Columbus Hospital Using “Human Patient Simulators” to Teach Physcians in Training

A Columbus medical center claims to be the first in the nation to have its own virtual hospital. Complete with a trauma center, operating room, and intensive care unit, Riverside Hospital’s Center for Medical Education and Innovation also teaches doctors and nurses with high-tech simulators that mimic real patients. It’s hoped the virtual environment will lead to better-trained health care workers and reduce the number of medical errors. WOSU’s Sam Hendren reports At Riverside Methodist Hospital, a figure identified as a 55-year-old male smoker is telling a nurse he’s having chest pains. Moments later, his heart stops beating and a Code Blue team is called

Can we check for a pulse please?

I don’t have a radial pulse

No carotid pulse

Not breathing

Start chest compressions After several shocks from a defibrillator and after several drugs are injected, the patient begins to respond

Continue the chest compressions

Can we check for a pulse please?

I’ve got one but it’s faint

Very good

This heart attack victim was never in any danger because he was never alive. He’s called a human patient simulator a life-sized model whose physical condition – which includes a heart beat and an expanding chest as he inhales — is controlled by a computer. Doctor Pam Boyers is director of medical education at Riverside Hospital

They’re incredible. These human patient simulators are programmed to have over 72,000 possible physiological responses. They breathe in room air and breathe out carbon dioxide. They blink; they can cry; they can have seizures, they can have chest pain, they can have breath sounds and bowel sounds. They can react to drugs and their physiology changes and they can metabolize drugs which is astonishing.

And they respond positively or negatively to the treatment they receive from doctors and nurses. Doctor Thomas Boes, who directs the hospital’s Internal Medicine Residency Program, supervised the just completed heart attack scenario

The sequence was scripted in that we wrote out a protocol of a typical code blue scenario – the type of symptoms that the individual had, the arrhythmias, the change in vital signs – we entered all that into the computer. Then how the computer responds depends on what is done to the simulator. There’s an algorithm so that if they do the correct sequence, the rhythm comes back, and the blood pressure comes up and oxygen improves.

The human patient simulators can help doctors practice putting catheters in veins and arteries. There’s a pelvic model doctors can use to search for a cyst or a tumor. Doctor Boyers and her colleagues believe that the more a health care worker can practice, the better the care they can provide. They also hope training will reduce the number of errors made during treatment. The average patient’s hospital stay is from 3 to 5 days – with that patient being taken 4 places within the hospital for specific procedures. It’s during these so called handovers – that a treatment error is more likely to occur. Doctor Boyers says Riverside’s 4-room virtual hospital may help reduce those errors

One room is a surgery or an operating room, another room is a trauma suite, another is an intensive care unit, and another is an ordinary patient room or treatment room. And this is really important because we feel this way we will be able to practice the hand-over of care and practice communication between health care professionals, so they can provide the optimal patient care.

The virtual hospital also has debriefing rooms where health care teams can watch replays of procedures, analyzing what went right and what went wrong. But Boyers says it’s also important to help physicians learn to nurture the relationship between doctor and patient

We want to remember the humanistic aspect of medical training. So for example, we can make a patient not do so well. And then we can process with the team, How did you feel? How did you react and how did you talk to the family? So this isn’t just about technology, this is also about humanism in training and caring for the patient at every level.

The use of human patient simulators was developed at Walter Reed Army Hospital but is relatively new so new that it was unknown to Riverside’s Chief resident physician Vippin Koshal, when he began medical school. Koshal says he’s encouraged by the prospect that human simulators can contribute to better healthcare

In medical school we learned from patients that we paid to act as patients for us. And of course they could only do limited things because we didn’t want to injure real live people. We can do that here and get a very true-to-life physiological response to see what it’s really going to be like when you walk into a patient’s room.

Sam Hendren, WOSU News