Peter Weinstock: Lifelike simulations that make real-life surgery safer
피터 웨인스톡(Peter Weinstock): 실제 수술을 더 안전하게 만드는 실물 모형 시뮬레이션
Dr. Peter Weinstock is an Intensive Care Unit physician and Director of the Pediatric Simulator Program at Boston Children's Hospital/Harvard Medical School. Peter and his team fuse medicine with state of the art special effects, puppeteering and 3D printing technologies to create lifelike simulations of complex surgeries. Full bio
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there was a new technology
여기 새로운 기술이 있고
of doctors and nurses,
and adults, patients of all ages;
환자들의 결과가 개선되고
어떻게 하시겠습니까?
부작용이 없다는 것입니다.
where care is delivered.
상관없이 이용 할 수 있습니다.
at Boston Children's Hospital,
중환자실 의사로서 말씀드릴 수 있습니다.
판도를 바꿀 획기적인 기술입니다.
사전연습인데요.
through medical simulation.
의료 시뮬레이션을 통해 이루어집니다.
the challenge ahead,
going to improve health care
개선할 수 있는 근거뿐만이 아니라
말씀드리겠습니다.
어린 여자아기죠.
우리는 이렇게 부릅니다.
just born into the world.
세상에 막 나온거죠.
that she is deteriorating.
빠르게 알아차릴 수 있었습니다.
her blood pressure is going down,
혈압은 낮아지고 있었죠.
is displayed in this chest X-ray.
찾을 수 있습니다.
a little infant's body.
한 것입니다. 작은 아기의 몸을요.
are supposed to be.
할 부분입니다.
that's where the abdomen is,
are supposed to be.
있어야 하는 곳이죠.
there's sort of that translucent area
of this child's chest.
옮겨가는지를 보실 수 있죠.
in the wrong place.
옳지 않은 장소에 있죠.
for this poor baby to breathe.
어렵게 만들고 있었습니다.
to the operating room,
back into the abdomen,
숨을 쉴 수 있게 해야합니다.
to the operating room,
to the ICU, where I work.
바로 데려가야 하죠.
on heart-lung bypass.
little incision in the neck,
vessels of the neck --
are about the size of a pen,
말씀드릴 수 있습니다.
drawn from the body,
it gets oxygenated,
diaphragmatic hernia --
allowed these intestines to sneak up --
내장기관을 움직이게 만드는데요.
to get the volume --
확보하기가 어렵습니다.
어려움이 있기 때문이죠.
curve at 100 percent.
발생하는 것이 아닙니다.
일반화시킬 수 있을까요?
that I trained for over 20 years,
the apprenticeship model.
견습 모형이라 불립니다.
a surgery maybe once,
기본전제에 근거합니다.
that surgery to the next generation.
다음 세대에 가르치게 되는 거죠.
that we are delivering care to.
우리는 연습을 한다는 겁니다.
있을 거라고 생각합니다.
high-stakes industry
유일한 산업일 것입니다.
approach through medical simulation.
더 나은 접근법을 소개해드리고 싶습니다.
to other high-stakes industries
산업을 방문한 것입니다.
of methodology for decades.
사용해 왔던 산업을요.
on a regular basis
시나리오를 실행합니다.
what they hope will never occur.
대비해 연습을 하는거죠.
the airline industry --
이것은 항공산업인데요
comforted by the idea
조종사와 승무원들이
on simulators much like these,
마쳤다는 생각으로 편하게 탑승하죠.
that we hope will never occur,
가지고 실습을 하는거죠.
우리는 알고 있습니다.
as far as to create fuselages
of the team coming together.
중요하기 때문입니다.
these rare, rare events,
혹시라도 발생하게 된다면
on the drop of a dime.
되어있습니다.
in some ways is the sports industry --
부분은 스포츠 산업인 것 같은데요.
위험 부담이 큰 분야죠.
baseball players practice.
야구 선수들이 연습하는 모습을요.
of progressive training.
생각하는데요.
is go out to spring training.
스프링훈련을 떠나는 것입니다.
but they're on a simulated field,
모의 구장에 있습니다.
경기를 하는거죠.
during the season games,
before they start the game?
가장 먼저 하는 일은 무엇일까요?
and do batting practice for hours,
타격 연습을 합니다.
being thrown at them,
종류의 투구들을 경험하는 거죠.
as they limber their muscles,
근육을 이완시키죠.
phenomenal part of this,
바로 이 점입니다.
any sport event,
볼 수 있습니다.
we're building practice swings like this
말씀드리고 싶습니다.
for the patients that we care about
타격 연습장을 만들고 있는 것입니다.
that we recently built.
who had a progressively enlarging head,
네 살 아이의 사례입니다.
neurologic milestones,
신경학적인 발달이요.
잠시 알아볼게요.
surrounding the brain.
두개골이 보이실 겁니다.
between the brain and cranium,
뇌를 둘러싸고 있는 물질은
cerebrospinal fluid or fluid,
유동체라 불리는 것입니다.
just bathing your brains
and flows through,
생성되어 흐른 뒤
occurs for all of us.
우리 모두에게서 일어나는거죠.
neurologic milestones.
따라가지 못하는 거예요.
a bit of the cranium off,
stick a drain in place,
배수관을 뚫는거에요.
this drain internal to the body.
다른 부분으로 가져오는 거죠.
in neurosurgical care
신경외과 치료의 진보가
minimally invasive approaches
만들어 주었다는 겁니다.
a camera can be inserted,
카메라가 들어가고
우리를 인도하면
that allows all that fluid to drain,
세포막 안에 구멍을 냅니다.
is no longer under pressure,
압력을 받지 않고
through a single-hole incision.
이 아이를 치료하는거죠.
기회를 갖게 될
this scope to the right place.
about this, even our own.
우리도 마찬가지죠.
답을 찾아냈죠.
not made in Hollywood;
헐리우드에서 만든 것이 아니에요.
a scope into the pepper,
작은 관찰용 기구를 꽂습니다.
부르는 일을 합니다.
using a little tweezer.
이 관찰용 기구를 사용합니다.
그들이 하는 방법입니다.
of doing this surgery.
가장 기본적인 요소이죠.
the apprenticeship model,
들어가게됩니다.
as they present themselves,
많은 사례들을 보는거죠.
할 수 있습니다.
reproductions of children
teams to rehearse
사전연습할수있게 도와주는거죠.
Division of the Simulator Program.
시뮬레이터 프로그램 부서죠.
만들어진 팀입니다.
보실 수 있습니다.
from CT scans and MRIs,
기본적인 데이터를 받아
of the child itself,
다시 만듭니다.
that have been casted as needed,
아이의 피부를 스캔한 요소도
and be able to output it
출력 할 수 있게 만듭니다.
three-dimensional printing devices
the child's anatomy will look like.
오차도 없이 똑같은 모형을요.
we performed this surgery.
출력되고 있습니다.
서부해안에 있는 소중한 친구 없이는
in Hollywood, California.
that are incredibly talented
큰 도약이 아닙니다.
that we are doing cinematography.
명확해집니다.
of our dear friends at Fractured FX
소중한 친구들의 사진입니다.
special effects firm.
that these individuals do.
매우 정교한 작업이죠.
and fused our experience,
우리의 경험을 녹여냅니다.
to Boston Children's Hospital,
out to Hollywood, California
these type of simulators.
발전시킬 수 있게 만드는겁니다.
is a reproduction of this child.
이 아이의 모형인데요.
on the child's head is reproduced.
보실 수 있을 겁니다.
that reproduced child --
아이의 모형입니다.
is, on one side, the actual patient,
needs to make its way down,
작은 카메라가 들어가야합니다.
in this membrane
who thinks which side is which,
내지 않겠습니다.
training opportunities,
실습 기회를 만들어 낼 수 있습니다.
as many times as they want,
할 수 있게 된 거죠.
until they feel comfortable.
만족감을 느낄 때까지요.
bring the child into the operating room.
수술실로 데려오는겁니다.
is not just the skill itself,
자체가 아님을 알고 있습니다.
who's going to deliver that care.
팀과 결합시키는거죠.
of a technician putting on a tire
끼우는 모습입니다.
again on this car.
going to be incorporated
the exchange of tires
타이어의 교환을 마치면
의료서비스에서 해 왔습니다.
is a simulated operation.
I just described to you,
시뮬레이터를 가져왔습니다.
at Boston Children's Hospital,
these native teams, operative teams --
You want the head down or head up?
머리를 내릴까요, 올릴까요?
the whole table down a little bit?
수술대 자체를 조금만 내려줄래요?
is behaving like a vessel.
8 to 8 1/2, all right? I'll be right in.
8 1/2사이즈로요. 곧 들어갑니다.
which is critical,
immediately and debrief them.
얘기를 듣는거에요.
프로세스 개선 방법과
and Six Sigma in the military,
and talk about what went right,
어떤 점이 잘 되었는지를 얘기합니다.
말하는 거예요.
and do it again.
in the moments when it matters most.
신중한 타격 연습을 하는거죠.
how we care for this child
설명해드릴게요.
at three o'clock in the morning.
얻어낸 자료를 가지고
out of scans and images,
to the virtual bedside,
on this child in the hours ahead --
수술할 팀입니다.
that I have with families
at Boston Children's Hospital
frequently in our ICU,
여러 번 치료했을 뿐 아니라
to do on your child,
수술을 했어요.
back to the operating room."
준비가 되었습니다."
ABOUT THE SPEAKER
Peter Weinstock - Pediatric ICU doctorDr. Peter Weinstock is an Intensive Care Unit physician and Director of the Pediatric Simulator Program at Boston Children's Hospital/Harvard Medical School. Peter and his team fuse medicine with state of the art special effects, puppeteering and 3D printing technologies to create lifelike simulations of complex surgeries.
Why you should listen
Dr. Peter Weinstock has merged his lifelong interest in human nature, medicine, theater and puppetry to develop one of the most advanced rehearsal spaces in medicine. Weinstock is a practicing pediatric intensive care unit physician at Boston Children's Hospital, where he serves as Senior Associate in Critical Care Medicine, Associate Professor of Anesthesia at Harvard Medical School, Chair of Pediatric Simulation and Director of the Boston Children's Hospital Simulator Program (SIMPeds). Weinstock works with his team of educators, psychologists, engineers, animators, special effects designers and 3D printers to immerse doctors, nurses, patients and their families in Hollywood-style "life-like" experiences -- all to optimize performance, clinical outcomes, as well as the entire healthcare journey for children and their families.
Weinstock received his PhD from Rockefeller University in molecular and cell biology, followed by clinical training in plastic and general surgery at the University of Pittsburgh and general pediatrics and critical care medicine at the Boston Children’s Hospital. His passion is in developing methods that link highly realistic practice and preparedness training directly to the delivery of high quality, safe care to improve the lives of infants, children and their families. Due to its inherent emotionality, Weinstock's approach to simulation is keenly connected to emotionality and behavioral psychology as essential elements of relationships and decision-making to understand and optimize human-human and human-technology interactions. Weinstock has rapidly grown SIMPeds to thousands of simulations per year, and the SIMPeds method has been adopted among pediatric teaching centers around the globe.
Weinstock frequently lectures internationally on state of art simulation and experiential learning, and he has published sentinel articles in innovative application and approaches to simulation -- from human factors to engineering and testing of next generation of ultra-realistic training devices. He has chaired meetings worldwide and is Founding President of the International Pediatric Simulation Society.
Peter Weinstock | Speaker | TED.com