Healthcare Simulation

Why Simulation Managers Want Educator Standards

Why Simulation Managers Want Educator Standards 1096 851 Level 3 Healthcare

Treating a gasping patient who’s reported severe shortness of breath or a postpartum mother who’s hemorrhaging can overwhelm a nursing student. Fortunately, simulated scenarios take the risk out of practicing in such emergencies. Unfortunately, not all nurse educators are trained to plan and implement these simulations to the same standards.

Scenarios that are too advanced or not properly planned can go wrong for students by creating panic, triggering post-traumatic stress disorder, and even causing them to change their majors.

Simulation is a powerful tool in healthcare education, but without education standards, too many students won’t get the most out of these experiences. If the educators who run the simulation labs aren’t trained to uphold a certain standard, lab experience may harm students by giving them a subpar education or a negative experience with the field.

The State of Education in Healthcare Simulation

There are currently nursing organizations that recommend standards or shadowing programs or that even offer certifications, fellowships, or boot camps to properly train and prepare nurse educators for using simulation in their teaching.

However, experts like Scott Atkinson, the Simulation Technology & Operations Specialist at Level 3 Healthcare, recommend a more formal, consistent pathway to becoming a simulation nurse educator.

Without these kinds of standards, it is impossible for educators to be on the same page when it comes to everything from curriculum and level of difficulty to safety and student satisfaction.

Establishing the Simulation Standard for Nurse Educators

To begin creating a standards matrix, professionals can look at the guidelines recommended by organizations like the National Council of State Boards of Nursing (NCSBN) and the training currently offered by organizations like the National League for Nursing.

Whether the eventual formal pathway includes some combination of specific coursework, certifications, mentoring, exams, or ongoing professional development, many industry leaders agree it’s time to hash out the details.

The Benefits of a Simulation Standard in Healthcare

Although the creation of a standard is somewhat complicated, the benefits will be well worth the effort. A standard will benefit:

  • Nurse educators by giving them career stability and assurance. Offering a formal certification or degree for nurse educators gives them confidence that their training can be used at most nursing simulation labs.
  • Nursing students by ensuring they receive the same quality of education as their peers—because they will be awarded credentials based on the same requirements.
  • Nursing schools by making it easier to evaluate whether educators have the necessary qualifications to run a successful simulation program.
  • Healthcare and patients in general by guaranteeing a quality education for nurses. Patients will be able to expect a standard level of care regardless of where they are treated because all nurses will be educated in the same way in their simulation training.

Next Steps

Simulation labs are an important investment for healthcare’s academic institutions. However, if your nurse educators lack the skills or knowledge to properly train students, much of that investment may be going to waste. If you have questions about healthcare simulation or would like to continue the conversation with an expert, email Scott Atkinson, our Simulation Technology & Operations Specialist, at

Nursing Education: Too Many Hats; Not Enough Heads

Nursing Education: Too Many Hats; Not Enough Heads 1200 800 Level 3 Healthcare

Too Many Hats, Not Enough Heads

Many simulationists share a common issue when it comes to day-to-day operations in a simulation. The reality is, many simulation programs are understaffed, and most faculty already have more hats than they can comfortably wear.  This has many programs looking closer at the evolving simulation operation specialist role.  But where does one find someone with the skills needed without sacrificing an educator position?

The shortage of nursing educators is a well-known concern; but too often the operations specialist role(s) merely become a strategy to fund another nursing educator.  Consider roles such as simulation lab coordinator, operations specialist, operations manager; search online for these roles. Candidates are often required to be a registered nurse with a master’s degree (MSN).  A look at the actual job skills required, and it has little to do with being a nurse and everything about supporting the many layers of simulation technology: network (wired & wireless), personal computers, server(s), audiovisual, inventory management systems, scheduling systems, etc.

Nevertheless, even while operational roles continue to evolve, many undergraduate nursing programs are hiring adjuncts to bridge gaps.  While it is a great opportunity for some nurses to get their foot in the door of a university-based nursing education program; the job is still only a part-time, temporary contract position.  Universities, are at fault here. It is appalling to see how little nursing educators earn compared to what they can earn in a hospital. Nurses are wonderful people. And of all the nursing roles, the role of the nursing educator seems to be filled with the most passionate, knowledgeable and skilled people.  No one is a nurse educator because the pay is great.  It is a calling. Operations Specialists (sim techs) owe quite a bit to our educator counterparts.

The Many Hats

The many hats that nursing educators and operations specialists wear these days has created new opportunities—too often opportunities that are ignored. That is why it is surprising that the requirement that simulation operational roles still favor nurses.  Surprising not because nurses are not capable of doing the technical and operational roles, but because the demands, the many hats that are already being worn are often counter-productive to the advantages that simulation brings.  Simulation programs that have non-nurse operational staff are discovering that the diverse background that many sim techs / operations specialists bring to the program enhances everyone’s role.

Like nursing educators, operations specialists find their job rewarding, personally. However, few if any are doing the job because the pay is good.  There is a higher calling.  The biggest difference between these two groups (OSes and Nursing Educators) is that the operations specialist do NOT have a formal path to prepare for career in simulation operations.  Those educational programs that exist for simulationists are more focused on the educator roles, with the assumption that operations is embedded in the educator role(s).

The Conversation

In a recent Level 3 Healthcare webinar, Scott Atkinson and H. Michael Young were asked about the best way to prepare to do the job of an operations specialist.  The advice that was shared is echoed here: identify the gaps in the simulation program where you work and endeavor to bridge those gaps. That is harder to do than it may seem. Regardless of the job, regardless of the professional field, it is hard to recognize when we do not know what we think we know (yeah, read that a couple of times).

Some of the smartest people realize how little they really know in the grand scheme of things.  That doesn’t mean they don’t recognize what they do know, but rather it takes some uncomfortable self-evaluation to admit what one does NOT know. It is not uncommon for college students to figure out that the more they learn, the more they realize how little they do know, and that their world keeps getting more mysterious, not more comprehensible.


On a personal note, that was H. Michael Youngs experience.  He has two college degrees, a graduate certificate in simulation leadership and education and am a CHSE.  He is an, editor and subject-matter expert in the field of simulation education, operations and technology.  However, each day he is reminded by how much he still needs to learn, and he is still trying to find answers to all the questions he has, and the longer his list of questions grow.  We know we don’t have all the answers—but we also don’t know all the questions yet either. Only the foolish have all the answers. Here are some principles that have served us well, and hopefully will help you in your journey as well.

  1. Stay curious and realize that you will be learning and growing for the rest of your lives.
  2. If you are wise, you will change your mind more often than you would like.
  3. Be a servant, and you will always have a job.
  4. Make your colleagues look good in the eyes of others. It isn’t about you.
  5. Read, write and practice good communication. It is the best way for people to know you.
  6. Love, like and be generous with your time and talents.

The sooner that an operations specialist (sim tech) can identify the gaps in their own professional path, the sooner they can find ways to fill those gaps.  One thing is clear these days, you will find it difficult to find a college degree that would solely prepare you for the role of an OS.  Most agree that knowing medical terminology and anatomy are gaps that need to be bridged early in the path to becoming an OS; it is the language we speak.  The Certified Healthcare Simulation Operations Specialist (CHSOS) was developed around communicating ideas and concepts to improve our ability to work across multiple domains: technology, education, and healthcare.  You need to know how to communicate with your IT department, your educators and clinical subject-matter experts.

Collaborate With Us

If you have read this far into this blog post, you are invited to reply on this topic.  Rather than providing you with answers to questions that you are not asking (yet), please share what you perceive to be the gaps in your own simulation program?  We are not just discussing operations here, as you may see other ways that would enhance your role in the simulation program.  At some point, your replies to this post will be reviewed and we can expand the conversation. Here are some questions that will help you get started in finding some important answers about your career; it is ok to use questions to answer these questions.

  1. What knowledge or skill(s) do you lack that would help meet a need in your simulation program?
  2. What in your own professional background has been an asset to your simulation program and should be considered for other simulation programs as well?
  3. Why did you choose to work in simulation operations and technology? (many of us stumbled on it, and it chose us)
  4. What kind of resistance have you received when trying to improve buy-in to new ideas you would like to implement?
  5. What formal education or licensing do you already possess?
  6. Is your job as an operations specialist only a step to your next goal, or have you arrived in your chosen profession?
  7. What would help you most in taking your next big step in your professional path?
  8. How many hats do you wear on a daily or weekly basis? (Is it time for more specialization in operations?)

For more information about the Level 3 Healthcare Education Matrix Webinar, Click the Video to watch and listen the full webinar.

Is It Time to Upgrade Your Simulation Technology?

Is It Time to Upgrade Your Simulation Technology? 2000 1226 Level 3 Healthcare

Just as medicine continues to advance, healthcare simulation—and the standards that govern it—are also evolving. It’s important that healthcare organizations keep up, but how do you know when and what parts of your simulation technology should be upgraded?

How to Tell It’s Time for Something New

Before you can decide how extensive of an upgrade your existing simulation AV requires, you need to know how to identify if and when an upgrade is required. Here are some symptoms of an aging or ailing simulation system:

  1. Users wish it did more. Faculty, staff, administrators, and other users should continually evaluate the simulation system and make note of features and tools that don’t meet their needs or expectations. Your audiovisual (AV) system provider or integrator might be able to address some of them. The rest will be critical data points when designing the next iteration of your simulation system.
  2. You plan to scale. There are two components to successful scalability. The first is whether your current system can grow with your program as it expands and evolves. For example, your current AV capabilities may not support your plans to expand. The second component of scalability is whether your existing solutions are compatible with newer technologies. At some point, those older technologies won’t be available for replacement anymore. If you are facing frequent compatibility issues, it’s time for an upgrade.
  3. You have trouble managing and maintaining it. If you don’t have AV experts on staff who can help you maintain and update your simulation solution, consider upgrading to a system that is easier to care for and that offers ongoing management and maintenance.

If you have discovered that you need an upgrade, how do you decide what kind of upgrade you need?


Renovation vs. Refresh: Which Do You Need?

A refresh means replacing and upgrading outdated equipment that’s part of your simulation system. Computers usually become obsolete in about five years, and the same is also true of your core AV systems. If your simulation system can support your projected growth but needs new peripherals or components, a simple refresh is enough to bring it up to date.

A renovation not only upgrades components that need to be repaired or replaced, it also expands features and functionalities, enabling your system to be compatible with future growth and needs. A renovation is an investment. Taking shortcuts that don’t address core shortfalls in your simulation system or improve user outcomes will ultimately cost more. To best plan for a renovation, you should: start documenting issues that impact the effectiveness of your program; assess whether or not your system can scale to meet your planned and desired system growth, and; get advice from experts and plan for the long term.


Next Steps

Whether you are undertaking a simple refresh or preparing for an extensive simulation renovation, input from AV experts is key to your success. The simulation experts at Level 3 Healthcare are here to help. Schedule a consultation today.

3 Steps You Should Take When Planning For Your Healthcare Simulation Facility

3 Steps You Should Take When Planning For Your Healthcare Simulation Facility 1000 681 Level 3 Healthcare

Building out a space for a healthcare simulation center involves much more than just finding a space and the technology to put into it. How will the technology work in the space to optimize workflows? How do you ensure the use of space and technology will be intuitive and user friendly?

There are at least 430 simulation centers in the U.S., but only a fraction of those are accredited. One reason for that may be that there are a lot of needs, standards, and best practices that are overlooked, so it’s important to make sure you know what to consider from the planning phase. Here are three key steps you can take to get your simulation facility ready for success long before it opens its doors:

  1. Select the right team.
    Be strategic when involving individuals on the planning team. Consider who the stakeholders are and who will have the knowledge and experience to make the new center succeed for years to come. Look at department heads, the clinical lab managers, faculty and simulation educators, operations staff, facility managers, and IT professionals.
    You’ll want to create a diverse team with members who have a collective knowledge of design, simulation education, operations, and technology to ensure that all stakeholder and user needs and concerns are considered.
  1. Evaluate your site and others.
    Allow the team to see what the space looks like before any work starts. Also take them to visit a variety of other healthcare simulation facilities. In visiting and connecting with other simulation users and technicians you may be surprise about how they are using emerging technologies like virtual reality and 3D printing. You may discover a need you didn’t know you had.Let them see the technologies being used by other teams, and give them the opportunity to ask what those users like as well as what they wish they had done differently.
  2. Partner with knowledgeable experts and consultants.
    When looking for outside experts, audio visual integrators, and architectural consultants, be sure to ask for their experience with projects specific to healthcare simulation. How many other healthcare simulation projects have they handled from the design phase all the way through implementation and testing? And do they provide ongoing service and support?Also ask about their knowledge of simulation education best practices. A technology integrator should understand what your organization is trying to achieve and how simulation technologies will help them achieve those goals.

Next Steps
To learn more about what you should know when beginning the planning process for a simulation facility, read the “Facility Planning & Audiovisual Technology” white paper, written by H. Michael Young, CHSE, Director of Healthcare Education & Business Development at Level 3 Healthcare. The paper takes a deeper dive into how to get your simulation facility planning off to a solid start. Learn details like what to expect at each phase of the planning process. It will also talk about other necessary steps, including defining organizational objectives, learning industry standards, creating a proposal, and securing funding.

Case Study: University Simulation Center in Provo, Utah

Case Study: University Simulation Center in Provo, Utah 2000 1278 Level 3 Healthcare

Level 3 Healthcare successfully implemented SIMStation into a four-year University Simulation Center in Provo, Utah. This center was a retrofit from an existing AV system, and Level 3 Healthcare was brought in to add a new dimension of user feedback, as well as, provide the newest technology the industry has to offer.

This Simulation Center includes a total of seventeen rooms. Six simulation rooms for capturing and using manikins, five standardized patients or OSCE exam rooms, five control stations in a centralized control room, as well as, four debriefing rooms where participants can watch the event live or playback for review, after completion.

This Simulation Center is utilizing Level 3 Healthcare’s newest web-based software interface, allowing for the seamless integration between patient exam rooms and simulation training rooms while also providing flexibility for access anywhere in the center through their network. A tablet version of SIMStation was integrated by the Level 3 Healthcare team, allowing for annotations, bookmarks, and making the software readily available for debriefing.

The L3HC team brought over 22 years of experience and, with the help of their in-house subject matter experts, was able to design a state-of-the-art facility complete with high definition PTZ cameras, wireless microphones, full tablet connectivity, mannequin control, vital sign capture, and voice modulation devices, which allow for educators to change the voice of a mannequin to be a man, woman, child, or create a completely new voice. With this solution, the university was able to greatly improve their workflow management and increase their technology capabilities for years to come.

The simulation facility included:


Each simulation room consists of two (2) PTZ cameras with zoom, two (2) video encoders for capturing vital signals or other compatible video devices and includes a single ceiling microphone and a ceiling speaker for communication from control space. Each room will use an wall plate for connecting a portable speaker for in-room Voice of Patient (VOP), and one (1) wireless microphone. The wireless microphone can also be used for private communication between the control room, Voice of Trainer (VOT) and the simulation room.


Exam rooms each include two (2) PTZ cameras with optical zoom, a single ceiling microphone and a ceiling speaker for communication from control space, an wall plate for connecting a portable speaker for in-room Voice of Patient (VOP), and one (1) wireless microphone. The wireless microphone can also be used for private communication between the Voice of Trainer (VOT), control room and the exam room.


The open bed labs consist of two (2) PTZ cameras with optical zoom. Each lab has a single ceiling microphone and a ceiling speaker for communication from control space.


Each room is equipped with a client provided display to allow for live viewing of the training rooms. Wet room 1 shall consist of two (2) PTZ cameras with optical zoom. Each room includes a single ceiling microphone and a single ceiling speaker for communication from control space.


The med station in the hallway shall consist of (2) two PTZ cameras with optical zoom, one (1) ceiling speaker and one (1) ceiling microphone for communication from control space.


Each control space shall consist of a touch PC to run SIMStation software and control cameras and source selection. Two (2) desktop microphones shall be provided allowing an operator to speak to the simulation room, a confidant via their earbuds, or VOP. Desktop speakers are provided as well as three (3) headphone ports for discrete listening. A tablet is available for each station to remotely add notes to simulations. Each control station will include a telephone capture device. A voice changer device will be included for each control station. This will allow for voice modification to the connected room.


This control space shall consist of a dual touchscreen system with PC to run SIMStation multi-room software and control cameras and source selection. This station is specific to OSCE or multi-room type capture where all exam rooms shall be captured at one time. Two (2) desktop microphones shall be provided allowing an operator to speak to the simulation room, a confidant via their earbuds, or VOP. Desktop speakers are provided as well as three (3) headphone ports for discrete listening. A tablet is available for each station to remotely add notes to simulations. Each control station will include a telephone capture device. A voice changer device will be included for each control station. This will allow for voice modification to the connected room.


The head end system shall consist of a server-grade PC to transcode video, audio, and act as a central storage device for an interim period. All IP switches and audio processing shall also be housed at this head end rack. A rack is provided, but equipment can be integrated into an existing IT rack if enough space is available. Central network location to be determined later.


Each debriefing space is equipped with a client provided display to allow participants to view the debriefing software. Inputs to the display are the debriefing PC by default. Each debriefing space will consist of one (1) PTZ camera with optical zoom. Debriefing room 1 will consist of two (2) PTZ cameras with optical zoom. This will be controlled via the provided tablet or wireless mouse/keyboard. An HDMI input plate is also provided for each room for auxiliary input sources. This will automatically take over the debriefing PC when plugged in. Ceiling speakers are provided to cover the entire room evenly with audio.


The Level 3 Audiovisual intelligent device monitoring (IDM) solution—Pulse—has been specifically designed to monitor the SIMStation product. The solution often includes a simulation lab or room, a control room, and a debriefing room where students and teachers can evaluate what happened in the simulations.

The Pulse monitoring device is a small appliance that monitors only the devices in your simulation rooms. It communicates securely to the Level 3 Healthcare data center through an outbound connection, thereby eliminating firewall concerns. The monitoring center servers are not on the cloud but self-hosted at the center where the servers analyze incoming data, and technicians can immediately respond to issues.

From resetting devices to their default or standard settings—like mic volume, camera position, etc.—to arranging an on-site support visit, Pulse services monitor and address device performance issues. The goal is to minimize problems that would affect the client’s use of the SIMStation and reach a resolution more quickly.

Since Pulse is specifically designed to monitor SIMStation devices and software, it can more efficiently identify and address issues.



For more information about this project, or pursuing a project for your own simulation lab. Please call 1-877-777-5328.

4 Ways to Optimize Time as an Operation Specialist

4 Ways to Optimize Time as an Operation Specialist 2000 1333 Level 3 Healthcare

A new hire, a simulation technician for an undergraduate simulation program, attended a manikin vendor’s class on programming scenarios.  She had already been working for many years in various IT roles, so learning the technology used in simulation was an exciting opportunity. The course was attended by over 15 nursing and EMT educators; they were almost salivating at the possibility of one day getting “their own” technician.  These educators had become keenly aware of the demands placed on them in addition to the courses they taught and related responsibilities, and now they were learning a relatively new technology. Before leaving, the simulation technician received several polite invitations to come work for their programs; in the same breath of the invitation was the expression of frustration that they did not have the funds or administrative will to further staff the simulation facility. 

Fortunately, the role of the simulation operations specialist (OS) has evolved quite a bit. Technicians can now earn professional certification in their field (CHSOS) and enjoy key leadership’s appreciation of the importance of the role—so the “will” now exists.  Salaries for the OS roles has improved but not enough to keep their OSs more than two or three years (generally speaking).  When an operations specialist leaves their job, they take their skills, knowledge and experience with them, often leaving a void in the program. 

So, how can simulation program leadership keep their highly qualified operations specialists from moving on to another simulation job? Time.  Time is the most valuable commodity for anyone, but it is also relatively cheap to distribute that commodity in a way that provides value to the simulation program, the operations specialist, and of course, leadership. Even if the budget doesn’t allow for a career-worthy salary, professional development and the time to do it provides a lot of value and satisfaction to the operations staff.  So, how can leadership enrich the operations specialists’ jobs? 

Protected Time 

This may seem strange for what often passes as an entry-level job for many simulation technicians. Providing protected time gives staff the breathing room, during the work week to read articles, simulation books, perhaps write blog posts or engage in discussions with other simulation professionals on organizational forums.  How does this benefit the simulation program? If the OS is not squandering their time playing online games or working a cross-word puzzle, then he/she can learn about new ideas, innovations, develop relationships with other OSs at other simulation programs.  We live in a connected community, so the time we protect can encourage a connection with the greater simulation community. These connections produce opportunities for mentoring, whether your OS is mentored, or is mentoring, either provides an opportunity for professional growth. 

Staff Training 

So many times, educators are invited to attend on-campus training provided by vendors for new simulation equipment, but the simulation technician is not invited.  Such courses are usually limited to a dozen or less, so leadership makes sure that the educators are first in line.  Hard to believe.  The hope is that the faculty “buy-in” to simulation by attending such courses, and for some, it is the nudge that they need.  However, it can also harden faculty resolve to not adopt simulation.  Simulation program leadership would do well to adopt a policy to train superusers first, and they will pass their knowledge on to educators and staff who want to learn more. It doesn’t take long for an OS or simulation technician to become discouraged when they are left out of valuable training.  To avoid frustrating staff, they should be included in training opportunities and be valued as a resource for busy educators who have no desire to dig into the technology itself, but rather want their students to learn.  The educators can then focus their expertise on scenario design and participant assessment/evaluation. 

Time to Learn, Time to Teach 

Too often faculty show up in the control room and communicate their intentions about the simulation activity—sometimes as it is being facilitated. This is a poor practice and only demonstrates the need for consumers of the simulation resources to learn about best practices, and to understand the role of the operations specialist in assisting subject-matter experts (faculty). A simulation technician should be extended the courtesy of having time to learn about the objectives of a scenario, and perhaps even participate in the development of the activity.  Such an intimate knowledge of the scenario and expectations of the educator will improve everyone’s experience.   

Some programs have policies and procedures that prescribe the appropriate amount of lead time and knowledge needed before a scenario can be validated as ready for implementation.  Many programs require at least a week or two to develop a scenario concept into a finished scenario. Other programs recognize that a large undergraduate program with dozens if not hundreds of educators may overwhelm a small staff with constant preparation and validation of new scenarios. Consequently, at least one program required that all scenario design requests not be fulfilled until the following term. 

Many operations specialists find themselves becoming teachers.  Whether the OS teaches new faculty and staff about the simulation technologies and operational policies, or they are called upon to oversee and teach students about the various skills prescribed in the curriculum.  All of this takes time, and without that time it is difficult for anyone to be prepared to engage in such activities.  Preparation time should be built into everyone’s schedule, including the operations specialists. 

With the development of the Certified Healthcare Simulation Operations Specialist exam(s), subject-matter experts in operations and technology insisted that some knowledge of instructional design concepts be assessed, even for those who are not expected, or allowed, to “teach.” The realization was that technicians could better support educators if they understood the theories behind the activities being planned. Ultimately, an experienced OS will teach—probably informally, but nevertheless they will teach learners, for example, how to use virtualized scenarios on PCs, teach new staff about the operations of the center, and perhaps even write policies and procedures recommendations. An understanding of educational concepts will improve their chances for success. 

In Conclusion 

The time has come where entry-level technicians and experienced operations specialists know they must plan for their careers.  Up until recently, there were not many opportunities to nurture their careers to be anything more than a low-level technician. Not all operations specialists or technicians are fresh out of school, more and more specialists are older and transitioning into another phase of their lives.  Because there are not many formal pathways for earning a degree to prepare for the role of an operations specialist, and those that do exist are limited to a certificate or associates degree. For operations specialists that have been working in that role for a while, the idea that the CHSOS requires a bachelor’s degree (or equivalent) is offensive.  They are already doing the work, why go into debt to learn what they have already learned?  However, for the future of the role to become a professional pathway to a fulfilling career, young adults may not learn everything on the job. Courses and degrees, just as provided for other professions (such as accountants, educators and technologists) will be necessary to give a clear pathway and evidence of expertise.  Combined with experience over time, the professionalization of the simulation technician can be realized. 

6 Standards for Simulation Programs of Any Size

6 Standards for Simulation Programs of Any Size 1900 1082 Level 3 Healthcare

There are plenty of times when size matters. A bite-sized candy bar won’t always satisfy a sweet tooth and a small business can’t always compete with larger players in their industry. For healthcare simulation programs, however, even a small team with limited funding can succeed just as well as their bigger counterparts. The key is to follow industry-designated best practices.

The International Nursing Association for Clinical Simulation and Learning (INACSL) recently released Standards of Best Practice for Simulation. Adhering to the standards of operation in particular can make any size simulation program sustainable, while also increasing the return on the investment made in simulation technology; improving outcomes, and; bringing students, educators, and leaders closer to their goals and objectives.

Best Practices to Support Your Small Simulation Program

  1. Define a strategic plan. With an easy-to-follow plan that clearly outlines goals, roles and responsibilities, and desired outcomes, a simulation program can run smoothly even with a small staff. Also address plans for on-the-job training, program evaluation, and how to measure ROI and justify ongoing expenditures. Develop a communications strategy and make provisions for equipment maintenance and replacement.
  2. Empower personnel. Every team member should have the training necessary to set up, operate, and maintain simulation equipment independently if needed. Others who use the equipment—such as educators and trainers—should also be trained to operate it independently. This ensures there is no interruption in simulations and helps relieve some of the pressure on a small team that may already be stretched thin.
  3. Create a management system. In addition to an overarching strategic plan, every simulation-based education program needs a day-to-day plan for scheduling rooms, prioritizing requests, managing operator availability, and setting up and breaking down equipment for simulation exercises. Written instructions for each scenario help ensure operators know what to do and that everyone is following the same system so that educators and students can meet their instructional objectives. Periodically review and seek user feedback on the system to improve as needed.
  4. Manage the budget carefully. The budget requirements of a simulation-based education program go beyond the initial investment in tools and technology. Consider training and operational costs, such as staff salaries. Equipment costs include maintenance, repair, and replacement expenses. Simulation operators can also consider income opportunities to support the program. For example, they can rent the simulation space when it’s not being used internally.
  5. Align the program with organizational goals. The simulation program should be guided by the needs and goals of the organization as a whole. This will increase leadership buy-in and might also allow you to tap into personnel and budgetary resources from other programs or departments. Communicating with stakeholders and participating in initiatives across departments will help integrate the simulation program into the larger organization’s mission, goals, and operation.
  6. Develop sustainable policies and procedures. Create guidelines for everyone people who might use the lab, including instructors, students, visitors, volunteers, etc. Document easy-to-follow guidelines for processes and procedures like data collection and storage, as well as safety information and scheduling guidelines.

Next Steps

Even if your team is small, there are additional resources at your disposal. Our Level 3 Healthcare team can answer your questions, assist in implementing your plan, and help your simulation program succeed. Schedule a consultation today.

SimGHOSTS USA 2018 Keynote Speech

SimGHOSTS USA 2018 Keynote Speech 2000 1038 Level 3 Healthcare

SimGHOSTS 2018 USA has officially wrapped up. It was a record breaking year in attendance at SimGHOSTS USA, hosted at the University of Tennessee Health Science Center’s Center for Healthcare Improvement and Patient Simulation. The conference was a success – and this successful event started off with a Keynote Speaker, for our team at Level 3 Healthcare, David Escobar. David shared with the audience his experience on how his career and life experiences took him from the military, EMS, management, and finally simulation technology operations for Cedars-Sinai, Los Angeles. “David connected with the audience by reminding everyone about the similar struggles we as simulation operators all face as not only do we have to solve technical problems but also countless administrative tasks as well” (

David’s whole presentation is shared below:

First off I want to thank SimGHOSTS for hosting another successful conference. Let’s give a hand for Lance, Ferooz, Kirrian, and the rest of the SimGHOSTS team.

For those that do not know me, my name is David Escobar, I am the Director of Healthcare Simulation with Level 3 Healthcare, who is your platinum sponsor for Simghosts 2018. So, today my talk will require some audience participation. With a show of hands, how many of you are first-time attendees? (show of hands) and, how many of you have been to any prior SimGHOSTS conferences? And… how many of you are not sure where you are right now? Ok perfect. Now I sat out, in the audience, for my first SimGHOSTS back in 2013. Now, fast forward 5 exciting years later and i’m given the opportunity to stand up here and provide the Keynote speech for SimGHOSTS 2018. I have been looking forward to giving the keynote speech. As I have worked as a simulation tech for several years, I have walked in your shoes.

A little about my background, back in the year 2005, like most 20 years old, I had no idea what I wanted to do with my life. I had worked many different jobs, some in retail, sales, and even security. I had always felt that I should be doing something more. I wanted to help others, and give back, but I just didn’t know which career path to take. Then something happened that put me on my current career path. Hurricane Katrina. Hurricane Katrina, made landfall in August 2005. how many of you remember that? Anyone here from New Orleans, or Mississippi? I was watching the news when it made landfall and saw the heartbreaking, terrible destruction that it caused and how it left our people in need of urgent help, it was then that I felt my calling. So I contacted my local Red Cross chapter and volunteered to go help. A few days later I was sent to Gulfport, Mississippi. Now, let me just clarify… I had no idea what to expect. There was no “gameplan” so to speak, at the time this was the biggest natural disaster in the United States. Everyday was moving into uncharted territory. During my time in Mississippi I came across many people needing medical help, but since I had no previous medical training all I could do was pass out bandages or call for someone else to help. I knew then when my time working with the Red Cross and I returned home, I would go to school to become an EMT. I was originally going to stay in Mississippi for 2 years on a long-term contract, working to help re-establish the local area, unfortunately my family experienced a devastating loss that brought me home much sooner than expected.. My younger brother Daniel, who was 17 at the time was killed when a friend who was drunk, decided to drive him and a couple of other high school friends. The accident claimed the life of my brother and another passenger in the car, Sonia who was also 17, both were seniors. After our family’s loss I immediately came home and that’s set my sights on becoming an Emergency Medical Technician.

I found a local EMT program and started to attend school at night, while working at Starbucks during the day. After I completed the EMT course I went to work for an ambulance company in Los Angeles County responding to 911 calls. I did that for a year before moving into the emergency room to work as an Emergency Department Technician at Pomona Valley Hospital in Pomona, CA. I ended up working the night shift in the ER for a little more than 6 years and during my time I got the chance to see just about anything and everything you can possibly imagine, im an adrenaline junkie so the ER was very exciting for me. As the years went on I was given more responsibility from scheduling for 40 EMTs, to ordering inventory and managing equipment.

One day I was approached by our education department and I was asked if I would be interested in a new position working in healthcare simulation for the hospital. I remember being told very little about what the position would include… all I knew was that it would involve training staff, working with computers and programming, and it would be very hands on. Since the position and the simulation program would be new to the hospital, we would be building this program from scratch.

At the time I had no idea what simulation meant or what I would be doing. Up to this point my simulation training had consisted of using CPR manikins or using a full body manikin during EMT school that offered no feedback or any real features, I learned by having to ask my instructor if the patient breathing, if they had a pulse, and what injuries do I see.

I remember thinking how would I adapt to the new position? where would I go to get training? am I qualified to run a simulation? I had lots of questions but found very few answers. I started touring local programs and connecting with other sim techs. During one of my tours, I was told about an organization called SimGhosts and how it was specifically for people doing the same job as me. So I submitted my request and I had the opportunity to attend my first SimGhosts conference in San Antonio, Texas in 2013. Attending the simghosts conference provided me with a new perspective of our simulation community, it was huge, there were dozens of vendors, specialized equipment, and techs with all kinds of backgrounds. There were classes for beginners to advanced. This wasn’t just some job that I decide to take, this was going to be my career. I continued to work at Pomona Valley for one more year before accepting a position at Cedars-Sinai Medical Center in Los Angeles, CA. During my time at Cedars-Sinai I had to the opportunity to grow professionally, I passed my CHSOS exam, I learned 3d printing and helped with numerous organizational committees for healthcare simulation. I worked there for almost 3 years before joining the Level 3 Healthcare team in 2017. In the 18 months since I was hired, I have been promoted from a subject matter expert, to now overseeing our heathcare simulation division for north america.

So why talk about my background? Like most of you I didn’t just start off working as a sim tech. I came from a different job, for me it was healthcare, pre-hospital and emergency. But for some of you its IT, AV, nursing, or something completely different. We also go by many different titles, sim tech, sim specialist, operations specialist, and last Simulationist, that one is from the SSIH dictionary. That is what makes our community so unique, we come from many different backgrounds and work in many different environments but we’re all here to help make a difference. The ideal background for our job is a highly debated topic, with schools of thought to support any of the ones I just talked about. So much discussion has been focused on the ideal background, that we tend to forget that almost all of us will be different.

How many of you are from a Nursing Program, Medical School, EMS, or Hospital program, how many of you are from a program I didnt list?. And the programs starting to utilize simulation is continuing to grow. I have even come across veterinarian and high-school programs in the last year.

So this brings me to the title of this talk, “more than just a sim tech, an open opportunity”. How many of you have ever thought, I’m just a sim tech? or, how many of you have been told that you are just a sim tech… I know I have on a few occasions. Some of you might think I am just a sim tech because you want more out of your job, maybe there are few or no opportunities for advancement? or maybe your pay is not where you think it should be, or maybe its because you don’t feel your role is important or valued?

First off I dont like the title of “tech”, from my experience the word “tech” implies you have a single job or have a single role and at some organizations, your pay can be significantly lower than a similar job title with “specialist” in it. We have started to see the community move away from using the title of sim tech and start using a title of operations specialist, simulation specialist, or some other combination of those titles. From experience we all know that, as sim techs, we do not only complete one job in a simulation center. Educating the community is half the battle, letting others know what our jobs really consist of will help improve job titles, pay, and future opportunities. Most of you already work on educating the community, through posts, blogs, and videos. I saw a great video on facebook recently, it was in one of the simulation groups, and it was about what goes into a simple task of emptying the beds, putting manikins away. To some it seems like it would be a simple task, but the reality is there is more than throwing the mankins on a gurney, you need to clean, move, address technical issues and more. Posting that video gave others the opportunity to understand more about what we do each day.

I’m here to say we are more than just a sim tech. Working as a sim tech, we find that our position requires us to fill multiple roles, that “other duties as assigned” on our job description tends to grow quite a bit as the time goes on. We troubleshoot IT, AV, and manikin issues, order supplies, stock cart, clean rooms, run simulations, coordinate planning with educators, process reports, fill in as actors, fabricate, become do it yourselfers, and of course run simulation scenarios. And I’m just skimming the list of what our jobs entail. We all know there is so much more we do in the course of our day. But despite the added value we bring to the community, there are some of you who may have experienced or will experience roadblocks during the course of your career. Often, our community can focus on the letters after our name, or what college degrees you have, or what is your job title. We can even be excluded in certain activities or responsibilities because some of us can lack similar education as our co-workers. Simulation deals with teamwork and communication, we preach those objectives daily, but we can easily forget to apply those principals to our teams as well.

I am asked often about when an organization is starting a simulation center what should they budget for. My first answer is staff. Hiring an experienced simtech will help to ensure your program will grow and be successful. Who better to help with equipment purchases, staff hiring, or simulation center layout and design. Instead of focusing on our weakness we need to promote our strengths.

As a sim tech we have many strengths:

Communication. We all know from working in simulation that communication is key to ensuring a positive environment. We need to communicate with not only with our co-workers, but also management, not just for our center but also organizational leadership. We communicate when we give tours to internal and external visitors, I have often joked that I need to add “tour guide” to my resume. During tours we have to describe learning objectives, practical examples of how simulation is used, often this is to groups that may have had no previous experience with simulation. How does this relate to healthcare, and day-to-day numbers (attendance, staffing, etc)
Problem Solving: this should be standard on all of your resumes. Since all of your centers can be using equipment differently based on your learners and objectives. We all find ourselves pushing what the equipment can do, versus what it was designed to do. With that, we have to problem solve not only technical issues, but also designing and increasing realism and efficiency. How many of you participated in the hackathon last year at SimGHOSTS? Anyone here from the winning team? For all the teams involved they were able to accomplish some much in a single day. Who better to design new products or improve current ones, then this group right here.

Willingness to learn. This skill goes right into what we do. All of us here are in a constant state of learning. We get new equipment, we included a new department to use simulation. We get tasked with improving center operations. We all never stop learning. The fact that all of you are here now is proof of that.

Ability to work under pressure. I enjoyed working on the ambulance and in the ER due to not knowing what my shift would consist of, would there be a shooting, stabbing, cardiac arrest, or would I end up just transporting patients to the floor all night. The same can be said about being a simtech. We are constantly being challenged with new scenarios, technology, and interacting with learners for all types of backgrounds. Being able to adapt to new obstacles quickly, and work in a high stress environment is something we all do. How many of you have been in the hot seat for a high-stakes scenario and everything stops working 5 minutes before the start? Hopefully no one throws their hands up and storms off, although im sure we have all felt that way more than once. Instead we take the challenge head-on and ensure we see it through.

I have come across many different job descriptions and have helped write job descriptions, and it is always interesting to see some of the skills required to work as a sim tech, a bachelor’s degree, advanced certification in AV, IT or healthcare, minimum of 2-5 years experience, CHSOS or CHSE. Prior experience in operations, patient simulator repair certification, oh and the position is considered entry-level and so is the pay. Its a highly debated topic with no definite right answer, there are many factors that go into that a sim techs role will be at a specific organization. So the question has to be asked, the job descriptions usually cover all the required skills for a sim tech position, but more often then not the pay is not at the level it should be.

Let’s talk about what goes into this type of sim tech background. We as sim techs are truly multi-rolled or a jack of all trades. To accomplish our daily work we have to master several different backgrounds (AV, IT, Healthcare, operations, business to name a few), now those backgrounds normally would take several years in each to gain some significant experience. Think of it this way, if im working in a hospital, if I needed help with a computer issue, I would reach out to IT, or IS (depending of what your IT department is called), now if its a wireless issue, there can be a wireless team that would respond separately, and thats just if the issue is IT related, if you needed AV help, same process. Now that type of workflow, each department handing issues that they have the staff and training in to deal with each issue is not uncommon, regardless if its a hospital, medical school, or university.

For simulation centers, who is usually the one answering the call regardless of the issue? You. We have grown our position from running manikins to be the all knowing, fixer of anything and of course do it yourselfer.

Each different background whether its IT, AV, or healthcare has a recognized training program and some have industry specific certifications. For many of us we usually have to quickly adapt an attitude of sink or swim, where we dont have the luxury to say I cant get to that today or I dont know how to do that, we are forced to quickly learn or risk impacting the center operations or even worse impact our job. Some of us are fortunate to work at a center that can employ multiple staff members to help with the workload. For some of us, we are one-person show. I started that way, in my first position my office was the storage/training/debriefing room.

So all this brings up the important question, where can we go from here. Being a part of this community has provided us with the opportunity to help shape its direction. As more simulation programs open their doors, the need to staff with simulation techs will continue to grow. With our skill set there are countless opportunities to make an impact in, from job advancement, to new positions such as a healthcare consultant, operations manager, or sales representative. As simulation centers integrate more cutting edge technology such as 3D printers, VR and AR headsets, sim techs are in a position to design, create and expand how these technologies will be used. I have already seen this community create new skills trainers, replacement parts, and software to improve daily operations.

Over the last several years I have been excited at the professional growth in our community. We have our first certification specifically for the simulation techs & specialists, the Certified Healthcare Simulation Operations Specialist (CHSOS) through SSIH. There have been standards completed with several organizations such as INASCL, and SSIH. There are several annual conferences dedicated to the sim techs and specialist community, here we are now at SimGhosts with 200 attendees, attendance continues to grow each year.. We also now have certificates and associate’s degrees offered at the college level and some of those programs are being taught by members of this group. These courses are encouraging more individuals to enter this field without prior experience. We are now seeing high-school programs adding simulation centers to their campuses, so even high-school students can start down the healthcare road early on! Also, I am seeing more and more regional groups starting up with the goal of sharing information and connecting with others in the community. The fact is, we are not going anywhere. We are definitely here to stay.

There are a couple of things I want to challenge this group with in closing

1. Be active. I challenge this group to get more active with the community. Some of you are new, and some of you have been a part of this community for many years. Use your knowledge to help others find solutions or mentor others so they can grow in this field. Get online and be active in community forums, post to linkedin, facebook or twitter. Write blogs, publish DIY videos. Take the opportunity to present at local and national conferences.

2. Get certified. With the creation of the CHSOS certification, we now have our own industry related certification. Help the CHSOS grow by pursuing it. If you are not sure what to study or how to prepare, im sure there are some videos out there to help you get started. If you already have your certification, get involved in helping others achieve theirs as well.

3. And last I want to you to challenge yourselves. Push yourself into unfamiliar territory. If you want to learn new skills, do it! We will only continue to grow yourselves if we continue to develop our profession and never stop learning. Do not ever sell yourself short.

So always remembers its not where we come from but where we are going.

Thank you everyone, and lets go have a great conference!

Simulation Provides Low-Cost, Low-Risk Nurse Training

Simulation Provides Low-Cost, Low-Risk Nurse Training 2000 1333 Level 3 Healthcare

Nurses are known for how busy they are since patient needs often can’t wait. And the nursing shortage means they need to focus on real patient care without the added responsibility of training students. In fact, a shortage of instructors is a big factor in why nursing schools turned away more than 56,000 qualified applicants in 2017.

Fortunately, in many instances, today’s simulation technology can take the place of clinical training in medical facilities.

The Benefits of Simulation in Nursing Training

The benefits of using simulation solutions to train nurses include:

  1. Nursing students face real scenarios. Simulation solutions allow students to practice treating patients with the same techniques they would use on real patients.
  2. They improve patient safety. With quality simulation training, nursing students can develop skills without risk to an actual patient. With recording and debriefing software, students learn what they did right and wrong in a scenario, as well as why.
  3. The training is thorough. With simulation, nursing students can train for scenarios that are rarely encountered in hospital or clinic settings but that are still important to be prepared for. In a clinical setting, illnesses and injuries are somewhat random, but in a simulated setting they can be carefully planned.
  4. Training is more efficient and cost-effective. Nursing schools can train students faster and more affordably with simulation solutions because students can test through more scenarios with fewer instructors.
  5. Nurses stay up to date. Nursing students can be easily trained in the latest medical treatments and techniques in patient care.

Simulation training can help nursing students improve their clinical skills, provide better patient care, build their confidence, and work better in teams. It’s important to have the right technology and resources in place for them to be successful.

The SIMStation Advantage

SIMStations are solutions designed specifically for medical simulations. They include all the necessary software, audio, and visual equipment needed for training, recording, and debriefing students.

In addition to providing effective, quality training of nursing students, SIMStations are economical and easy to install and help meet the needs of IT, educators, and administrators.

SIMStation solutions are flexible and upgradeable so that they grow with the institution’s nursing program—and there are even mobile options available. Developed by simulation experts, the solution contains all the tools necessary for high-quality training and for running a training room, control room, or debriefing room.

The SIMStation comes in a variety of product lines to suit the needs of any institution. There are also options for apps and management to improve the simulation experience. An experienced audiovisual partner can help institutions choose the simulation solution that best aligns with their goals.

Next Steps

Level 3 Healthcare’s team of medical engineers integrate audiovisual solutions into medical and healthcare settings. Our team can answer all your questions about simulation and also provide a free nursing school consultation. Level 3 can help you determine if the SIMStation is right for your institution. Contact us today.

3 Ways to Increase Faculty Buy-In for Simulation

3 Ways to Increase Faculty Buy-In for Simulation 2000 1121 Level 3 Healthcare

Imagine someone sitting you down in the cockpit of an airplane and telling you to figure out how to fly it. Seems ridiculous, right? The technology is so daunting and complex, anyone who isn’t a trained pilot would need a lot of help to figure it out.

Sitting a faculty or staff member down in a simulation lab and telling them to run a scenario would be just as difficult and confusing for them—though probably not as terrifying

Without the proper training, simulation technology can be intimidating for educators. They can’t just sit down and figure it out. When faculty members are unsure of how to use a solution such as a simulation system, they are unlikely to support an organizational investment in it. They are also unlikely to use it even if the organization invests in the technology. However, removing common barriers, concerns, and misunderstandings faculty members face can help you improve buy-in and increase adoption of simulation solutions at your institution or organization.

Why Does Buy-In Matter?

Hospitals, clinics, and universities can spend hundreds of thousands of dollars on simulation solutions, so the biggest incentive for increasing faculty buy-in for simulation is to make sure you are spending that money on tools educators want—and are therefore more likely to use. Part of improving buy-in and adoption also means addressing some other challenges simulation facility operators face, including a reluctance on the part of leadership to provide funding for equipment maintenance and upgrades. Another issue is often that there isn’t adequate staffing to run scenarios, troubleshoot issues, and provide training.

How Can You Increase Faculty Buy-In?

There are several steps simulation facilitators can take to increase faculty buy-in and adoption for simulation solutions.

  1. Explain the benefits. Incorporating simulated scenarios into their curriculum takes extra time and effort for faculty members, so they will be more likely to do it if they can see what’s in it for them. Benefits include:
    • A more comprehensive curriculum
    • Improved student performance
    • Easier assessment of student competencies
  2. Offer the necessary training. Faculty members who know how to use simulation technologies are more likely to incorporate simulation scenarios into their curriculum. Training should be offered more than once a year or semester and should include how to write and program a scenario, as well as how to run it. If faculty members understand all the capabilities of your simulation solution, it will be easier for them to develop scenarios that support their course objectives.
  3. Provide adequate support. Even faculty members who have been trained to use simulation solutions will run into problems they don’t know how to fix. If those issues take a long time to resolve, educators and learners will lose valuable time, and they’ll have a negative experience with the solution, making them less likely to want to use it again. Educators will have a better user experience and be more likely to use the simulation system again if you address their technical issues as quickly as possible. 

Next Steps

Level 3 Healthcare has a staff of simulation experts who can answer questions about everything from incorporating AV technology into medical training to designing a new simulation lab. Contact us today with your questions.