Queen’s Clinical Simulation Centre celebrates RCPSC accreditation
This afternoon we celebrated a significant milestone for the Faculty of Health Sciences – the Royal College of Physicians and Surgeons of Canada’s accreditation of our Clinical Simulation Centre (CSC).
It’s hard to exactly pinpoint how simulation in healthcare education started. Some might argue that the very birth of simulation is rooted in our initial experiences with standardized patients. Others might argue that simulation, especially in the procedural areas, was birthed in a long-standing tradition of the use of cadavers and animal models in health care learning. Regardless of where it started, I would suggest that what has fueled the amazing growth of simulation in our professions can be attributed to four things.
First, without doubt, the patient safety movement has emphasized the need that we must avoid medical errors at all cost. And fundamental to that avoidance is the notion of practice. As Vice Lombardi, the famous football coach once said, “…it’s not practice that makes perfect, stupid….it’s perfect practice that makes perfect.” And really, the only logical venue for perfect practice is in a simulation environment.
The second element that has fueled the growth of simulation labs has been technology. While I remember doing an anastomosis on a Penrose drain, now our students can practice an anastomosis on lyophilized intestine, surrogate bioengineered vessels, or using computer-based simulations.
The third element that has taken us to a new level in simulation, and this is somewhat of a paradox, has been the whole issue of work-hour restrictions in North America and across the world. These restrictions, as severe as 35 hours per week in Norway, are a new reality that we are all learning to live with. But fundamental to this new reality is that we must, at all costs, maximize the educational value of each hour that we have with our students and residents. Certainly in terms of preparedness for doing procedures, there is no better bang for the buck that simulation-based training.
The fourth and final reason that simulation has taken off and will continue to be a critical element in the training of health professionals is the issue of evidence. Day after day, week after week, month after month, for the last fifteen years, we have seen scholarly evidence emerge that simulation-based training leads to greater efficiency, fewer errors, increased trainee confidence, and transfer of the skills learned in the lab to the real world of our resuscitation rooms, our clinical wards, and our operating theatres.
Given this rapid growth in simulation, it was not long ago that our health sciences students at Queen’s were scrambling for space for technical skills training and patient simulation. Early on, the School of Nursing generously shared their modest 800-square-foot lab with their student colleagues, but with a growing need for simulation training there was little room for expansion. Finally, the call for a large, state-of-the-art, and interdisciplinary simulation laboratory was answered with the announcement of the New Medical Building.
Shortly after the announcement was made, Dr. Bob McGraw was appointed as the inaugural Director of the CSC. Leading up to the centre’s construction, Dr. McGraw and a small team travelled to simulation laboratories all over North America to research what was working, and what wasn’t. When it came time for construction, the details had been meticulously laid out, and on more than one occasion, I found Dr. McGraw in the midst of it all with a construction hat on.
The CSC eventually opened in September 2011, the end result of eight years of careful planning with broad input from all three schools in the Faculty of Health Sciences; it is now the contemporary, high-tech training space that we’d hoped it would be. Within its 8,000 square feet of space, the simulation lab’s team now hosts over 800 sessions each year, 20% of which are interprofessional in nature. With the recent introduction of competency-based medical education here at Queen’s, we’ve seen a marked increase in both the number of residency training sessions hosted in the lab and in the sophistication of the simulation. Additionally, many of those studying simulation training are now conducting their research within the CSC.
That said, the rapid uptake meant that “in some respects, we were flying by the seat of our pants,” explains Dr. McGraw. “The accreditation program offered by the RCPSC provided us with an opportunity to step back and review our processes and be sure that our educational, research, and patient safety goals were in line with what other more experienced Canadian centres were offering. It also allowed us to see how we looked from the ‘outside’ by having experienced simulation program leaders tour our centre and review our documents.”
In the end, the CSC was granted full 5-year accreditation status from the Royal College. “The external recognition from the RCPSC validates all of the hard work and shows that the vision of our predecessors is being properly realized,” says our former dean, Dr. David Walker. “This accreditation augurs well for multidisciplinary health professional education in the years ahead.”
“While we received a number of useful suggestions for moving forward, on the whole the accreditation team were very impressed with our facility, our programs, and in particular our dedicated faculty and staff,” says Dr. McGraw.
Kim Garrison, the CSC Operations Manager, agrees that the centre is special because of the people it engages. “Queen’s has the most capable faculty members who exhibit knowledge and patience that could not be surpassed. We also have a dedicated team of staff who consistently make the CSC a welcoming environment to work and learn in; we are thankful that the leadership in the Faculty of Health Sciences is so supportive and opens many doors for our simulation sessions to grow.”
Of course, being the unabashed supporter of simulation training in health care education that I am, I couldn’t be more proud of the CSC and the students, staff, and faculty who make it so great. To Dr. McGraw, Ms. Garrison, and their small, yet dedicate team – thank you for everything you’ve done to make this centre a first-rate place to study, work, learn, and teach.
If you’d like to leave a comment for the CSC team or share a great sim lab story, please feel free to do so in the comments below. Or, if you’d like to have an old-fashioned chat about the history of simulation, feel free to drop by the Macklem House; my door is always open.