Sim&Care, the birth of a project


By Héloïse Guillot  /  March 28th 2019

It all started at the end of 2018, during a meeting between members of InSimo and the Rheumatology team of Professor Gottenberg from Hautepierre Hospital (Strasbourg). A need was then identified: a training solution for medical procedures involving needle insertion, such as lumbar puncture. Indeed, these technical procedures are delicate, and cause stress both for the patient and for the doctor. The less this latter is trained, the more painful and source of complication the procedure can be. However, according to the “see one, do one, teach one” concept, medical students often still learn by practicing directly on patients. But the trend is changing. The French National Authority for Health now advocates “Never the first time on the patient”, and recommends the use of simulation to train students.
The rheumatology team and Professor Gottenberg were therefore keen to get involved in educational initiatives around simulation and InSimo wants to help them develop solution for lumbar puncture training.
The idea of ​​the HEINRICH project (for High-fidelity Educational Interactive Needle Spine Insertion Control using Haptics) was born. This was the opportunity for a direct application for a collaboration then in progress with the Interaction Team of the Institute of Intelligent Systems and Robotics of the University of Pierre and Marie Curie: to develop a first prototype of a lumbar puncture simulator with force feedback. This would be the concrete support for continuing the dialogue with the medical team, in order to deliver a simulator that meets real educational expectations.
lumbar puncture simulator heinrich project
First tests with the Hautepierre rheumatology department team
The first tests showed an obvious need: the simulator must not only recreate the technical gesture in a realistic way, but it must also immerse the student in an environment faithful to reality. Indeed, while learning the gesture is essential, it is not enough to make the educational solution complete. It is also necessary to take into account the prior clinical reasoning, the environment, the relationship between the physician and his patient, to generate the stress felt by both during the intervention. Palpation to choose the point and angle of insertion, as well as the manipulation of the patient during the procedure should also be considered. In addition, it is necessary to consider several types of patients with anatomical variability and pathologies that complicate the procedure.
The idea is gaining ground: to successfully recreate the environment of the lumbar puncture and the interactions between caregiver and patient, while taking educational needs into account. How to best integrate these aspects in a simulator?
Design thinking workshop in preparation for HHC 2019
An answer was given to us during a preparation workshop for the Hacking Health Camp, thanks to the Design Thinking approach: augmented reality. Place the student in an environment that is not realistic, but real, using a maximum of elements from reality: a person willing to represent the patient, therefore real interactions, a real hospital room .. On this will only be superimposed thanks to the simulation the invasive aspects of the procedure.
It is with this vision that we decided to take our project to Hacking Health Camp 2019, in order to bring together new ideas, and to confront them with the community gathered during this event. For the occasion, Heinrich was renamed Sim&Care. Many people took interest and we were joined by Emilie, Laure, Léa, Lokmane, Houria and Elisa. Thanks to this eclectic team, ideas were flowing, and we were able to realize our concept through a prototype.
Our amazing team at HHC 2019
After two days of hard work, the result was presented to the jury. The feedback was very positive, and Sim & Care was rewarded with the “Transgene – BioValley France – Health Factory” prize, which are among the main partners of the hackathon. Sim&Care was recognized to be an innovative, modular solution which meets a real need and which will eventually cover the learning of all delicate daily medical procedures.
First tests on augmented reality
Sim & Care winner of the “Transgene – BioValley France – Health Factory” award
We came back from this weekend boosted, ready to continue the HEINRICH adventure (aka Sim&Care) to provide an innovative solution for learning everyday medical procedures through simulation, both to improve student training and patients well-being!

A big Thank you to all the people we met from the start and who allowed us to move forward on this project!

lumbar puncture simulator
Find out more about Sim&Care, our Lumbar Puncture Simulator
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