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A University of Florida (UF) faculty researcher whose innovative human-patient simulation training technology was once the fourth-leading source of royalty income for the University of Florida is again contributing to the advancement of new technologies that may revolutionize the health care simulation industry.

Samsun Lampotang, Ph.D., is the Joachim S. Gravenstein Professor of Anesthesiology at UF, where he also serves as director for the Center for Safety, Simulation & Advanced Learning Technologies (CSSALT), director for simulation innovation in the Office of Educational Affairs/Office of Medical Education, and director for the Clinical and Translational Science Institute Simulation Core.

In 1987, he was part of a team responsible for creating the first prototype of a Human Patient Simulator – a lifelike mannequin created to display vital signs and react to medical procedures – that today is used around the world for medical training. Lampotang has since shifted focus to increasing the accessibility of simulation, which he describes as “a risk-free, experiential training method.”

Like learning how to drive, he explained, medical training often requires both the student and instructor to be present. This can prove challenging, especially when instructors are medical professionals with busy schedules and patient care responsibilities that compete with time for teaching. Created in the CSSALT lab with funding from the Department of Defense, Lampotang’s latest innovation makes it possible for medical students, residents and deployed military medical personnel to learn a complicated central venous access (CVA) procedure without the guidance of an instructor. CVA is a life-saving skill as part of trauma or combat casualty care.

The CVA simulator includes a 3-D, mixed reality human torso model that is connected to a laptop. The simulator is turnkey, meaning that a person unfamiliar with it can unpack, set up and use it in seven minutes. As students perform the CVA procedure on the mannequin, the software platform records and reports on performance and provides feedback, including 3-D visualization of the procedure. Rather than measuring success based on the number of hours spent training, training continues until competency in the skill has been demonstrated on the simulator. In other words, training is competency-based instead of time-based, acknowledging that users learn at different speeds.

Lampotang and his UF colleagues recently conducted a study in which half of a group of residents were taught by human instructors and the other half learned using the self-study, self-debriefing feature on the CVA simulator. Results proved the instructorless CVA simulator was non-inferior to a human instructor. The simulator also trained residents to competency faster, allowing 200 to be trained in just three months.

“Residents don’t have to wait for an instructor to become available in order to practice and acquire basic skills,” said Lampotang. “During self-study of CVA, they’ll be receiving training that is non-inferior to being taught by an average human instructor.”

Even in 2014, when the simulator was still a prototype, its portability and ease of use made it possible to loan it to the U.S. Navy Medical Center in San Diego, California, after an impromptu meeting with a Navy anesthesiologist. After another unplanned encounter at the Military Health System Research Symposium in Orlando in 2018, Lampotang arranged for an Army captain and physician to take a CVA simulator with him during his deployment to Iraq. The simulator survived a five-month deployment and was rejuvenated as needed on location. Military personnel have since requested the simulator for a second tour of duty.

The ability to train more medical professionals to competency in a shorter amount of time could result in a major return on investment for funds spent on simulator training, especially considering that simulation training has already been proven by other researchers to result in a return of investment of up to 7:1, explained Lampotang. In the meantime, he is excited to continue refining the CVA simulator technology and applying this model to training devices for other procedures.

Now, Lampotang wants to prove the device’s efficacy in improving patient outcomes, a small step in the right direction in the health care field where medical errors are the third-leading cause of death and account for over $4 billion in malpractice lawsuits.

“There is still much to be done in the young field of health care simulation,” he said. “The future is definitely bright.”

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