SIMCharacters is a patient training, safety and consulting company that was founded in 2012 in Vienna, Austria by Dr. Jens-Christian Schwindt — a leading expert in neonatology and healthcare simulation education. Since the company was founded, SIMCharacters has broken new ground in the development of small patient simulators, and combines know-how in medicine, lifelike anatomy and high-class animation technology. The goal of SIMCharacters is to improve the quality of care of critically ill children, especially term and preterm infants.

When teaching healthcare professionals and learners about preterm care, Schwindt was deeply concerned by the limited pathologies and unrealistic anatomy offered by modern day preterm simulators. Determined to improve the outcomes of more than 15 million preterm births a year, he established SIMCharacter’s flagship product, the world’s first high emotion preterm simulator, Paul, as a way to innovate beyond current limitations. The development was also intended to improve the realism and learning outcomes of NICU and PICU training programs, the vision behind Paul is to transform that standards beyond high-fidelity simulators and into high-emotion simulators.

In the past, realistic technology simulating the small body of a 27-week-old infant, such as Paul, had not been available. Yet today, professionals can use the Paul learning tool to gain experience performing life-saving procedures during delicate critical care emergencies. According to Schwindt, this is why clinical simulation is quickly becoming a modern way to educate and train healthcare professionals, allowing for the safe high-stakes practice of behavioral, cognitive and technical skills.

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According to the SIMCharacters’ website, providing high-quality care for a preterm baby is a uniquely complex and time-sensitive process, which can be extremely challenging for inter-professional neonatal healthcare teams. Although preterm birth remains the most common cause of death among infants, the company notes that preemies weighing only 500 to 1,000 grams can survive as healthy babies when cared for by highly-trained healthcare professionals.

With this in mind, and along with design support from leading experts in healthcare, education, electrical manufacturing, animatronics and special effects, SIMCharacters created Paul. This highly-realistic preemie infant represents a 27 week born neonate with anatomically correct airway, weighing merely 1000 grams, measuring only 35 centimeters long and providing lifelike movement for an infant of such a young age. The manikin is designed to empower neonatology teams with high-fidelity simulation experiences, improve learning, patient safety and clinical care outcomes.

“Our mission at SIMCharacters is to improve the quality of care for critically ill preterm and newborn babies by advancing the realism and effectiveness of training simulators,” Schwindt said.

With healthcare personnel, families and programs caring tirelessly for preterm newborns, the SIMCharacters team knows that creating high-emotion simulation requires understanding and empathy. Employed across the globe, SIMCharacters and the Paul simulator are taking the next step in the future of medical simulation. To demonstrate these steps, SIMCharacters attends conferences each year, including those hosted by SimGHOSTS and the International Meeting for Simulation in Healthcare (IMSH) from the Society for Simulation in Healthcare (SSiH).

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Paul Simulator Features

The Paul simulator has a high-realistic internal and external anatomy, including a 3D printed larynx based on real-life preterm MRI scans. Additionally, 3D printing is used to create the upper airway, ideal for intubation training and all modern preterm stabilization strategies like LIS (MIST) and INSURE. Other features include highly realistic internal and external anatomical structures and convincingly lifelike clinical practice features. Adding to the realistic nature, the medical simulation manikin is produced using real hair.

The healthcare simulation manikin also comes equipped with authentic pathologies specific to preterm babies with physiological and pathological breathing patterns, necrotizing enterocolitis, cyanosis and hyperoxia. Preprogrammed symptom complexes that able to be explored through Paul are respiratory distress syndrome, biparietal diameter, necrotizing enterocolitis, abdominal distension, pneumothorax and apnea. Users can further track spontaneous breathing with a respiratory rate variable between 0 and 100 bpm and infinitely variable lung compliance.

Paul also features variou sensors to detect ventilation, intubation depth, oesophageal intubation, chest compressions and other measures. As for pulses, chest compressions and pure heart, lung and abdominal sounds, learners can use Paul to take a palpable pulse on all four extremities and on the umbilical cord. They can practice thorax compressions, insertion of peripheral catheters in all four extremities (exchangeable), insertion of umbilical venous catheters (exchangeable umbilical cord) and simulation stethoscope for position-dependent auscultation of heart, lung and bowel sounds — without disturbing technical noises.

With one touch controls, users can easily review real-time display of all preterm simulator conditions including: chest compressions, tube depth, UVC position and motion artifacts. Data collected from learner interactions with Paul, such as intubation, UVC insertion, and chest compressions, combine with a custom annotations and are automatically recorded into Paul’s debriefing log. If a simulation program also owns a SIMStation debriefing system, all of Paul’s log files can be immediately transferred to a debrief room and become ready for review.

Learners can regularly bring simulation in-situ with completely wireless control systems that are easy to transport and setup. Then, with real patient monitors, users can instantly change layout screen to a preferred manufacturer. They are able to change certain monitor parameters, like parameter display, curve position and color code, as well.

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Programming scenarios for Paul do not require a separate application or complicated training. Instead, users simply create and quicksave their desired patient state. They can easily chain quicksaves together with time modifiers to create new scenarios in under five minutes.

Setting up of the Paul system takes just a few minutes, as the system connects completely wirelessly. Paul works over Wi-Fi between the included simulator, control tablet and patient monitor. Learners can continuously use Paul while he rests on top of the charging station concealed below the sheet, or pick up and hold Paul for an hour and a half of possible battery use.

When purchased, users can choose between SIMCharacters’ two or five year warranty extension and care program. This extends a one year standard warranty to two years or five years with a system guarantee on all parts and labor. Two year plans include one preventive maintenance return of the Paul systems for complete refurbishment.

A five year plan includes two such returns. Repairs can be completed at the SIMCharacters facilities, with all shipping and handling costs covered. Ready-to-use replacement systems are available to be shipped to an institution if their system malfunctions for any reason, or if a product is required during refurbishment period. The company also offers free software updates and regularly shows its premature infant simulator products at healthcare simulation conferences such as SESAM every year.

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