Before 'sim man,' med schools taught with old-school techniques

"I've never tried this before" is the last thing you want a doctor to say to you. However, there is a first time for everything, and medical procedures are no exception.

Fortunately, Penn's School of Medicine uses advanced technology to enable students to practice procedures on mannequins that can simulate complex surgical procedures.

Though this simulation technology is relatively new and is expanding with the opening of the Measey Simulation Suite in June, some sort of hands-on practice is already a standard for medical students.

Prior to 1997, when Penn started using advanced simulation in its medical curriculum, students had to gain experience in less-sophisticated ways.

Before complex full-body simulation men were available, medical students used task trainers, like arm models, to practice routine procedures such as drawing blood and administering IV's. Some of these task trainers are still in use today.

Using task trainers allows students to practice ordinary procedures that are performed on a regular basis.

"A patient should not need to worry if the doctor is going to hit the vein on the first try," said Neal Gauger, a simulation specialist at the Hospital of the University of Pennsylvania.

Another simulation technique still used at the School of Medicine is the use of real people, known as standardized patients, who are trained to act out symptoms and scenarios that the students may see in practice.

"About three-fourths of the standardized patients are actors and actresses who work at night and prefer simulating to waiting tables during the day," said Gail Morrison, the vice dean for education at the Medical School.

Standardized patients are a particularly useful tool because not only can they act out symptoms of a disease, but they can also help train students in the more emotionally challenging aspects of medical care.

Situations like breaking bad news, talking with sexually and physically abused victims and dealing with angry patients are a few situations that standardized patients act out.

Task trainers and standardized patients can also be combined to increase the reality of the simulation. These combined-form simulations are often used for traumatic situations like shootings or childbirth.

"Having a real person there who can scream, cry and bang on the table is much more realistic. People don't just lie there," Morrison said. "You realize the hysteria that can brew in a situation, and you have to learn not to get drawn into that. People get pretty shaky at first."

These older techniques will also be utilized at the new Measey Simulation Suite. Simulation is useful because students and doctors can practice procedures over and over with no real consequences, doctors say.

Simulation also helps build confidence that students can carry with them when they start their careers, said Esther Chen, the director of medical student education in the Department of Emergency Medicine.

But, "some things you just can't simulate," Chen added. "I don't see it as a way to replace actual patients in medical education, but it's a good way to supplement."

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