The Growing Use of Simulation to Improve Patient Care

It is said that practice makes perfect. In the case of health care delivery, simulation practice can make for perfect outcomes for patients. Dr. Daniel Scott, Assistant Dean of Simulation and Student Integration at UT Southwestern, and Krystle Campbell, Director of Simulation Center Operations, share their perspectives on how imitating reality serves to improve patient care.

A Safe Learning Environment for Medical Competency

“The whole premise of simulation is that we can teach learners outside of the clinical environment with no consequences to actual patients,” Dr. Scott said. “Thus, we are imitating reality but in a completely safe and learner-focused setting.” Simulation enables learners to be in the driver’s seat of their education by providing a safe learning environment, where they can practice as much as needed to reach competency. Through individual and team training, health care simulation teaches the norm of medical care scenarios as well as the exceptions.

These scenarios present learners with high-acuity, low-frequency events that can occur in each setting, often involving interprofessional teams (medicine, nursing, allied health, etc.), so they know how to effectively respond as a cohesive unit. In this way, the center offers a multidisciplinary approach to medical education and research that includes skills training, surgical and non-surgical simulations, disaster training, and emergency care.

The Importance of Teamwork and Communication

Training is heavily focused on working as part of medical care teams. “Health care teams need to know effective communication mechanisms and teamwork skills to ensure the right steps are being done to manage patient care and approach challenging cases with a shared mental strategy – in other words, a collective group of team members thinking through the challenge ahead of them,” Ms. Campbell said. An integral benefit of the Sim Center's effectiveness is the ability to take training beyond individual tasks to incorporate team training and multidisciplinary full system training.

High-Fidelity Technology and Realistic Scenarios

“The fidelity of a simulation is reflective of the degree of realism it has relative to the clinical setting,” Dr. Scott explained. Each year, special effects artists and simulation enthusiasts produce more lifelike simulators, wounds (moulage), and environments. Some newer “patient” simulators at the Center have motion-tracking eyes and more realistic characteristics, such as skin. Simulation Center scenarios replicate various clinical care situations that include labor and delivery, emergency care, and surgery.

Simulation team members have also begun to perfect the ability to use 3D printers to make models. These models have been used for training or in discussions with patients, family members, and surgical planning. Training materials have been developed to meet the need for learners, such as different suture models including a molded ear and hand.

Key Simulation Facilities and Environments

The real-life environment allows healthcare providers to move as a team through initial assessment in an ER, to procedures in the OR or Labor & Delivery and end with long-term care in the ICU. The following environments are utilized for hands-on training:

• Emergency Room and Intensive Care Unit
• Operating Room
• Labor & Delivery
• Hospital Patient Rooms and Clinic Exam Rooms
• Nurses Station

Advanced Simulators and Task Trainers

To enhance education and reduce medical errors to improve patient safety, the centers utilize high-fidelity technology such as:

• 3D Systems GI-Bronch Mentor II endoscopic simulator
• 3D Systems U/S Mentor ultrasound simulator
• Mentice Vascular Intervention simulator
• CAE Human Patient Simulator (Adult and Pediatric)
• SimMan 3G and SimMan Classic manikins
• SimBaby and SimNewB patient simulators
• Stryker High Definition Laparoscopic trainers

“Some simulations replicate the real situation closely while others, like task simulations, intentionally deconstruct parts of a procedure into its critical components,” Dr. Scott said. For example, high fidelity manikin-based simulations recreate situations in a setting such as an ICU, emergency room, or delivery suite and are often sufficiently realistic that they create ‘suspension of disbelief’ for the participants.