Gender Specific Differences in Advanced Airway Trauma: Open-Source Physiology Engines Can Fill the Gap and Reduce Cost Barriers (Preprint)
Authors: Baird Austin , Bentov Itay , Timm Eric , Roach Victoria , Sweet Rob , Hananel David 
Published: January 2025

BACKGROUND

Gender plays a role healthcare simulation in multiple areas: communication, specific treatments, outcomes, anatomy, biases, and others. Often female simulators and virtual patient avatars are only skin deep, not considering the vast physiological differences at play in between the biological sex of the patient and the chosen gender and associated physiological state of the patient. It is important that as healthcare simulation evolves, gender specific physiological differences are communicated and taught to prospective students in a variety of simulation experiences.

OBJECTIVE

We aim to leverage recent advances in physiology engines to detail specific educational scenarios that may be used for simulation training. We aim to show sex-specific differences in physiological response to each described scenario.

METHODS

We leverage the Modular Healthcare Simulation Education System (MoHSES) to facilitate and connect advanced physiological models of airway trauma to a robotic manikin. These models consider sex when constructing the patients' initial state by allometrically scaling volumes, masses, and pressures. Although the physiological models do not consider the vast hormonal differences in gender and their relationship to trauma, they do show marked differences between the physiological state of the patient during the simulation. Each patient is configured individually. Each parameter corresponds to distinct pressures, flows and volume changes in the physiology engine upon initialization. These patients are then used by the BioGears physiology engine to simulate respiratory trauma. The MoHSES platform is used as the software framework to connect the specific patient physiology to the advanced manikin. All software is available free and open source.

RESULTS

We show that for complex airway trauma patient cases, the physiological models that interface with an advance robotic manikin provide marked differences between gender configurations and the initial patient data. This initialization may be configured by the user to be leveraged in a variety of learning modalities by interfacing with the MoHSES platform. The following scenarios are presented to the reader: Description: Male and female response to a fatal fentanyl overdose. You are dispatched to an adult male, slumped over on the ground at a bus stop. The 911 caller is unsure if the patient is breathing. The bus stop is in a public place, outdoors, mild weather, afternoon, scene is secure. Description: 28 y/o female is aiding in the demolition of a wall with her partner when she was struck on the left chest on the back swing sledgehammer. Patient reported immediate pain on inspiration, movement, or palpation. This has trended into respiratory distress. Description: 28 y/o female is aiding in the demolition of a wall with her partner when she was struck on the left chest on the back swing sledgehammer. Patient reported immediate pain on inspiration, movement, or palpation. This has trended into respiratory distress.

CONCLUSIONS

By being able to configure a unique patient using an advanced physiological model in a healthcare simulation setting, we can produce unique learning experiences that are centered around the gender of the patient. As these physiological models’ progress, the distinct gender related trauma outcomes of patients seen in the clinic can be translated to advanced healthcare simulation settings. Gender plays a distinct role in trauma outcomes of patient and healthcare simulations must evolve to teach these differences as they may lead to dramatically different treatment considerations and educational experiences.