Practice can make perfect, but the pressing need to combat a completely new virus sweeping the planet doesn’t leave a lot of room to train.
To help Oregon Health & Science University health care workers be as prepared as possible for the global coronavirus pandemic, OHSU quickly turned to its simulation experts to train and teach timely topics such as how to safely care for COVID-19 patients and how to use personal protective equipment without putting themselves or patients at risk.
“Simulation offers a safe, structured environment to learn a new skill through repeated practice until you have it nailed down,” said Donn Spight, M.D., FACS, an associate professor of surgery in the OHSU School of Medicine and associate director of OHSU Simulation.
OHSU routinely uses simulation to educate and train its students, residents, fellows and faculty in a variety of health care skills and procedures. Health profession students, for example, often interact with actors hired to portray patients so students can put lessons into practice. And surgeons frequently rely on tabletop models and human donor tissues to refine their techniques.
But when the global pandemic prompted OHSU to narrow its focus onto the coronavirus in March, OHSU’s simulation experts altered their work, too. In addition to staff who provide direct patient care, the OHSU Simulation team was declared essential for responding to the pandemic.
“We are helping make sure staff are ready to deliver quality care to coronavirus patients before the pandemic gets worse,” Spight said.
OHSU Simulation staff used an artificial lung and their mock ICU room to train more nurses on the complicated life support equipment that could be in high demand as COVID-19 cases increase. They also partnered with the OHSU Department of Anesthesiology and Perioperative Medicine to develop a video to train staff on a new method for placing breathing tubes that’s designed to lower the risk of staff contamination from the virus.
Given the sudden increase in virtual health exams, the OHSU Simulation team also has fast-tracked a planned student simulation involving an actor portraying a patient during a video visit. OHSU’s Department of Family Medicine has used a similar simulation to train medical students for a few years, but now OHSU Simulation is expanding it for nursing and other health professions students
Simulation facilities also are enabling faculty to develop new tools that could lessen the pandemic’s burden. Stephanie Nonas, M.D., and Jeff Gold, M.D., in the Division of Pulmonary and Critical Care Medicine, are using artificial lungs and a realistic medical mannequin that breathes like a real person to test and reconfigure ventilators so they could each potentially support two or more patients simultaneously, instead of the normal one. And staff from the research lab of Albert Chi, M.D., M.S.E., in the Division of Critical Care and Acute Surgery are using the same simulation equipment to test and refine a 3D-printed ventilator prototype they are developing.
“The OHSU Simulation lab has been instrumental,” Chi said, noting OHSU’s lifelike devices enabled his team to make significant design improvements that wouldn’t have been obvious otherwise.
This isn’t the first time OHSU Simulation has risen to meet an immediate and intense need. Simulation staff also developed training videos during the 2014 Ebola outbreak to ensure staff knew the safest way to put on and take off personal protective equipment without accidentally contaminating themselves.
One of those 2014 videos was shared again last month when staff needed to remember the same critical techniques for a new challenge. Spight also expects the materials and efforts developed by OHSU Simulation staff now will be redeployed for a future, unforeseen crisis.