Middle East Snapshot

Middle East Snapshot

HTE correspondent Marty Kauchak provides one detailed insight on the fast paced expansion of healthcare simulation and training activities in the Middle East.

Healthcare facilities in the Middle East are stepping up their pace of embracing learning technologies and technology-enabled instruction across their curricula. Just within the last 30 days this web site posted a short article noting Women’s Hospital of Hamad Medical Corporation will be the first in the Middle East to adopt the TeamSTEPPS training programme to enhance patient care and safety by developing teamwork capabilities and inter-professional practice among its healthcare providers.

And so it was no surprise when one of my “sources” in the Middle East confirmed her center has a May 2017 scheduled opening on its horizon – presenting an editorial opportunity too good to let pass.

Joanne Davies, RM, MSc, CHSE, the director of the Simulation Center /Department and vice chair of the MENA Simulation Network at the Sidra Medical & Research Center in Doha, Qatar, initially explained that Sidra Medical and Research Center is a new Women and Children’s hospital.

To support the facility’s plans to become a regional academic medical and research center, a simulation center was designed to enhance the educational needs of this large facility. “Due to open in May 2017, and with the support of an international team of simulation experts, the aims of this simulation center and program are to: enhance patient safety using simulation based learning; support the reporting onboard and orientation of 5,000 staff to this new healthcare facility; support system testing of this new facility; conduct continuous professional development; build simulation programs in response to quality/risk/patient safety data; support community and patient and family centered programs; form collaborative partnership programs with key stakeholders and international groups; conduct life support training; develop and deliver faculty development programs; develop and deliver technical training programs; and work on future business opportunities.”

In a strategy that should resonate quite well with healthcare simulation and training professionals in other corners of the globe, Davies added “The development of expertise in simulation based learning is paramount to the success of any simulation program.”  As part of a SidraSim Simulation Resource Library, the internal core simulation team has developed the following, burgeoning catalogue of training, based on best practice standards from international programs: an introduction to simulation; education learning theory related to simulation based learning; simulation modalities; team training principles, including Crisis Resource Management (CRM) and TeamSTEPPS; principles of simulation education and simulation scenario design; introduction to debriefing and advanced debriefing programs; simulation technology (includes the use and operation of each of the higher technology  manikins); clinical simulation management system training; tracking in an E-Portfolio of the documentation of “flying hours” in simulation based learning; and finally, providing mentorship, advancement and reflection for all facilitators and core simulation team members.

The team further plans to partner with international centers to offer advanced programs in the future.

Simulation Center Design

Davies also provided a glimpse of this new facility’s design. In future HTE articles this author will compare and contrast design attributes of a number of new simulation centers.

As part of the design to support the opening and operations of this new 450 bed Women and Children’s hospital, a proposal was developed and approved for an ultra-modern state of the art simulation center. The space is 1,500-sqm and is divided into a variety of multi- purpose and flexible work zones: back of house –offices/ staff rooms/faculty space; simulation suites; modular debrief areas; modular clinical skills labs /classrooms; standardized patient areas; technology-enhanced learning zone and finally storage spaces/ washrooms and staff facilities.

“The aim of the Sidra Simulation Center is to support the Sidra Medical and Research Center’s vision of being a ‘beacon of learning and discovery’ and enabling the tri-partite organizational mission of exceptional clinical care, with a focus on education and research as our core pillars,” Davies emphasized.

The simulation center was designed in partnership with the Canadian architect company HDR. The aim of the design was to incorporate: state of the art technology to support learning and operations; innovative space design; flexible and modular space; a practical usability to ensure seamless learner flow; practical and well equipped spaces to ensure ease of use by core simulation staff and simulation supporting faculty; future proofing for advancements in simulation technologies; “virtual walls” to enhance flexible learning spaces and support innovative simulation projects’ and the use of “smart” technology and the latest in simulation management and audio visual systems.

Davies provided further elucidation on the center design and noted the main simulation suites consist of five rooms. All have a flexible design with core clinical equipment as a base line and the ability to move more specific clinical equipment from the storage areas depending on the context of the scenarios. One large 60sqm space is the only “fixed space” and serves as a large, simulated OR due to the amount and complexity of the equipment. Each lab has an individual control room for ease of operations and nose reduction. The debrief areas are opposite the simulation suites to support learner flow. “These debrief rooms have moveable walls so this space can accommodate either single debrief room spaces or combine spaces for large teams. All of these spaces include smart technology solutions a centralized simulation management /AV system for live feeds and to support learning, debriefing and research,” the center leader explained.

The large clinical skills area has the capability, due to moveable walls and the flexible design features, to be made into one large classroom for up to 60 learners, or two, three or four clinical skills labs. Each location has appropriate headwalls , gases and electrical outlets to support multiple educational needs again all supported by a state of the art simulation management and AV system.

The standardized patient (SP) suite was also designed to accommodate six SP training sessions and includes a full suite of changing rooms, faculty observation areas and corridor flow that allows for the separation of the SP from the learners to support realism and immersive learning.

“Storage and office spaces have also been considered with this design as the need for storage space cannot be understated and can take up 20 to 25% of your centers space,” Davies emphasized.  Logistics such as adequate sound proofing have been addressed by using customized design and materials.

Current, identified limitations include no wet lab facilities, but the center plans to collaborate with local partners to support this training if required. And focusing on another trend in the wider healthcare S&T sector, this staff is also exploring other emerging technologies that are slowly replacing the need for tissue.

Attention to Internal/External Stakeholders

Sidra’s focus is on expanding simulation & training competencies among its internal learners and among external groups.

Internally, Sidra’s simulation department will support a variety of learners from undergraduates and residency program placements to post-graduate orientations, and provide continuous professional development opportunities for clinical and all support team services. Davis added, “Inter-professional team based learning will be a major part of our model supporting the educational needs of individual and teams with the organization. System testing is also a major element of the data we will be collating as part of this new hospital opening.”

As significant, Sidra Medical and Research Centers Team has developed strong collaborative partners with local, regional and international simulation stakeholders and specialists. A few examples include: the local public hospital corporation Hamad Medical Corporation; Weill Cornell Medical School –Doha Campus; The University of Calgary Nursing Program-Doha Campus; The College of the North Atlantic Allied Health Program –Doha Campus; regional collaborations such as the co-development of the Middle East and North Africa simulation network with centers such as Dubai; international relationships with simulation societies and experts; and simulation vendors locally and internationally.

Sidra’s presence as a healthcare learning center of excellence will strengthen simulation and training-enabled instruction in the Middle East. As Davies noted, “Our team appreciates the value of developing a strong simulation program supported by the wonderful technology and resource we have within the region. The plans over the next two years are to open the main simulation center, continue to deliver our foundational programs especially around faculty development; this includes helping to build local and regional capacity in the field of simulation.”

Essential programs also include assisting the clinical teams within Sidra to open the main Women and Children’s hospital using simulation as a key modality for orientation and system testing to ensure a safe team and patient opening. This has already commenced with the opening of the outpatients clinic. The community expert added, “ Simulation practice clinics have been conducted prior to each go live date to ensure the teams and environments are ready to provide patient care. This is also a wonderful opportunity to also collect data in this growing field to support the enhancement of simulation locally, regionally and internationally.”

Near-Term Roadmap

The Main Sidra Simulation Center will be handed over to the team in December 2016. A temporary lab has been set up in the current Sidra Medical and Research Center outpatients’ clinics to ensure program development and simulation support can be offered for the opening and orientation of the outpatient building, and the team can be ready to support the opening of the Main Sidra Hospital. Davies concluded and emphasized, “The programs have been developed with a team of subject matter experts using an inter-professional approach to simulation based education whenever possible or relevant to the programs objectives. The simulation department model will provide excellent learning spaces but also support insitu or point of care simulation opportunities for the teams within Sidra with its mobile technology and team of simulation experts to support this approach.”

Author's note: Ms. Davie would like to acknowledge the work of all the Sidra Simulation Team members past and present, The members of the Qatar Simulation Consortium , SimHealth Consultants and the Simulation community who have all contributed to this project. She may be contacted at