A new simulator manikin is a real lifesaver at The Villages Regional Hospital.
Photos: Nicole Hamel
He bleeds, he sweats, he cries, he pees. He’s just like any other human—almost.
He doesn’t have a name. And he’s always in the hospital and will never be released.
“He” is the SimMan Vascular, a simulator manikin that arrived in February at The Villages Regional Hospital. The realistic, full-body patient is part of the hospital’s simulation program that teaches critical skills to nurses, physicians, and technicians.
The health-care field has used manikin simulators since the 1990s, but as computer technology has evolved, so has training, says Chloe Storman, a clinical educator and critical care nurse at TVRH. The SimMan represents the cutting edge of virtual reality simulators and is the most versatile of its kind. Only two such simulators are being used in the world—he has a “brother” in Norway.
“We’ve never had manikins before that could do what he does,” Chloe says. “We can do a lot of procedures that we would do in the hospital.”
The high-fidelity SimMan covers the entire patient pathway and can be used to simulate heart attack, stroke, and acute trauma patients, and endovascular procedures such as cardiac catheterizations and thrombectomies. Staff members can be assessed for individual and team skills, critical thinking, and assessment skills based on these realistic situations that they will face in the hospital.
“Our goal here at The Villages for Central Florida Health is to simulate twice and act once, which means we no longer are practicing on patients but we’re practicing on simulators so we can have those high-risk, low-frequency skills,” Chloe says.
The main goals of simulation education are improving skills, communication, processes, patient safety, and patient mortality.
For some patients, time can be the most critical factor affecting survival, recovery, and long-term health, she says. The SimMan is crucial to improving the “chain of survival,” or the steps the hospital initiates when someone comes in with trauma such as stroke, heart attack, or fractures. For example, once EMS calls the hospital to report a heart attack victim is on the way, the clinician’s goal for “door-to-open-vessel time” is 90 minutes or less.
“We can simulate that patient and actually move through our processes to find barriers or room for improvement so that we can further decrease our door-to-open-vessel time,” Chloe says.
The SimMan is only about 5 feet 2 inches tall and 90 pounds, but’s he’s anatomically correct, rugged, wireless, and self-contained. Nurses and doctors can perform a tracheotomy or put a chest tube in him, administer drugs and fluids, or place him on life support. He also speaks and can be programmed to describe his symptoms and react to treatment, even by screaming and shouting. “He” also can be programmed as a “she.”
“The only thing he doesn’t do is get up and walk, and that would make my life a lot easier,” Chloe jokes.
Everyone in the hospital can benefit from using the SimMan. And when Chloe pushes a “code blue” button, a critical response team jumps into action to save him.
“We can use him with EMS, clinicians such as nurses, techs, CNAs (certified nursing assistants),” Chloe says. “Physicians are very excited because they’re the ones that do endovascular procedures and they can utilize him for things in the OR or the cath lab.”
As a doctor working in the intensive care unit when a patient’s health is deteriorating rapidly, Dr. Andrew Seevaratnam says practicing real-world scenarios on the SimMan can improve technical skills and communication, leading to better patient care and safety. Dr. Seevaratnam, of Ocala Lung and Critical Care, is the ICU director and pulmonologist at TVRH.
“You can train procedures and you can also train scenarios,” the doctor says. “You can simulate case-based scenarios like cardiac arrest or acute MI (myocardial infarction) or stroke care. So, it helps the staff work as a team in a simulation environment and learn from what they’re doing.
“It’s really useful for simulating critical-care scenarios like airway management, so we teach our respiratory therapists to manage emergency airway intubations and how to resuscitate patients,” he adds.
The SimMan is not the only type of simulator at TVRH but he’s the “Cadillac,” Chloe says. He’s providing the “wow factor” to staff and community members alike.
“Everyone is astonished by all the things that he can do, how realistic he is, and so people are extremely excited to utilize him in education,” she says.
Chloe is devoted to education and credits Michael Pittman, TVRH chief clinical officer and site administrator, for backing the department.
“Without Michael, we really wouldn’t have the department at all,” she says. “He has always been very passionate in motivating me as an educator to produce the simulation program.”
The acquisition of this simulator required blood, sweat, and tears—not from the SimMan, but from Chloe and members of the TVRH Auxiliary Foundation. She contacted Laerdal, a manufacturer in Norway, where an engineer was developing exactly what she wanted. Laerdal combined its design with the software of a Swedish company, Mentice. But building the SimMan took six months, and the training on him was immersive and time-consuming because he was so new, she says.
Chloe successfully pitched her idea to the foundation, which funds the hospital’s Support Our Workforce initiative to assist in the development and education of hospital staff. Then contributors had to be convinced and funds rounded up for the purchase. The SimMan is listed for $182,000, but the hospital got him for $165,000—all donated by the foundation—which is a bargain in Chloe’s view.
Auxiliary Foundation President Dick Campbell was instrumental to the SimMan project, she says.
“Without Dick, we wouldn’t have him,” she says. “Dick is very passionate about education and he has been helping our department since we’ve developed.”
The SimMan is a key component of the hospital’s educational suite and keeps staff from having to travel elsewhere for training, Dick says.
“I just believe technology is going to control medicine,” he says. “So, you really have to be in tune with the most current technology, and that’s what I believe the SimMan permits the physicians and the nurses to do.
“We just feel the need for medical staff is so great, we want to do our part to help it,” Dick adds.
Chloe awaits one other contribution from the foundation, which, as the donor, has the “naming rights’’ for the SimMan. She feels a name establishes a connection with the staff.
“Our other simulator is Stella Smith,” she says. “This creates a real, live situation, so anytime the staff sees Stella coming down the hallway, they know to address her as a person, because what we want to do is make the learner believe and perceive that this is a real, crucial situation.”
With or without a name, the SimMan has a guardian of sorts in Chloe. The lengthy, labor-intensive quest to get him almost was like waiting for a birth.
“It’s been a very exciting experience,” Chloe says. “Everybody says he’s like my child. You get really attached because it brings self-gratification for me to see my learners entertained. Everybody has been able to benefit from something in our simulations that we do here.”