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By Hannah Wallace
Since it first took flight in 1982, the Orbis Flying Eye Hospital has touched down in 96 countries, from Mongolia to Kenya to Barbados. Today, the hospital’s latest iteration—a customized MD-10 aircraft launched in 2016—is still flying around the world with full-scale eye surgery capabilities and state-of-the-art teaching technology, including a CAE PediaSIM patient simulator.
Orbis and its international partner institutions conduct more than 3 million eye screenings, 40,000 training sessions and 80,000 eye surgeries annually. With PediaSIM, the Flying Eye Hospital, which is responsible for about 20 percent of Orbis’s impact, embarks on a new frontier in its mission to end avoidable blindness. The manikin represents a vital and fast-growing part of the organization’s training program, the first step in a new emphasis on simulation.
Up to six times a year, volunteer pilots from FedEx fly the Eye Hospital to Orbis’ international partner institutions, where the plane’s crew of full-time doctors, nurses and support staff, joined by volunteer physicians, perform exams and surgeries to address a range of eye issues, including cataracts, glaucoma, strabismus and retina diseases.
But treating patients directly is just the start of Orbis’ mission. The Eye Hospital achieves a long-term, even-farther-reaching impact by training local ophthalmologists, anesthesiologists, nurses, and medical instructors, who can then train even more people in each locale to perform these life-changing procedures. In the 1980s, the Eye Hospital flew to Bangladesh, where Orbis staff trained the country’s very first retina surgeon (the plane’s operating room even hosted his first procedure). That Bangladeshi physician has gone on to train dozens of residents and fellows.
CAE’s PediaSIM manikin is currently used on the plane for anesthesiology scenarios. “One-third of all of our patients are usually pediatrics needing general anesthesia,” explains Dr. Hunter Cherwek, Orbis’ deputy chief of clinical services. “We wanted an opportunity to train more anesthesiologists to give safe and effective anesthesia. Obviously, we were blown away with [the PediaSIM] technology.”
Orbis’ mission affects “not just the eye, but the whole person,” says CAE’s Diane Mathe, who trained Orbis staff to use the simulation technology. “PediaSIM allows healthcare providers to improve team performance and communication in pediatric critical care. Some of the major interventions you can perform include airway management, chest tube insertion, needle cricothyrotomy and venipuncture, things that they might have to consider during general anesthesia. [Orbis staff] have to learn all the nuts and bolts of the manikin and the software, because then they have to go out and use that technology to train other people.”
The Flying Eye Hospital’s ability to reach a worldwide audience continues to evolve. In addition to its fully functional operating room, the plane is equipped with multiple cameras and a 46-seat classroom for demonstrations. Now, via an online learning portal at cybersight.org, Orbis is also able to broadcast its surgeries and its training regimens to learners in 40 countries.
“The trickle-down effect and the academic legacy of Orbis is incredible, and now it’s propagated through the internet,” says Cherwek. “And now we’ve added simulation.”
Simulation, he adds, can reinforce brain pathways and improve thought processes, and Orbis’ instructors have embraced PediaSIM as part of the organization’s comprehensive, multi-level approach to training—so much so that Orbis is already planning on expanding its simulation program as the 36-year-old Flying Eye Hospital adapts to the ever-changing world of medical training technology.
“Our technology is going to be an evolution, incorporating more and more simulation, more and more feedback, video reviews, role play, and scenario reviews,” Cherwek says. “We’re looking for how to best leverage things like artificial intelligence, virtual reality and the internet to create the most realistic, highest-fidelity scenarios possible, and also to deploy that globally, for free.
“I see nothing but opportunities.”