Title: A Mixed Reality Simulator for Learning to Manage Variability

Funding Source:

NIH, National Library of Medicine R21,

Duration: 2011-2013


PI: John Quarles, Ph.D. – UTSA

Co-PIs: Samsun Lampotang, Ph.D., Benjamin Lok, Ph.D. – University of Florida

Senior Personnel: Nikolaus Gravenstien, M.D. – University of Florida

Simulation Engineer: David Lizdas   University of Florida

Research Assistant: Jason Jendrusch – UTSA



Inter-patient variability is a major contributing factor to adverse outcomes in many areas of medical practice and especially in conscious sedation procedures. For example, two patients of similar height, weight, and age may react very differently to the same sedative, resulting in over sedation or under sedation. In many of these cases, patients who are assessed to be at minimal risk are actually at high risk. Then, problems, such as unexpected respiratory depression, cause an adverse outcome, such as neurologic damage or death. Current training programs mainly train students through lectures and real world experience, which logistically cannot bring students to competency in an acceptable amount of time. To address this problem, this proposal aims to develop an immersive mixed reality (MR) based training simulator for educating students about variability in conscious sedation procedures.

Approach: Specifically, the proposed simulation will augment a mannequin patient simulator with a simulation model of variability, an immersive virtual reality patient, and conceptual visualizations of the patient’s internal processes. This mixed reality patient will not only offer a wider variety of hands-on experience through the incorporation of patient dialog but it will additionally simulate a variety of external characteristics, such as race, weight, height, and age, and offer conceptual visualizations of highly variable internal characteristics, such as drug sensitivity. Based on these reconfigurable characteristics, the proposed MR-based simulator will give students hands-on experience with a wide variety of simulated patients in a short amount of time. Ultimately, the simulator aims to afford students a deeper understanding of to manage variability.

Specific Aims: 1) Develop a patient variability model for use in interactive simulation of conscious sedation, 2) Enable variability management training with mixed reality patients and debriefing, 3) Establish face validity and investigate the educational effects of simulated variability. The goal of the proposed simulator is to provide a variety of hands-on experiences and feedback that will accelerate learning, enhance decision making skills, and enable students to more effectively manage variability in conscious sedation.


Figure 1: Left: A student interviews the virtual patient  Right: Transparent Reality visualization of propofol in the body