Jackson Memorial Hospital
1611 NW 12th Ave. (C-301)
Miami, FL  33136
Tel: (305) 585-6970
Fax: (305) 545-6501

The Facility

Located on the fourth floor of the Institute Building, the simulation laboratory opened in December of 2004.  The facility com­prises over 2000 square feet of space dedi­cated to simu­lation-based train­ing activities and research. It consists of a control room, an operating room, an emergency room/ICU, three exam rooms for encounters with standardized patients, a conference room for didactic teaching and audio-visual debriefings, micro-simulation laboratory, a storage room, an equipment room, and an office suite.

The simulation area was designed to be flexible to accommodate single and multi-patient simulations and recreate various patient care areas (e.g., operating room, emergency room, intensive care unit, radiology suite, ward room, cardiac catheterization lab, and ambulatory clinic). To suspend disbelief, all aspects of actual treatment areas including standard and advanced surgical and anesthesia equipment, medications, medical gases, overhead lights, and x-ray film illuminators, have been incorporated into the design of the simulation space.

The core of the simulation area is an array of computer-controlled full-body patient simulators that present realistic vital signs and respond in real time to clinical interventions. Physiological parameters and disease proc­esses can be pre-programmed or changed at any time during the simulation. The Center uses both SimMan (MPL/Laerdal), HPS (METI), and Noelle (Gaumard) equipment and is capable of supporting six separately controlled, computerized, high-fidelity mannequins.  

The Simulation Center also includes a Standardized Patient (SP) Program, which provides additional flexibility for the design of teaching programs. The SP Program uses actors who are trained to present to students as "patients." SPs learn how to simulate the symptoms of a disease, and are coached on how to respond to questions from the students. They also perform some teaching and assessment functions for trainees. Although it is not possible to inject drugs, defibrillate, or perform invasive procedures on the SPs, they do an excellent job of presenting symptoms and interacting with the medical students and complement high-fidelity simulators. Typically trainees interview an SP, and then perform examinations or procedures on the mannequins.       

While the simulators can be fully con­trolled from the bedside for informal one-on-one teaching, during full-scale team-based simulations, in­structors can oper­ate simulators and the video equipment from the control room, which is located between the OR and the ER/ICU room and includes one-way obser­va­tion windows.  These windows allow the instructors to observe trainees’ actions, con­trol video record­ing of the session, modify the simulation in progress, and pro­vide a voice for the patient (through speakers in the manne­quins’ heads).  

The control room contains the core of the audio-visual system which consists of a digital video recorder, cameras, monitors, and microphones for communication and individual participant recording, an editing setup to create educational materials for remote and off-line learning. The audio-visual system records views of the simula­tion rooms from differ­ent vantage points as well as con­current physiol­ogic data on the patient moni­tors. Specialized software generates annotated recordings of students’ encounters with simulators or SPs along with the clinical skill assessment data for comprehensive education and training. After scenarios with simulators or SPs, trainees participate in instructor-led, video-aided debriefing sessions to reflect on individual and team performance during simulation.