on messaging and edge service behaviours:

<message sessionID=”ABC” deviceID=”123” action=”sessionStatus”><configuration ID=”456” value=”act1” type=”cdata” /><parameter ID=”456” value=”0” type=”int” /><parameter ID=”789” value=”60” type=”mmHg” /></configuration></message>

<message sessionID=”ABC” deviceID=”123” action=”transferData”><parameter ID=”456” value=”10” type=”int” /><parameter ID=”789” value=”50” type=”mmHg” /></message>

Page 17: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Service Specification

Components:

• Messaging – to and from the Eye

•Behaviours – in response to messages

Defines how a service works

Defines wrapper:wrapper = service – device capability

Allows for any future device or variant to be added to the HSVO NEP framework

Page 18: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Service Architecture

Page 19: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

HSVONEP: SimMan

UI

runtime

scenarioAPI

Page 20: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

HSVONEP: OpenLabyrinth

route, time counters

topography

Page 21: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Edge Service Paths

Page 22: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

NEP STEP

• Services for Telemetrics & Evaluation of Performance

• Builds on HSVO to include:– Extended services

– New services

– Platforms as services – ONE-ITS, CBRAIN

• Telemetrics streaming• Telemetrics coding• Telemetrics modeling• Savoir3

Page 23: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

SISTER

• SISTER: Simulation Integration Specification for Technology Enhanced Research

• an integration specification for simulation platforms

• simple, extensible, open

• still in R&D but looking to implement soon

• ? Candidate (Canadadidate?) for future spec process

Page 24: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Challenges

• Profound heterogeneity

• Black boxes – commercial implementation

• Endpoints, APIs and their complete absence

• Benefits of implementation – still in R&D

• SISTER is a research spec at present

• Levels of integration and control

• Exchange – semantics, flow, emergence

• Defining conceptual as well as technical spaces

Page 25: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Ways Forward

• Paths of intention demonstrate need and potential

• Many ways to implement simulation continua

• Classic opportunity for standards activity

• Key role in bridging safely and confidently into practice

Page 26: Interfacing High Fidelity Mannequins with Web- Based Training Rachel Ellaway, Ph.D. 1,2, David Topps MD 1 1 Northern Ontario School of Medicine, 2 St George’s

Interfacing High Fidelity Mannequins with Web- Based Training

Rachel Ellaway, Ph.D.1,2, David Topps MD1

1Northern Ontario School of Medicine, 2St George’s University of London

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