OHSU Looks at Patient Simulator as Teaching Tool for Future

03/02/00    Portland, Ore.

Realistic simulator offers "real-life" medical experience

The patient doesn't get clammy skin or bleed when cut, but it does breathe, have a heart rate and a voice. On March 8, the patient will be at Oregon Health Sciences University to be poked, suctioned, resuscitated and closely watched for adverse reactions to medical interventions, but its poise and tranquility should put its audience at ease. The patient is actually a sophisticated, computer-controlled mannequin that simulates a human patient in a variety of clinical settings.

The OHSU School of Medicine, in collaboration with MedSim Simulation Inc. of Fort Lauderdale, Florida, is staging the demonstration so that faculty and students can see for themselves the advantages, and disadvantages, of using patient simulators for teaching and research purposes. Although the school currently does not own a patient simulator, Edward Keenan, Ph.D., associate dean for medical education at OHSU's School of Medicine, says that the school is evaluating the possibility of purchasing a patient simulator and would include it as a key part of a clinical simulation and skills-teaching center. "We're looking at ways to better utilize technology in the education and training of medical students and residents."

Patient simulation centers have sprung up at medical centers around the country, but none yet exists in Oregon. Simulation centers can realistically replicate fully functioning operating rooms, intensive care units, emergency departments or patient rooms, with the mannequin as the star patient. The mannequin's internal components can interface with various types of patient monitors and simulate respiration, heart rate, blinking and even speech.

Medical school leaders envision a multidisciplinary simulation center where all OHSU students, including dental, medical, nursing and allied health professions, can go to learn and experience clinical situations in a controlled and reproducible environment. The computerized mannequin, along with a control and observation room, and other lifelike training devices, would comprise one aspect of the center. The other major part would involve real humans who have been trained to portray, or "act out," clinical conditions and then assess the skills of student physicians in handling those situations.

One advantage of the patient simulator is that "students can run through a situation over and over again," according to Richard Botney, M.D., assistant professor of anesthesiology, School of Medicine, "and it's completely safe. No one gets hurt." He says that patient simulators also allow students the opportunity to practice things they might not encounter except in rare circumstances, such as emergency situations. Botney draws a parallel between patient simulators and flight simulators where students can gain valuable experience before tackling the real thing.

Botney and Keenan are quick to point out that no matter how sophisticated the patient simulator, it cannot replace experience with living tissues and organisms. For example, the simulators cannot be used for surgical training.

However, the mannequins have become popular teaching aids in fields such as anesthesiology, where a physician-in-training can administer drugs and other substances, all the while watching how these substances affect the patient's respiration, heartbeat and general condition. Some of the patients even "talk."