A medical student places a chest tube in a patient lying on
an operating table, while another
student conducts a colonoscopy. Everything is just as it
would be in a real operating or treatment
room, except that the patients won't be harmed or complain
if mistakes are made — they're robots.
These high-tech, electronically outfitted manikins are
equipment in the new $5 million medical
and surgical simulation training center at the Johns
Hopkins Outpatient Center in East Baltimore,
which opened this month.
The "sim" center contains two fully operational ORs,
two intensive care units, high-fidelity
computerized manikins that mimic physiologic and behavioral
response to procedures and 12
examination rooms where students practice routine exams on
actors posing as patients with particular
complaints and symptoms.
The manikins have breath sounds and heart tones,
palpable pulses and a monitor that displays
vital signs as students, physicians, nurses and other
health care professionals practice everything
from bag-mask ventilation, intubation and defibrillation to
chest tube placement and endoscopies.
Computer programs test decision-making skills and knowledge
on topics such as advanced cardiac life
support and trauma management.
"The idea is to get it right before they treat real
patients," said the center's director,
Elizabeth Hunt, assistant professor in the School of
Department of Anesthesiology and
Critical Care Medicine.
The troupe of paid professional actors who are trained
to portray patients submit themselves
to trainees who practice taking histories, performing
physical exams, breaking bad news and
communicating in a compassionate manner.
"Students can learn the science of medicine in many
different ways, but there is only one good
way to learn good bedside manner, and that is with real
people," Hunt said.
Each of the 15 simulation rooms in the center is
equipped with adjustable cameras, microphones,
one-way glass for observer viewing and large flat-screen
monitors so students and staff can quickly
review trainees' performance while it's fresh in their
In addition to training students and staff, Hunt says
the center will be used to train medical
staff on new equipment, and for teaching emergency medical
technicians and paramedics. Outside
groups may also be welcome during continued medical