Pushing the limits of simulation training

NAIT's Simulation Centre re-creates the stark reality of health-care careers

You’ve just stepped into a room to find a sticky substance on the floor and someone lying nearby, moaning. There’s a nauseating smell in the air. You’re nervous – a little scared, even. You wonder, “Am I cut out for this?”

For those studying at NAIT to be a paramedic, respiratory therapist, sonographer or other health-care provider, that’s an important question.

Since 2008, students have been thrown into the sometimes messy critical care scenarios that they will inevitably face in the field – all in a controlled, safe environment. Simulations involving manikins, actors and computer programs, test their skills and even rattle their nerves while providing invaluable teaching moments.

NAIT is taking that even further with the Simulation Centre, a new facility located in the Centre for Applied Technology that makes the most of the potentially alarming.

“One hundred per cent, there’s a shock element,” says Respiratory Therapy student Nickie Cowan. Even if students are never put in positions where they don’t feel safe, “It’s kind of scary to put together everything you’ve learned in a real-life scenario. But if you mess up now, you won’t do it again.”

Dramatic reality

nait simulation centre paramedic students

The 650-square-metre (7,000-square-foot) Simulation Centre gives students the chance to “mess up” in one of nine theatres used to recreate the dramatic realities of operating rooms, intensive-care units, accident scenes and more.

The facility’s only limitation is the creativity of the staff.

Interim simulation coordinator Joe MacPherson (Respiratory Therapy ’95) has spent almost a decade creating complex health-care simulations for instructors to use with their students.

“It’s our job to increase the stress level and create teachable moments,” he says. “This is where a student can make critical mistakes and then learn from those mistakes.”

MacPherson and his team constantly refine their art to ensure that – outside of practicum placements in real hospitals and clinics – students get a full understanding of the demands of their future professions.

They pipe actual hospital sounds through speakers to mimic the chaos of an emergency room, cover floors with realistic bodily fluids, and introduce stomach-churning smells. If it’s not a high-tech manikin that students work with, it’s a professional actor trained to express symptoms specific to a particular ailment.

“It’s our job to increase the stress level and create teachable moments.”

“We have the ability and the desire to create the most realistic situations possible,” says MacPherson. “We want [students] to interact with as many of the senses as possible, not just the visual aspect of a simulation.”

They also want students from different programs to interact as they would in a real hospital setting – one of the chief concerns of Simulation Centre director Kerri Oshust (Medical Radiologic Technology ’99). “We’re working on creating scenarios that bring different programs together. [That’s] part of the great opportunity with this centre,” she says.

For example, an ambulance simulator, located just outside the centre’s doors (complete with its own harrowing driving simulation), gives Emergency Medical Technician students the experience of transporting a patient, rushing into the centre and starting treatment in the hallway.

They hand the patient off to the Emergency Department, where a Respiratory Therapy student might take over, perhaps removing an airway obstruction. Meanwhile, Medical Radiologic Technology students could prepare to take a mobile x-ray.

NAIT simulation centre monitoring room

While students literally get their hands dirty, instructors can watch from a distance, directing almost every aspect of the environment from one of the control rooms.

Hidden behind a one-way mirror, they can turn a scenario on its head.

Students might think they’re treating a standard leg fracture until a few clicks and flipped switches introduces an unexpected emergency.

Thanks to cameras, nothing goes unnoticed. Student performance is recorded for debriefing and review, where instructors explain what went well and what could be improved.

Pushing boundaries

After recently partnering with simulation specialist CAE Healthcare, the School of Health and Life Sciences is now home to state-of-the-art manikins that will enhance their simulation training.

Alarmingly lifelike – and capable of everything from responding to medication to giving birth – they’ll help students develop the myriad, complex skills they’ll use on actual human beings.

“The leading-edge simulation technology available to our students and staff is second to none in Canada,” says Rick Trimp, the school’s dean. “This partnership will push the boundaries of health-care simulation and offer a real-world, interdisciplinary education that will advance patient safety.”

A simulation leader

As part of the partnership with CAE Healthcare – an international leader in the field of health-care simulation – NAIT’s Simulation Centre received distinction as a one of the company’s centres of excellence.

The polytechnic is one of only three simulation facilities in the world and the only one in Canada to be recognized this way.

This partnership will help promote NAIT as a hub of simulation research and develop best practices for advanced simulation education using CAE technology

Trimp and his team also have plans to create a virtual simulation theatre in the centre. Using projectors, they’ll be able to create a complete accident area of their own design.

“One day we could set it up to look like a desert in Kandahar and do mass army casualty simulations. Or we could project the Anthony Henday Drive during a vehicle collision,” he says.

In the eyes of the polytechnic’s instructors and staff, such efforts are an important part of the future of health-care education.

The better prepared students become in the classrooms and labs, the more comfortable and competent they’ll be when they end up on a real accident scene where there’s no instructor directing the outcome, the blood and the odours are real, and lives hang in the balance.

Few know that reality better than Nickie Cowan. On the second day of her clinical placement, she had a patient whose tracheostomy tube stopped working. “What do you do when someone is awake but can’t breathe?” she asks.

Recalling her training, she knew exactly what to do. “We had gone through this kind of scenario numerous times in the Simulation Centre. And because of those simulations, I was prepared and it went the way it should have gone,” says Cowan.

“The patient was OK.”

Almost human

At the Simulation Centre, a manikin might be defined as the next best thing to a real patient. A new partnership with CAE Healthcare has equipped the School of Health and Life Sciences with 17 of the most realistic and intricate manikins NAIT students have ever seen, as well as other state-of-the-art simulation aids.

NAIT simulation centre CAE manakinNow, they can refine their skills in safe, controlled environments at the centre or at other programs and locations on campus with the help of shockingly real pieces of equipment. Here are a few examples:

  • The Human Patient Simulator - a manikin with working cardiovascular, respiratory and neurological systems that reacts to anesthesia and other medications
  • Caesar - a heavy-trauma manikin that can simulate severe injuries, such as severed limbs
  • Lucina - presents obstetrical emergencies while giving birth to a baby manikin
  • Cut suits - worn by actors to give students the ability to perform a variety of emergency procedures



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