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UC Davis Health System's simulator program trains in the no-risk zone
It's late afternoon in a hospital trauma receiving room. Three young doctors-in-training talk with a patient as they prepare him for surgery.
Stan D. Ardman, a 55-year-old truck driver, is complaining of chest pain following an accident. Suddenly, the monitors go wild — the patient's blood pressure falls precipitously as his heart begins beating erratically.
The young doctors snap into emergency mode. One takes charge, beginning chest compressions, shocking the patient with a defibrillator and instructing her impromptu team to inject epinephrine and deliver oxygen. Another team member documents each step in the resuscitation process.
The quick response and procedures are evidence of a well-trained team working together. The three physicians assessed the patient's condition, made critical medical decisions, and stabilized the patient. A life saved?
Not exactly. That's because "Stan," also known as Standard Man, is a sophisticated instructional simulator used to provide training to health-care students and professionals.
State-of-the-art training tool
Stan is one of several high-tech simulation systems and state-of-the-art training tools now being used at the Center for Virtual Care, a facility and program established by the UC Davis School of Medicine at its teaching hospital in Sacramento.
Simulation systems have come a long way since the introduction of those rubbery mannequins on which many people learned CPR. Like a real patient, Stan, can be injected with medication and have tubes inserted into his throat or abdomen to open up an airway or relieve fluid buildup.
Developed by a Florida-based company, the unit has a pulse, normal and abnormal breathing and heart sounds, pupils that are sensitive to light, and an airway that swells when exposed to a medication to which he's programmed to be allergic.
‘You can't beat a surgical robot for accuracy.’
Will Fuller, UC Davis gastrointestinal surgeon
Programming a variety of medical situations
Sophisticated programming allows students to practice a variety of medical situations in a supervised learning environment, so that by the time they are assigned a real patient, they are skilled, experienced and confident.
"The use of simulators in medical education is the equivalent of flight simulator training for pilots," says Judith Hwang, an anesthesiologist and one of the School of Medicine's faculty instructors at the center.
"Regardless of expertise, students learn new procedures, make errors and, more importantly, learn how to recover from them," Hwang added. "Since their 'patients' are never at risk, trainees become more confident and more proficient in their skills."
With four full-sized mannequins, including a newly acquired infant version, one can simulate everything from a busy, intensive-care unit to a multi-vehicle crash, thereby allowing medical students, paramedics, nurses and physicians to practice their roles in tandem.
Robotic surgery simulator
In addition to the patient simulators, doctors who want to try a form of "virtual surgery" can get a real workout in another room at the center, where a surgical robot is set up exclusively for training.
This machine allows doctors to develop and hone their robotic skills – often practicing with colorful rubber bands to replicate the minute movements needed in surgery – before actually using them in the operating room.
"You can't beat a surgical robot for accuracy," notes Will Fuller, a gastrointestinal surgeon at UC Davis. "But learning to manipulate robotic arms safely and efficiently really takes practice. Having a training unit available is a wonderful benefit for surgeons like myself who are always looking to acquire new skills or maintain the existing ones."
Looking ahead
On the home page: Several UC Davis medical students practice creating an airway for their virtual patient, "Stan D. Ardman" (aka "standard man"). (John Swain/UC Regents photo)
The Center for Virtual Care is one of only a handful of medical centers in the United States that offers such a comprehensive variety of simulator training experiences at one site. Plans are in the works to take training to a whole new level by expanding the current facilities to include a virtual children's hospital, mental health ward and even a fully equipped trauma unit.
"The bottom line is patient safety and improving care," said Hwang. "When healthcare professionals have the chance to practice skills as well as work together as a team, patients benefit from the experience gained. The reason UC Davis is taking a leadership role in developing system-level education is to improve the health of its patients and skills of its medical students and staff."