VA PA Sim Center
Simulated Delivery Room Enviornment (SDR)
Neo/CRM

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The Simulated Delivery Room (SDR) is a physical space which replicates a real delivery room with high fidelity. It is equipped with real medical equipment which is fully functional, sophisticated life-like manikins with realistic anatomic characteristics and data streams controlled by internal physiologic and pharmacokinetic models, and simulator faculty skilled in creating the human interactions, stressful conditions, and complex environmental cues that exist in the real delivery room. All events that take place within the Simulated Delivery Room are recorded on multiple cameras on time-coded videotape for review during formal debriefing sessions.

Description of the Training Program

The Simulated Delivery Room Training Program is modeled after the Crew Resource Management training programs utilized by NASA and the airline industry in preparing pilots and astronauts for in-flight crises. The Simulated Delivery Room creates realistic, dynamic crisis situations requiring the application of effective technical and behavioral skills in a coordinated team response. Such training allows health care personnel to practice the skills necessary to better prepare for and effectively respond to crisis situations which have potentially disastrous effects for mothers and babies.

A typical Simulated Delivery Room Training Program is a full-day experience involving:

  1. didactic instruction in the principles of crisis resource management
  2. videotape review of the management of crisis situations in aerospace and medicine
  3. an in depth orientation to the manikins, medical equipment, and other resources used to simulate the delivery room environment
  4. intensive participation in simulated delivery room crises, followed immediately by debriefings by faculty with expertise in both delivery room medicine and simulation training.

The emphasis of the Program is on active participation by those in attendance; up to 5 scenarios (each one followed by an in-depth debriefing) can be conducted each day. The Program can be tailored to meet the specific needs of the participants. It can be scaled in intensity to challenge the novice as well as the seasoned clinician. The course can be designed with a focus solely on neonatal resuscitation or expanded to include team training issues in the care of the pregnant woman and her baby. To date, pediatricians, neonatologists, anesthesiologists, obstetricians, neonatal nurse practitioners, pediatric and obstetric nurses, respiratory therapists, residents and fellows have participated. Up to 10 participants can be accommodated per course. CME, CEU, and NRP certification are available.


A view from the SDR during delivery. As baby manikin is being delivered by an obstetrician played by Dr Steve Howard (right) and to be handed to Dr David Kaegi, a neonatology fellow (left).

Another view from the SDR during delivery. A baby manikin is being delivered by Dr David Kaegi (left). Dr Steve Howard (in the background) plays the role of an anesthesiologist during a crash OB scenario.

A view from the SDL during resuscitation. Brian Smith, RN, a delivery room nurse specialist intubates the baby manikin.

A view from the control room. Dr Lou Halamek, (left) directs actions during a simulated delivery scenario while Dr Brian Smith (right) controls the adult simulator which represents a female during the delivery.

Another view from the Control Room showing the different views from the SDR. The large monitor view (left) captures activities around the adult simulator managed by an anesthesiologist during a difficult labor situation. This view also captures physiologic data of the adult simulator through out the simulation session (picture-in-picture). The view to its right captures activities pertaining to resuscitation of the neonatal simulator manikin. The view above is a broader view of the resuscitation of the neonatal manikin capturing the different members of the resuscitation and delivery room teams and their interactions. All three views are captured on videotape and used to analyze team performance. Dr Yasser Sowb (left) controls the adult simulator & audiovisual system during such sessions.

A view from the debriefing room during a videotape review of management of crisis situations from aviation. Dr Lou Halamek (far right close to monitors) directs the discussion and videotape analysis. This room is also used after each simulated delivery session to analyze and critique the trainees' performance during the scenario.

Neonatal Resuscitation Training in the Simulated Delivery Room (NeoSim)

Dates offered: can be arranged with Dr Lou Halamek at the contact information below.

Site: Simulation Center for Crisis Management Training in Health Care at Veterans Affairs Health Care System in Palo Alto, California

Length of program: approximately 0730 - 1700

Number of participants: minimum 5; maximum 10

Target audience: pediatricians, neonatologists, delivery room nurses, neonatal nurse practitioners, respiratory therapists, trainees in these disciplines, and all who may be called upon to resuscitate a newborn

Options:

  1. NRP certification: Provider cards will be issued upon successful completion of the written and technical examinations.
  2. CME/CEU: Physicians are eligible for up to 10 hours of Category 1 CME and nurses up to 12 contact hours through the Stanford University School of Medicine.

Perinatal Team Training in the Simulated Delivery Room (Sim DR)

Dates offered: can be arranged with Dr Lou Halamek at the contact information below.

Site: Simulation Center for Crisis Management Training in Health Care at Veterans Affairs Health Care System in Palo Alto, California

Length of program: approximately 0730 - 1700

Number of participants: minimum 5; maximum 10

Target audience: anesthesiologists, obstetricians, pediatricians, neonatologists, delivery room nurses, neonatal nurse practitioners, respiratory therapists, and trainees in these disciplines

Options:

  1. NRP certification: Provider cards will be issued upon successful completion of the written and technical examinations.
  2. CME/CEU: Physicians are eligible for up to 10 hours of Category 1 CME and nurses up to 12 contact hours through the Stanford University School of Medicine.

For more information or to design a course tailored to your needs please contact:

Louis P. Halamek, M.D.
Assistant Professor in Pediatrics &
Co-Director of Training Program in Neonatal-Perinatal Medicine
Division of Neonatal and Developmental Medicine
Department of Pediatrics

Stanford University School of Medicine
750 Welch Road, Suite 315
Palo Alto, CA 94304
voice: 650-723-5711 fax: 650-725-8351
email:


Dr Lou Halamek's Bibliography
Department of Pediatrics at Stanford University

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