In the latest installment of our occasional conversations with Fort Worth leaders, Karen Meadows, director of the Regional Simulation Center at the University of North Texas Health Science Center, discusses the center’s new space and why simulation matters for students in health care.

This conversation has been edited for length and clarity. For an unabridged version, please listen to the audio file attached to this article.

Alexis Allison: So Karen, what is the Regional Simulation Center?

Karen Meadows: The Regional Simulation Center is an educational center that uses interactive forms of training to prepare students and health care professionals to provide high-quality patient care. The focus is really on learning skills and improving safety and effectiveness and efficiency in health care services. Simulation training is the thing that sort of serves as a bridge between what happens in the classroom and the clinical practice setting. It allows learners to take what they learned in a lecture for instance, and actually try it out before they go and use those skills in the clinical setting. And that’s important, because it allows them to make mistakes in a place that is safe to do so, in a place where they can receive feedback on their skills and make some improvements before going out into their clinical areas.

Allison: I know that this center is getting an overhaul. Can you tell us about the impetus for this renovation and this new space?

Karen Meadows is the director of the Regional Simulation Center. (Courtesy | Health Science Center)

Meadows: Absolutely. We’ve had a simulation center on our campus for over 20 years. But we now have over 2,400 students enrolled in the various programs at UNT Health Science Center, so we were really over capacity and needed to refresh and update equipment. Our leadership had a vision to create a new, state-of-the-art center that would serve as a collaborative hub, if you will, for our faculty and students as well as community providers, and that this could serve as a way to support our mission, which is to create solutions for a healthier community.

Allison: Well, you mentioned that it’s a place where students can apply what they’re learning in class and make mistakes. Can you talk about how it actually works?

Meadows: Certainly. So right now, the way our students engage with this, the faculty develop simulation activities and curriculum and then they bring a group of students through the center to do either skills training, or they may participate in simulated patient encounters and that kind of thing, to learn new skills. And we will continue to do that. One of the things that we’re looking forward to in our new center is also having some open hours that students can come in and practice on their own in the lab, and that’s going to be new. So they can take what they learned in class and continue to practice as many times as they need to perfect the skills.

Allison: Can you give a specific example of a simulation that they might experience?

Meadows: Many of our students will learn to do a medical interview at the very beginning of their training. They will learn how to greet the patient, talk about what the chief complaint is, how to take a history and get the appropriate details and read the patient and do a physical assessment. We use actors, actually, to play the role of patients, which is kind of interesting. They’re called “simulated participants” in our world, and the students really learn on real people. We also have other types of simulation activities where they might engage with a mannequin or what we call a task trainer. We have some full body computerized mannequins that breathe, they have a heartbeat and a pulse, breath sounds, they can even blink their eyes. You see their chest rise and fall — they look very realistic actually. So they can use those, especially when we’re doing invasive procedures that you can’t do on a human being.

Karen Meadows, director of the Regional Simulation Center, demonstrates simulation equipment next to a mannequin, which she then “saved.” “We’ve brought him back to life many times,” she said. (Courtesy | Health Science Center)

We also have some task trainers — these are partial body parts that are designed for doing a very specific skill, like a central line placement. A central line is an IV catheter that actually goes in the chest and all the way into the patient’s heart, and it can provide medications that you can’t give otherwise. These very high-risk procedures, you can imagine, you want to do those with plastic and practice until you have the skill down and you’re safe and ready to go to the hospital and do that in real life. That’s really the importance of the simulation center. 

Allison: Well, I know this new iteration of the center will have a virtual reality component, which to me seems like another way to be immersive. How can that virtual reality component benefit students?

Meadows: Yes, so the new center will have two projection rooms that are fully immersive — the projection is on all four walls. The nice thing about it is that it can provide a setting that we might not be able to provide otherwise. So for instance, we have a wilderness medicine program. We can actually go take a 360-degree camera out into some remote area and take a photo, and then bring that back in and bring that back into our  immersive projection rooms, put that up on the wall and then do a simulation. You can have that noise in the background, things like that. These projection rooms also have triggers built in so that you can get assistance if you need to. Algorithms can be available to students, if we choose to do that, so as the learner gains more knowledge about the basics, we can start making it more challenging, putting in interruptions and new problems that might occur in that setting. And that’s just not possible in a more traditional simulation environment. 

A rendering of an immersive simulation room in the newly renovated Simulation Center. (Courtesy | Health Science Center)

Allison: You mentioned with the wilderness medical example that the faculty can add triggers or interruptions to give the students more of a realistic experience. How else does being part of the setting help students versus just interacting with an actor, for example?

Meadows: Making it realistic is so important. So many times people walk away, and they say they didn’t even realize that it wasn’t real. You start interacting, even with the mannequin that’s plastic. So students go away feeling a lot more prepared for whatever experiences that might be. And wilderness medicine is one, but imagine, you could also set up that environment to look like an OR or other places where people might provide clinical skills and services.

Allison: Thank you. And I know that the center opens in late June and that some instructors from Harvard Center for Medical Simulation will be here. What will they cover in their training?

Meadows: This will be a four-day, fully immersive course called “Simulation as a Teaching Tool.” The Harvard CMS — Center for Medical Simulation — is very well known in the simulation community for providing high-quality faculty development. We’re looking forward to having this program here. It will provide a full spectrum of that faculty development, everything from learning how to provide a safe environment for learning, we call it psychological safety — that’s really important in the learning environment — they will learn how to conduct a needs assessment, how to write a scenario, how to implement a simulation, how to debrief. Debrief is really important in simulation, it’s really where much of the learning takes place.

Also evaluating the simulation — how can we improve that experience for learners in the future? All of those things will be covered in this course. And it is a well-known course, a lot of people will attend a course such as this and be able to add it to their resume. It’s something that our faculty are going to appreciate having and using in the future, and it will also help us to standardize the way that we do things.

Allison: Can you say a little bit more about psychological safety?

Meadows: Yes. Psychological safety is important in all aspects, but particularly in simulation, because, as you can imagine, you may be in front of your peers, having to be a little bit vulnerable, and put yourself out there and be OK with making a mistake and having others see you do that. The key to this is making sure that everyone feels that we respect anything that they bring to the table, that it’s OK to make mistakes, that we know that everyone is here to learn and grow, and that we’re not here to embarrass them. It’s all about learning. And when people feel like it’s OK to make a mistake, then they feel psychologically safe. That’s a key to learning. 

There’s lots of different ways (to pursue psychological safety). Even letting people know what to expect when they come to the center is so important. What our role is, what we expect from the learner as well. And then we’ve built in some things within our center to promote that. It’s a beautiful center, lots of glass walls and that kind of thing. Once in a while, you need some privacy. So even when the rooms have glass, we have decided that it’s a good idea to have a way to close a curtain, so that when you need to have a quiet, private conversation, you can do that and not feel like you’re on display.

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis AllisonHealth Reporter

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....

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