SimWars has grown since 2017 to become a national, intervarsity simulation competition in acute emergency medical and surgical scenarios in Ireland. (Photo by Haleeda Hilmi)

The scene is set. It’s a cool, fresh morning, with a slight breeze in Cork, Ireland. More than 100 students from all six medical schools across the Republic of Ireland arrive at the break of dawn armed with coffees, water, trepidation and many dark hours of training under their belt.

It’s 8 a.m. in the state-of–the-art simulation center at the University College Cork (UCC), ASSERT.

Twenty-two healthcare professionals are in position and at their stations and await the arrival of the competitors. This senior team includes doctors, advanced nurse practitioners, nurses, paramedics, over 20 volunteers and staff from four gracious sponsors.

The first group of five students competing in SimWars await their instructions. Suddenly, a trainer appears and says: “Code Blue. Arrest team upstairs to Room One.”

The five students with various experience ranging from first year students to seniors, dressed in color-coded scrubs, race up the stairs to begin their first of three test scenarios.

How SimWars Began in Ireland

SimWars Ireland was initiated in 2017, by two medical students from University College Dublin (UCD), Jamie Condren and Tiarnan Byrne. The goal was to help facilitate medical students’ exposure to stressful and difficult situations and promote professionalism and teamwork with colleagues prior to graduation. 1, 2

It has grown since 2017 to become a national, intervarsity simulation competition in acute emergency medical and surgical scenarios. Medical students from all years of training assume the role of a first-response team as they stabilize and manage the simulated patients.

The ‘patients’ range from complex multiple trauma, to ectopic pregnancy, respiratory failure and sepsis, all very real and challenging emergency scenarios. This simulated, high-fidelity setting provides an opportunity for medical students to extend beyond the classroom and launch into a real-life, high intensity setting while working alongside paramedics, EMS, nursing staff and senior colleagues.

The competition format creates a carefully planned and implemented stressful environment, which mimics reality and provides for increased self-awareness and student’s preparedness for the clinical setting.

A faculty of “Attending Consultants” (physicians in Ireland) and Residents from various specialties from Emergency Medicine, to Psychiatry, and a team of paramedics and nursing staff, volunteer to train the teams in their free time to enrich the undergraduate clinical education program in the six months prior to the competition event.

The winners of the 2019 Ireland SimWars National championships were, for the second year in a row, from the University College Cork (UCC), Cork, Ireland. The winning team was made up of first and second-year medical students. Their final scenario occurred in front of a full live audience and team of 20 judges with them competing against two other teams.

Their case began with a professional handover from volunteer paramedics. They then set to work as a team to resuscitate a young male, multiple trauma case, with a seizure thrown in for good measure!

In the previous six months, these five students from different backgrounds, who met for the first time, merged into a working functioning group demonstrating confidence, communication, teamwork, and a trust in each other that would be difficult to engender in a purely academic setting.

SimWars continues to be organized exclusively by students each year who volunteer for many sleepless nights, grey hair and caffeine overdoses. However, the secondary benefit is the experience gained in managing a tricky matrix of people (trainers and students) to be in the same place at the expected times, multiple time per week, over a period of six months. An added benefit is the training occurs in all six medical schools in the Republic of Ireland.

The students in UCC this year (authors Shawn Albers, Ryan Sless, Danielle Gillette, Kathryn Lesko, Kevin Barry Murphy) were from Ireland, Canada and the United States. The students credit their success this year with having been past competitors of SimWars, forging early links and engaging relationships with faculty staff of UCC School of Medicine as well as access to ASSERT center training facility, which played a pivotal role in SimWars 2019.

The UCC SimWars committee is no stranger to awards. In November 2018, after their local UCC SimWars competition took place, their three teams were chosen from 60 students chosen to compete at the national event. This competition was recently awarded with the honor of ‘Best Academic Event’ at UCC for the 2018-2019 academic school year.

Ms. Kathryn Lesko, (Graduate Entry medical student, Year 3) won Bene Merenti, a Societies Guild Award for ‘Best Individual Contribution.’ In addition, the SimWars committee were awarded ‘Best Financial Management’ award for their outstanding achievements in sponsorship and fundraising, which was pivotal to the success of the event.

The SimWars committee, trainers and student participants would like to encourage all frontline professionals and trainees, in all spheres to consider simulation as a medium for training.

“TELL ME AND I FORGET. TEACH ME AND I REMEMBER. INVOLVE ME AND I LEARN.”

–BENJAMIN FRANKLIN

References

1. Bird G, Swampillai C, Lacey O, et al. Recently graduated doctors’ self-reported preparedness in the management of acutely ill patients. A 5 year review of London deanery’s foundation programme simulation training: a clinical challenge for medical education? IntensCare Med. 2012. 38:S301.

2. Ali J, Dunn J, Eason M, Drumm J. Comparing the standardized live trauma patient and the mechanical simulator models in the ATLS initial assessment station. J Surg Res. 2010.