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Teaching and Learning Moments

Our First Simulator: A Fond Farewell

Ahmed, Rami DO, MHPE

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doi: 10.1097/ACM.0000000000001745
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Medical simulation is now a mainstream and integral part of the academic medicine experience. Roughly a decade ago, though, it was still considered a novel approach to educating health care providers. Although simulators exist in many forms, full-body, high-fidelity simulators are the workhorses of simulation labs. This is the story of my institution’s first full-body simulator.

Your body was designed for excellence in medical education. From basic history and physical exam training, to code blue training, to in situ simulations, you have come to life over and over again, invigorating, educating, and shaping future medics, nurses, and physicians.

Emergency medicine residents resuscitated you from yet another motorcycle crash today. You have served proudly for eight years in a bustling simulation lab. Roughly 10,000 learner encounters later, you have had your head replaced twice, your tongue lacerated and replaced several times. Only one of your eyes still blinks. Your teeth have been knocked out during intubations too many times to count. Somehow, miraculously, your torso and inner hardware have remained intact.

Together you and I have witnessed excellence in patient care, cringeworthy management, and everything in between. I have seen the light glowing in hundreds of students’ eyes as a result of the lessons they learned attempting to repeatedly resuscitate your wearied body, leadership and personal growth after every session.

I estimate that roughly 100 hours of CPR have been performed on your chest. With chest compressions that are 2 inches deep, that translates to 15 miles of compressions. You have provided countless hours of leadership education to numerous providers and most definitely have played a part in saving lives and improving outcomes.

“See one, do one, teach one” is a distant memory in time. Now it’s “See one, practice many, do one (perfectly).” Some simulation labs give their mannequins the white glove treatment, careful to keep them looking pristine. But not in this house, not in this lab.

In this house, only deliberate practice matters, and you were on the business end of thousands of chest compressions, defibrillations, emergent intubations, and chest tubes.

You served proudly.

As we carefully package your body one last time in the original box, I flash back to the days of excitement when we opened you up for the first time. The training opportunities seemed endless. I now feel sadness mixed with a sense of excitement. Sadness at the departure of a good friend who has been with me since the beginning. I have countless memories of training former residents in my mind. Excitement looking forward to the future to the improved training we will be able to provide as a result of the lessons we have learned from you.

On this day, you trained your last students and have served a life that any educator in medicine would be proud of. Your proverbial jersey will be hung from the rafters of this lab. You were the hospital’s first simulator, and you have had a profound impact on many. You gave us everything you had. There is an exhaustion in your eyes well beyond the moulage on your face. Today, good friend, we send you to your final resting place, and many of us are forever in your debt.

It was one hell of a ride.

Rami Ahmed, DO, MHPE
R. Ahmed is simulation medical director, Summa Health System, Akron, Ohio; e-mail: [email protected]

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