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| Residents practicing in the Simulator Suite |
Children's Hospital Boston and Harvard Medical School have invested in state-of-the-art, high-fidelity simulator programs to optimize learning in the acute care setting. Children's Simulator Suite is an exact reproduction of an intensive care unit bed space. The suite is outfitted with gas outlets, medical equipment, and both pediatric and infant patient simulators. Adjacent to the simulated patient room is a video control room linked to a conference room through closed circuit cameras for video-based debriefing sessions. An example of residents being trained in the suite is shown here. Additionally, the Program to Enhance Relational and Communication Skills (PERCS) has been developed to train critical care clinicians in communication skills by simulating difficult end-of-life discussions with standardized actors who play the roles of patients and parents. The simulator suite is used on a regular basis during the junior year ICU rotation. There are weekly mock codes with the residents, fellows, nurses, and respiratory therapists. In addition, there are frequent procedure sessions led by the ICU fellows to practice procedures such as intubation, central line placement, and chest tube placement.
At BMC, the PICU utilizes a portable SimBaby, which can simulate a range of conditions and enables a number of procedures from intubation to IV placement. The PICU senior develops a weekly mock code for the ward team, which starts with interns learning to use basic equipment and progresses to the ward junior running a complex cardiac code.
Given the importance of, and the difficulty in running a code well, the practice of mock codes is not restricted to ICU rotations. They are scheduled as part of all of the inpatient rotations as well as during intern, junior, and senior rounds. The focus is on increasing skill level over time, knowing how and when to call for help and importantly, the basics of good communication in running a successful code.
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