Boston MedFlight’s Simulation Lab

June 23, 2021 How do the best of the best learn to care for the sickest of the sick?
Among many factors that enable Boston MedFlight to operate at the highest level of critical care transport, training and experiential education are paramount.
 
Boston MedFlight’s state-of-the-art simulation lab epitomizes our ethos of continuous learning, refinement, and improvement. Simulation provides our teams a unique opportunity to practice clinical procedures, decision making, critical thinking, and teamwork in an environment without risk to patients or providers. The experience is realistic in every detail. We work exactly the same way on our high-tech manikins (they breathe, talk, and blink, they have vital signs, bleed, and can have invasive procedures performed on them). In this educational environment we can focus on learning, unlike a real mission where we must solely focus on the patient.
 
Our simulation scenarios aren’t confined to the lab. We design cases to be mobile so that we can practice in the field and in our vehicles, on the ground and in the air. “At hospitals, training scenarios are staged in a fully functional hospital room and the manikin lives in that room,” says Michael Frakes APRN, FCCM, Director of Clinical Care and Chief Quality Officer. “It’s very different for us. We want to create a case wherever that might be: in the field, emergency department, nursery, or intensive care unit, and take that case on the move, in an ambulance or aircraft.”
 
In addition to mobility, the clinical depth sets our simulations apart. “Simulation as a method of medical training is ubiquitous,” Michael says. “But our approach to simulation is unique. The vast majority of simulation is designed for students or trainees. And while we certainly do hundreds of hours of scenarios with those who are new to BMF, most of our work is with providers who have up to 30 years’ experience. So we have to build our cases to be not only realistic and educational but also challenging for providers at all levels.”
 
“The sim lab enables our providers to be extremely well-rounded,” Michael explains. “We are one of the only transport teams in the world where the same providers take care of neonate, pediatric, obstetric, and adult patients. Everyone. We are ready all day, every day, at every base. The simulation environment is an incredibly important part of that.” With this breadth of expertise and flexibility, no matter what a case calls for, the right expert provider is on the scene.

Tammi Wallace-Wood, BSN, CCRN, CFRN, Boston MedFlight’s Education Manager, speaks to the importance of practicing situations that may occur infrequently but are particularly high-risk. “We do high-risk OB simulation, for example,” Tammi says. “Obstetric patients are a small percentage of our flight volume, but massive shock from hemorrhage is not an uncommon cause of death. So even though it is low frequency, we need to know how to handle a case like that. That’s really the point of simulation.”
 
In extracting maximum benefit from simulation training, each scenario is immediately followed by a structured debriefing that includes team-member and team evaluation.
 
“The quality of our simulation lab enables us to take care of the select, most critically ill. “The challenge is great,” says Michael. “But when all you do every single day is train and care for the sickest of the sick, you get to be very good at it."