May 30, 2013

Four times per year Drexel University’s College of Nursing and Health Professions offers a Certificate in Simulation course in the Center for Interdisciplinary Clinical Simulation and Practice (CICSP). On the first day of the event, participants are asked to assist with the care of the injured after a mass casualty disaster. In the past, the staff at the Simulation Lab has created scenarios involving a bus accident, a terrorist bombing, a house fire, bird flu, and even a zombie apocalypse. This year’s disaster is a post-earthquake recovery. The idea for the disaster comes from the International Medical Corps’ Logistic Team who came together for a week in Italy simulating a humanitarian emergency response after an earthquake.

The Medical Corps team was flown to Italy for one week and was immediately immersed into a complex scenario. Using this idea, the staff of CICSP created the fictional country of “Terremoto” (the Italian word for “earthquake”) as the backdrop for the disaster. The Lab was transformed from a simulated healthcare setting into a post-disaster earthquake recovery center where the wounded could be triaged before being transported to a health care facility. Among the changes to the lab environment were to cover all of the walls with burlap and sheets, raise the temperature in the space (Terremoto is a tropical country) play the recorded sounds of a forest in the background, play the sound of a helicopter landing and an aftershock, use wooden boards and cinderblock for benches, and even to use a simulated fire to boil water.

The scenario helped the participants to coordinate and collaborate with each other, work as teams in a shared experience and a complex environment, and reach the best decisions for the group. Some of the challenges faced by the participants were to care for a patient with an amputation, a pregnant woman injured in the quake, a young mother who brings in her child buried under the rubble, and a host of other casualties. A twist was included in the scenario: the men who had been asked to provide security for the scarce food, water, and medication stole the provisions from the group for their own use.

The participants at the conference all have an interest in simulation. Many are simulation lab directors and coordinators themselves, while others are faculty who use simulation in their courses. A primary objective of this exercise was to put them into a scenario as a student. Most have never been the student in a simulation exercise. Having this experience will help them understand what their student experiences. It was also the goal of the program to show them what can be done with simulation. There are many more settings that can be created for simulation besides a healthcare institution. As this scenario demonstrated, we can create just about any earthly environment!

by Carol Okupniak, Director of the Center for Interdisciplinary Clinical Simulation & Practice