This fall, the UCLA Simulation Center celebrates its 20th anniversary. From its humble beginnings in a shared CHS lab space with a single mannequin – the beloved “Stan” – the center has grown to a 9,000 square foot, newly renovated facility in Westwood’s Learning Center. With state-of-the-art computerized simulation rooms, debriefing areas, and a small army of mannequins, the center’s programs help students and clinicians at all levels improve performance, shorten response times, and maintain practice standards.
Randolph Steadman, MD, MS, our department’s Professor and Vice Chair for Education, established the Simulation Center in 1996 with an investment from the Department of Anesthesiology and Perioperative Medicine. Partnership with the David Geffen School of Medicine (DGSOM) followed soon, and now the center trains hundreds of health care students, nurses, dentists, and physicians each year throughout the UCLA Health System.
Creating Learner-Centric Dialogues
Dr. Steadman began his career in emergency medicine and worked as an Advanced Critical Life Support (ACLS) instructor. Upon completing his training in anesthesiology at UCLA, his faculty mentor suggested he find a practice niche. Remembering how engaged and activated his ACLS students were while working with mannequins, he decided to investigate the growing field of simulation. After traveling to Stanford University to observe its anesthesiology department’s simulation program, Dr. Steadman was convinced that one would be of great benefit to UCLA.
“A lot of anesthesia is preparing for things that don’t happen frequently,” Dr. Steadman said. “Students don’t encounter critical events often, but we can guarantee they see them in the Sim Center.”
Simulations offer students and faculty the opportunity to deconstruct the decision-making process. Traditional medical training focuses on an “apprenticeship” model, where students and residents accompany attending physicians on rounds, observing decisions as they are made and taking part as their experience allows. However, Dr. Steadman feels this model leaves gaps in training.
“I felt my experience in medical school – the apprenticeship model – was extremely flawed,” Dr. Steadman said. “Following a doctor around was not very learner-centric. I couldn’t learn their thought process.” The Simulation Center, he believes, enables students to practice the “how” of providing care, and deepens their empathy and critical thinking skills by creating a space for them to question the “why”.
In the Simulation Center’s first year, our department’s faculty anesthesiologists offered to work with medical students during their physiology curriculum. The collaboration gave students an exciting introduction to the field of anesthesiology. Word spread quickly, and soon the Simulation Center began fielding requests from other departments. Today, simulation experience is an integral part of training in anesthesiology, emergency medicine, family medicine, internal medicine, pediatrics, obstetrics, radiology, surgery and nursing.
In 2000, Yue Ming Huang, EdD, MHS, came on board as the center’s first full time staff to support simulation and clinical research. After completing her doctorate degree in 2006, she joined the faculty and became the Education Director. Dr. Huang conducts extensive research on instructional techniques, teamwork, communication skills, and the effectiveness of simulation training. The program has added a team of actors (the Standardized Patient Program) to help trainees develop patient communication skills.
Maxine and Eugene Rosenfeld, longtime donors to the Chancellor’s Associates, have made generous $1 million gifts to the center twice, in 2006 and 2016, underwriting new tools such as the human patient simulator, which has life-like physiology and the ability to "talk" and interact with the learner. The gifts have also allowed the center to purchase additional clinical equipment such as ultrasound machines, enabling it to expand its capacity and innovations.
In order to serve additional clients, the center is developing screen-based and online simulation tools. By partnering with technology and gaming companies, the center is exploring how augmented reality (AR) and virtual reality (VR) scenarios may contribute to health care education.
In recent years, the center has created on-site simulations as part of quality initiatives at the Ronald Reagan Hospital, and added workshops in Child and Intimate Partner Abuse, and in Transgender Medicine.
The center is expanding its reach by developing assessment tools and programs for on-going certification. The American Board of Anesthesiology uses the Simulation Center for its Maintenance of Certification program, and offers weighted credits to those who choose simulation over lecture-based recertification.
The Simulation Center’s multidisciplinary staff continues to create solutions for UCLA’s diverse learning groups. As of last year, the DGSOM reported that students attended simulation training up to nine times each year. From a student’s first year of medical school to on-going professional certification and team-wide, site-specific quality exercises, the Simulation Center has become an integral part of the UCLA Health System’s commitment to leading-edge patient care and innovation.