SIM Wars Returns: Teams to Compete in Treating Live Simulated Patients

When it comes to winning the popular SIM Wars event at ENA’s annual conference, the teams with long-time colleagues who have worked side-by-side for years don’t necessarily cruise to victory.  

Chris Kroboth, clinical education manager at event organizer iSimulate, said he has watched complete strangers form teams on-site and perform extremely well. 

“We find some of the teams that struggle the most are the ones that have worked together forever,” Kroboth said as he looked ahead to the competition at Emergency Nursing 2022 in Denver. “They know each other, they’re the godparents of the other person’s kid, and then they just assume things, and things get lost in translation and overlooked.”

The competition, scheduled for Oct. 1-2 in the Experience Hall, will pit emergency nursing teams from around the world against each other to evaluate how well they manage simulated patients — live actors wearing IV task trainers. 

Teams are presented with crash carts containing simulated medications and vital sign monitors, waveforms and lab values. The team scores will be based on the totality of management and clinical decisions, or what Kroboth calls high-level criteria such as communication, crew resource management, team dynamics and bedside manner. 

“It’s not granular, like ‘Was the IV the appropriate size and in the exact spot — and was the appropriate aseptic technique used?’” he said. “If you put the IV in the hand when it should have been in the AC, but you still started the IV and that’s what you needed, along with ensuring other critical tasks and interventions are occurring, then you’re good. It is also all about recognition and recovery.”

If a team accomplishes only three tasks and they are the most correct three tasks needed in the simulation, they will do well, he added. If that team also ensures good bedside manner, closed-loop communication, CRM and cross checks with solid team dynamics, then they will likely walk away with the win. 

iSimulate, creator and provider of the educational technology competition, fosters an environment that’s as realistic as possible — hence, the live patients rather than manikins — to help competitors suspend disbelief and focus on the moment. The cases have all actually occurred and are not complex, though in moments of stress, they can become complex, Kroboth said. 

After the simulation, iSimulate presents competitors with a case-based module to recreate the same experiences for colleagues at home. The modules discourage instructors from allowing students to verbalize treatment steps rather than physically doing them. According to Kroboth, verbalizing interventions or actions isn’t realistic and can create training scars. 

“We want providers to train in real-time as they would at the bedside,” he said. “The military figured this out forever ago, to train like you fight. If someone can’t find a tool, medicine or an intervention, they need to recover. It fosters an environment of creativity, exploration and recovery.”

Teams range from three to five people, though iSimulate organizers have found that four is optimal. All teams will compete in the preliminary round on the first day, and the top three will advance to the finals on the second day. 

Emergency situations in previous years included a thoracic aortic aneurysm, where the EKG looked like a heart attack; a septic patient who was an IV drug user presenting with a mild altered mental status; patients with dysrhythmia due to electrolyte imbalances; and patient transfer scenarios that involved evaluation of the dialogue between the nurses and transfer crew.