For medical students, hands-on experience in the emergency room means high pressure cases, in often life and death situations. Today, medical educators are using new teaching tools that combine state-of-the-art technology and role playing.
Inside the emergency room at Northwestern’s Feinberg School of Medicine, students are getting real-life medical experience in a virtual ER.
As an emergency medical technician wheels in a patient on a gurney, the team begins their work.
In the ER, Chief resident Matthew Pirotte leads the medical team in treating a car crash victim.
The treatment is real, but the exercise is simulated.
Here, doctors and nurses in training can be immersed in a complex medical simulation to learn firsthand about the pressures and procedures involved in treating patients.
“They’ve noted at the scene that the patient is decreasing in mental status, seems to also be experiencing severe chest pains and there’s bruising on the chest,” explains Dr. Jon Vozenilek, Director of the Northwestern Simulation Program.
Before each medical emergency simulation, he briefs the trauma team as to what they can expect when the patient arrives.
“In general, what we try to create is an emergency situation,” said Vozenilek. “What you saw today was a trauma resuscitation, which involved nurses and doctors working together to resuscitate a patient from a traumatic event.”
Once the simulation begins, the trainees must treat the patient and their colleagues as if they are taking part in a real world emergency scenario.
“Hi, this is trauma surgery,” said Dr. David Salzman as he answers the phone in the adjacent control room.
Inside the control room, which looks like a mini-television studio, technicians and faculty work together to make sure that the simulation is as close to real-life conditions as possible.
They can monitor the patient’s vital signs and send in X-rays while the entire procedure is viewed through a one-way mirror and recorded using closed-circuit cameras and in-room microphones.
The patient, which is known as a simulator, can do some pretty incredible things. It can blink; the pupils can react to light. It breathes. And all of these things can be monitored and regulated from the control room.
The simulator can respond to medication so that the doctors can actually see what’s happening to the patient.
“It takes a while to get used to the unique characteristics of simulation,” said Matthew Pirotte. “Obviously dealing with real patients is different. I think you have to step into a mindset where you realize that you’re focusing on other aspects of patient care; generally, more cognitive and teamwork aspects as opposed to the hands-on.”
Matt adds that the simulation exercises provide an opportunity not available on actual hospital shifts. Without the chaos of juggling all the different cases, he says residents and nurses are able to focus in on one patient and one case in a way that allows them to refine their approaches in a risk-free environment.
The simulation recordings are then taken to a debriefing room where students review the procedure and their performance is evaluated.
“Debriefings are very helpful,” said Trauma Nurse Jennifer Mullen. “They allow you to really look at what happened, and it’s nice to see yourself from outside and know if you’re wandering around aimlessly, or if you’re actually doing what you’re supposed to be doing in there. I think that’s extremely beneficial for all of us.”
Dr. Vozenilek says the simulation program is really intended to emphasize the importance of how doctors and nurses work together, and interact in the confines of a real-life medical environment.
“Our mission is to enhance patient quality through outcomes research,” he said. “Many centers focus on the clinical research and the education. We’re trying to bridge into this type of research that actually proves that simulation saves lives and impacts the hospital very directly.”
The program, he says, marks a shift in medical education, from having 100 students in a lecture hall to having smaller groups learning; using cutting-edge technology and still getting hands-on experience.