How a free medical telesimulation platform is saving children’s lives | Penn Today
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The mortality rate for sepsis among children in Kumasi, Ghana, is much higher than in higher-resource settings, and researchers from
Children’s Hospital of Philadelphia
(CHOP), the
University of Pennsylvania
, and Ghana
identified lack of training as a key barrier
to administering critical medical services in time.
To train Ghanian providers on how to recognize and manage septic shock, they turned to
Annenberg Hotkeys
, a free, openly accessible interactive distance learning platform developed by Kyle Cassidy, co-founder of the
Annenberg Extended Reality Lab
at the
Annenberg School for Communication
, and pediatrician
Elizabeth Sanseau.
Research led by
Vanessa Denny
of the
Perelman School of Medicine
found that after 45 pediatric emergency department providers at Komfo Anokye Teaching Hospital (KATH) completed a tele-simulation using Annenberg Hotkeys, the sepsis mortality rate in children dropped from about 36% to 10%—the difference between 25 deaths and seven. They also saw that clinicians were more likely to provide supplemental oxygen and place IVs. Their findings were
published in
Pediatric Critical Care Medicine
“This simple tool makes such a difference in the lives of children,” says Denny, also an attending physician in the
Division of Pediatric Critical Care Medicine
at CHOP. “We were able to develop a tool that was easy to use, was found to be feasible by the users, was low-cost, and improved mortality in critically ill children.”
View large image
CHOP physician Madiha Raees and colleagues are in the process of analyzing data from a study in Botswana that utilized Annenberg Hotkeys to help medical providers retain information from an in-person training simulation on pediatric resuscitation. For the study, they filmed videos using mannikins in CHOP's simulation lab.
(Image: Courtesy of Shannon Wolf/CHOP)
Annenberg Hotkeys allows users to users to offer
multiple paths and outcomes for trainees
, where each video represents a different choice. Pre-made modules are
available for free online
, but users can also shoot their own video based on their specific learning objectives.
While the original pediatric medical modules from Cassidy and Sanseau feature manikins, researchers on this study filmed Ghanian children—with parental consent—in septic shock at KATH. “It is crucial that training programs aimed at improving outcomes reflect the population and setting the health care providers serve,” the authors write.
In the simulation, medical providers can set up an IV fluid bolus (a rapid infusion over a short time), intubate the patient, and administer antibiotics—decisions that dictate whether the child in the simulation gets better or dies.
Study participants described the experience as engaging, skill-enhancing, and relevant. Denny says while the study ended in September 2024, KATH providers integrated Annenberg Hotkeys into their medical education for newer residents and nurses. “With global health work, we always aim to create solutions that are feasible and sustainable in the community,” Denny says.
One platform, many options
Cassidy and Sanseau
developed Annenberg Hotkeys in the spring of 2020
to train medical students in COVID diagnosis and treatment, as traditional in-person instruction was unavailable.
The program can be used on a phone and does not require continuous internet connectivity, making it valuable in settings with limited digital infrastructure. An open-access paper published in
Cureus Journal of Medical Sciences
last year provides guidance on how to shoot video clips, edit, and assemble a module.
Denny says that she wants to expand simulations beyond sepsis to include other common critical-care illnesses in children. She is also working on a project using Annenberg Hotkeys that fellow CHOP physician
Madiha Raees
is leading in Botswana. Denny and Raees have also been approached by hospitals in Nigeria, Tanzania, Pakistan, and Latin America.
Cassidy notes that although the pre-made modules involve medical cases, Annenberg Hotkeys can be adapted for any sort of education related to decision making, adding that the accessibility of Annenberg Hotkeys means he doesn't know who all is using it. “It’s up to other people to figure out what they can do with it,” he says.
Vanessa C. Denny is an attending physician in the Division of Critical Care Medicine at Children’s Hospital of Philadelphia and an assistant professor of anesthesiology, critical care, and pediatrics at the Perelman School of Medicine.
Kyle Cassidy is a technologist at the Annenberg School for Communication and co-founder of the Annenberg Extended Reality Lab.
The other co-authors are Vinay M. Nadkarni, Elizabeth Sanseau, Heather A. Wolfe, Charlotte Z. Woods-Hill, and Bingqing Zhang of CHOP; Justicia Amisah, John Adabie Appiah, Gustav Nettey, and Larko Owusu of Komfo Anokye Teaching Hospital; Princess R. Acheampong of Kwame Nkrumah University of Science and Technology; and Ebor Jacob G. James of Christian Medical College.
This study was funded by the University of Pennsylvania, CHOP, and the National Institutes of Health.
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