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High-Fidelity Manikin-Based Simulation

This is as close to real clinical experience as simulation gets.

A high-fidelity manikin-based simulation
as seen from the control room.

By far the most complex type of simulation, HFMBS occurs almost daily in Samuel Merritt University’s (SMU) Health Sciences Simulation Center (HSSC). All SMU students, and many working health professionals, join these role plays.

Here’s how HFMBS works: In a simulated clinical setting such as an operating room, or an ICU learners encounter some combination of events that might occur there. Each learner is assigned a relevant role. A manikin exhibits the behaviors and symptoms of a patient who might be in that situation. Medical equipment registers data about the patient’s condition. Real health professionals and/or trained actors perform the roles on a multi-disciplinary team. Events unfold according to a script unknown to the learner, usually involving a critical event that challenges the learner’s ability to respond. Everyone remains “in character” for the entire scenario, which lasts about 15 minutes before the group moves to a conference room for a facilitated debriefing.

The core features of any HFMBS are these:

Realistic Clinical Setting ↑ 

The HSSC’s four simulation suites (2 sim suites in each HSSC, North and South) were designed and equipped specifically for the implementation of HFMBS. More on SMU’s Simulation Suites.

Live Participants ↑ 

In addition to one or more learners, every HFMBS scenario is populated by one or more, and often five or six, actors. These may be Standardized Patients, SMU faculty members and/or community physicians, nurses and other health care providers who have agreed to perform assigned roles. Real RNs, MDs, CRNAs, midwives and other health professionals bring an especially rich realism to the HFMBS scenarios in SMU’s HSSC.

Debriefing ↑ 

Students and faculty debrief following a simulation scenario.

During the debriefing that follows any HFMBS scenario, there is a deliberate emphasis on open discussions of errors and safety concerns. The goal is to maximize the extent to which lessons learned are applied to effective clinical practice and improved patient safety.

Examples of HFMBS Content in SMU’s Simulation Library ↑ 

Any of the following HFMBS templates may be run as a stand-alone scenario or as a “surprise twist” in a larger and seemingly unrelated performance.

Basic Life Support (BLS)  ↑ 

BLS training is incorporated into the learning objectives of many of the HFMBS scenarios used across SMU’s curricula, notably pre-licensure nursing, nurse anesthesia, and podiatric medicine.

Crisis/Crew Resource Management (CRM)  ↑ 

Relevant to all disciplines, CRM scenarios focus on complex problem solving, decision making, resource management, and teamwork. Learners who have participated in CRM scenarios are better prepared to prevent and resolve crisis situations that might lead to errors or jeopardize patient safety.

Advanced Cardiac Life Support (ACLS) ↑ 

SMU utilizes the Laerdal American Heart Association scenarios developed for teaching ACLS using SimMan.