title: Simulation at the point of care: reduced-cost, in situ training via a mobile cart.
abstract: OBJECTIVE
  The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  A tertiary care pediatric teaching hospital.
  
  
  RESULTS
  A self-contained mobile simulation cart was constructed at a cost of $8054 (mannequin not included). The cart is compatible with any mannequin and contains all equipment needed to produce a high quality simulation experience equivalent to that of our on-site center--including didactics and debriefing with videotaped recordings complete with vital sign overlay. Over a 3-year period the cart delivered 57 courses to 425 participants from five pediatric departments. All individuals were trained among their native teams and within their own clinical environment.
  
  
  CONCLUSIONS
  By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.
authors.affiliation: Division of Critical Care Medicine, Department of Anesthesia, Program in Medical Simulation, Children's Hospital and Harvard Medical School, Boston, MA, USA. peter.weinstock@childrens.harvard.edu
authors.forename: Peter H
authors.initials: PH
authors.lastname: Weinstock
authors.forename: Liana J
authors.initials: LJ
authors.lastname: Kappus
authors.forename: Alexander
authors.initials: A
authors.lastname: Garden
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Burns
mesh_terms: D003363:Cost Control; D004501:Education, Medical / Q000191:economics / Q000379:methods; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006784:Hospitals, Teaching / Q000458:organization & administration; D008348:Manikins; D016544:Patient Simulation; D019095:Point-of-Care Systems / Q000191:economics*