Q: I teach pharmacology, and I think simulation could work in my course. Unfortunately, I can’t get any time in the sim lab. I’ve heard people talk about sim in the classroom, but it seems like a lot of work to set up a simulator in a classroom, and I’m not sure if I’d ever be able to get my hands on one. What do you think about simulation in a pharm class? Do you have any suggestions for helping me get buy-in from the sim director?

A: This is a great question, and one that’s particularly applicable to any health professions faculty who are shifting to competency-based education with its focus on experiential learning. I agree 100% that simulation will work well in your course. And here’s the good news: you don’t need a simulator!

For lots of us, when we think of simulation, we picture the technology and the simulated setting our learners will be in. I’ve really broadened my view of simulation over the years, and realize that simulation isn’t about the technology or the setting. What I’m trying to accomplish in the simulation lab is to have my learners engage in clinical decision making. That is usually accompanied by them being in a physical space that resembles their practice setting, and includes a “patient.” This allows them to think and act in unison. I can reliably recreate the “think” part in a classroom and have my learners engage in realistic decision making just as they would do in the sim lab. So, I now believe that any time we have our learners engage in realistic clinical decision making, we are doing simulation.

Here are some examples of how you can incorporate simulation in your classroom:

No tech:

An unfolding case study in which learners are given small bits of information and are then asked to interpret that information and decide what questions to ask next. A bit more information is given, they pursue that, etc. All along the way, they are assessing, interpreting, making decisions, implementing interventions, evaluating the outcome of the interventions, communicating with other team members using SBAR, and providing patient education. All of this can be done with just PowerPoint slides (or without them). Having learners in small groups for some of the decision-making time also allows for collaboration.

Visually Enhanced Mental Simulation:

This tabletop approach is great if you can get your learners into small groups. Using a picture of a patient, equipment, medications, etc, learners can work through a patient situation that asks them to apply pharmacology and physiology knowledge, prioritize actions, communicate, and do patient assessments. Imagine a situation in which learners had to start a heparin drip. They would have opportunities to do dosage calculation, prioritize labs/bolus dose, select the correct picture of a vial and/or a syringe to administer a bolus dose, and set up the IV infusion (if the sim lab can provide IV pumps, great!).

Here’s a paper on VEMS: https://www.johs.org.uk/article/doi/10.54531/NDXV6633

Some tech:

Set up a vital signs generator on the classroom computer. This can be done by working with your AV support people in the lab or your IT department. Most smartphone app stores have a vital sign generator app that can be mirrored to a display. When discussing cardiovascular medications, generate vital signs and have learners make decisions based on them: when to hold or discontinue a medication, when to notify the team that a dose is too low or too high, etc.

The Human Touch:

If there is a class that focuses on patient teaching or medication reconciliation, consider using standardized patients in the classroom. Each SP could work with a small group as they provide teaching or as they reconcile medications.

-Mary Fey, Associate Director, CMS-ALPS