CREASS: a bridge between classroom learning and real life experience


It is a well-known fact that health professionals train for several years and constantly, alternating practice and theory. Among other things, such training ensures that health professionals can respond to whatever situation they find themselves in. In this field, as well as in others, such as aviation, one of the ways to improve skills is professional training based on simulation.

Let us stay briefly on the aeronautical industry example. For pilots, simulation training is crucial. Flight simulators are a great way for the future pilot to learn the mechanics of how to fly an airplane without any of the negative consequences should something go wrong. For new pilots-in-training, this is really the only way to learn safely.

In the same way, a health professional complements his traditional training of patient care with simulation training: through this format, they face the greatest possible stressors and all real conditions – taken to the last consequences – without impacting on a real patient.

This type of training has proven to have many advantages that help improve the skills of healthcare professionals and, in return, ensure patient safety, quality of care, reduce healthcare costs, and maintain continuous training.

Normally, this type of training was carried out abroad, however, with the emergence of the Center for Training and Simulation in Health (CREASS, for its acronym in Spanish), an initiative of the Ministry of Health (MINSA), the isthmus now has technology-based training simulation.

CREASS was born in November 2015, when MINSA, Caja del Seguro Social (CSS), and the National Secretariat of Science, Technology, and Innovation (SENACYT) signed a specific agreement to give shape to the idea that has become the center.

Thanks to an alliance with the University of South Florida (USF) that allowed Panama to learn first-hand, from the good practices, operation and structure of the Center for Advanced Medical Learning and Simulation (CAMLS), it was then possible, in the three subsequent years, to establish a structural design and determine the physical space for the operation of CREASS in Panama.

According to Dr. Tatiana Carles, CREASS Operations Manager, the new headquarters, on the Ciudad del Saber campus, is betting on a broad and far-reaching vision: “there will be 1,733.32 square meters of space for advanced clinical surgical simulation, distributed in three floors,” she explains.

The first floor will be for surgical skills training, it will include ten surgical surgery towers, an open operating room, a microsurgery room, and classrooms for multipurpose activities, in addition to a temporary 24-48 hour animal nursery and animal sedation rooms. 

The second floor will be multipurpose, adapting to different simulation training demand needs that may arise.

The third floor is clinical for clinical skills and virtual patients where the highest-fidelity simulators will be, such as those of virtual robotic surgery.

While this new facility is being built, CREASS has not stopped operating. From its current location in the City of Knowledge, some seven hundred training have been carried out in 2020 alone, with some thirty Panamanian instructors in simulation, all public sector workers.

Dr. Carles explains that it is expected that with the new center in design, it will be possible to carry out between 3,000 and 5,000 annual trainings, once the center reaches its full capacity.

Reality-based training

What does a normal day at CREASS look like? A lot like real life. The morning we spoke with Dr. Carles, the health professionals in training at the time were immersed in practical learning that simulates life itself.

In CREASS, you work either with simulated or virtual patients or with standardized patients; that is, with actors who are trained to be patients and to be subjected to the specific procedure in which the health professional will be trained. Hybrid trainings are often done between simulated and standardized patients.  But, whichever way you train, one thing is clear: the patients blink, breathe, cry, sweat, and have heartbeats and pulses.

Professionals train at CREASS to save real lives. For example, Dr. Carles explains that professionals train surgically using pads that realistically simulate human tissue. At other times, they work with patients recreating offices, intensive care units, delivery room, prenatal care, etc.

A valuable tool in the fight against COVID-19

In 2020, CREASS has contributed by generating solutions and knowledge through simulation. From there, training has been carried out for health and safety personnel (doctors, nurses, dentists, police officers, SINAPROC) in collaboration with the Health Emergency Operations Center, on the management of personal protective equipment, that is, how the equipment must be worn, removed and discarded, as well as the training regarding the collection and transport of COVID-19 test samples.

According to Carles, the trainings carried out in the context of the COVID-19 pandemic have focused “on training on the handling of biosafety equipment and personal protection equipment, traceability, and rapid response equipment, as well as room personnel. As well as urgency and swab testing.” Carles explains that training in basic life support and advanced cardiovascular support has also been reinforced for staff who care for COVID patients.

Dr. Carles ensures that in the midst of the pandemic, simulation training provides an excellent and safe learning environment, as it enables a bridge between classroom learning and real-life clinical experience.

On the other hand, in a context in which before one had to leave the country to receive this type of training, the center’s operations manager explains that Panama could become a destination for simulated health training since this is the first of its kind in Central America.

In fact, this year the first training for health professionals from other Central American countries have already been held at CREASS. CREASS continues to contribute to public health in this pandemic year and has training sessions scheduled until the end of the year.

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