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MEDICAL Simulators help to train real doctors at pseudo hospital

Saturday, June 18, 2005


Medical residents and veteran doctors and nurses are testing their skills in ways they never imagined.
COLUMBUS (AP) -- Mr. Jones complained of chest pain, shortness of breath.
Then he crashed.
"No pulse! Start CPR!" yelled Dr. Thomas Boes.
Boes, nurse Paula Meyers and two others scrambled to save him. They shocked Jones' heart back into rhythm, gave him a drug to boost his blood pressure and sent him to the catheterization lab, where doctors could clear the clog that threatened his life.
Mr. Jones made it. But, truth be told, the team wouldn't have lost much sleep had it lost him.
This patient returns from the dead.
Riverside Methodist Hospital on June 9 officially opened its Center for Medical Education and Innovation: a pseudo hospital full of pseudo patients treated by real doctors.
The first-of-its-kind training center is equipped with an array of simulation equipment.
Doctors can thread catheters into the heart, remove gallbladders, try to save a trauma victim with a severed leg.
Thousands of scenarios
Technicians can program the simulators to create thousands of scenarios. The patients can have complications, pre-existing conditions, allergies and difficult-to-understand accents.
"It's a geek's dream," said Gina Ruffner, a medical-simulation technician.
In the middle of an intubation, the fake patient's tongue can swell, challenging the doctor to slide the breathing tube down the windpipe correctly.
They talk and cry. They slobber. They pee and bleed. Cover their eyes with your hand and their pupils dilate. Put your fingers in the crook of their arm and you feel a pulse.
Riverside's medical residents and veteran doctors and nurses are testing their skills in ways they never imagined.
"It's amazing," said Dr. Jason Winterhalter, who is ending his first year of residency.
He threaded a wire through a virtual patient's heart chambers and into the artery that leads to the lung. He hit a snag and had to pull out the wire partially and rethread it.
"If I go into a patient's room, now I know what to look for, I know where I am," said Dr. Winterhalter, one of 130 residents at Riverside. "This is so realistic."
The old way boils down to three steps: Learn in the classroom, learn by watching and then try it yourself.
The new way allows attending physicians to test their students in all sorts of ways, with all sorts of complications. Cameras record their successes and failures. Computer programs compare their efforts with those of novices and experts.
They also practice the less clinical things, like how to tell relatives when patients die and how to discuss sensitive issues, including organ donation.
At moments, the scenarios seem real.
Despite the pressure, Dr. Winterhalter said he's calm when working with the simulators because he knows he can't hurt them if he stumbles.
"Anxiety is almost completely taken out of the picture, and when that happens you can learn so much better."
For 30 years, Riverside doctors put away money they planned to invest one day in medical education. The center cost them more than $3 million. An additional $1 million is set aside to operate it the first year, and an additional $1 million is in for an endowment, said Dr. Pamela Boyers, director of medical education.
Medical workers throughout the world learn on patient simulators, and some medical schools have been aggressive in teaching on them. But the Riverside center is the first to put so many simulators and so much technology in a virtual hospital setting where all kinds of hospital workers can practice together, Dr. Boyers said.