Eight Critical Factors in Creating and Implementing a Successful Simulation Program from Joint Commission Journal on Quality and Patient Safety

critical sim program success factors

Having just wrapped up our free posting of the HealthySimAdmin videos (8 recorded sessions focusing on the administration of medical simulation programs), we thought we might continue the series sharing other external resources on the topic, today sharing “Eight Critical Factors in Creating and Implementing a Successful Simulation Program” from The Joint Commission Journal on Quality and Patient Safety which was produced by Elizabeth H. Lazzara, PhD; Lauren E. Benishek; Aaron S. Dietz, MA; Eduardo Salas, PhD; and David J. Adriansen, EdD, NREMT.

Background: Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians’ knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and “memorable” heuristic of the important facets of simulation program creation and implementation, as represented by eight critical “S” factors—science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies.

Conclusion: The eight factors—science, staff, supplies, space, support, systems, success, and sustainability—represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors’ relative importance may change as the program evolves.

Consider specifically number 6: Systems

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Systems should match fidelity requirements to training needs and ensure that technological infrastructure is in place! This is why considering events like SimGHOSTS is so important for your program!

For example, some simulators emphasize physical fidelity, in which the physical components of the task environment are replicated in the simulation. Physical fidelity, which can include not only equipment but even simulated patients, enables clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures. The Center for Medical Simulation (Boston), for example, enhanced the physical realism of a critical care setting by including actual medical equipment and integrating oxygen and nitrogen systems. The center also uses a mannequin that has locking mechanisms to enable the instructor to control the positioning of the jaw and neck. Other types of simulations, such as personal computer–based systems, emphasize cognitive fidelity—the extent to which the skill in the real task is duplicated in the simulated task—over physical realism. High-cognitive-fidelity simulations are equally useful when the goal of training is to foster nontechnical skills such as problem solving and decision making that are needed in the task environment. For example, in a low-fidelity simulation, in which researchers at the Keck School of Medicine at the University of Southern California (Los Angeles) used material purchased from a craft store to develop a Total Abdominal Hysterectomy (TAH) teaching model, the simulation improved both knowledge and confidence among gynecology residents— illustrating that physical and cognitive fidelity are not necessarily mutually exclusive. Best practices for SBT in health care call for matching fidelity specifications to training requirements.

When determining the level of physical realism to incorporate in a simulation, system developers should partner with subject matter experts (for example, clinicians, nurses, administrators) and training experts to ensure that program objectives are realized. In addition to selecting the right type of simulator to employ during training, it is of paramount importance to ensure that the technological and organizational infrastructure is in place to support the training. For example, training systems that use laptops may require periodic software updates and are prone to all the familiar ills and frustrations of personal computers. Issues related to signal strength, server errors, and network security are also important considerations when using a local area network (LAN) or when using the Internet.

Read the full 8 Critical Factors Article here the Patient Safety Journal Website!

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Alldattia Provides A/V Systems to Brazilian Sim Centers



Are you looking for Simulation Design services in Brazil or South America? Alldattia assists in the specification, design and installation of audiovisual corporate environments, specializing in medical simulation suites. Since 2005, they have provided hospital and surgical environments with system additions including medical devices with audio capabilities, Video, IT and Telecommunications. Systems designed by Alldattia are already running in more than 30 installations.

Recently they shared some of the lesssons learned from installing A/V systems in medical simulation spaces (some translation errors may exist):

“But a new technology was put in the market and in 2009 we started to install Realistic Medical Simulation environments. At first, we did exactly what was on the books and we immediately understood that who wrote those books knew a lot about simulation but nothing about audio and video. We’ve installed seven simulation environments for one particular client and it worked fine, but could be better. After some training, the instructors was able to operate a 50 knobs audio mixer with very little trouble. Most of the times they was not quick enough to adjust audio levels, or to eliminate audio feedback. You can imagine the mess that fifty knobs and other dozen of buttons that look all the same can do during an emergency situation. Lots of audio feedback, lots of too much volume, too low volume, and lots of complaints.

We attended Congresses, intensively interacted with globally recognized experts on medical simulation, manufacturers of simulation systems, manufacturers of medical devices, and several other experts that could contribute with us to develop better and simpler systems for the medical learning environment. We still do it. It’s a continuously learning, researching and developing. Intuitive (one button) System – UNIT (Tiradentes University, Aracaju, Brazil) Intuitive (one button) System – UNIT (Tiradentes University, Aracaju, Brazil) Back to the design desk, we started to develop what we called “the one only button system”. It’s basically a bunch of electronics that sit on hidden places where the user can’t touch or barely see. We try to hide everything that does not need to be visible. The only things that we still can’t hide are set in the top of the desk. And it has one only button (press and release). That’s it. And we never had another complaint.

The basic idea is to let the instructor to focus on medical things and completely forget about electronic devices. He or she already have too much to concentrate when operating the medical and simulation devices and scenarios. The intuitive system that we built does not need any training. Of course that one or another customization is necessary from one client to another, but it’s expected. Some clients need special features and we like it a lot. We learn with our client needs. There is one important thing that we learned, and this might be the most important.

Besides learning from clients, we need to teach and educate them before start talking about electronics. It’s necessary to listen a lot, design solutions and, sometimes, to explain why that ‘simple’ thing that is being requested should not be implemented. It’s important to put expectations to a certain level that we can accomplish.”

Learn more at the Alldattia Website today!

Level 3 Healthcare Provides State-of-the-Art Medical Simulation Center A/V System Design & Installation

sim lab av integrators

Are you about to build or renovate a new simulation space? I cannot emphasize enough the importance of hiring an audiovisual design consultant who has previous experience working with medical simulation spaces. There is so much learning that takes place when trying to integrate A/V systems across a number of rooms, networks, and campuses. I cannot tell you how many consulting calls I have had with simulation champions around the world who have to completely redesign their entire A/V system after only a year of use because they did not work with an experience service provider from the get go. Just as we know that simulation education requires staff to receive special training, so too should we consider the special knowledge required to successfully put together the countless A/V systems our simulation spaces require. For the numerous reasons below, I do recommend you call on Level 3 Healthcare to explore their support when building (or rebuilding) your simulation space.

About Level 3 Healthcare

Level 3 Healthcare is a customer focused group of medical engineers trained in the process of integrating current audiovisual technology to medical work spaces, clinical training centers and simulation labs. Level 3 Healthcare provides advanced multimedia solutions in OR’s, ER’s, ED’s and medical education centers.

This healthcare engineering group has pioneered designs in large anatomy labs, dental training facilities, telehealth initiatives, live HD video distribution, 3-D surgical theaters, recording, archiving, content management and video media retrieval systems. Level 3 Healthcare’s core competency is integrating the myriad of medical, simulation, broadcast and professional technology into a seamless, easy to use system, curriculum or application.

Our approach is to work directly with our clients to understand their needs and curriculum and apply technology to improve efficiency, work flow and learning. Examples of our applications include; intraoperative surgical suites, digital O.R.’s, nursing simulation centers, procedure rooms, 3-D visualization facilities, clinical AV networks, campus-wide central recording systems and telemedicine video conferencing initiatives for collaboration and critical decision making.

simulation av design

5  Star Service

On Konsiderate.com, the community driven ratings and review platform for medical simulation products and services has a powerful testimonial from a Simulation Center Director in the United States who rated Level 3 Healthcare a “5/5 stars” saying:

“We used the services of Level 3 Healthcare to integrate a 10,000 Sq Ft. Simulation Center. I was very impressed with their initial responsiveness, and importantly their continued support since product installation. Level 3 worked with me to develop a system, as an end user i felt would work within our facility. This was achieved and they have helped create an incredible learning environment. In our case they were working with established systems which needed to work with additional technologies. The project was completed on time and it delivered expected outcomes. Very impressed and would suggest a discussion with them early in the development process. The whole team did a superb job.”

Supporting Community

Level 3 Healthcare are the back-to-back Platinum Sponsors of the annual SimGHOSTS event, which is taking place in Los Angeles this August 4th-7th. By sponsoring the event at such a high level for a second year in a row, Level 3 Healthcare continues to demonstrate their support of those operating medical simulation technology with the community and resources they need to succeed. Having spent time with the leadership of L3HC, I can attest that they are a dedicated and professional group to connect with.

Visit Level3Healthcare.com today to learn more!

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‘Fundamentals of AV Workshop’ Pre-Con at IPSSW 2015 May 3rd in Vacouver

medical simulation a/v systems

Looking to learn how integrate audiovisual systems and processes into your healthcare simulation program? Are you new to the technology, production techniques, or lab design? Join myself and other SimGHOSTS leadership for our comprehensive “Fundamentals of A/V” pre-conference workshop at the International Pediatric Society Symposium and Workshop May 3rd in beautiful Vancouver Canada!ipssw 2015

In this workshop SimGHOSTS Founder and Executive Director Lance Baily teams up with SimGHOSTS Event Director Ryan Eling and SimGHOSTS Vice President Ferooz Sekandarpoor to cover the ins and outs of audiovisual technology and its use in healthcare simulation. Drawing on their experiences in Hollywood, higher education media technology and simulation center design, this dynamic team will use hands on demonstrations and activities to explore the many factors when choosing, installing and operating the latest in audiovisual technology. The workshop will cover four major topics: components to an A/V system, overview of major simulation A/V platforms, simulation A/V design concepts and the basics of shooting video.

Simulation centers use audiovisual technology to record and stream video content; This requires many technological components which are often locked behind cabinets and in closets. In the first third of this workshop, the doors will be pulled wide open as we look at cameras, mixers, cables, speakers and more. Get your hands on many pieces of hardware and learn how equipment from multiple manufacturers work together to create an audiovisual recording system.

In order to have a successful simulation program, a center must have a robust and reliable audiovisual streaming and recording system. These A/V systems are a significant investment, so how does a simulation center staff select the appropriate solution to handle their needs? How do you seamlessly integrate this critical technology into your center? What other technological systems must be considered when designing the A/V system for a simulation center? Discussion will cover the types of simulation labs (OR Type, ICU type and Ward type, Skills lab), proper layout/standard layout, Audio Video infrastructure, IT requirements and incorporating telemedicine. The audience will learn the tips and techniques that are required to design or retrofit their simulation spaces.

For the final section of the workshop, the presenters will discuss the basics of video and audio recording, including cinematography and other Hollywood techniques. Participants will then divide into small groups and have the opportunity to film short movies. A final discussion will cover video editing and how simple, free or cheap software can allow simulation centers to create their own training and orientation videos.

Target Audience

Professionals working in simulation who utilize audio or video equipment to stream, transmit or record simulation exercises.

Learning Objectives:

  • Identify the required and optional components to an A/V capture system
  • Compare and contrast the types of A/V system designs suitable for simulation
  • Demonstrate proper video and audio recording techniques
  • Describe the challenges and opportunities unique to A/V solutions in simulation
  • Assess your own center’s A/V system(s) flexibility, capability, and usability.

Learn more about the course on the IPSSW 2015 Pre-Con Workshop Page!

About IPSSW 2015:

Join renowned and global experts in the world’s largest meeting dedicated exclusively to pediatric and perinatal simulation for three days of in-depth discussion on the role simulation plays to provide safe and effective care to sick children and infants, and the continued evolution and expansion of pediatric simulation across the globe. IPSSW2015 will feature distinguished international speakers from a range of industries with important in-sights applicable to our practice. Don’t miss an inspiring conference with unmatched networking and knowledge exchange in hands-on workshops, roundtable sessions, special interest groups and poster presentations!

Click here to Register Today for this IPSSW Pre-Con Event!

Why You Need a Medical Audiovisual Technology Consultant For Simulation Center Design

medical simulation design consultant

Our friends at Drake Systems Group wrote in to let us know of a recent article entitled “Design Teams for Simulation Centers Call for Medical Audiovisual Technology Consultant”. I have heard numerous times from Simulation staff about the nightmares associated with their new medical simulation space because their design team was unaware of the pitfalls of building such a technology-intensive clinical training lab. This is of no fault of the end-user, nor the design company, because no one “knows what they don’t know”.  In other words, if you are building a new space – there are countless benefits to working with a medical simulation audiovisual and technology design consultant.

drake systems group

Here’s an excerpt from the article which further explains why: “A general audiovisual design consultant typically does not have the expertise or medical knowledge prerequisites for medical simulation systems design.  There are no training programs per se.  Too much time is spent learning on the job, which proves potentially unpleasant and unnecessarily costly for the client and simulation center staff.  Many audiovisual designers new to the medical field overlook details and create overly complicated systems that never get used properly, and clearly do not meet a facility’s needs. Additional support and problem solving to try and optimize poorly designed systems leads to lost time, blown budgets, and client frustration.”

If you are interested in hearing examples of the simulation center design from a diverse panel of simulation program administrators – check out the downloadable video content available through HealthySimAdmin.com.

Here’s more about the article: “Healthcare simulation is one of the few technology markets that continues to grow annually. Design in this field is highly specialized, and design teams should seek medical audiovisual technology consultants with considerable expertise or else risk delay, missed objectives, and frustrating project builds.

This DSG article will:

  • Differentiate between generalist audiovisual and medical audiovisual
  • Give the reader a unique insight into the medical audiovisual technology
  • Define the benefits of including expert technology consultant on the Sim Center Design Team”

Click Here to access the article written by Drake Systems Group, Inc. Vice President Brian Moores.

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AV Integration – What’s important to Consider?

When working with simulation labs, at some point you are going to have to assess the audio/visual needs of your program.

After attending infoCOMM here in Las Vegas recently, I read a great article in the July/August issue of AVTECHNOLOGY by Carolyn Heinze about AV & IT integration needs with regards to new building projects.

Designing AV Systems for Sim Labs

Carolyn writes “As it stands with any project—be it in the IT space, server deployment, building a bridge or implementing something to do with AV—planning is, by far, the most important task,” says John Lamberson, technical director at Crestron Electronics, Inc. For example, an integration may call for the distribution of audio and video data over the network, while at the same time requiring control data that updates managers on aspects such as lamp life for the projectors deployed throughout the facility. “Those are two very different things, and it’s important that the AV integration company, as well as the IT managers, get on the same page with reference to what’s going on and what requirements both parties have to be successful.”

When redesigning your sim lab space or developing a new space, the IT and AV issues you will face will be complicated, unique and at times, overwhelming.  Having a project lead that can help guide the process on all levels, from start to finish, with highest level administrative support is a crucial need when developing new AV/IT programs in learning environments.  Everything from what system hardware and software is necessary, to where to install the cameras and how many server-backups to have running.

Read more of Carolyn’s article “Putting it All Together – Planning for AV project management” for some key insights.

What key issues did YOU face when designing and installing your sim labs new AV systems? Write a comment and share with the community!