Yuri Millo, M.D. and  Pamela Leonard describe the advancements in their latest simulation center to better meet learner needs.

This past June (2011), we at Simulation and Training Environment Lab (SiTEL) of Medstar Health opened our newest Clinical Simulation Center, CSC DC, located at 4000 Connecticut Avenue N.W., Washington, D.C. 20008. This center is a state-of-the-art facility built in partnership with Herman Miller. CSC DC serves both MedStar’s hospitals and the healthcare community in the national capital region. During the first ten weeks of operations, CSC DC saw 1,524 participants during the peak on boarding time for new nurses and physicians entering MedStar’s healthcare system.

The need for new learning environments in healthcare is met through simulation training centers like CSC DC. Clinical Simulation Centers in general are emerging as free-standing learning environments, supporting all areas in healthcare education and training. Our CSC DC in particular is one of the nation’s most advanced Clinical Simulation Centers, because our design approach for CSC DC included elements that can be easily moved or adjusted. This design concept was modular, and like a stage in a theater, our faculty and technologists can re-stage the learning environment for any type of training, as many times as needed.

When it comes to learning, the user experience is everything. The physical environment impacts how students learn. Thus, the challenge we at SiTEL faced with designing our new simulation training environment was to create a space that can be rapidly transformed, allowing frequent transitions across diverse training needs. Our CSC DC accomplishes this. Adaptability is the most desired form of flexibility from an operational viewpoint. This refers to the capability of making operational changes without construction. CSC DC’s modular design supports multiple technologies that combine to create an exceptionally realistic environment. The space is designed to train healthcare professionals and students in the domains of skills acquisition, clinical reasoning, communication, and team training. To meet these needs, we’ve used technology to define the spaces in CSC DC, rather than have permanent, immovable walls define our space. With this movable structure, the interior space of CSC DC is easily tailored so it is a more effective use of space for our faculty, students, and technologists. This allows for multiple uses through the lifetime of CSC DC.

Learning Lounge

CSC DC includes a new concept for learning spaces known as a Learning Lounge. Our Learning Lounge is a place where personalized learning can occur and where each encounter is different from the learner’s point of view. In essence, the Learning Lounge is a protected time and space for reflection, research, or exploration. Our Learning Lounge concept was inspired by the desire to shift healthcare organizations toward becoming learning organizations. Much like our center’s overall structure, CSC DC’s Learning Lounge is an adaptable space designed to meet the needs of students and faculty.

Our CSCs: Mission and Courses

In addition to our new center, we also operate several other centers in the Baltimore and D.C area. The mission of our Clinical Simulation Centers (CSCs) is to improve patient safety and clinical outcomes by integrating clinical simulation-based teaching methodologies into the training curriculum for all healthcare professionals. All of our CSCs craft a particular learning environment that creates experiential education. We integrate medical simulation and traditional medical training to reinforce best practices and patient safety mental models and strive to keep medical errors at an absolute minimum. Continued changes in technology also create an arena where patient safety concerns become even more critical. At our CSCs, we respond to patient safety concerns by teaching medical procedures using real life, immersive simulations. In immersive and interactive learning environments, medical professional gain valuable experience in a realistic environment, learning with patient simulators instead of real patients. Last year, our CSCs completed training for 186 different courses, increasing our volume of participants to 11,517. These courses encompassed over 46,000 hours of training. We will continue to gear our training courses toward procedural skills acquisition, clinical reasoning, communication skills, and team training. We design courses for all those who provide essential care in the healthcare environment. This includes disciplines such as hospital security, spiritual care, students, nurses, residents, physicians, advanced practice providers, and pre-hospital and allied health professionals. One of our nation’s greatest unsolved challenges is training for healthcare, and we at SiTEL have assembled one of the most unique teams in the nation to address this need. In addition to training the healthcare community, our CSCs also participate with local high schools to immerse students interested in becoming healthcare providers in the healthcare environment.


In addition to the flexible functionality of our simulation spaces and the student-centered focus of our courses, our simulation centers are highly-accredited teaching facilities that meet the rigorous educational standards of many of the top medical education groups in the nation. In 2009, we became a member of the American College of Obstetricians and Gynecologist Simulation Consortium. The American College of Obstetricians and Gynecologists (ACOG) Simulations Consortium was initiated to offer simulations-based obstetric and surgical skills training to obstetricians and gynecologists. Its mission is to develop and implement unique simulation-based curricula to augment traditional procedure-oriented education in obstetrics and gynecology.


In March 2009, we also received testing status from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). The mission of Fundamentals of Laparoscopic Surgery (FLS) is to provide surgical residents and practicing surgeons with an opportunity to learn the fundamentals of laparoscopic surgery in a consistent, scientifically accepted format and to provide a tool to test cognitive, clinical, and technical skills, with the overarching goal of improving the quality of patient care. The FLS program teaches residents and surgeons the physiology, instrumentation, and technical skills involved in performing basic laparoscopic surgery. In addition, the FLS assessment component measures a candidate’s cognitive knowledge, case/problem management skills, and physical dexterity.


With a movable structure, the interior space is easily tailored to allow for multiple uses through the lifetime of CSC DC. Image Credit: SiTEL
With a movable structure, the interior space is easily tailored to allow for multiple uses through the lifetime of CSC DC. Image Credit: SiTEL


We are also an authorized American Heart Association (AHA) Training Center providing emergency life support classes at our Clinical Simulation Centers. All of our resuscitation courses incorporate AHA outcome data, resulting in expanded code blue curricula.

Finally, in June 2009, we also received Level 1 Accreditation I from the American College of Surgeons Accredited Education Institutes (ACS AEI). The vision of the ACS AEI is to create a network of ACS-approved regional Education Institutes that offer practicing surgeons, surgical residents, medical students, and members of the surgical team a spectrum of educational opportunities, including those that address acquisition and maintenance of skills and focus on new procedures and emerging technologies. The ACS AEI also seeks to focus on competencies and to specifically address the teaching, learning, and assessment of technical skills using state-of-the-art educational methods and cutting-edge technology.

Editor’s Notes:

Yuri Millo, M.D., Director, Simulation and Training Environment Lab (SiTEL). Dr. Millo is the Director of The Simulation and Training Environment Lab (SiTEL), part of MedStar Health in Washington D.C.


Dr. Millo’s main focus is education and training for healthcare force using innovative technologies and pedagogical approach for adult learners. He developed serious games as Code Orange Simulator for emergency preparedness and Treatment of Burn Patient Simulator “ Burn 101”, motion capture tools for surgical skill trainers on Xbox console, development of procedure simulators, shell games for online and mobile healthcare education, and HDLS courses ( highly interactive hands on courses for low frequencies high impact hospital events).

Pamela Leonard,RN, MS, Director , Clinical Simulation Centers, SiTEL (Simulation and Training Environment Lab) MedStar Health Pam started the Wall of Honor at the Washington Hospital Center CVRR. She was inspired by the original Wall of Honor developed by Charlotte Farris and her group at Baylor University Medical Center. Pam stated, "This display is not just a great way to recognize the nurses for their professional commitment, but also encourages others to pursue advanced certification.”