From docs to med students, new UW Hospital simulation center gives practice time

2011-11-02T07:00:00Z From docs to med students, new UW Hospital simulation center gives practice timeDAVID WAHLBERG | dwahlberg@madison.com | 608-252-6125 madison.com

When Sim Baby's oxygen level drops, its mouth turns blue.

METIman groans and coughs from heart failure.

TraumaMan's neck can be punctured to create a tracheostomy, or hole for breathing.

The high-tech manikins — anatomical models used in health care, as opposed to storefront mannequins — are among the stars of UW Health's Clinical Simulation Program, featuring a new $6 million facility on the first floor of UW Hospital.

The 6,500-square-foot center, which had its grand opening Tuesday, lets nurses, medical students and even experienced surgeons practice their skills in an environment much safer than on real patients.

"If you're the patient, which would you rather have us do?" asked Dr. K. Craig Kent, UW Hospital's chairman of surgery, who pushed for the center when he took the job three years ago.

The aviation, military and nuclear industries long have used simulation. Medical schools around the country have joined in during recent years, but few have dedicated centers like UW Health's, said Dr. Michael Seropian, president of the Society for Simulation in Healthcare.

Fields such as anesthesia and laparoscopic surgery have started to require simulated training, so many academic medical centers are planning such centers, Seropian said.

"We are seeing a rapid growth in this technology," he said. "It's improving the safety and quality of care."

At UW Health, nurses, medical students and residents, or doctors-in-training, will use the center most, said George Keeler, simulation program manager.

The manikins enable students and health care workers to learn how to put breathing tubes in patients, insert catheters, tie stitches, lift patients out of bed and diagnose problems such as obstructed airways, Keeler said. Some of the models breathe in anesthesia gases and respond to drugs.

Trauma and intensive care teams can use the center's mock hospital rooms to mimic emergencies such as car crashes or heart attacks. A "HeartWorks" torso lets users practice taking ultrasound images of the heart.

Even seasoned doctors will make use of the center. Surgeons can grasp surgical instrument handles while watching a video screen to improve the dexterity needed for laparoscopy, operations through tiny holes instead of large incisions.

The hospital plans to invite doctors and other medical staff from the region to take simulation courses, Kent said. One day, scans of patients' bodies might be incorporated to create customized simulation programs.

"Surgeons could do a run-through on your anatomy the night before your procedure," Kent said.

Vascular surgery, which deals with diseases of the blood vessels, is one area that can especially benefit from simulation, said Kent, who specializes in the field.

To clear plaque from carotid arteries in the neck, the surgeons used to perform surgery using large incisions. Now, in many cases, they thread catheters through the groin instead and deploy stents, or tiny mesh cylinders. Both procedures can reduce the risk of plaque causing strokes.

The stent procedure is complicated, even for surgeons who excel at the traditional approach, Kent said. "You essentially have to learn a new type of surgery," he said.

Simulation allows surgeons to practice until they feel they're ready to work on a patient, he said.

It's a departure from the mantra that has guided medical education for decades: "See one, do one, teach one."

Now, perhaps, it's "Simulate many, do one."

The big difference, according to Keeler: The stakes are much lower at the simulation center.

"There's no risk here to the patients or to the practitioners," he said.

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