Northern Health is one of Victoria’s busiest public health services, covering a local community of approximately 728,000 people. Already operating across several sites in the northern suburbs, Northern Health have recently opened a hi-tech teaching and training facility in Epping, partnering with The University of Melbourne and LaTrobe University to train their students. AV and IT plays a major role, powering advanced medical simulation technology that brings mannequins to life. Jason Allen checked in…
A medical simulation lab, if you’ve not been in one before, can be unsettling to the outsider. Built to look, feel and act like a real hospital facility, a typical simulation lab will house a high- tech human mannequin, eerily lifelike, lying on an operating table, prepped for surgery. Underneath its plastic skin, sensors, machines, a computer and a WiFi link connect it to computers in a control room, reporting its vitals like a real person, and enabling the clinician running the simulation to trigger actions like seizures and heart attacks. The purpose of these realistic environments is to enable current and future health professionals to develop their skills in safety. Recording and distributing video and audio of the simulations is paramount to the educational outcome, and involves some heavy-duty video and audio capture, switching, encoding, and editing.
Faking It, For Real
Sitting down with Northern Health’s Kollen Sussman, Director of Education Research, Mary De Gori, Acting Director of Capital Planning and Development, and Todd Mason, Simulation Manager, I began by asking about the design philosophy behind the multiple simulation laboratories on-site. “They’re simulations of a consulting room, a four bed ward- type room, part-task room, and two rooms designed as operating theatres, one simulating an ICU and another an emergency department cubicle,” said Mary De Gori. “It gives you the breadth of a whole hospital.”
“The simulation labs are built to simulate a patient’s flow from consulting to operation to recovery,” added Kollen Sussman. “They’re also designed to serve two audiences; existing Northern Heath staff from across the service, and students in the field of allied health, medical and nursing. One purpose of the facility is, as a centre of excellence for education and research, to attract and retain staff to the northern region. Another is to increase the number of students we can train and support.”
(Kollen Sussman – Director of Education Research, and Mary De Gori – Acting Director of Capital Planning & Development)
(Todd Mason – Simulation Manager, and Manoje Indraharan – CHW Consulting.)
Practice Makes Perfect
Research into the nature of clinical education itself is a third goal of the centre. “That’s one of the exciting things that the partners here want to do that’s a bit different,” said Todd Mason. “The most obvious application for simulation in research is using it to determine its role in education itself. We need to make sure time in the simulation centre is valuable time. We can also test new procedures and practice and improve them. There’s a focus on intra-professional training where we explore new things with the different professions working together. It gives you a test bed to try out new ideas.”
Manoje Indraharan, Operations Manager at CHW Consulting, became involved as a specialist AV consultant to the project. “This is CHW’s ninth medical simulation project,” he reported. “Each project is unique. It’s like a collaborative classroom in that it needs to be designed to meet the client’s vision of how they’ll use it. But there are some aspects they have in common; all simulations need to be recorded, and you need to find an easy way to control the cameras, and start/stop recording.”
Back Of House
To this end, a formidable range of AV equipment is installed in the surgical simulation rooms. Three Sony EVI-H100V/W PTZ cameras are fitted unobtrusively in the corners of each room. Four Audix AUD-M40W-6 ceiling microphones combine with Revolabs HDMICWEAR microphones worn by students to capture audio. A Samsung LCD screen in each room is used to display instructions to participants, or emulate the patient’s vital signs monitor. Tannoy CVS6 ceiling speakers can relay the instructors’ ‘Voice of God’, spoken through Shure SHR-MX418D/C gooseneck mics. All audio is processed through BiAmp Tesira DSP.
In the control room’s rack, an AMX Enova DGX 16×16 digital media switcher handles incoming video and audio, scaling and routing to and from the network via Extron
DTP HDMI 230 HDMI Twisted Pair Transmitters and Receivers for distribution and recording. The clever addition of an Extron SME 100 H.264 Streaming Media Encoder enables visitors to the lab to connect a USB hard drive to simply record all of their activity, ready to take away, without having to connect to the facility’s network. An AMX Modero S Series touch panel at the operating position ensures simple control of what is a very complex set-up.
(Anthony Millar – ProAv Solution’s)
Medical simulation recording and editing software is a highly specialised, yet competitive, market space. “We evaluated five different software packages,” continued Manoje. “Studiocode ticked all the boxes. It’s the most flexible package we’ve come across. It allows you to record and stream multiple video and audio signals simultaneously, tag them and set markers to come back and review. It’s made for these environments. For ease of operation, we included joystick controls for the cameras so they’re easy to pan, tilt and zoom, and touch panel control that’s clearly labelled to start and stop record on Studiocode.”
Anthony Millar, Project Manager for Victoria at ProAV Solutions, helmed up the team responsible for installing the project. “ProAV Solutions have installed into many simulation labs,” he observed. “The point of difference at Northern Health was incorporating the Studiocode software with a fully integrated, easy to use, AMX control interface. Instead of a DVR or streaming box, Studiocode really helps review the output, with four independent recording streams per lab. It’s recording three cameras, all the mics including the ‘Voice of God’, and telemetry from the mannequin. Not only that, the system can stream live into the debrief room and both lecture theatres by either DX link, or from the network stream encoder for external audience review.”