Tulane University opens advanced medical simulation and team training centre

Tulane University School of Medicine announced today the opening of the Tulane Centre for Advanced Medical Simulation and Team Training, a $3 million, 14,000-square-foot facility dedicated to improving patient safety and preventing medical errors through comprehensive training for all health care professionals - physicians, nurses, pharmacists as well as medical students and residents - in a realistic environment.

The centre vividly replicates a hospital setting with a fully equipped emergency room, intensive care unit, operating room, clinical exam rooms, hospital patient rooms, nurses station and labour and delivery suite to give health care providers a real-world environment to learn, practice and master the latest techniques for patient care. The centre also features high-fidelity, life-sized robotic patients that can mimic ailments and symptoms hospital staff see on a daily basis. The manikins breathe, move their eyes, speak and have a variable pulse and heart rate. They react to doses of medication, receive intravenous therapy and can even go into cardiac arrest and expire.

While Tulane's centre features the latest in industry standard equipment, what sets it apart from other medical simulation centres is its emphasis on inter-professional team training. Instructors will use techniques developed in the military and aviation sectors to teach health care trainees and professionals to respond as a team to different scenarios and problems. The centre will incorporate TeamSTEPPS, which stands for Team Strategies and Tools to Enhance Performance and Patient Safety. The program, which was jointly developed by the Department of Defence and the Agency for Healthcare Research and Quality, is a system for training health care providers in better teamwork practices using standardised communications strategies and protocol. The guiding philosophy is that effective teamwork is vital to reducing medical errors.

'Despite the fact that most health care today is delivered by teams, health care professionals are rarely training together,' says Dr Benjamin Sachs, senior vice president and dean of Tulane University School of Medicine. 'The centre, which is one of the few in the country with medical simulators and team training, will provide physicians and students the opportunity to learn first-hand the benefits of working together to reduce medical errors in a realistic environment.'

The Tulane Centre for Advanced Medical Simulation and Team Training will allow students to follow a patient's journey from an initial diagnosis in a doctor's office to being rushed into an operating room for life-saving treatment. Another unique feature of Tulane's centre will be the integration of standardised patients from its nationally recognised Standardised Patient Program into the training process to emphasise communication and interpersonal skills in medical care. Standardised patients are lay people trained to act as if they have real disorders. Along with robotic manikins, they provide the opportunity to simulate the full continuum of care a patient would receive in a clinic or hospital. At times, this could also include a standardised patient who would role-play the patient's spouse or care-giver so that a physician or student-in-training would have to explain their diagnosis to family members. They could even be called upon to explain complications or deliver bad news about unintended outcomes.

To maximise the lessons learned in training, the centre has an integrated network of 42 cameras and numerous microphones to record all aspects of procedure simulation. A team of health care trainees can spend the morning performing laparoscopic surgeries in one room and enter a debriefing room immediately after where an instructor can screen a DVD of their work to assess their skills. This monitoring system can also link off-site classrooms to live simulation sessions so medical students can observe residents or others in training; two-way microphones allow classroom facilitators to ask instructors questions as sessions are in progress.

'Having the ability to review web-based video of the simulation event is a tremendous asset for participants who can assess their work and reinforce the techniques they practised,' says Dr James Korndorffer Jr., medical director for the centre. 'This greatly enhances the educational opportunity of the simulation training.'

The facility incorporates several high-fidelity, virtual reality simulators, including Mentice's VIST (Vascular Intervention Simulation Trainer), Sibionix's GI Mentor II endoscopic trainer, as well as six high-definition laparoscopic training stations. These simulate procedures such as angioplasty or colonoscopy.

There are eight manikin patients, including: Medical Education Technologies' adult Human Patient Simulator (HPS), a top-of-the-line, fully automatic, high-fidelity patient simulator specifically designed for training in anaesthesia, respiratory and critical care; PediaSIM, which is a paediatric HPS calibrated to mirror responses of a young patient; two adult SimMan(R) models, which are portable, advanced patient simulators that have realistic anatomy and clinical functionality; SIMbaby and SimNewB, which are life-sized infant and newborn manikins; and two NOELLE Maternal and Neonatal birthing simulators, which feature pregnant manikins that can go into realistic labour and delivery. The facility will also incorporate numerous, smaller devices that focus on specific tasks and areas of the body. These range from artificial limbs used to instruct students in administering an IV to artificial torsos used to demonstrate abdominal surgery.

The centre is located at 131 S. Robertson St. on the third floor of the Murphy Building in New Orleans' downtown medical district. While one of its primary functions will be training Tulane students and residents, it has a broader mission to serve as a best-practices training and certification resource for health care providers throughout the region and any other industries that benefit from a simulated environment.