The same question pops into the mind of nearly every patient being treated by a young doctor or surgeon: How many times has he or she performed this procedure? Could I be the first? Though medical residency education has always been structured so that you are never in fact “the first,” new simulation technologies have come online that provide residents and student nurses with more—and more varied—clinical experience than was ever thought possible, all before ever seeing a single patient.
The Brooklyn Hospital Center has created a simulation laboratory equipped with this state-of-the-art technology, which lets students practice interventions on highly realistic, computer-controlled mannequins and other materials that replicate human tissue and biological systems.
According to Chief Academic Officer Benson Yeh, MD, the simulation lab—located right in our Downtown Campus—represents a paradigm shift occurring in medical education taking hold throughout the country.
“It used to be taken for granted that nearly all residency-level education needed to happen in the traditional way,” said Yeh, referring to the time-honored process of following the course of illness and recovery throughout the arc of a patient’s hospital stay.
“But new technologies have turned that model upside down. Some procedures can be taught almost exclusively in our simulation lab, thus avoiding patient risk. It’s a win-win situation for patients and medical students.”
The high fidelity of today’s simulation technologies opens up two important educational doorways.
“Simulation labs are great for helping students learn procedural competencies like inserting a central venous catheter line or performing laparoscopic surgery,” said Dr. Yeh. The technology gives residents the chance to practice an intervention dozens or even hundreds of times. They can even replay a video of their own work on a computer.
But as helpful as it is for developing fine motor skills, medical simulation really shines when it comes to teaching students how to make complex diagnoses and treatment choices, both of which require weighing multiple pieces of information either simultaneously or in quick succession.
“It’s not enough for a student to recognize that a patient is in distress,” said Dr. Yeh by way of example.
“You have to consider the age and gender of the patient, his or her vital signs, prior medical history, and so on. All of these data points guide the decisions a doctor makes from moment to moment, with each new piece of information or change in the patient’s condition potentially leading to a new branch of choices. Simulation laboratories like ours help students acquire these judgment skills. You can’t get this from a conventional academic setting.”
Despite the great potential for competency building, it’s interesting to note the technology has other, unexpected, educational uses. While no technology in and of itself can teach compassionate healthcare, the simulation lab provides “real opportunities for doctors and nurses in training to see the world through the patient’s point-of-view,” said Nurse Christine Fothergill-Cox, Director of Nursing Education for The Brooklyn Hospital Center.
This may require a bit of clever misdirection, however.
A student may enter a simulation thinking the objective is just fine tuning a clinical skill, but the real goal of the session may be to reveal how attentive the caregiver is to a patient’s level of pain. “Students come away understanding that it’s not enough to give great care technically,” said Fothergill-Cox. “You also have to help your patients avoid any unnecessary discomfort.”