"World-changing" is the phrase Dr. Susana Barroso-Fernandez uses to describe the Simulation Hospital that is a part of the University of Miami School of Nursing & Health Studies, and that’s because, well, it is. Dr. Barroso-Fernandez is both assistant professor of clinical, and director of Simulation Hospital special projects, and she has been involved with the project since the beginning.

She came to the facility 12 years ago, and recalled, "Our previous dean was a visionary. We were already doing simulation work at that time, but we realized we needed more space to be able to grow the program. So she put together a group of individuals who not only had simulation experience but also nursing specialty experience, and said, ‘There’s no limit. What would you want in a simulation space? If you could have everything to be able to teach students the way you wanted, what would that look like?’"
The result is the five-story, 41,000 sq. ft. Simulation Hospital that, according to Dr. Barroso-Fernandez, "is designed to be a center for everyone to come and become better educated, whether they’re a local community, national, or international group of partners. It is an effort to change health care education and the way participants learn, whether they are students or practitioners, nurses or physicians. It’s the whole aspect of patient care."
How that is being accomplished is through a series of courses and scenarios that enable medical personnel to participate and either gain or refresh their skills. As Dr. Barroso-Fernandez explained, you have to imagine the simulation hospital as a real hospital. All of the equipment is real, and everything the participants are going to be using is real.
"The difference comes when they get to the bedside. They are either going to meet a simulator as their patient, or a standardized patient – a human being who has been trained to portray the role. They then care for this patient, and the scenarios are audio- and video-taped. At the end, we bring them together and we debrief them. We’re going to go through things that went well, along with areas for improvement; so when the students walk away, it wasn’t just a task, it’s that ‘ah-ha’ moment of being able to reflect on what they did and what they would do differently."
She said the space can be used in different ways. If a group has everything it needs to put on its own class, but doesn’t have the space, the space can be rented. If someone wants a more specialized course, the simulation hospital can build it for them. For example, she said they are currently working with a group of school nurses who want a refresher course on how to handle children for certain scenarios they may be exposed to – allergic reactions, an asthma attack, even basic first aid. "They came to us and we built this course for them, and then put it on for a fee. Sometimes we already have a course that’s very similar and we can just tweak it to meet the learning needs of the participants. Sometimes we have to build a course from scratch, and that’s going to take a little more time."
No matter the situation, the health care specialist walks into the hospital environment and assumes whatever his or her role is. "And they are going to take care of the patient. The patients happen to be simulators, but they still have a heart rate, they have a respiratory rate, they can sweat, they can talk to the health care provider, they can simulate myriad different symptoms, disease processes, injuries. In being faced with a realistic patient, they can make mistakes, learn from their mistakes, do it again until they get it right, but no harm is going to come to the patient."
Dr. Barroso-Fernandez said 1,100 deaths occur daily in the United States because of preventable medical errors, and simulation is designed to break that cycle. "If we can put you in an environment where you are emotionally committed, and put you through these scenarios and have you learn from your mistakes, you’re less likely to make mistakes in the clinical environment. And as you learn from these mistakes and go out and face similar issues, you’re going to remember what you did in simulation, and it makes you a better practitioner.
"This is an amazing opportunity, not only for our students here at UM, but for every practitioner who wants to come and get better. We can change the world."