By TINA ALVEY
The Register-Herald
LEWISBURG, W.Va. — A doctor and nurse work feverishly in one corner to staunch the bleeding from an accident victim’s severed limb, while another nurse urges a woman sitting next to an ailing toddler’s bed to extinguish her cigarette, and a third medical team coaxes answers out of an obviously intoxicated woman, getting little help from her distraught husband.
(Register-Herald photo by Jenny Harnish)
Similar scenarios play out in emergency rooms across the country every day, but this particular chaotic scene is one of many staged every day in the Clinical Evaluation Center at the West Virginia School of Osteopathic Medicine. And its purpose is to give medical students an opportunity to practice their skills in a realistic setting, but with lifelike mechanical simulators or trained individuals who portray the roles of patients.
“This program is one of the main reasons I came to this school,” said Scott Gay, a third year medical student from Dallas, Pennsylvania. “Here, we can practice with ‘patients’ before we need those skills in a real situation.”
Skills that Gay and other students have honed within the walls of the 37,000-square-foot, multi-million-dollar facility on the Lewisburg campus range from taking medical histories from the trained role-playing patients — known as standardized patients — to dealing with opiate overdoses and traumatic physical injuries.
A graduate teaching associate who assists faculty with various duties while continuing his own education, Gay participated in the multilayered ER demonstration described above that was staged for the media on Friday. As the physician assigned to stabilize the manikin with a severed limb, Gay gained valuable practice in his field — emergency medicine — that could well contribute to a positive outcome for a patient one day.
The program’s assistant medical director, Dr. Elizabeth Ziner, noted that WVSOM students are exposed to patient simulation scenarios beginning in their first year of med school.
“We create cases they have to work through, but in a safe and controlled environment,” she said. “And afterwards, we give them feedback to help them improve their skills. Simulation improves patient safety by allowing students to practice here before treating real patients out there.”
The Clinical Evaluation Center (CEC) also hosts inter-professional events, bringing in pharmacy and nursing students to better teach teamwork and clarify what each member of that team does in a given situation.
“The emphasis today is on a multidisciplinary approach to health care, and we are introducing students to that concept early here,” Ziner said. “This is an extraordinary center, and our staff is highly skilled.”
That staff includes physicians, nurses and a respiratory therapist, Ziner pointed out, adding that faculty from many specialties throughout the school also contribute by helping to write diverse scenarios for the simulations.
“Everybody is invested in this training,” Ziner said.
WVSOM was the first medical school in West Virginia and the first osteopathic medical school anywhere to receive accreditation through the Society for Simulation in Healthcare.
The CEC has 24 lifelike human patient simulators, costing between $20,000 and $200,000 each. Those simulators run the gamut from infants, children and adults to specialized birthing simulators. In addition, the facility has more than 130 task trainers — models of body parts used to learn a specific task, like suturing or joint injections.
The CEC employs between 60 and 70 standardized patients, who are individuals from the community who have been trained to accurately portray the role of a patient with a specific medical condition. They assist the students in developing communication and clinical skills and in working through difficult emotional situations.
One of those standardized patients, Elaine Fox of Lewisburg, explained, “There are lots of hours of training for any lab or event we do, a lot of memorization. Students may veer off and chuckle (during a simulation), but we have to stay in character.”
As a standardized patient for the past three years, Fox said, “I just like the interaction with the students. I like the change-up. I’m never sick in real life; I’m only sick here.”
And just as instructors evaluate the quality of the technical aspects of the students’ performance of their duties in the simulations, standardized patients also are responsible for handing out grades to the participants.
“The human side is what we grade them on,” Fox said. “How they interact with us — talk to us, listen to us — that’s where we come in.”
CEC staff member Angie Amick, an LPN, said, “We also want students to interact with the patient’s family to learn how to judge whether a family member has important information to offer or should instead be disconnected from the patient during the interview process. We want good bedside manner. We want good communication with the patient.”
She said the scenarios devised for the simulations are designed to incorporate lessons that have already been taught to the students in classrooms, thereby reinforcing the learning. The scenarios last for between a half-hour and an hour each.
“Students say the hands-on experience helps them remember what they’ve learned,” Amick said.
“The more you do something, the more automatic it becomes,” Ziner added. “It’s like they say, ‘Practice makes perfect.’ That’s what we hope the students take away from this. This is their garage, where they get to tinker with the machinery before they go out on the road with it.”
Amick said many of the simulations represent “something we’ve actually seen.” She said the aim of some of the scenarios is to prepare the future physicians for difficult patients or relatives of patients.
“When you see this training actually influences the care to patients, that’s what makes it all worthwhile,” she said.
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