Biomedical Engineering Reference
In-Depth Information
4.5
Chapter 4.5
Simulation facility design
Michael Seropian
4.5.1 The virtual hospital - a virtual
fantasy?
pedagogically sound. Indeed, classrooms are built the way
they are for a reason. The same consideration applies to the
construction of a simulation center or facility. Although
this point may seem subtle, it has profound implications.
Mixing of students and participants undergoing distinct
and different simulation experiences can be inherently
distracting and artificial. They are in the same relative
space for artificial reasons. This is potentially disruptive
to the education process. As with most educational ac-
tivities, the concept of contextual isolation should be a top
priority. The notion that people need to learn in an envi-
ronment that is filled with distractions is fallacious.
I once was involved in a role-play. It went something like
this. The hospital CEO walks in to announce that a major
donor wants the hospital to build a simulation center. The
monies are for start-up and construction but cannot be
used for ongoing costs. The room is filled with excitement.
Surgery has wanted to enter into this domain and sees the
opportunity to have the center accredited by the American
College of Surgeons. Nursing has long seen simulation as
a mainstay for quality, workforce issues, and cost savings.
Anesthesiology, Emergency Medicine, Obstetrics, and the
Intensive care representatives are all equally enthusiastic
to develop simulation programs for team, crisis manage-
ment, and skills training. The CEO announces that the
donor wants the hospital to build a simulation center that
is a virtual hospital. It should look and feel like a hospital.
Eyes around the table are big and clearly eager and pleased.
This scenario sounds great. Many consider it the uto-
pian solution. Who wouldn't want a simulation facility
that looked exactly like a hospital? The reality is that the
notion of a virtual hospital may actually be candy for the
mind. It is sweet and desirable. It is however a solution
that is likely reserved for those with not only unlimited
start-up funds but deep pockets for ongoing costs. The
reality is that hospitals are built the way they are to deliver
patient care as their primary focus. A hospital environ-
ment is filled with distraction and people with cross-
purposes. Although dealing with this may be a course in
itself, it is just a small part of the totality of clinical
education. Education is a secondary or even tertiary focus
in a hospital. On the other hand, a simulation center's
primary focus must be education. The educational prin-
ciples and environment must be optimized and must be
4.5.2 Design and build
for the actual use
Unless one is able to design a virtual hospital that achieves
true separation of activity, the risk of disruption of the
immersive experience inherent to simulation is possible if
not likely. As people exit a high-fidelity mannequin-based
simulation, they are often still ''in the moment'' as they
move to debriefing. Being distracted by passing colleagues
having just completed a VR training session is not peda-
gogically desirable. So what is the answer? There is not one
answer. It is important for people developing centers to
carefully assess what is desired versus what is needed.
They may not be the same thing. The seduction of
reproducing the environment to the exacting detail is
potent but likely a waste of money. As one considers what
and how to build a center, it is important to consider how
the activity (especially if it is immersive) allows a certain
amount of leeway not possible in a hospital. Once a par-
ticipant is immersed, do they really look at the wall details?
Do the wall details immerse them or does the interactivity
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