Backgrounder: “Living, breathing” mannequins now part of curriculum for Vancouver Island health students

About simulation training

Simulation is being used more regularly in health education as a means to increase the capacity and quality of health practice education. Patient simulation exercises create learning experiences not otherwise readily available in the health care setting and provide learners with the opportunity to develop critical thinking skills and practice techniques repeatedly and safely.

Students learn to master techniques they are likely to encounter prior to entering the clinical environment and are therefore more confident, enabling them to focus on problem-solving and patient interaction instead of the mechanics of patient care procedures.

Professionals will also use the centre to refresh their health practice knowledge, learn new skills, as well as master multi-disciplinary health team skills.

About CICSL

This centre provides a learning space for enacting health care scenarios while capitalizing on the benefits and value of clinical learning through teams and technology. This collaboration brings together three centres of study and practice in addition to gaining the benefits of their extensive subsequent networks.

• CICSL is the newest addition to BC’s network of clinical simulation centres.
• Victoria’s new centre has three simulation laboratories:

• Ward/Flex Lab replicates a patient care or recovery room;
• Critical Care Lab replicates an emergency room, a trauma bay, or a critical/intensive care unit;
• Operating Room (OR) Lab replicates an OR for anesthesia and surgical scenarios.

• Technicians and/or instructors work from one of two observation booths – in the Critical Care Lab or the OR Lab - to program and operate mannequins to simulate medical conditions, such as elevated heart rate, decreased blood pressure, restricted breathing, to name a few.
• The simulation debrief room has videoconferencing equipment where instructors and students review and discuss learning objectives before and after each session.
• The centre also features office space, storage areas, change rooms and lockers.
• Construction started in August 2014 and was completed in April 2015.
• The centre measures a total of 3,337 ft2 (313 m2).

Funding

• Capital costs: $2.9 million.
• Operating costs: $350,000 per year.

CICSL users

• Undergraduate medical students and post-graduate medical residents.
• Undergraduate midwifery students.
• Undergraduate (years 3 and 4) and post-graduate nursing students.
• Practicing professionals* seeking continuing education and skills development.
• Health researchers from Island Health, UVic and UBC.

* The term ‘practicing professionals’ include doctors and nurses, as well as first responders, respiratory therapists, anesthesiologists and midwives. Other learners may include social workers, public health care workers, child care workers, health information science workers, as well as health researchers from other institutions and disciplines.

About the mannequins and task trainers

Powered by wireless technology, these simulated human patients are ultra-modern learning tools designed to elevate the understanding of human health care education for a range of professionals.

The mannequins range in age and body type from newborn to adult. Each has a name, a medical and social history, and life-like features including blinking eyes, a beating heart, working lungs, and a voice that responds to treatments.

Each mannequin can also be programmed to behave in different ways with vital signs that respond to treatments and interventions, and an intercom system that allows the patient’s voice to be heard by the care delivery team. They have a pulse and transmit these electrical rhythms to bedside monitors with vital signs that respond to treatments. The simulation technologist in the control booth can program various medical conditions which range from common clinical situations to high acuity events requiring urgent interventions.

Task trainers provide learners with the key elements necessary for on-demand practice of clinical procedures. This allows for skills development of often ultrasound-guided procedures such as a lumbar puncture, vascular access, and advanced airway management.

About the training sessions

CICSL learning sessions have been customized by local educators and practice professionals to address realities that reflect the health care needs of Victoria and the Island Health region where access, service availability, priority and cost are important factors.

CICSL is also aligned with the provincial model and network defined by the BC Simulation Task Force. Further, an interprofessional education model and a team-based, patient-centred care approach are identified as best practices for regions such as ours where long distances between health centres, many remote communities, and a large aging population impact service delivery and quality expectations for a range of health professionals. Learning is also focused on increasingly complex patient needs, changing practice technologies, diverse practice settings and professional specialization.

Project partners

• Island Health provides health care to more than 765,000 people on Vancouver Island, the islands of the Georgia Strait, and in the mainland communities north of Powell River and south of Rivers Inlet.

• University of Victoria - The Faculty of Human and Social Development delivers educational programming to prepare professionals to participate in improving health and social well-being of children, families and communities. In addition to the School of Nursing, the faculty is also home to the schools of Child and Youth Care, Health Information Science, Public Administration, Public Health and Social Policy, Social Work, as well as an Indigenous Governance program.

• The Island Medical Program delivers the University of British Columbia Faculty of Medicine MD Undergraduate Program in collaboration with the University of Victoria and Island Health. Established in 2004, the Island Medical Program aims to address regional shortages of physicians in BC, particularly in rural and small communities.

The need for simulation centres

Simulation replaces or amplifies real experiences with guided experiences that evoke or replicate dynamic, complex and unanticipated medical situations in a fully interactive and safe manner. Simulation is changing much of the ways in which medicine is taught, including how trainees acquire relevant skills and how doctors, nurses and other health care staff develop and refine their skills. As a modality, simulation contributes to both the retention and recruitment of health care professionals.

Human performance in health care is strongly influenced by the interaction between the task, the environment, the situational context and the behavior of team members. Extensive research shows that superior cognitive and technical skills are not enough to ensure safety: effective teamwork skills are a must.

Previously, clinical training was independent to each practice even though these learners would, one day, practice in multi-disciplinary teams. Nurses trained with nurses and doctors trained with doctors. Now, training replicates practice and simulation centres allow for safe environments using real and relevant scenarios and tools that do not interfere with day-to-day hospital and health care service delivery.

Benefits of simulation learning

• Facilitates acquisition, application and consolidation of knowledge.
• Offers opportunities to practice increasingly complex skills in a safe and supportive environment.
• Provides an environment to develop and test clinical judgment, and interact with team members.
• Fosters reflective practice, lifelong learning and increased culture of safety and team cohesion.

The CICSL Floor Plan

View on Island Health website.