At Humanitas Mater Domini in Castellanza, ACLS simulation has become a key tool in healthcare staff training. With regular sessions, realistic scenarios, and in-depth debriefings, the Emergency Department team aims to standardize cardiovascular emergency management, improve communication between operators, and train future professionals. It is an innovative and replicable model focused on patient safety and the continuous growth of the healthcare team.
When the heart stops, preparation makes the difference
At the Emergency Department of Humanitas Mater Domini in Castellanza (VA), since December 2023, cardiovascular emergency management is no longer just a clinical issue, but also an exercise in precision training. Every month, doctors, nurses, healthcare workers, and students engage in high-fidelity simulations to deal with scenarios of cardiac arrest and complex arrhythmias. At the heart of this project is ACLS – Advanced Cardiovascular Life Support, the international protocol for advanced cardiovascular emergency management.
According to David Gaba, one of the founding fathers of simulation in medicine, simulation is a technique that allows real experiences to be replaced or amplified through guided experiences, interactively replicating the salient aspects of the real world. It is now an internationally established method and increasingly recognized as an essential tool for continuing education in healthcare.
In the context of the Castellanza Emergency Department, simulation has now become a regular fixture, with monthly exercises taking place in faithfully recreated environments: a hospital room transformed into a real emergency station, equipped with a heart rhythm simulator and a high-fidelity manikin.
Compared to classroom teaching, simulation allows concepts to be internalized through direct experience, improving clinical performance.
— Carlo Maino, Director of the HMD Castellanza Emergency Department
Immersive, systematic, and realistic training
Each session follows a well-defined structure: from familiarization with the setting to the initial briefing, through the division of roles within the team, to the simulated scenario and subsequent debriefing.
The debriefing, which lasts about 30 minutes, is when the technical, communication, and management aspects that emerged during the simulation are analyzed in depth.
The aim is to move away from an operator-dependent approach and promote standardization of emergency procedures according to shared guidelines based on scientific evidence.
From a nursing point of view, these simulations help to keep skills that are not used every day alive and to develop leadership and autonomy in critical contexts.
— Enrico Viceré, PS HMD Castellanza Nurse
The added value of the Simulation Center
To complete the training program, every four months the team participates in intensive simulation days at the Simulation Center of Humanitas University in Rozzano, where they work in high-fidelity environments identical to real hospitals.
These eight-hour days allow participants to tackle more complex and realistic scenarios, improving not only their technical skills but also cross-cutting skills such as team communication and decision making in critical situations.
Simulation for students too
The project has recently opened its doors to university education: for about a month now, third-year students on the Nursing Degree Course at Humanitas in Castellanza have been actively participating in simulations, guided by an expert team consisting of two doctor and two emergency room nurses.
In our academic field, we are increasingly seeking to adopt this teaching method, which is effective in consolidating theoretical knowledge and applying it in all care settings.
— Laura Mansi, Nursing Degree Course Coordinator, Hunimed Castellanza
The aim is to prepare future professionals to deal with highly complex emergency situations in a structured and informed manner.
Towards an exportable training model
The positive results obtained in the field are encouraging us to look further ahead: the team is planning to extend the simulation to all the hospital’s operating units by setting up a core group of dedicated trainers. The next step will be to train new facilitators so that the culture of patient safety can be spread through simulation throughout the region and in other healthcare settings.
Scientific studies confirm the effectiveness of simulation in improving patient safety, communication between professionals, and team operational efficiency. The feedback gathered in Castellanza also points in this direction:
- Greater cohesion in multidisciplinary teams
- Clearer and more structured communication in emergencies
- Better assignment of roles
- More serenity in error management as a learning opportunity
It is no coincidence that the World Health Organization has included simulation among its recommended methods for clinical training.
“Simulation allows you to put yourself to the test in a protected environment. Mistakes are not failures, but tools for individual and collective growth.”
Conclusion
Time invested in simulation is never wasted: it is time for growth, reflection, and learning in a safe environment, where even mistakes become valuable allies for improving individual skills and team cohesion. The strength of this project lies in its rigorous organization and the active and informed participation of all those involved. The concrete and measurable results obtained confirm what has already emerged in the scientific literature.
The goal is ambitious but realistic: to build a simulation-based clinical training model that can be replicated and exported to every area of the hospital and to all healthcare settings, both local and hospital-based, that wish to evolve in the management of critical patients. A cultural and professional challenge that starts with training to transform care.
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