Telenoid: the next generation in simulation

As a clinician fascinated by the use of new technologies to achieve outcomes, it’s hard to go past anything that is looking at bridging the divide between human emotions / touch and technology. Telenoid is one such project. It’s aim is to provide an effective way to transfer people’s presence.

The research on telepresence is booming and it’s fairly widely accepted that videoconferencing is superior to teleconferencing and that platforms like virtual worlds provide even better telepresence sometimes. Telenoid is a step further again, providing a tangible means of interacting with someone remotely. In the second video below you’ll see its creator citing a key inspiration was the ability for remotely located grandparents to interact more with their grandchildren. That alone is laudable but for me the clinical simulation potentials stood out pretty strongly.

Real patients as simulation

Imagine the ability to have a ‘patient’ reflecting the emotions and speech of a real person in combination with the current simulation functionality i.e. feedback, monitoring of biometric data etc. Taken a step further: a real patient experiencing a real health issue is able (with consent of course) to have their experience transferred to a simulation exercise in real time. There are already consumer devices on the market able to control avatars via thought processes, this is only a small step beyond that.

A specific example:

a. Marjorie is a patient with bowel cancer who is scheduled to have chemotherapy.

b. She consents to her next outpatient chemotherapy session being used for simulation purposes with third-year nursing students at a local university.

c. On arrival at the clinic for her chemotherapy, Marjorie agrees to wear a discreet headset that both captures her emotions as well as her voice as she goes through the process.

d. At the university the students are in a laboratory environment set up for chemotherapy and the simulation mannikin is reflecting Marjorie’s experience as students use the same clinical pathway as the clinic to simulate providing the chemotherapy. The voice recorder allows the students to hear what the nurse is actually doing for Marjorie, providing the opportunity to contrast practice and to ‘see’ what impact that practice is having on Marjorie.

It sounds a little clunky and requires tight integration betwen education and practice, but the potential is there. Using dementia as an another example (although this is where consent can be fraught with difficulties): imagine the power of a mannikin that spoke and reflected the emotions and movements of an individual with severe dementia. The learning potential is enormous and would have the subsequent benefit of much more confident and confident new practitioners.


The first video shows a conversation with Telenoid:

This one shows Telenoid up closer and note how easily people interact with it:

ars electronica: telenoid from Fabian Mohr on Vimeo.

Thanks to Meg over at Future of Sex for the heads-up. Yes, the potential for this technology in regards to sex is likely to be the driver for its further enhancement and adoption. Who’d of thought?

Cancer survival: Second Life Machinima

There’s not a lot to add to the great description provided by the creators:

“Between Worlds: A Journey of Hope” is a machinima produced by Panacea Luminos of NY HealthScape (USA) filmed and edited by Aliceinthenet (UK) and written by Skylar Smythe (Canada).  The inspirational piece is a story of cancer survival and accessing health information, supports and friendship in the virtual world of Second Life.   We invite you to visit: to view the film and encourage your feedback and comments.

There’s four parts, which you can see below:

Vanderbilt nurses: a case study

Tech website TMCnet has a very useful overview of Vanderbilt University’s use of Second Life with their nursing students. For the seasoned observer there’s nothing particularly new but if you’re only starting to familiarise yourself with the area, it’s an excellent read.

The article is useful in another way: it reinforces where health professionals are broadly up to in this area”

1. Acknowledgement of the potential

2. Utilisation of consumer tools like Second Life, supported by significant funding

3. Demonstrable positive experiences, within a broad simulation environment

There remains real challenges to delivering clinical simulation for more intricate or non-pyschosocial aspects of care delivery. The ability to do fine procedural work remains limited outside of expensive proprietary systems, but rapid progress is being made. The pace of the progress continues to grow and it’s a fairly safe prediction that more immersive and complex simulations will be avilable to undergraduate students in under five years.

Virtual International Day of the Midwife 2011

A collaboration between Griffith University (Australia), Otago Polytechnic (New Zealand) and the University of Canberra (Australia), the Virtual International Day of the Midwife is in its third year (2009 and 2010 proceedings links).

For more information or to express interest in presenting, check out the VIDM Wiki.

The call for expressions of interest is as follows:

*Call for Expressions of Interest*
The organising committee are now calling for Expressions of Interest (EOI)
to present at the VIDM eVent. While the EOI must be in English we welcome
presentations in other languages. We also welcome EOI from non-midwives and
midwifery students. Presenters need not be experienced in using electronic
media – members of the organising committee will be able to give support.
Please provide a short paragraph (no more than 150 words) describing your
presentation and the form it will take (for example a PowerPoint
presentation, live or email discussion, video, photographic slide show,
story-telling session). Please also include your status (eg midwife,
non-midwife, midwifery student), country of origin and language of
presentation. Your presentations or resources should;

– Have a clear aim or purpose
– Focus on maternity care or midwifery
– Be of interest to an international audience
– Be appropriate to the chosen media

If you would like to give a live presentation, please indicate what time and
time zone you are available in your EOI.

*Support for speakers*
Please note: We will be using the web-conferencing platform Elluminate. All
live sessions will be facilitated by an experienced online facilitator so
you will be supported at every stage.

*When and where to submit your EOI*
Please submit your EOI by 11th March 2011 by;

– Email to Sarah Stewart:
– Or add it to the VIDM wiki

– Or add to the VIDM Facebook page

Texture breakthrough: clinical simulation implications

A story over at New Scientist caught my eye today. It describes a new approach to developing textured 3D objects that provides much greater realism for relatively less work, particularly for amateur content creators:

The potential of this in clinical simulation is fairly obvious. Whether it be surgery or anatomical exploration, expect to see some of those expected evolutionary improvements in quality just a little bit sooner. Developments like this also illustrate the importance of graphical accuracy in simulation – the more easy it becomes to manipulate objects in a realistic way, the better the outcomes garnered.

World of Warcraft and Microsoft Kinect: the progress continues

Here’s a great video showing the use of the Kinect to play World of Warcraft using a software framework called FAAST. After the initial demo there’s some useful discussion by the University of Southern California’s Institute for Creative Technologies on its potential applications.

Those applications are something discussed here regularly: rehabilitation and physical activity. Imagine the impact of the technology shown in the video for someone who plays a dozen or more hours of an MMO each week? Let alone someone with a chronic disease or multiple lifestyle risk factors.

Anyway, have a look for yourself:

For my interest in clinical simulation, these developments are of particular interest. Truly effective simulation is likely when health practitioners are physically able to replicate tasks. With my crystal ball in hand, I can’t see that being any more than five years away.

AIDS Quilt Launch: support and expression

I’ve gone on ad nauseam about the benefits of virtual environments in regard to communal support around health issues. In the physical world, one of the most powerful support campaigns of the past 25 years is the AIDS quilt. Thanks to a joint initiative between Startled Cat and Jokaydia, that sucess story has moved into the virtual worlds of Second Life and Jokaydia’s OpenSim grid.

The premise is simple but powerful: ask those who have lost loved-ones to HIV/AIDS to commemorate those lost in a 3D version of a quilt. Like most of these things, you need to see it for yourself to get the power of it, but once you do it becomes obvious. I had a wander around the handful of quilt rooms already created and was impressed to saythe least – the overall build in Second Life is stupendous and easy to get around / navigate.

The launch of the 3D AIDS quilt occurred today and the call is now out for people to contribute.

For more information, go to either the website or check it out for yourself in Second Life.

Methamphetamines, cravings and relapse: in Second Life

UCLA have undertaken a fascinating study within Second Life, using it as an immersive environment to replicate scenarios around methamphetamine use and the triggers those scenarios provide in relation to cravings and potential for relapse.

Read the full details here, plus there’s a short introduction video here. The preliminary outcomes of the study showed that the simulation is proving more effective for cue exposure than traditional methods such as videos and use of drug paraphernalia such as needles, syringes and preparation implements. There’s planned future research on looking at what treatments work best to reduce cravings, using the simulation as the benchmark measurement.

Aside from the obvious benefits this approach is going to bring for improved treatment interventions, some other key points need to be made:

Simulation is more than hospitals: There tends to be a focus on the use of virtual worlds to simulate hospital and paramedical environments. Those aspects are very important, but being able to replicate community environments where problematic behaviours occur, is an equally rich vein to mine as a health professional.

Virtual can be better than real: One of the preliminary outcomes mentioned was that the simulation demonstrated better cue exposure than just interacting with drug paraphernalia. This seems a little counterintuitive, but with illicit drug use in particular, the environment surrounding the use is a pivotal component, so replicating such an environment, if done authentically, is going to beat a counselling room with syringes and spoons every time. There is an enormous number of health issues where the same applies, meaning that not only can costs of interventions be lowered in some circumstances, but efficacy can also be improved.