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| ISL at Stanford |
CISL Groups & Facilities
CISL has several core simulation groups and a number of simulation facilities. A large Immersive Learning Center will be built as part of the Learning and Knowledge Center building to open in late 2009. Here are short descriptions of each of the existing groups and facilities with links to websites that have many more details. They are listed roughly in the order of their founding (See also History)
Patient Simulation Center of Innovation
at VA Palo Alto Health Care System
The Simulation Group at VA Palo Alto is the pioneering inventor of modern mannequin-based patient simulation. They performed their first pilot-test simulations in 1986, and have had a dedicated simulation center since 1995. Besides inventing the modern simulator technology they are responsible for introducing the current paradigm of high fidelity simulations addressing both behavioral and teamwork skills as well as technical/medical skills, adapting many concepts and practices from those used in commercial aviation simulations.
;)
Originally concentrating on anesthesiology – the field of pioneers Gaba, Howard, Fish (and now including Drs. Harrison, Fanning, and Mudumbai), the Group has expanded to include Stanford faculty working on simulation in Intensive Care and Rapid Response Teams (Lighthall, Barr, Geller, Bertaccini), Emergency Medicine (Harter and Smith-Coggins), Respiratory Therapy (Miller and VA Palo Alto RT staff). A spin-off group in pediatric anesthesia (Chen, Edler, Honkanen, Williams, Hackel) conducts simulation training in actual clinical work environments. This group also conducts research on performance assessment and on testing of human factors of medical devices and procedures using simulation.
This Group a long-standing dedicated simulation center. Currently occupying around 2200 square the VA Simulation Center has 2 large simulation rooms – one set up as on operating room and one as an ICU, ED, or Ward. This Center has 5 simulators – 3 permanently set-up and 1 adult simulator for “in-situ” training exercises in actual clinical environments. The VA group provides the infant simulator to the pediatric anesthesia simulation team.
Stanford University Medical Media
and Instructional Technology (SUMMIT)
The SUMMIT Group led by Parvati Dev, PhD and Leroy Heinrichs MD is a world leader in applying computer-based instructional technologies to health care. Among other key work they develop web-based applications, internet and internet-2 systems, and “virtual worlds” --- computer systems in which the patient, the clinical facility, and all personnel are represented virtually. An “avatar” on the screen represents each participating individual.
;)
Participants can interact with the simulated patient and with other personnel via their avatar, who can speak, make expressions, and perform a variety of actions. SUMMIT also is a leader in the evaluation and testing of procedural simulators, especially in surgery. SUMMIT operates a large Collaboration Room which provides facilities for the various modalities and activities described above.
Center for Advanced Pediatric and Perinatal Education (CAPE)
Work on neonatal and pediatric simulation began in the late 1990s by Lou Halamek, MD at the VA Simulation Center (veterans have children and grandchildren too!). Philanthropy enabled the group to create the CAPE facility near the Lucille Packard Children’s Hospital at Stanford.
CAPE develops, conducts, and evaluates training in neonatalogy, perinatalogy (including combined-team training linking obstetrics (OB – Drs. Daniels and Harney), OB anesthesia (Dr. Lipman), OB nursing (Ms. Arefeh), and neonatal intensive care, neonatal transport. CAPE has one large simulation room with two simulation bays and several different simulators (maternal and neonatal). CAPE also conducts research on simulation pedagogy and on human factors.
The Goodman Simulation Center
The Goodman Simulation Center, under the direction of Thomas Krummel, MD is located in close proximity to the operating room suites at Stanford Hospital. This center will utilize mannequin based team training, and a training program for laparoscopic surgery using part-task trainers. The ultimate goal is surgeons will rehearse an operation on a patient-specific palpable hologram that is digitally derived from models that are constructed from diagnostic imaging data and later, deliver the data set of that operation with robotic assistance.
;)
The surgical curriculum, from PGY1 to PGY5 will incorporate simulation-based training to build the skills of the novice practitioner to fine-tuning the skills of the advanced resident preparing for practice.
Endovascular Simulation Program – Jason Lee, MD was recruited to Stanford to lead the endovascular simulation program. This program will be housed in the Goodman Simulation Center. The program is will expand beyond vascular surery to involve housestaff and offer continuing medical education in cardiology and interventional radiology. See link for Dr. Lee's presentation at the Western Vascular Society (9/07)
School of Medicine Teaching Facilities
CISL works with faculty and staff of the School of Medicine’s core teaching facilities that also engage in various types of immersive or simulation-based learning. The Standardized Patient suite provides 10 mock clinic rooms and support systems for the interaction of clinical learners with standardized patient actors. The Clinical Procedure Training Facility is used for teaching medical students essential clinical procedures and manual skills.
Cardiovascular Surgery Simulation (CVS-Sim Center)
;)
Located at the VA Palo Alto HCS affiliate, the CVS-Sim Center is a 400 sq. ft. laboratory with thoracic models, arrested heart models, model for beating heart surgery, anastomosis and valve replacement task stations, intra-aortic balloon pump station, perfusion equipment, cardiovascular surgical instruments and supplies, operating table, video recording capability, porcine hearts for wet-lab, computer with educational DVD/CDs, and reference books and other educational materials. Based on a series of task/skill stations, wet-lab procedures, and environmental simulation, we have developed a comprehensive program intended to provide initial and follow-up simulation training and practice of cardiovascular surgery for the surgical resident.
The laboratory along with the CVS simulation course provides an environment for cardiac surgery and general surgery residents to practice cardiac surgical techniques and procedures. The simulation laboratory is designed to permit the resident to engage in a progressive experience; each task or sub-procedure is intended to allow the resident to demonstrate proficiency through direct tutoring and practice in the laboratory and in the simulated operating room. Directed by Drs. James I. Fann and Thomas A. Burdon, the CVS-Sim Center is a part of the Stanford Cardiothoracic Surgery curriculum.
Other Immersive and Simulation-based Learning Activities at the Stanford School of Medicine
A number of other independent investigators, laboratories, scholars, and teachers work on or utilize immersive or simulation-based approaches in their work. A partial list includes:
- Dentistry – Paul Brown, DDS
- Internal Medicine – Lisa Shieh, MD, PhD
- Obstetrics – Julie Arafeh, RN, CNS, Kay Daniels, MD, Maurice Druzin, MD, Denise Lopez, RN
- Orolaryngology – Gerald R. Popelka, PhD, Nik Blevins, MD
- Obstetric Anesthesia – Steve Lipman, MD
- Pediatric Anesthesia – Alice Edler, MD, Michael Chen, MD
- Urology - Benjamin I. Chung, MD, Joseph Liao, MD, Jeffrey Reese, MD , Raj Shinghal, MD
