Biomedical Engineering Reference
In-Depth Information
4.5.6.4 Full-sized high-fidelity
mannequin-based area
but must meet the code for the facility. The ventilation
must meet specific code requirements before certain
gases such as pure oxygen and volatile anesthetics are
used. There are several centers that do not use oxygen at
all. This is usually satisfactory but may become prob-
lematic if the equipment that is in use requires the
presence of pure oxygen to function properly (e.g., cer-
tain newer ventilators). The cost of decommissioning
a ventilator by bypassing its built-in safety features may
far outstrip the cost of effective ventilation. Similarly,
the cost of ventilation to evacuate anesthetic gases may
far outstrip the educational value of having real gases
present. Ventilation must also consider heat, which is
determined by the number of people in given space and
all the heat generating equipment (e.g., an Audio/Video
rack, or numerous video displays).
A functioning vacuum/suction system should also
exist as participants expect it. This is an example of
a detail that adds to a room's fidelity but does not restrict
its functionality. The system may be small and self-
contained, as are found in dental offices, or may tie into
an existing system.
There have been many variations of design of this type of
learning environment. There is no one good answer. The
type of simulation, flow, and the participant type (and
quantity) are important in the design of this setting.
The high-fidelity area is a special circumstance where
more than one room is used for a single activity. The
rooms include a conference room, control room, supply
area, and simulation room. The challenge is in placing
these rooms and areas in proximity to each other, so that
flow within the space as a whole is self-contained and
undisturbed by other learning activities in the center
(revisit
Figure 4.5-1
).
This area is much like an apartment. In this case, the
apartment contains a control room, a simulation theater,
a debrief area, and a core area (where meds, patient
supplies, etc., are housed). The apartment should be ac-
cessible in multiple ways and for different purposes. In
one case, the purpose may be related to the participant
and the other specific for the operator (to be able get
equipment and deal with things behind the scenes with-
out being seen or heard). If possible, the apartment should
be designed in such a way that its rooms could be used
together or for multiple activities. In this way, if a full-
scale simulation session is not occurring, the debriefing
room can be used as a conference room, and the simula-
tion theater could be used for bedside training with the
group in the room. This type of arrangement provides
maximal flexibility while maintaining contextual isolation
for the participant. A center can truly exist with multiple
activities and little crossover of participants and faculty. A
center that is built with a central corridor presents
a specific dilemma when the space on either requires
movement through the common corridor for activities
excluding entering and leaving the facility. Careful
arrangement/placement of rooms is paramount. A design
that has its simulation rooms at one end and debriefing
rooms at the other opens the center to considerable dis-
ruption of different courses as people move in and out of
the different learning environments. Learning areas
should have little or no overlap and the use of the corridor
should be restricted for entrance, egress, bathroomneeds,
and other non-class-related issues.
4.5.7.2 Sound
The design and structure of the center should involve the
input of a sound specialist. It is important to consider the
isolation of sound from one area to another. This includes
considerations such as wall treatments, special ceiling
materials, wall construction, etc. The ventilation system
must also be considered as it can provide considerable
background noise. The level of noise is determined by the
size of the ducting and the velocity of the air flow. The
reverberation and transmission of sound through mate-
rials and through hung ceilings can be considerable. These
issues degrade sound quality and pose problems for the
setup of the Audio/Video system for broadcasting and
recording. The size and shape of a room will also change
the sound dynamics more than one would expect.
Building a room that is a perfect square will produce dead
spots (nodes) where sound cancels itself out as it reflects
off the walls. This may all sound like minutiae but con-
sidering this early will make a large difference in the
quality and ease of setup of your AV equipment.
4.5.7.3 Lighting
4.5.7 Utilities
Lighting affects the experience of the individual, the
activity, and the quality of recording if any is to be done.
The ''temperature'' of the lighting should be consistent
with the lighting requirements of the video equipment in
use. The placement of the lights should also be carefully
thought out, lest they reside exactly where the ceiling-
mounted LCD projector needs to go. Lighting must also
4.5.7.1 Gases and suction
As with a hospital, a simulation center will need to pro-
vide compressed gases for two purposes: (i) to deliver
gases to virtual patients and (ii) to drive equipment. The
plumbing for the gases does not need to be hospital grade
