Unveiling shows VA’s simulation work to provide better Veteran care

A crowd of people gathered around Jonathan Nguyen as he spoke to a mannequin lying in a hospital bed. Stranger yet, this one talked back. As its eyes blinked and its chest cavity rose and fell from simulated breathing, it told Nguyen about its pain.

This interaction displayed the latest simulation center for improving Veteran care, unveiled Sept. 17 at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. The opening coincided with Healthcare Simulation Week Sept. 16-20.

Simulation growing

Simulation is a rapidly growing program within VA, said Dr. Scott Wiltz, associate medical director for training at the SimLEARN National Simulation Center in Orlando, Florida. The program helps train healthcare professionals to improve service to Veterans.

“We want to make sure everyone is trained to a standard,” Wiltz said. “That’s the key to zero harm, high reliability healthcare, earning the trust of Veterans.”

As an example, Wiltz said a cardiac arrest victim is 50% more likely to survive at a VA medical center. He said a study showed the increased survival rate was due to standardized training, which is one of the main goals of simulation.

VA currently has a network of 12 advanced certified sites. Wiltz said these sites are doing the “biggest and best of simulation” for VA, including virtual reality training and video training. Instead of sitting behind a screen completing computer-based training, healthcare providers can learn skills through hands-on and live-action demonstrations.

The programs also greatly increase training opportunities, leading to better-trained staff to serve Veterans. A typical training program could train 10-12 people at a time. With virtual classes, multiple sites can join in, training up to 50 people at a time. The programs also recently opened up to DoD and Immigrations and Customs Enforcement (ICE) healthcare participants.

Simulation is used in other industries as well, such as training pilots and aircrew on aircraft, and oil and gas employees on pipeline design and storage management.

Newest facility

At Richmond, trainers can program the mannequin for a variety of different scenarios, said Nguyen, who is a simulation operations specialist. The mannequin talks, breathes and even bleeds. Trainers can simulate cardiac arrest, code blues, gunshot wounds and a host of other situations.

Throughout the training room, microphones and cameras capture events as they unfold. Once a scenario is finished, trainers can replay and point out where trainees can improve. Many times, trainees will see areas where they can improve just by watching the replay.

The simulation components can also move outside the training room and into work areas, Nguyen said. The medical center recently trained on an operating room fire with smoke and fake fires, as well as moving patients up and down stairs if there’s an evacuation.

Patient safety and path forward

Since VA has a large population of residents, or doctors in training, simulation can help with patient safety significantly.

“We can teach people a lot of stuff before they go out,” said Dr. Michael Czekajlo, director of the Simulation Center. “If you’re a nursing student, a medical student or resident, you can be on your cardiology rotation and there were no heart attacks the week you were there. With simulation, we can make sure you saw that process.”

Czekajlo said having simulation allows a chance to perfect techniques. The technology has been used to help brain surgeons test new methods to ensuring standardized care, all without harming any patients.

The latest opening is an example of VA’s path forward on healthcare technology. Wiltz said there are pockets within VA doing very well with simulation training, which they are trying to expand. Additionally, VA is collaborating with the Defense Health Agency, sharing information and resources to improve care.

For more information about VA’s SimLEARN program, vist https://www.simlearn.va.gov/.