The Importance of Healthcare Simulation

Competing Nationally
After competing in RVUCOM’s simulation competition last December, two teams were chosen to attend the annual American Medical Student Associations (AMSA) Convention & Exposition to compete in the SimChallenge. The RVUCOM teams competed against 14 teams of both DO and MD students from across the country. Both teams made it through the first round that included identifying ear and eye pathology on examination simulators, interpreting still-shot ultrasound images, caring for a virtual patient, and handling a coding, simulated patient onstage. The following days of competition consisted of head-to-head clinical scenarios on life-sized computerized simulators, as well as human actors wearing hyper-realistic simulating equipment, such as the Cut Suit®. Each clinical case required the teams to display medical knowledge, clinical skills, teamwork, and communication in front of a panel of judges and live audience. In the end, Team 1 made it to the semi-finals and Team 2 made it to the quarter-finals.

Regardless of the outcome, both teams expressed an appreciation for the experience. “We often judge ourselves based on personal failures and accomplishments that come in the form of a numerical grade, forgetting that knowledge…is just a piece of the puzzle,” said SD Snodgrass. “My experience demonstrated how vital teamwork is to being successful in medicine. It provided the opportunity to expand and apply medical knowledge and clinical skills, and develop communication, empowering myself to work effectively under pressure.”

Bringing the Lessons Home
Despite the many medical simulators and task trainers on the RVU-CO campus, their use is often reserved for a limited number of training opportunities. In order to prepare for the competition, the teams scheduled time with simulators, trainers, and faculty members to strengthen their skills, practice teamwork and communication, and receive feedback. “Preparing for and competing in this competition was…the most memorable of my time in medical school so far,” said SD Glaze. “I became committed to [integrating] more simulation into the training opportunities available at RVU and [sharing] my newfound love and appreciation for simulation with our student body.”

On March 31st, the members of both teams came together to host “Simulation Experience” for 24 first- and second-year medical students. SD Glaze and SD Jystad developed a complicated patient scenario similar to a challenge at the national competition. They coordinated an interactive, hands-on experience centered around the case with multiple stations that allowed students to approach the patient’s care from various perspectives. The participating students alternated through different learning stations in the Harvey Lab and Standardized Patient Rooms.

At one station, SD Jystad and SD Glaze worked with students on requesting and interpreting labs and imaging related to the case. “It was a great learning experience to break down the process of interpreting a chest x-ray in a systematic way to avoid any oversight,” said SD Jystad. SD Curtis and SD Smith led an intubation station with task trainers, while SD Slusarenko led a crash course in ACLS protocol and the importance of prioritizing and recognizing critical physical exam findings. Dr. David Ross, SD Sandler, and Diego Puentes, OMS II, ran the simulation that incorporated all aspects of care and encouraged a team approach to the complicated case.

Feedback from the participating students was very positive with many expressing interest in future sessions. “The [Simulation Experience] was one of the highlights of my first year at RVU,” said Ashley Hooper, OMS II. “It incorporated many of the clinical things we learned in our system courses in a way that we hadn’t been exposed to. It was quite the awakening for me as I had not seen an EKG or chest x-ray since that system had been covered months before. I felt like I was in a real emergency room helping to manage a very sick patient, which is something I don’t think I would’ve experienced as a first-year medical student without [this event].”

The Creation of SimConnect
The Simulation Experience closed with an exciting announcement about the future of simulation at RVU-CO. “SD Jystad and I had presented a proposal to Dr. Ross about incorporating simulation into the curriculum,” said SD Glaze. “This first Simulation Experience was a trial run of that original idea, called SimConnect. I wanted to develop a way to blend the various components of our medical education – system courses, clinical skills and procedures, patient care – into an integrated experience focused on a single patient’s clinical scenario.”

SimConnect is a student-run program that will coordinate more of these hands-on, case-based simulation sessions throughout the year. “We hope to host a SimConnect session each month that coordinates with the curriculum for first- and second-year students. However, students from the [MSBS and PA programs] are welcome to join,” said SD Glaze. The same multi-station approach will be applied to each SimConnect session, with student scholars preparing short interactive lesson plans for their stations. “We hope these experiences will strengthen the understanding of concepts, skills, and procedures taught in class for both the scholars and participating students. The goal is to synthesize the various lessons through the team-based simulation station and the following debriefing session.”

SD Jystad added, “I think most of us fear the inevitability of being responsible for a patient whose life hangs in the balance [and that] inertia associated with this fear will hurt a patient who needs quick and resolute action. Simulation allows you to rely on foundational knowledge to act without hesitation.” As an example, she described an incident in which she and several other students were sitting at a coffee shop and another patron began to seize. “The ideas of assessing scene safety, protecting their airway, and putting them in a safe position were reflexive. Preparing and competing in simulation competitions has taught me that some of the most basic actions can be the most life-saving. That’s what we hope to bring to our classmates through SimConnect.”

The SimConnect team is growing. Dr. Ross serves as the primary faculty mentor and SD Glaze leads a team of many of the inaugural simulation team members. SD Hooper leads several second-year students: “I feel as though simulation training should be incorporated into all medical school curriculums. Taking the learning outside of the classroom and into [something like] the real thing was extremely  beneficial to my own learning. This single experience has inspired me and my peers to [continue the SimConnect idea] and formally research whether simulation training helps with retaining the enormous amount of information presented in the first and second years of medical school.” Photos provided by Danielle Glaze. 

Students should look for upcoming announcements via email and on the class Facebook pages for sign-up instructions. For more information about SimConnect or to offer ideas for future sessions, please contact Danielle.Glaze@rvu.edu or Ashley.Hooper@rvu.edu.