UC Riverside SOM – Healthcare Simulation Success Story
The University of California Riverside School of Medicine (UCRSOM) opened its doors in 2013 graduating its first class in 2017 with seventy-seven students to be admitted this fall. How did this sim program come about and how is simulation in healthcare evolving at this institution? Today Dr. Kim Baily PhD, MSN, RN, CNE, takes a closer look at the UCR SOM program and its UC Riverside simulation lab is housed with the Center for Simulated Patient Care (CSPC) which serves the professional and local communities as a focal point for research and development of new simulation techniques for medical education.
Unlike other medical schools in the UC system, UCRSOM is not located within a major medical center but rather students rotate through a variety of medical centers and hospitals in Inland Southern California to obtain their clinical experience. In year 1, after being assigned a physician-mentor, students begin a three-year Longitudinal Ambulatory Care Experience where they participate in the care of patients under the supervision of their mentor.
The UC Riverside simulation lab is housed with the Center for Simulated Patient Care (CSPC) which serves the professional and local communities as a focal point for research and development of new simulation techniques for medical education. The Center works closely with faculty and students from the School of Medicine and with other researchers at other UC and UC Riverside schools and departments to design and development new, leading-edge technologies and training methods for simulation in clinical care. The CSPC uses task and patient simulators including standardized patients, mechanical patients, virtual and augmented reality. UCRSOM has trained some of their standardized patients to become educators and has named these standardized patients “Patient Instructors”.
Chris Miller, C.H.S.E., M.I.C.P., M.S.C.P. the current Director of Operations, joined UC Riverside in 2013 and like many healthcare simulation champions, found that simulation was non-existent and no one actually knew how to turn on the manikins. Using connections from his previous career as a firefighter and paramedic, Miller made the SOM manikins available to the local fire department. Staff at UC Riverside SM began to take notice as firefighters practiced codes and other clinical situations. Wesley Lockhart C.H.S.O.S., M.Ed., Simulation Specialist joined the CCPC in 2014.
Five years later, the simulation center is busy with undergraduate and graduate learners working with task trainers, high fidelity manikins, standardized patients, virtual and augmented reality. Interestingly, mechanical medical simulation is still not formally included as part of specific undergraduate coursework however, 100% of undergraduate medical students participate in a voluntary simulation program. The level of voluntary participation attests to the quality of the simulation at UCRSOM and the benefits of simulation perceived by their undergraduate medical students.
Breakdown of UCRSOM Simulation Use:
- Community: 1%
- Campus: 15%
- Undergraduate Medical Education (OSCE): 10%
- Undergraduate Medical Education Extra Curricular: 32%
- Graduate Medical Education: 42%
Kudos to the simulation team for supporting programs beyond the School of Medicine — this shows community involvement and center awareness not to mention the increased utilization and greater ROI!
Undergraduate Medical Education
Includes simulation in a variety of extracurricular activities including:
- ACLS bootcamp.
- Healthcare Simulation Selective in which qualified second year students use simulation to teach first year student clinical skills.
- Fourth Year “Back to Basics” which includes two weeks of basic skills review and two weeks of specialized simulation activities based on the learner’s anticipated elective following graduation.
- L.E.M.E. (Longitudinal Emergency Medicine Experience).
- S6 (Super Summer Spectacular Saturday Sonography Smackdown) for second year students.
Graduate Medical Education
All post graduate students participate in simulation. In post graduate (PG) year one, learners participate in simulation scenarios created by PG year 2 students who are responsible for developing course objectives as well as writing the scenarios and operating the simulation equipment during the scenario. PG year 3 learners act as attendings. This program started in the Internal Medicine Program, but the concept has become the standard across all of the Centers sponsored and affiliate GME programs.
In addition to the above activities, the CSPC is involved in several community collaboratives including:
- ERASE – Response to Austere or Severe Environments includes EMT and CERT certifications for undergraduate premedical students in the main UCR Campus.
- UC Riverside Highlander Emergency Medical Services.
- SoCal HEAL, the Southern California Healthcare Educators Alliance produces IPE events:
- 35-40 10-person teams consisting of Medical, Pharmacology, PA, PM, and Nursing students use slowly resolving cases to improve interprofessional teamwork.
- Smaller IPE occurs within the CSPC in scenarios and code training with Team STEPPS underpinnings within each session..
- RADIUS-A – Riverside Aerial Delivery Unmanned System Alliance, the use of drones to deliver medicine and communication devices in isolated parts of the County of Riverside.
The UCRSOM simulation lab, which partners regularly with the Cedars Sinai Medical Center Women’s Guild Simulation Center for Advanced Clinical Skills, is working towards accreditation through the Society of Simulation in Healthcare. Currently, the simulation center has two simulation suites and one virtual reality suite however, a new 13,000 square feet simulation lab is under construction with 5000 sq. ft. being devoted to mechanical simulation/task trainers and 8000 sq. ft. to clinical skills.
The success of the CSPC simulation program is directly related to the dedication of the simulation staff. The program highlights the need for adequate funding for simulation operative staff without which, simulation programs would likely flounder.
Today’s article was guest authored by Kim Baily PhD, MSN, RN, CNE, previous Simulation Coordinator for Los Angeles Harbor College and Director of Nursing for El Camino College. Over the past 16 years Kim has developed and implemented several college simulation programs and previously chaired the Southern California Simulation Collaborative.
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