A Place to Make Mistakes: Simulation Centers

This article focuses on this Children’s Hospital Los Angeles (CHLA) video, outlined below.

Eight-month old Maddie Sims was ejected from a car and transported by EMS to the hospital. She was cyanotic on arrival. A team of Children’s Hospital Los Angeles (CHLA) techs, nurses and physicians packed around Maddie’s bedside.

“Let’s get the leads and get the airway,” delegates one physician. 

While the alarm sounds go off, the clinical team works restlessly to give Maddie another go at breathing.

Maddie Sims is actually CHLA’s high-fidelity infant patient simulator. After the simulation ends, the clinical team and instructors at CHLA Las Madrinas Simulation Research Laboratory hold a “debriefing” to discuss what happened. Some of the learning points include what worked well and what to do better next time. These clinicians are literally practicing medicine using a real-life situation in a non-stressful environment.

Simulation centers are growing across the US, mainly due to a transforming medical education curriculum and patient safety1. Simulation centers also provide interdisciplinary healthcare teams hands-on training to improve patient care. In such an environment, clinicians are allowed to recover from medical errors without causing harm to patients. Further, healthcare providers can advance their skills and learn how to communicate with teams.

Simulation centers are areas where mistakes can be made and health professionals can benefit from the lessons learned. Simulators like Maddie are realistic in terms of anatomy and clinical functionality: she breathes, has a heartbeat, can vary her resistance to ventilation, seizes and changes skin color as in cyanosis. The types of procedures a clinician can practice on a high-fidelity simulator include intubation, defibrillation, and CPR. A virtual learning environment is appropriate for medical schools and continuing education programs.  Students of a simulation program not only learn how important it is to communicate with a team, but they can build their medical competencies and confidence. 

[1] CH Argani et al. The case for simulation as part of a comprehensive patient safety program. Am J Obstet Gynecol.  2012 Jun; 206(6): 451-5.