Inside the new Des Moines University Regional Simulation Center, which provides simulation technology and training spaces for the region’s professional and academic health care programs, there is what organizers call a “House of Horrors.”
It is a simulated home health care catastrophe.
Students are tasked with entering this mock-up of a home and finding safety issues that they can address with the homeowner, a manikin lying in a bed with multiple bruises on its legs.
“We have overdone it,” said Beth Culross, director of the regional simulation center. “We have overachieved the amount of errors and safety issues that could be in this home.”
In the kitchen, an empty wine bottle lays on its side. There is a burned oven mitt on the stove. On the counter, the homeowner’s medicines are mixed in with animal medication. The cupboard is full of junk food and expired food is in the fridge. There’s also a fake bug on the floor.
Students come in and they identify the problems.
“And then they meet as a group and talk about what we need to do to help this person improve their situation,” Culross said.
When the student exits the room, there is an answer key pointing to the litany of problems in the room.
The simulation center also includes virtual reality and an immersive studio room to help teach safety in health care settings.
One hospital room, like the “house of horrors,” is outfitted with a host of problems and the user can come in and identify the problems through touching a screen.
“We have an overflowing trash can,” she said. “We have a sharps container with things sticking out of it. We have a patient name band out in the open. We have an electronic health record open where anyone could see it. This person [the patient], she wouldn’t be able to get out of the bed. There’s things blocking the bed on each side.”
The simulation center is housed in the DMU32 Health and Business Complex at 3200 Grand Ave., part of DMU’s former campus. Partners include Des Moines Area Community College, Des Moines Public Schools and Mercy College of Health Sciences, according to a news release.
Culross said the center was established to both serve the community and help build the health care workforce in Iowa.
The center was funded with a $5 million grant from Polk County, she said. She anticipates about 1,000 to 1,500 learners per year will go through the center.
“I’m hoping that they’re introduced to health professions and understand what they can do in health care when they get out of high school,” she said. “The nursing students – it’s to reinforce what they’re learning, help them gain more confidence when they go into a hospital room to take care of a real person.”
The center, in addition to simulating home health care, can simulate primary care and hospital acute care experience, Culross said.
“We have manikins that the students can do wound care [on],” she said. “They can practice taking vital signs, doing [a] bed bath.”
The regional simulation center came to be after a conversation between Angela Franklin, president and CEO of Des Moines University Medicine and Health Sciences and Polk County Supervisor Angela Connolly in summer 2021, Franklin said.
Connolly and others were concerned about what was going to happen after DMU moved to its new 88-acre campus in West Des Moines in 2023 and left behind a space that had been their simulation center that had opened in 2005, Franklin said.
“They were also trying to figure out what to do with some ARPA [American Rescue Plan Act] funds, which are the [federal] COVID relief dollars that every county received,” Franklin said. “What Polk County Board of Supervisors really wanted to do was use funds … to help [the] health professions workforce.”
Franklin thought that COVID relief dollars could be used to create and bring a regional simulation center “back to life,” she said.
“For us, it would be workforce development. It would be a pipeline, having an opportunity to train and encourage young learners who might be interested in STEM professions,” she said.
The Polk County grant has not all been spent; the funding allowed DMU to hire staff and purchase technology and equipment, she said.
“But at some point the money is going to run out … and we want to have it be self-sustaining, which means that that team is dedicated to building new relationships and new partnerships with individuals who will pay to use this space,” Franklin said.
Technology for simulation centers has advanced, and artificial intelligence is baked into a lot of the software packages DMU bought, Franklin said.
“So if you went into some of the rooms where there were patients – that the manikins were there – they were speaking to you, so they can actually do a case based on generating the most likely outcomes and answers,” Franklin said. “So that’s the technology that runs that software, a lot of that has artificial intelligence baked in.”
Medical simulation programs are also happening across Iowa.
The University of Iowa’s Simulation in Motion-Iowa, also known as SIM-IA, is a mobile health care training program providing simulated clinical learning opportunities across the state. The program takes its training directly to rural areas, rather than having to send emergency medical professionals to a training session once or twice a year, said Jacinda Bunch, clinical assistant professor at the University of Iowa and senior adviser to SIM-IA.
“What we do is we take out a mobile simulation to EMS, critical access hospitals, community health care providers, long-term care facilities. And what we do is we have simulated patients that have all of the physical and anatomical features that you would expect in a live patient, and then those providers are able to take care of them,” Bunch said. “We can create scenarios that they don’t see very often, so that they can practice their protocols and go through those, or things that they do quite a lot that they would like to improve.”
SIM-IA conducted its 1,000th training on March 10 with Badger Fire and Rescue in Badger.
The program has three trucks – one in Sioux City, one in Des Moines and one in the Iowa City area, said Jason Smith, western region coordinator for SIM-IA.
The program is administered through the UI’s College of Nursing, Bunch said.
Original funding for the program came from the Helmsley Charitable Trust, which provided almost $8 million to purchase the trucks, the simulators, the equipment and get people trained, Bunch said. The Wellmark Foundation also provided the program with a $5.3 million gift to expand access to advanced health care and emergency training across rural Iowa, organizers said.
The technology for the medical simulations has advanced in recent years, said Smith, who became a paramedic in 2017.
“When I first started in EMS, we had just a manikin, which was a stand-in for a body. You could do, like chest compressions on it, but that was about it,” he said. “Now we have manikins – they can bleed, they can breathe. They can make sounds. We have manikins where their pupils will constrict with light. You can start IVs. You can do chest tubes. We can do just about anything that somebody would need to do to another person having a medical emergency.”