​Round one, a suicide attempt at home. Blood seeping across the floor and the family near inconsolable. Round two, a woman in labor stuck in traffic with no medical equipment to speak of besides one’s own ingenuity. Round 3, severe harm to the patient after a car crash and a mother worried for her sick child amid the crisis.

On the 23rd of February 2019, we held the opening ceremony for the very first simulation-based competition in Pakistan at the Centre for Innovation in Medical Education, Aga Khan University. An idea which begun as an impetus to connect a highly talented and competitive body of staff and students to the power of simulation and conflict. To challenge them in ways that would not have been practical just a few years ago. And inspired by what other had done around the world, we held our very own SIMWARS.

Our multi-faceted team of organisers consisted of CIME team, SPIE (Society for Promotion of Innovation in Education) volunteers, medical & nursing students, all of whom were dedicated to bringing a new experience to AKU. A new way of sparking thought and creativity in yet uncharted territory. And, now that we’ve had this event, I’d like to reflect back and to plan ahead. What made this event unique? What did it bring to our teams? What is the emergent role of simulation in healthcare and how can this event build on that utility?

Let’s start with the teams. Each included a nurse, a doctor, and students from both nursing and medicine. Each team acting as a functional unit of the healthcare system. At each stage our participants were faced with controlled adversity. We challenged their speed of response, their sheer creativity, the sum of their knowledge, their ability to prioritise and yet remain organised, but most importantly their strength in communication.

All this brouhaha is found in every ward and triage around the world. But, what I believe SIMWARS brought to the table were experiences entirely apart from what the walls of the hospital could offer. It acted on a different gyrus to the ones we normally use. In one of the more memorable responses to a question posed by the jury “Why did you ask the husband for a lighter so you could sanitize the knife?” the participant - a student - replied, “I just assumed he would as almost everybody smokes these days in Karachi.” There hasn’t been a systematic review by Cochrane yet on how many people smoke in Karachi, but he was right. The husband had a lighter.

Simulation allows us to learn and see things in new and sometimes more practical ways. It gave us, as the organisers, the ability to create new worlds and scenarios in a few hours. Our participants were able to learn how to deal with critical situations in controlled environments. We’ve all heard how VR is going to change everything, how AI will make us redundant, how robotics will bring surgery into a new era. Simulation encompasses all of these. The world is changing rapidly and the way we learn must adjust equally so.

Perhaps events like SIMWARS are one part of that puzzle.

Regardless, I hope that the competitors found value in the event. And that in the future we can amplify what was great about this first step and build on it.

Written by,

Muneeb Khan, Medical Student Year III, AKU