SIMCharacters In-Situ Simulation
The Company SIMCharacters
There are people who dedicate themselves completely to one thing. Dr. Jens Schwindt – CEO of SIMCharacters GmbH, et al. – can clearly be considered one of these people. The renowned physician, international expert, and frequent speaker in the fields of pediatrics and neonatology has dedicated his entire work to the health of premature and newborn children. His scope of professional practice now encompasses nearly all system areas and standards in his field, from consultation and education to training and evaluation.
In addition to his medical practice, Dr. Schwindt's activities expanded early on into the medical-pedagogical field. His efforts were not only aimed at professionalizing and optimizing practice-oriented simulation training and education, but also at propagating the benefits of simulation in medicine on a broad societal level. As an example of this, his media-effective talk at TEDx Donauinsel 2018 should be mentioned, among others.
With his SIMCharacters Training team, Dr. Schwindt conducts so-called in-situ simulation training courses in hospitals throughout the German-speaking region. These are video-based simulation training courses that take place in the actual work environment of the trainees. The training spectrum ranges from singular skills training to more complex team training supported by AV recording and debriefing systems.
Dr. Schwindt is highly regarded in the international professional community for his methodical approach as well as for his professional competence and commitment. But not only that: With his sense of innovation, he has also provided development impulses regarding safety standards and quality assurance in pediatrics and neonatology. In this context, the founding of SIMCharacters should be mentioned in particular; a company that offers "Paul", probably the most realistic pediatric simulation manikin on the market. Two successor models of the simulation manikin are currently being developed and soon to be launched (as of January 2023).
In-situ Training in Vöcklabruck, Austria
The Foundation of SIMStation
Besides SIMCharacters, Dr. Schwindt also served as an important driving force in another innovation story. He played a key role in the development of SIMStation!
At the beginning of his training activities, Dr. Schwindt had to experience repeatedly that there was no AV system on the market that met his high demands for recording, transmission and debriefing of simulation training. Especially the in-situ requirements to obtain high quality audio and video recordings despite being mobile and spatial flexibility proved to be a problem. And with this problem, he turned in 2012 to three companies in the fields of multimedia software, broadcast and stage media technology that had already been cooperating for long time. His idea: If the expertise of the companies could be combined, all the technical requirements would be in place to realize his idea of a high-end recording and debriefing system for mobile in-situ training. The birth of SIMStation.
Admittedly, the road from the idea to SIMStation, the globally active company with a wide range of product lines, was a long one. The idea was followed by several months of close cooperation: The SIMStation team accompanied Dr. Schwindt on his training courses and seminars throughout Europe. Primarily, the goal was to learn more about healthcare simulation training. What is the purpose of simulation training? What is the exact process? And how can AV technology support both the training leaders and the simulation participants in their efforts? This founding period turned out to be a mutual learning and development process, which led to promising results. The first major highlight of the collaboration: the launch of the SIMStation Pro prototype, a completely new mobile AV system that enabled mobile recording and debriefing of in-situ simulation training. (By the way: If you want to get some impressions of this exciting time, here you can find some nice pictures.)
In-Situ Simulations with the SIMStation Pro
Whether you believe or not: Now in 2023, the first SIMStation Pro built for Dr. Schwindt is still in use. Over the past 10 years, this mobile AV system has been used to run hundreds of simulations, record and debrief many thousands of hours of video footage and train many hundreds of professionals at approximately 100 sites. To be able to deliver this impressive performance, the SIMStation Pro system is regularly maintained by us and updated to the latest software version compatible with the system.
The video based SIMCharacters training, which uses the SIMStation Pro, is planned as a multi-day training series with several session runs. All professional groups involved in the care of critically ill children are included. The training cycle usually begins with a lecture on the evening before the training sessions – with the aim of creating a common mindset and problem awareness. This theoretical part of the team training is technically already realized with the hardware components of the SIMStation Pro (projector and loudspeaker).
On the following practical part of the simulation, groups with a maximum of ten participants from the various professional groups (physicians from different disciplines, nurses, nursing assistants, etc.) are trained for half a day in three different training scenarios.
At the beginning of the training, each group will be familiarized with the exact training procedure (simulation, control, transmission, and debriefing), the possibilities and limitations of a simulation manikin and the technical aspects (recording and debriefing, A2R = Audio to Room, live video transmission, role of the SIM nurse, etc.). Afterwards, the participants will be divided into two groups. While one group trains in the simulation room, the other group observes the training in the transmission room. After the training, which lasts approximately ¼ hour, all participants gather in the transmission room for an AV-supported debriefing. For the next session run, the participants of the teams are changed and again divided between the simulation and transmission room, etc.
The Mobile SIMStation Pro Equipment
The SIMCharacters team consists of at least two, but usually three instructors, a SIM nurse (=instructor who is present in the simulation room during the training) and a technical support (who usually has a surprising appearance as a relative of the patient). Both team size, training structure and training process make the SIMStation Pro the perfect companion here: the system offers the necessary mobility and user-friendliness required for the flexible, intensive training sessions. In addition, the individual simulation participants can also be equipped with headset microphones. This ensures that communication among participants is transmitted in every detail, making it comprehensible to all instructors and observers at all stages of the simulation.
All components of the mobile SIMStation Pro can be stored in robust cases. The entire system can thus easily fit in the trunk of a compact car. A rolling board, which is always included in the scope of delivery, enables easy transport from the parking lot to the site of use.
The Recording Unit
Depending on the structural conditions, the recording unit is set up as close as possible to the simulation room (sometimes even in the corridor). The exact location depends, of course, on the spatial conditions and clinical workflow of the station. In any case, the supplied loudspeaker boxes have a headphone connection for the instructors, so that unhindered training control is possible even under difficult acoustic conditions ("noise pollution").
On a large 23-inch screen, instructors can watch the transmitted video streams live and add annotations to what is happening (critical or good action, start/end of treatment, etc.). The SIMStation control microphone can be used to directly influence the scenario: either in the form of public announcements to all participants (Audio to Room; via room loudspeaker) or via "secret" instructions for the SIM nurse (Audio to Private; via in-ear device). The recording unit contains five receiver units for the participants' radio microphones and one transmitter unit for the SIM-nurse's in-ear device, as well as connections for a boundary microphone or an acoustic source via XLR connection. 6 LAN ports allow direct connection of cameras or streaming image sources (e.g., a Patient-Monitor Capture-Device) and are also network points to the other SIMStation Units. This reveals a clear advantage of this system design: Since all units only need to be connected with one LAN cable, almost all spatial barriers can be easily bypassed.
The Accessory Box
Indispensable for on-site use: the accessory box. The drawer system is lined with precisely fitting foam inserts so that the particularly sensitive equipment can survive even longer and bumpy transport routes without any problems. These foam inserts also support a quick visual check as to whether certain devices have been "forgotten".
The Debriefing Unit
Live transmission of the training
Far too little attention is often paid to the live transmission of the training for the observing part of the group. The possibility of simultaneously viewing a scenario from up to three different perspectives, including the patient monitor, opens a completely new perspective for the trainees – on their working environment as well as on the processes presented - and thus immensely increases the scope of discussion in the subsequent debriefing.
Debriefing is considered the great art within simulation and is performed by SIMCharacters at the highest international level. The annotations created during the training are transferred to the SIMStation Remote Tablet for the debriefing and are available immediately after the training. On the one hand, these serve as orientation for the instructors regarding the process of the training, and on the other hand, they function as jump markers for the video sequences to be played. The goal of an AV-supported debriefing is not to play as many video sequences as possible, but to quickly find the recordings that are relevant for the defined learning purpose. This goal-oriented access to the recordings is supported in every respect by the clear and user-friendly SIMStation Software. One more reason why the SIMStation Pro system has proven to be indispensable for SIMCharacters' in-situ training over the years.
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