“Sir, are you allergic to any medications?”
An NYU medical student is addressing a man being moved from a backboard to a bed in a hospital’s Intensive Care Unit. The student is part of a team including a BMCC nursing student, a physician from NYU Langone Medical Center, and the two EMTs who delivered the "patient"—actually, a state-of-the-art mannequin that can breathe and bleed, whose pupils dilate, who can have a seizure, give birth and even sweat.
State-of-the-art emergency preparedness
This simulated training scenario, and others like it, are now possible because of an unprecedented partnership between The City University of New York and NYU Langone Medical Center.
Together, they created the New York Simulation Center for Health Sciences (NYSIM), a 25,000-square-foot facility located in Manhattan’s Bellevue Hospital Center.
NYSIM came to fruition under the leadership of New York State Assembly Speaker Sheldon Silver, and with $20.8 million in funding from the City and State of New York.
“I’m proud of this simulation center, which is the largest and the best urban facility of its kind in the nation,” said Speaker Silver at the Center’s recent ribbon cutting.
“As a resident of Lower Manhattan who was at home on September 11th, 2001," he said, "I am especially pleased that Downtown Hospital will have the ability to utilize this facility to train its emergency response team—as will local and volunteer organizations—and that nursing students at Borough of Manhattan Community College will also be taking advantage of the training that is provided here.”
CUNY Senior Vice Chancellor for University Relations Jay Hershenson moderated NYSIM’s recent ribbon cutting.
“In 2004, CUNY received funds through Borough of Manhattan Community College, to begin work on developing the Center,” he said, “and with Assembly Speaker Sheldon Silver’s leadership the project was allocated nearly $20.8 million—$10.4 million contributed by the State; $10.4 million contributed by the City with the help of Mayor Bloomberg.”
Howard Wolfson, Deputy Mayor of NYC for Government Affairs and Communications, described NYSIM as a testament to what happens “when public and private institutions come together,” and CUNY Chancellor Matthew Goldstein commented that, “The unusual experience of weathering two natural disasters in the same week—an earthquake and a hurricane—has served as a reminder to all New Yorkers of just how much we rely on trained personnel who can respond to emergencies in an instant.”
Iris Weinshall, CUNY Vice Chancellor for Facilities Planning, Construction and Management, who oversaw the building of NYSIM, described it as “an important benchmark in preparedness training since 9/11," and Dr. Kathryn Brinsfield, speaking on behalf of U.S. Department of Homeland Security Secretary Janet Napolitano said, “Homeland security starts with ‘hometown security’,” and “the need for preparedness has never been greater.”
A new paradigm for training
Dr. Thomas Riles, NYSIM Executive Director and Associate Dean for Medical Education and Technology at NYU Langone Medical Center said that while disasters causing mass casualties are rare, “The individual and team training provided at the Center will increase the likelihood that any one of us could survive, whether stricken by heart attack or struck with debris from a bomb.”
NYSIM features a disaster training room, a 5-bed ICU, two operating rooms, trauma rooms, a labor and delivery room and 14 patient examination rooms, all equipped with over 100 cameras to record training sessions for students to review in debriefing sessions.
Dr. Robert I. Grossman, Dean and CEO of NYU Langone Medical Center, described the new Center as “not only state-of-the-art in terms of technology, but the first of its kind to put nurses, doctors, medical students and first responders in a collaborative, multi-disciplinarian setting,” providing “a new paradigm for training.”
BMCC President Antonio Pérez also spoke, and commented that medical mannequins have been in use at the College for over ten years.
“They give students the ability to practice, and practice, and practice,” he said, and he envisions the application of simulation learning in other settings, such as laboratory sciences, and online.
Realism is important
Following the ribbon cutting, guests were invited to watch teams of students and physicians conducting emergency response simulations, including one that showed an emergency Cesarean section, and was led by Grace Ng, NYSIM’s Associate Nursing Director.
“You’ll notice the sound of the equipment beeping,” she said. “Realism is important. Health care professionals are trained not just to observe, but to listen for certain sounds.”
Millie Hepburn Smith, a Nurse Educator with NYU Langone Medical Center, explained that students working in teams with the medical mannequins are expected not just to treat, but also to interact with their “patients.”
In another simulated session, the supervising physician guided a student team as they responded to a “patient’s” distraught “father”—one of many actors performing as a patient’s family member, or as a patient presenting a certain sets of symptoms.
“Nurses or medical students need to know what questions to ask, and to be really good at patient education,” or relaying medical information and advice, to people without medical training, explained Dr. Sondra Zabar, Director of the NYU Primary Care Residency Program. “You need to listen to the patient’s story.”