June 8, 2010By Dr. Kim Baily

Out of the Closet and Into the Sim Lab!

Until the summer of 2008, the nursing department at El Camino had literally a closet full of expensive simulation equipment but no clearly defined simulation program. Faculty complained that it took too much time and effort to drag the equipment into the lab and set it all up. Anyway, why use the manikin to teach Foley catheter insertion when a hip model would work just as well?

Two years later we have a thriving simulation program and a dedicated simulation lab. How did we move out of the closet and into the simulation lab?  Presented in this article are two key components of a successful simulation program!

One:  Educate faculty!

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First, identify a group of interested faculty. One person is not enough because setting up a healthcare simulation lab takes a considerable amount of effort.    All instructors need to see the usefulness of medical based simulation for their own students even if they are reluctant to be facilitators and “debriefers”. Create a simulation committee so that one individual does not shoulder all the work.   Although debriefing a scenario resembles the post conference following a typical hospital clinic day, there are some unique challenges associated with healthcare simulation. Initial faculty training is vital.   If instructors don’t enjoy their initial experience in the simulation lab, they may be hesitant to return. Enlist the support of the department chair; she or he might be able to coax hesitant faculty to join in the fun.

We were fortunate enough to have some funding to pay for some outside expert help to design the simulation lab and to provide faculty training.  Indeed we spent more money on faculty training than we did on converting a classroom to a dedicated simulation lab. Over twenty instructors went through six days of workshops.    The funding covered the presenter’s salary but no stipends for the faculty who attended. The colleges counted two of the workshop days as flex days but the remaining four days were not funded.  Fortunately, the ECC faculty was committed to simulation and attended of the workshop days unpaid.  We provided CEUs and a free lunch!  We also realize that ongoing training is a must.

Monica Gross was designated as our simulation champion.  She attended workshops, conferences and webinars and then returned to help train other faculty.  Monica was provided 20% release time to coordinate the lab and work with individual trainee faculty after each day of sim to provide feedback about the days events. She debriefed the debriefer! We are fortunate in the state of California to have the California Institute for Nursing and Health (CINHC) and the Regional Health Occupations Resource Center (RHORC) that have supported simulation and have provided low cost simulation training at the basic, intermediate and advanced levels. California also has a thriving statewide healthcare simulation organization that promotes and supports this new type of education. Instructors new to healthcare simulation are encouraged to attend workshops. New instructors are paired with experienced faculty in the simulation lab until they feel comfortable being on their own.

Another low cost way to train faculty is to send your faculty to local nursing schools that have well-established simulation programs.  We routinely host faculty from surrounding schools. These visitors are welcome to spend a few hours or a few days with us. Be careful to vet the simulation center before you send faculty to visit another school because not all simulation centers are created equal.

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We started with a number of basic scenarios and we assumed that faculty could jump right in and teach any of the scenarios even if the subject was not their specialty. However, we soon found out that when we randomly assigned instructors to scenarios, instructors were uncomfortable if the scenario did match their area of expertise. Also the students quickly realized if an instructor was not a content expert and the realism of the scenario tended to diminish. We wanted simulation to be a positive experience for faculty and students, and so now we have a content expert in each scenario.

Two:  Hire a simulation tech!

The second vital component of a successful simulation program is the simulation technician.  We could not run the sophisticated simulation equipment and focus on the educational needs of students without the help of our tech. Our simulation tech is an EMT with computer skills and he has been a great match for our simulation lab. The attributes of an effective simulation technician are the subject of other articles on HealthySimulation.com so I will not go into details here. We could not run our program without our simulation tech.

The simulation tech frees the faculty to teach.  While faculty debrief, our tech sets up the next simulation and then run the scenario.  The tech keeps the equipment in order, sets up electronics and manikins; trouble shoots technical problems and generally keeps the lab functioning.  My greatest concern is that the soft money we use to pay the tech will dry up in this current economic downturn.


Setting up a new Simulation Lab takes a lot of time and hard work.  Reward and invest in those who love simulation and they will help to water the new earth of your Simulation Program! Post any questions or comments below and we will be sure to answer them!

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