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Chaos and order: the simulated context

Carlo Mahfouz
Tech
July 19, 2022
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An excerpt from Reality Check: In Pursuit of the Right Questions.

I was on the floor of the International Meeting on Simulation in Healthcare conference when I  heard screaming in the near distance. I turned toward it and saw some people gathering and others running. It sounded like an emergency, and someone was in grave danger. The cries echoed in the hall. Someone was in a lot of pain. My body and senses tuned and honed in on it. It grabbed my full attention. A sense of fear and flight kicked in.

What was happening? Was I in danger? Emotions and feelings I knew I should not be having were triggered.

I came closer and saw machines beeping, such as the patient monitor, which showed vitals dropping quickly. You have seen the same ones flat-lining and beeping every time someone dies in multiple movie scenes.

Various nurses and doctors were running around the patient on the gurney. It was chaotic. After a few minutes passed, it calmed down, and everything went back to normal. The patient survived,  but the patient was never in real danger in the first place, and this was not the first time it had happened that day.

These simulations are the norm at this conference. It’s a major conference I attended yearly to showcase our learning management solution to thousands of educators, doctors, and nurses looking for ways to improve and explore the latest innovations and best practices in health care simulation.

The scene above was a scenario simulated with an actor, equipment, moulages, and more to create as close as possible a realistic environment of a trauma situation unfolding. And that was only in one corner. On my other corner, I could see a full-body manikin of a woman birthing a  baby. On another corner, I see genitalia props, internal organs, preemie baby manikins, fake blood packets, all of which are tools and props used to improve the training of health care professionals and simulate the closest possible interactions to those with real patients.

The entire simulation was recorded. Monitors captured the vitals generated from the participants’ interactions. Educators and doctors would review the video and the different stats and provide meaningful feedback to their students on how they could improve. They were not evaluated on their medical know-how only but on aspects like dealing with the chaos, the emotions, and the disruption that ensued.

The simulation replicated not only the physical elements and medical aspects of the scenario but the context, which is often missed in some training. When the stakes are too high, and a problem’s consequences are dire, such as in health care, simulation is a great technique to engage with a problem and assess it without the consequences. Being a simulated context, it triggers responses like how to prioritize and focus. It minimizes the training cycles to get us there faster.

These simulations represent a simulated context. We can play different scenarios multiple times and improve our attention to what matters. We simulate an environment with predetermined characteristics to entice engaging with unknown behavior that will surface in that moment only.

The scenario is preset, and hence based on a lot of constraints, but when it is run, there is freedom for everyone to operate. This freedom to take part in the defined context is the same as the spirit of the rules.

The constraints and rules that we set define every problem. How we leverage scope determines how we can position ourselves for success. The prioritization becomes more critical as we engage with more complex and overarching challenges. The goal is to understand without running into infinite loops and endless rabbit holes.

Carlo Mahfouz is a technology executive and author of Reality Check: In Pursuit of the Right Questions.

Image credit: Shutterstock.com

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