On Wednesday 6th November I spent my first day observing the activities at the Simulation Centre, Larbert, sitting in on a training day for Junior Anaesthetists. The training follows a three stage method: briefing (within training rooms); simulation (within simulated clinical environment); followed by de-brief and evaluation (discussion and watching recorded footage of simulation within training rooms). In order to participate I was given the role of Surgeon’s Assistant. When I first stepped into the simulated theatre in my scrubs and put on my robe, mask, gloves and hat, I was somewhat nervous and daunted by the fact I had no idea what to do and it did cross my mind just how nervous I would have been if it was a real patient on the bed, not just Standard Man (Stan for short), the high definition mannequin.
The staff at the Simulation Centre are trying to achieve what they describe as ‘psychological fidelity’ i.e. an experience that feels real for the trainees. Methods they use to do this include briefing the training group about the patient scenario outside of the simulated theatre, so that they enter speaking to the ‘patient’, rather than the mannequin, the ‘Surgeon’ in the training scenario (who is part of the training team) plays a vital role in this realism, pushing the trainees with real world pressures (there are ‘x’ amount of patients still to get through today) and of course the physical responses from the high definition mannequin itself. The scenarios were all emergency situations and the stress was palpable whether observed as a participant within the simulated theatre, or as an observer watching the live video feed within the training room, which creates an extraordinary environment that all participants are psychologically invested in.
The training room live video feed
The training sessions demonstrated to me the complex interpretations that are routine undertakings for medics. The multi-layered information from readings (heart rate, CO2 levels, etc), the patient themselves (is breathing shallow, lopsided etc) and the other contingent activities within the room (even down to the effect of tilting the bed), requiring systematic consideration (in the de-briefs, algorithms to apply in different situations were discussed) to establish the required response (anaesthetic, pain relief, physical intervention, and also importantly when to use the phone in the corner of the room to phone for further help).
All of these scenarios are set up and operated by the Simulation Centre’s Control Room. It’s from here that the Simulation Centre staff voice the patient (the live voice comes out through the mannequin), operate the software that controls the mannequin, observe and also where that phone in the corner of the simulated theatre phones through to. On my next visit I’m going to be shown the ‘Standard Man’ software that controls the mannequin, to look at the possibility of manipulating set scenarios.
In the meanwhile, I also learnt some new vocabulary, examples of which are below:
cricoid, tachycardic, turp syndrome, hypoxia, intubation, bradycardic, hypercapria