Simulation Center helps train staff, educate future health care providers

Meet Hal. He’s one of the manikins at MidMichigan Health. With reactive eyes, dilation and the ability to blink, sometimes it feels like he’s real. And depending on the day, he might have a collapsed lung, a cardiac arrest, pneumonia, or anesthesia induced hypothermia, among other conditions. He’s there to help physicians and staff train.

“People can make mistakes and no one gets harmed,” says Joyce Cook, a senior simulation specialist who has been with MidMichigan Health for seventeen years. “We can reset the simulator over and over again.”

The Simulation Center, located in the Gerstacker Building of MidMichigan Medical Center – Midland, is home to four simulations rooms, a task training room, a control room, as well as five high-fidelity manikins, meaning they closely resemble a human reaction. Ranging from adult male and female patients to children and even newborns, the manikins are used for training staff and Rapid Response Teams, skill building in different departments and educational programs at the local high schools and colleges. 

The Simulation Center inside MidMichigan Medical Center – Midland helps doctors and staff train for specific situations, aids in skill-building and educational demonstrations.

The 3,000 square-foot center is equipped with hospital beds, a crash cart, forced air and other features necessary for treatment. The simulation rooms use special “manikins”, the manikins are programmed to respond with realistic responses based on the care they receive, such as movement, changes in breathing and heart rate.

Through interacting with these near life-like patients, new nurses and physicians are able to become familiar with rare conditions and refine procedures before having to actively perform them on patients.

“The education the manikins offer leaves our learners feeling more confident,” says Cook. “We have the ability to prepare people and work out the issues in a new procedure before they are faced with a real-life scenario.”

The five manikins have different profiles ranging from Hal and Victoria — male and female adults — to a five-year-old and two newborns. They embody a variety of medical health conditions including rare complications that can occur during labor deliveries and unique respiratory conditions. Cook says the number one training request she usually receives is to do a mock code, or a code blue for adults, which indicates a cardiac arrest.

Joyce Cook, senior simulation specialist and another nurse practice a mock procedure.

“Every time the manikins receive an upgrade, the simulation experience gets more realistic,” says Cook. “Sometimes people will be like ‘it blinked at me’.”

After a session with the manikin, Cook leads the education teams through a debrief where they discuss what went well and what can be done to make the process run more smoothly.

One department that regularly makes use of the Simulation Center is Obstetrics or OB. Between Victoria and the newborns, the Simulation Center offers training on how to address rare complications that can put both the mother and newborn child at risk.

Joyce Cook, senior simulation specialist with MidMichigan Health

“Victoria has probably had more than 5,000 babies in simulation,” says Cook as she describes the range of symptoms that the simulator can embody.

The OB Department uses the manikins to mimic unique conditions such as post-partum hemorrhaging or shoulder dystocia, a complication that occurs in less than five percent of pregnancies and can cause the infant’s shoulders to become stuck in between the mother’s pelvis during birth.

“It’s invaluable for our teams to have these simulations be part of our learning,” says Jeanette Musser, 43, a registered nurse focusing on maternal and child health. “Nurses can practice being in very stressful, life-threatening situations and they know that if something didn’t go as well, it’s a safe environment to make those mistakes and learn from them.”

Musser helps coordinate biannual trainings and skills certification for her department. For her, one of the most impactful uses of the manikins comes in helping prepare teams to handle neonatal mock codes. During these scenarios, teams of nurses and physicians have to figure out how to resuscitate a newborn who may be coding, a situation where things can go awry in a matter of seconds.

“It’s quick thinking, and knowing what to do that can really make a difference during that time frame,” says Musser.

Manikin Victoria has probably had more than 5,000 babies in simulation.

For the trainings, team leaders present participating groups with an imagined scenario — sometimes one they have come across in their own experiences — and staff must work together to stabilize the patients. When it comes to working with a newborn, staff can create almost all the interventions they might seek out in real life, including intubation, starting an IV and placing an umbilical cathode.

The manikins also give teams a chance to work together and troubleshoot without risking patient lives. Staff are able to learn how to work across roles and departments to ensure the best care is provided in a smooth and efficient manner.

“When you are in that situation with a patient, you have the ability to think back to the knowledge gained in training that you need to be able to have a good outcome for the patient,” says Musser.

The Simulation Center at MidMichigan Medical Center – Midland got its start in July 2015 and has since conducted everything from skills days with different departments to training for Rapid Response Teams and educational programs for the local high schools. MidMichigan Medical Center – Gratiot, located in Alma, Mich., also has a Simulation Laboratory onsite. Besides academic centers, the next closest simulation facilities are in Lansing or Traverse City.

“It’s quick thinking, and knowing what to do that can really make a difference during that time frame."

Cook has found that younger students, especially those from the high schools, are just as interested in the technology and engineering behind the manikins as they are in learning about the organ systems they mansifest.

“On days when I’m not too busy, I can play around with different functions and show them if you push this button, this happens,” says Cook.

It was her own curiosity that first got Cook involved with MidMichigan’s Simulation Center. She remembers watching a vendor demonstration, and when the presenter asked for volunteers she got up and started asking questions.

“My boss said we found a person who can help us get this program going,” said Cook who has been helping with the Center since its conception. “I have an interesting job with a lot of variety, which I enjoy very much.”

The simulation rooms use special “manikins”, the manikins are programmed to respond with realistic responses based on the care they receive, such as movement, changes in breathing and heart rate.

Michelle Kent, started at MidMichigan Health nearly 20 years ago. During her time as an EMS paramedic, she remembers using the Simulation Center to help train Rapid Response Teams at the Medical Center.

“It’s all hands on,” said Kent, life support educator for MidMichigan Health. “If someone has nerves about going into a patient’s room, they can go into that simulation first.”

Kent has two daughters who are on the path to become nurses and she sees what a difference a simulation experience can make.

“The more you see something, and the more you practice it, the better you get,” said Kent. “Really doing it, not pretending you are doing it, but putting your hands on a patient and completing different procedures makes a big difference.”

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MidMichigan Health is a non-profit health system, headquartered in Midland, Michigan, affiliated with Michigan Medicine, the health care division of the University of Michigan. MidMichigan Health covers a 23-county region with medical centers in Midland, Alpena, Alma, Clare, Gladwin, Mt. Pleasant and West Branch. In addition to its Medical Centers, MidMichigan Health also offers both home health care and physician services, and has a strong commitment to medical education.