The mission of the education lab is to use current applications as well as create new ones. We are fulfilling the first part by incorporating numerous models and simulators into the curriculum at a wide variety of educational levels. The equipment available ranges from simple part task trainers and mechanical models through computer programs to virtual reality simulators.

But it is not the equipment that makes this lab unique. Rather, it is the multi-departmental collaboration to develop novel applications that makes us stand apart from other facilities. Having equipment is only the beginning. From the start, educators must understand that it is the teaching objective, the lesson plan, which drives the development of a successful educational session. Once the objectives are in place, the instructors can look to the equipment to find the most suitable tools to teach their lesson. In some cases, the task trainers are sufficient to get the ideas across. In other cases, the life-like reactions and realistic environment of the human patient simulator are necessary in order to drive the points home.

Successful teaching sessions also require thoughtful feedback from the instructors.  In many advanced sessions, time spent on the scenario itself is a small fraction compared to the time spent debriefing and discussing the scenario afterwards.  Quality debriefing is critical to the success of these sessions, but does not come automatically.  Sally Rudy led the Simulation Center team in developing a course that teaches instructors to more effectively use simulation as an educational tool by teaching them debriefing techniques, educational theory, and other educational tools in a week-long Instructor Course.

Many of the applications in the Simulation Lab have been developed around specific areas in resident and student curriculums where we felt that current models or teaching methods were not as effective as they could be. One such example is the First Three Days Program. So far, both Anesthesia and Surgery have used these resident level introductions, and Emergency Medicine is using a modified format across the first month. The First Three Days in Anesthesia (F3DA) was the first program. It was so successful that a number of institutions around the world have begun their own versions. In July 1998, The First Three Days in Surgery (F3DS) was introduced into the curriculum. Both programs have had very positive reviews from both the residents and the faculty.

Another driving force for application development is to be able to evaluate and give feedback in areas that are currently difficult or impossible to assess. One such application is the endoscopy simulator that is currently used by a number of departments. This model will give the trainee immediate feedback as well as review a number of hard to measure parameters. It also has the capability to keep track of performance improvements over time, so that the trainee and instructor can easily determine which areas need work and which areas have been mastered. This ability to determine the problem areas enables trainees to focus their attention and time on certain aspects that need improvement, spend less time in overall training, and move to the clinical setting faster.

The lab is also helping to create programs in critical areas where competency must be demonstrated in the lab prior to attempting the procedures on real patients. The Department of Anesthesiology has adopted a difficult airway management protocol based on both the American Society of Anesthesiologists guidelines, as well as the European Difficult Airway Society protocol. Using these guidelines they have identified three airway management skills which they believe must be mastered by all residents: fiberoptic intubation, intubation using a Laryngeal Mask Airway, and cricothryoidotomy. To review the full content, including logistical problems and solutions for implementation, please email Leonard Pott.

Outreaches to the local community as well as to charitable healthcare groups worldwide is a priority for the Simulation Lab. The lab participated for the first time in Operation Smile in October 2008, training more than twenty doctors from countries throughout Central and South America. The next Operation Smile course will occur in June 2009.