Board #325 - Technology Innovation Development of Educational Perfusion Simulation Software for Cardiopulmonary Bypass (Submission #9144)

Abstract

Introduction Simulation-based education is gaining widespread acceptance as a teaching tool in medicine. Its particular advantage is that no harm can come to patients.1 Realistic full-scale simulation is now possible using a sophisticated manikin, software, and a full complement of actual medical equipment. Simulation training is particularly useful for teaching students how to manage rare or infrequent events. In a simulation environment, however, the arena for measuring performance is limited. On one hand, there is full-scale (high-fidelity) patient simulation with “real” physical inputs and “real” environmental interactivity.2 On the other hand, the conditions are created by computer-based simulations and partial-task training devices. Computer-based simulations rely on the participant to transform a two-dimensional screen-based experience into a meaningful representation of a real-life situation. We developed computer-based simulation as a first step to educate students about a technique and its troubles. There are many types of simulation tool; these tools change as the technology develops. Computer-based software applications can be used effectively to teach students. We describe computer software that we created to educate students about extracorporeal circulation. Description We developed software for simulation education of an extracorporeal circulation that is under continuous development in our laboratory. We based the software on the integrated hardware system, Perfusion Education System. The system comprises only the computer that runs the control application. It does not include the hydraulic simulator or an electronic interface unit such as a hardware system. The monitor can display part of a heart-lung machine and the relevant safety devices, vital simulation data, the stage of the operation, and the anesthesia status. Using the software, the perfusionist performs extracorporeal circulation surgery based on the monitor’s information using a cursor according to the surgeon’s scenario. The arterial pump flow is controllable by operating a sliding lever. Balancing the arterial pump flow and the venous flow is required while controlling the total blood volume. For example, if the trainee makes an error by not getting proper insufflation gas to the oxygenator, the PaO2 levels are reduced, as shown in the patient’s blood analysis via user interface monitoring. Thus, the trainee is able to understand the basic operation using this application before undergoing actual machine training. Conclusion Using the monitor, trainees are able to perform the fundamental extracorporeal circulation operation by operating an arterial flow pump and other manipulations. With this software, it is possible to study an operation and become familiar with a fundamental pump-oxygenator system at a desk, without having to work directly with a heart-lung machine. This software can be a useful adjunct during student education. As for real vital parameters, nearly full-scale simulations are possible by using the numerical model already devised. This is not only an educational tool, since in the future, it can be used as a rehearsal perfusion simulation system in which patient data can be input. It enables educators to establish a protocol that determines if the hemodynamics predicted are real. In summary, we developed computer-based software for perfusion simulation in an attempt to provide a comprehensive solution. This software will enable perfusionist educators to teach trainees to address a wide variety of clinical problems. With more applications, novel techniques can be more widely explored and confirmed before use on patients.