A Medical Training Facility: The University of Ottawa Skills and Simulation Centre (uOSSC)

With a total square footage of ≈ 20 000 ft2, the uOSSC is the largest simulation centre in Canada! I toured the innovative uOSSC and spoke with its manager, Kevin Thomas. The mannequins used for training were stunningly lifelike (they even give birth!). Watching from behind a one-way mirror, I even had the opportunity to observe a medical resident practice diagnosing and treating a patient. How cool!

 

Who Uses the uOSSC Simulators?

Undergraduate students in the Faculty of Medicine at the University of Ottawa as well as postgraduate medical residents take courses at the uOSSC. The centre also provides continuing professional development to practicing physicians. The uOSSC is operated in partnership by The Ottawa Hospital and the University of Ottawa Faculty of Medicine.

 

Why use Simulators?

The clear advantage of using simulators in the medical field is the direct correlation to improvements in patient safety. During training at a simulation centre, learners can feel unafraid of making mistakes since they know that no patients are at risk. They can also repeatedly practice procedures that are rarely available in the clinical environment. Thus, they can become more proficient in dealing with rare occurrences.

 

High Fidelity Simulation

A high fidelity simulation is one in which a learner uses mannequins to practice diagnosing and treating disorders. Learners use tools that would be available in a real clinical environment and the training simulation as a whole is made to be as realistic as possible.

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The full body mannequins act as the patients that learners practice on. They have simulated pulses in their necks, arms and feet as well as heart and breath sounds. If mannequins go into cardiac arrest, they can be shocked with real energy to get their hearts pumping. Mannequins cry, bleed, sweat and blink. Their pupils even react to light! Perhaps most importantly, they respond accurately to medications, fluids and chest compressions. These impressive pieces of technology are controlled wirelessly and technicians and nurses often play the voice of a mannequin and run its vital signs.

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One mannequin that I saw can realistically give birth to a baby mannequin. Complications such as breach and shoulder distortia can be created and a Caesarian section can even be done on the mother mannequin! I also got to try out Harvey, a mannequin that can simulate about 20 different heart conditions as well as a normal heartbeat. The mannequins are a critical tool in the four high-fidelity simulation rooms that the uOSSC hosts, namely two operating rooms, one intensive care room and one labour and delivery suite/emergency room.

 

Procedural Skills

Procedural skills training teaches a specific kind of technique. For example, a trainee may use a model of skin to learn how to suture or a model of a chest to learn how to put in a chest tube. Trainees work in one of the uOSSC’s sizeable rooms. Each room contains rows of surgical tables and a large screen on the wall. The screen is used to project a view of the teacher’s operating table so that the rest of the class may emulate it.

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Procedural skills training is used in all the different departments and divisions within the Hospital and the uOSSC offers a lot of it! In fact, the trainees were going through such huge amounts of expensive skin material that the uOSSC chose the more cost-effective option of making its own simulated skin. The uOSSC techs make skin with various layers and thicknesses. They also go through special training on how to make wounds, kind of like Hollywood make-up artists!

An example of a procedural skill is laparoscopic surgery training for surgical residents and practicing surgeons. Traditional surgical techniques used a large incision to allow access to organs. This meant much longer healing times and much higher risks of infection. In contrast, laparoscopic surgery involves strategically cutting a few small holes to allow instruments, a light and a camera to enter the body. Performing laparoscopic surgery is a new and challenging skill for some practicing surgeons. This is because it is difficult to operate with a longer instrument and hard to adjust to using a camera to see the surgery. Laparoscopic surgery is but one example of how it is essential for the medical profession in general, and for physicians, nurses and techs in particular, to keep up with the ever evolving field of healthcare.

 

OSCE (Objectively Scored Clinical Evaluation)

Learners at the uOSSC have what is referred to as a Standardized Patient Encounter. In other words, they walk into a surprise scenario where a real actor plays the part of someone who is afflicted with a specific condition. The learner must diagnose and suggest a treatment for the patient in a time sensitive and monitored environment. There is a proctor, an experienced doctor, on the other side of the one-way mirror watching learners and taking notes on how they do! This is a chance for learners to take patient histories, hone their communication skills and apply their medical knowledge in a realistic situation.

 

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The physician proctor on the other side of the one-way mirror runs the computer that captures a video of the experience. He or she also tags the video at key moments in the scenario, adding notes on how the learner is doing and how the learner can improve. Following the scenario, the proctor and the learner discuss the experience in a conference room. Often, more time is spent in discussions than in the actual scenario! The departments of anaesthesia, obstetrics and gynecology, critical care and emergency medicine run the OSCE type of simulation.

 

The Future of Simulation in Medical Training

Overall, highly functional mannequins are allowing medical professionals more hands-on training than ever. Simulation centres are an emerging trend and there are now simulation centres in nearly every major teaching institution and hospital in Canada! The University of Ottawa Skills and Simulation Centre is at the forefront of this revolution in healthcare training.

*Photos courtesy of the uOSSC