OR 360 at Cedars Sinai

From Simulation to Holographics: How St. Louis Can Educate the Next Generation of Healthcare Professionals

Across St. Louis and the country, leading healthcare institutions are using innovative design strategies to help students learn by doing and minimize the gap between what they learn in school and what they practice in the real world. Here's a peek at a few.

There’s a big difference between reading about how to surgically remove someone’s tooth and actually having to pick up forceps and extract one out of a real-life patient experiencing pain and panic.

In a snapshot, that’s the core challenge of health education. The best way for students to learn is by doing, but letting someone do before they’re ready in healthcare can have severe implications of injury, sickness or even death.

Across St. Louis and the country, leading institutions are focused on tackling that challenge by combining the best pedagogies, tools and experiences to minimize the gap between what students learn in school and what they practice in the real world. They’re working to do this at a time when healthcare is experiencing rapid change, from everything spanning new legislation to robots that can pick up and move patients.

There’s no singular blueprint for universities to follow to minimize this gap, but leading-edge responses are connecting students to real-world settings via technology-rich, simulation-based environments where they can constantly practice, learn, fail, team with others, try again and improve themselves.

Locally, Barnes Jewish College Goldfarb School of Nursing houses six simulation labs in its Clinical Simulation Institute focused on preparing future nurses to provide safe, competent and high-quality patient care. The Washington University in St. Louis Farrell Learning and Teaching Center also offers simulated clinic, hospital and OR space to train students.

These environments are positively blurring the lines between learning and practice. In them, students learn how to execute procedures in trial settings. Equally important, these spaces also make students “workforce ready” by empowering them to model how they’ll interact and collaborate with other care team members (pharmacists, physicians, physical therapists, etc.) in real live medical workplaces.

Simulation spaces sound great, and they truly can be, but creating ones that work for students and maximize ROI is no easy task. The best simulation environments are often built upon ideas, research, student engagement and expertise.

That said, there are key trends and elements that can help lay the foundation for St. Louis institutions looking at the future of their health curriculum. Here’s a look at four that could help inform future local efforts.

Build Simulation Spaces Backwards

It’s key for learning institutions to recognize the spaces their healthcare students will work in may be significantly different than those we’re accustomed to today.

Malcolm X College
A virtual hospital at Malcolm X College helps students learn how to interact with patients and other care providers in real-time. | Photo: Hedrich Blessing

Malcolm X College in Chicago addressed this when they set out to launch a new health sciences campus. Leaders from Malcolm X, in addition to the design team for the new campus, spent extensive time meeting with local healthcare CEOs and senior leaders to talk about the skills and knowledge future employees would need to be successful.

Malcolm X College
At Malcolm X College, instructors can observe and record students as they perform simulated medical procedures and provide valuable feedback. | Photo: Hedrich Blessing

Empowered by that research, Malcolm X then revamped its curriculum accordingly and designed a brand new health sciences campus to support it. The campus is a strategic response to the gap between current market of qualified healthcare professionals, and the projected 84,000 healthcare jobs set to come on-line in the Chicago region over the next decade.

Malcolm X College
Malcolm X College, students have access to a simulated patient cabin of an ambulance where they can learn and test their skills. | Photo: Hedrich Blessing

This future-focused campus will help Malcolm X students seize these opportunities thanks to numerous simulation experiences, including:

  • Exam rooms with computers wired to a database filled with hypothetical patient records to mimic work with electronic medical records
  • Pediatric wards, an emergency room and a mock living room for home healthcare providers in training
  • A virtual hospital where all disciplines in the building can learn collaboratively in real-world environments.
  • A set of doors that open to a trial patient cabin of an ambulance
  • An operating room that puts instructors behind a two-way mirror for observation and records students’ performance with a camera, so lessons can be reviewed together on video or sent home with students to study.
  • Simulation patients, aka, high-tech mannequins that can cry, bleed, shake, have a seizure and more as they react to students’ care efforts

As St. Louis institutions seek to create new simulation environments, they should follow a similar path. Partnering with local health systems and organizations can help them understand what experiences will best help their students succeed in the future.

Be Focused and Purposeful

While certain simulations spaces and tools can be general – think of all the different ways a high-tech, responsive mannequin can educate students – others thrive on their focus. At A.T. Still University’s School for Dentistry and Interprofessional Education Instruction, they offer dental students high-tech mannequin heads where they can practice tooth extraction, cavity filling, routine cleanings and other key dental procedures. While a simulation set of teeth may not have diverse value, it’s a critical testing ground for dental students.

A.T. Still University
Students at A.T. Still University are able to learn, test and improve their dentistry skills in simulated real-world environments. | Photo: Fentress Photography

Moreover, A.T. Still University surrounds these mannequin heads with hands-on learning spaces, a 65-station dental simulation clinic, a wet laboratory for learning molding techniques, spaces for imaging and a 15-room human patient simulation suite allowing for a wide variety of health care scenarios with full-sized mannequins. By embracing technology, simulation and team-based learning in these ways, A.T. Still has created a remarkably future-focused health program.

A.T. Still University
At. A.T. Still University’s School for Dentistry, students interact with high-tech mannequin heads where they can practice tooth extraction, cavity filling and routine cleanings. | Photo: Timothy Hursley

Every day, new technologies for general health and specific care segments are being developed. Even niche health schools should consider investing in appropriate simulation technology and surrounding it with collaboration areas where students can mix with other disciplines.

Focus on Collaboration – Think Big

One of the most important simulation activities students can take part in is experiencing how best to engage with medical staff from other health disciplines. Healthcare continues to shift in the direction of multi-disciplinary team care models where physicians, pharmacists, occupational therapists, nutritionists and more all must work together to successfully care for patients. In order to be, “workforce ready” upon graduation, students need to model this collaboration in school.

As part of a master plan exercise for a university in Minnesota, our design team recently helped them create a vision for how all seven of their different medical programs could learn together in one building. The planning required spatial and programmatic solutions that helped the different departments break down siloes and advance an interdisciplinary learning platform.

Similarly, the new Missouri State University O’Reilly Clinical Health Sciences Center advances multi-disciplinary learning by uniting occupational therapy, nursing, nurse anesthesia and physician assistant studies in the same building as an outpatient clinic. Both of these solutions educate students in a way that allows them to build expertise in specific topics while also inherently understanding the roles different care members play in the real world. They significantly shorten learning curves for students when they enter the workforce and have to live these realities.

Don’t Create Spaces that Dictate Simulation

Just as colleges and universities are using simulation spaces to educate students, health systems are also using them to help doctors and medical staff practice procedures and identify new best practices. Cedars Sinai is at the forefront of this effort with their OR 360 — a simulation center designed to help doctors improve care in the “golden hour,” which is the first 60 minutes after traumatic injury.

OR 360 is unique in that it’s inspired by theater and stage design and is thus endlessly reconfigurable thanks to a gridded trolley system for medical equipment, moveable walls and more. This allows OR 360 to set the stage for any scenario they need to test. Already, the space has yielded new ideas about the use of standardized, color-coded trauma bays and whiteboards that are now in practice in Cedars Sinai surgical suites.

OR 360 at Cedars Sinai
The OR 360 at Cedars Sinai is an endlessly configurable space that helps medical teams identify new strategies to improve trauma care. | Photo: Benny Chan / Fotoworks

This idea of creating simulation spaces that are “endlessly reconfigurable” can help local schools spur new levels of student innovation while also enhancing their spaces’ flexibility and adaptability.

Stay on the Cutting Edge

Being plugged into the latest and greatest tech advances in healthcare is no longer an option. With new ideas and tools launching constantly, colleges, universities and academic medical centers need to stay up to speed and seek out those that can strengthen their simulation environments and put them ahead of their competitors.

For example, Microsoft recently launched HoloLens, the first self-contained, holographic computer enabling people to engage with digital content and interact with holograms in the world around them. This device creates a new augmented reality, where people, places and objects from the physical and virtual worlds merge together in a blended environment. HoloLens is the kind of tool that could prove a game-changer for simulation environments. To succeed, this technology will need companies, entrepreneurs and universities to partner in exciting new ways to develop content and educate students. Ultimately, it can be as powerful and useful as we make it to be.

Simulation spaces are one of the best ways for local institutions to bridge the gap between what students learn and the ways they’ll work. These spaces require more than just the latest technology available though, they demand strategic physical spaces with seamless tech integration that empower interaction, collaboration and discovery. St. Louis’ academic and health communities should continue to seek out new ways to advance these types of spaces and raise the bar for healthcare education in America.