How patient simulators enhance medical education

Virtual technology helps train tomorrow's physicians
By: | Issue: March, 2019
March 4, 2019

Kelly WalshThe latest in patient-simulation technology allows medical students to look at the human body in ways they haven’t been able to before. Still, some educators find that even today’s advanced mannequins—even the pregnant ones—lack the crucial feel of a real cadaver.

Mercy College, a private, multi-campus college in New York state, recently built the Health Professions Clinical Simulation and Learning Labs on its main campus in Dobbs Ferry, just north of New York City. These facilities employ a variety of medical patient simulation technologies.

Miriam Ford, assistant professor and co-director of the Nursing School of Health and Natural Sciences explained the range of tools available during a tour of the labs. Digital cameras throughout the lab enable review and assessment of how students perform with the faux patients.

“Every year in the United States, the third leading cause of death is medical errors,” says Karen Koziol, director of clinical simulation. Students get hands-on practice with these patient simulators to reduce medical errors.

The labs feature multiple generations of the medical mannequins, from the simple “low-fi” models with no sensors, to the top of the line “high-fi” models. These have internal sensors that enact bleeding and produce sounds with the help of a remote human controller, among other features. There is even a pregnant female mannequin that gives birth.

To add more of the human experience to these virtual patients, all are regularly assigned new identities and often new genders. Students learn their names and medical history from patient charts.

The big picture

One of the newer technological additions to the lab is an interactive video display table. The Anatomage Table is a technologically advanced visualization system for anatomy education. The long, narrow, glass-screened table top displays a high resolution image of a 3D human body. A corresponding image is displayed on a large, double-screen display mounted on the wall.

Virtual tools have replaced the use of animals for learning in many cases.

One advantage of this digital system is the ability to zoom in to resolutions that exceed what is possible with a physical “analog” cadaver. These 3D constructions were created by layering thousands of 2D images of millimeter-sized slices of donor bodies, says Ferdinand Esser, assistant professor of Health Sciences at Mercy. The high-res 3D imagery makes it possible to dissect sections through planes and rotate them to explore the body from any angle with the simple flick of a virtual scalpel.

Improving haptic feedback

“There are many ways that today’s virtual technologies can be an effective educational aid,” says Steven Schwaitzberg, professor and chair of the Department of Surgery at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.

“Virtual tools have replaced the use of animals for learning in many cases. They can teach junior surgeons the steps for removing a gallbladder, for example,” Schwaitzberg says. “There is clearly a role for VR, but until programming catches up with reality, we can still do many things more affordably with physical models.”

Virtual tools need to advance significantly in terms of providing haptic feedback if they are going to effectively displace the use of cadavers and other physical specimens, he says. Haptic feedback simulates the sense of touch through motions, force and vibrations.

One haptically-enabled patient and procedure simulator combines a VR headset and a pair of pen-shaped 3D manipulators that are seen as scalpels by the user. Users feel the resistance of tissue and bone as they manipulates the pens.

With each year, advances in virtual medical simulations provide increasingly effective—though costly—options for educators to better prepare tomorrow’s medical professionals.

Kelly Walsh, CIO of The College of Westchester in New York, is author of the Emerging Ed Tech blog at www.emergingedtech.com.