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The Virtual Clean Room

The clean room is the heart of any clinical pharmacy. It is a large, completely sterile environment made up of several interconnected rooms where pharmacists prepare medication and other materials that have to be guaranteed 100% contamination free. Every hospital possesses one, and staff who enter it have to know exactly what they are doing, or they risk contaminating their own work, and that of everyone around them.

Because of this, when it comes to training new pharmacists, clean rooms available for this purpose, are extremely thin on the ground. In essence, all real work in the room has to be halted, whilst the students are let in. Often, the room needs to be re-sterilized afterwards, which can shut it down for half a day.

Purdue University, in Indiana, US, decided enough was enough. They could not build their own clean room, not and be able to keep it to the same standards of cleanliness- it would sit idle and collect dust when students were not using it, so they realised they needed a clean room that would always stay clean, and which would be there when students required it. They created a virtual replica clean room.


A Tour of the Clean Room

Created in the Rosen Centre for Advanced Computing, the virtual clean room is displayed on a C-4 CAVE. That is to say, two walls, floor and ceiling of the environment, consist of back-projected display screens, which connect almost seamlessly to one another, with a single mainframe behind the wall, syncing the displays up to one another perfectly. The fifth and sixth screens were removed in this case, to allow a lecture hall / tutorial space to be constructed adjacent, so that students in large numbers can sit and look into the virtual clean room, or exercises related to it can be set up in the non-virtual space.

Another advantage of course, of using a CAVE-like set-up, is it gives graphic design students a chance to practice. Constructing the virtual clean room was a long process, which began with trips to clean rooms all over the US, and several hundred photographs of them inside equipment, inside fridges, photographs of shelving, of layout, of dimensions. From these photographs, an average clean room's dimensions and layout was constructed as a 3D space. To populate this space, many hundreds of 3D models were created, individually modelling pillboxes, syringes, storage drawers, gel packs, everything that was needed.

Rather than outsourcing the work, Purdue again looked to its trainee army. Graphic design students were employed, as part of their coursework, to create the 3D models and to create the textures that would be used to skin them, with the final result being objects to place in the clean room for pharmacy students to practice with.

At the same time as photos were taken, the sounds of a clean room in action were taken. Different recordings made from different stations in different clean rooms, could now be integrated both as general overlapping background noise in the virtual replica, and as a given station is approached, that sound rises to the fore. It is all intended to make the replica as accurate as possible for a student using it.

After all, the whole idea is to replicate the experience of being in an actual clean room so that when a student steps into a real one for the first time, they already know all the procedures, and how to operate within the environment: they integrate with the existing staff rather than making expensive mistakes.

Group Work

The virtual clean room is, as mentioned previously, a C4. This means two walls of the standard CAVE set-up are missing, and teaching facilities abut it. These facilities can handle up to 20 students at once, all looking straight into the virtual clean room in front of them. To facilitate immersion in these cases, the clean room is designed with anaglyph stereoscopy in mind - it can easily and quickly be shifted to render with red-green colour stereoscopy. With every student and their lecturers donning anaglyph glasses, the 3D models displayed on the walls, leap into seeming physical being.


A group of students using stereoscopy in one corner of the clean room

To maximize the training potential, as you will note in the photograph above, each student is made to don the standard clean room apparel before being allowed into the clean room. A sterile head cover, surgical mask, gown and booties are all required before entering a clean room, especially with increased concern about pathogens. The virtual room, designed to as closely as possible mimic the procedures of an actual one; demands nothing less.

This time is thus used for students to familiarise one another with dressing and undressing for a sterile working environment.

Navigation in the 3D environment is accomplished in one of two ways. For groups, a Wanda 3D pointer is used; one person holds it, and directs everyone about the room, by waving it about - exactly the same technology as a Wii-mote, just been around longer. For individual students, a head tracker is used, such that their head becomes the 3D pointer, and where they look, the simulation moves to.

When group sessions are set up, typically instructors set up tables nearby, which contain 'smart' pill bottles or dumb terminals, all linked back into the simulation. Students might be expected to mix chemical compounds to create necessary medication or assemble surgical equipment. Everything they pick up has a sensor and accelerometer inside it: if they pick up and mix the wrong chemicals, or grab the wrong item, the computer will know.

Likewise, dumb terminals allow individual interaction with the simulation when there are too many students to use the main interface all together. Monitor and mouse combinations allow the students to move round and interact with the clean room. Everything they click on is monitored and scored.


A single student in the Clean Room, navigating via Head Tracking

Mistakes

The 3D environment is not static, and items can be picked up and moved, handled, or shifted around. It would not be a very good training simulator if this was not possible, of course. As a side effect of this, the initial state is saved, and loaded as necessary. Work in progress can also be saved as a clean room state, as can exercises. One very useful and frequently used exercise is a clean room with a few odd elements in it. When a file is loaded, it may have a coke can in the medicine fridge, or some folded cardboard behind shelves, open syringes just laying on the side, or any number of other possible sources of contamination.

Part of the reason the main interface is so detailed, is that it is trying to train students to notice these kinds of details, realize that they are wrong, and deal with them appropriately. In a working clean room, that could be the difference between a sterile implant and a patient with severe infection. This is the kind of practice it is trying to instill.

The virtual clean room, is in use with students now. It first entered use at the beginning of 2009, and all of Purdue's pharmacy students will pass through here as part of their training.

References

Purdue creates first virtual clean room for training pharmacists

Purdue Utilizes Virtual Clean Room For Training

Patient safety focus of immersive virtual environment for training pharmacists

Photos of the virtual clean room

Virtual Cleanroom Videos

Staff Comments

 


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