Competency in the Airway- Breathing –
Circulation – Disability - Exposure (ABCDE)
approach is required for working in the emergency department.
The ABCDE
approach is used for performing an initial systematic assessment of any
critically unwell or deteriorating patient, and intervening as necessary. This
method involves ordered examination, investigation and intervention, focusing
on each major body system in turn. Any problems are addressed as they are
identified with the patient being regularly re-assessed.
The aim of the ABCDE approach is to improve the clinical outlook of the unwell
patient, with or without a definitive diagnosis.
Using gaming and simulation technology and a
high-fidelity model of human physiology (abcdeSIM),
Erasmus University Medical Center, Technical University of Twente, IJsfontein, a bureau for interactive
media, and the Dutch national primary care residency program have improved training
in emergency medicine in a cost-efficient manner.
The abcdeSIM Serious
Game provides an online simulated emergency department, where residents can
apply and exercise their emergency care skills with virtual patients. Its
design was based on analyzing the task demands of the ABCDE approach for stabilizing acutely ill patients.
Departing from the background presumption that doctors
have less and less time to educate students, the game teaches players to apply
the ABCDE method without a doctor
having to be present. In a realistic and immersive emergency department
environment, doctors and nurses are challenged to care for the sickest
patients. Players learn to accurately assess the medical condition of each
patient, recognize life threatening illnesses and injuries, and resuscitate and
stabilize in ordered priority.
The following versions of abcdeSIM are currently available:
·
abcdeSIM for emergency physicians
·
abcdeSIM for emergency department nursing
·
abcdeSIM for pre-hospital primary care
·
abcdeSIM for severe burn victims
·
abcdeSIM for pediatrics
Gameplay
In the game, players have 15 minutes to stabilize a virtual
patient. They don’t know what the problem is, just like in real life. To find
out what kind of complications there are and which patients need their
attention first, players have to follow the ABCDE approach properly.
Realistic simulation
The game offers a realistic simulation of the human
circulatory system to mimic complications as possible. Players can make use of
all the tools and professionals that are also present in a real emergency.
According to the developers, the underlying technique is
extremely special. It is not a simulation where the options clicked on by
doctors are connected to “right” or “wrong” codes. In order to properly simulate the interaction
between all the processes, a true-to-life cardiovascular, respiratory and
medication model was built into the game.
For example, the model of the circulatory system simulates
the pumping of the heart, and calculates, on the basis of the amount of blood, what
the blood pressure is. Based on the user-selected drug dosage, the influence of the
virtually administered medication on the welfare of the patient can also be
determined to an exact level.
Scalability
The basis of the abcdeSIM
is a faithful simulation of the human body and a universal method to apply
first aid. This ensures that the game can be easily customized for other
specialties and other countries.
abcdeSIM includes a high-fidelity
physiological model that contains more than 200 parameters for circulation,
respiration and consciousness. This model creates a realistic and immersive
experience in which the players can see the direct results of their chosen
diagnostics and treatment.
After completing a scenario, players get feedback
on what went well and what not. They have to match score thresholds before proceeding
to the next scenario.
Value Proposition: “Train lifelike patient scenarios without
putting patients at unnecessary risk. Just like flight simulators have
increased airline safety, abcdeSIM
aims to increase patient safety.”
abcdeSIM is the first Serious Game
in the Netherlands to be recognized as a full training tool. It has been
accredited by the Royal Dutch Medical Society, the Dutch College of General
Practitioners and various specialized professional associations for medical
consultants, such as the Netherlands Association of Internal Medicine.