As the aftermath of the Ebola scare sets out across the United States, the conversation is transitioning from existential alarm to more constructive questions about America’s vulnerability to infectious diseases. It is now clear that the Dallas hospital at the epicenter of the initial crisis lacked the training needed to deal with even a single Ebola case, let alone a full-blown outbreak. Indeed, subsequent cases demonstrate that the U.S. medical system — among the most sophisticated in the world — could not contain the disease. With little or no direct experience with Ebola prior to the recent crisis, most hospitals have only general infection control policies and procedures. An overwhelmed emergency room staff cannot be expected to learn on the job, especially not in a state of panic. We need a new way to prepare our medical professionals.
The CDC is scaling up crash course training for nurses, doctors and caregivers in every corner of the country; training that should have been an ongoing process in anticipation of such an epidemic. Combating and mitigating these crises must be a proactive measure, rather than a reactive one. It is important to note that the kinds of errors made in Dallas —- from improperly worn protective gear to faulty disposal of waste—could only have been mitigated through training that comes through heavy repetition and practice —- a substantial investment for statistically small risk and cost.
One emerging strategy is to utilize high-tech simulation games to develop the muscle memory needed to handle infectious disease outbreaks, such as how to take off protective gear in a way that doesn’t expose the medical staff to Ebola, as it appears to have happened in Dallas. These technologies, which immerse users in contextual, realistic situations that require critical thinking, allow users to make choices, test their knowledge, skills and judgment, experience consequences, and modify their behavior until they get it right. Such simulation games are now being used by doctors and nurses to improve patient satisfaction, by the military to combat PTSD and suicide and by a variety of organizations to address addiction to legal and illegal drugs.
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This technology is beginning to be adapted to fight infectious disease. The approach is grounded in how adults learn and apply information and develop the “correct” automatic response to high stress situations. It immerses users in interactive movies that portray the complexity of real life and recognizes that people make decisions based on both knowledge and emotion. The solution enables individuals to practice critical skills in a safe environment that mirrors their own workplace. Because the physical setting, characters and challenges are realistic and resemble their own, the training is engaging and “sticky.” People see themselves, their coworkers and their world and experience the consequences of their choices in the safety of cyberspace. Combining the universal appeal of story, the magic of film and the power of gaming, the methodology delivers a memorable tool to which people can reach back when they face critical decisions in real life. If experience is the best teacher, these high fidelity simulations are clearly the next best—and no one gets hurt or sick.
We expect much of our medical professionals. Their ability to diagnose, mitigate, treat, and prevent the spread of potentially hundreds of infectious diseases have life or death consequences for themselves and the entire nation. The lessons of the recent outbreak demonstrate not only the enormous courage and compassion of these professionals, but the urgent need to give them the practical training they need to do their jobs at the front lines of our national health security.
