Imagine you are a young veterinarian in eastern Washington state, and you have been called to assess and treat an ailing cow on a 100-acre farm.The owners run a business with approximately 40 head of cattle, and the sick cow is in active labor but is not progressing through to delivery. You have come alone and the rancher is seeking your expertise in a critical situation that you have learned about in school, but have never done in practice up to this point. Your actions are predicated on your ability to summon the knowledge you gained from classes and your limited clinical experience.

Like any human-focused health profession, Veterinary Medicine is dependent upon the psychomotor skill development and retention that is offered through simulation-based education. Fortunately, you went to Washington State University’s College of Veterinary Medicine and learned from the first and only accredited program of its kind in the world through the Society for Simulation in Healthcare.And during your time at Washington State, you were put through many simulations similar to this that prepared you for treating emergent situations with large and small animals.

Pullman, the home of Washington State, is nestled into the far eastern border of the state close to Moscow, Idaho. Vast plains of wheat fields stretch on all sides of this part of the state, and the winters can be brutally cold and snowy. But that town also offers a host of outdoor sports in addition to the many activities provided through a large, PAC-12 university like WSU.

The WSU College of Veterinary Medicine Simulation-Based Education has been serving students for over 12 years and is led by founding Director, Dr. Julie Cary.The program became accredited through SSH this past year and has grown into a unique model for simulation-based education.But, like most simulation programs, things started out slow with room for improvement. “We started out pretty rough…for lack of a better word,” describes Dr. Cary.Working on communication skills primarily, “We were meeting in a (large, one room) area, and the coaches didn’t know what we were doing, the actors didn’t know what they were doing and we had a lot to figure out,” she states. “We brought somebody in from the human-side to get things started and learned from there.”When pressed about what she meant by “human-side,” Dr. Cary laughed and said “that makes sense in my world completely, but I realize the audience I’m talking to might not understand that!”

And that statement really emphasizes the work Cary and her team had to deal with. In human-based simulation, we have come to expect that high-fidelity simulators are readily available for purchase with all of the appropriate responses and physical behaviors. We have created studied methodologies for debriefing and standardize patient experiences. But, from the Veterinary Medicine point of view, there was nothing like this out there, and much of what WSU has built over the past 12 years was created from scratch. From developing simulated animals like dogs, cows, horses, and sheep, to the use of “simulated clients” instead of patients, the Program has journeyed into a realm where no man (or simulationist) had gone before. “Pets can’t speak for themselves, so we had to create a Standardize Client program in which we had the pets’ owners be the voices that helped our students understand what was going on with their animals so they could then assess the situation and ask the questions that needed answered.” The Simulated Client Program is coordinated by Daniel Haley who has a Masters of Fine Arts in Directing, and an extensive history in theater.

The physical footprint of the Program has grown exponentially over the past 12 years, and now includes small and large animal spaces, two surgery suites that include technology to simulate anesthesiology, an emergency vet clinic space, and 10 paired exam rooms that mimics a veterinarian’s office where the Simulated Client Program resides.

WSU is also heavily involved in the surrounding community and state-wide agency education. One of the in situ events that the Program has been involved with includes large animal technical rescue situations. “We have an 850-pound horse model that we can stick in a ditch upside down and help the students and outside agencies learn how to safely maneuver around him and be able to provide the animal the help it requires,” states Dr. Cary.

Another example is an annual disaster management and planning rotation where Vet Medicine students work with counties in Washington to help them develop and create policies on what to do as it relates to animals during disaster situations. “This past year we were involved in the evaluation of one county’s disaster plan for using the county fairgrounds as an evacuation center for large and small animals in community during a disaster.” This would include how many animals they could take in, and how they would have to structure the area. “We had over 50 (simulated) animals of various sizes there to help them see what was possible and what was not,” Cary further explained.

WSU has become very active with SSH over the past four or five years, including presentations that they have conducted at IMSH this past year and the upcoming year as well.Dr. Cary is also the only active veterinarian who is a Certified Healthcare Simulation Educator (CHSE) in the Society.

Dr. Cary is very complimentary of SSH’s accreditation process.“The process has been so important for us. It has helped us become more organized, and has shown us where our strengths and weaknesses are.” She continues, “much of what we were doing was not written down before, and accreditation has helped us become what we call shelf-stable, meaning someone could come in to help run our program and find the important information at their fingertips.”

WSU has already received a number calls from other Colleges of Veterinary Medicine to learn about SSH accreditation and how they might become involved. In addition, graduated WSU students and specialists are now carrying the seeds of simulation-based education to the clinical programs and schools that they are going to work for.

WSU is an outstanding model for a side of simulation that many of us have just not thought of before, and that is what is beautiful about the simulation model: that it can work for such a wide variety of health and human service disciplines, both for humans and animals.

To learn more about becoming an SSH Accredited Simulation Program, please visit https://www.ssih.org/Credentialing/Accreditation for details on eligibility requirements or contact accreditation@ssih.org.