Sim First When Seconds Count: Simulations help prepare code teams

When a patient’s heart stops, every second matters—and so does every role on the code team. 

That’s why UAB Clinical Simulation partners each year to host immersive, interprofessional Code Blue simulations designed to sharpen teamwork, communication and life-saving skills. 

This summer, internal medicine residents, registered nurses and respiratory therapists stepped into a simulated hospital environment to practice Advanced Cardiovascular Life Support (ACLS) in real time. 

“The goal is to train learners in best practices for teamwork and communication to deliver high-quality ACLS care,” said Ryan Kraemer, M.D., professor of medicine and one of the simulation’s facilitators. “All learners benefit from hearing each other’s perspectives and cross-training.” 

In each scenario, participants rotate through key code team roles, from team leadership to medication administration to delivering compressions, while responding to a simulated cardiac arrest event. Along the way, facilitators observe, offer feedback and guide debriefs that focus on the most crucial elements of resuscitation. 

For Kraemer, some takeaways stand above the rest: “The importance of clear roles, closed-loop communication, huddles and teamwork,” he said.

Those lessons mirror the simulation’s origins. A few years ago, residents were surveyed about the situations they felt least prepared to face after medical school. The overwhelming answer? Leading a Code Blue. 

“To address this, we created a dedicated Code Blue simulation during intern orientation—before residents start clinical duties,” said Robert Smola, M.D., assistant professor of general internal medicine. “After completing the simulation, residents report they feel more comfortable assisting in Code Blue situations.” 

They also gain a clearer understanding of every team role, greater confidence in operating the crash cart and AED, and the ability to anticipate the needs of their colleagues under pressure. 

It’s an approach that underscores Clinical Simulation’s mission: providing learners a safe place to practice high-stakes care before ever touching a patient. As Kraemer noted, “The team provides a fantastic sim experience every year.” 

To learn how simulation can benefit your own team or department, email simulation@uabmc.edu. 

UAB Medicine’s Clinical Simulation program offers opportunities for individuals and teams across UAB Medicine and beyond to practice before they deliver care. We encourage all who provide and support patient care to “SimFirst.” Together, we can put our patients’ safety first.