CHARACTERISTICS OF SIMULATION CENTERS

Although one can install a simulator in a laboratory or conference room, many institutions have equipped complete simulation centers. Figure 84-13 shows a floor plan of the multiroom simulation center of one of the authors (D.G.) at the VA Palo Alto Health Care System and Stanford University. Figure 84-14 illustrates the equipment of a simulation center in more detail. Typically, these centers provide a separate control room to allow complex simulations to be presented without an instructor intruding on the simulated case. The center also provides a debriefing room where videotapes of the simulation session can be reviewed. Some centers have elaborate computer-controlled audio-video systems allowing the recording of multiple views with real-time annotation of the tapes and rapid search to marked portions of the tape. Figure 84-15 shows the simulator control room with advanced audio-video equipment at the Center for Patient Safety and Simulation of one of the authors (M.R.) in Tübingen, Germany. Dedicated centers facilitate all types of research and training applications of simulators, but they are especially important for

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Figure 84-13 Multiroom simulation center at the VA-Palo Alto Health Care System and Stanford University. Two control rooms and two audiovisually interconnected lecture rooms provide the opportunity to run three patient simulators at the same time. ER, emergency room; ICU, intensive care unit; OR, operating room.

The costs of a simulator training program can be shared among the anesthesia departments of multiple institutions, as was the case at the Boston Anesthesia Simulation Center. The cost can also be shared among different departments within a single institution because the simulator can be a resource tool for training in other areas besides anesthesia. The anesthesia simulator is really a simulator of a critically ill patient, which can be a suitable platform for training of physicians, nurses, technicians, and

Figure 84-14 Prototypic example of a simulation center. The instructors in the control room look through a one-way mirror into the operating room/intensive care unit (ICU) while they control the "patient" from the simulator workstation and direct the audiovisual recording. Various remote-controllable video cameras, microphones, and loudspeakers in the simulator room provide the best possible view and sound from the "scene." Trainees perform on the simulator mannequin and the vital sign monitors and have to interact with the personnel involved at the same time. Nonactive participants can watch the scenarios live from the adjacent debriefing room, where the video-assisted debriefing session takes place right after every scenario (former simulation center at University of Tübingen, Germany). (From Decker K, Rall M: Simulation in anaesthesia: A step towards improved patient safety. Minim Invasive Ther Allied Technol 9:325–332, 2000.)