Simulation-based education builds confidence and skills in CVM students

Dr. Robert Keegan closely watching veterinary students on multiple computer monitors.
Dr. Robert Keegan monitors veterinary students as they work through a scenario in the WSU College of Veterinary Medicine’s Simulation-Based Education Program.

John Hanlon, a second‑year veterinary student, enters the treatment room where his patient, a five‑year‑old Black Lab mix named Chloe, lies anesthetized on the surgery table. Hanlon hooks up her oxygen, and other equipment, so he can monitor her vitals and notices Chloe’s blood pressure dropping. He checks her eyes to see if she’s still responding, and nothing happens.

Moving quickly, he makes the call to decrease the amount of anesthesia flowing to Chloe. Almost immediately, her pressure improves—but she’s not out of the woods yet. While her pressure is no longer in the red zone, it’s still low. Hanlon reevaluates, and increases her fluid drip. That does the trick, and Chloe’s pressure rebounds.

Meanwhile, a fellow vet student, Breanna Cantrell, steps into an examination room to learn from client Betty Thompson what has been going on with Ranger, a nine‑year‑old German shorthaired pointer who has had a cough for two weeks. Cantrell works with Thompson to understand the timeline of the cough, what might have caused it, what is most important to her regarding finances, and how aggressively Cantrell should work in trying to find the cause. Before leaving the room, Cantrell summarizes what she’s learned from Betty and acknowledges her financial constraints.

These textbook scenarios are exactly how a veterinarian should respond, however there’s a slight difference from the real world.

Chloe is a stuffed animal who’s been fitted with state‑of‑the‑art sensors, and all of her vitals are controlled by Dr. Robert Keegan, head of Anesthesia and Critical Care Simulation for WSU’s College of Veterinary Medicine’s Simulation-Based Education. Betty Thompson is a trained actress, and Ranger doesn’t exist.

The quality of WSU’s simulation training

On April 10, the program received accreditation from the Society for Simulation in Healthcare, making it the nation’s first‑ever accredited program developed for and devoted to veterinary care. Simulation serves as a critical resource for veterinary students—giving them the chance to practice, make mistakes, and receive feedback with no negative consequences to live patients.

Dr. Julie Cary, director of Simulation Based Education, explains, “We believe simulation is a key component to training some of the most prepared and competent veterinary graduates in the country. We use simulation to enhance student exposure and experience, building their confidence and increasing patient safety.”

Medical doctors and nurses have used simulation for years, and now CVM is leading the way in advancing technical and clinical knowledge through the use of simulation training for veterinarians.The program provides hands‑on simulated veterinary training, from anesthesia to surgery to emergency room care, including the key aspects of communication with clients, colleagues, and the public.

Dr. Bryan K. Slinker, dean of the College, said, “The full accreditation of WSU’s simulation‑based education program is an important milestone. Julie Cary, her staff, and all of the individuals—including the many generous donors supporting this program—who had a hand in achieving this accreditation are to be congratulated. I could not be more proud and grateful for this unmatched progress.”

Lethea Russell, program coordinator, recalls a scenario in which students in simulation training were given an animal’s heart that had stopped. In the hustle and bustle, the group had prepped several syringes with the medicine for the patient, but had forgotten to label them. When switching between rounds of CPR, the students prepared to administer medication to the animal and realized they had no idea which syringe held which medicine. “I can almost guarantee you,” Lethea said, “that’s a mistake those students will never make again.”

In the program, students gain more than hands‑on clinical simulation training. They also practice face‑to‑face interactions with clients through the College’s Clinical Communication Program. Overseen by Dr. Cary, and Daniel Haley, who has a BFA in acting and an MFA in directing, students have the opportunity to work though client interactions in a safe space with knowledge coaches and well‑trained simulated clients. This enables the learner to try multiple approaches (or rewinds) to understand how best to support the client with whom they are working.

The most valuable part of these simulations are the facilitated debriefs that happen afterward. Each student receives feedback from his or her peers and a coach—a role filled by a variety of veterinarians, from post‑DVM graduate students to experienced private practitioners.

As coach Dr. Monica Bando explained, “Not only do I continue to learn about and develop my own skills for effective communication, I help guide the students by sharing my own experiences and challenges. I want to help students further develop their communication skills, which better prepares them for success as future veterinarians.”

In its 11 years, the simulation program has seen rapid growth, starting with client communication skills and basic surgical training. The implementation of simulation‑based training into clinical disciplines, such as anesthesia, surgery, critical care, disease investigation, and disaster management has advanced student decision‑making skills and resulted in a marked improvement in student clinical performance and patient outcomes. Because of the rapid growth, space and resources have become critical.

Take the anesthesia simulation elective. It is a popular elective course, and because of space constraints, up until recently only half of the students could be accommodated. However, thanks to a transformative gift from alumni Lisa (’08) and Jim (’80) King, the Clinical Simulation Center has just opened a new simulation surgery suite that, coupled with some minor curricular revisions, will allow all second‑year students access to this vital training.

With additional support from Gary and Diane Price, the DVM Class of 1979, and Kyle (’74, ’80) Frandle, DVM, and his wife Kathy (’74, ’75) the Center staff has been able to purchase critical technological equipment and software, and state‑of‑the‑art animal models, which provide learners even greater opportunity to enhance their skills.

What’s next for the nation’s first accredited veterinary simulation center?

With the addition of space and resources, more courses and rotations are looking to integrate simulation into their training. Faculty, students, and clients have seen a remarkable difference in the clinical readiness of graduating veterinary students who have participated in simulation‑based education.

As societal expectations of high‑quality, affordable veterinary care continue to rise, producing graduates with problem‑solving and technical skills, and excellent communication training, will become increasingly critical.

Visit the WSU Foundation website to support the center.

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