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Despite the lighthearted “Santa’s elves” theme of the West Virginia School of Osteopathic Medicine’s (91�㽶��Ƶ) second annual Student Sim War, the event had a serious goal: to help prepare medical students for the kind of emergency situations they may someday encounter as physicians.

The Sim War was a demonstration of simulation, or the practice of recreating clinical situations in a safe, controlled environment. The activity, which took place Jan. 31, pitted two teams against one another to diagnose and treat an “elf” who showed signs of delirium before collapsing at Santa’s Reindeer Games. One team, “the Newbies,” consisted of Class of 2023 students Rhyan Bailey, Ravirajsinh Chudasama, Thao Nguyen, Patrick Quigley and Michelle Russell, while the other team, “the Arctic Puffins,” included Class of 2022 students Joseph Bolger, Garrett Parsons, Heather Reeves, Kelsey Steele, Michael Wilson and Benjamin Woodward.

Participants had 10 minutes to complete the encounter and were judged on teamwork, communication and medical knowledge. Both teams correctly diagnosed the patient as suffering from thyroid storm — a potentially fatal condition in which one’s thyroid overproduces hormones — and septic shock, which occurs when an infection in the bloodstream causes dangerously low blood pressure. In the end, the Class of 2022 team was named the winner, receiving a candy-filled trophy.

One student who participated in the Sim War, Thao Nguyen, said she found the event challenging, but worth it.

“It was a lot of work. We came in a lot on weekends to prepare for it,” Nguyen said. “But it allowed me to get hands-on practice. I usually wouldn’t have the experience of doing a chest tube until my third or fourth year, or maybe even until residency. To be able to practice it as a first-year student gives me a good foundation.”

During the activity, teams worked to quickly assign roles to their members, assess the situation and determine a plan of action to stabilize the patient, a 26-year-old elf named Max who was portrayed by a human-patient simulator. Participants checked Max’s vital signs, ordered lab work and noted physical symptoms such as an abscess on the upper thigh in order to arrive at a diagnosis. Teams used closed-loop communication to verbalize each step of the process, helping them to minimize errors and maintain the patient’s safety.

Clear communication also helped ensure that the audience could understand what was taking place. That’s important, said Clinical Evaluation Center Medical Director Elizabeth Ziner, D.O., because the Sim War was also intended as a way to increase awareness of the use of simulation at 91�㽶��Ƶ.

“Students were excited to show off their skills, and to show that they’re learning to work together and communicate as a team,” Ziner said. “The case we asked them to do was very complicated; it was a resident-level case that required advanced skills. I think they performed well.”

Ziner explained that simulation­ has become common in medical education and is considered an essential component of teaching aspiring physicians to care for patients. Simulation often uses tools such as robotic devices, known as human-patient simulators, or human actors playing the role of people with illnesses, known as standardized patients.

“Simulation saves lives,” Ziner said. “We have very advanced equipment at 91�㽶��Ƶ; our human-patient simulators are able to cry, bleed and respond to medications. Students are able to do procedures on the simulators that they wouldn’t be able to do on standardized patients, allowing them to build their confidence in a learning environment that allows them to make mistakes.”

​91�㽶��Ƶ’s Clinical Evaluation Center was the first center in West Virginia to be accredited by the Society for Simulation in Healthcare.