Virtual patient care is creating exciting learning opportunities for interventional cardiologists. Atman P. Shah considers how training through gaming can deliver a state-of-the-art profession.
Recently, I was between patients, with a few minutes to spare. I opened an app on my phone designed for practising cardiology cases and began to interact with a case that required the use of a virtual aspiration catheter and atherectomy drill to debulk stenosis. It was a tough case; as the virtual patient’s health status decreased, the accompanying music became progressively more intense and urgent. Unfortunately, I only scored two out of a possible three, and lacked enough time for another attempt. I closed the app and return to the reality of my next patient in the clinic.
That might seem like science fiction, but it is not. The convergence of video games and medicine is creating new learning opportunities for physicians, with apps that help doctors to practice difficult procedures via their mobile devices, and even to earn continuing medical education (CME) credits while doing so.
Though direct patient care will remain the backbone of medical education, novel educational pathways, including video game technology, provide experiential learning in a risk-free environment. This tool can be used on an as-required basis. Medical video games also give physicians a platform to learn about new therapies, practice emerging techniques, and try out the latest medical devices.
There is a large gap between where healthcare education is now and where it is going, and gaming in cardiology is leading the way. Apps and games on mobile phones are readily available, and medical gaming apps allow physicians to play realistic and challenging cases at a time and place of their choosing. It is much cheaper and easier to access than a simulator, which could be many miles distant and often provides a below-par experience.
Everyone can play
Physicians generally excel at hand–eye coordination, and medical video games will be intuitive even for those who are not into gaming. Cardiologists are accustomed to looking at screens while holding a device in a particular way for a particular reaction—a situation very similar to gaming. In the cardiology game Cardio Ex, the high-intensity patient scenarios lend themselves to the real-life work of a cath lab. And, as in video games, there is a beginning, a middle, and an end to each procedure or level. Apps such as Cardio Ex are created by advanced video game designers with compelling and realistic content, akin to those of medical illustrators, whose intricate images we rely on in textbooks.
Practice makes perfect
There are multiple benefits to physicians embracing games in healthcare, particularly in the current era where burnout due to high volume workload, long hours, medical school loans, and the bureaucratic burdens of keeping an electronic healthcare record (EHR) is prevalent. Anything that keeps clinicians engaged and refreshed is a bonus, and spending time on a challenging case in a risk-free environment can provide a welcome break from the stress of live clinical work.
In my experiences with residents and fellows, I have noticed that trainees are sometimes less willing to ask questions or take risks for fear of losing the respect of their peers. Medical video games allow physicians to practice difficult cases multiple times, facilitating experimentation with the impact of different actions upon outcomes. This learning-by-doing—a stimulating change from the “see one, do one, teach one” model—aids recalibration, mindfulness, and renewed focus. It also increases the awareness of techniques and complications prior to working on an actual patient. Practising and perfecting a technique through full immersion in challenging and collaborative cases, trying out different methods, and learning from mistakes without harming patients, increases personal satisfaction and confidence during live procedures.
CME is an added bonus
When medical apps are CME eligible, doctors are even more motivated to find the time to fit them into busy schedules. In my work for the medical video game company Level Ex, I review hundreds of cases and write objectives and learning benefits for cases that are challenging enough to gain CME credit. The cases must be guideline-based and have no industry or other bias, as the CME committee is stringent about what is acceptable. Through exposure to these cases, cardiologists can enjoy enhanced training opportunities directly from their phones.
Advanced technology and gaming offers great potential for cardiology. Currently, Cardio Ex features coronary artery disease, but content and graphics for peripheral and structural heart disease would further expand training opportunities. Video game technology is poised to fundamentally change how we teach physicians, and can influence the future development of interactive board certification testing. Creating medical training opportunities that are more accessible and relevant to the modern world is just what the doctor ordered.
Atman P. Shah MD, FSCAI is an interventional cardiologist and associate professor of medicine at the University of Chicago, Chicago, USA, and is a physician advisor at Level Ex.