 |
Left: First-year students Greg Root and Katie Lee work with Dr. Joan Stewart on one of the new clinical education training simulators. |
Keeping clinical education for future doctors as much like real life as possible helps teach them how to accurately diagnose patients.
Oklahoma State University College of Osteopathic Medicine’s clinical skills education department six-figure investment in upgrades combines trained, live human standardized “patients” with new medical training simulators (SIMS) and provides an integrated clinical skills training experience.
Joan Stewart, D.O. ’85, associate dean for clinical education, says the new center is a safe, controlled environment where students can practice and refine clinical skills and decision-making before they work with patients. The additional clinical practice contributes to reduced medical errors and increased patient safety, she points out.
 |
Emily Lim (left) directs technology at the new facility, which integrates the SIMS with human standardized patients trained in various scenarios. The human touch gives emotional and psychological clinical challenges to students. The SIM mannequins present a range of clinical and medical problems that human patients cannot “act out.” Students are evaluated in both SIM and standardized patient encounters, which are recorded and can be reviewed by student and faculty on password protected screens.
Human “patients” learn to play a role and respond to student’s questions. Students have 14 minutes to get a patient history, conduct an examination and decide on a differential diagnosis. |
Then, they have nine minutes to list subjective and objective findings, an assessment and a plan. “This system has a digital recording and announcement system to announce how much exam time is left, when to leave the exam room and it also times the SOAP note process,” Lim says. It is exactly like what they will encounter at the National Board of Osteopathic Medical Examiners PE exam.
Students are evaluated on their ability to formulate a correct differential diagnosis, interpersonal and communication skills, patient examination skills including osteopathic structural exam, use of osteopathic manipulative therapy and creating a treatment plan.
SIMS can seem almost human and with Lim at the controls they can initiate the encounter conversation with anything from “hello” to “I feel sick.” “We keep the encounter as real as possible,” Lim says. Students can use SIMS to practice intubation, starting an IV, chest compression or CPR. “Standardized patients can’t make their lungs wheeze, make their hearts race or change their pulse,” Lim says. The Sims can do almost anything human, including regurgitating. They can talk, breathe and answer questions. They can be examined, catheterized and intubated.
Johnathan Franklin, director of clinical education, says the SIMS can also be used to evaluate resident physicians in objective, structured encounters either on campus or in a hospital. Monitors showing replicas of commonly used computer screens at the OSU clinics and the OSU Medical Center are available.
The software can make the SIMS “crackle” in one lung and not the other, increase their heart rate, change blood pressure, pulse or oxygen saturation, and can mimic the physical findings of a very sick patient. Lim can remotely operate a program that can give a SIM a collapsed lung, simulate a code blue (no pulse, no respiratory rate) or a more common occurrence such as an asthma attack, angina, or pneumonia.
Lim took intensive training to learn the SIM system. “My technical background in video and telemedicine certainly helped,” she says as she adjusts SIM controls in a room banked with computer screens. She also is responsible for keeping the equipment operational. Students can evaluate the experience thorough feedback including surveys and comments.
|
