Canadian Medical Training Evolves with Simulation Labs Using Extron Fiber Optics

The Canadian province of British Columbia recognized that simulation labs enable doctors to master intricate medical procedures without risk to patients. To keep up with training demand, the gross anatomy simulation lab built on the five city block Vancouver General Hospital campus was incrementally expanded to include seven simulation labs and a variety of support rooms. It has become the internationally recognized Centre of Excellence for Simulation Education and Innovation, or CESEI. A multi-disciplinary academic facility, CESEI uses state-of-the-art electronic communication to provide instruction and research opportunities to medical students, physicians, surgeons, nurses, Canadian Forces medical technicians, and other health care professionals. Subject matter covers the full gamut of medical training, from basic skills such as CPR and giving injections to techniques developed by specialists in the fields of emergency medicine, intensive care treatment, and anesthesiology.

McSquared System Design Group designed the AV system for each expansion of CESEI, which also had to allow remote access from the hospital located two blocks away. FOX Series fiber optic products from Extron were evaluated and selected each time. “Simulation labs are becoming a mainstay of higher learning, and the AV systems really tie it all together," says Marcel Schoenenberger, Principal Consultant at McSquared. "Extron’s fiber optics meet the exacting performance criteria and reliability requirements inherent with advanced medical training and research."

Extron’s fiber optics meet the exacting performance criteria and reliability requirements inherent with advanced medical training and research.

Marcel Schoenenberger, Principal Consultant at McSquared System Design Group

AV Technologies in Simulation Labs

The typical teaching lab includes an instructor tower workstation and up to eight student workstations. The tower is an enclosed rack with medical equipment and AV capabilities that provide high resolution imaging, audio reinforcement, and precise presentation control. Surgical-grade monitors mounted on articulated arms above each workstation provide easy access to lesson materials. A large screen projection system or high resolution 80" flat panel display at the front of the room allows close examination of medical instrument manipulation. To capture instructor and student performances, Panasonic high definition cameras are mounted over the workstations and a set of two to four PTZ cameras are installed in corners of the room. Content can also be sourced from computers and other equipment connected to the fiber optic infrastructure to enhance the learning experience.

Lab AV systems are designed around Extron's FOX Matrix 3200 . Each modular 32x32 matrix switcher is populated with the appropriate number of 8x8 multimode matrix boards for the space. Signals are extended using the FOX DA8 eight output distribution amplifier and a selection of Extron FOXBOX and PowerCage ^® FOX Series fiber optic transmitters, receivers, and scaling receivers. Some of the PowerCage enclosures are mounted in ceiling boxes rather than the rack to enable further extension and conserve space.

“The benefits of using fiber optic products and cabling within a simulation lab are the standard features of the technology,” says Schoenenberger. "Fiber gives us long distance transmission over a small cable that remains in place during refresh cycles, consistent quality of the delivered signal, and isolation or lack of electrical interference with such devices as sensitive medical imaging equipment and simulators."

Lab simulator models include simulacrums, plastic mannequins considered low or medium fidelity simulators and task trainers, and high fidelity or active models. An active simulator can mimic medical conditions and responses, ranging from breathing, crying, and bleeding to convulsing and going into full cardiac arrest. It is operated through a set of encapsulated computer and AV systems. According to Schoenenberger, the most challenging aspect of this type of application is tying together the wide variety of equipment. By integrating the simulator’s computer, camera, recording, and debriefing systems with the lab's FOX Matrix, one operator is able to monitor and coordinate simulator and presentation activities from the control room.

Control Room

Each lab is associated with a control room that features two-way communication for real-time exchanges during room preparation and lessons. System operators and medical personnel in the control room are able to closely observe lab activities from workstations with 20" monitors and on a 2x2 videowall. FOXBOX Rx HDMI receivers deliver signals routed from the lab’s main overhead camera and vital signs monitors to the various displays. Periodically, views are switched among transmissions from the PTZ and student workstation cameras to improve visibility within the control room. When two labs that share a control room are both in use, content for each space is routed to one half of the videowall and headphones with mics are used.

Simulation training labs are linked to the province’s distributed medical training program. This allows any lab's AV system to be controlled from a remote facility’s control room, including the master support desk located in the Diamond Health Care Centre of Vancouver.

Conclusion

Over 2,000 medical personnel make use of the 3,000-square foot CESEI facility annually. Through the use of technology, an equal number are able to participate at local spaces or remotely from another lab, lecture theater, or classroom. The success of CESEI has led to the building of medical simulation training labs in select locations throughout the province.

Simulation labs are at the forefront of incorporating technology into medical instruction, providing training and research for the broadest range of medical conditions and treatments. “As more medical practitioners discover the advantages of using simulation labs, this type of installation is becoming an exponentially growing segment of our industry," says Marcel Schoenenberger of McSquared. "There used to be no AV technology in teaching labs; now it’s hard to imagine a simulation lab without a high performance system such as Extron's FOX Matrix.”

* Please see the full story on British Columbia’s Distributed Medical Training Program in the Summer 2015 edition of the AVSD, the journal of AV systems design and engineering.