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Manual of simulation in healthcare 2nd Edition Riley
Manual of simulation in healthcare 2nd Edition Riley
Manual of Simulation
in Healthcare
Manual of simulation in healthcare 2nd Edition Riley
1
Manual of Simulation
in Healthcare
SECOND EDITION
Edited by
Richard H. Riley
School of Medicine and Pharmacology,
University of Western Australia
and
Department of Anaesthesia and Pain Medicine
Royal Perth Hospital, Australia
1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Oxford University Press 2016
The moral rights of the author have been asserted
First Edition published in 2008
Second Edition published in 2016
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2015944564
ISBN 978–0–19–871762–1
Printed in Great Britain by
Clays Ltd, St Ives plc
Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
text or for the misuse or misapplication of material in this work. Except where
otherwise stated, drug dosages and recommendations are for the non-pregnant
adult who is not breast-feeding
Links to third party websites are provided by Oxford in good faith and
for information only. Oxford disclaims any responsibility for the materials
contained in any third party website referenced in this work.
Foreword to the first edition
There is a long history of using simple devices to simulate the real experience in healthcare
education. A simple example would be teaching students to handle needles and sutures
using a pig’s foot or a piece of simulated skin. A more complex example is the use of the
famous Resusci Anne™ to teach a partial task such as chest compressions associated with
positive-pressure ventilation. The development of sophisticated, instrumented, manne-
quins coupled with computerized physiology and pharmacology programmes began a
new era in healthcare simulation. These new mannequins had the ability to react to student
interventions in a realistic and automatic manner not requiring instructor intervention.
The mannequins were originally developed and popularized within the field of anaesthe-
siology. It was quickly realized that not only could these mannequins be used to simulate
an anaesthetist’s interaction with a patient but also that they can be used for team-building
situations leading to the development of ‘crisis resource management’. In the short period
of the past two decades, the use of mannequins to create simulated experiences has been
adopted by diverse healthcare providers including nursing, various medical subspecialties,
and other allied health providers.
Healthcare educational institutions around the world are recognizing the need for pro-
viding their students with simulated experiences not only to enhance the educational ex-
perience but also to improve on patient safety. When embarking on the development of a
simulation centre, some of the questions inevitably asked are:
◆ How large should the centre be?
◆ What types of rooms do I need in a simulation centre?
◆ How will I run the centre?
◆ What equipment should I buy?
◆ Who will the users be?
Dr Riley has chosen contributors for this book who have the experience necessary to
answer these questions. Section one provides simulation centre logistics, section two
discusses the various equipment available, and section four addresses the needs of the dif-
ferent subspecialties.
For me, the most important section of this book is section three—Education Compo-
nents. A machine is simply a machine unless it is integrated into the learning environment
using sound educational principles. The question concerning educational integration
of the simulation modalities is often left off the initial list when planning a simulation
Foreword to the first edition
vi
programme. Dr Riley needs to be congratulated for devoting a large section of this book to
education; education is the pivotal element in determining a centre’s success.
2008
David H Wilks MD
Professor and Chair
Department of Anesthesiology
West Virginia University
School of Medicine
Foreword to the second edition
Confucius made the case for the utility of simulation and debriefing some 2,500 years ago
by observing that real experience, however profound in nature, was always tinged with risk
or potential harm. He suggested that rehearsing or imitating practice was perhaps a sen-
sible and pragmatic way to mitigate some of this experiential risk. Perhaps even more im-
portantly Confucius also highlighted that without meaningful reflection all activity runs
the risk of being meaningless . . . So from across antiquity Confucius offers wisdom as to
the potential utility of simulation in professional education.
His analysis of wisdom would appear to support the fundamental importance of ex-
periential learning; he makes a clear case for emulation and rehearsal and highlights the
utility of debriefing and reflective practice. All of these concepts are basic tenets of adult
and humanistic learning and deeply enshrined in contemporary thinking in simulation-
based education.
It would appear, therefore, that the concepts underpinning the value of simulation are
nothing new!
In modern times simulation has become established as a major educational modality in
healthcare education. Over the last decade simulation has moved from being an emergent
and disruptive educational innovation into a mainstream element of most healthcare cur-
ricula. This renaissance has been fuelled in part by the enthusiasm, evangelism, and pas-
sion of many of the early adopters and advocates of simulation. Organizations have also
been keen to demonstrate their innovative credentials by boarding the innovation band-
wagon. Many such initiatives or programmes have brought about a stepwise improvement
and transformation of healthcare education.
Not all strategies, however, have been so successful.
It is therefore timely and apposite that Richard Riley and colleagues have taken the op-
portunity afforded by a second edition to bring their original and trusted text up to date.
This edition brings current advances in contemporary simulation practice and thinking
into one place.
Effective simulation-based education is a complex and challenging field of educational
practice. It is a wide family of educational techniques and technologies, contexts, and ap-
plications with many distinct forms, opportunities, and challenges. These are explored and
considered in detail throughout the new edition.
This second edition offers many hard won insights, experiences, and learning from an
international cadre of simulation experts. They share learning from their successes but
with a commendable degree of openness and humility; they offer their cautions and mis-
takes so providing the reader with the unique opportunity to learn from their wisdom and
experience.
Foreword to the second edition
viii
This book provides a generous offering of innovative and thoughtful insights from many
leaders in the field of simulation in healthcare. Further this manual reflects that simulation
in healthcare shows all the characteristics of a maturing field of academic practice, the ini-
tial evangelism, and enthusiasm replaced by principle and concept, construct, and utility.
The emerging criticality, collegiality, and community reflected in this new edition sug-
gest to me that simulation has now come of age as an academic discipline.
I expect that this book will find a prominent home in the offices and centres of those
engaged in high quality, simulation-based education.
Confucius could only wonder at the technology available today but in many ways I sus-
pect he would immediately recognize and approve of the current application and utility of
simulation in healthcare.
2015
Ian Curran
Professor of Innovation and Excellence in Healthcare Education
Queen Mary University of London
Preface to the first edition
The idea for this manual came to me during the inaugural Simulation and Skills Training
Special Interest Group of the Australian and New Zealand College of Anaesthetists held in
Perth, September 2000. At that time the chief references for those of us who had entered
the world of medical simulation were David Gaba’s book Crisis Management in Anesthesi-
ology and his chapter in Miller’s textbook of Anesthesia. Learning how to use the commer-
cially available medical simulators was achieved through attendance at Dr Gaba’s ACRM
Instructor’s Course at Stanford and old-fashioned on-the-job practice. Subsequent discus-
sions with colleagues in this growing field made it apparent that many of us were strug-
gling with common problems but that there were some very creative solutions. However,
the process of mustering these collective talents and experiences was quickly subdued by
the pressures of teaching and administration in a new simulation centre.
My association with local and international simulation meetings not only enriched my
knowledge of simulation in healthcare but also brought me into contact with many lead-
ers in simulation. I am deeply grateful that many of these simulation leaders have kindly
shared their expertise with us. Thanks must also go to hospital and organizational ad-
ministrators and heads of departments who have supported the simulation community.
I thank those who have mentored and inspired me: David Wilks, Myroslav Klain, Peter
Winter, and Peter Safar. I also would like to thank Sara Chare, Clare Caruana, Eloise Moir-
Ford, Anna Winstanley, Catherine Barnes, Georgia Pinteau, Kelly Hewinson, Kate Wan-
wimolruk, and the team from Oxford University Press who kept me on track. Finally, I
wish to express thanks to my wife Vera who has been my support and strength through the
simulation journey.
2008
Richard H Riley
Perth, Western Australia
Manual of simulation in healthcare 2nd Edition Riley
Preface to the second edition
The response to the publication of the first edition of this manual has been gratifying. It
has been more than enough reward to know that many have found it to be helpful as they
seek to enhance their healthcare programmes with simulation-based education. For this
edition, I had the sad task of replacing some sub-specialty areas with combined chapters
and new topics. The advent of web-based storage has allowed us to supplement these pa-
perback and digital editions with additional resources that are in current use at various
simulation and skills centres.
Any success that this book achieves is due to these talented authors and I remain very
thankful that they have shared their expertise with us. Further, I continue to learn from
colleagues, educators, and students in the simulation community. If I have learnt only one
thing from simulation, it is that the historic concept of a teacher and students as separate
entities is not only wrong but that it can be a barrier to education. I cling to the hope that
at some time in the distant future I will achieve some level of expertise in this field. I also
would like to thank Caroline Smith, Nicola Wilson, James Cox, Cherline Daniel, Paul Nash
and the team from Oxford University Press, who kept me on task; and Ian Curran and
Brydon Dunstan. Thanks to David Gaba and Ray Page for being so inspirational. Finally, I
thank my wife Vera who has been my support on the simulation journey.
Richard Riley
Perth, Western Australia 2015
Richard@pobox.com
Manual of simulation in healthcare 2nd Edition Riley
List of Contributors xv
Part 1 Design, logistics, equipment, and history
1 Lessons from aviation simulation 3
Ray Page
2 Simulation centre design 16
Ross Horley
3 Simulation centre operations 29
Yue Ming Huang and Thomas Dongilli
4 Simulators, equipment, and props 51
Chris Chin
Part 2 Education
5 Developing the skills and attributes of a simulation-based
healthcare educator 65
Al May and Simon Edgar
6 Teaching a clinical skill 78
Jeffrey M Hamdorf and Robert Davies
7 Teaching in clinical settings 89
Fiona Lake
8 Teaching and learning through the simulated environment 102
Iris Vardi
9 Simulation in nursing education and practice 115
Joseph S Goode Jr and John M O’Donnell
10 Incorporating simulation into the medical school curriculum 128
Randolph H Steadman, Maria D D Rudolph, Christine C Myo-Bui,
and Rima Matevosian
11 Interprofessional education 141
Robert P O’Brien and Jonathan Mould
12 Scenario design—theory to delivery 151
Chris Holland, Chris Sadler, and Nusrat Usman
13 Debriefing—theory and techniques 166
Janice C Palaganas, Brendan Flanagan, and Robert Simon
14 Training and assessment with standardized patients 185
John R Boulet and Anthony Errichetti
Contents
Contents
xiv
15 Team-building exercises and simulation 208
Andrew Anderson
16 Teaching and learning in simulation using the problem-based approach 221
Russell W Jones
17 Patient safety and simulation 235
Christine L Mai, Rebecca D Minehart, and Jeffrey B Cooper
18 Non-technical skills: identifying, training, and assessing safe behaviours 249
Rhona Flin and Nicola Maran
19 Current concepts in mannequin-based simulation assessment 265
Leonie M Watterson and Jennifer M Weller
20 Research in simulation 277
Alexander (Sandy) Garden
21 Airway training devices 290
Cindy Hein, Cyle Sprick, and Harry Owen
Part 3 Applied simulation
22 Cardiopulmonary resuscitation and training devices 305
Sheena M Ferguson and Anthony R Lewis
23 Respiratory medicine and respiratory therapy 317
Brian Robinson
24 Simulation in critical care 330
Joshua S Botdorf, Julie A Schmidt, William F Dunn, and Kianoush Kashani
25 Simulation for teamwork training 345
Geoffrey K Lighthall, Nicolette C Mininni, and Michael DeVita
26 Surgical simulation 356
Roger Kneebone and Fernando Bello
27 Simulation-based emergency medicine and disaster training 368
Mary D Patterson, John A Vozenilek, and Mark W Bowyer
28 Simulation in paediatrics 383
Nicole K Yamada, Janene H Fuerch, and Louis P Halamek
29 Obstetric simulation 397
Shad H Deering
30 Creating virtual reality medical simulations: a knowledge-based
design and assessment approach 411
Dale C Alverson, Thomas P Caudell, and Timothy E Goldsmith
31 Role of cognitive simulation in healthcare 424
Usha Satish, Satish Krishnamurthy, and Mantosh Dewan
		
Glossary of medical and simulation terms, acronyms, and abbreviations 439
		
Index 453
Educational Commission for Foreign
Medical Graduates
Philadelphia, PA, US
Col (ret) Mark W Bowyer, MD, FACS,
DMCC
Ben Eiseman Professor of Surgery
Chief, Division of Trauma and Combat
Surgery
Surgical Director of Simulation
Uniformed Services University
Bethesda, MD, US
Thomas P Caudell, PhD
Professor
Department of Electrical & Computer
Engineering
Department of Computer Science
(secondary)
Department of Psychology (secondary)
University of New Mexico
Albuquerque, NM, US
Chris Chin MBBS, FRCP, FRCA, MA
Clin Ed
Staff Anesthesiologist
British Columbia Children’s Hospital
Clinical Instructor, University of British
Columbia
Vancouver, BC, Canada
Jeffrey B Cooper, PhD
Professor of Anaesthesia
Harvard Medical School
Massachusetts General Hospital
Founder and Executive Director,
Center for Medical Simulation
Boston, MA, US
Robert Davies, MBBS, FRACS
Australian and New Zealand Surgical
Skills Education and Training Committee
Dale C Alverson, MD
Professor Emeritus of Pediatrics and
Regents’ Professor
Professor, Health Sciences Center Library
and Informatics Center
Medical Director, Center for
Telehealth and Cybermedicine
Research
University of New Mexico
Albuquerque, NM, US
Andrew Anderson
Chief Executive Officer
Association for Simulated Practice in
Healthcare (ASPiH)
Managing Director
Crawford Medical Limited
London, UK
Fernando Bello, BSc (Hons), PhD
Reader in Surgical Graphics &
Computing
Division of Surgery
Department of Surgery and Cancer
Imperial College London
Paterson Centre
St Marys Hospital
London, UK
Joshua S Botdorf, DO
Department of Medicine
Division of Pulmonary and Critical Care
Medicine
Mayo Clinic
Rochester, MN, US
John R Boulet, BSc, MA, PhD
Vice President, Research & Data Resources
Foundation for Advancement of
International Medical Education and
Research
List of Contributors
List of Contributors
xvi
New York Institute of Technology-College
of Osteopathic Medicine
Old Westbury, NY, US
Sheena M Ferguson, MSN, RN, CCRN,
CNS
Chief Nursing Officer & Administrator
University of New Mexico Hospitals
Albuquerque, NM, US
Brendan Flanagan, MBBS, FANZCA
Department of Anaesthesia &
Perioperative Medicine
The Alfred Hospital
Melbourne, VIC, Australia
Rhona Flin, PhD
Chair of Applied Psychology
School of Psychology
University of Aberdeen
King’s College
Aberdeen, UK
Janene H Fuerch, MD, FAAP
Fellow in Neonatal-Perinatal
Medicine
Division of Neonatal and Developmental
Medicine
Department of Pediatrics
Stanford University School of Medicine
Center for Advanced Pediatric and
Perinatal Education
Packard Children’s Hospital at
Stanford
Palo Alto, CA, US
Alexander (Sandy) Garden, MBChB,
PhD, FANZCA
Rotational Supervisor
Department of Anaesthesia
Wellington Hospital
Adjunct Professor
School of Biological Sciences
Victoria University
Wellington, New Zealand
Royal Australasian College of Surgeons
East Melbourne, VIC, Australia
COL Shad H Deering, MD, FACOG
Chair, Department of Obstetrics and
Gynecology
Uniformed Services University of the
Health Sciences
Bethesda, MD, US
Michael DeVita MD, FCCM
Director, Critical Care
Harlem Hospital Center
Assistant Professor, Internal Medicine
Columbia College of Physicians and
Surgeons
New York, NY, US
Mantosh Dewan, MD
Professor
Department of Neurosurgery
SUNY Upstate Medical University
Syracuse, NY, US
Thomas Dongilli, AT
Director of Operations, WISER
University of Pittsburgh
Pittsburgh, PA, US
William F Dunn, MD
Mayo Clinic Multidisciplinary
Simulation Center
Rochester, MN, US
Simon Edgar, MBChB, FRCA, MMed
Consultant Anaesthetist
Director of Medical Education NHS
Lothian, Edinburgh
Education Coordinator, Scottish Centre
for Simulation and Clinical Human
Factors (SCSCHF)
Stirling, UK
Anthony Errichetti, PhD
Chief of Virtual Medicine
Director, MS in Medical/Healthcare
Simulation Program
List of Contributors xvii
Chris Holland, MBBS, BAO, MMedEd,
FRCA, FFICM, FAcadMEd
Consultant in Intensive Care
Director of Clinical Practice
Lecturer in Clinical Education
King’s Healthcare Partners
London, UK
Ross Horley, CEng
Adjunct Lecturer, School of Medicine
University of Notre Dame Australia
Director, Medical Synergies Ltd
Stirling, WA, Australia
Yue Ming Huang, EdD, MHS
Education and Operations Director,
UCLA Simulation Center
Associate Adjunct Professor, Department
of Anesthesiology
David Geffen School of Medicine at UCLA
University of California,
Los Angeles, CA, US
Russell W Jones, BSc, DipEd, BEd
(Hons), PhD
Professor of Clinical Education, Edith
Cowan University
Professor of Clinical Education, Royal
Flying Doctor Service
Edith Cowan University
Joondalup, WA, Australia
Kianoush Kashani, MD, FASN, FCCP
Assistant Professor in Internal Medicine
Division of Nephrology and
Hypertension
Division of Pulmonary and Critical Care
Program Director—Critical Care Fellowship
Mayo Clinic Multidisciplinary Simulation
Center
Rochester, MN, US
Roger Kneebone, PhD, FRCS, FRCSEd,
FRCGP
Professor of Surgical Education
Timothy E Goldsmith, PhD
Associate Professor
Department of Psychology
University of New Mexico
Albuquerque, NM, US
Joseph S Goode Jr, CRNA, MSN
Faculty, University of Pittsburgh
School of Nursing
Department of Nurse Anesthesia
Staff Nurse Anesthetist, Presbyterian
Hospital
University of Pittsburgh Medical
Center
Pittsburgh, PA, US
Louis P Halamek, MD, FAAP
Professor and Associate Chief for Training
and Assessment
Division of Neonatal and Developmental
Medicine
Department of Pediatrics
Stanford University School of Medicine
Director, Center for Advanced Pediatric
and Perinatal Education
Packard Children’s Hospital at Stanford
Stanford Children’s Health
Palo Alto, CA, US
Jeffrey M Hamdorf, MBBS, PhD, FRACS
Winthrop Professor of Surgical
Education
Director, Clinical Training and Education
Centre
Head, School of Surgery
The University of Western Australia
Nedlands, WA, Australia
Cindy Hein, DipAppSc, BHSc, PhD
Extended Care Paramedic
SA Ambulance Service
Postdoctoral Research Fellow
Flinders University
Bedford Park, SA, Australia
List of Contributors
xviii
Christine L Mai, MD
Instructor in Anaesthesia
Harvard Medical School
Massachusetts General Hospital
Boston, MA, US
Nicola Maran, MBChB, FRCA, FRCSEd
Consultant Anaesthetist
Associate Medical Director for Patient
Safety, NHS Lothian, Edinburgh, Scotland
Educational Coordinator, Scottish Centre
of Simulation and Clinical Human Factors,
NHS Forth Valley, Larbert, UK
Rima Matevosian, MD
Chair, Department of Anesthesiology
Olive View—UCLA Medical Center
Associate Dean
David Geffen School of Medicine at UCLA
University of California,
Los Angeles, CA, US
Al May, MBChB, FRCA, FCARCSI
Educational Coordinator
Scottish Centre for Simulation and
Clinical Human Factors
Larbert, UK
Rebecca D Minehart, MD
Assistant Professor in Anaesthesia
Harvard Medical School
Massachusetts General Hospital
Boston, MA, US
Nicolette C Mininni, BSN, RN, MEd,
CCRN
Advanced Clinical Education Specialist,
Critical Care
University of Pittsburgh Medical Center
UPMC Shadyside
Pittsburgh, PA, US
Jonathan Mould, PhD, MSc, RSCN,
RGN, RMN, Adult Cert Ed
Lecturer and Researcher, School of
Nursing, Midwifery and Paramedicine
Division of Surgery
Department of Surgery and Cancer
Imperial College London Clinical Skills
Centre
St Marys Hospital
London, UK
Satish Krishnamurthy, MD
Professor
Department of Neurosurgery
SUNY Upstate Medical University
Syracuse, NY, US
Fiona Lake, MD, FRACP
Respiratory Physician, Sir Charles
Gairdner Hospital
Eric Saint Professor of Medicine
School of Medicine and
Pharmacology
The University of Western Australia
Crawley, WA, Australia
Anthony R Lewis, BSc, PhD, MB BCh,
FRCA, FANZCA
Consultant Anaesthetist
Department of Anaesthesia
St George Hospital
Director, iSimulate Pty Ltd
Sydney, NSW, Australia
Geoffrey K Lighthall MD, PhD
Associate Professor
Anesthesia and Critical Care
Stanford University School of
Medicine
Stanford, CA, US
Christine C Myo-Bui, MD
Assistant Clinical Professor
Department of Anesthesiology and
Perioperative Medicine
David Geffen School of Medicine at
UCLA
University of California,
Los Angeles, CA, US
List of Contributors xix
Mary D Patterson MD, MEd
Medical Director for Simulation Center
for Safety and Reliability
Akron Children’s Hospital
Professor of Pediatrics
Northeast Ohio Medical College
Akron, OH, US
Richard H Riley, MBBS, FANZCA
School of Medicine and Pharmacology
University of Western Australia
Anaesthesia and Pain Medicine
Royal Perth Hospital
Perth, WA, Australia
Brian Robinson, MSc, PhD
Senior Lecturer
Graduate School of Nursing, Midwifery &
Health Te Kura Tapuhi Hauora
Victoria University of Wellington
Wellington, New Zealand
Maria D D Rudolph, MD
Visiting Scholar
UCLA Simulation Center
David Geffen School of Medicine at
UCLA
University of California,
Los Angeles, CA, US
Chris Sadler, BSc, PhD (Physiol),
MBBS, FRCA
Consultant Anaesthetist
Training Programme Director,
Barts & The London School
of Anaesthesia
Director of Strategy for Simulation &
Essential Clinical Skills
Barts Health, London, UK
Usha Satish, PhD
Professor
Department of Psychiatry
SUNY Upstate Medical University
Syracuse, NY, US
Curtin University
WA, Australia
Robert P O’Brien, EdD, MEd, BA, BTeach
Honorary Senior Fellow
Melbourne Medical School
University of Melbourne
Melbourne, VIC, Australia
John M O’Donnell, CRNA, MSN,
DrPH
Professor of Nursing and Chair,
Department of Nurse Anesthesia
Director, Nurse Anesthesia Program
Associate Director, WISER
University of Pittsburgh
Pittsburgh, PA, US
Harry Owen, MBBCh, MD, FANZCA
Professor, School of Medicine
Flinders University
Bedford Park, SA, Australia
Ray Page, Dip Radio Technology, Dip
Television, Dip Industrial Electronics
Former Manager
Simulator Services
QANTAS Airways
past Chair, IATA Flight
Simulator Technical Committee
Inaugral Chair
Simulation Industry Association Australia
(SIAA)
Australia
Janice C Palaganas, PhD, RN, NP
Principal Faculty
Director of Educational Innovation and
Development
Center for Medical Simulation
Massachusetts General Hospital
Department of Anesthesia, Critical Care,
& Pain Medicine
Harvard Medical School
Boston, MA, US
List of Contributors
xx
Duane and Mary Cullinan Professor in
Simulation Outcomes
Associate Professor, Emergency
Medicine
University of Illinois College of Medicine
at Peoria
Associate Professor of Bioengineering
University of Illinois College of
Engineering Urbana Champaign, Peoria,
IL, US
Leonie M Watterson, MB BS, FANZCA,
MClinEd
Clinical Associate Professor, Sydney
Medical School, University of Sydney
Director, Sydney Clinical Skills and
Simulation Centre, Simulation
Division
Royal North Shore Hospital
St Leonards, NSW, Australia
Jennifer M Weller, MD, MBBS, MClinEd,
FANZCA, FRCA
Associate Professor and Head of
Centre for Medical and Health Sciences
Education
School of Medicine, University of
Auckland
Specialist Anaesthetist, Auckland City
Hospital
Auckland, New Zealand
Nicole K Yamada, MD, FAAP
Clinical Assistant Professor
Division of Neonatal and Developmental
Medicine
Department of Pediatrics
Stanford University School of Medicine
Associate Program Director, Center
for Advanced Pediatric and Perinatal
Education
Packard Children’s Hospital at
Stanford
Palo Alto, CA, US
Julie A Schmidt, MSN, RN
Department of Nursing
Mayo Clinic
Rochester, MN, US
Robert Simon, EdD
Senior Director, Educational
Leadership & International
Programs, Center for Medical Simulation
Department of Anaesthesia, Critical Care,
and Pain Medicine
Massachusetts General Hospital
Harvard Medical School
Boston, MA, US
Cyle Sprick, BSc, PhD
Paramedic, South Australian Ambulance
Service
Director, Clinical Simulation
Unit
Flinders University
Bedford Park, SA, Australia.
Randolph H Steadman, MD, MS
Professor and Vice Chair
Department of Anesthesiology and
Perioperative Medicine
Director, UCLA Simulation Center
David Geffen School of Medicine
at UCLA
Los Angeles, CA, US
Nusrat Usman, MBChB, FRCA
Consultant Anaesthetist
Barts Health NHS Trust
London, UK
Iris Vardi, BAppSc, DipEd, MEd, PhD
Principal Consultant Higher Education
Director, Vardi Consulting
Perth, WA, Australia
John A Vozenilek, MD
Chief Medical Officer for Simulation
Jump Trading Simulation and Education
Center, OSF Healthcare System
Part 1
Design, logistics, equipment,
and history
Manual of simulation in healthcare 2nd Edition Riley
Chapter 1
Lessons from aviation simulation
Ray Page
◆ Simulation was previously described as having achieved an integral role in the avi-
ation industry. This role can now be described as essential for this industry.
◆ The standards developed by the industry have been maintained and regulation con-
tinues to evolve, driven by technological changes, and changes to the training envir-
onment brought about by developments in aircraft technology.
◆ Until relatively recently, aviators were required to manually fly their aircraft within
very tight tolerances of just a few knots, and basic airmanship skills learned during
initial training were maintained during operational flying. Now, automated control
of aircraft flight parameters prevent a pilot from exceeding the flight envelope of the
aircraft.
◆ With progression to fly-by-wire control of modern aircraft, the pilot is even fur-
ther removed from the rigours of basic aircraft control and handling; unless some
unforeseen event arises which suddenly requires skills that are not used in normal
operation.
◆ The extent of computer-controlled operations in normal procedures has high-
lighted the need for basic skills to be taught and maintained in all conditions. Ad-
vanced simulator training is the only practical means available to complete such
advanced training.
◆ The use of fly-by-wire control of commercial aircraft has raised concerns with the
Federal Aviation Authority (FAA) that will lead to a ‘fundamental rewrite’ of flight
training rules to require all enhanced training to take place in flight simulators.
◆ This has arisen from a number of major accidents where pilots failed to recognize
and react to some fundamental problems, being totally dependent on the aircraft
automatic flight controls and possibly suffering from a lack of skill in manually fly-
ing the aircraft for recovery.
Overview
Lessons from aviation simulation
4
1.1 Introduction to lessons from aviation simulation
In the original edition of this manual, there were historical references to the invention and
development of simulation devices, as well as training methods used, to illustrate the pro-
gress made with the use of flight simulation. This was shown to be based on the advances
of technology, especially in the areas of computing science, as well as experience gained
with use of the flight simulator as both a training and checking device. Specific areas were
highlighted as the basis of the success and acceptance of simulation as a complete and valid
form of training and testing.
◆ Comprehensive training analysis of what was required to be simulated
◆ Accurate data and performance of what was to be simulated
◆ Accurate modelling of the simulation
◆ Simulation device constructed to standards using adequate computational power and
speed (fidelity of simulation)
◆ Full acceptance testing (any area not tested cannot be regarded as correct)
◆ Testing and compliance to international standards to ensure regulatory control
Since the initial publication there have been advances in all areas, though none more so
than the actual method in which modern aircraft are controlled, and this has had, and will
continue to have, a significant impact on training.
The world has suffered a financial crisis which has had a dramatic impact on aviation,
with airlines experiencing the need for cost reduction resulting in moves to newer, more
efficient aircraft. These new aircraft, however, also now feature new piloting techniques.
While the crisis has somewhat abated, the need for cost savings has not and demand for
air travel has increased enormously, with the industry now facing major challenges to be
able to meet the demands of increasing training throughput while maintaining standards
and managing the introduction of new and more complex aircraft.
In this environment, standards play a vital part in ensuring pilots receive and maintain
the skills necessary to fly safely every time they take to the air.
◆ To provide and maintain pilot skills will require a boost in simulator fidelity to han-
dle the new training scenarios. Costs of implementing new standards, in part due to
simulator upgrades, have been estimated to be at least $354 million.
◆ In Australia, CASA has recently updated regulations to mandate the use of Simu-
lation for certain flight crew training requirements in the air transport and other
sectors where this may be considered appropriate. This resulted from a number of
accidents and incidents that occurred when dangerous abnormal conditions were
being practiced in the aircraft.
Overview (continued)
1.2 Flight simulation standards 5
1.2 Flight simulation standards
Prior to the 1970s there were no standards for flight simulation devices and accreditation
was based on individual country regulatory authorities, providing vastly differing per-
formance criteria requirements.
In the early 1970s a small group of flight simulator maintenance engineers from the
world’s airlines formed an association to be known as IAFSTA (International Airline
Flight Simulator Technical Association). This group was formed to discuss the lack of
standards, data, and performance problems with flight simulators then in service. The
simulator manufacturers did not react kindly to open forum criticisms and legal threats
were made.
IAFSTA was disbanded and the membership looked to IATA (International Air Trans-
port Association) to form a committee. In October 1973 the IATA FSTC (Flight Simulator
Technical Committee) held its first meeting in Denver, Colorado.
The FSTC set about the task of forming sub-committees and working groups to exam-
ine what was needed to develop and publish standards for flight simulation. There was a
huge wave of cooperation, though many avionics and airframe manufacturers at that time
could not really understand or appreciate the need for the levels of fidelity being sought
and many closed, volatile sessions were held along the way.
In 1980 the first edition of the IATA publication ‘Flight Simulation Training Device
Design and Performance Data Requirements’ was published and became an automatic
contractual document in the purchase of flight simulators and training devices. This docu-
ment is now in its seventh edition.
With the standards established, a push was made to offer incentives to the aviation in-
dustry to increase flight simulator fidelity, with an objective to eventually move all train-
ing and checking from the aircraft to the flight simulator. Discussions were held with the
FAA, which agreed to an incentive programme with landing credits as the initial goal. This
became the start of a long process of driving technology and improved aircraft data collec-
tion and testing to achieve ‘zero flight time’ (the ability to use the flight simulator as a total
replacement for all aircraft training and testing).
This was a total cooperative effort between all parties. As an example, it was a Qantas
simulator engineer, endorsed by the FSTC, who actually controlled the Boeing flight test
for the data required for the Boeing B747–400.
1.2.1 Regulation
The aviation industry remains highly regulated and as a basic element of flight safety air-
crew training and simulation are well covered in these regulations.
All nations have to abide by their own regulatory authority and agreement was reached
to produce The ICAO (International Civil Aviation Organization) Manual of Criteria
for Qualification of Flight Simulators, which now forms the basis of most nation’s
regulations.
Lessons from aviation simulation
6
1.3 The aviation industry
Towards the end of the last century, the world economy was slowing and airlines were
feeling the effects, resulting in major cost-cutting. Airlines were restructured and, in some
cases, national carriers were ‘privatized’. This resulted in many cases of stripping of experi-
enced technical personnel to improve the financial bottom line of the airline. Cost-cutting
also placed restrictions on technical and training personnel being able to attend confer-
ences and meetings of airline organizations, such as IATA.
In order to ensure that airlines continued to maintain their understanding of tech-
nical developments and investigation for solutions to technical problems, alternative ap-
proaches and organizations were sought by the flight simulator fraternity.
Fortunately, this happened as the aircraft being operated moved to the ‘fly-by-wire’ air-
craft concept, and the flight simulators used actual aircraft flight control computers, which
were simulated, or the now-accepted practice of the aircraft software integrated into the
simulator under licence, from the software provider. The acceptance of the flight simulator
into the mainstream avionics world was now complete.
The following describes how existing aircraft organizations have incorporated the flight
simulator into their existing operations, therefore ensuring the ongoing fidelity of the
simulator in parallel to the actual aircraft.
1.3.1 ARINC (Aeronautical Radio Incorporated)
This organization was originally incorporated in 1929 and chartered to serve as the air-
line industry’s single licensee and coordinator of radio communications. ARINC was also
responsible for all ground base radio stations and transport communications, as well as
supporting commercial aviation and the US military.
In 1978, ARINC introduced ACARS (Aircraft Communications Addressing and Re-
porting System), a data link system that enables ground stations, as well as aircraft main-
tenance bases, to communicate with an aircraft without voice, but with data, including
interfacing to on-board units such as the FMS (Flight Management Systems) to allow up-
dating of flight-planning information.
With the introduction of the B767, the FMS on this aircraft presented tremendous diffi-
culties for flight simulator training, as faults and repositioning introduced for training in
the simulator caused the FMS (aircraft unit) to signal a systems failure and remove them-
selves from controlling the simulated aircraft—as it perceived this as a disaster situation.
This presented huge training problems and the obvious solution was to incorporate simu-
lation software in an aircraft-certified on-board unit which could be locked out during
regular aircraft use.
The incorporation of any non-aircraft software in airborne avionics was unheard of and
initially vehemently opposed by ARINC engineers with a long battle, originally led by the
IATA FSTC, and later by a group of airline simulator engineers led by Qantas and British
Airways. This was finally agreed when it was revealed that the FMS manufacturers actually
used such a feature for their testing of this unit.
1.4 Fly-by-wire aircraft 7
This was an historic first for flight simulation, as it recognized the importance of the
role played by simulation training and also the safety of coexisting software between air-
craft and flight simulator, which would be imperative for the future of fly-by-wire aircraft
simulation. The battleground also extended to the aircraft manufacturers, as this problem
impacted on the production cycle of the B767.
1.3.2 Aviation committees
Flight simulation was now entering the world of avionics and the advent of fly-by-wire
aircraft would dictate a new role of adherence to ARINC standards and participation in
associated aviation committees.
1.3.3 AEEC
The Airline Electronics Engineering Committee (AEEC) develops the engineering stand-
ards and technical solutions for avionics, networks, and cabin systems that would provide
interchange ability with reduction in life-cycle costs.
More than 4,000 engineers and scientists, representing some 250 sponsoring organ-
izations, participated in the development of consumer-based ARINC standards. These
standards define the key elements of equipment and systems installed in more than 10,000
aircraft worldwide.
1.3.4 AMC
The Aviation Maintenance Committee (AMC) is concerned with the maintenance and
reliability of avionics and the development of technical standards, in compliance with
ARINC standards. The annual meeting is attended by more than 750 avionics mainten-
ance experts from around the world and identifies issues with both immediate and long-
term maintenance improvements.
1.3.5 FSEMC
The Flight Simulator Engineering Maintenance Committee (FSEMC) provides cost-­
effective solutions to flight simulator operational and maintenance problems. The annual
conference is attended by more than 300 flight simulator experts from around the world to
discuss technical solutions to engineering and maintenance issues, with long-term savings
as well as increased efficiency for simulator users.
The activities of the FSEMC are led are led by a steering committee with the Terms of
Reference approved by the ARINC Board of Directors. The ARINC Standards Develop-
ment Document specifies the procedures to develop voluntary consumer-based ARINC
standards.
1.4 Fly-by-wire aircraft
This is a system which replaces the conventional manual aircraft flight controls with an
electronic interface which allows the pilot to input his commands (fly up)—(turn left)
Lessons from aviation simulation
8
through either conventional flight controls, or a side or centre stick (like a computer game
controller) which provides a signal to a computer. This computer then performs calcula-
tions based on the flight control laws programmed into the flight control computers, which
along with inputs from other sensors and the air data internal reference units commands
the flight control surfaces to adopt a configuration that will achieve the desired flight path.
1.4.1 Weight saving
Digital fly-by-wire systems are now used in the majority of new commercial aircraft as they
provide many advantages over the earlier aircraft by replacing hardware such as cables and
linkages with associated pulleys and push rods. Overall, this reduces weight, equipment
space areas, and the number of potential failure points that require maintenance and rou-
tine service checks.
Electronic systems require less maintenance, as opposed to traditional mechanical and
hydraulic systems, which require tension adjustments, lubrication, leak checks, and fluid
changes.
Preflight safety checks can now be performed using the Built-in Test Equipment (BITE),
which allows a number of control movement steps to be performed automatically and to
report any fault or failure automatically.
1.4.2 Safety and redundancy
Aircraft control systems may now be a multiplex to prevent loss of control, in the case of
a failure of one or two channels. High-performance fighter-type aircraft are basically un-
stable to gain performance, and could not be flown manually as they required some 20 to
30 on-board computers to rapidly compute high-speed manoeuvres. The control system
will attempt to prevent a stall or can stop the pilot from over-stressing the airframe.
The Space Shuttle, for example, had an all-digital fly-by-wire control system. This system
was first exercised (as the only flight control system) during the unpowered flight ‘Ap-
proach and Landing Tests’ carried out on Space Shuttle Enterprise in 1977.
1.4.3 Airbus vs Boeing
The fundamental difference between the two main commercial aircraft suppliers is that,
with Airbus aircraft, the computer always retains the ultimate control and will not allow
pilots to fly outside performance limits.
With Boeing 777 airliners, the two pilots can completely override the computerized
flight-control system to permit the aircraft to be flown beyond its usual flight control en-
velope during emergencies.
1.4.4 Intelligent Flight Control Systems (IFCS)
This is a later development spearheaded by NASA, which is designed to compensate for
any aircraft damage or failures during flight. This system, for example, would automatic-
ally use engine thrust and other avionics to compensate for loss or failures of other control
Exploring the Variety of Random
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spectacle, possesses no novelty. Catalunian industry does not arise from any
superior education, by which men obtain a clearer insight into their moral
duties, and higher views of the human character; on the contrary, no
Spanish peasant is more ignorant than a Catalunian boor; none are more
enslaved by the priesthood; and in no other province, have the inhabitants
shewn so much, their veneration for the apostolical party both in church and
state. The secret of Catalunian industry, is the same as that which has
covered with fertility many an Alpine valley in Switzerland,—self-interest.
Give to the labourers of the earth an interest,—a property in the land which
they cultivate, and the world would become one wide extended garden. The
land upon which the Catalunian labours, is either his own, or held by him
upon a lease, sometimes for lives, sometimes in perpetuity, with a fine upon
succession or alienation; but at all events, for so long a period as to invest
the tenant with a real interest in the property which he cultivates.
From the Venta, where we slept, to Tarragona, the road winds among
rugged hills, along the sea shore. I noticed many beautiful heaths by the
way side, but the soil is not rich enough to repay cultivation. At a venta
close by the sea, called Hospitalet, we stopped to breakfast. Soon after, we
entered the plain of Tarragona, almost vieing in fertility with the huertas of
the more southern provinces, and reached the city to a late dinner.
I had expected much from the antiquities of Tarragona; but I confess
they disappointed me. They possess few of those features which strike or
delight the traveller who is not professedly an antiquarian. When a Roman
amphitheatre is shewn to me, I always think of the amphitheatre of Nismes;
if I look upon an aqueduct, I see placed beside it the Pont de Gard. The
remains of the amphitheatre are little more than visible; the aqueduct,
though fine, is certainly not comparable to that which I have named; and the
tower of Scipio is merely the tower of Scipio. I was greatly surprised at the
ignorance of the inhabitants respecting their antiquities. The cicerone whom
I first engaged, scarcely knew of their existence; and one group of priests
whom I addressed, and another group of respectable looking men, could
give me no information upon the subject.
The cathedral of Tarragona is worth a visit, particularly the court and
cloisters, which are surrounded by innumerable pillars. The canon who
accompanied me, said they were Roman, but upon one I noticed a
representation of the crucifixion, and upon another the last supper,—and
upon others I could trace Gothic designs. It is possible that some Roman
pillars found elsewhere, may have been conveyed to this court. The
ecclesiastic who walked round the cathedral with me, spoke in earnest
language of the decline of piety; and so deeply did the old man lament this
that, as he laid his hand upon his heart, I saw the tears start into his eyes.
I was delighted with the posada at Tarragona; the posadero, an Italian,
put forth his utmost skill in cookery, and seeing that I relished the wine he
set before me, which was really excellent, he brought a pint bottle of choice
wine, which he had had eleven years in his cellar. It proved perfect nectar,
and the owner was quite charmed with the praises I bestowed upon it.
I found it impossible to understand the Catalunian dialect, which is
indeed almost a distinct language,—this is a difficulty that is felt in all the
provinces. The dialects of Biscay, Andalusia, Valencia, and Catalunia, are
all different from each other, and distinct from the Castilian; the better
classes in all the provinces, of course, understand and speak Castilian,—
with certain imperfections in pronunciation, such as in Andalusia, where th
is used in place of s, which gives a softness, but an indistinctness to the
language; but the lower classes, the persons met with in the ventas, and the
muleteers, often speak a dialect that is altogether unintelligible.
I was much pleased at the port of Tarragona, with the operation of
sorting the nuts, which form an important article of export. In one of the
principal warehouses I saw from two hundred to two hundred and fifty
girls, seated upon stools, at a table which extended the whole length of the
room; heaps of nuts lay upon the floor, and men were constantly filling
baskets with these and emptying them upon the table. The girls drew the
nuts towards them by handfuls, and distinguishing, as if by an instinctive
knowledge, the empty from the full nuts, they swept the good into a basket
between their knees, and the empty, they dropped into a basket at their feet.
Nothing can exceed the rapidity with which these operations are performed;
it is really a busy and an animated scene; the labour employs the hands
only, for it is by the touch the quality of the nut is distinguished; and the
mind being disengaged, the constant prattle and the frequent laughter, give
to the scene an appearance almost of a party of pleasure.
Tarragona is the chief exporting port of Catalunia. Its exports consist of
nuts, almonds, wines, and brandy. The nuts sent to the English market are
known by the name of Barcellona nuts; but they are neither grown near, nor
exported from Barcellona. They are grown more in the interior of the
province, and are all exported from Tarragona. The average export of nuts
from Tarragona is from twenty-five to thirty thousand bags. There are four
bags to a ton; and they were placed on board last autumn at 17s. 6d. per
bag. The whole of this export is for the English market. The export of
almonds is about twelve thousand bags. From five thousand to five
thousand five hundred pipes of wine are exported from Tarragona, to Rio
Janiero, the Brazils, Guernsey, and Jersey; and of brandy, about four
hundred pipes are exported, chiefly for Cette, and Cadiz, from which
places, it finds its way into the wine butts of Bourdeax and Xeres. Cork
wood, and cork bark, also form a small export from Tarragona.
I left Tarragona for Barcellona in a small carriage, something better than
a tartana, and two mules, which trotted all the way. The country is chiefly a
wine country; and the road winds among hills, covered in the lower parts
with vines, and higher up, with pine. Numerous villages, engaged in the
wine and brandy trade, are scattered along the shore, but all of these have
considerably suffered from the loss of the colonies. After passing Vendrill
we left the sea coast; and about three leagues from Barcellona, entered a
charming country, covered with romantic hills,—clothed with fir, and
embosoming numerous small and beautiful valleys; and emerging from
these, I found myself in the Huerta of Barcellona. The approach to
Barcellona is less striking than the approaches either to Murcia or Valencia;
nor does the city itself present so imposing an appearance; but the
commerce upon the road, greatly exceeded what I had seen in the
neighbourhood of any other city in Spain. I reached the gate before dusk,
and alighted at the Fonda de las quatros Naciones.
CHAPTER XXI.
—
BARCELLONA—JOURNEY TO THE FRONTIER.
General Character of Barcellona, and its Population; Paseos, Ramparts, and Fortifications;
the Conde de España; his Policy; Interview with the Conde; his Character and
Government; Anecdotes of his Government; Political Feeling in Barcellona; Churches
and Convents; the Opera; Monjuich; Barcellonetta; Decrease of Trade with England, and
its Causes; General Trade of Barcellona; an Execution; the Priesthood and the People; a
Miracle in 1827; Prices of Provisions; Visit to Montserrat; Journey from Barcellona to
the Frontier; Delightful Scenery; Proofs of Catalunian Industry; Gerona Figueras; the
Pyrenees, Reflexions.
A glance at Barcellona is sufficient to show, that we approach the frontier.
We no longer see a purely Spanish population. Spanish hats are scarcely to
be seen, nor is the mantilla altogether indispensible. In the buildings too, we
perceive a difference; the streets are wider, and few of the houses are
adorned with balconies. I thought too, but this might be fancy, that I could
perceive a different expression in the countenances of the people. Of one
thing I am certain, that although the women of Barcellona have not perhaps
the grace of the Andalusians; their claims to beauty are stronger: their
features are more regular, their complexions are clearer, their hair less
coarse, and their forms slighter: still it must be admitted, that there is more
witchery hid in the eye of an Andalusian, than perhaps in all the separate
charms of a woman of Barcellona. No one, however, can walk along the
streets, without perceiving in the female population, sufficient evidence of
being no longer among a people exclusively Spanish. I found another
peculiarity in the aspect of the Barcellona population—a peculiarity
however, that refers only to the time I visited Barcellona. No caps were to
be seen: these, as well as grey hats, were forbidden, immediately upon the
revolution breaking out in France. For my own part, I continued to wear my
grey hat while in Barcellona, without being challenged; but I have good
reason to believe, that this forbearance arose from the authorities knowing
that I had the honour of being acquainted with the Conde de España, the
ruler, and dictator of Catalunia. But the strange, and gaudy dress of the
Catalunian peasantry is the most striking peculiarity in the appearance of
the Barcellona population: all wear their red caps, which hang at least a foot
down their backs; and with their crimson girdles, and gaudy coloured
woollen plaids, they give a peculiar grotesqueness to the appearance of the
Rambla—the principal street of Barcellona—which is almost always
crowded.
Barcellona is particularly fortunate in its promenades; the Rambla is
scarcely inferior to the Boulevards of Paris; and there is a charming walk
round the whole of the ramparts; every moment the view changes,
sometimes looking towards the huerta, and sometimes towards the
mountains, with the villages, and country houses of the merchants lying
under them; sometimes towards the hill and fortress of Monjuich; and
sometimes towards the sea; and that part of the promenade which is above
the sea, is without exception, the finest promenade in any city I have ever
seen. Barcellona would be better without its fortifications; for owing to
them, the city has been confined within too narrow bounds; and the whole
space within the walls, is filled up with houses, in place of (as in other
Spanish cities) gardens mingling with the buildings, and adding both to the
beauty and the healthfulness of the place. The fortifications of Barcellona
are of little real use to it. I was informed by the commander of the citadel,
that the city could not maintain a siege of one week, against a sufficiently
well appointed army; nor could the occupation of it be maintained for one
day, if the citadel or Monjuich were in possession of an enemy.
The day after my arrival in Barcellona, I was presented to the Conde de
España, a man who has made himself to be respected by some, and feared
by all; owing to the promptness, decision, and tyranny of the measures by
which he has from time to time put down the most formidable insurrections;
and owing also to the influence which he has more than once shewn he has
the power of wielding, over the determinations, and the actions of the king.
No man has more enemies than the Conde de España, both at court, and in
the province which he governs; and constant attempts are made in the
highest quarters, to remove him from his government, and from the
confidence of his royal master. The Archbishop of Toledo is his bitterest
enemy, and has never forgotten the insult he put upon the dignitaries of the
church, in the year 1827; but the king knows that whatever his faults may
be, they are faults that prove him to be a zealous and faithful servant; and
the fittest man to govern the turbulent Catalunians; and when upon a late
occasion, the Duke del Infantado strongly urged upon the king, the
unpopularity of the Conde de España, and the propriety of removing him,
his majesty cut the matter short by saying, “I wish I had a Conde de España
in every province;” one of the most sensible things the king ever said, if he
wishes to preserve his authority.
The Conde de España is not very easy of access; he is seldom seen,
though his presence is always felt; his system of government is secret; and
in the province of Catalunia, it may be said to have come in place of the
inquisition,—with instruments as numerous and as masked, with power as
unanswerable, with measures as prompt, and sometimes as unjustifiable,
and with a bolder heart and a stronger head to direct the machine. It was a
mere chance whether I should be admitted to an audience: indeed, no one in
Barcellona knows, whether he be in the city or not. The parade takes place
before his residence, and the guards are mounted at his gate every morning,
but this is no proof that he is within. The Conde was at home however; and
the names of his Britannic Majesty’s Consul, and English gentleman, were
passed inward. We walked into an anti-room where a Spanish general, and
several other persons were waiting. How long they might have preceded us
I cannot tell, but in a few minutes, we were informed that the Conde would
see us; and we were conducted through a long suite of magnificent
apartments, and ushered by an aide-de-camp, into a little mean dirty
parlour, without a bit of matting to cover the brick floor, the walls white
washed, a wood fire almost burnt out, and the furniture consisting of one
small table, and two or three chairs. There sat the Conde de España, writing,
or, at least, signing his name to a number of papers. He immediately rose,
and received us with the utmost curtesy, made us sit down, and asked me
some particulars of my journey, and in what state I had found Spain. I told
him, what I really believed to be true, that Spain was at that time, the most
tranquil country in Europe; and that I had no where found the slightest
indication of commotion. This reply was no doubt gratifying: the Conde
ordered wine and segars, and the conservation took a more general turn. He
spoke of France, and said he considered it hastening towards republicanism.
He then spoke of himself, his conduct, and his enemies; and said, that as a
private individual, he always acted justly, and morally right; but as a public
man, he clothed himself with a garment of policy,—an ingenious, but not a
new apology for the commission of iniquity. I remained about a quarter of
an hour; and when I took leave, he did me the honour to offer me the
freedom of the royal box at the opera; and also to invite me to his country
seat, where he said he spent much of his time, for that to be respected, (he
meant feared) one must not be seen too often. The Conde appears to be
about fifty, he is rather under the middle size, and somewhat lusty; his head
and face are large, and his eyes expressive of much. One may read in them,
violent passions, penetration, reflection, and cunning.
The character of the Conde de España has been variously represented.
All admit, however, that he is a man of most determined and fearless
character; and that Catalunia, which, to be preserved in tranquillity in these
perilous times, requires to be ruled with a rod of iron, could not be entrusted
to any man better qualified to wield it. When he first took upon him the
government of the province, he committed many oppressive acts; some of
which I have related in the chapter entitled “State of Parties,” consisting, for
the most part, in banishment without trial; and even in some instances,
carried so far as secret execution. This was soon after the fall of the
constitution; and some apologists of the Conde excuse these proceedings
upon the plea of political necessity; an expression that, in my mind,
involves a sophism, because I do not believe that the moral government of
the universe can ever include in it a necessity for doing evil.
The government of the Conde de España has sanctioned many lesser acts
of inquisitorialness and oppression. Several despotic orders were issued
immediately upon the French revolution breaking out: ever since that time,
no greater number than four persons are permitted to dine together in a
coffee-house; nor are politics allowed to form the subject of conversation in
any house open to the public; and it is believed, that the Conde is not
entirely ignorant of the conversation that passes in many private houses
also. He has even had the boldness to interfere with the usages of the
church, by interdicting the celebration of the midnight mass in the
cathedral, at Christmas; probably, because he disliked the assemblage of so
great a number of persons during the night: but, of course, mass was
permitted to be celebrated in a more private way. The strictness of the
Conde extends also to morals: all houses of ill-fame are suppressed, and
instances occurred, even while I was in Barcellona, of inquisitorial
strictness in more private matters relating to morals. Dining one day in
company, one of the gentlemen at table received a message while at dinner,
which he immediately attended to, and withdrew; I saw a smile pass round
the table, and I afterwards learnt, that the occurrence was not unusual. The
gentleman had a liaison with a chére amie, who lived in lodgings provided
by him; but this the police would not permit; and, to escape their
interference, these lodgings were changed every few days; and every few
days he was questioned as to his secret, and obliged to pay a fine. This was
the act of the police; and, although the police is not within the department
of the Conde, who is captain-general, not civil governor of the province, yet
it is well known that both the military and civil government are in his
hands; and that the civil authorities do not move a step without his
permission. Along with this strict surveillance of morals, the Conde’s own
morals are irreproachable, and he neglects no opportunity of showing his
regard for religion; he is present at all its public ceremonials; and assumes
an air of the deepest devotion. This is doubtless to please the party of
Carlists, who might otherwise prove dangerous. But with all these
inquisitorial and tyrannical acts, even his enemies admit, that he is the only
man who could have kept Catalunia tranquil: and peaceable-minded
persons, however they may condemn the means by which the quiet of the
province has been preserved, are satisfied with a government under which
they feel a security against civil commotion.
It is a great mistake to suppose that the Conde de España is attached to
the apostolical party; quite the reverse: he is a decided, thorough-going
royalist, who will exert himself to the very uttermost for the preservation of
the king’s government; and come when it may, a revolution in favour of
either Carlists or liberal, the deadliest stand against it will be made in
Catalunia, if the Conde de España be then captain-general. But, that he is no
Carlist, is evident from his conduct in 1827, when he put that affront upon
the bishops, which I have already said has been one means of securing the
enmity of the Archbishop of Toledo. The circumstances are as follow:—In
the latter part of 1827, when the Catalunian insurrection in favour of the
Carlists took place, and when fifty thousand men in arms threatened the
province with anarchy, and Barcellona with capture, the Conde de España
represented to the king the necessity of his appearing in Catalunia; and after
his majesty had arrived, he, by advice of the Conde, called a convocation of
bishops, ostensibly to consult respecting the state of the province. The
Conde well knew the connexion of the bishops with the plot; and was in
possession of documents that proved their guilt. The Conde, as representing
his majesty in that province, or by express delegation, presided; and all the
bishops being assembled, he addressed them to this effect, if not almost in
these words:—“My Lord Bishop,” said he, taking a paper from his pocket,
and unfolding it, “you know this,”—and turning to another, and shewing
another paper,—“and you, my Lord, know this,” and so on, producing
documents that connected every one present with the conspiracy; “and now,
gentlemen,” said he, addressing the assembly, “you perceive that I hold in
my hands proofs of treason; you who have fomented this rebellion, can put
it down; and I have instructions from his majesty, if the rebellion be not put
down within forty-eight hours,—I am sorry for the alternative, gentlemen,
—but my instructions are peremptory, to hang every one of you; and it will
be a consolation for you to know, that the interests of the church shall not
suffer, for the king has already named successors to the vacant sees.” This
reasoning was effectual; the bishops knew the man they had to deal with;
and within forty-eight hours, the insurrection was at an end. A man who
threatens to hang a bench of bishops, cannot surely be called an apostolical.
At the same period, but before the council had been called, when Gerona
was closely pressed by the insurgents, the bishop dispatched a letter to the
Conde de España, saying, that it would be necessary to give up the city to
the besiegers. The Conde, who very well knew how the inclinations of the
bishop lay, and what were the defences of the city, but who also knew the
influence possessed by him over the inhabitants, who might force the troops
to give it up, wrote, in reply to the bishop, that his lordship being upon the
spot, was no doubt best able to judge of the state of the city; and adding,
that along with the letter which he had sent to the bishop, he had also sent
instructions to Gerona, that when the enemy entered the gate, the first thing
they should see, might be the gibbet of a traitor bishop.
It is generally understood that, but for the Conde de España, the French
army would not have evacuated Spain; and that the king was brought down
to Catalunia with this ultimate object. When the Conde was made captain-
general, he refused to reside in Barcellona, because it was in possession of
the French, and he established himself at Tarragona. He then advised the
king to pay a visit to Barcellona, and obtained permission to write to the
French authorities there to prepare for his majesty’s reception. To this the
French general replied, that he would receive the king, but not any guards;
and the Conde, who knew that such would be the reply, told the king that he
was insulted; the king got angry, and refused to go to Barcellona, and even
left Catalunia. The French general now suspected he had committed an
error, and he sent for instructions; an ambassador was despatched in
consequence to the king, who was then at Valencia, requesting to know
what were his majesty’s wishes. The Conde de España had been busily
employed in the meanwhile, priming Ferdinand to act with spirit; and when
the king was asked what his wishes were, he replied that he wished the
French army to evacuate Spain. The only pretext for the occupation of
Spain, was to defend the king; and the king declaring that he wanted no
defence, this pretext was at an end.
The Conde de España is of French extraction, but at an early age he
entered into the service of Spain, and by his talents and zeal, he has raised
himself to the highest honour that could have been conferred upon him,—in
having received for his title the name of the country that conferred it. The
count dislikes, or affects to dislike, every thing French, and likes, or affects
to like, every thing English. He speaks English fluently, and few things are
more disagreeable to him than to be addressed in the French language.
With respect to political feeling in Barcellona, I may say that, among the
upper ranks, there is a secret wish for some change,—for a milder
government, less tyranny, and a free press; but there is no feeling in favour
of what is called a constitution. At the time the French revolution broke out,
there was naturally much excitement in Barcellona; but I found the
universal opinion of the best informed classes to be, that the state of moral
and political feeling among the Catalunians must prevent the progress of
any movement in the province; and that no attempt in favour of greater
liberalism has the smallest probability of success on that side of Spain,
unless by foreign interference. When I was in Barcellona, there were many
Carlists prisoners in the city; and before I left it thirty prisoners were
brought from Zaragosa. It was generally thought that if the Conde de
España had a carte blanche as to the disposal of them, many ran a risk of
visiting Ceuta.
The public buildings of Barcellona are not deserving of much notice,
with the exception of the custom-house and the cathedral. The cathedral is
light and beautiful, in the late Gothic stile, with finely painted windows, and
a choir of wood workmanship of singular delicacy. The convents, with the
exception of the Dominicans, are without any attraction. In that convent
there were formerly some curious records in the cloisters, of the heretics
who had been burnt, from the year 1489 to the year 1726; but these the
monks have thought proper to remove. I saw nothing in the convent to
attract attention, excepting a picture of a certain saint who came from
Majorca to Barcellona in six hours, with no other boat than his cloak. Great
part of this convent was destroyed in the war of independence; and the
monks are now erecting a large and handsome building for the reception of
their library. The only other religious edifice worth a visit, is the church of
the Jesuits, which is remarkable for the beauty of its marbles.
The opera house is also a respectable building, and the interior is large
and handsome. I several times availed myself of the entreé to the royal box,
presented to me by the Conde de España. The Conde is never seen in it; but
it is always lighted in the interior, by elegant candelabras, and centinels
stand at the door, as if ready for the reception of royalty, or its
representative. The opera of Barcellona enjoys a considerable reputation
among the European operas; and the inhabitants are passionately attached to
it: but last year, it was considered below its usual strength. The whole of the
boxes in the house, with the exception of five, are private boxes; and cost
50l., 55l., and 60l., according to their situation, for the season. This
impresses one with no mean idea of the inhabitants of a provincial city, who
can afford to rent the whole of the boxes in a large opera house, at so
considerable a price. Single places too, in what is called the lunetta—a row
of seats all round the front, and a little beneath the level of the boxes, are
taken by the season; and it is rarely that one of these remains unlet after its
commencement. These places cost fifty dollars, and many of the best seats
in the pit, are also let for the season, at forty dollars. The first bass is paid
the sum of two thousand five hundred dollars for the season, the first tenor
three thousand dollars, the principal female singer two thousand four
hundred dollars, the second two thousand dollars; and a benefit is worth
eight or nine hundred dollars; for, upon these occasions, besides the free
places, presents are made by proprietors of boxes.
While at Barcellona, I walked one morning to the hill and fortress of
Monjuich, accompanied by Colonel Barry, then commandant of the citadel.
I believe that if sufficiently provisioned, the fortress is considered to be
impregnable. There are about two hundred brass cannon mounted, and an
immense number of unmounted guns, and a large garrison. In descending
the hill, and making a circuit towards the sea, some large stones with
Hebrew characters upon them, were pointed out to me; but the inscriptions
are now illegible. It is believed that this was the burying place of the Jews,
and the name Monjuich seems to favour the supposition.
From Monjuich, after walking through the citadel, which is even a more
perfect fortification than the other, though by situation, less strong, I
continued my walk to Barcellonetta, the port of the city: the buildings are
modern, and ugly; all built upon the same plan, and all constructed of red
brick. A massive breakwater defends the entrance of the harbour to the
south; it is already four hundred yards in length, and four hundred yards
more are to be added to it. It is forty feet broad, and thirty feet high. There
were few vessels of any size in the harbour, excepting two Spanish sloops
of war, and a few foreign brigs. The foreign trade of Barcellona is reduced
almost to nothing; particularly the trade with England. About thirty years
ago, seven hundred British vessels entered the port in one year. Since then,
the number has rapidly decreased. In the year 1825, fifty-three British
vessels entered the port, and in the year 1830, only eleven. This decrease in
the trade with England, is owing to several special causes. One of these, is
the non-importation of English hardware, which used formerly to supply
almost exclusively, the Spanish markets. This trade has changed its
direction; and in place of hardware of British manufacture, it is now the
manufacture of Germany that is used: they say it is much cheaper, and
nearly equal in quality. Another cause of the decline of commerce between
England and Barcellona, is a change in the direction of the fish trade. The
Swedish and Norwegian fish are now preferred by the retail dealers,
because, when steeped, they imbibe water, which the cod of Newfoundland
do not; and, as they are sold by weight, the dealer finds his profit in this
preference. Besides this preference, which has deprived England of an
important branch of trade, the fish trade of Barcellona has suffered a
general decline ever since the year 1826. At that time, a house in Madrid
(Shea) obtained a monopoly of this trade in the Catalunian ports; and
immediately, with a short-sighted policy, additional duties were laid on.
From that time, the general import declined; and, although the duties have
since been lightened, the trade has not revived; because, when fish was
scarce and dear, the convents, where it is chiefly consumed, made use of
vegetables in its stead, and have now become accustomed to this change in
diet. Still another branch of trade which is lost to the commerce of England,
is cotton. The Catalunians have discovered that it is cheaper to import
cotton direct from Pernambuco, than to take it by way of England.
All these are changes in the direction of the commerce of Barcellona,
operating upon the trade with England; but, some of them not affecting the
extent of Barcellona commerce; nor, with the exception of cotton,
connected with its export trade. But the export trade of Barcellona has
almost entirely ceased. This, which consisted in silk and cotton
manufactured goods for the Spanish colonies, is now at an end, with the
exception of the small quantity still sent to the Havannah; and the export of
shoes also, which employed in their manufacture at Barcellona, before the
loss of the colonies, upwards of two thousand hands, has also entirely
ceased.
I had an opportunity, while at Barcellona, of being present at an
execution—the first I had seen in Spain. The man had been condemned to
the galleys for some previous offence, and had murdered one of his fellow-
convicts; and, although this is not an agreeable spectacle, yet, as in every
country, public spectacles, whether agreeable or the reverse, exhibit some
peculiarities either of character or of manners, I resolved to be present.
Three o’clock was the hour appointed; and all that morning, as well as great
part of the day before, there was an unceasing noise of little bells, carried
through the streets by boys in scarlet cloaks, with the bell in one hand, and a
box in the other, collecting alms to purchase masses in the different
convents and churches, for the soul of the felon. There is another thing
worth relating, connected with the last days of a felon in Spain. A society,
called the Benevolent Society, undertakes to soften the last three days of his
existence, and to diminish the terrors of death, by the singular device of
increasing the pleasure of life. During these three days, he may have every
luxury he desires; he may feast upon the daintiest viands, drink the choicest
wines; and thus learn, in quitting the world, new reasons for desiring to
remain in it.
I obtained a good situation, close to the military who guarded the
ground. Besides the platform, there was erected, at a little distance, an altar,
upon which was placed an image of the Virgin and Child; and opposite to
this, a cross, with an image of Christ extended upon it. I was much struck
with the procession; the unfortunate felon was accompanied by upwards of
two thousand masked penitents, who looked more like a train of devils than
human beings; a black cloak entirely enveloped the body and the head,
holes only being left for the eyes and mouth; a black pyramidical cap, at
least eighteen inches high, crowned the head; and each carried in his hand a
long white wand. This strange escort was the result of an indulgence
published, and addressed to all persons conscious of secret crimes, and
penitent; granting its benefits to such of them as submitted to the
humiliation of accompanying the felon to the scaffold. Two accomplices of
the felon also accompanied him, that they might benefit by seeing him
hanged; and a friar of the Franciscan order, was his spiritual guide.
After having been led to the altar, and then below the cross, where he
repeated a number of prayers, he ascended the platform attended by the
friar, who carried a large cross in his hand. When the offices of religion
were concluded, the man wished to address the people, and twice began
“Mis Hermanos,” but his voice was instantly drowned by shouts from a
crowd at some distance behind the platform, no doubt so instructed; and
when he found that he could not be heard, he gave the signal, and the
executioner immediately leapt upon his shoulders, and swung off the
platform; while the friar continued to speak, and extend the cross towards
him, long after he was insensible to its consolations. The spectacle
concluded by the friar ascending to the summit of the ladder, and delivering
a sermon, in which he did not omit the exhortation of contributing largely
towards masses for the soul of the deceased. The exhortation was not
without its effect; the little bells immediately began to ring, and hundreds
obeyed the invitation to piety.
Barcellona has always been celebrated for the zeal of its priesthood, and
for the pains taken by them to hoodwink the people; and even in these days,
religious bigotry is far more prevailing than might be expected in a city so
near the frontier; and which has had so much connexion with foreign
nations. In another chapter, I related a circumstance that occurred eight
years ago, when a peasant was condemned to ten years imprisonment in the
citadel, because he said unthinkingly, that an image of some virgin was
made of wood; and so late as the year 1827, another very flagrant example
of religious superstition, and of the use made of it even in these days by the
clergy, occurred at Barcellona. There was in one of the churches, or
convents, an image of a Virgin, called I believe, the Virgin of St. Pilar, and
this image was black. It was at this time, that an outcry had been raised
against the liberals, who were called Negroes; (negro is the Spanish for
black) and the rumour got abroad, that the negroes went to this church, to
pay adoration to the Black Virgin. Such being the case, the priests and friars
ventured upon and concerted a miracle which might have the double effect
of strengthening the faith of the people, and of bringing the negroes into
still greater discredit. One morning it was publicly announced, that the
Virgin of St. Pilar, had changed from black to white; and the good Catholics
of Barcellona were invited to go and see the miracle with their own eyes;
and they went by thousands. Let it not be forgotten that this happened only
three years ago.
I have to add to these notices of Barcellona and its inhabitants, the price
of provisions. Beef sells at thirty-two quartos per pound, of thirty-six
ounces. Mutton, thirty-five quartos; scarcely cheaper than in England. Pork,
twenty quartos per pound of sixteen ounces; a good fowl costs twelve reals;
and a pair of chickens the same—both as dear as in England. A turkey,
thirty-two to forty reals. The best bread, seven quartos (2d.) per pound. The
wages of artizans are, in general, 2s. 6d. per day; and field labour about
1½d., without including victuals.
Before finally quitting Barcellona, I resolved to pay a visit to Monserrat,
—a place that has derived remarkable notoriety from the singularity of its
situation. I accordingly left Barcellona at the early hour of four, in a galera,
which passed within half a league of the foot of the mountain. The country
between Barcellona and Martorrel is the same as I have described on my
journey from Tarragona; and from Martorrel to the foot of Monserrat, the
land is divided between corn and wine; it is every where populous, and
every where exhibits proofs of Catalunian industry. The approach to
Monserrat from this side, is not remarkably striking, owing to the elongated
form of the mountain; but as we approach nearer, its height, and singular
conformation, become sufficiently imposing. After quitting the galera, I
walked to the small village that lies at the foot of the mountain; and having
got some chocolate, and a guide, I began the ascent. A zig-zag path, of not
less than a league and a half, leads up the mountain to the convent, which is
not seen until at an abrupt turn it is discovered lying on a platform, in a
recess of the rocks which rise in perpendicular cliffs directly behind it. The
view from this platform is wild and imposing; towards the north, a long line
of snowy summits marks the Pyrennean boundary of the Peninsula; towards
Barcellona, the Mediterranean is seen beyond the rich and diversified
country that lies between the mountains and the sea; while the mountain
itself,—its lower part encircled by a belt of wood,—its grotesque range of
rocky peaks above, and its convent, and hermitages, are not the least
striking features of the landscape. In the interior of the convent I saw little
deserving of notice; the occupation of it by the French, and other causes,
have left it nearly a ruin; but its ruins shew its former extent. The
architecture of the building is mixed; part of it is Gothic; while later parts
were built in the time of Julius II., and of Philip III. There were formerly
seventy monks in the convent; but now, it is inhabited by thirty only. I saw
in the refectory, a pilgrim who had come all the way from St. Jago in the
Asturias, and who was going to Rome. By the rules of the convent, a
pilgrim is fed three days within it. He was a man past the middle age, and
was rather reserved in his communications; not appearing willing to tell any
more than where he had come from, and whither he was going. His habit
was covered with scallops and little images.
Monserrat is not the interesting spot it was formerly. The numerous
hermitages were then tenanted, and the convent possessed many curious
and valuable things; but the French carried away the latter, and destroyed
the former; and now, Monserrat is worthy of a visit only on account of its
situation, the view enjoyed from it, and the singularity of its aspect and
conformation. The mountain is said to be four thousand feet high; and the
platform of the convent is two thousand five hundred feet above the
Mediterranean; the lower parts are treeless, with the exception of a few
scattered and stunted ilex; but its acclivities are covered with a thick carpet
of box, juniper, rosemary, and a thousand fragrant shrubs.
I returned to the inn about dusk, and found the accommodation so bad,
that I regretted I had not accepted the letter offered by the Conde de España,
to the abbot; but I did not, at that time, purpose visiting Monserrat; and
perhaps a dormitory in the convent might have been as comfortless as the
quarto in the venta. Next morning, at day-break, I left the village on
muleback, and arrived in Barcellona in sufficient time to make one at the
hospitable board of Mr. Annesley, nephew of Earl Annesley, and his
Britannic Majesty’s consul at Barcellona, whose many kindnesses,
gentlemanly attentions, and unwearied hospitality, I eagerly and gratefully
acknowledge.
My journey in Spain now approached its conclusion,—I had only to
travel from Barcellona to the frontier; and as the general aspect of the
country could be seen as well by rapid as by slow travelling, I resolved to
take advantage of the public conveyance, and left Barcellona by the
Diligence, for Perpignan, some hours before day-break. The year had
already expired, but winter had scarcely made itself felt. The mornings and
evenings, indeed, had been chilly enough to turn one’s thoughts towards the
comforts of a fire; and once or twice at Barcellona, when I walked round
the ramparts before breakfast, I observed a thin covering of ice upon the
pools; but there had been no rains,—the days were clear and sun-shining;
and one might liken the season to a dry month of March in England,—only
with fewer clouds.
It is scarcely possible to conceive a more beautiful drive than between
Barcellona and Gerona. The road keeps near to the sea all the way, and an
enchanting country lies on the left. You pass through a succession of little
plains, each from half a mile to three miles across, and each containing a
village. These plains lie in little recesses of the mountains, which screen
them behind, and separate them from each other, leaving one side open to
the sea. They are covered with the finest vegetation, which advances within
twenty yards of the sea, and are generally skirted by a hedge of aloes, that
runs all along the coast. Between these plains the hills run forward into the
sea, generally terminating in perpendicular cliffs; and the road, after
traversing the green level, approaches close to the sea, and is carried along
the front of the precipice, till having passed the barrier, it then descends into
another of these little smiling recesses. These plains were covered with
beautiful and promising crops when I passed through them; and round the
villages, beds of every kind of vegetable,—cauliflower, cabbage, carrot,
onion, and pease, shewed excellent crops, all ready for the kitchen. Every
house, the centre of its own little farm, has a draw-well in its
neighbourhood, from which the land is supplied. Some of these villages
were singularly beautiful, particularly Cardetta, hanging upon some heights
above the sea, with its little fertile plain,—all that the mountains would
allow to it,—lying at its feet. These heights were entirely covered with the
prickly pear, the last I saw; and near that village I also saw the last palm
tree; but it was of stunted growth, not the stately and branchy palm of
Elche.
The difference between the villages and cottages of Catalunia, and of the
other provinces of Spain, is seen at a glance; and in the state of the
inhabitants, the difference is equally striking. The houses and cottages have
an air of greater neatness and comfort,—there is glass in the windows, and
the insides display the articles of furniture in common use. No beggars, and
fewer ragged people are seen,—industry is evidently active,—stones are
removed from the ground, and collected in heaps,—fences are more
general, and more neatly constructed,—nobody is seen basking in the sun,
—even the women and girls who are tending the cattle, are not sitting idly
wrapped up in plaids, but every one has her spindle in her hand. In short
there is altogether a new order of things.
We breakfasted at Mataro, a considerable and once a flourishing sea-
port, famous for the excellence of its wine; and, till lately, famous for its
linens and laces, which were exported to the colonies; and about mid-day
we left the sea-coast, and entered the mountains. New and charming scenes
awaited us in passing through these mountains to Gerona. Covered with
stately pine, their sides were also clothed with the richest underwood of
evergreens, flowering shrubs, and fragrant plants; among which the
beautiful arbutus was particularly distinguished. After emerging from the
mountains, we entered the fertile and sheltered valley of Gerona, where we
arrived about sunset. This was once a place of importance, now chiefly
attested in the number of its religious edifices, for here there are no fewer
than thirteen churches, besides the cathedral and eleven convents. The
bishopric is richer than that of Barcellona. At Gerona we supped, and slept,
and set out next morning about day-break.
Between Gerona and Figueras, I saw nothing that deserves to be
recorded, excepting the change in temperature; a bitter wind blew off the
Pyrennees, and reminded me that I had left the regions of the south behind;
and when we reached Figueras I hailed a blazing fire upon the hearth, with
the satisfaction of a northern traveller. The fuel here, attracted my notice; it
was a thin dark cake, which, upon inquiry, I found to be the refuse of the
olive, after it is pressed, and which, I have no doubt, might be given with
advantage to the cattle. I learned, however, that it is not put to this purpose,
though it is given to pigs and poultry. The price of this cake is sixteen reals
(3s. 4d.) the 100 lb. It is singular, that at this town, so near the frontier, the
inn should still be in all respects, the Spanish posada: it is just as little
French as the posada of Murcia or Andalusia: the fire still blazes in the
middle of the floor; coffee and tea are still unattainable; and meat is to be
found not in the inn, but in the market: how numerous and expressive must
be the shrugs of the Frenchman who makes Figueras his first halting place.
Caffé au lait, or coutelettes, are alike out of the question.
From Figueras to Junquera, the last town in Spain, I passed through a
pleasant undulating country, and then entered the valley that lies under the
Pyrenees,—a valley not fertile, but picturesque, traversed by a small
mountain stream, covered with the olive and the cork tree, and winding into
the recesses of the mighty barrier that shuts out the Peninsula from the rest
of the world. Rising above the valley, I found myself inclosed among the
mountains, and leaving Spain behind; I had left the carriage, to walk up the
steep ascent; and soon, Bellegarde, upon the summit of the pass, and the
pillars that mark the boundary of the kingdoms, appeared in sight. The
valley behind was still visible through the defile; and as I turned round to
look upon Spain for the last time, a thousand recollections and vague
fancies crowded upon my mind. I felt a sensation something like pride, in
having traversed Spain. Much I had seen to interest, much to delight, much
to lament, much to remember; and as I turned away, regret was not
unmingled with my other feelings. As I pursued my way up the mountains,
that had now shut out the view of the valleys below, Spain, as fancy had
once pictured it—and Spain, as I had seen it, rose successively to my
memory. But it pleased me to discover, that romance had outlived reality, or
was mingled with it; for the fragrant, and palmy valleys of Spain, still lay
among the regions of fiction; Seville retained in my mind, its character of a
fabled city; the Sierra Morena was yet traversed by the knight of La
Mancha; and Spain, with all its realities before me, was still the land of
romance.
THE END.
Printed by S. Manning and Co., London house-yard, St. Paul’s.
FOOTNOTES:
[A] Since this was put to press, Sir George Don has been recalled.
[B] Some account of this enterprise seems to be a natural digression; and as the
fullest account of the rash attempt which led to the abandonment of the enterprise, is
to be found in the work of M. Bourgoing, I make no apology for transferring it to
these pages. “The court of Spain, weary of the fruitless blockade of Gibraltar, which
excited the ridicule of all Europe, and of the besieged themselves, seriously
determined to take this fortress by some extraordinary expedient or other, against
which its steepness, its formidable artillery, and all the skill of General Elliot should
prove unavailing. Plans poured in from all quarters; some bold to extravagance,
others so whimsical, that it was scarcely possible to look upon them as serious.
Several of this kind I received myself. One of those sent to ministers, formally
proposed to throw up, in front of the lines of St. Roch, a prodigious mount, higher
than Gibraltar, which would consequently deprive that fortress of its principal means
of defence. The author had calculated the quantity of cubic fathoms of earth, the
number of hands, and the time that would be required by this enormous undertaking,
and proved that it would be less expensive, and less destructive than the prolongation
of the siege upon the plan on which it had been begun.
“Another proposed to fill the bombs with a substance so strongly mephitic, that on
bursting in the fortress, they would either put to flight, or poison the besieged with
their exhalations.
“The plan of D’Arçon was at length presented, and engaged the more serious
attention of the Spanish government.
“This plan, first projected at a distance from Gibraltar, by that engineer, who,
notwithstanding the issue of that famous siege, still enjoyed the reputation of a man
of great talents, was afterwards matured and modified by him within sight of the
fortress. But how many crosses was he doomed to experience! * * * * * * * *
Scarcely any thing is known respecting it, except what relates to the ten floating
batteries, which, on the 13th of September, 1782, foolishly exposed themselves to the
fire of Gibraltar, and were reduced to ashes by the red-hot shot from the English
batteries. This method of summing up the result of enterprises, is very convenient for
indolence or malignity, but would furnish history with very erroneous elements.
Enlightened by contemporary historians, her pages will inform posterity, that if this
great undertaking failed, it was from a concurrence of circumstances which the genius
of D’Arçon could not possibly control. One of the principal was, the hurry with
which the plan was put in execution, before all the necessary preparations had been
made for ensuring its success. It is well known that the ten batteries had been so
constructed as to present to the fire of the fortress, one side covered with blinds three
feet thick, and kept continually wet by a very ingenious contrivance. The red-hot balls
were thus expected to be extinguished on the spot where they penetrated; but this first
measure proved incomplete. The awkwardness of the caulkers prevented the working
of the pumps, which were designed to keep up the humidity. It succeeded only on
board one of them, the Talla-Piedra, and that very imperfectly. But this was not all;
though the place where they were to take their stations had been but very slightly
sounded, they had received instructions what course they were to pursue, in order to
avoid striking, and to place themselves at a proper distance. This precaution likewise
proved unavailing. Don Ventura Moreno, a brave seaman, but incapable of executing
a plan, stung to the quick by a letter sent him in the evening of the 12th of September,
by General Crillon, which contained this expression: ‘If you do not make an attack,
you are a man without honour;’ hastened the departure of the batteries, and placed
them in an order contrary to the plan which had been adopted. In consequence of this
mistake, no more than two could sustain themselves at the concerted distance of two
hundred fathoms. These were, the Pastora, commanded by Moreno himself, and the
Talla-Piedra, on board of which, were the Prince of Nassau, and D’Arçon: but they
were exposed to the fire of the most formidable battery; that of the Royal Bastion,
instead of all ten being drawn up around the old mole, and receiving only sidewise
the fire of that battery.
“The only two batteries which occupied this dangerous post made great havoc,
and sustained dreadful loss. The Talla-Piedra received a fatal shot. In spite of all
precautions, a red-hot ball penetrated to the dry part of the vessel: its effect was slow.
The Talla-Piedra had opened her fire about ten in the morning; the ball struck her
three and five. The mischief did not appear irremediable till midnight. The San Juan,
one of her next neighbours, shared the same fate. It appears certain that the eight
others remained untouched.
“But what was still more distressing, every thing was wanting at once: cables to
tow off the batteries in place of accident, and boats to receive the wounded. The
attack was to have been supported by ten ships, and upwards of sixty gun-boats.
Neither boats, gun-boats, nor ships, made their appearance.
“Lastly, according to the projected position, the gun-boats were to have been
seconded by the one hundred and eighty pieces of cannon at the lines of St. Roch.
This co-operation was rendered impracticable. Near four hundred pieces of artillery
were to have opened at once upon North Bastion, Montagu Bastion, and Orange
Bastion. With a superiority of nearly three hundred pieces, D’Arçon flattered himself
that he should be able to silence the artillery of the fortress. What was his
consternation when he found that the besiegers had no more than sixty or seventy
pieces, to oppose to more than two hundred and eighty belonging to the besieged.
“The combined squadron remained quiet spectators of this tremendous scene:
Guichen, who commanded the French ships, sent to offer assistance to Moreno; who
replied that he had no occasion for any.
“Matters continued to grow worse; and no remedy could be devised. Eight of the
batteries were at too great a distance to do or to sustain much injury. The two others
bore in their bosoms the elements of destruction. Moreno, despairing of being able to
save any of them, and resolving that they should not fall into the hands of the English,
directed that those which were already in flames should be suffered to burn, and that
all the others should be set on fire. I have seen the original order to this effect. Such
was the result of that day, on which were annihilated ten vessels—the masterpieces of
human ingenuity—the building of which cost three millions of livres, and whose
artillery, anchors, cables, rigging, &c., amounted to two millions and a half more.
“D’Arçon, in the first moment of his consternation, acknowledged that he alone
was to blame for the fatal issue of the day. I had for a considerable time in my
possession the original of the short, but emphatic letter, which he wrote to Montmorin
the ambassador, from the very shore of Algesiras, amid the dying sound of the
artillery, and by the light of the burning batteries. It was as follows: “I have burned
the Temple of Ephesus; every thing is lost, and through my fault. What comforts me
under my misfortune is, that the glory of the two kings remains untarnished.” But on
recovering from the shock, D’Arçon wrote a learned memoir, in which he took great
pains to modify the confession which had escaped him; and to prove that he had more
than one partner; or rather that circumstances, the most untoward and imperious,
constituted his only fault.
“Scarcely had Gibraltar foiled beneath its walls, this formidable attempt, when in
sight of our armies and our squadron, the place was re-victualled by Admiral Howe,
who afterwards, with his thirty-six ships, boldly entered the Mediterranean. He was
seen from Buena Vista passing from one sea to the other; every spectator supposed
that he was running into the jaws of destruction. The fifty-two ships which were in
the bay, weighed anchor, and pursued him; but Howe baffled our endeavours, as
fortune had done our plans; and returned through the Streights in the same security as
he had entered them.” Such is the account given by M. Bourgoing. He had access to
know the facts, and they are probably correct; but there is, evidently, a French polish
over the whole detail.
[C] The existence of this gateway, and the story connected with it, are perhaps
known to few, but were identified in the researches made to verify this history. The
gateway is at the bottom of a great tower, at some distance from the main body of the
Alhambra. The tower had been rent and ruined by gunpowder, at the time when the
fortress was evacuated by the French. Great masses lie around, half covered by vines
and fig trees.—Chronicle of the Conquest of Granada.
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  • 8. 1 Manual of Simulation in Healthcare SECOND EDITION Edited by Richard H. Riley School of Medicine and Pharmacology, University of Western Australia and Department of Anaesthesia and Pain Medicine Royal Perth Hospital, Australia
  • 9. 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 2016 The moral rights of the author have been asserted First Edition published in 2008 Second Edition published in 2016 Impression: 1 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 2015944564 ISBN 978–0–19–871762–1 Printed in Great Britain by Clays Ltd, St Ives plc Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work.
  • 10. Foreword to the first edition There is a long history of using simple devices to simulate the real experience in healthcare education. A simple example would be teaching students to handle needles and sutures using a pig’s foot or a piece of simulated skin. A more complex example is the use of the famous Resusci Anne™ to teach a partial task such as chest compressions associated with positive-pressure ventilation. The development of sophisticated, instrumented, manne- quins coupled with computerized physiology and pharmacology programmes began a new era in healthcare simulation. These new mannequins had the ability to react to student interventions in a realistic and automatic manner not requiring instructor intervention. The mannequins were originally developed and popularized within the field of anaesthe- siology. It was quickly realized that not only could these mannequins be used to simulate an anaesthetist’s interaction with a patient but also that they can be used for team-building situations leading to the development of ‘crisis resource management’. In the short period of the past two decades, the use of mannequins to create simulated experiences has been adopted by diverse healthcare providers including nursing, various medical subspecialties, and other allied health providers. Healthcare educational institutions around the world are recognizing the need for pro- viding their students with simulated experiences not only to enhance the educational ex- perience but also to improve on patient safety. When embarking on the development of a simulation centre, some of the questions inevitably asked are: ◆ How large should the centre be? ◆ What types of rooms do I need in a simulation centre? ◆ How will I run the centre? ◆ What equipment should I buy? ◆ Who will the users be? Dr Riley has chosen contributors for this book who have the experience necessary to answer these questions. Section one provides simulation centre logistics, section two discusses the various equipment available, and section four addresses the needs of the dif- ferent subspecialties. For me, the most important section of this book is section three—Education Compo- nents. A machine is simply a machine unless it is integrated into the learning environment using sound educational principles. The question concerning educational integration of the simulation modalities is often left off the initial list when planning a simulation
  • 11. Foreword to the first edition vi programme. Dr Riley needs to be congratulated for devoting a large section of this book to education; education is the pivotal element in determining a centre’s success. 2008 David H Wilks MD Professor and Chair Department of Anesthesiology West Virginia University School of Medicine
  • 12. Foreword to the second edition Confucius made the case for the utility of simulation and debriefing some 2,500 years ago by observing that real experience, however profound in nature, was always tinged with risk or potential harm. He suggested that rehearsing or imitating practice was perhaps a sen- sible and pragmatic way to mitigate some of this experiential risk. Perhaps even more im- portantly Confucius also highlighted that without meaningful reflection all activity runs the risk of being meaningless . . . So from across antiquity Confucius offers wisdom as to the potential utility of simulation in professional education. His analysis of wisdom would appear to support the fundamental importance of ex- periential learning; he makes a clear case for emulation and rehearsal and highlights the utility of debriefing and reflective practice. All of these concepts are basic tenets of adult and humanistic learning and deeply enshrined in contemporary thinking in simulation- based education. It would appear, therefore, that the concepts underpinning the value of simulation are nothing new! In modern times simulation has become established as a major educational modality in healthcare education. Over the last decade simulation has moved from being an emergent and disruptive educational innovation into a mainstream element of most healthcare cur- ricula. This renaissance has been fuelled in part by the enthusiasm, evangelism, and pas- sion of many of the early adopters and advocates of simulation. Organizations have also been keen to demonstrate their innovative credentials by boarding the innovation band- wagon. Many such initiatives or programmes have brought about a stepwise improvement and transformation of healthcare education. Not all strategies, however, have been so successful. It is therefore timely and apposite that Richard Riley and colleagues have taken the op- portunity afforded by a second edition to bring their original and trusted text up to date. This edition brings current advances in contemporary simulation practice and thinking into one place. Effective simulation-based education is a complex and challenging field of educational practice. It is a wide family of educational techniques and technologies, contexts, and ap- plications with many distinct forms, opportunities, and challenges. These are explored and considered in detail throughout the new edition. This second edition offers many hard won insights, experiences, and learning from an international cadre of simulation experts. They share learning from their successes but with a commendable degree of openness and humility; they offer their cautions and mis- takes so providing the reader with the unique opportunity to learn from their wisdom and experience.
  • 13. Foreword to the second edition viii This book provides a generous offering of innovative and thoughtful insights from many leaders in the field of simulation in healthcare. Further this manual reflects that simulation in healthcare shows all the characteristics of a maturing field of academic practice, the ini- tial evangelism, and enthusiasm replaced by principle and concept, construct, and utility. The emerging criticality, collegiality, and community reflected in this new edition sug- gest to me that simulation has now come of age as an academic discipline. I expect that this book will find a prominent home in the offices and centres of those engaged in high quality, simulation-based education. Confucius could only wonder at the technology available today but in many ways I sus- pect he would immediately recognize and approve of the current application and utility of simulation in healthcare. 2015 Ian Curran Professor of Innovation and Excellence in Healthcare Education Queen Mary University of London
  • 14. Preface to the first edition The idea for this manual came to me during the inaugural Simulation and Skills Training Special Interest Group of the Australian and New Zealand College of Anaesthetists held in Perth, September 2000. At that time the chief references for those of us who had entered the world of medical simulation were David Gaba’s book Crisis Management in Anesthesi- ology and his chapter in Miller’s textbook of Anesthesia. Learning how to use the commer- cially available medical simulators was achieved through attendance at Dr Gaba’s ACRM Instructor’s Course at Stanford and old-fashioned on-the-job practice. Subsequent discus- sions with colleagues in this growing field made it apparent that many of us were strug- gling with common problems but that there were some very creative solutions. However, the process of mustering these collective talents and experiences was quickly subdued by the pressures of teaching and administration in a new simulation centre. My association with local and international simulation meetings not only enriched my knowledge of simulation in healthcare but also brought me into contact with many lead- ers in simulation. I am deeply grateful that many of these simulation leaders have kindly shared their expertise with us. Thanks must also go to hospital and organizational ad- ministrators and heads of departments who have supported the simulation community. I thank those who have mentored and inspired me: David Wilks, Myroslav Klain, Peter Winter, and Peter Safar. I also would like to thank Sara Chare, Clare Caruana, Eloise Moir- Ford, Anna Winstanley, Catherine Barnes, Georgia Pinteau, Kelly Hewinson, Kate Wan- wimolruk, and the team from Oxford University Press who kept me on track. Finally, I wish to express thanks to my wife Vera who has been my support and strength through the simulation journey. 2008 Richard H Riley Perth, Western Australia
  • 16. Preface to the second edition The response to the publication of the first edition of this manual has been gratifying. It has been more than enough reward to know that many have found it to be helpful as they seek to enhance their healthcare programmes with simulation-based education. For this edition, I had the sad task of replacing some sub-specialty areas with combined chapters and new topics. The advent of web-based storage has allowed us to supplement these pa- perback and digital editions with additional resources that are in current use at various simulation and skills centres. Any success that this book achieves is due to these talented authors and I remain very thankful that they have shared their expertise with us. Further, I continue to learn from colleagues, educators, and students in the simulation community. If I have learnt only one thing from simulation, it is that the historic concept of a teacher and students as separate entities is not only wrong but that it can be a barrier to education. I cling to the hope that at some time in the distant future I will achieve some level of expertise in this field. I also would like to thank Caroline Smith, Nicola Wilson, James Cox, Cherline Daniel, Paul Nash and the team from Oxford University Press, who kept me on task; and Ian Curran and Brydon Dunstan. Thanks to David Gaba and Ray Page for being so inspirational. Finally, I thank my wife Vera who has been my support on the simulation journey. Richard Riley Perth, Western Australia 2015 Richard@pobox.com
  • 18. List of Contributors xv Part 1 Design, logistics, equipment, and history 1 Lessons from aviation simulation 3 Ray Page 2 Simulation centre design 16 Ross Horley 3 Simulation centre operations 29 Yue Ming Huang and Thomas Dongilli 4 Simulators, equipment, and props 51 Chris Chin Part 2 Education 5 Developing the skills and attributes of a simulation-based healthcare educator 65 Al May and Simon Edgar 6 Teaching a clinical skill 78 Jeffrey M Hamdorf and Robert Davies 7 Teaching in clinical settings 89 Fiona Lake 8 Teaching and learning through the simulated environment 102 Iris Vardi 9 Simulation in nursing education and practice 115 Joseph S Goode Jr and John M O’Donnell 10 Incorporating simulation into the medical school curriculum 128 Randolph H Steadman, Maria D D Rudolph, Christine C Myo-Bui, and Rima Matevosian 11 Interprofessional education 141 Robert P O’Brien and Jonathan Mould 12 Scenario design—theory to delivery 151 Chris Holland, Chris Sadler, and Nusrat Usman 13 Debriefing—theory and techniques 166 Janice C Palaganas, Brendan Flanagan, and Robert Simon 14 Training and assessment with standardized patients 185 John R Boulet and Anthony Errichetti Contents
  • 19. Contents xiv 15 Team-building exercises and simulation 208 Andrew Anderson 16 Teaching and learning in simulation using the problem-based approach 221 Russell W Jones 17 Patient safety and simulation 235 Christine L Mai, Rebecca D Minehart, and Jeffrey B Cooper 18 Non-technical skills: identifying, training, and assessing safe behaviours 249 Rhona Flin and Nicola Maran 19 Current concepts in mannequin-based simulation assessment 265 Leonie M Watterson and Jennifer M Weller 20 Research in simulation 277 Alexander (Sandy) Garden 21 Airway training devices 290 Cindy Hein, Cyle Sprick, and Harry Owen Part 3 Applied simulation 22 Cardiopulmonary resuscitation and training devices 305 Sheena M Ferguson and Anthony R Lewis 23 Respiratory medicine and respiratory therapy 317 Brian Robinson 24 Simulation in critical care 330 Joshua S Botdorf, Julie A Schmidt, William F Dunn, and Kianoush Kashani 25 Simulation for teamwork training 345 Geoffrey K Lighthall, Nicolette C Mininni, and Michael DeVita 26 Surgical simulation 356 Roger Kneebone and Fernando Bello 27 Simulation-based emergency medicine and disaster training 368 Mary D Patterson, John A Vozenilek, and Mark W Bowyer 28 Simulation in paediatrics 383 Nicole K Yamada, Janene H Fuerch, and Louis P Halamek 29 Obstetric simulation 397 Shad H Deering 30 Creating virtual reality medical simulations: a knowledge-based design and assessment approach 411 Dale C Alverson, Thomas P Caudell, and Timothy E Goldsmith 31 Role of cognitive simulation in healthcare 424 Usha Satish, Satish Krishnamurthy, and Mantosh Dewan Glossary of medical and simulation terms, acronyms, and abbreviations 439 Index 453
  • 20. Educational Commission for Foreign Medical Graduates Philadelphia, PA, US Col (ret) Mark W Bowyer, MD, FACS, DMCC Ben Eiseman Professor of Surgery Chief, Division of Trauma and Combat Surgery Surgical Director of Simulation Uniformed Services University Bethesda, MD, US Thomas P Caudell, PhD Professor Department of Electrical & Computer Engineering Department of Computer Science (secondary) Department of Psychology (secondary) University of New Mexico Albuquerque, NM, US Chris Chin MBBS, FRCP, FRCA, MA Clin Ed Staff Anesthesiologist British Columbia Children’s Hospital Clinical Instructor, University of British Columbia Vancouver, BC, Canada Jeffrey B Cooper, PhD Professor of Anaesthesia Harvard Medical School Massachusetts General Hospital Founder and Executive Director, Center for Medical Simulation Boston, MA, US Robert Davies, MBBS, FRACS Australian and New Zealand Surgical Skills Education and Training Committee Dale C Alverson, MD Professor Emeritus of Pediatrics and Regents’ Professor Professor, Health Sciences Center Library and Informatics Center Medical Director, Center for Telehealth and Cybermedicine Research University of New Mexico Albuquerque, NM, US Andrew Anderson Chief Executive Officer Association for Simulated Practice in Healthcare (ASPiH) Managing Director Crawford Medical Limited London, UK Fernando Bello, BSc (Hons), PhD Reader in Surgical Graphics & Computing Division of Surgery Department of Surgery and Cancer Imperial College London Paterson Centre St Marys Hospital London, UK Joshua S Botdorf, DO Department of Medicine Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester, MN, US John R Boulet, BSc, MA, PhD Vice President, Research & Data Resources Foundation for Advancement of International Medical Education and Research List of Contributors
  • 21. List of Contributors xvi New York Institute of Technology-College of Osteopathic Medicine Old Westbury, NY, US Sheena M Ferguson, MSN, RN, CCRN, CNS Chief Nursing Officer & Administrator University of New Mexico Hospitals Albuquerque, NM, US Brendan Flanagan, MBBS, FANZCA Department of Anaesthesia & Perioperative Medicine The Alfred Hospital Melbourne, VIC, Australia Rhona Flin, PhD Chair of Applied Psychology School of Psychology University of Aberdeen King’s College Aberdeen, UK Janene H Fuerch, MD, FAAP Fellow in Neonatal-Perinatal Medicine Division of Neonatal and Developmental Medicine Department of Pediatrics Stanford University School of Medicine Center for Advanced Pediatric and Perinatal Education Packard Children’s Hospital at Stanford Palo Alto, CA, US Alexander (Sandy) Garden, MBChB, PhD, FANZCA Rotational Supervisor Department of Anaesthesia Wellington Hospital Adjunct Professor School of Biological Sciences Victoria University Wellington, New Zealand Royal Australasian College of Surgeons East Melbourne, VIC, Australia COL Shad H Deering, MD, FACOG Chair, Department of Obstetrics and Gynecology Uniformed Services University of the Health Sciences Bethesda, MD, US Michael DeVita MD, FCCM Director, Critical Care Harlem Hospital Center Assistant Professor, Internal Medicine Columbia College of Physicians and Surgeons New York, NY, US Mantosh Dewan, MD Professor Department of Neurosurgery SUNY Upstate Medical University Syracuse, NY, US Thomas Dongilli, AT Director of Operations, WISER University of Pittsburgh Pittsburgh, PA, US William F Dunn, MD Mayo Clinic Multidisciplinary Simulation Center Rochester, MN, US Simon Edgar, MBChB, FRCA, MMed Consultant Anaesthetist Director of Medical Education NHS Lothian, Edinburgh Education Coordinator, Scottish Centre for Simulation and Clinical Human Factors (SCSCHF) Stirling, UK Anthony Errichetti, PhD Chief of Virtual Medicine Director, MS in Medical/Healthcare Simulation Program
  • 22. List of Contributors xvii Chris Holland, MBBS, BAO, MMedEd, FRCA, FFICM, FAcadMEd Consultant in Intensive Care Director of Clinical Practice Lecturer in Clinical Education King’s Healthcare Partners London, UK Ross Horley, CEng Adjunct Lecturer, School of Medicine University of Notre Dame Australia Director, Medical Synergies Ltd Stirling, WA, Australia Yue Ming Huang, EdD, MHS Education and Operations Director, UCLA Simulation Center Associate Adjunct Professor, Department of Anesthesiology David Geffen School of Medicine at UCLA University of California, Los Angeles, CA, US Russell W Jones, BSc, DipEd, BEd (Hons), PhD Professor of Clinical Education, Edith Cowan University Professor of Clinical Education, Royal Flying Doctor Service Edith Cowan University Joondalup, WA, Australia Kianoush Kashani, MD, FASN, FCCP Assistant Professor in Internal Medicine Division of Nephrology and Hypertension Division of Pulmonary and Critical Care Program Director—Critical Care Fellowship Mayo Clinic Multidisciplinary Simulation Center Rochester, MN, US Roger Kneebone, PhD, FRCS, FRCSEd, FRCGP Professor of Surgical Education Timothy E Goldsmith, PhD Associate Professor Department of Psychology University of New Mexico Albuquerque, NM, US Joseph S Goode Jr, CRNA, MSN Faculty, University of Pittsburgh School of Nursing Department of Nurse Anesthesia Staff Nurse Anesthetist, Presbyterian Hospital University of Pittsburgh Medical Center Pittsburgh, PA, US Louis P Halamek, MD, FAAP Professor and Associate Chief for Training and Assessment Division of Neonatal and Developmental Medicine Department of Pediatrics Stanford University School of Medicine Director, Center for Advanced Pediatric and Perinatal Education Packard Children’s Hospital at Stanford Stanford Children’s Health Palo Alto, CA, US Jeffrey M Hamdorf, MBBS, PhD, FRACS Winthrop Professor of Surgical Education Director, Clinical Training and Education Centre Head, School of Surgery The University of Western Australia Nedlands, WA, Australia Cindy Hein, DipAppSc, BHSc, PhD Extended Care Paramedic SA Ambulance Service Postdoctoral Research Fellow Flinders University Bedford Park, SA, Australia
  • 23. List of Contributors xviii Christine L Mai, MD Instructor in Anaesthesia Harvard Medical School Massachusetts General Hospital Boston, MA, US Nicola Maran, MBChB, FRCA, FRCSEd Consultant Anaesthetist Associate Medical Director for Patient Safety, NHS Lothian, Edinburgh, Scotland Educational Coordinator, Scottish Centre of Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK Rima Matevosian, MD Chair, Department of Anesthesiology Olive View—UCLA Medical Center Associate Dean David Geffen School of Medicine at UCLA University of California, Los Angeles, CA, US Al May, MBChB, FRCA, FCARCSI Educational Coordinator Scottish Centre for Simulation and Clinical Human Factors Larbert, UK Rebecca D Minehart, MD Assistant Professor in Anaesthesia Harvard Medical School Massachusetts General Hospital Boston, MA, US Nicolette C Mininni, BSN, RN, MEd, CCRN Advanced Clinical Education Specialist, Critical Care University of Pittsburgh Medical Center UPMC Shadyside Pittsburgh, PA, US Jonathan Mould, PhD, MSc, RSCN, RGN, RMN, Adult Cert Ed Lecturer and Researcher, School of Nursing, Midwifery and Paramedicine Division of Surgery Department of Surgery and Cancer Imperial College London Clinical Skills Centre St Marys Hospital London, UK Satish Krishnamurthy, MD Professor Department of Neurosurgery SUNY Upstate Medical University Syracuse, NY, US Fiona Lake, MD, FRACP Respiratory Physician, Sir Charles Gairdner Hospital Eric Saint Professor of Medicine School of Medicine and Pharmacology The University of Western Australia Crawley, WA, Australia Anthony R Lewis, BSc, PhD, MB BCh, FRCA, FANZCA Consultant Anaesthetist Department of Anaesthesia St George Hospital Director, iSimulate Pty Ltd Sydney, NSW, Australia Geoffrey K Lighthall MD, PhD Associate Professor Anesthesia and Critical Care Stanford University School of Medicine Stanford, CA, US Christine C Myo-Bui, MD Assistant Clinical Professor Department of Anesthesiology and Perioperative Medicine David Geffen School of Medicine at UCLA University of California, Los Angeles, CA, US
  • 24. List of Contributors xix Mary D Patterson MD, MEd Medical Director for Simulation Center for Safety and Reliability Akron Children’s Hospital Professor of Pediatrics Northeast Ohio Medical College Akron, OH, US Richard H Riley, MBBS, FANZCA School of Medicine and Pharmacology University of Western Australia Anaesthesia and Pain Medicine Royal Perth Hospital Perth, WA, Australia Brian Robinson, MSc, PhD Senior Lecturer Graduate School of Nursing, Midwifery & Health Te Kura Tapuhi Hauora Victoria University of Wellington Wellington, New Zealand Maria D D Rudolph, MD Visiting Scholar UCLA Simulation Center David Geffen School of Medicine at UCLA University of California, Los Angeles, CA, US Chris Sadler, BSc, PhD (Physiol), MBBS, FRCA Consultant Anaesthetist Training Programme Director, Barts & The London School of Anaesthesia Director of Strategy for Simulation & Essential Clinical Skills Barts Health, London, UK Usha Satish, PhD Professor Department of Psychiatry SUNY Upstate Medical University Syracuse, NY, US Curtin University WA, Australia Robert P O’Brien, EdD, MEd, BA, BTeach Honorary Senior Fellow Melbourne Medical School University of Melbourne Melbourne, VIC, Australia John M O’Donnell, CRNA, MSN, DrPH Professor of Nursing and Chair, Department of Nurse Anesthesia Director, Nurse Anesthesia Program Associate Director, WISER University of Pittsburgh Pittsburgh, PA, US Harry Owen, MBBCh, MD, FANZCA Professor, School of Medicine Flinders University Bedford Park, SA, Australia Ray Page, Dip Radio Technology, Dip Television, Dip Industrial Electronics Former Manager Simulator Services QANTAS Airways past Chair, IATA Flight Simulator Technical Committee Inaugral Chair Simulation Industry Association Australia (SIAA) Australia Janice C Palaganas, PhD, RN, NP Principal Faculty Director of Educational Innovation and Development Center for Medical Simulation Massachusetts General Hospital Department of Anesthesia, Critical Care, & Pain Medicine Harvard Medical School Boston, MA, US
  • 25. List of Contributors xx Duane and Mary Cullinan Professor in Simulation Outcomes Associate Professor, Emergency Medicine University of Illinois College of Medicine at Peoria Associate Professor of Bioengineering University of Illinois College of Engineering Urbana Champaign, Peoria, IL, US Leonie M Watterson, MB BS, FANZCA, MClinEd Clinical Associate Professor, Sydney Medical School, University of Sydney Director, Sydney Clinical Skills and Simulation Centre, Simulation Division Royal North Shore Hospital St Leonards, NSW, Australia Jennifer M Weller, MD, MBBS, MClinEd, FANZCA, FRCA Associate Professor and Head of Centre for Medical and Health Sciences Education School of Medicine, University of Auckland Specialist Anaesthetist, Auckland City Hospital Auckland, New Zealand Nicole K Yamada, MD, FAAP Clinical Assistant Professor Division of Neonatal and Developmental Medicine Department of Pediatrics Stanford University School of Medicine Associate Program Director, Center for Advanced Pediatric and Perinatal Education Packard Children’s Hospital at Stanford Palo Alto, CA, US Julie A Schmidt, MSN, RN Department of Nursing Mayo Clinic Rochester, MN, US Robert Simon, EdD Senior Director, Educational Leadership & International Programs, Center for Medical Simulation Department of Anaesthesia, Critical Care, and Pain Medicine Massachusetts General Hospital Harvard Medical School Boston, MA, US Cyle Sprick, BSc, PhD Paramedic, South Australian Ambulance Service Director, Clinical Simulation Unit Flinders University Bedford Park, SA, Australia. Randolph H Steadman, MD, MS Professor and Vice Chair Department of Anesthesiology and Perioperative Medicine Director, UCLA Simulation Center David Geffen School of Medicine at UCLA Los Angeles, CA, US Nusrat Usman, MBChB, FRCA Consultant Anaesthetist Barts Health NHS Trust London, UK Iris Vardi, BAppSc, DipEd, MEd, PhD Principal Consultant Higher Education Director, Vardi Consulting Perth, WA, Australia John A Vozenilek, MD Chief Medical Officer for Simulation Jump Trading Simulation and Education Center, OSF Healthcare System
  • 26. Part 1 Design, logistics, equipment, and history
  • 28. Chapter 1 Lessons from aviation simulation Ray Page ◆ Simulation was previously described as having achieved an integral role in the avi- ation industry. This role can now be described as essential for this industry. ◆ The standards developed by the industry have been maintained and regulation con- tinues to evolve, driven by technological changes, and changes to the training envir- onment brought about by developments in aircraft technology. ◆ Until relatively recently, aviators were required to manually fly their aircraft within very tight tolerances of just a few knots, and basic airmanship skills learned during initial training were maintained during operational flying. Now, automated control of aircraft flight parameters prevent a pilot from exceeding the flight envelope of the aircraft. ◆ With progression to fly-by-wire control of modern aircraft, the pilot is even fur- ther removed from the rigours of basic aircraft control and handling; unless some unforeseen event arises which suddenly requires skills that are not used in normal operation. ◆ The extent of computer-controlled operations in normal procedures has high- lighted the need for basic skills to be taught and maintained in all conditions. Ad- vanced simulator training is the only practical means available to complete such advanced training. ◆ The use of fly-by-wire control of commercial aircraft has raised concerns with the Federal Aviation Authority (FAA) that will lead to a ‘fundamental rewrite’ of flight training rules to require all enhanced training to take place in flight simulators. ◆ This has arisen from a number of major accidents where pilots failed to recognize and react to some fundamental problems, being totally dependent on the aircraft automatic flight controls and possibly suffering from a lack of skill in manually fly- ing the aircraft for recovery. Overview
  • 29. Lessons from aviation simulation 4 1.1 Introduction to lessons from aviation simulation In the original edition of this manual, there were historical references to the invention and development of simulation devices, as well as training methods used, to illustrate the pro- gress made with the use of flight simulation. This was shown to be based on the advances of technology, especially in the areas of computing science, as well as experience gained with use of the flight simulator as both a training and checking device. Specific areas were highlighted as the basis of the success and acceptance of simulation as a complete and valid form of training and testing. ◆ Comprehensive training analysis of what was required to be simulated ◆ Accurate data and performance of what was to be simulated ◆ Accurate modelling of the simulation ◆ Simulation device constructed to standards using adequate computational power and speed (fidelity of simulation) ◆ Full acceptance testing (any area not tested cannot be regarded as correct) ◆ Testing and compliance to international standards to ensure regulatory control Since the initial publication there have been advances in all areas, though none more so than the actual method in which modern aircraft are controlled, and this has had, and will continue to have, a significant impact on training. The world has suffered a financial crisis which has had a dramatic impact on aviation, with airlines experiencing the need for cost reduction resulting in moves to newer, more efficient aircraft. These new aircraft, however, also now feature new piloting techniques. While the crisis has somewhat abated, the need for cost savings has not and demand for air travel has increased enormously, with the industry now facing major challenges to be able to meet the demands of increasing training throughput while maintaining standards and managing the introduction of new and more complex aircraft. In this environment, standards play a vital part in ensuring pilots receive and maintain the skills necessary to fly safely every time they take to the air. ◆ To provide and maintain pilot skills will require a boost in simulator fidelity to han- dle the new training scenarios. Costs of implementing new standards, in part due to simulator upgrades, have been estimated to be at least $354 million. ◆ In Australia, CASA has recently updated regulations to mandate the use of Simu- lation for certain flight crew training requirements in the air transport and other sectors where this may be considered appropriate. This resulted from a number of accidents and incidents that occurred when dangerous abnormal conditions were being practiced in the aircraft. Overview (continued)
  • 30. 1.2 Flight simulation standards 5 1.2 Flight simulation standards Prior to the 1970s there were no standards for flight simulation devices and accreditation was based on individual country regulatory authorities, providing vastly differing per- formance criteria requirements. In the early 1970s a small group of flight simulator maintenance engineers from the world’s airlines formed an association to be known as IAFSTA (International Airline Flight Simulator Technical Association). This group was formed to discuss the lack of standards, data, and performance problems with flight simulators then in service. The simulator manufacturers did not react kindly to open forum criticisms and legal threats were made. IAFSTA was disbanded and the membership looked to IATA (International Air Trans- port Association) to form a committee. In October 1973 the IATA FSTC (Flight Simulator Technical Committee) held its first meeting in Denver, Colorado. The FSTC set about the task of forming sub-committees and working groups to exam- ine what was needed to develop and publish standards for flight simulation. There was a huge wave of cooperation, though many avionics and airframe manufacturers at that time could not really understand or appreciate the need for the levels of fidelity being sought and many closed, volatile sessions were held along the way. In 1980 the first edition of the IATA publication ‘Flight Simulation Training Device Design and Performance Data Requirements’ was published and became an automatic contractual document in the purchase of flight simulators and training devices. This docu- ment is now in its seventh edition. With the standards established, a push was made to offer incentives to the aviation in- dustry to increase flight simulator fidelity, with an objective to eventually move all train- ing and checking from the aircraft to the flight simulator. Discussions were held with the FAA, which agreed to an incentive programme with landing credits as the initial goal. This became the start of a long process of driving technology and improved aircraft data collec- tion and testing to achieve ‘zero flight time’ (the ability to use the flight simulator as a total replacement for all aircraft training and testing). This was a total cooperative effort between all parties. As an example, it was a Qantas simulator engineer, endorsed by the FSTC, who actually controlled the Boeing flight test for the data required for the Boeing B747–400. 1.2.1 Regulation The aviation industry remains highly regulated and as a basic element of flight safety air- crew training and simulation are well covered in these regulations. All nations have to abide by their own regulatory authority and agreement was reached to produce The ICAO (International Civil Aviation Organization) Manual of Criteria for Qualification of Flight Simulators, which now forms the basis of most nation’s regulations.
  • 31. Lessons from aviation simulation 6 1.3 The aviation industry Towards the end of the last century, the world economy was slowing and airlines were feeling the effects, resulting in major cost-cutting. Airlines were restructured and, in some cases, national carriers were ‘privatized’. This resulted in many cases of stripping of experi- enced technical personnel to improve the financial bottom line of the airline. Cost-cutting also placed restrictions on technical and training personnel being able to attend confer- ences and meetings of airline organizations, such as IATA. In order to ensure that airlines continued to maintain their understanding of tech- nical developments and investigation for solutions to technical problems, alternative ap- proaches and organizations were sought by the flight simulator fraternity. Fortunately, this happened as the aircraft being operated moved to the ‘fly-by-wire’ air- craft concept, and the flight simulators used actual aircraft flight control computers, which were simulated, or the now-accepted practice of the aircraft software integrated into the simulator under licence, from the software provider. The acceptance of the flight simulator into the mainstream avionics world was now complete. The following describes how existing aircraft organizations have incorporated the flight simulator into their existing operations, therefore ensuring the ongoing fidelity of the simulator in parallel to the actual aircraft. 1.3.1 ARINC (Aeronautical Radio Incorporated) This organization was originally incorporated in 1929 and chartered to serve as the air- line industry’s single licensee and coordinator of radio communications. ARINC was also responsible for all ground base radio stations and transport communications, as well as supporting commercial aviation and the US military. In 1978, ARINC introduced ACARS (Aircraft Communications Addressing and Re- porting System), a data link system that enables ground stations, as well as aircraft main- tenance bases, to communicate with an aircraft without voice, but with data, including interfacing to on-board units such as the FMS (Flight Management Systems) to allow up- dating of flight-planning information. With the introduction of the B767, the FMS on this aircraft presented tremendous diffi- culties for flight simulator training, as faults and repositioning introduced for training in the simulator caused the FMS (aircraft unit) to signal a systems failure and remove them- selves from controlling the simulated aircraft—as it perceived this as a disaster situation. This presented huge training problems and the obvious solution was to incorporate simu- lation software in an aircraft-certified on-board unit which could be locked out during regular aircraft use. The incorporation of any non-aircraft software in airborne avionics was unheard of and initially vehemently opposed by ARINC engineers with a long battle, originally led by the IATA FSTC, and later by a group of airline simulator engineers led by Qantas and British Airways. This was finally agreed when it was revealed that the FMS manufacturers actually used such a feature for their testing of this unit.
  • 32. 1.4 Fly-by-wire aircraft 7 This was an historic first for flight simulation, as it recognized the importance of the role played by simulation training and also the safety of coexisting software between air- craft and flight simulator, which would be imperative for the future of fly-by-wire aircraft simulation. The battleground also extended to the aircraft manufacturers, as this problem impacted on the production cycle of the B767. 1.3.2 Aviation committees Flight simulation was now entering the world of avionics and the advent of fly-by-wire aircraft would dictate a new role of adherence to ARINC standards and participation in associated aviation committees. 1.3.3 AEEC The Airline Electronics Engineering Committee (AEEC) develops the engineering stand- ards and technical solutions for avionics, networks, and cabin systems that would provide interchange ability with reduction in life-cycle costs. More than 4,000 engineers and scientists, representing some 250 sponsoring organ- izations, participated in the development of consumer-based ARINC standards. These standards define the key elements of equipment and systems installed in more than 10,000 aircraft worldwide. 1.3.4 AMC The Aviation Maintenance Committee (AMC) is concerned with the maintenance and reliability of avionics and the development of technical standards, in compliance with ARINC standards. The annual meeting is attended by more than 750 avionics mainten- ance experts from around the world and identifies issues with both immediate and long- term maintenance improvements. 1.3.5 FSEMC The Flight Simulator Engineering Maintenance Committee (FSEMC) provides cost-­ effective solutions to flight simulator operational and maintenance problems. The annual conference is attended by more than 300 flight simulator experts from around the world to discuss technical solutions to engineering and maintenance issues, with long-term savings as well as increased efficiency for simulator users. The activities of the FSEMC are led are led by a steering committee with the Terms of Reference approved by the ARINC Board of Directors. The ARINC Standards Develop- ment Document specifies the procedures to develop voluntary consumer-based ARINC standards. 1.4 Fly-by-wire aircraft This is a system which replaces the conventional manual aircraft flight controls with an electronic interface which allows the pilot to input his commands (fly up)—(turn left)
  • 33. Lessons from aviation simulation 8 through either conventional flight controls, or a side or centre stick (like a computer game controller) which provides a signal to a computer. This computer then performs calcula- tions based on the flight control laws programmed into the flight control computers, which along with inputs from other sensors and the air data internal reference units commands the flight control surfaces to adopt a configuration that will achieve the desired flight path. 1.4.1 Weight saving Digital fly-by-wire systems are now used in the majority of new commercial aircraft as they provide many advantages over the earlier aircraft by replacing hardware such as cables and linkages with associated pulleys and push rods. Overall, this reduces weight, equipment space areas, and the number of potential failure points that require maintenance and rou- tine service checks. Electronic systems require less maintenance, as opposed to traditional mechanical and hydraulic systems, which require tension adjustments, lubrication, leak checks, and fluid changes. Preflight safety checks can now be performed using the Built-in Test Equipment (BITE), which allows a number of control movement steps to be performed automatically and to report any fault or failure automatically. 1.4.2 Safety and redundancy Aircraft control systems may now be a multiplex to prevent loss of control, in the case of a failure of one or two channels. High-performance fighter-type aircraft are basically un- stable to gain performance, and could not be flown manually as they required some 20 to 30 on-board computers to rapidly compute high-speed manoeuvres. The control system will attempt to prevent a stall or can stop the pilot from over-stressing the airframe. The Space Shuttle, for example, had an all-digital fly-by-wire control system. This system was first exercised (as the only flight control system) during the unpowered flight ‘Ap- proach and Landing Tests’ carried out on Space Shuttle Enterprise in 1977. 1.4.3 Airbus vs Boeing The fundamental difference between the two main commercial aircraft suppliers is that, with Airbus aircraft, the computer always retains the ultimate control and will not allow pilots to fly outside performance limits. With Boeing 777 airliners, the two pilots can completely override the computerized flight-control system to permit the aircraft to be flown beyond its usual flight control en- velope during emergencies. 1.4.4 Intelligent Flight Control Systems (IFCS) This is a later development spearheaded by NASA, which is designed to compensate for any aircraft damage or failures during flight. This system, for example, would automatic- ally use engine thrust and other avionics to compensate for loss or failures of other control
  • 34. Exploring the Variety of Random Documents with Different Content
  • 35. spectacle, possesses no novelty. Catalunian industry does not arise from any superior education, by which men obtain a clearer insight into their moral duties, and higher views of the human character; on the contrary, no Spanish peasant is more ignorant than a Catalunian boor; none are more enslaved by the priesthood; and in no other province, have the inhabitants shewn so much, their veneration for the apostolical party both in church and state. The secret of Catalunian industry, is the same as that which has covered with fertility many an Alpine valley in Switzerland,—self-interest. Give to the labourers of the earth an interest,—a property in the land which they cultivate, and the world would become one wide extended garden. The land upon which the Catalunian labours, is either his own, or held by him upon a lease, sometimes for lives, sometimes in perpetuity, with a fine upon succession or alienation; but at all events, for so long a period as to invest the tenant with a real interest in the property which he cultivates. From the Venta, where we slept, to Tarragona, the road winds among rugged hills, along the sea shore. I noticed many beautiful heaths by the way side, but the soil is not rich enough to repay cultivation. At a venta close by the sea, called Hospitalet, we stopped to breakfast. Soon after, we entered the plain of Tarragona, almost vieing in fertility with the huertas of the more southern provinces, and reached the city to a late dinner. I had expected much from the antiquities of Tarragona; but I confess they disappointed me. They possess few of those features which strike or delight the traveller who is not professedly an antiquarian. When a Roman amphitheatre is shewn to me, I always think of the amphitheatre of Nismes; if I look upon an aqueduct, I see placed beside it the Pont de Gard. The remains of the amphitheatre are little more than visible; the aqueduct, though fine, is certainly not comparable to that which I have named; and the tower of Scipio is merely the tower of Scipio. I was greatly surprised at the ignorance of the inhabitants respecting their antiquities. The cicerone whom I first engaged, scarcely knew of their existence; and one group of priests whom I addressed, and another group of respectable looking men, could give me no information upon the subject. The cathedral of Tarragona is worth a visit, particularly the court and cloisters, which are surrounded by innumerable pillars. The canon who accompanied me, said they were Roman, but upon one I noticed a representation of the crucifixion, and upon another the last supper,—and upon others I could trace Gothic designs. It is possible that some Roman
  • 36. pillars found elsewhere, may have been conveyed to this court. The ecclesiastic who walked round the cathedral with me, spoke in earnest language of the decline of piety; and so deeply did the old man lament this that, as he laid his hand upon his heart, I saw the tears start into his eyes. I was delighted with the posada at Tarragona; the posadero, an Italian, put forth his utmost skill in cookery, and seeing that I relished the wine he set before me, which was really excellent, he brought a pint bottle of choice wine, which he had had eleven years in his cellar. It proved perfect nectar, and the owner was quite charmed with the praises I bestowed upon it. I found it impossible to understand the Catalunian dialect, which is indeed almost a distinct language,—this is a difficulty that is felt in all the provinces. The dialects of Biscay, Andalusia, Valencia, and Catalunia, are all different from each other, and distinct from the Castilian; the better classes in all the provinces, of course, understand and speak Castilian,— with certain imperfections in pronunciation, such as in Andalusia, where th is used in place of s, which gives a softness, but an indistinctness to the language; but the lower classes, the persons met with in the ventas, and the muleteers, often speak a dialect that is altogether unintelligible. I was much pleased at the port of Tarragona, with the operation of sorting the nuts, which form an important article of export. In one of the principal warehouses I saw from two hundred to two hundred and fifty girls, seated upon stools, at a table which extended the whole length of the room; heaps of nuts lay upon the floor, and men were constantly filling baskets with these and emptying them upon the table. The girls drew the nuts towards them by handfuls, and distinguishing, as if by an instinctive knowledge, the empty from the full nuts, they swept the good into a basket between their knees, and the empty, they dropped into a basket at their feet. Nothing can exceed the rapidity with which these operations are performed; it is really a busy and an animated scene; the labour employs the hands only, for it is by the touch the quality of the nut is distinguished; and the mind being disengaged, the constant prattle and the frequent laughter, give to the scene an appearance almost of a party of pleasure. Tarragona is the chief exporting port of Catalunia. Its exports consist of nuts, almonds, wines, and brandy. The nuts sent to the English market are known by the name of Barcellona nuts; but they are neither grown near, nor exported from Barcellona. They are grown more in the interior of the
  • 37. province, and are all exported from Tarragona. The average export of nuts from Tarragona is from twenty-five to thirty thousand bags. There are four bags to a ton; and they were placed on board last autumn at 17s. 6d. per bag. The whole of this export is for the English market. The export of almonds is about twelve thousand bags. From five thousand to five thousand five hundred pipes of wine are exported from Tarragona, to Rio Janiero, the Brazils, Guernsey, and Jersey; and of brandy, about four hundred pipes are exported, chiefly for Cette, and Cadiz, from which places, it finds its way into the wine butts of Bourdeax and Xeres. Cork wood, and cork bark, also form a small export from Tarragona. I left Tarragona for Barcellona in a small carriage, something better than a tartana, and two mules, which trotted all the way. The country is chiefly a wine country; and the road winds among hills, covered in the lower parts with vines, and higher up, with pine. Numerous villages, engaged in the wine and brandy trade, are scattered along the shore, but all of these have considerably suffered from the loss of the colonies. After passing Vendrill we left the sea coast; and about three leagues from Barcellona, entered a charming country, covered with romantic hills,—clothed with fir, and embosoming numerous small and beautiful valleys; and emerging from these, I found myself in the Huerta of Barcellona. The approach to Barcellona is less striking than the approaches either to Murcia or Valencia; nor does the city itself present so imposing an appearance; but the commerce upon the road, greatly exceeded what I had seen in the neighbourhood of any other city in Spain. I reached the gate before dusk, and alighted at the Fonda de las quatros Naciones.
  • 38. CHAPTER XXI. — BARCELLONA—JOURNEY TO THE FRONTIER. General Character of Barcellona, and its Population; Paseos, Ramparts, and Fortifications; the Conde de España; his Policy; Interview with the Conde; his Character and Government; Anecdotes of his Government; Political Feeling in Barcellona; Churches and Convents; the Opera; Monjuich; Barcellonetta; Decrease of Trade with England, and its Causes; General Trade of Barcellona; an Execution; the Priesthood and the People; a Miracle in 1827; Prices of Provisions; Visit to Montserrat; Journey from Barcellona to the Frontier; Delightful Scenery; Proofs of Catalunian Industry; Gerona Figueras; the Pyrenees, Reflexions. A glance at Barcellona is sufficient to show, that we approach the frontier. We no longer see a purely Spanish population. Spanish hats are scarcely to be seen, nor is the mantilla altogether indispensible. In the buildings too, we perceive a difference; the streets are wider, and few of the houses are adorned with balconies. I thought too, but this might be fancy, that I could perceive a different expression in the countenances of the people. Of one thing I am certain, that although the women of Barcellona have not perhaps the grace of the Andalusians; their claims to beauty are stronger: their features are more regular, their complexions are clearer, their hair less coarse, and their forms slighter: still it must be admitted, that there is more witchery hid in the eye of an Andalusian, than perhaps in all the separate charms of a woman of Barcellona. No one, however, can walk along the streets, without perceiving in the female population, sufficient evidence of being no longer among a people exclusively Spanish. I found another peculiarity in the aspect of the Barcellona population—a peculiarity however, that refers only to the time I visited Barcellona. No caps were to be seen: these, as well as grey hats, were forbidden, immediately upon the revolution breaking out in France. For my own part, I continued to wear my grey hat while in Barcellona, without being challenged; but I have good reason to believe, that this forbearance arose from the authorities knowing that I had the honour of being acquainted with the Conde de España, the ruler, and dictator of Catalunia. But the strange, and gaudy dress of the Catalunian peasantry is the most striking peculiarity in the appearance of
  • 39. the Barcellona population: all wear their red caps, which hang at least a foot down their backs; and with their crimson girdles, and gaudy coloured woollen plaids, they give a peculiar grotesqueness to the appearance of the Rambla—the principal street of Barcellona—which is almost always crowded. Barcellona is particularly fortunate in its promenades; the Rambla is scarcely inferior to the Boulevards of Paris; and there is a charming walk round the whole of the ramparts; every moment the view changes, sometimes looking towards the huerta, and sometimes towards the mountains, with the villages, and country houses of the merchants lying under them; sometimes towards the hill and fortress of Monjuich; and sometimes towards the sea; and that part of the promenade which is above the sea, is without exception, the finest promenade in any city I have ever seen. Barcellona would be better without its fortifications; for owing to them, the city has been confined within too narrow bounds; and the whole space within the walls, is filled up with houses, in place of (as in other Spanish cities) gardens mingling with the buildings, and adding both to the beauty and the healthfulness of the place. The fortifications of Barcellona are of little real use to it. I was informed by the commander of the citadel, that the city could not maintain a siege of one week, against a sufficiently well appointed army; nor could the occupation of it be maintained for one day, if the citadel or Monjuich were in possession of an enemy. The day after my arrival in Barcellona, I was presented to the Conde de España, a man who has made himself to be respected by some, and feared by all; owing to the promptness, decision, and tyranny of the measures by which he has from time to time put down the most formidable insurrections; and owing also to the influence which he has more than once shewn he has the power of wielding, over the determinations, and the actions of the king. No man has more enemies than the Conde de España, both at court, and in the province which he governs; and constant attempts are made in the highest quarters, to remove him from his government, and from the confidence of his royal master. The Archbishop of Toledo is his bitterest enemy, and has never forgotten the insult he put upon the dignitaries of the church, in the year 1827; but the king knows that whatever his faults may be, they are faults that prove him to be a zealous and faithful servant; and the fittest man to govern the turbulent Catalunians; and when upon a late occasion, the Duke del Infantado strongly urged upon the king, the
  • 40. unpopularity of the Conde de España, and the propriety of removing him, his majesty cut the matter short by saying, “I wish I had a Conde de España in every province;” one of the most sensible things the king ever said, if he wishes to preserve his authority. The Conde de España is not very easy of access; he is seldom seen, though his presence is always felt; his system of government is secret; and in the province of Catalunia, it may be said to have come in place of the inquisition,—with instruments as numerous and as masked, with power as unanswerable, with measures as prompt, and sometimes as unjustifiable, and with a bolder heart and a stronger head to direct the machine. It was a mere chance whether I should be admitted to an audience: indeed, no one in Barcellona knows, whether he be in the city or not. The parade takes place before his residence, and the guards are mounted at his gate every morning, but this is no proof that he is within. The Conde was at home however; and the names of his Britannic Majesty’s Consul, and English gentleman, were passed inward. We walked into an anti-room where a Spanish general, and several other persons were waiting. How long they might have preceded us I cannot tell, but in a few minutes, we were informed that the Conde would see us; and we were conducted through a long suite of magnificent apartments, and ushered by an aide-de-camp, into a little mean dirty parlour, without a bit of matting to cover the brick floor, the walls white washed, a wood fire almost burnt out, and the furniture consisting of one small table, and two or three chairs. There sat the Conde de España, writing, or, at least, signing his name to a number of papers. He immediately rose, and received us with the utmost curtesy, made us sit down, and asked me some particulars of my journey, and in what state I had found Spain. I told him, what I really believed to be true, that Spain was at that time, the most tranquil country in Europe; and that I had no where found the slightest indication of commotion. This reply was no doubt gratifying: the Conde ordered wine and segars, and the conservation took a more general turn. He spoke of France, and said he considered it hastening towards republicanism. He then spoke of himself, his conduct, and his enemies; and said, that as a private individual, he always acted justly, and morally right; but as a public man, he clothed himself with a garment of policy,—an ingenious, but not a new apology for the commission of iniquity. I remained about a quarter of an hour; and when I took leave, he did me the honour to offer me the freedom of the royal box at the opera; and also to invite me to his country
  • 41. seat, where he said he spent much of his time, for that to be respected, (he meant feared) one must not be seen too often. The Conde appears to be about fifty, he is rather under the middle size, and somewhat lusty; his head and face are large, and his eyes expressive of much. One may read in them, violent passions, penetration, reflection, and cunning. The character of the Conde de España has been variously represented. All admit, however, that he is a man of most determined and fearless character; and that Catalunia, which, to be preserved in tranquillity in these perilous times, requires to be ruled with a rod of iron, could not be entrusted to any man better qualified to wield it. When he first took upon him the government of the province, he committed many oppressive acts; some of which I have related in the chapter entitled “State of Parties,” consisting, for the most part, in banishment without trial; and even in some instances, carried so far as secret execution. This was soon after the fall of the constitution; and some apologists of the Conde excuse these proceedings upon the plea of political necessity; an expression that, in my mind, involves a sophism, because I do not believe that the moral government of the universe can ever include in it a necessity for doing evil. The government of the Conde de España has sanctioned many lesser acts of inquisitorialness and oppression. Several despotic orders were issued immediately upon the French revolution breaking out: ever since that time, no greater number than four persons are permitted to dine together in a coffee-house; nor are politics allowed to form the subject of conversation in any house open to the public; and it is believed, that the Conde is not entirely ignorant of the conversation that passes in many private houses also. He has even had the boldness to interfere with the usages of the church, by interdicting the celebration of the midnight mass in the cathedral, at Christmas; probably, because he disliked the assemblage of so great a number of persons during the night: but, of course, mass was permitted to be celebrated in a more private way. The strictness of the Conde extends also to morals: all houses of ill-fame are suppressed, and instances occurred, even while I was in Barcellona, of inquisitorial strictness in more private matters relating to morals. Dining one day in company, one of the gentlemen at table received a message while at dinner, which he immediately attended to, and withdrew; I saw a smile pass round the table, and I afterwards learnt, that the occurrence was not unusual. The gentleman had a liaison with a chére amie, who lived in lodgings provided
  • 42. by him; but this the police would not permit; and, to escape their interference, these lodgings were changed every few days; and every few days he was questioned as to his secret, and obliged to pay a fine. This was the act of the police; and, although the police is not within the department of the Conde, who is captain-general, not civil governor of the province, yet it is well known that both the military and civil government are in his hands; and that the civil authorities do not move a step without his permission. Along with this strict surveillance of morals, the Conde’s own morals are irreproachable, and he neglects no opportunity of showing his regard for religion; he is present at all its public ceremonials; and assumes an air of the deepest devotion. This is doubtless to please the party of Carlists, who might otherwise prove dangerous. But with all these inquisitorial and tyrannical acts, even his enemies admit, that he is the only man who could have kept Catalunia tranquil: and peaceable-minded persons, however they may condemn the means by which the quiet of the province has been preserved, are satisfied with a government under which they feel a security against civil commotion. It is a great mistake to suppose that the Conde de España is attached to the apostolical party; quite the reverse: he is a decided, thorough-going royalist, who will exert himself to the very uttermost for the preservation of the king’s government; and come when it may, a revolution in favour of either Carlists or liberal, the deadliest stand against it will be made in Catalunia, if the Conde de España be then captain-general. But, that he is no Carlist, is evident from his conduct in 1827, when he put that affront upon the bishops, which I have already said has been one means of securing the enmity of the Archbishop of Toledo. The circumstances are as follow:—In the latter part of 1827, when the Catalunian insurrection in favour of the Carlists took place, and when fifty thousand men in arms threatened the province with anarchy, and Barcellona with capture, the Conde de España represented to the king the necessity of his appearing in Catalunia; and after his majesty had arrived, he, by advice of the Conde, called a convocation of bishops, ostensibly to consult respecting the state of the province. The Conde well knew the connexion of the bishops with the plot; and was in possession of documents that proved their guilt. The Conde, as representing his majesty in that province, or by express delegation, presided; and all the bishops being assembled, he addressed them to this effect, if not almost in these words:—“My Lord Bishop,” said he, taking a paper from his pocket,
  • 43. and unfolding it, “you know this,”—and turning to another, and shewing another paper,—“and you, my Lord, know this,” and so on, producing documents that connected every one present with the conspiracy; “and now, gentlemen,” said he, addressing the assembly, “you perceive that I hold in my hands proofs of treason; you who have fomented this rebellion, can put it down; and I have instructions from his majesty, if the rebellion be not put down within forty-eight hours,—I am sorry for the alternative, gentlemen, —but my instructions are peremptory, to hang every one of you; and it will be a consolation for you to know, that the interests of the church shall not suffer, for the king has already named successors to the vacant sees.” This reasoning was effectual; the bishops knew the man they had to deal with; and within forty-eight hours, the insurrection was at an end. A man who threatens to hang a bench of bishops, cannot surely be called an apostolical. At the same period, but before the council had been called, when Gerona was closely pressed by the insurgents, the bishop dispatched a letter to the Conde de España, saying, that it would be necessary to give up the city to the besiegers. The Conde, who very well knew how the inclinations of the bishop lay, and what were the defences of the city, but who also knew the influence possessed by him over the inhabitants, who might force the troops to give it up, wrote, in reply to the bishop, that his lordship being upon the spot, was no doubt best able to judge of the state of the city; and adding, that along with the letter which he had sent to the bishop, he had also sent instructions to Gerona, that when the enemy entered the gate, the first thing they should see, might be the gibbet of a traitor bishop. It is generally understood that, but for the Conde de España, the French army would not have evacuated Spain; and that the king was brought down to Catalunia with this ultimate object. When the Conde was made captain- general, he refused to reside in Barcellona, because it was in possession of the French, and he established himself at Tarragona. He then advised the king to pay a visit to Barcellona, and obtained permission to write to the French authorities there to prepare for his majesty’s reception. To this the French general replied, that he would receive the king, but not any guards; and the Conde, who knew that such would be the reply, told the king that he was insulted; the king got angry, and refused to go to Barcellona, and even left Catalunia. The French general now suspected he had committed an error, and he sent for instructions; an ambassador was despatched in consequence to the king, who was then at Valencia, requesting to know
  • 44. what were his majesty’s wishes. The Conde de España had been busily employed in the meanwhile, priming Ferdinand to act with spirit; and when the king was asked what his wishes were, he replied that he wished the French army to evacuate Spain. The only pretext for the occupation of Spain, was to defend the king; and the king declaring that he wanted no defence, this pretext was at an end. The Conde de España is of French extraction, but at an early age he entered into the service of Spain, and by his talents and zeal, he has raised himself to the highest honour that could have been conferred upon him,—in having received for his title the name of the country that conferred it. The count dislikes, or affects to dislike, every thing French, and likes, or affects to like, every thing English. He speaks English fluently, and few things are more disagreeable to him than to be addressed in the French language. With respect to political feeling in Barcellona, I may say that, among the upper ranks, there is a secret wish for some change,—for a milder government, less tyranny, and a free press; but there is no feeling in favour of what is called a constitution. At the time the French revolution broke out, there was naturally much excitement in Barcellona; but I found the universal opinion of the best informed classes to be, that the state of moral and political feeling among the Catalunians must prevent the progress of any movement in the province; and that no attempt in favour of greater liberalism has the smallest probability of success on that side of Spain, unless by foreign interference. When I was in Barcellona, there were many Carlists prisoners in the city; and before I left it thirty prisoners were brought from Zaragosa. It was generally thought that if the Conde de España had a carte blanche as to the disposal of them, many ran a risk of visiting Ceuta. The public buildings of Barcellona are not deserving of much notice, with the exception of the custom-house and the cathedral. The cathedral is light and beautiful, in the late Gothic stile, with finely painted windows, and a choir of wood workmanship of singular delicacy. The convents, with the exception of the Dominicans, are without any attraction. In that convent there were formerly some curious records in the cloisters, of the heretics who had been burnt, from the year 1489 to the year 1726; but these the monks have thought proper to remove. I saw nothing in the convent to attract attention, excepting a picture of a certain saint who came from Majorca to Barcellona in six hours, with no other boat than his cloak. Great
  • 45. part of this convent was destroyed in the war of independence; and the monks are now erecting a large and handsome building for the reception of their library. The only other religious edifice worth a visit, is the church of the Jesuits, which is remarkable for the beauty of its marbles. The opera house is also a respectable building, and the interior is large and handsome. I several times availed myself of the entreé to the royal box, presented to me by the Conde de España. The Conde is never seen in it; but it is always lighted in the interior, by elegant candelabras, and centinels stand at the door, as if ready for the reception of royalty, or its representative. The opera of Barcellona enjoys a considerable reputation among the European operas; and the inhabitants are passionately attached to it: but last year, it was considered below its usual strength. The whole of the boxes in the house, with the exception of five, are private boxes; and cost 50l., 55l., and 60l., according to their situation, for the season. This impresses one with no mean idea of the inhabitants of a provincial city, who can afford to rent the whole of the boxes in a large opera house, at so considerable a price. Single places too, in what is called the lunetta—a row of seats all round the front, and a little beneath the level of the boxes, are taken by the season; and it is rarely that one of these remains unlet after its commencement. These places cost fifty dollars, and many of the best seats in the pit, are also let for the season, at forty dollars. The first bass is paid the sum of two thousand five hundred dollars for the season, the first tenor three thousand dollars, the principal female singer two thousand four hundred dollars, the second two thousand dollars; and a benefit is worth eight or nine hundred dollars; for, upon these occasions, besides the free places, presents are made by proprietors of boxes. While at Barcellona, I walked one morning to the hill and fortress of Monjuich, accompanied by Colonel Barry, then commandant of the citadel. I believe that if sufficiently provisioned, the fortress is considered to be impregnable. There are about two hundred brass cannon mounted, and an immense number of unmounted guns, and a large garrison. In descending the hill, and making a circuit towards the sea, some large stones with Hebrew characters upon them, were pointed out to me; but the inscriptions are now illegible. It is believed that this was the burying place of the Jews, and the name Monjuich seems to favour the supposition. From Monjuich, after walking through the citadel, which is even a more perfect fortification than the other, though by situation, less strong, I
  • 46. continued my walk to Barcellonetta, the port of the city: the buildings are modern, and ugly; all built upon the same plan, and all constructed of red brick. A massive breakwater defends the entrance of the harbour to the south; it is already four hundred yards in length, and four hundred yards more are to be added to it. It is forty feet broad, and thirty feet high. There were few vessels of any size in the harbour, excepting two Spanish sloops of war, and a few foreign brigs. The foreign trade of Barcellona is reduced almost to nothing; particularly the trade with England. About thirty years ago, seven hundred British vessels entered the port in one year. Since then, the number has rapidly decreased. In the year 1825, fifty-three British vessels entered the port, and in the year 1830, only eleven. This decrease in the trade with England, is owing to several special causes. One of these, is the non-importation of English hardware, which used formerly to supply almost exclusively, the Spanish markets. This trade has changed its direction; and in place of hardware of British manufacture, it is now the manufacture of Germany that is used: they say it is much cheaper, and nearly equal in quality. Another cause of the decline of commerce between England and Barcellona, is a change in the direction of the fish trade. The Swedish and Norwegian fish are now preferred by the retail dealers, because, when steeped, they imbibe water, which the cod of Newfoundland do not; and, as they are sold by weight, the dealer finds his profit in this preference. Besides this preference, which has deprived England of an important branch of trade, the fish trade of Barcellona has suffered a general decline ever since the year 1826. At that time, a house in Madrid (Shea) obtained a monopoly of this trade in the Catalunian ports; and immediately, with a short-sighted policy, additional duties were laid on. From that time, the general import declined; and, although the duties have since been lightened, the trade has not revived; because, when fish was scarce and dear, the convents, where it is chiefly consumed, made use of vegetables in its stead, and have now become accustomed to this change in diet. Still another branch of trade which is lost to the commerce of England, is cotton. The Catalunians have discovered that it is cheaper to import cotton direct from Pernambuco, than to take it by way of England. All these are changes in the direction of the commerce of Barcellona, operating upon the trade with England; but, some of them not affecting the extent of Barcellona commerce; nor, with the exception of cotton, connected with its export trade. But the export trade of Barcellona has
  • 47. almost entirely ceased. This, which consisted in silk and cotton manufactured goods for the Spanish colonies, is now at an end, with the exception of the small quantity still sent to the Havannah; and the export of shoes also, which employed in their manufacture at Barcellona, before the loss of the colonies, upwards of two thousand hands, has also entirely ceased. I had an opportunity, while at Barcellona, of being present at an execution—the first I had seen in Spain. The man had been condemned to the galleys for some previous offence, and had murdered one of his fellow- convicts; and, although this is not an agreeable spectacle, yet, as in every country, public spectacles, whether agreeable or the reverse, exhibit some peculiarities either of character or of manners, I resolved to be present. Three o’clock was the hour appointed; and all that morning, as well as great part of the day before, there was an unceasing noise of little bells, carried through the streets by boys in scarlet cloaks, with the bell in one hand, and a box in the other, collecting alms to purchase masses in the different convents and churches, for the soul of the felon. There is another thing worth relating, connected with the last days of a felon in Spain. A society, called the Benevolent Society, undertakes to soften the last three days of his existence, and to diminish the terrors of death, by the singular device of increasing the pleasure of life. During these three days, he may have every luxury he desires; he may feast upon the daintiest viands, drink the choicest wines; and thus learn, in quitting the world, new reasons for desiring to remain in it. I obtained a good situation, close to the military who guarded the ground. Besides the platform, there was erected, at a little distance, an altar, upon which was placed an image of the Virgin and Child; and opposite to this, a cross, with an image of Christ extended upon it. I was much struck with the procession; the unfortunate felon was accompanied by upwards of two thousand masked penitents, who looked more like a train of devils than human beings; a black cloak entirely enveloped the body and the head, holes only being left for the eyes and mouth; a black pyramidical cap, at least eighteen inches high, crowned the head; and each carried in his hand a long white wand. This strange escort was the result of an indulgence published, and addressed to all persons conscious of secret crimes, and penitent; granting its benefits to such of them as submitted to the humiliation of accompanying the felon to the scaffold. Two accomplices of
  • 48. the felon also accompanied him, that they might benefit by seeing him hanged; and a friar of the Franciscan order, was his spiritual guide. After having been led to the altar, and then below the cross, where he repeated a number of prayers, he ascended the platform attended by the friar, who carried a large cross in his hand. When the offices of religion were concluded, the man wished to address the people, and twice began “Mis Hermanos,” but his voice was instantly drowned by shouts from a crowd at some distance behind the platform, no doubt so instructed; and when he found that he could not be heard, he gave the signal, and the executioner immediately leapt upon his shoulders, and swung off the platform; while the friar continued to speak, and extend the cross towards him, long after he was insensible to its consolations. The spectacle concluded by the friar ascending to the summit of the ladder, and delivering a sermon, in which he did not omit the exhortation of contributing largely towards masses for the soul of the deceased. The exhortation was not without its effect; the little bells immediately began to ring, and hundreds obeyed the invitation to piety. Barcellona has always been celebrated for the zeal of its priesthood, and for the pains taken by them to hoodwink the people; and even in these days, religious bigotry is far more prevailing than might be expected in a city so near the frontier; and which has had so much connexion with foreign nations. In another chapter, I related a circumstance that occurred eight years ago, when a peasant was condemned to ten years imprisonment in the citadel, because he said unthinkingly, that an image of some virgin was made of wood; and so late as the year 1827, another very flagrant example of religious superstition, and of the use made of it even in these days by the clergy, occurred at Barcellona. There was in one of the churches, or convents, an image of a Virgin, called I believe, the Virgin of St. Pilar, and this image was black. It was at this time, that an outcry had been raised against the liberals, who were called Negroes; (negro is the Spanish for black) and the rumour got abroad, that the negroes went to this church, to pay adoration to the Black Virgin. Such being the case, the priests and friars ventured upon and concerted a miracle which might have the double effect of strengthening the faith of the people, and of bringing the negroes into still greater discredit. One morning it was publicly announced, that the Virgin of St. Pilar, had changed from black to white; and the good Catholics of Barcellona were invited to go and see the miracle with their own eyes;
  • 49. and they went by thousands. Let it not be forgotten that this happened only three years ago. I have to add to these notices of Barcellona and its inhabitants, the price of provisions. Beef sells at thirty-two quartos per pound, of thirty-six ounces. Mutton, thirty-five quartos; scarcely cheaper than in England. Pork, twenty quartos per pound of sixteen ounces; a good fowl costs twelve reals; and a pair of chickens the same—both as dear as in England. A turkey, thirty-two to forty reals. The best bread, seven quartos (2d.) per pound. The wages of artizans are, in general, 2s. 6d. per day; and field labour about 1½d., without including victuals. Before finally quitting Barcellona, I resolved to pay a visit to Monserrat, —a place that has derived remarkable notoriety from the singularity of its situation. I accordingly left Barcellona at the early hour of four, in a galera, which passed within half a league of the foot of the mountain. The country between Barcellona and Martorrel is the same as I have described on my journey from Tarragona; and from Martorrel to the foot of Monserrat, the land is divided between corn and wine; it is every where populous, and every where exhibits proofs of Catalunian industry. The approach to Monserrat from this side, is not remarkably striking, owing to the elongated form of the mountain; but as we approach nearer, its height, and singular conformation, become sufficiently imposing. After quitting the galera, I walked to the small village that lies at the foot of the mountain; and having got some chocolate, and a guide, I began the ascent. A zig-zag path, of not less than a league and a half, leads up the mountain to the convent, which is not seen until at an abrupt turn it is discovered lying on a platform, in a recess of the rocks which rise in perpendicular cliffs directly behind it. The view from this platform is wild and imposing; towards the north, a long line of snowy summits marks the Pyrennean boundary of the Peninsula; towards Barcellona, the Mediterranean is seen beyond the rich and diversified country that lies between the mountains and the sea; while the mountain itself,—its lower part encircled by a belt of wood,—its grotesque range of rocky peaks above, and its convent, and hermitages, are not the least striking features of the landscape. In the interior of the convent I saw little deserving of notice; the occupation of it by the French, and other causes, have left it nearly a ruin; but its ruins shew its former extent. The architecture of the building is mixed; part of it is Gothic; while later parts were built in the time of Julius II., and of Philip III. There were formerly
  • 50. seventy monks in the convent; but now, it is inhabited by thirty only. I saw in the refectory, a pilgrim who had come all the way from St. Jago in the Asturias, and who was going to Rome. By the rules of the convent, a pilgrim is fed three days within it. He was a man past the middle age, and was rather reserved in his communications; not appearing willing to tell any more than where he had come from, and whither he was going. His habit was covered with scallops and little images. Monserrat is not the interesting spot it was formerly. The numerous hermitages were then tenanted, and the convent possessed many curious and valuable things; but the French carried away the latter, and destroyed the former; and now, Monserrat is worthy of a visit only on account of its situation, the view enjoyed from it, and the singularity of its aspect and conformation. The mountain is said to be four thousand feet high; and the platform of the convent is two thousand five hundred feet above the Mediterranean; the lower parts are treeless, with the exception of a few scattered and stunted ilex; but its acclivities are covered with a thick carpet of box, juniper, rosemary, and a thousand fragrant shrubs. I returned to the inn about dusk, and found the accommodation so bad, that I regretted I had not accepted the letter offered by the Conde de España, to the abbot; but I did not, at that time, purpose visiting Monserrat; and perhaps a dormitory in the convent might have been as comfortless as the quarto in the venta. Next morning, at day-break, I left the village on muleback, and arrived in Barcellona in sufficient time to make one at the hospitable board of Mr. Annesley, nephew of Earl Annesley, and his Britannic Majesty’s consul at Barcellona, whose many kindnesses, gentlemanly attentions, and unwearied hospitality, I eagerly and gratefully acknowledge. My journey in Spain now approached its conclusion,—I had only to travel from Barcellona to the frontier; and as the general aspect of the country could be seen as well by rapid as by slow travelling, I resolved to take advantage of the public conveyance, and left Barcellona by the Diligence, for Perpignan, some hours before day-break. The year had already expired, but winter had scarcely made itself felt. The mornings and evenings, indeed, had been chilly enough to turn one’s thoughts towards the comforts of a fire; and once or twice at Barcellona, when I walked round the ramparts before breakfast, I observed a thin covering of ice upon the pools; but there had been no rains,—the days were clear and sun-shining;
  • 51. and one might liken the season to a dry month of March in England,—only with fewer clouds. It is scarcely possible to conceive a more beautiful drive than between Barcellona and Gerona. The road keeps near to the sea all the way, and an enchanting country lies on the left. You pass through a succession of little plains, each from half a mile to three miles across, and each containing a village. These plains lie in little recesses of the mountains, which screen them behind, and separate them from each other, leaving one side open to the sea. They are covered with the finest vegetation, which advances within twenty yards of the sea, and are generally skirted by a hedge of aloes, that runs all along the coast. Between these plains the hills run forward into the sea, generally terminating in perpendicular cliffs; and the road, after traversing the green level, approaches close to the sea, and is carried along the front of the precipice, till having passed the barrier, it then descends into another of these little smiling recesses. These plains were covered with beautiful and promising crops when I passed through them; and round the villages, beds of every kind of vegetable,—cauliflower, cabbage, carrot, onion, and pease, shewed excellent crops, all ready for the kitchen. Every house, the centre of its own little farm, has a draw-well in its neighbourhood, from which the land is supplied. Some of these villages were singularly beautiful, particularly Cardetta, hanging upon some heights above the sea, with its little fertile plain,—all that the mountains would allow to it,—lying at its feet. These heights were entirely covered with the prickly pear, the last I saw; and near that village I also saw the last palm tree; but it was of stunted growth, not the stately and branchy palm of Elche. The difference between the villages and cottages of Catalunia, and of the other provinces of Spain, is seen at a glance; and in the state of the inhabitants, the difference is equally striking. The houses and cottages have an air of greater neatness and comfort,—there is glass in the windows, and the insides display the articles of furniture in common use. No beggars, and fewer ragged people are seen,—industry is evidently active,—stones are removed from the ground, and collected in heaps,—fences are more general, and more neatly constructed,—nobody is seen basking in the sun, —even the women and girls who are tending the cattle, are not sitting idly wrapped up in plaids, but every one has her spindle in her hand. In short there is altogether a new order of things.
  • 52. We breakfasted at Mataro, a considerable and once a flourishing sea- port, famous for the excellence of its wine; and, till lately, famous for its linens and laces, which were exported to the colonies; and about mid-day we left the sea-coast, and entered the mountains. New and charming scenes awaited us in passing through these mountains to Gerona. Covered with stately pine, their sides were also clothed with the richest underwood of evergreens, flowering shrubs, and fragrant plants; among which the beautiful arbutus was particularly distinguished. After emerging from the mountains, we entered the fertile and sheltered valley of Gerona, where we arrived about sunset. This was once a place of importance, now chiefly attested in the number of its religious edifices, for here there are no fewer than thirteen churches, besides the cathedral and eleven convents. The bishopric is richer than that of Barcellona. At Gerona we supped, and slept, and set out next morning about day-break. Between Gerona and Figueras, I saw nothing that deserves to be recorded, excepting the change in temperature; a bitter wind blew off the Pyrennees, and reminded me that I had left the regions of the south behind; and when we reached Figueras I hailed a blazing fire upon the hearth, with the satisfaction of a northern traveller. The fuel here, attracted my notice; it was a thin dark cake, which, upon inquiry, I found to be the refuse of the olive, after it is pressed, and which, I have no doubt, might be given with advantage to the cattle. I learned, however, that it is not put to this purpose, though it is given to pigs and poultry. The price of this cake is sixteen reals (3s. 4d.) the 100 lb. It is singular, that at this town, so near the frontier, the inn should still be in all respects, the Spanish posada: it is just as little French as the posada of Murcia or Andalusia: the fire still blazes in the middle of the floor; coffee and tea are still unattainable; and meat is to be found not in the inn, but in the market: how numerous and expressive must be the shrugs of the Frenchman who makes Figueras his first halting place. Caffé au lait, or coutelettes, are alike out of the question. From Figueras to Junquera, the last town in Spain, I passed through a pleasant undulating country, and then entered the valley that lies under the Pyrenees,—a valley not fertile, but picturesque, traversed by a small mountain stream, covered with the olive and the cork tree, and winding into the recesses of the mighty barrier that shuts out the Peninsula from the rest of the world. Rising above the valley, I found myself inclosed among the mountains, and leaving Spain behind; I had left the carriage, to walk up the
  • 53. steep ascent; and soon, Bellegarde, upon the summit of the pass, and the pillars that mark the boundary of the kingdoms, appeared in sight. The valley behind was still visible through the defile; and as I turned round to look upon Spain for the last time, a thousand recollections and vague fancies crowded upon my mind. I felt a sensation something like pride, in having traversed Spain. Much I had seen to interest, much to delight, much to lament, much to remember; and as I turned away, regret was not unmingled with my other feelings. As I pursued my way up the mountains, that had now shut out the view of the valleys below, Spain, as fancy had once pictured it—and Spain, as I had seen it, rose successively to my memory. But it pleased me to discover, that romance had outlived reality, or was mingled with it; for the fragrant, and palmy valleys of Spain, still lay among the regions of fiction; Seville retained in my mind, its character of a fabled city; the Sierra Morena was yet traversed by the knight of La Mancha; and Spain, with all its realities before me, was still the land of romance. THE END. Printed by S. Manning and Co., London house-yard, St. Paul’s.
  • 54. FOOTNOTES: [A] Since this was put to press, Sir George Don has been recalled. [B] Some account of this enterprise seems to be a natural digression; and as the fullest account of the rash attempt which led to the abandonment of the enterprise, is to be found in the work of M. Bourgoing, I make no apology for transferring it to these pages. “The court of Spain, weary of the fruitless blockade of Gibraltar, which excited the ridicule of all Europe, and of the besieged themselves, seriously determined to take this fortress by some extraordinary expedient or other, against which its steepness, its formidable artillery, and all the skill of General Elliot should prove unavailing. Plans poured in from all quarters; some bold to extravagance, others so whimsical, that it was scarcely possible to look upon them as serious. Several of this kind I received myself. One of those sent to ministers, formally proposed to throw up, in front of the lines of St. Roch, a prodigious mount, higher than Gibraltar, which would consequently deprive that fortress of its principal means of defence. The author had calculated the quantity of cubic fathoms of earth, the number of hands, and the time that would be required by this enormous undertaking, and proved that it would be less expensive, and less destructive than the prolongation of the siege upon the plan on which it had been begun. “Another proposed to fill the bombs with a substance so strongly mephitic, that on bursting in the fortress, they would either put to flight, or poison the besieged with their exhalations. “The plan of D’Arçon was at length presented, and engaged the more serious attention of the Spanish government. “This plan, first projected at a distance from Gibraltar, by that engineer, who, notwithstanding the issue of that famous siege, still enjoyed the reputation of a man of great talents, was afterwards matured and modified by him within sight of the fortress. But how many crosses was he doomed to experience! * * * * * * * * Scarcely any thing is known respecting it, except what relates to the ten floating batteries, which, on the 13th of September, 1782, foolishly exposed themselves to the fire of Gibraltar, and were reduced to ashes by the red-hot shot from the English batteries. This method of summing up the result of enterprises, is very convenient for indolence or malignity, but would furnish history with very erroneous elements. Enlightened by contemporary historians, her pages will inform posterity, that if this great undertaking failed, it was from a concurrence of circumstances which the genius of D’Arçon could not possibly control. One of the principal was, the hurry with which the plan was put in execution, before all the necessary preparations had been made for ensuring its success. It is well known that the ten batteries had been so constructed as to present to the fire of the fortress, one side covered with blinds three feet thick, and kept continually wet by a very ingenious contrivance. The red-hot balls were thus expected to be extinguished on the spot where they penetrated; but this first
  • 55. measure proved incomplete. The awkwardness of the caulkers prevented the working of the pumps, which were designed to keep up the humidity. It succeeded only on board one of them, the Talla-Piedra, and that very imperfectly. But this was not all; though the place where they were to take their stations had been but very slightly sounded, they had received instructions what course they were to pursue, in order to avoid striking, and to place themselves at a proper distance. This precaution likewise proved unavailing. Don Ventura Moreno, a brave seaman, but incapable of executing a plan, stung to the quick by a letter sent him in the evening of the 12th of September, by General Crillon, which contained this expression: ‘If you do not make an attack, you are a man without honour;’ hastened the departure of the batteries, and placed them in an order contrary to the plan which had been adopted. In consequence of this mistake, no more than two could sustain themselves at the concerted distance of two hundred fathoms. These were, the Pastora, commanded by Moreno himself, and the Talla-Piedra, on board of which, were the Prince of Nassau, and D’Arçon: but they were exposed to the fire of the most formidable battery; that of the Royal Bastion, instead of all ten being drawn up around the old mole, and receiving only sidewise the fire of that battery. “The only two batteries which occupied this dangerous post made great havoc, and sustained dreadful loss. The Talla-Piedra received a fatal shot. In spite of all precautions, a red-hot ball penetrated to the dry part of the vessel: its effect was slow. The Talla-Piedra had opened her fire about ten in the morning; the ball struck her three and five. The mischief did not appear irremediable till midnight. The San Juan, one of her next neighbours, shared the same fate. It appears certain that the eight others remained untouched. “But what was still more distressing, every thing was wanting at once: cables to tow off the batteries in place of accident, and boats to receive the wounded. The attack was to have been supported by ten ships, and upwards of sixty gun-boats. Neither boats, gun-boats, nor ships, made their appearance. “Lastly, according to the projected position, the gun-boats were to have been seconded by the one hundred and eighty pieces of cannon at the lines of St. Roch. This co-operation was rendered impracticable. Near four hundred pieces of artillery were to have opened at once upon North Bastion, Montagu Bastion, and Orange Bastion. With a superiority of nearly three hundred pieces, D’Arçon flattered himself that he should be able to silence the artillery of the fortress. What was his consternation when he found that the besiegers had no more than sixty or seventy pieces, to oppose to more than two hundred and eighty belonging to the besieged. “The combined squadron remained quiet spectators of this tremendous scene: Guichen, who commanded the French ships, sent to offer assistance to Moreno; who replied that he had no occasion for any. “Matters continued to grow worse; and no remedy could be devised. Eight of the batteries were at too great a distance to do or to sustain much injury. The two others bore in their bosoms the elements of destruction. Moreno, despairing of being able to
  • 56. save any of them, and resolving that they should not fall into the hands of the English, directed that those which were already in flames should be suffered to burn, and that all the others should be set on fire. I have seen the original order to this effect. Such was the result of that day, on which were annihilated ten vessels—the masterpieces of human ingenuity—the building of which cost three millions of livres, and whose artillery, anchors, cables, rigging, &c., amounted to two millions and a half more. “D’Arçon, in the first moment of his consternation, acknowledged that he alone was to blame for the fatal issue of the day. I had for a considerable time in my possession the original of the short, but emphatic letter, which he wrote to Montmorin the ambassador, from the very shore of Algesiras, amid the dying sound of the artillery, and by the light of the burning batteries. It was as follows: “I have burned the Temple of Ephesus; every thing is lost, and through my fault. What comforts me under my misfortune is, that the glory of the two kings remains untarnished.” But on recovering from the shock, D’Arçon wrote a learned memoir, in which he took great pains to modify the confession which had escaped him; and to prove that he had more than one partner; or rather that circumstances, the most untoward and imperious, constituted his only fault. “Scarcely had Gibraltar foiled beneath its walls, this formidable attempt, when in sight of our armies and our squadron, the place was re-victualled by Admiral Howe, who afterwards, with his thirty-six ships, boldly entered the Mediterranean. He was seen from Buena Vista passing from one sea to the other; every spectator supposed that he was running into the jaws of destruction. The fifty-two ships which were in the bay, weighed anchor, and pursued him; but Howe baffled our endeavours, as fortune had done our plans; and returned through the Streights in the same security as he had entered them.” Such is the account given by M. Bourgoing. He had access to know the facts, and they are probably correct; but there is, evidently, a French polish over the whole detail. [C] The existence of this gateway, and the story connected with it, are perhaps known to few, but were identified in the researches made to verify this history. The gateway is at the bottom of a great tower, at some distance from the main body of the Alhambra. The tower had been rent and ruined by gunpowder, at the time when the fortress was evacuated by the French. Great masses lie around, half covered by vines and fig trees.—Chronicle of the Conquest of Granada.
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