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Overview

Development and Testing of a Space-Adapted Human Patient Simulator

Principal Investigator:
Harold K. Doerr, M.D.

Organization:
Baylor College of Medicine

Astronauts have practiced launches, landings and dockings using computer simulators since the beginning of the space program. They also practice doing experiments, releasing a satellite or adding a part to the International Space Station – all before a mission gets started. In that vein, astronauts, crew medical officers and biomedical engineers will enhance their flight medical training by practicing health emergencies on a state-of-the-art human patient simulator, which is programmed to experience various medical emergencies. Dr. Harold Doerr is leading a team from the NSBRI, NASA Johnson Space Center and Wyle Laboratories to simulate physiological adaptation to the space environment, create scenarios that could occur in space, develop the corresponding diagnostic and treatment computer algorithms and help develop the training materials for astronauts and ground crew.

NASA Taskbook Entry

Technical Summary

During its history, NASA has understood the educational benefits of using simulation as demonstrated by its integration of simulation into multiple aviation disciplines to prepare astronauts for spaceflight. The NASA Space Life Sciences Directorate (SLSD) at the Johnson Space Center (JSC) has observed these benefits along with recognizing the recent success of medical patient simulation in teaching terrestrial medicine. As a result, the SLSD developed an infrastructure to use high-fidelity medical patient simulation as a teaching tool for astronaut crew medical officers (CMO) and flight surgeons (FS). To integrate medical patient simulation into medical training programs, the SLSD tasked the NSBRI with constructing a team that has the expertise and experience to develop medical patient simulation-based curricula.

NSBRI assembled diverse clinical and scientific personnel from both inside and outside the space medicine community to create the Medical Operation Support Team (MOST). Since its inception, the team has used its unique skill sets to develop eight medical patient simulation-based products for these cohorts per the direction of NASA Medical Operations Branch (MOB), the Astronaut Office, and the NASA Human Research Program (HRP). Overall, the MOST has used its expertise with their strong space medicine collaborations and JSC's medical patient simulator infrastructure to develop robust space medicine training products.

Goals for 2007-2008

  1. Adapt Human Patient Simulator (HPS) physiologic scripting and modeling to spaceflight training.
  2. Develop an integrated, multimedia medical curriculum and web development to integrate with the HPS training sessions.
  3. Develop, evaluate and validate space medical procedures.
  4. Maintain and expand the multidisciplinary team in conjunction with JSC's needs and requests.

Key Findings Linked to Goals

  1. a) The MOST developed an experimental integrated medical simulation program for the FSs and astronaut CMO of the STS-118 mission. This came at the direct request of physician-astronaut, Dr. Dave Williams, FS for STS-118. The session was the first simulation exercise of its kind and is being reviewed by the MOB for possible integration into the Space Medicine Training flow. The impact of this training has been positive as demonstrated by the CMOs and FSs from STS-125 requesting similar training.

    b) The MOST developed an emergency medicine scenario for an Emergency Medical Drills session that was conducted during the 12th and 13th expeditions of the NASA Extreme Environment Mission Operations (NEEMO) project. This work was tasked by the NASA-JSC Medical Operations Manager and was reviewed/approved by the JSC HRP. The impact of this training has been positive as demonstrated by the positive feedback from NEEMO crew members and the NEEMO coordination team requesting to conduct similar training for future NEEMO missions, in particular, NEEMO 14.

    c) The team expanded the Clinical Core Competency Training for the JSC FSs by adding and teaching an Airway Management lesson (Airway Management #1). In addition, the team drafted a follow-up Airway Management lesson (Airway Management #2) with the objectives of using simulation-based instruction to teach the FS cohort how to use the airway management techniques from the previous lesson in real-time clinical scenarios relating to both terrestrial and spaceflight environments. These two lessons result in a total of three Core Competency Training Sessions developed by the MOST for the JSC Flight Surgeons. The impact of these sessions has been positive as the JSC Medical Operations Manager and the JSC Space Medicine Training Lead have indicated that they would like the MOST to continue developing and teaching more sessions.

    d) The MOST continued to provide Post-Soyuz Landing Clinical Training (Medical simulation training specific for post-International Space Station Soyuz landings in Kazakhstan given to two teams prior to landings) and Individual Clinical Refresher Training (Individual clinical training using medical patient simulation that is designed to strengthen a specific clinical skill set) on a per-request basis from the FSs. The impact of these training sessions has been positive as demonstrated by the positive feedback from MOB participants.

     

  2. The framework of the MOST website prepares the student for their session by having the student take a brief pre-session test. This test identifies the students weaknesses, thus allowing the session to be oriented to help strengthen the students weaknesses. The data collected from pre- and post-session tests allows the MOST to measure the effectiveness of their instruction. The website infrastructure was finalized and was ready to be populated with learning modules; however, the decrease in funding halted next steps. The impact was minimal.

     

  3. The MOST has received positive feedback from NASA regarding the teams evaluations of procedures and equipment throughout the project, the decrease in project.

 

Earth Applications

The operational and environmental constraints imposed by spaceflight demand novel approaches to mitigating medical issues. The Medical Operation Support Team's continued use of medical patient simulation to develop space-relevant clinical training products for NASA's Flight Surgeon cohort will provide a significant advance in telemedicine capability within Mission Control for both low-Earth orbit and lunar class missions.

Terrestrial benefits from this project are also anticipated including the adaptation of the training for providing medical care in remote environments with limited medical resources such as the wilderness, underwater habitats, high-altitude base camps and polar expedition locales.

This project's funding ended in 2008