What Is a Simulator–a Clinical Checklist or a Theater?

CHAPTER 1 What Is a Simulator–a Clinical Checklist or a Theater?




Jimmy grows up, insists you call him “James” now, although most of the students in his quantum physics class call him “Professor.”


In this most advanced of disciplines, the professor still delivers his lectures the old-fashioned way—white chalk on a blackboard. The students shuffle in, take off their bulky jackets, and set up their laptops to take notes. James had initially resisted this maneuver, and he found the clicking keys irksome; but alas, after a while there was so much clicking it became a kind of white noise, and you tuned it out.


“What does a single electron do when it comes to this sheet of metal with two holes in it?” the professor asks.


No one’s hand goes up. There weren’t any hands free; they were all glued to their keyboards!


James turns around, draws a square representing the sheet of metal, and draws a little dot, the electron, with a little arrow pointing toward the square.


Click, click, click, click, click, click.


(“How are they drawing this picture on their computers?” James thinks. “Notebooks and pens were better for drawing pictures.”)


“Simple,” James explains, “the single, indivisible electron passes through both holes.”


Click, click, click… click. Click, click. Click. Click.


The clicks fade out and the lecture hall gets quiet. Outside, in the distance, the carillon’s bells start playing “Amazing Grace.” Every student’s head lifts up from their laptops as they look at the blackboard.


The single electron passes through both holes.


Now just how the heck can it do that?


A single simulator passes through a couple holes of its own. For a simulator can be viewed as two separate creatures:




But like the elusive and tricky electron, the clinical checklist and the theater inhabit the same simulator experience. Is this as incomprehensible as quantum physics?


No. As the core of this book—the 50 simulator scenarios—show, each scenario has an element of the clinical checklist, and an element of theater—educational theater.








For example, you set up a simple scenario for medical students:



















You could throw in other steps (sedate prior to induction), or you can take out steps (if a bunch of medical students are standing around, just have them intubate, one after another, so everyone gets to do something). But the idea is the same—you use the simulator as a checklist. You ensure that the student does the right things in the right order.


“Oops,” the instructor corrects, “you just induced, but you forgot to preoxygenate first. Let’s try that again.”


“Nope, nope,” the instructor observes, “you induced anesthesia all right; but if you put that laryngoscope in before you give the paralytic, you are going to be in for the fight of your life as they bite down on that scope.”


Good lessons all, and good lessons linked to the “simulator as a clinical checklist.”


But the good thing about the simulator, and what really gives it a zing from the instructor’s and the student’s point of view is that the simulator also functions as “educational theater.” And theater is limited only by the imagination of the playwright and the actors. So you can end up with Juliet lamenting her romantic plight, Willie Lomax lamenting his wasted life, or Stella lamenting that she has “always depended on the kindness of strangers.”


Bring up the lights, lift the curtain, and “Break a leg.” The educational theater is going live. Anything—but anything—that the instructor wants to teach is now on the playbill.


May 31, 2016 | Posted by in ANESTHESIA | Comments Off on What Is a Simulator–a Clinical Checklist or a Theater?

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