Medical science may have changed over the years, but the skills needed to be a good doctor–listening to patients, making the proper diagnosis, and not panicking in complex situations–have not. The Weill Cornell Medical College in New York was founded nearly 200 years ago to provide the best education possible to students pursuing degrees in medical science. The college boasts affiliations with top-tier teaching hospitals, such as New York-Presbyterian Hospital and the Memorial Sloan-Kettering Cancer Center, in order to give students access to cutting-edge, hands-on experience. Today, the school's mission remains the same, but its teaching tools have gone high-tech.
The college, named after former Citigroup chief executive Sanford "Sandy" Weill, recently completed a $1.7 million renovation of an entire floor, creating what is now a state-of-the-art clinical skills and medical simulation center. The center is outfitted with AV systems in every space, including in twelve examination rooms, a simulation room, case study classroom, and videoconferencing room. Medical students not only apply their classroom knowledge to real patients (played by hired actors), but also simulate procedures on controllable mannequins.
"The goal is to help them become comfortable with patient diagnosis and working in a high tech, paperless environment," says Kevin Filano, systems design engineer with Professional Products Inc. (PPI) in Gaithersburg, Md.
Filano, along with fellow system design engineer Matt Franklin, worked with Cornell and AV consulting firm Shen Milsom & Wilke to create discrete AV systems that are capable of audio/video capture and recording in every room.
"Weill Cornell Medical College has invested in high-end components, a unified control room, and more monitoring and recording capabilities than systems we've previously installed," says Filano, who says that most schools build three to six exam rooms whereas Weill Cornell chose twelve. "We were allowed to design the systems based on their needs, as well as work the AV into the architecture to give students a comfortable environment."
Standard workflow for students includes practicing medical procedures, as well as critical skills like patient interaction, while being monitored and recorded by faculty members. Depending on the assignment, students in exam rooms work with trained, hired actors as live patients whereas students in the simulation room are working on more complex procedures on a specialized mannequin.
Every space is wired for video capture, and students are graded and critiqued by their professors based the video recorded via Panasonic and Sony PTZ cameras, and in-ceiling Beyerdynamic microphones installed in all the exam rooms. Playback is handled, in part, by a distributed audio system that includes TOA ceiling loudspeakers.
Professors can choose to observe students via live streaming to desktops or by recalling previously recorded sessions from the video-on-demand server. According to PPI, video acquisition and distribution leverages MPEG-4 compression and both unicast and multicast streaming over a dedicated IP infrastructure. That's in addition to traditional video, audio, and RGB routing over Extron distribution devices. The clinical skills and medical simulation systems combine specialized software from B-Line Medical with an AMX control system using an XML-based command structure.
Patients access exam rooms through the center's main hallway. In this hallway is a series of observation desks where professors and other faculty can use one of fifteen stations with school-provided Apple computers and/or installed display monitors to observe live feeds from any clinical room. They can also page any of a room's occupants from the observation stations. The audio feeds traverse a Listen Technologies infrared transmitter installed overhead.
"Professors can tune into any of the twelve exam rooms and hear how the students are interacting with the patient," says Franklin. "If they want to comment, they can page the student to the hallway."
The center's unified control room acts as a central hub for the floor. From here, a bank of LCD displays show video feeds from all rooms, as well as diagnostics for the patients. The control room operator can observe all exam rooms and page a student to a specific room for patient assistance.
Two Apple computers, one running the mannequin simulation program and the other monitoring patient information from exam rooms, are flanked by Elo touch panels for the AMX control system. An Extron RGBHV router lets the operator stream live video to the displays or record it on an Envivio Mindshare Lite appliance for later viewing.
The facility's observation desks allow faculty to monitor students, listen in on proceedings, and even page people in the individual rooms.
PPI's design strategy was to have the least amount of people running the most number of rooms. For instance, in the adjoining simulation room, students can practice intricate medical procedures on the mannequin before doing them on live patients. A control room operator running the simulation program can watch the room via the one-way mirror while using a dedicated Elo Touch Systems touch panel and AMX control system to direct the mannequin. Meanwhile the nearby Apple computer also allows the operator to keep an eye on exam room video feeds at the same time.
Inside the simulation room, an NEC plasma flat panel display shows the mannequin's consolidated diagnostic information on one screen. A smaller monitor and Apple computer reside on a side table so the students can update the patient's chart without leaving the room. A PTZ camera and in-ceiling microphone discretely capture the room's activity.
Today, student doctors use Weill's new systems on a daily business. Though the project was done on a tight schedule PPI's team insists the ongoing colaboration among itself, the client, the consultant, and the building design team resulted in a system that never needed a modification and delivered what Cornell was looking for.