Imagine a completely newly built hospital. Already on the way over the so-called "Golden Gate to Campus" bridge you are amazed by the imposing facade in orange red, by the perfectly shaped, modern-looking architecture. You enter the hospital – a building with more than 8,000 square meters on 5 floors including its own ambulance car, helicopter port on the roof and additionally 2-level underground car park. In the hospital's extensive hallways, you will discover an emergency room, operating room, inpatient care and intensive care units, numerous exam rooms, dental offices, and hospital rooms – all well-equipped, all state-of-the-art. Intubations, surgeries, deliveries, resuscitations ... Everywhere, medical staff and junior medical students are tirelessly at work. And in all this hustle and bustle, there is only one thing that is not to be found: patients. Welcome to SIMU – the simulation center of the Faculty of Medicine of Masaryk University in Brno!

Okay, there are, of course, patients in SIMU. However, these are not real, even if they appear deceptively real. They are either low or high-fidelity simulation manikins, virtual reality figures in 3-D or actors specialized in simulation. These standardized patients are main characters of simulation scenarios for students of the medical faculty of Masaryk University. From singular skills training to more complex team training, academic trainees are given the valuable opportunity to practice/learn important medical skills, treatment procedures, and communication structures in a hands-on setting. The big advantage: In contrast to everyday medical practice, mistakes can be made in this protected environment. Far away from real patients and the associated health consequences, the didactic added value of recognizing mistakes through practical training and learning effectively from them unfolds. So that they do not take place where it matters: with real, living people.

The idea for SIMU, a simulation center in the form of a simulated, fully equipped hospital, was born in 2014. And the idea was a big one. In the educational context of the university, the idea was to create an unique place where simulation training could be conducted independently of the resources and premises of real medical institutes. A place where simulation is no longer just a time-limited training supplement or optional education activity, but can develop its full potential – didactically, methodologically, and structurally. n this way, this project represented nothing less than a challenge against a widespread misunderstanding: namely, that simulation is an isolated niche discipline reserved for only a few specialists. The idea of SIMU thought of simulation in a much larger way: simulation should become an essential, an integrative part of medical studies at Masaryk University.

However, it was still a long way to the concrete implementation of the initial idea. The planning of the huge simulation center alone took several years. While the active exchange with existing international simulation centers and renowned health institutes provided a valid picture of the current simulation status quo, the project execution itself required an intensive cooperation of multidisciplinary expert teams. Only through the close interaction of architecture, project management, medicine, research, university, simulation, and media technology (to name just a few disciplines) could such an ambitious project be turned into reality. In the case of SIMU, an impressive success story: After intensive construction and engineering work, the ambitious project, funded by the European Union*, was completed on schedule at the end of summer 2020 – an astonishingly short construction time given the monumental dimensions of the simulation center.

*The simulation center SIMU was supported by the European Structural and Investment Funds.

Already in its first year, SIMU offered (learning) space for 3,000 students and a wide range of diverse simulation possibilities. In 2022, there were already 4,700 students, and up to 6,000 students are expected in 2023. The students are supervised by more than 300 teachers, including students from higher grades who pass on their acquired knowledge to younger classmates. This involvement of more experienced students in active teaching already illustrates that immense value is placed here on modern teaching methods. According to the motto "Practice is the best teacher.", students at SIMU are less confronted with frontal teaching, but are encouraged to acquire content themselves: by self-initiative, group work, practical exercises, etc. SIMU's premises reflect this approach architecturally. Instead of classical seminar rooms with mono-centered lecturer's place and audience places aligned to it, there are many common rooms, which open generous space for group-dynamic discussions and interactions: Learning by doing instead of just listening.

Practical simulation training is a perfect complement to this modern pedagogical approach. As an integral part of the medical curriculum, most of the medical subjects from the 1st to the 6th semester are taught at SIMU. The percentage of time students spend at SIMU during this part of their medical studies varies from subject to subject but can be as high as 80 percent for such practice-centered studies as intensive care. Thereby, the content and structure of the simulation training are developed in close cooperation between the professors at Masaryk University and the simulation technicians of SIMU. The training offer is thus directly aligned with the curriculum and expands from year to year. This allows the theoretical content to be perfectly complemented by the practical aspects of medical training. Learning and experience come together, and in mutual interplay complete both undergraduate and postgraduate education.

To ensure that both students and teaching staff get the maximum learning benefit from the simulation training, SIMU has chosen video-based recording and debriefing systems from SIMStation. The customized AV systems (fixed and mobile system variants) ensure that the design and control as well as the transmission and debriefing of the simulation training are carried out as efficiently as possible. Since such a huge project requires a permanent local contact person, our distributor AV Media Experts was responsible for the on-site project planning, and the installation of the SIMStation components was handled by AVT Group. This cooperation turned out to be extremely successful. In 2022, AV Media Experts received the GPA Excellence Award for the project in Toronto and has been nominated for the prestigious Inavation Award for 2023.

Here some figures, which illustrate the enormous technical dimension of the project:

• SIMU has its own 25-strong team of technicians and IT staff (including 3 AV technicians) who ensure perfect technical operations.
• In total, there are 56 well-equipped teaching/simulation rooms, 11 control stations + 1 mobile SIMStation Control Unit and 7 debriefing rooms.
• Recording and debriefing of the simulation training is performed with 1 SIMStation Enterprise, 1 SIMStation Pro and/or 1 SIMStation Essential. From mobile to server-based solutions, all SIMStation product lines of the latest generation are in use in SIMU.

• All SIMStation systems are operated with the latest version of the SIMStation Software 6.0 – with the full functional scope of this innovative solution.
• Data networking/transmission is provided by 1 separate server room and 6 audio server units (for implementing digital audio optimization functions).
• There are 32 boundary microphones, 28 wireless microphones, 11 PTZ IP cameras, 48 IP cameras, 14 media screens, 20 VoIP telephones, numerous patient monitors as well as digital loudspeakers for "audio to room" and "audio of patient", ...
• Also in use: 24 high-fidelity simulation manikins, more than 13 high-fidelity simulation beds, 14 3-D simulators, an ambulance simulator, a CT simulator, and much more.

What is true for the curriculum and the range of simulation training is also true for the technology: SIMU is committed to the state of the art, and just like the training offered, the technical equipment of the simulation center is constantly being tested, expanded, and modernized. At SIMU, innovation is not a state, but a process; one that never stops. This requires constant, close cooperation with medicine, research, and industry. A vivid example: the pre-implementation and pre-launch of the new SIMStation Software 6.0 in SIMU in summer/fall 2022.

SIMU played a key role in the agile development of the new SIMStation Software 6.0. Through the partnership and constant exchange with SIMU, SIMStation received/is receiving many valuable indications as to which new features of the SIMStation Software could add value to the simulation practice. Just as new developer ideas from SIMStation often bring many impulses for new practical training opportunities in SIMU. Application meets development and vice versa; both influence each other.

The productive exchange is followed by an extensive test phase. As soon as our project and development teams complete the first beta versions of new software functions, they are implemented in SIMU in advance. This brings great benefits for all involved: SIMU is given the opportunity to test all new functions in everyday simulation. How can the new functions be used in practice? What new application possibilities can be implemented? How can the curriculum be enriched as a result? SIMStation, on the other hand, benefits from a technical test environment with institutional dimensions that encompasses all SIMStation product lines and possible applications of the functions in question. Application and development present themselves as two sides of the same coin, pursuing the same goal: To constantly expand the range of simulation, and to make simulation technology better and better. This mutual development process reveals itself concretely as what a partnership is all about: a solution where everyone benefits.

“For me, SIMU is the embodiment of a dream of change. It is a realization of a vision for me and a confirmation that it makes sense not only to have visions but also to work hard for them. SIMU is a team for me. A team of extraordinary people who know they have to work through every change.”

Petr Štourač
Head of Department of simulation medicine

The process described above illustrates in many ways SIMU's claim to itself: to constantly promote and advance innovation as an incubator in the field of simulation. This also means thinking simulation internationally and institutionalizing simulation in the study of medicine. With its teaching offer and activities SIMU takes a leading role in this respect.

• Video-based simulation training in SIMU is an integral part of medical studies at Masaryk University. Completion of the training courses is obligatory for all students of all disciplines. Practical application becomes an obligatory standard to methodically enrich the theoretical education.
• The simulation center SIMU is not an isolated institution but works in close interdisciplinary cooperation with the theoretical specialists of the university. Theory and practice influence each other and are each coordinated to provide students with balanced curricula and the best possible education.
• As a renowned simulation center, SIMU acts as an advisor for new simulation projects, even outside Europe. As a European best-practice example, SIMU is regularly visited by delegations seeking inspiration for the construction of new simulation centers and institutes.

• SIMU has an excellent international network. Student and academic resident programs provide a basis for personnel exchange projects and international knowledge transfer. Accordingly, large parts of the teaching language have already been changed entirely to English.
• A separate study branch (PhD course) focusing on "Healthcare Simulation" was implemented in 2022/2023. This ensures that medical simulation at SIMU is not only applied in concrete terms, but that the knowledge, methods and added value of medical simulation can also be passed on directly. A crucial step to establish and expand the potential of simulation at other educational institutions as well.

This visionary understanding of simulation and its consistent implementation in SIMU are essential to establish simulation training as one of the leading didactic methods in medical studies and simulation in general as an essential part of quality assurance in medicine. All this makes SIMU not only an impressive training facility, but a showcase project throughout Europe; a pioneering project that sets completely new standards.