“I feel terrible,” the 20-year-old ) emergency-room patient moans. She’s wheezing badly and ) getting dizzier by the minute.
Doctors move quickly to fit ) a nasal cannula over her nose and start administering oxygen. ) They check her heart rate and blood pressure, call for ) an EKG and put their stethoscopes on her chest to listen ) to her lungs. Detecting severe bronchospasms, they decide ) to hook her up to an albuterol inhaler and do an epinephrine ) IV drip. As her stats drop, they begin manually bagging ) her, forcing air into her lungs. It’s touch ) and go.
Well, sort of. The patient is actually a $35,000 ) patient simulator—a plastic mannequin that speaks, ) breathes, and has carotid and femoral pulses. An invaluable ) teaching tool, SimMan can go by the alias of Josephine ) or Joe, depending upon which genitalia and wig s/he is outfitted ) with on any given day. “Standardized patient actors ) are also simulators,” says ) David Gaba, professor of anesthesia and associate dean ) for immersive and simulation-based learning. “But ) they don’t ) like to get stuck with needles, have tubes put in them, ) or have serious diseases and die.”
Gaba is fondly ) known as the “father of simulation” by ) physicians at the Veterans Administration Hospital, where ) one of Stanford’s simulation centers—the oldest ) in the nation—is located. The School of Medicine also ) trains students on simulators at the Stanford Center for ) Advanced Pediatric Education, in the Stanford Barn, and ) this fall will open a third center, for the department ) of surgery. Gaba adds, “when ) the big new medical education building opens in 2009, one-quarter ) [of it] will be a learning center that will combine all ) the modes of immersive learning—standardized patients, ) mannequin-based simulators, virtual reality and part-task ) trainers,” which ) are simulated portions of the body, like an arm on which ) to practice sutures.
The voices behind Josephine and Joe ) at the VA center belong to Rebecca Smith-Coggins, associate ) professor of surgery, and Phil Harter, assistant professor ) of surgery. They take turns sitting behind a one-way mirror ) in a control room next to the simulated emergency room, ) turning up the dial on heart rates and contributing the ) occasional “Ohhhh, I think ) I’m gonna die.”
In addition to training interns ) and residents, the pair also teaches Introduction to the ) Management of the Ill Patient, a course for second-year ) medical students. Working on the mannequins, aspiring doctors ) learn how to start IV lines, insert breathing tubes, treat ) severe allergic reactions and defibrillate patients in ) full arrest. Says Practice of Medicine course director Clarence ) Braddock, “It gets them as ) close to what it’s like to take care of a really sick ) patient as we can.”
