3- Collaborative solutions for Coronavirus – Virtual Reality (VR) Training

Combating COVID-19 requires novel ideas…

Discover how, through collaboration with different experts, Virtual Reality (VR) is being used to train clinicians and humanitarian workers to respond to the global pandemic.

The story started six years ago when in 2014, Ebola devastated western Africa. Very few international organisations had significant experience in responding to the outbreak and even fewer had a comprehensive training pathway. Médecins Sans Frontières (MSF) were an exception, offering an Ebola specific training course in Brussels where learning took place in a real life replica of an Ebola treatment centre. Clinicians and humanitarian workers from all over the world flew to Brussels to receive the training. UK-Med’s Health Director Lina Echeverri – who at the time was the Clinical Lead for Save the Children’s Ebola response – had previously worked for MSF and had completed the Ebola training. She came up with an idea to develop a similar training which would be accessible to more humanitarian health workers using the help and expertise of CRIMEDIM.

CRIMEDIM are a world leading research centre in emergency and disaster medicine based in Italy. The organisation has been a designated World Health Organization (WHO) Collaborating Centre for Training and Research in Emergency and Disaster Medicine since August 2016.

As a faculty member at CRIMEDIM, Lina contacted Luca Ragazzoni – the current Scientific Coordinator of the research centre – to discuss the potential of creating a training program preparing humanitarian workers for the Ebola response using VR. Luca is a Medical Doctor specialised in Anaesthesiology with a PhD in disaster medicine and is an expert in developing training curricula for medical staff. Using donated specialist VR software, he worked with Lina to develop the very first VR training to respond to outbreaks in the world. This was an innovative solution to train more individuals without the need for a physical treatment centre or international travel.

Based on an innovative hybrid simulation model, the training combined Virtual Reality Simulation task-trainers and actual equipment and protocols such as donning and doffing of PPE. Participants were then walked through a Virtual Reality version of an Ebola Treatment Centre (ETC) enabling them to familiarise themselves with the high-risk environment and to practice complex protocols which would be in place in an actual ETC setting. The trainees carried out competency-based tasks and put their operational skill sets to use using real equipment and performing procedures on mannequins. Tasks included peripheral venous cannulation, isolated blood drawing, cleaning and bathing the patient, the removal of bodily remains, the safe disposal of dead bodies, PPE donning and doffing, and patient and staff flow from low to high risk areas.

The first training took place in London eventually making it to the field in Sierra Leone. In 2015, the entire national staff and Save The Children Team who were responding to the outbreak in Sierra Leone were trained by Luca using the programme – this accounted for over 1,000 individuals.

Health care worker in full PPE during an Ebola pre-deployment training simulation.
The view of a trainee walking through the virtualized Ebola Treatment Centre (ETC)
An aerial view of the virtual reality version of the ETC.

Luca talks through the latest VR design for a COVID-19 Community treatment centre

In March this year, PhD candidate and faculty member of CRIMEDIM Lina once again decided to employ the innovative and practical nature of VR to train individuals to respond to the COVID-19 pandemic. This time the design used was that of a community COVID-19 treatment center which was designed by UK-Med member Veronica Sanchez. A Water, Sanitation and Hygiene (WASH) Architect by profession, Veronica is an expert in the design and construction of emergency facilities for infectious diseases. Using her expertise, Veronica designed a safe, effective and fully modular community treatment centre for COVID19, ranging from 6-500 beds. The design can be stand-alone or embedded in an existing structure or building. Her incredible design was approved by the WHO in March this year and is currently being used and implemented in a number of countries including Spain with Spanish Red Cross, Mauritania with AECID and Rwanda. It has also been shared with different organizations such as Africa Centres for Disease Control and Prevention (Africa CDC), International Organization for Migration (IOM) and MSF.

The collaboration didn’t stop there. Lina led the assessment in Greece early this year, spotting a particular gap in screening and triage areas for COVID-19 patients. She drew upon Veronica’s expertise again and together they designed a screening and triage area for COVID-19 suspects and patients. Based on the technology used during the Ebola response, CRIMEDIM has effectively combined Virtual Reality Simulation with Veronica’s WHO verified community treatment centre design. This collaboration is enabling staff to familiarise themselves with the high risk environment, become familiar with the internal settings of the COVID-19 treatment centres and practice complex protocols which will be in place.

This innovative combination is gaining pace and recognition. It is currently being shared with the WHO and the intentions are for it to be shared with the entire global Emergency Medical Team (EMT) community as a tool. The screening and triage area layout has been shared in Burkina Faso, Ghana and Zambia, informing the in-country training of health professionals UK-Med is facilitating. It has also been shared by Veronica and the Polytechnic University of Madrid to students and academics.

By combining Veronica’s expertise in WASH and architecture, Luca’s expertise in VR and training medical staff, and finally Lina’s extensive medical and humanitarian experience, the training was born. The success of the training offers us a glimpse into what the future of humanitarian training could look like in increasingly virtual world. It also shows what humanitarian organisations can achieve by working with research centres. Most importantly, it shows us what is possible when we draw upon each other’s skills and collaborate.

Want to learn more?

Luca recently delivered a 20 minute presentation for UK-Med’s Just in Time training discussing how VR is being used to train humanitarian workers and clinicians responding to COVID-19 using Veronica’s design. To watch his presentation and learn more, click the button below.