A doctor is walking down the hospital hallway and is abruptly stopped by one of his colleagues: "Can you help? My patient is deteriorating. I need someone now!" It may be a patient with an arrhythmia and altered vital signs or a patient who has gone into a diabetic coma. Only one thing is certain — it's not real.
It's medical simulation.
"Medical simulation allows medical students to try things and see the consequences without risk, so they can explore and learn, just like we all learned things when we were 3 or 4 years old," says UCLA anesthesiologist Randolph Steadman, MD.
The UCLA Simulation Center
Dr. Steadman, a professor and vice chair of the Department of Anesthesiology at the David Geffen School of Medicine at UCLA, is the founding director of the UCLA Simulation Center, which he has led since its inception in 1996.
The 9,000-square-foot Simulation Center — the first of its kind in Southern California to provide medical simulation-based training — is an educational unit that promotes experiential and interactive learning. It serves a number of different groups, including medical students, residents and practicing physicians who are participating in continuing medical education.
"We have the actual equipment they would encounter when providing patients with care," says Dr. Steadman. "In some cases, they are seeing that equipment for the first time and learning to use it in a simulated setting before they use it in an actual setting."
Just as a new pilot must spend hours in flight simulation before taking off in an actual plane, medical students are required to participate in medical simulation. For example, on the final day of a fourth-year medical student's intensive care unit rotation, they are asked to handle one of a number of scenarios — such as a patient with gastrointestinal bleeding or an altered mental state — to test his or her knowledge and skills.
How simulated learning comes to life
After graduation, medical students might encounter these types of situations, but they would not be expected to deal with them autonomously. A resident would supervise them, and an attending physician would supervise the resident. However, in the Simulation Center, because there is no risk, they are permitted to make all of the decisions.
"This encourages them to get cognitively involved," explains Dr. Steadman. "They'll be the ones asking the questions, doing the exam, ordering the laboratory test and making decisions based on those initial actions."
The scenarios generally last between five and 10 minutes, but Dr. Steadman says it can feel like an eternity for students. "They may make mistakes," he says. "But they get to see the consequences of their mistakes, and then we debrief them."
The debriefing focuses on learning and retention. It gives students the opportunity to ask the questions they were asking of themselves during the scenario and get input from their peers and the facilitator.
"One of the ways to minimize medical errors is to learn from them," explains Dr. Steadman. "With the Simulation Center, we can recreate medical errors, so that the next generation of learners can understand the situations in which errors occur."
By Emily Williams