Model patient makes himself at home in Ahlberg Hall
3:50:07 PM CDT - Thursday, November 04, 2004
By Shannon Littlejohn
Nurse practitioner Heather Baker and physician assistant Rick Muma consulted over the patient lying face-up on the examining table.
"He's not breathing," said Muma.
"I know he's not," said Baker with concern as Muma strode to the beeping monitor bedside and clicked the computer mouse a few times.
The patient immediately started breathing deeply and calmly.
SimMan breathes, speaks, has heart and bowel sounds and pulses that can be felt. Various procedures can be performed on him, too.
Photo by Inside WSU
Medical miracle? More like a manufacturing miracle. The patient in question is SimMan, a simulated human purchased this summer by the College of Health Professions to help train future health-care professionals.
SimMan, trademarked by his maker, Laerdal, breathes, speaks, has heart and bowel sounds and pulses that can be felt. His airway allows for intubation and advanced life support skills. He responds to CPR or being shocked with defibrillators.
"You can tube him, do abdominal endoscopy, bag him, start an IV — pretty much anything you can think of," said Muma, associate professor and chair of the physician assistant program. "If you stick your finger in his mouth, his tongue comes up and he bites down. That simulates a real patient's automatic response."
SimMan can be programmed by computer as a model patient or a student's worst nightmare as he demands attention and goes into cardiac arrest if the right steps are not taken.
It all depends on the case scenario programmed into SimMan by Wichita State's health professions faculty.
"There are stock scenarios in the manual," said Baker, who is the clinical educator and coordinator of the pediatric nurse practitioner program in the School of Nursing. "But we can also customize SimMan for our own needs."
For now, it's SimMan's cardio-pulmonary, respiratory and gastro-intestinal system that most interest the health professions faculty.
"I'm teaching cardiopulmonary this semester," said Muma. "So chest pain is the scenario we've developed."
Muma will show his students how to respond to a patient having chest pain and the right steps to take to determine the problem.
With Muma at the computerized controls, SimMan can respond to treatment administered by a student. If the student fails to follow appropriate protocol, SimMan will have an adverse clinical outcome. That provides an opportunity for discussion of symptoms and treatments that lead to better outcomes.
Muma gave a quick demonstration, programming SimMan to go from feeling pretty good to crisis mode.
"Doc, I feel like I'm dying," said SimMan. The blips on his monitor sped up and, left alone, he demonstrated a mercifully quick death. The right steps could have saved him.
Baker said SimMan is so realistic that other medical schools have reported students breaking into tears over his dying, even though they know he'll breathe again for another training session.
"They get very close to him over the course of their training," she said.
It's vital training for health-care professionals. The American Medical Association reports that error in emergency situations, despite the sometimes heroic, lifesaving efforts of health-care responders, accounts for the deaths of thousands of patients annually.
SimMan is an ideal training model for students, said Baker.
"You can't really learn on a standardized patient; you just test," she said.
Physician assistant students Brian Zerger, left, and Jon Bigler take the vital signs of SimMan, a simulated human recently acquired by the College of Health Professions to help train its students.
Photo by Inside WSU
The U.S. military trains medics with SimMan and owns about 400 models, said Muma. They are taken out in the field with portable computer packs, he said.
"The military ones are dressed in full battle gear — fatigues and boots, the whole thing," said Baker. "And they've got burns and cuts and all kinds of things on those models."
Medical schools were early buyers of patient simulators at costs of more than $100,000, but the simulators have become much more affordable. WSU's College of Health Professions paid about $25,000 for SimMan; the start-up computer equipment was another one-time cost of $25,000.
Muma and Baker hope to add another SimMan and are working with the WSU Foundation to find a potential donor. Eventually they also hope to get SimBaby for pediatric training. SimBaby will likely be more expensive, said Muma.
The simulated patients provide students the opportunity to practice life-saving clinical, technical and decision-making skills without risk to patients or health-care providers, said Baker.
Still, statements like, "I think I'm dying," must make the mundane tasks of health care seem pretty appealing. A student would no doubt much rather hear, as some WSU nursing faculty programmed into SimMan:
"Nurse, isn't it time for my sponge bath? And while you're at it, bring me a drink. I'm thirsty!"