Residents Use Anesthesia
Human Simulator to Build Skills
Meet Stan, a real smart dummy. He's a complex character who doesn't talk, yet speaks volumes to those who visit him at his home at the Ruth Lilly Medical Library at Indiana University School of Medicine.
Stan, short for Standard Man, is a $200,000 artificial patient positioned on the surgical table at the Anesthesia Human Patient Simulator Laboratory. He's wired to a computer programmed with a vast array of conditions - many of them deadly - that put the education and training of residents to the test.
"The simulator lab allows participants to recognize and practice treating rare critical events that may happen in the OR without the stress of having a live patient in front of them," says Andrew F. Stasic, MD, clinical assistant professor of anesthesia, who directs resident education in the laboratory along with Jeffrey L. Lane, MD.
"Let's put this big fellow to sleep now," says Dr. Lane, clinical assistant professor, sitting at the computer console. Attending the patient are a pair of second-year residents. Touch Stan's left wrist and you feel a pulse. His chest rises and falls. His eyelids close as one of the residents places the inhalant mask over his face. The other resident closely monitors the vital signs and information blinking on the anesthesia machine.
"Remember to review the patient's history," Dr. Lane reminds the residents. "You have to be prepared." For this scenario, Stan is a middle-aged truck driver, fifty pounds overweight with a history of hypertension. The diagnosis is an aneurysm. But early in the procedure, the trucker's heart stomps on the brakes. The residents attempt CPR and get no response. They power up the defibrillator machine and deliver shocking jolts. Nothing again. They quickly discuss and decide to inject epinephrine. Gradually, they get a pulse and the vital signs on the screen return to normal readings.
"These guys are doing well," Dr. Stasic whispers. "A little rough in places, but they kept their wits about them."
Following the scenario, Drs. Stasic and Lane review with the residents the pluses and minuses of their performance. The computer also has documented every action taken during the procedure, while an overhead video camera has recorded their actions.
The session complete, Dr. Lane boots up the computer for the next pair of residents. This time, Stan's a fifty-five-year-old woman who has been admitted for cholecystectomy, a routine procedure.
Maybe.