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Tuesday November 22, 2011 Edition
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Hardly Science Fiction Anymore: Spending Time at the Simulation Lab with Dennis Maloney

Dennis Maloney examining the ear of one of the training mannequins in the Task Trainer Room at the Clinical Simulation Lab.
photo provided
Dennis Maloney examining the ear of one of the training mannequins in the Task Trainer Room at the Clinical Simulation Lab.
Dennis Maloney listening to the heart beat of one of the four mannequins in the Operating Room at the Clinical Simulation Lab.
photo provided
Dennis Maloney listening to the heart beat of one of the four mannequins in the Operating Room at the Clinical Simulation Lab.
Dennis Maloney displaying some of the equipment used for surgical training in the Virtual Reality Room at the Clinical Simulation Lab.
photo provided
Dennis Maloney displaying some of the equipment used for surgical training in the Virtual Reality Room at the Clinical Simulation Lab.

Tuesday November 22, 2011

    The American movie audience experienced a life-altering meeting with the computer and robotic age in the summer of 1968. Cast as one of two main characters in the film 2001, A Space Odyssey, the A-235 Unit computer Hal transports the audience into the world of the future where computers decide the fate of humanity and the best and worst of human traits are implanted in the metal casings of the robots. In one scene, Hal turns to his human counterpart and remarks, “I am putting myself to the fullest possible use, which is all I think that any conscious entity can ever hope to do. Let me put it this way, Mr. Amor. The 9000 series is the most reliable computer ever made. No 9000 computer has ever made a mistake or distorted information. We are all, by any practical definition of the words, foolproof and incapable of error.” For most Americans our knowledge of robotics, simulations and virtual reality is mostly limited to the realm of video gaming and astonishingly enough, in recent months the dairy farm. What we know is based on what we see, and our window into the current technological uses for robotics and simulations is limited.

    Enter into the mix Dennis Maloney from Bristol, Vermont, a former high school guidance counselor, teacher and assistant principal with 29 years in education. He left the field of education to become a businessman and mediation specialist. The likelihood of his life involving the latest in robotic technology seems far from what he expected. After leaving education in 2004, Maloney owned his own mediation company and worked in conjunction with the Vermont Family Court, Small Claims Court and the Family Courts of Vermont to settle disputes and reach agreements. While daughter Cristine was attending UVM’s College of Medicine and his second daughter, Lisa, worked in the field of medicine, Dennis was not a part of the medical technology field until a chance meeting changed the direction of his life. Through his daughter Cristine he heard about the Clinical Simulation Laboratory at UVM that was pairing the newest in technology with the goal of increasing patient safety, recovery and surgical success while decreasing the chance of error through simulating reality with state-of-the-art mannequins, training stations, virtual reality and robotics. For Maloney and the other members of the Simulation Lab team, science fiction is not in a film but a reality that is in use every day.

    Located in the Rowell Building on the UVM Campus, the Clinical Simulation Laboratory in conjunction with the University of Vermont College of Medicine and College of Nursing and Health Sciences, Fletcher Allen Health Care, and the Vermont Air National Guard, is a learning lab where doctors, nurses, residents, interns, emergency room staff and Air Guard medical staff come to learn, practice and simulate real life experiences in the field of medicine. It opened in March of this year under Director of Clinical Simulation Michael Ricci, M.D. and Director of Operations Cate Nicholas, M.S., P.A., Ed. D.

    Each day brings together different professionals to use different protocols, programs and equipment at the lab. “One part of our work involves the use of mannequin simulators,” shared Maloney. “These are specialized mannequins and range in price from $40,000-$60,000 a piece. The mannequins can sweat, their eyes can dilate, they can demonstrate various pulses, and they can produce breath sounds and are used in countless different simulations. One mannequin is for pediatric use. One female mannequin delivers a baby and the list goes on.”  

    Maloney went on to explain that not only can the technicians speak through the mannequins giving them a voice and having them interact with the health professionals in the simulation, but he and other staff members take part in the simulations playing the role of a parent, spouse, younger sibling or other family member. One recent program, he explained, involved trying to attain zero infection rates when placing central lines in patients. The Simulation Lab provided training in this procedure. “It is fascinating to see the doctors, nurses, anesthesiologists work together to reach their goals,” shared Maloney. In the last few months, Fletcher Allen Health Care has reported a zero percent infection rate for the placement of central lines which demonstrates the power of the simulation process.

     Another section of the Clinical Simulation Lab is called the task training room where body-part models, such as shoulder joints and knee joints, allow all levels of medical staff to explore and practice procedures on body-part models that act and react like the real thing. In this lab, there is an array of models of heads, eyes, ears, limbs and body trunks for further study. The body-part models can be used for learning how to draw blood, treat wounds, and practice joint injections and management of airways. Programs are created based on the training needs of the medical students or medical professionals.

     Another area consists of six hospital rooms with all of the supplies and machines found in regular hospital rooms. The mannequins are quaintly named Hal, Mercedes and Bentley, among other names. One example of how these rooms are used is for nurses requiring recertification in cardiac issues. The nurses speak with the mannequin patient and a technician responds through the mannequin.  The nurses take a medical history, check vitals, and handle a host of simulated responses including losing a pulse, loss of consciousness and lethargy.

    Another example has Maloney playing the part of an anxious father who brings his lethargic son into the emergency room. Agitated and highly nervous, he dominates the interview process and keeps questioning the staff about what is wrong with his son. Another trainer controls the pulse, breathing and body responses of the mannequin. At key times, Maloney increases the emotional intensity or decreases it and simulates a situation he might have experienced while serving on the Bristol Rescue Squad. The attending physician, who is in the corner of the room, watches the responses of the medical personnel and uses the simulation as a teaching situation.

    The virtual reality/robotics lab is the newest part of the Clinical Simulation Laboratory and appears at first glance to be something out of science fiction.  Physicians practice surgical procedures using simulation machines that give feedback to the operator. Some specific machines simulate surgery on knees and shoulders. Medical students studying surgical procedures use laparoscopic arms to develop eye-hand coordination and can explore the procedure in 3-D. “The purpose of all of these tasks,” shared Maloney, “is to improve medical skills so that less invasive procedures are done and errors are avoided. This results in patients recovering sooner with fewer side effects.”  

    With each work day being a new adventure, Maloney continues to explore daily the growing link between technology, robotics and medicine. He is proud to be a part of the team of professionals in the Clinical Simulation Lab who are taking the concept of real world teaching to the next level and providing a place, structure and unending possibilities for the professionals of the UVM College of Medicine and College of Nursing and Health Sciences, Fletcher Allen Health Care and the Vermont Air National Guard to come together to blend medical knowledge with cutting edge technology learning how to improve health and patient care at all levels of intervention. Maloney’s story is an example of Vermont ingenuity and the passion for people working together to advance medical care.   


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