VR tech helps train staff on Code Whites

HAMILTON, Ont. – St. Joseph’s Healthcare Hamilton has become the first hospital in Canada to adopt virtual reality technology to help staff prepare for and respond to real or perceived threats from individuals. It can be challenging for healthcare workers to navigate situations in which individuals may present threatening, violent or aggressive behaviour – known in hospitals as a Code White.

The Department of Education and Learning and The Forensic Psychiatry Department at St. Joe’s has embarked on a new pilot project to help improve the response to Code White situations by using virtual reality to simulate real-life scenarios – including experiences that provide insight into the patient’s perspective.

Dr. Azim Gangji (pictured), vice president of Education, and Leslie Steinberg, director of Education and Learning at St. Joe’s, emphasize that the new training module serves as a vital resource, enabling staff and learners to navigate complex and challenging scenarios in a secure setting, offering a more effective alternative to real-life simulations.

Dr. Gary Chaimowitz, head of the forensic service and academic lead at St. Joe’s, said the new training module offers an innovative way to help staff gain vital experience in a controlled environment.

“It’s a safe and ethical way of teaching people how to prepare for a very dramatic situation,” said Dr. Chaimowitz. “The hands-on training can be very stressful and people can get quite frightened.”

Diana Marginean, knowledge translation specialist with the forensic psychiatry program at St. Joe’s, said the VR simulations allow participants to learn at their own pace and stop and ask questions when needed.

Dr. Chaimowitz and Marginean collaborated with SimWave, a technology company in Ottawa, to create various immersive VR White Code training scenarios tailored to general psychiatry and forensic psychiatry, as well as general medicine scenarios.

“It’s an up-and-coming technology that is rapidly evolving,” says Marginean. “We are at the cutting edge of this wave.”

During training, staff will put on VR headsets and use controllers to feel physically present in a scenario and interact with simulated patients and colleagues, providing realistic and immersive experiences.

An example of one of several Code White scenarios that the team developed includes an exact replica of an inpatient unit at West 5th. It’s a semi-gamified experience that features a narrator who guides users, explaining the challenges of night shifts with reduced staff and the importance of managing safety when caring for patients who may have a history of aggressive or violent behaviour.

It also includes verbal de-escalation techniques, allowing staff participants to learn from interactions between colleagues and patients, helping them with their training for real-life health situations.

Dr. Chaimowitz says that some of the VR scenarios are designed to help staff understand situations from the viewpoint of patients. For example, some patients may be moved to seclusion rooms for when they are feeling agitated.

In one of the VR training scenarios, staff will experience what it’s like to be a patient in a seclusion room, understanding what it’s like for a patient in confinement. Another VR scenario example includes a patient asking staff for help but receiving varying responses.

“It’s not just skill based in terms of technical skills, but also some of the softer skills in terms of better appreciating what it’s like on the other side as a patient and how to talk to people and what their experiences are like,” says Dr. Chaimowitz.

Dr. Azim Gangji, VP, education, Department of Education and Learning are implementing a virtual reality simulation centre in the Centre for Education and Innovation at the West 5th Campus, where staff, physicians and learners will be able to try out a variety of psychiatric VR code scenarios, including Code White. It will be equipped with a large TV and VR headsets ready for use.

Dr. Gangji said, “This will be a significant step forward in educating our healthcare learners and future staff. By integrating virtual simulations into education and healthcare, we bridge the gap between theoretical knowledge and real-world application, fostering deeper understanding and development of competence.”

According to Ms. Steinberg, the Department of Education and Learning plans to expand virtual simulation scenarios to encompass acute care situations and interprofessional collaboration environments. She highlights that “virtual simulation fosters critical thinking, decision-making, adaptability, collaboration, and communication in dynamic scenarios that closely reflect real-world challenges.”

The team is aiming to officially roll out the VR staff training this year.

Source: Ontario Hospital Association