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George Brown trains its nurses to heal the sick and to innovate

By Jerry Zeidenberg

TORONTO – At the new George Brown College campus, which specializes in health sciences, a new generation of nurses and personal support workers are being educated with the help of myriad high-tech tools. They include computerized manikins that can have heart attacks, bleed and even have babies.

“The point is to give high-fidelity simulation to nursing students before entering the hospital environment,” said Robert Luke, PhD, Vice President of Research and Innovation at George Brown College. The beautifully designed, two-year-old building – constructed to maximize the amount of natural light – is situated at the foot of the city, just beside Lake Ontario.

The high-tech manikins are operated in control booths next door to four simulation suites, by technicians who control their vital signs. Faculty are involved in building the sophisticated scenarios for the manikins and technology. Students can then be faced with a multitude of problems they might encounter in a hospital – such as patients whose blood pressure suddenly drops, who stop breathing, or go into shock.

When the students react, the manikins will also respond – for better or worse, depending on whether the measures taken are appropriate.

Teachers and colleagues can watch the action through one-way glass panels; students can then come back into the meeting rooms for a debriefing. Cameras and microphones in the mock-clinical suites have captured what happened, and can be replayed for the benefit of the nurses-in-training.

The school also runs a mock-operating room, where nurses are trained to react to the scenarios they will encounter in the OR. There, too, cameras record the play-by-play, for the benefit of analysis and discussion afterwards.

In addition to the computerized simulation suites with high-fidelity manikins, George Brown College has a 60-bed simulated hospital – with a lower-tech form of manikins filling the beds. “It’s a practice lab for nursing students,” said Dr. Luke. “But in the event of an emergency, like SARS, under certain conditions it could function as a hospital. The area does not have oxygen, but could use tanks, so the condition of the patient would need to be considered.”

He noted that during the 2003 SARS crisis in Toronto, several of the city’s hospitals were locked-down. If this situation were to happen again, the beds at George Brown could be used to treat patients.

Not only do nursing students learn the practice and procedures of traditional nursing at the school, but they use and experiment with a variety of advanced technologies. The school does charting on its own electronic health record, and has deployed many new systems.

Indeed, it actively encourages innovative companies to test their new technologies in the simulated hospital wards, where nursing students can evaluate them and help with their improvement.

“We integrate research projects right into the curriculum,” said Dr. Luke. “The projects aren’t just given to one or two students. Instead, all students are involved.”

Currently, George Brown is fostering dozens of research projects. One of the most exciting collaborations is with Toronto-based Infonaut, a specialist in infection control systems.

By using a variety of sensors in the hospital rooms, researchers are able to determine how close nurses are getting to patients and how often this occurs; knowing who visited patients can help when trying to sort out the possible transmission of diseases.

A new, wireless technology from Infonaut is also monitoring the soap and hand-wash pumps, tracking whether nurses are cleaning their hands as often as they should.

In addition to fine-tuning the setup of the technology in the George Brown College hospital rooms, the school recently helped run a trial in the transplant unit at the University Health Network. “We retrofitted many hand-wash units,” commented Dr. Luke.

Research and innovation is something that Dr. Luke is passionate about – for the sake of better education, improving healthcare and spurring the economy.

“Canada is really good at producing innovations, but we’re near the bottom of the OECD nations in turning innovations into products,” said Dr. Luke. He asserted that’s got to change.

He and the team at George Brown are doing their utmost to instill a new mentality. “Every hospital employee should be aware of innovation, and the need to make things better,” said Dawn Davidson, Director of Research. “They should be actively trying to improve productivity while on the job.”

That’s why a big part of the mission is to educate nurses in the art and science of innovation while they’re in school. “They’re going to be ambassadors for change in the hospitals,” said Davidson.

Of course, the idea isn’t to duplicate the basic research that’s being done across town at the University of Toronto – one of the world’s leaders in fundamental health research. “We focus on the practical side, on applied research,” said Dr. Luke.

The George Brown College site near Casa Loma, further north in the city, houses a facility that can prototype both hardware and software products. “The faculty in the Advanced Prototyping Lab like to say they can make anything there,” quipped Dr. Luke.

Meanwhile, the lakefront site contains many workspaces for startups and growing companies to come in, meet with students, and hash-out new products and plans for expansion. “We can help them go from idea to delivering an invoice to customers,” said Dr. Luke, noting the school has expertise in all stages of commercialization.

The school also trains personal support workers, an increasingly important cadre of healthcare specialists who help take care of the elderly and infirm, often in their own homes. To this end, George Brown operates a Health eHome lab.

It simulates the typical household, with living room, bedroom and kitchen. Here, George Brown College is also involved in innovation. It is working with a private-sector company called Good Robot to develop ‘smart home’ technologies that can improve the health of patients and their families.

“They’re using passive surveillance to monitor people,” said Davidson. “For example, if the fridge doesn’t open in the morning, or the medicine cabinet isn’t opened when it should, a family member can be alerted,” she said. The alerts can go to a smartphone or a computer. “You can then call your mom or loved one to see if everything is OK,” she added.

If it isn’t, you can call for help – which could make the difference between health and a hospital visit.

Davidson mentioned that George Brown recently did a trial with 20 patients, and is in the process of partnering with retirement homes so that administrators can keep closer tabs on their frailer residents.

The spirit of innovation is built into so many aspects of the George Brown structure on the lakeshore. There are open spaces in the school that double as meeting places and spur-of-the-moment teaching spots, with white boards on the walls and tiers of benches that are reminiscent of Greek amphitheatres.

The classrooms themselves have no fixed seats. Desks are on wheels, and can be moved into a variety of configurations for learning in groups. Most of the classrooms have video cameras mounted on the ceilings – many of the classes can be live-streamed and stored for replay later.

That’s because remote learning is very popular. “Nurses working in hospitals can’t get here during the day, but many want to upgrade their skills,” said Dr. Luke. “They can do it remotely, or they can watch a lecture at night when they’re at home.

“We’re all for disrupting the traditional classroom and creating new forms of learning.”

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