A look inside the medical simulation boom
January 14, 2011By Mara Zepeda
Simulation centers like these allow medical and nursing students to make mistakes but without killing people. The centers may be one way of reducing medical error, which is a leading cause of death.
In the video featured above, Chris Eden describes how he landed his job at Drexel's simulation lab through a temp agency.
Medical simulation centers are cropping up at universities across the country. But how do you train faculty and staff to run one of these centers if they’ve never participated in a simulation themselves? A new certificate training program at Drexel University's College of Nursing and Health Professions seeks to do just that.
The conference began on Monday, January 10. For the simulation that day, there will be a downtown terrorist attack. Injured patients will stream in to the hospital’s emergency room. There’s bloody gauze all over the floor, mannequins with fractured bones sticking out, a temporary morgue in the corner. And then there’s Chris Eden. Chris is a lab tech who’s spent dozens of hours creating this scene. And he will also be playing a victim.
John Cornele, the lab's coordinator, explained Chris' injuries. "He's got a laceration on his forehead," Cornele said. "He was in an explosion. And we're going to give him bleeding from the ears because he probably has a fractured skull." He instructs Chris to tilt his head to the left. "What I’m going to do now is I’m going to use much more liquid blood and let it run down the side of his face," Cornele said. "And drip on to his clothes. Which is actually natural. So we're ok with that."
Then, John dabs blood at the silicone gash, straps on a neck brace and sprinkles Chris head to toe dirt. John tutors Chris on what to say. He has to show signs of an obvious concussion but also a less apparent spinal cord injury.
"How does my head feel?," asked Chris. "Your head hurts like heck," said John. "All you can feel is your head, your face. Your head hurts." He instructed Chris to say "My head hurts. What happened to me? Where am I?" and told him to be repetitive and confused. "If the [participants] don't reorient you back to reality you keep asking where are you and what happened."
Simulation centers like these allow medical and nursing students to make mistakes but without killing people. The centers may be one way of reducing medical error, which is a leading cause of death. Universities have jumped on board, and over the last decade, there’s been a glut of money to build SIM centers like these, which explains how Chris ended up here on a gurney with a bloody sweater.
"I got this job through a temp agency," he said. "They couldn’t describe it to me. They were talking about it as an administrative assistant position. I carry around mannequins and other limbs and body parts. Every once in a while I put on make up, and I, you know lay in a bed and scream and moan about how much pain I'm in."
Chris has an eye for detail. He burned the mannequins’ clothes in his back yard firepit. He worked to simulate the odor of diesel and soot— what the emergency room might smell like after a bomb, and he also made fake IDs.
"I scanned my own driver’s license," he said. "So I took a picture of each of these mannequins and kind of like slid the picture over mine and then changed their name and date of birth."
All of Chris’s hard work is part of a Drexel’s new certificate course in simulation that’s targeted to nurses and other health professionals. While many universities have SIM centers, few programs that train faculty and staff on how to run these centers.
"Many of us are thrown into a new position: 'Here's a SIM center. I want you to run it. Well how you do it? Teach yourself.' We realized that there was a need to teach the teachers or to train the trainers," said Rocky Rockstraw, Drexel Assistant Dean of SImulation
"Most of us run simulation labs, set up simulation labs, organize simulation labs, very few of us have ever been the participants in a simulation. That's how we wanted to start the conference. To let them experience what it is their participants experience when they come to a SIM lab," said Carol Okupniak, the lab’s director. Their hope this program will change that.
The moment Chris has been waiting for arrives. The 25 participants are gathered in an ajoining conference room, listening to Rocky’s lecture. And then, John knocks on the door. "Excuse me," he said, "I'm sorry to interrupt." He went on to explain that there's been a bus bomb on Independence Mall, near the Liberty Bell, and Philadelphia is in a state of emergency. He asks if anyone has experience with mass casualties and the group follows him to the ER.
A group approaches Chris on his gurney. "Can you tell me your name?" they ask. "Can you squeeze my hand?" Chris replies with moans and confusion. A control room monitors video camera trained on his bed. And then the simulation ends.
By 2012, the medical simulation industry is expected to be a $1.5 billion industry. The trend has spread internationally. Maria Phillips traveled from South Africa to attend. Her hospital received a $2.5 million grant to start a SIM center.
"What I learned is how does a student experience a simulation. I learned what we are doing to the student. And now I have a lot of respect for that," says Phillips.
For Chris, he’ll wash off his make up and reset the room for a long week of simulations.