At the Universities of Florida and Porto, and in close collaboration with CAE Healthcare, Willem van Meurs, PhD in control engineering, Toulouse, France (1991), designed simulators for medical student education, anesthesia, intensive care, emergency medicine, pediatrics, and labor and delivery. These and similar devices all but eliminated training of basic interventions and common critical incidents on live animals and real patients. Pedagogical conditions can be optimized without concern for patient safety. Total sales of the simulators developed by the teams Dr. van Meurs led or participated in now exceed 1 billion dollars. These simulators rely on mathematical models of cardiorespiratory physiology and pharmacology. He has a special interest in fetal and neonatal physiology. He is a past president of SESAM and the author of Modeling and Simulation in Biomedical Engineering, McGraw-Hill (2011), and of The Dolls' Engineer, a personal journey through three decades of medical simulation, SimEdita (2023). Recent work includes development of Explanatory Models in Acute Care in collaboration with the Radboud University.
Link to the book!
https://www.shop.simzine.news/en/home/2-the-dolls-engineer.html
Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
At the Universities of Florida and Porto, and in close collaboration with CAE Healthcare, Willem van Meurs, PhD in control engineering, Toulouse, France (1991), designed simulators for medical student education, anesthesia, intensive care, emergency medicine, pediatrics, and labor and delivery. These and similar devices all but eliminated training of basic interventions and common critical incidents on live animals and real patients. Pedagogical conditions can be optimized without concern for patient safety. Total sales of the simulators developed by the teams Dr. van Meurs led or participated in now exceed 1 billion dollars. These simulators rely on mathematical models of cardiorespiratory physiology and pharmacology. He has a special interest in fetal and neonatal physiology. He is a past president of SESAM and the author of Modeling and Simulation in Biomedical Engineering, McGraw-Hill (2011), and of The Dolls' Engineer, a personal journey through three decades of medical simulation, SimEdita (2023). Recent work includes development of Explanatory Models in Acute Care in collaboration with the Radboud University.
Link to the book!
https://www.shop.simzine.news/en/home/2-the-dolls-engineer.html
Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sims Solutions or our sponsors. This podcast is sponsored by Echo Healthcare. Echo Healthcare is a leading provider of hyper realistic medical simulation solutions, immersive virtual learning environments and educational content, with a focus on improving patient safety and lives. Echo Healthcare is now offering 7 Sigma Intubation and Airway Management task trainers under their robust product portfolio. Contact Echo Healthcare today for any of your simulation training needs. Thanks to Echo Healthcare for sponsoring this week's podcast. Contact Echo Healthcare to find out more about their new 7 Sigma Intubation and Airway Management Task Trainers. Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host, Deb Tauber, and co-host Jerrod Jeffries as they sit down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.
Deb Tauber:Welcome to another episode of The Sim Cafe. Thank you for joining us and, Je hello, how's everything for you today?
Jerrod Jeffries:We got another guest over from Europe so I'm excited to hear about his journey, but I'll let you give a proud introduction of who we have Deb.
Deb Tauber:Thank you so much. And today we have Willem Van Meurs, and he came from the University of Florida in Porto and in close collaboration with CAE Healthcare, so we're very excited to have the opportunity to speak with him and learn about his journey. So with that, earlier you said we may call you Willem, so thank you. Why don't you share your journey, the path that led you into the world of medical simulation?
Willem Van Meurs:Okay, well, thank you so much for having me and I think you're doing an excellent job on sharing, creating accessible information for a broad and growing community of simulationists. So my start in this realm and I call it modeling and simulation is really early 1986, which is just after the French Revolution, I believe. So I was doing a research project for the Eindhoven University of Technology and my electrical engineering studies there and I looked at what's called the respiratory sinus arrhythmia and after that I did a PhD in control engineering in Toulouse in France, working on a heart-lung machine, and that enabled me to say yes to a request from the University of Florida when they were looking for somebody who could model the cardiovascular and respiratory systems of the alpha and anesthesia simulator they had they were designing. So in 1992, I moved to Gainesville, Florida, and at the time the medical students were training on dogs and sheep still, and anesthesia residents were training on real patients on us, and the plan and the admission there was to create at the time was called the Gainesville Anesthesia Simulator. It's now called the Human Patient Simulator, which was a simulator that was breathing real gases, real oxygen, real CO2, real anesthetic gases and that had a number of models of human physiology to make it react to what you did to it. But we did develop a few other simulators there, a pediatric simulator and a baby simulator.
Willem Van Meurs:And then, after six years in Gainesville, my French wife and I and by then our two American children moved back to Europe and we moved to Porto and at the University of Porto I set up a team of obstetricians and mathematicians that designed the delivery simulator, and I felt I owed that to my dad, who was an obstetrician, and that was a successful project. It took a while to get it to market, but the Lucina Childbirth Simulator is now also commercialized by CAE Healthcare. In two phases I moved back to the French Pyrenees, which is where my wife's from, and I now live in a small farm on the French side of the Pyrenees with my wife and donkey. Our kids are in Paris. But then I did play a role in the SESAM Society for a while and right now my most important research with the University in the Netherlands is on what we call explanatory models. So it's a visualization of complex underlying physiology to help acute care physicians think in very critical situations. So that's in a nutshell my path, my 36 or seven years long path through simulation.
Jerrod Jeffries:I think that's already a mic drop, milen, that's just like OK, whoa, that's pretty incredible. I'm looking at Deb's face. You got to close your mouth a little. It's been open for too long, thank you. Where to start. I mean one is, I think, the HPS. The HPS, when it was released, was groundbreaking in regards to the with an ithotis and pushing CO2 and being able to have that level of fidelity. One how long did that research and development take? And two once it kind of went to market, what were you feeling?
Willem Van Meurs:Well, the research and development took about six years, so not all that long, and I had to. There were a few very nice moments, of course, in the development of the simulator. One was when I got a very around 1993, I believe 30 years ago I got a very worried call from an engineer who was demonstrating the simulator in failed Colorado and he said Willem, I'm running the COPD patient and he's hyperventilating like crazy. So what's going on? I said Well, Ron, what altitude are you at? And it turned out the simulator had detected the lack of oxygen in high altitude and so we just had to change one parameter so that it would adapt to that altitude and then we were on the road again. So that was a nice, certainly a nice moment in our experience there.
Willem Van Meurs:I also remember a little bit later when the CAE's predecessor, METI, Medical Education Technologies, had just built a new plant and I was working there with a colleague and I left the plant through the back door, worked around the plant to get my rental car up front and I came past the loading dock and there was a truck with parts and there was space for another truck that was shipping completed simulators. And just eight years before that those were just ideas of a bunch of people sitting around the table in Gainesville, florida. So there's been lots of interesting moments. I can think of EER the television series EER using our simulator in one of their sequences, newsweek doing a special on the simulator. So it's been a great ride. And now I'm interviewed. Are you guys come on?
Disclaimer/ Echo Health Ad/ Show tags:Well, it's the gift that keeps on giving.
Jerrod Jeffries:I mean, you are one of the pioneers of simulation, because when it comes to scaling this industry, especially when you started it from modeling and simulation I do like how you also put it that way. In 86, there were people doing simulation, but it was very hard to connect the dots, and obviously through internet it's much easier and within healthcare organizations we're then able to then connect even more to the organizations. We're then able to then connect even further by Congresses and Congresses and memberships, but also through other types of media such as print, digital and so on, with what we're doing. But I do know that there's also something that you've put into print. That's called the Dahls Engineering Book. I want to touch on that a little bit if you can tell our listeners something about it We'd be happy to.
Willem Van Meurs:That's one of so. My major talent is, I believe, is to get myself in trouble, and the Dahls engineer was a good example of that. So I was planning to write two books, but they both and I'm still planning on those but they had co-authors and they weren't ready. So I had started to write down just a little bit about my convoluted life, mostly for my children, because they hear some stories but it's complicated. So, and then I ran into an old friend from New Orleans and I hadn't seen her in 34 years and she was writing her own autobiography, and so I told her about the two chapters I had at the time and so I talked about that and she encouraged me to keep on writing. And I talked to Pier Luigi and Grazia, whom you've interviewed, and at the time I was writing articles I'm still writing articles for the magazine Simzine and he said oh, that's nice, send me a chapter. So I did, and a week later we had a verbal agreement on a short autobiography which was about, well, mostly about my life and complicated path through four continents and 14 cities and villages and so on, but also about 30 years in medical simulation. So, and that book was released at the most recent SESAM conference.
Willem Van Meurs:So it's and the reason it's called the Dahls Engineer is that for a while I lived in two places in my village where my wife and children lived and the Pyrenees, and I still had the research team, my research team in Porto that developed the delivery simulator. So I had a small house in Vila Novodegaia, which is on the other side of the river from Porto, and my neighbors there had seen me on television talking about the delivery simulator and other simulators and so they called me who engineered those bonekos in Portuguese, which means the Dolls Engineer. So we, Pier Luigi, and I thought that was a nice potential title for the book. So, yeah, there's a. It was. It was very enjoyable to write it from a personal point of view, but it was also nice to describe in an informal way some of this surprising history of yeah, no longer training on animals and real patients. That's what it was about for me.
Jerrod Jeffries:I want to pick up a copy of the book and I want you to sign it. But if we, we can include that link in the show notes. So if people do want to purchase it, that's through where now For?
Willem Van Meurs:now, because we're talking the publisher, which is the same publisher as for Simzine, so it's called Simedita, is talking to Amazon, et cetera, but for now it's the publisher is the only site that sells it. So well, we'll, we'll put it. If you can put a link, that would be great.
Deb Tauber:Yeah certainly yeah.
Willem Van Meurs:Perfect.
Deb Tauber:Will you be at IMSH?
Willem Van Meurs:I may. I don't cross the ocean that often anymore for a number of reasons, so I don't know yet. I will be visiting in October. I will be in North Carolina and I will actually be visiting another piece of simulation history. So Mike Bernstein, who took over METI and who then sold it to CAE healthcare, is a good friend and he has just moved to North Carolina and I'm going to visit him. So we'll have a lot to talk about. But I'm still not sure about IMSH.
Deb Tauber:Okay, all right. Why don't you tell us a little bit more about Simzine, the magazine, the?
Willem Van Meurs:Yeah, I'm very glad to do that. That was I got involved with Simzine, I think around the previous SESAM conference, in which was in Seville, the first conference after COVID, so it was a very exciting European conference and and I like Pier Luigi and we liked each other right away and he's the editor-in-chief of Simzine. The two aspects I like most about Simzine are maybe three, but it definitely two is that it's Multilingual. So it's it's in English, but it also has Italian and Spanish versions. All all the articles are translated in between those languages and it has both a paper and an electronic version. So on the paper version you get, obviously you get just one language, but there's always a QR code if you don't read the other language. So if I try really hard, I can read Italian if it's about simulation, but but I, yeah, I can't read English and Spanish without without too much effort. So those I like those two aspects, the Multilingual aspect and and the fact that it's both on paper and then in the electronic format, and it also gives quite a bit of attention to technology, which had a little bit disappeared from the programs of the of the international conferences, and I don't mean obviously clinical aspects and educational aspects are the most important aspects in our domain, but the the tools, the technology, software is important as well, so there's room for that. So I'm very happy to To participate in Simzine, and just today.
Willem Van Meurs:The next issue is number 10 is going to press today and I interviewed one of my former Portuguese students, so In Portuguese, so we added a language to the journal. So we're very happy about that. Not so much for the Portuguese people, because they, most of them, read and and write English, but of course, brazil is a big country and giving people Well, like people in Italy and Spain and and Brazil access to important information about simulation is very important. So, and not all of these people read English. So I'm very happy with this journey, I'm very glad to be able to contribute to it.
Deb Tauber:Thank you.
Jerrod Jeffries:I think I saw you at CSAM this year because I was also at the conference. Unfortunately didn't know each other then, but can you tell us about the conferences here, how it was received in 23 or how you've seen it developed throughout the years?
Willem Van Meurs:Well, that's what I'm sure interview, because I was too busy Inventing and raising my first child to go to the first CSAM conference. But I think I've been to all CSAM conferences since and next year is, I believe, conference number 30 or 29, and the society exists, has existed for for for 30 years. So what I liked about the last conference in Lisbon was, of course, well, we had one conference before, after COVID. I mentioned the civil conference, which was was a blast being being able to go to a conference again and face-to-face interaction and and the numbers kept rising and and Lisbon was was very much a success and One of the factors of success of the Lisbon conference, I think, was there was there. Well, there's a very good chair of the scientific chair of the conference, Christina Gias Navarro, and she works in close collaboration with the editor in chief of the scientific journal. So Gabe Reedy is the editor in chief of advances in simulation, which is the scientific journal, open access scientific journal of CSAM, and so, yeah, a lot of into too much very interesting conference. I couldn't, couldn't go to all the workshops it's, but just what I can do is just give you a brief Idea of the content. I worked with lots of different teams. So so the three presentations I gave I think do reflect the diversity of the conference.
Willem Van Meurs:I did give a workshop with a young in Italian investigator, three young in tell Italian investigators, on Selecting the best simulator for your job, and we talked about simulation technology and virtual reality in mannequin based technology Etc. So there was kind of a practical workshop. I presented a very theoretical paper on a new asset-based balance model for general use in acute care simulators, together with a group from the Netherlands. And then I presented a paper on Space medicine and I've worked with investigators on the Australian space medicine program and Because the Australians once won commercial space flight, for example the two-hour flight between Sydney and London and you can do that through space.
Willem Van Meurs:But the challenge there is not technical Space tourism already does that but the challenge is medical. You put a young astronaut in a rocket and he or she will come out, you, you put me in a rocket and and there's a big question mark at the at the end. So we're using modeling and simulation to Well, my one of my colleagues, like Swan loan and in now back in the Netherlands, uses the concept of medical Digital twins to to simulate the patient and submit the patient, a traveler, and the potential traveler To the conditions of commercial space flight. So I gave a presentation on that. So very stimulating, very broad conference.
Jerrod Jeffries:That's cross-spectrum. I think this is the first time I've heard a something with space which I, you know I geek out on the simulation technician side. The space thing is like wait what? Of course I don't have time to go go much into that given your background, but I'll follow up on that another pod in the future. You know, I think, getting back, like just the, the atmosphere within Lisbon was so many people were probably, you know they were very excited, of course, to connect with people and I remember there was so much connection that was happening, that was so great to see again and it's been kind of far and in between for a few years, so it's wonderful to see.
Deb Tauber:Yeah, thank you for your contributions. Now, Willem, how did you enjoy your role as president of ?
Willem Van Meurs:So well, I enjoyed teaching and I love R&D, and being a SESAM president was more of a okay, well, this needs to be done, Somebody needs to do it. But I think I got involved in 2003 or four or so and spent six years on the executive committee in two years as a president. But in 2003, it was kind of urgent because we had 40 paying members registrants. So we needed to do something or the society would disappear. And over the years, the last conference I was involved with in that period had 400 paying registrants in Copenhagen in Denmark. So, yeah, it was a successful ride and of course, that was the trend of the time. The IMSH increased numbers as well. But it was a bit of a challenging time and we really needed to be efficient to make sure the society survived. And we did, and by now we have 1100 or 1200 registrants. So I think we're certainly out of the woods in those organizational terms.
Jerrod Jeffries:And I mean seeing that growth throughout the years and, of course, there's nothing consistent. There's this graph that goes up and down and sideways and turns over. I think there's a I don't want to say a refound, but there's a focus within healthcare simulation, as we can see these numbers growing across the board with all healthcare organizations. But in order to continue to increase that simulation footprint in Europe, what would you recommend or where do you see certain trends going?
Willem Van Meurs:I'm sorry to say that, but I don't know, it's been a while. I mean, I left the Netherlands in 1985, so I don't really think in a national scale and I don't think that much at a European scale either. What I would like to contribute, if I may turn the question that way, is that I would like for simulation worldwide to become more visual and to show more of what goes on inside the patient and anatomically and physiologically, and we've been working on that in the context of what we call explanatory models and the other big thing. And that's, I believe, a holy grail for a lot of simulationists. And again, it doesn't really matter which country or which continent you are on. We'd like to get objective performance indices and we can obtain those. For example, if we look at myocardial perfusion and oxygenation or cerebral perfusion and oxygenation, and if you have a model-driven simulator, those indicators are available and we don't use them and we would be able to tell how a simulated patient's brain or heart would have been doing. And maybe later on we'll look at the kidneys etc. But if we start with the vital organs, we could provide objective performance indices and I really think that that would affect the simulation around the world and, if I do, you make me think about Europe.
Willem Van Meurs:So Europe's challenge and opportunity is its diversity. I mean we have 28 countries, we all speak different languages and we have all different healthcare systems. So huge challenges but also huge opportunities. And we can experiment something in Denmark and then, if it works, apply it in Germany and then all over the European Union. So there's yeah, it's quite a challenge, and if we meet those challenges we create a lot of new things in Europe. But again, I don't think we're SESM definitely is not thinking just Europe. It's by origin in European society. We get people from the Arab world, from Australia, from the US, so it's a Europe-centered international conference.
Jerrod Jeffries:That's how I look at it, yeah, and I think it's great. I mean hearing more visual cues. I think trying new things is always going to be important, because we can't just keep doing things the way we were. I really like that you would highlight that aspect, doing something a little differently. So thank you.
Willem Van Meurs:And think about it. My maternal grandmother was one of the first female radiologists in the Netherlands and being able to, I told the other kids in school that my grandmother looked through people and they didn't believe me, but it was true. And being able to look inside people without opening them up has totally changed healthcare. And I think we could do a similar change in simulation as well, and there are already some simulators out there that do that that look at anatomy and physiology using augmented reality, and I just would like to see more of that, and I think it will change the mental models that the healthcare providers have if they really have a clear picture of what's going on inside their patients.
Deb Tauber:Yeah, I think the Simzane magazine, being digital as well as on paper, is also aiding to spread the word, and congratulations on your 10th episode this week.
Willem Van Meurs:Yeah, thank you. It's going to the printer today. I had somebody on email earlier to provide some corrections.
Deb Tauber:Are there any parting words that you'd like our listeners to hear from you?
Willem Van Meurs:So I feel a bit sorry that you have to listen to the fossil that I am in this field, but it's certainly despite that, it's still a young field and it needs growth and maturing. So I would encourage you to keep the good work coming, and that's true for the same cafe as well. So thank you.
Jerrod Jeffries:Well, thank you for your contributions, people like you and where we need to pass on that knowledge that you've accumulated for decades. And I don't want to say it's a shortcut, but it's the same thing as a good book, right, you can go through the lessons yourself and learn it the hard way over years, or you can read a book and shave off a couple of years. But I think, with the world of simulation, because of what path you've had to forge, as well as many others, but there's so many ways that we can say, ok, we know this doesn't work, because here's the data. And if we're able to show the data based off what you've already presented and accomplished, then we're able to actually focus our time, energy, resources on what really matters.
Willem Van Meurs:That's a great observation, and the inventions and the innovation is important, but documenting the data is probably just as important.
Jerrod Jeffries:Definitely, so thank you.
Deb Tauber:Yes, it is very, very important to make sure that we learn from different sources and learn the origins. I'm really fascinated by your story. I can't even imagine what it must have been like to be one of those original five coming up with the first human patient simulator.
Willem Van Meurs:Well, read my book. Yeah, yeah, it's mostly stories indeed, and I do think that we also live by those. And then, of course, we need the scientific journals and the scientific books as well, but a lot of what we do is mostly easily transmitted by stories.
Deb Tauber:Yes, all right. Well, thank you, and to you guys Good evening, and to the rest of our guests Good morning, Good afternoon, wherever you're at. Thank you and happy simulating.
Disclaimer/ Echo Health Ad/ Show tags:Thanks to Echo Healthcare for sponsoring this week's podcast. Contact Echo Healthcare to find out more about their new seven Sigma intubation and airway management task trainers. Thanks for joining us here at The Sim Cafe. We hope you enjoyed. Visit us at www. innovativesimsolutions. com and be sure to hit that like and subscribe button so you never miss an episode. Innovative Sim Solutions is your one stop shop for your simulation needs. A turnkey solution.