Felix Marquez on AI VR pediatric EMS training

The challenges faced by EMS recruiting, retaining, financing and training are magnified in agencies nationwide, pushing some to breaking point.

Training for low-volume, high-risk emergencies can be difficult to prioritize, especially in rural agencies, as it can be time-consuming, costly, and labor-intensive.

Under a new program sponsored by the Florida EMS Section, experienced EMS trainers from the Orlando Medical Institute (OMI) are teaming up with Health Scholars to provide training to up to 300 first responders through Oculus VR headsets that are equipped with AI-assisted, voice-focused clinical training for pediatric emergencies.

“Thanks to this partnership, EMS nurses will have better access to advanced training in pediatric medical emergencies, including practicing critical cognitive skills needed to manage these emergencies in the field,” said Janna Patterson, MD, FAAP, senior vice president of global child health. and life support for the American Academy of Pediatrics. “The Florida program is a good testing ground for determining whether a blended learning program with VR can make real-life training more accessible and scalable for EMS personnel across the country.”

Participants will complete an evidence-based blended simulation learning curriculum to practice the role of team leader and care for acutely ill pediatric patients in multiple settings in accordance with the ILCOR evidence-based review and American Heart Association guidelines.

I recently reached out to experienced EMS educator and OMI President Felix Marquez, BS, NRP, to discuss the program.

EMS1: How are rural EMS providers particularly challenged to train for rare events?

Marquez: Each rural area has its own specific challenges. For example, North Florida is not as developed as some of the other areas I have trained in due to the lack of resources available to them. Although there is a local community hospital, it is not staffed by physician assistants. One doctor oversees all medical cases. So if someone had significant trauma it would not be treated at the local facility. The patient should be transferred to a major medical center. Depending on where you are in North Florida, that means an hour or two for transportation. With these transfers you often have to deal with seriously ill patients and there is little information about the correct and safe transport.

Another challenge is the lack of funding. This means that there are only three ambulances. When all three ambulances are on call, it becomes very important to have the right training to stabilize patients in the field waiting for transport. I run into similar situations in the Florida Keys and in Tallahassee.

The final challenge has to do with the proximity of EMS personnel to these rural areas. Often the staff are from Miami and have to commute for several hours (4 to 6 hours). This means that planning a workout can be a real challenge.

What are the goals of this program?

Our main goal is to stop skill loss and regain the skills needed to save lives when EMS personnel are in the thick of a stressful situation. We had a student who used the training within days of taking the VR training. He was able to confidently assess what was wrong with a pediatric patient and it saved the child’s life. The goal is not only to understand the information, but also to preserve the information for days, weeks, months later and provide that quality care to the citizens and the people who deserve it. Pediatric calls are low volume and high risk. It is crucial to remember the training in the field so that the child does not pay the ultimate price with his life. Failure of training often means psychological trauma, such as PTSD for the EMT/paramedic. This is all preventable with competent and efficient training.

How did the program start?

There is a gap in high-risk scenario training, especially for rural EMS professionals. Several of us in the community saw a way forward and knew that with support from state funding, we could provide an efficient and effective training program to bridge the gap and properly support EMS personnel and their communities.

I got involved through a friend who had always had a passion for the countryside. In the beginning I helped her with her initiatives as a favor and once I started teaching I got really hooked. Enabling critical education through the use of technology has become a passion. When I pass, the mark I want to leave will change the way education is delivered to rural areas so that there is the same access as urban areas.

How does AI-enabled technology help to fill gaps in national education?

Virtual reality (VR) with AI-assisted speech technology through Health Scholars has enhanced the ability for my nationwide EMS to learn anywhere, anytime. The biggest lesson learned during the pandemic is that learning doesn’t have to stop just because we’re not in the same room. Connecting via Zoom, with online resources or by using VR means that education is accessible where the internet is accessible. There are no limits. I can send you an Oculus Quest headset loaded with a Health Scholars training application that can deliver critical clinical practices and, in near real time, view performance reports on my phone and see how students fared. As an instructor, I can then use the performance analyzes to see whether the staff is meeting the objectives and competences.

I believe in the power of technology so much that my school’s slogan, Orlando Medical Institute, is “Where education meets technology.”

How does VR training work?

It really couldn’t be simpler. We use Health Scholars VR software with an Oculus Quest headset and all we need to make it work is Wi-Fi. All updates are automatic. There are two controllers, you put the headset on, turn it on and you’re good to go. While we can never fully duplicate the stressful field environment, VR has allowed us to create some of the stress so EMS providers can better handle it right away. EMS personnel can be virtually placed in a stressful situation, trained and retrained on how to deal with it, then take off the headset and breathe.

How can this technology be operationalized in the EMS setting?

To answer this question, we must first talk about the most important person: the EMS provider. Basic wrap up on how to deal with a pediatric patient is something a normal EMT or paramedic would already know, but the question is, when was the last time they did the pediatric assessment or had a pediatric call to sharpen their skills to keep? We assume they are proficient because they are certified, which is where a lot of training fails.

When dealing with a virtual environment, these scenarios can be created to notify EMS personnel and deliver the refresher courses on demand. Whereas before, with personal mannikin based training, the cost can be prohibitive. The cost-effectiveness means we can deliver the training when it’s needed rather than just once a year. We know skill decay, so when we practice efficiently on-demand, teams have the skills and confidence they need in the field so we can deliver the best patient care possible.

How can national EMS organizations in other states look for a similar program?

There are many national forums where we all talk about what’s cutting edge. The real key is that other states must be willing to pioneer or integrate something new.

What’s next for OMI?

Then we apply for a new scholarship to understand the best methods and tactics for EMS education. We’ve learned that VR is an important part of successful training, but we want to dig deeper and refine a blended learning model. Hopefully, with current success, this means we can train 48 more Florida locations nationwide with quality education for adult and pediatric appeals.

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