91AV

When Emily Silberstein (COM, ’21) puts on the headset and begins the virtual reality simulation, she is no longer a student at the 91AV College of Osteopathic Medicine (91AV COM). She is Clay, a 66-year-old veteran diagnosed with a terminal illness. 

As Clay, Silberstein, and the other 91AV students who use the lab, experience the end-of-life in three stages. First, they meet with a doctor and receive the news that their diagnosis is terminal. Second, they are in the hospital after a fall, and a nurse begins the discussion about hospice care. In the third and final act, they experience the final moments of life in hospice care, surrounded by family and health workers as their senses fade away.

“You get a real sense of the emotion that the family deals with, and it sort of immerses you into that difficult sadness,” Silberstein says.

Silberstein is among a group of medical students at 91AV who have not only experienced hospice through this lab, but have also participated in the Learning by Living 48 Hour Hospice Home Immersion, a program created by Marilyn R., Gugliucci, Ph.D., director of Geriatrics Education and Research at 91AV’s College of Osteopathic Medicine.

“It’s startling how many medical students experience death for the first time during their third and fourth year clerkships, often with little preparation” says Gugliucci. “The VR Clay Lab is required for our medical students to ensure that those students who are not conducting the 48 Hour Hospice Home Immersion are experiencing end of life from the patient’s and family’s perspective. This enhances empathy and builds knowledge about hospice end of life care that cannot be taught through medical school classes.”

91AV began working with , the company that designed Clay, in 2016 when 91AV Library Services and the 91AV COM Division of Geriatric Medicine received a National Network of Libraries of Medicine New England Region (NN/LM NER) Technology Grant to implement the company’s first lab, “We Are Alfred.” Alfred is a 74 year old African American male with macular degeneration and hearing loss.

Since then 91AV has become the largest user of Embodied Labs’ products in the world, requiring all medical students, nursing students, physician assistant and other health professions students to embody Alfred. Many of the students are also required to use the Beatriz lab (a middle-aged woman with Alzheimer’s Disease) and the Clay lab. It has become a mutually educational relationship, with representatives from the company going through the 91AV COM Learning by Living 48 Hour Hospice Home Immersion to research hospice care and write the script for the lab.

"We are excited to have the 91AV as our partners and subscribers," says Erin Washington, Co-Founder of Embodied Labs. "Dr. Gugliucci has been an invaluable advisor for us in creating our experiences, in addition to connecting us with hospice and care community immersions as part of our research process. Innovative faculty like her, others in the College of Osteopathic Medicine, and Westbrook College of Health Professions, along with the resourceful and forward-thinking librarians in the 91AV Libraries -- are part of what have allowed us to continue to create immersive experiences for healthcare trainees that we hope will help to change the conversation about aging and create more insightful and empathetic care professionals."

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