USU Simulation Center Marks 25 Years of Innovation and Excellence

From a “Four Seasons” garden shop to a flourishing hub for medical education and training, the Val G. Hemming Simulation Center celebrates a quarter of a century of innovation. 

Maj. Julie Thompson, a USU nursing student, recently applies a combat action tourniquet to 

a “patient” during a scenario in the Wide Area Virtual Environment (WAVE) at USU’s Sim 

Center. (Image credit: Airman Magazine)

September 19, 2024 by Claire Pak

The Uniformed Services University’s (USU) Val G. Hemming Simulation Center (Sim Center) founded in 1999, marked its 25th anniversary just in time for Healthcare Simulation Week (September 16 - 20), a national awareness event for simulation in healthcare and medical education. 

The Sim Center, led by Director and Associate Dean for Simulation Education Dr. Patrick Monahan and Assistant Dean for Simulation Dr. Joseph Lopreiato, observed the occasion with on-campus demonstrations and displays, and a 25th anniversary celebration attended by USU leadership and special guest Dr. Val Hemming, former dean of the USU F. Edward Hebert School of Medicine. 

Dr. Val Hemming (right) and his wife Alice Hemming at the dedication of the Val G. Hemming Simulation

Center. (courtesy photo)

The Sim Center was the “brainchild” of Hemming, former Associate Dean for Clinical Affairs Dr. Emmanuel Cassimatis, and others. In the mid-90s, as Lopreiato explains, medical schools were beginning to introduce innovative ways to teach clinical skills to medical students. Hemming and Cassimatis believed that simulation, a novel idea in medical education at that time, could be an effective teaching tool. With support from then-President Dr. James Zimble, the University received authorization to establish the center in September 1999. The actual physical facility was built a year later after Army Lt. Gen. (Dr.) Ronald Blanck, then-Commanding General at the Walter Reed Army Medical Center (and later USU Board of Regents chair), secured 8,000 square feet of space in the old “four seasons” garden shop at the military exchange complex at the Forest Glen Annex in Silver Spring, Md., roughly 15 minutes from the USU campus. Founding Director Dr. Richard Hawkins hired the Sim Center’s inaugural staff, including standardized patient trainer Grace Ann Adamo, Dr. Gilbert Muniz, Dr. Alan Liu; and Drs. Christoph Kaufmann and Mark Bowyer, who established a surgical simulation program with financial support from the Association of Military Surgeons of the United States.

The Sim Center was named in honor of Hemming in 2012; and has been expanded a number of times, with the last expansion in 2020 bringing its total square footage to 30,000, including multiple classrooms, clinical exam rooms, mannequin labs, research space, and the Wide Area Virtual Environment (WAVE). The Val G. Hemming Simulation Center is now the largest healthcare simulation center in the DoD, and part of a National Capital Region consortium including the simulation center at AT Augusta Medical Center, Joint Base Andrews clinics and surgical center, and the Walter Reed National Military Medical Center. This consortium has received dual accreditation from the American College of Surgeons and the Society for Simulation in Healthcare. 

The Sim Center is led by Director and Associate Dean for Simulation Education Dr. Patrick Monahan

(pictured left) and Assistant Dean for Simulation Dr. Joseph Lopreiato (right). (Courtesy photos)

Although simulation in medical education is a relatively recent innovation, Lopreiato points out that the military has employed simulation since the 1930s, with simulation incorporated into training for pilots, navigators, tank operators, and more. Healthcare simulation is also an important tool in training other professions including nursing, clinical psychology, social work, and chaplaincy. Monahan explains that the broad category of “simulation” encompasses four main methods: human simulation, mannequin based simulation, task trainers and virtual reality.  Human simulation employs “standardized patients,” individuals (often professional actors) who are trained to act out written medical scenarios with students. By observing the interaction between students and “patients,” instructors can evaluate students’ skills in performing physical examinations, taking patient histories, and communicating effectively. “This is our bread and butter,” Monahan says, emphasizing the value of human simulation. 

For procedure-based training that cannot be safely performed on humans (intubation, CPR, surgery), “we use plastic people,” says Monahan, including mannequins and test trainers, which are manufactured body parts. Mannequins range from simple plastic forms to high-fidelity mannequins with embedded electronics that mimic human vital signs and physiological responses. The WAVE immerses learners in 3D scenarios based on deployment or combat conditions, exposing trainees to environments that they may experience in real life, complete with sound, lighting, and even olfactory effects. 

Simulation, as Monahan points out, is useful for learners at every stage of healthcare education, from novice students to practicing, experienced clinicians. The Sim Center  works collaboratively with course and module directors to develop simulation-based training geared to students’ learning needs in the School of Medicine and the Graduate School of Nursing as well as graduate medical education programs. Monahan and Lopreiato believe that the Sim Center has a responsibility to serve as “stewards” of simulation education, and they continue to innovate as they begin their 26th year, experimenting with artificial intelligence applications to write simulation scenarios, structure after-action debriefings, and create new ways of assessing skills. Lopreiato is also experimenting with remote simulation to “take the Sim Center to the learner,” ensuring access to simulation-based training for students on rotations and military clinicians deployed in remote locations. 

Dr. Faye Abdellah, former dean of the Graduate School of Nursing; Val Hemming, former dean of the School

of Medicine; and James Zimble, former USU president, started the first renovations for the building that would

become home to the Sim Center. (Photo credit: HM2 Albert Dalmau)

The Sim Center team is proud of its heritage and leadership in simulation education. Lopreiato has served as president of the Society for Simulation in Healthcare, and he and Monahan serve as stakeholders in the Defense Medical Modeling and Simulation Office at the Defense Health Agency. The Sim Center has conducted numerous tours for a variety of hospitals, institutions and agencies throughout the years, and its design has been copied by other centers. With 112 peer-reviewed publications since 2004 and $28 million in grant funding over the last 15 years, it also has a robust research program with an emphasis on skills development. As Monahan and Lopreiato like to say:  “If you can think of it, we can probably simulate it.”