From left: Ameera Cluntun and Samantha Majcher treat a mock trauma patient in STRATUS.

From practicing IV placement and CPR to managing a difficult airway or a complicated multi-system failure, the Neil and Elise Wallace Simulation, Training, Research and Technology Utilization System (STRATUS) Center for Medical Simulation at BWH offers a variety of training to meet the needs of staff and trainees throughout the hospital, as well as beyond BWH.

In January, the STRATUS Center was re-accredited by the American College of Surgeons (ACS) as a comprehensive training institute. The ACS, which sets standards for how surgical education and training should be offered, lauded the center’s scope of educational programs, curriculum development and resources for delivery of effective education as among the best in the nation.

Physicians, nurses, physician assistants, residents, fellows, students and other clinicians from all specialties use the center for simulation-based educational programs, either as part of individual skills training programs or as part of a Graduate Medical Education training program. Recently, outside groups have traveled to the STRATUS Center from across the U.S., as well as from Saudi Arabia, Brazil, Colombia, China, the United Arab Emirates, India and parts of Europe.

The center, which prides itself on being service-oriented, offers curriculum experts and simulation specialists, as well as state-of-the-art equipment and an operating room (OR) that is a replica of a BWH OR. Through a one-way mirror, faculty and technicians can watch the activity inside and regulate a mannequin’s vitals, breath sounds, pulse and blood flow for simulation exercises.

“In addition to being a local and international leader in clinical education, STRATUS has been on the cutting-edge of simulation-based assessment, research and process improvement,” said Charles Pozner, MD, medical director of STRATUS. “It also has a robust research program, publishing more than 130 manuscripts over the last decade, including the first scientific investigation employing simulation in the New England Journal of Medicine. Hospital departments also use STRATUS to introduce or assess clinical processes to improve patient safety.”

Programs can be one of several formats:

Scenario-based simulations. Participants are presented with a clinical scenario and asked to manage the situation. Vital signs and other physiology can be altered to meet the needs of learners or the team’s actions. Post-scenario debriefing enables the faculty to interactively deconstruct the case with participants, providing an engaging learning environment.

Skills trainings. Expert faculty hosts these sessions, intended to teach a specific surgical or medical skill such as knot tying, tissue dissection, IV line placement, lumbar puncture and airway management.

System and quality assessment. These sessions mimic scenarios that involve emergency preparedness, such as Ebola preparedness training and mock codes, so staff can develop and reinforce best practices.

Assessments. Participants are evaluated on a particular skill set by completing competency exercises. BWH mandates that all clinicians who insert central lines pass a standardized assessment using mannequins at STRATUS before performing the procedure on patients. 

Non-technical skill development, such as collaboration and communication among teams, are also of the utmost importance to STRATUS. “Learning how to communicate and understand each other’s thought processes is essential,” said Pozner. “In times of high stress, even experts have gaps in knowledge. Collaboration helps clinicians to find the answers they need.”

Added Sheldon Singh, operations manager: “We help clinicians develop and hone their clinical skills, striving to provide a great experience so that patients can have the best experience possible at BWH and beyond.”