Next generation nursing education at La Source
Paul Milligan visited the new site of an established medical school in Switzerland committed to not only providing cutting-edge nursing training but also to become a centre of health innovation.
Located in the heart of Lausanne in Switzerland, La Source is a non-profit foundation which oversees both a nursing school and a renowned clinic. Ecole Le Source welcomes more than 1,000 undergraduate and postgraduate students on two sites.
The first site was inaugurated in 2014, and houses the school’s management team, and admin personnel. The newest site, opened in September last year at a cost of €8m, and is located in the Palais de Beaulieu, near the headquarters. With nearly 6,000 square metres, the new site meets the school’s pressing need for extra space to account for a student body that tripled in the previous 15 years.
The School of Nursing Sciences La Source was founded in 1859 as the world’s first secular nursing school, in 2018, La Source added a new dimension to its history through the creation of the Source Innovation Lab (SILAB). Featuring 21 hospital beds and two replica apartments in a simulated hospital, it is now a first-class centre for healthcare research and teaching, in which its able to test proofs of concepts for new ideas or prototypes. Research at La Source is dedicated to meeting the challenges in six specialised teaching and research laboratories focused on mental health and psychiatry, aging and health, paediatric and family health, community health promotion, care quality and safety and healthcare systems, ethics and interprofessional collaboration. This is a site capable of producing the next generation of nurses.
The task of creating the new site to work for both students and researchers was a collaboration between La Source and local systems integrator Projection Nouvelle. It was invited to tender for the project, and after winning the tender began working with Ecole’s AV manager, Guy Stotzer, to add more detail to the designs. Upon entering La Source you first see an area a breakout and relaxation space for students. This space is surrounded by rooms for the SILAB, some are dedicated to self-training, where students can enter in groups or go in with a teacher if they are studying something in particular for an exam. There are also senior labs for elderly care which look at how elderly people can stay at home longer, rather than in a care home or hospital. As you move around La Source you are struck by how closely it simulates a real hospital, “It is a clinical environment hospital, but without real patients. What we have created is a complete concept,” adds Stotzer.
AV technology is everywhere you look at La Source, and everything is run via IP. The site is full of Cat6 cabling, with 1080p video distributed via 64 AMX (SVSi) encoders to a selection of 55-85in Sony flat panel displays, audio is distributed throughout the building via Dante courtesy of Biamp Tesira DSP. New technology in the form of VR and robotics sits alongside more established AV in the form of digital signage and projection. A robot called Pepper is currently being developed at SILAB which is helping nurses calculate the correct dosage of medicine to give patients. Two VR stations, featuring Oculus Rift headsets, are being used to successfully perform (virtual) blood transfusions. The labs are well attended but to make sure they are used to their full potential La Source is hiring someone to help maximise room usage, “She will be interface between all these technical possibilities and the students because even if we open the door, it doesn't mean that they will come. She will be like a Sherpa to say ‘come in and try’, in the best possible world the doors will be open and the students will be inside all day long trying the materials, but as this is quite new we must help them to not be too shy,” says La Source general director, Jacques Chapuis.
The biggest AV challenge says Alexandre Rouvelet, technical director from Projection Nouvelle, was that the client wanted to send every audio and video signals to every room in the building. “Because they wanted to move the technology from room to room, they needed lots of flexibility in the installation. It was a very big challenge to design this and to calculate the right bandwidth, and to programme the AMX (systems).” The AV installation took two months and was in two phases. “We worked on the proof of concept in their old building to test the possibilities of what the teachers or students could do, and to show them the reality of how it would really work in the new building,” says Rouvelet. “It was very important we made this proof room/test room, because when it was time to do the install we didn’t lose time because we knew what we had to do.” The flexibility of the AV is evident by how much power the AMX system (programmed by Rouvelet) has around the building. “With the AMX we can control every screen in the building, and programme the screens for digital signage, and power them on/off. If a camera is moved all we have to do is change the patch cable and tell the AMX system this camera is now in this room. Once you have done this everything is automatic – recording, streaming power on/off, and PTZ control.”
The simulation rooms are where the AV really shines at La Source. Students use the rooms to perform medical procedures on a real-life person (an actor acting out a particular medical condition) or a highly sophisticated electronic mannequin (called Jean-Paul). Every simulation room has four Panasonic PTZ cameras (to avoid video blind spots), and every session is recorded for future analysis. After the briefing you can view the video via a secure central database. “The videos are important because most of them are stressed when they come in, so they don't always remember exactly what they did. So the videos can help with that,” says Stotzer. The other students can also view what is happening in the simulation via a live feed in a neighbouring room. The monitors in the viewing rooms are split into four separate feeds, featuring video from different angles of the room, so there are no blind spots but also a live feed of blood pressure, oxygen levels and heart rate information too.
The teacher is outside the room, but there is two-way audio and the teacher can communicate via mic and a hidden speaker under the patient’s bed to give a realistic sound of the patient talking. Via the four room cameras the teachers can also see how much medicine the trainee nurse injects, or what medicine they are using. A Sony screen in each simulation room provides the patient file for each student to see. The mannequin performs vital functions in the simulation says Chapuis; “It’s good we have Jean-Paul because we can do things that are normally impossible. We can’t simulate cardiac arrest on an actor because afterwards you would have to perform a cardiac massage, so we do it on the mannequins, it’s the same when applying a trachea, it’s easier on a mannequin than an actor.”
Shure ceiling mics were chosen for their coverage (so there are no audio blind spots as well as video blind spots). “We have eight mic loops creating different levels of sound coming in, we decided to buy ceiling mics because we want we didn't want to have to run in and have to put mics on people,” says Stotzer. Good audio is a crucial part of the accuracy of the simulations says Chapuis; “In our past experience in a smaller facility than this, we found it was easy to have good images but very difficult to have good sound. When we are shown other facilities and they show us videos it's very nice to see, but it's very bad to hear. So we wanted to improve the quality of the sound. The audio quality is important because you have sounds in the room but you must also hear the sounds coming from the monitors.”
All video can be streamed off-site from an H.264 encoder if necessary, via StarLeaf or Teams or Skype, and the bandwidth has been calculated for a worst case scenario, and can actually transmit 70GB of video at the same time. Twelve Barco ClickShare systems can also be found around La Source, one for every classroom. Two lecture theatres top off the impressive array of rooms kitted out with high-end AV technology, with one seating 250 people, the other seating 155. Both have identical control rooms, and both feature 8,000 lumens NEC laser projectors, four Active Audio line arrays, one Lab.Gruppen amp, three Shure wireless mics and a Catchbox throwable wireless mic. There are two desks in each theatre in which the presenter can control the AV, each one has been programmed by Rouvelet to be as easy to use as possible, “If you’ve got 150 people sat here there's enough stress about without worry about which buttons to press.” This is done by programming a number of presets into the AMX control panel, so the presenter just has to click the applicable preset and not worry about anything else. If one theatre is too busy it can transmit audio and video to the other lecture theatre as an overspill area.
Even though the project has been running a year it is still a challenge to absorb all the information we need to absorb says Stotzer. “What is interesting is that such a project involves collaboration between teachers and technicians, it’s still ongoing because things evolve every day.”
ActiveAudio MPA6150 amplifiers, SA180S and SA250S loudspeakers
Ampetronic ILD500 induction loops
Audinate Dante Via software
Behringer AMP800 headphone amplifier
Biamp Tesira Forté DSP
Catchbox throwable mix
Focal Dimension soundbar
LabGruppen E2:2, Lucia 60/2 amplifier
Shure BRH440M mics, SM58 mics, MXW1 ceiling array mics, WL184 lavalier mics
Presonus Eris 4.5 monitors
SoundTube CM500i ceiling speakers, SM1001 subwoofers
AMX NMX-ENC-N1122 encoders, Modero 10-in touchpanels
AV Stumpfl Inline, Magnum projection screens
Extron SMP111 H.264 streaming media processor
Barco CSE200 ClickShare
BlackMagic HDMI-SDI mini converters, MC SDI-HDMI micro converters
Starleaf Group Telepresence 3351
Extron HDP101 HDMI to DisplayPort converter
NEC PX602UL laser projector, PX803ULA laser projector
Oray CineVision projection screens
Panasonic AW-HE40H PTZ cameras, AW-RP50 live video switcher
SMS flat panel mounts
Sony FW-55XE8001, FW-65XE8501, FW-75XE8501, FW-85XD8501 HD displays
Symetrix x12OUT Dante expanders