Advancing Crisis Management Training in Health Care
The VA Simulation Center has pioneered the use of mannequin-based, fully interactive simulators in anesthesiology, intensive care, emergency medicine and other clinical settings. Under the direction of David M. Gaba, M.D, professor of anesthesia, the group has led simulations for research and training since 1986, running a dedicated simulation center since 1995. Its current facility, which occupies 2400 square feet, contains a replica operating room, a replica ED/ICU/ward, four patient simulators and complete audiovisual recording, annotating, and playback capabilities.
The original hands-on anesthesia simulator was invented at Stanford in 1986 by Dr. Gaba and his team. The MedSim-Eagle Patient Simulator is an outgrowth of two generations of patient simulators designed and built here known as C.A.S.E. (Comprehensive Anesthesia Simulation Environment). The patient simulator is used for training medical students and anesthesia residents.
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 Debriefing session during an ACRM course led by Steve Howard, MD (far right close to monitors) |
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Faculty members at the Simulation Center developed a special intensive curriculum on Anesthesia Crisis Resource Management (ACRM). This one-day course teaches participants to become better crisis managers in the operating room or intensive care unit. The course uses a high faculty to participant ratio (4-to-3) and incorporates didactic sessions, group exercises, a two-three hour simulation session, and a two-three hour debriefing session. During debriefing, faculty and participants critique the simulation session using videotaped recording of the simulations. Residents take the ACRM course once per year during the three years of their residency.
