"It doesn't matter if you have a state-of-the-art mannequin in the cupboard; if you don't know what to do with it, it's really of no use to you."
She says the United States-acquired AV system offers a theatre footage and patient monitor playback, side by side, on multiple screens. It is invaluable for post-theatre debriefing. This will make the difference to students' learning and career-readiness, says Torrie.
"Now in debrief, we take students back through the footage on the screens and say 'How did we decide who led that situation?' We look at the dynamics at play in team relationships. It isn't necessarily right that the doctor has the lead role in every single situation, there are so often instances where say, a nurse, might have had the most effective, leading approach."
Professor Alan Merry, head of the university's School of Medicine, drove the leading standards at the Tamaki campus, but head of anaesthesiology and associate professor Simon Mitchell led the design and function.
Anaesthetists were the first in medicine to delve into the non-technical skills and influences on human performance. More than 20 years ago, Professor David M Gaba initiated this at Stanford University.
He is known for extensive work on human performance, patient safety issues and applying organisational safety theory to health care.
Mitchell explains how the thinking has been developed and integrated into courses now.
"Medical students doing airway management training, for instance, come and spend a day in lectures and practical sessions in the airway laboratory. They then take their newly learned skills out to the operating room environment and practise them for two weeks. At the end of this time they come back to the centre and have to demonstrate mastery of the skills in a simulated airway "emergency" scenario in a one-on-one examination.
"So simulation teaches the skills initially, then assesses them at the end of their clinical attachment."
Simulation and anaesthetic technician Kayeleen Henderson refers to the gravity with which the students approach the operating theatre as "the magic". Everyone is fully dressed and scrubbed for surgery and in a sense the students "believe in it". From her spot in the "engine room" she controls Jackie Brown entirely: a rise in heart rate here, a decrease in oxygen there.
Each theatre scenario has a learning objective, which is "fleshed out" with a script she and other trainers and actors use. The students are well aware their individual performance is being monitored intensely. Some even become overwhelmed.
Brenda Wraight, director of Health Workforce New Zealand (HWNZ), says quality simulation training is essential for medical careers. HWNZ is part of the Ministry of Health and is responsible for "planning and development of the health workforce".
"Simulation-based education is a practical and necessary method of teaching/learning, evaluating competence, and enhancing career progression," Wraight says.
"Simulations can also help development of new strategies and tactics for specific scenarios, enhance organisational performance, team building, cross-functional collaboration, and investment in formal training."
So will students trained at the highest fidelity centres be better prepared for real patients? Will they make better doctors and nurses because of it?
Paul Ockelford, the chairman of the Medical Association and a practising clinical haematologist, says there are too many variables at work to promise precisely that.
"Good-quality training is immensely important. But it needs to be applied properly for a person to become a quality practitioner. However, this development is very exciting for the association; the debrief period is crucial to students."
So, does more money spent on improved simulation training actually translate to fewer patient fatalities?
"I think it is more a case of 'less is left to chance'. Repetitive training and the resulting perfection of procedure reduces risk and offers the opportunity to perfect a complex procedure away from the drama of the operating theatre." He says flight simulation training is the best analogy.
Mitchell agrees, saying you only need to look at flight simulation training to understand how seriously students take medical simulation; a pilot wouldn't fly a plane full of passengers without innumerable hours of training first.
It's not entirely surprising, then, that Air New Zealand training captain Bob Henderson has been an integral part of the design process at the centre.
"While theory certainly has its place, active participation always accelerates learning. What simulation preparation does is reduce the tunnel vision that tends to occur in emergency situations" he says.
Torrie stresses that medical simulation isn't only about crises though.
"Often it is about getting learners skilled in simple elements of medicine that can build up into complex tasks, before it is practised on a real patient ... It has to be practised every day, or it will be forgotten in a crisis."
