Within an expansive $43 million Veterans Affairs establishment furnished with surgery suites, critical care units, and an outpatient facility, there are no patients. At least not any authentic ones.

Located minutes away from the Orlando International Airport in Florida, the 53,000-square-foot structure is known as the National Center for Simulation Validation, Evaluation, and Testing, or SimVET. It acts as the central location where teams of frontline medical staff from the VA come to practice procedures and pilot new technologies, all without risking unnecessary harm to patients.

For example, if a group of healthcare providers desires to fine-tune their approach to opioid overdoses or trial a new artificial intelligence tool, they can repeatedly rehearse the process at SimVET. By training in a controlled setting, healthcare workers can troubleshoot issues and confirm that new concepts are viable and safe to deploy.

SimVET, inaugurated in 2016, exemplifies the surge in simulation use within healthcare, which has grown more prevalent and sophisticated in recent years. As health systems are analyzing numerous new AI tools flooding the market, facilities like SimVET can help sift through the clutter.

The Veterans Health Administration caters to 9 million veterans across 172 medical centers nationwide. Each medical center boasts a simulation program, with some having a dedicated space on-site.

The SimVET facility in Orlando stands as the most extensive simulation center within the VA, surpassing many others in the country, as noted by Dr. Scott Wiltz, the medical director of the VA’s Simulation Learning, Evaluation, Assessment, and Research Network, or SimLEARN.

In military and industries like aviation, practicing high-risk scenarios is customary, with pilots often spending hours honing skills in flight simulators. In healthcare, hospital systems and medical schools traditionally enlist professional actors to aid in training physicians, while virtual reality headsets are gaining popularity for surgery practice. However, SimVET takes it a step further.

The typical objective is to achieve “as close [to] a level of realism as possible,” Wiltz mentioned in an interview.

“The operating rooms exemplify this,” Wiltz elaborated. “We feature two fully equipped operating rooms, complete with all standard equipment: lighting, booms, authentic anesthesia machines. We even have a mannequin that reacts realistically to anesthesia.”

good had the opportunity to visit SimVET in March, encountering lifelike mannequins that are a prominent feature of the facility. These models display various skin tones, hairstyles, and facial features, with some programmed to speak, move, and encounter complications. An “elderly” mannequin at the site showcases wrinkles and more pronounced veins, while another can simulate giving “birth” to a “baby” mannequin.

Wiltz highlighted that the figures are meant to represent both the VA’s veteran population and the broader populace of the country. He indicated that the facility houses “well over” two dozen mannequins.

Wiltz disclosed that around 60 full-time staff members operate at SimVET, managing several trials and initiatives concurrently. National program offices and VA frontline workers often bring simulation ideas to SimVET, and occasionally, ideas originate from the facility itself.

SimVET has the capability to provide services funded directly by the VA, making it more practical for groups to approach them rather than seek external vendors, according to Wiltz.

Amanda Borchers, a patient safety manager at the Lexington VA Medical Center in Kentucky, was part of a surgical emergency team that visited SimVET in May of the previous year. Their aim was to enhance their response to unforeseen complications that could arise during surgery, prompting them to collaborate with SimVET in early 2023.

Borchers identified that some of the more vulnerable veterans in their community suffer from respiratory, cardiac, or circulatory challenges that may lead to sudden difficulties during procedures. Their team sought to craft a new protocol to enhance readiness for such obstacles, like expedited blood retrieval for an operating room.

With guidance from SimVET leadership, Borchers and her team structured several simulations before arriving on-site and connected with various field specialists nationwide.

During a packed week at the facility, the team engaged in comprehensive training sessions, brainstorming solutions to specific problems with experts and SimVET staff.

“You can make mistakes, but in a controlled environment, allowing for improvement. It’s a cyclical process,” Borchers expressed in an interview. “The transformation and the preparedness for unexpected emergencies were astounding.”

Borchers mentioned she had participated in simulations previously, but nothing equated to the experience at SimVET. The venue mirrors her daily work environment, enabling her to rehearse every aspect of her routine duties.

“It’s spot on,” she emphasized. “You could realistically perform a surgery right there and then.”

Upon concluding their weeklong session, Borchers and her team departed SimVET equipped with the foundation of a new medical protocol—a facility-wide response system for a specific type of emergency. Analogous to “code blue” referenced in media for instances of cardiac or respiratory arrest, their developed protocol would trigger an announcement over the intercom as “code SET,” representing “surgical emergency team.” This code alerts a designated team to provide immediate assistance when unexpected complications arise during or post-surgery.

While SimVET provided the initial practice and validation for their concept, they still needed the support of the Lexington VA Medical Center. Presenting the protocol to their leadership, the team refined the response structure and identified personnel and resources crucial for its implementation.

Subsequently, the medical center initiated internal simulations, refining the code within select departments during the fall. The testing expanded in the spring, progressing to facility-wide simulations incorporating the new code.

As the medical center modernizes its paging system, Borchers anticipates another simulation to launch once the updated system is operational. If all unfolds smoothly, code SET will be integrated into real patient scenarios within the ensuing two to three months.

Borchers aims to see code SET adopted across VA medical centers nationally, with staff from several states already partaking in simulated training, paving the way for the code to evolve into a VA-wide program.

“Thankfully, this initiative wasn’t a response to an adverse event, but rather stemmed from people recognizing that while we handle things well, we can always strive for improvement,” Wiltz remarked.