Sim Center

Sim Center

A robotic manikin that sweats, sheds tears, has a heartbeat, and pulse. An imaging table that allows you to view skin, muscles, organs, and veins at any angle and to any depth. Detailed, unscripted interactions with “patients” in a serious form of improv theater.

That’s just some of what you’ll find at the Network Simulation Center at St. Luke’s. It’s a place where medical students can sharpen existing skills (or learn new ones), as well as practice their patient-doctor interactions.

“Student experience with simulations is an essential part of medical training,” says Megan A. Augustine, Director of Network Simulation. “Until 2014, we had separate spaces dedicated to the school of medicine and the school of nursing. But then we merged everything into a single location.” It was a wise move—as word spread throughout the network, attendance at the Sim Center grew from 3,700 people in 2014 to over 12,000 in 2018.

Many of us are familiar with golf simulators—devices that help you improve your game without setting foot on an actual course. And so it is with the Sim Center. Lifelike models help students learn proper techniques for inserting a chest tube, delivering a baby, making an incision, and other procedures…without the risk of harming an actual person. “If you make a mistake,” Augustine said, “you’re in a safe, controlled environment, and will get immediate feedback from your instructor.”

But the faux patients aren’t simply inanimate objects. Properly called human patient simulators (HPS), these quasi-androids can imitate breathing, sweating or tearing, exhibit a pulse, and demonstrate a range of symptoms. They’re connected to medical monitors that present EKG, blood pressure, oxygen uptake, even lab results, and radiology reports.

Their programmed responses to “treatment” can also push students to react professionally and quickly to unexpected situations. “Students can deliver ‘Sim Baby’ from ‘Sim.’ We can also program Sim Mom to have a medical emergency—hemorrhaging for example—so the student suddenly has two patients that need immediate attention,” Augustine explained.

The facility also features a Mimic dV-Trainer®, a sophisticated simulator that replicates the action and “feel” of the network’s da Vinci® robotic surgery system. On a smaller scale, students also use body part simulators (“task trainers”) to practice inserting arterial lines, performing intramuscular injections, inserting catheters, treating foot ulcers, and many other procedures.

In 2017, St. Luke’s realized that its large class sizes combined with its limited number of task trainers meant that many students were losing out on practice time. The cost-saving solution? Making those items in-house.

Thanks to the St. Luke’s Auxiliary, the Sim Center purchased a 3D printer, enabling the facility to produce its own devices for injections; inserting peripherally inserted central catheter (PICC) lines; treating foot and leg ulcers, abscesses, pressure wounds, hand trauma; suturing,
caring for ostomy stomas, and lots more.

“Since 2017, the printer has saved us over $40,000,” Augustine said. “Those items are costly to buy, and we use a lot of them. “But the printer also gave us an additional benefit; we can produce trainers to our own specifications, instead of relying only on what’s commercially available, and do it quickly. For example, the wound department asked for specific simulated deep wounds and pressure wounds, and a stomach for ostomy training. We produced exactly what was needed.”

In May, the Center installed an Anatomage table, which enables students to see high-resolution 3D images of external and internal anatomy. “Data from four fully scanned human cadavers are in its memory,” Augustine said. “Students can call up the images, isolate portions of them if desired, rotate them in any direction, remove the skin, extract an organ—it’s essentially a virtual dissection table.”

But medical training involves more than acquiring clinical technique; doctors and nurses must also consider the human side as well. What’s my bedside manner? How do I announce bad news? How do I handle an angry patient? Am I asking the right questions? In the Sim Center, students interact with standardized patients (SPs). These are actors who portray people with complex personal backstories, medical histories, and symptoms—and who stay in-character throughout the session, reacting to each student’s questions, approach, and demeanor.

Other hospital functions have benefited from the program as well. “It’s part of our constant effort to improve the St. Luke’s experience,” Augustine said. “SPs can help everyone—even the non-clinical staff—on a care team learn to engage personally with our patients.”

Want to learn more? Join St. Luke’s in celebrating “Simulation Week” across the world, September 16-20, at our Sim Center open house! You’ll be able to see simulators, try your skills at wound care, dissect an organ on the Anatomage table, see the 3D printer in action, and more. Check out the photo gallery on Instagram: @stlukessimcenter.

Have you spotted St. Luke’s mobile Sim Center yet?

“It’s fully equipped,” Augustine said, “so it provides practically every capability of the actual Sim Center, including SP sessions. It also features A/V recording capabilities; learners can review their procedures in the truck’s debriefing area.”

The 34-foot Freightliner truck, custom-built for St. Luke’s, means distant providers no longer must travel to Bethlehem for simulation training. Because the truck comes directly to users, there’s no need to cover shifts, or spend time on the road.

The Sim truck started traveling around the network in July, and, beginning in August, will appear at some community events throughout the Lehigh Valley. “We likely have the truck at many St. Luke’s-sponsored events, or take it to schools for our ‘Stop the Bleed’ program,” she added.

Watch for it!

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