Subway Derailment Simulation Showcases How Columbia Nursing Uses Cutting Edge Technology in Nursing Education

Imagine walking into an emergency room amidst chaos. A subway derailment has occurred and injured straphangers are rushing in with a range of injuries. It’s your job as a nurse practitioner to assess the pain and begin to triage injuries.

You introduce yourself and ask the patient if they know where they are and what happened.

“I’m at Columbia, some hospital,” the patient responds. “The train jumped the track and I hit the handrail. I was standing and I went straight into it. My nose won’t stop bleeding, I think I broke my nose!”

Down the hall you hear another patient clutching her leg with a bone protruding out, yelling for help.

“Can someone help over here? I need something for this pain! I think I’m going to be sick!”

Thankfully, the injuries in this case aren’t real, but the people yelling for help are. They are what the health care community knows as “standardized patients” (SPs), or trained actors who receive a medical history to memorize and play the role of “patient” in a simulated health care environment.

The derailment simulation was one of many on display at Columbia Nursing’s Helene Fuld Health Trust Simulation Center Open House on Thursday, January 25. The event aimed to demonstrate the power of simulated learning in the future of health education, and was open to alumni and faculty members of Columbia and NYP s as well as health care and industry professionals  from medicine, nursing, and simulation.

“Millions of people ride the subway every day, and we definitely thought it was something relatable that would allow students to learn how to prioritize a large range of injuries,” said Eileen Thomas, EdD, assistant professor, who put together the scenario for the open house. “In simulation, we like to expose students to things they don’t typically see, so when they come across it in their career, they will be confident and ready to respond.”

The derailment simulation featured four trained SPs, who all donned stage make-up and hospital gowns to bring their roles of injured “straphangers” to life. With the aid of a professional make-up artist, they presented injuries and symptoms ranging from broken noses, head trauma, lacerations, and bleeding for advanced practice nursing students to assess, diagnose, and treat.

“People loved it and couldn’t believe how real it felt,” said Kellie Bryant, DNP, executive director of simulation. “This open house was about showcasing how Columbia Nursing students learn critical skills using high-fidelity manikins and standardized patients.”

In addition to the subway derailment, the open house featured other simulation scenarios to showcase how students learn these critical skills using both robotic manikins, task trainers, and SPs in its new, state-of-the-art Helene Fuld Health Trust Simulation Center—one of the largest simulation centers dedicated to nursing simulation in New York State.

Claire Brieva ‘20 is a current Columbia Nursing Family Doctor of Nursing Practice (FNP) student who participated in the derailment simulation.

“To be able to practice such a high stress situation in a safe learning environment definitely makes me feel more confident and comfortable in my ability as a nurse practitioner to think quickly,” Brieva said. “We’re so lucky to get to learn in this kind of environment.”

The two-story 16,000-square-foot facility is designed to promote patient safety and prepare students for real-world practice in an ever changing, complex health care system. All simulation rooms have video recording capabilities that are used to provide feedback to students.

“It’s all about making students more competent health care providers,” Dr. Bryant said. “Students have classroom learning and also have clinical practicums, but simulation aims to bridge the gap between the two. We want all mistakes to happen in this safe learning environment so they learn from the simulation and are better prepared to work in the clinical environment after graduation.

Research has shown that the use of simulation improves students’ critical thinking, clinical judgment, communication, and overall clinical skills. SPs, like those used in the subway derailment simulation, help to enhance that learning and create an additional level of realism to the scenarios.

“The SPs were so real that you forgot they were acting,” Brieva said. “The fact they can respond to your questions and give you feedback really adds a completely new level to my education.”

In addition to use for Columbia Nursing students and faculty, Dr. Bryant says that the space is also utilized for interprofessional simulations and opportunities for collaboration. Dr. Bryant says there have already been several simulations that brought different specialties and professions together.

“Health care environments are all about collaboration and teamwork to provide the best quality care you can give to patients,” Dr. Bryant said. “In simulation we strive to replicate the clinical environment so our students have a smooth and easier transition to the clinical setting.”

See more photos from the evening here. 

Interested in learning more about The Helene Fuld Health Trust Simulation Center? Contact Kellie Bryant, DNP, executive director and assistant professor of Columbia University School of Nursing at kbd2146@cumc.columbia.edu