SONHS Simulation Hospital | Immersive Learning | UM News Special Report | University of Miami

The opening of the new state-of-the-art Simulation Hospital at the University of Miami provides students at the School of Nursing and Health Studies (SONHS) with an expanded educational experience that makes them the active agents of their learning.

“The Simulation Hospital will serve as an anchor for education and research that is unique to anyplace in the U.S.,” said new SONHS Dean Cindy Munro. “While simulation has been around for years, the new hospital represents an exponentially bigger piece of the educational experience—similar to me learning to use a slide rule in high school and now having a supercomputer.”

The five-story, 41,000-square-foot, fully equipped Simulation Hospital will be among the largest and most advanced simulation hospitals of its kind in the world. As a living laboratory, it will serve as a hub for students, healthcare professionals, first responders and corporate partners to design, test and master skills and technologies to transform healthcare education, research and practice.

The benefits of the new facility, which opened on September 28, 2017, will not just be felt by the local healthcare industry, but global partners as well.

“The Simulation Hospital is not just a building—it’s a concept,” said Susana Barroso-Fernandez, assistant professor of clinical at SONHS and director of simulation operations. “If you look beyond teaching and nursing students, we can work with healthcare professionals ranging from first responders and disaster response teams to fire and police departments, as well as the community, such as families who have to learn to care for loved ones with injuries at home. We have the opportunity to have a global impact on healthcare education.”

“The real world of healthcare can be messy. It’s very difficult as a nursing student to be thrown into that messy real world and know how to respond,” Barroso-Fernandez added. “Here we can create a simulated environment where, all at once, the phone is ringing, physicians are giving you orders, and the patient is telling you they don’t feel good—sort of organized chaos—and yet here you have the time to think about what you’re going to do, how to respond, and then have the time immediately after to debrief and reflect on what you did. That’s a very powerful environment.”

Immersive learning shifts the onus of the learning from the teacher to the student. The learning becomes more “active” as the student assumes responsibility to manage, structure, and control their learning objectives and outcomes. Assessments of learning overwhelmingly indicate that active learning is superior in terms of application to “passive” learning.

For decades, nursing education has been dictated by the “see one, do one, teach one” approach, where nurses in training were expected to see a procedure, then perform and be responsible for it and even teach someone else how to do it. 

“That’s not the best we can do,” said Nicole Crenshaw, assistant professor of clinical and program director of the SONHS acute care nurse practitioner program. “With the Simulation Hospital, we’re able to bring the students in, learn a procedure, practice the procedure over and over, ask questions so they have the ability to understand exactly how to do it and why they’re doing it a certain way, and, all the while, not placing the patient in harm’s way.” 

The Simulation Hospital puts much more decision-making responsibility associated with learning in the students’ hands; instead of one-time watching and then one-time trying, they can practice repeatedly, ask questions and seek feedback—learning is more applied and more integrated.

By offering more real-life scenarios, the Simulation Hospital expands the scope of healthcare education, especially in terms of teamwork, which is essential to improving patient outcomes.

“We’ll be able to bring together other disciplines in respect to managing patient care—it may be pharmacology, physical therapy or respiratory therapy that can work together, almost in concert, to provide well-rounded care for the patients,” said Crenshaw, a nurse for 24 years.

Equipped with an emergency department, an outpatient clinic with six exam rooms, labor and delivery suites, four operating room suites, a critical care unit, video teleconferencing capabilities throughout, access to an electronic medical records database, and a Skills Resource Center that takes up the entire fifth floor, the Simulation Hospital offers a much broader opportunity to educate and to assess learning.

“We expect to teach teamwork skills and communication skills, in addition to how students medically manage patients,” added Crenshaw. “Students will be exposed to disease processes that they would see frequently in a clinical setting, but the beauty of simulation is that they are also exposed to processes that are very rare, and that can be manipulated in a simulated setting so that students can learn how to manage patients and disease processes that they don’t have a high chance of seeing but that are important to know.”

“We talk to students and tell them what to expect with a simulation environment. It relieves their anxiety and helps them understand that they are expected to make mistakes, that they are not harming anyone and they are really learning to make their practice better in a clinical setting,” said Crenshaw. “We make mistakes here so that we don’t make them in the real world.”