Across the country, the use of patient simulation has created a new paradigm for training and educating professional health care students. The use of standardized patients (trained actors who portray a patient in a medical situation to teach and evaluate health care students) and sophisticated computerized mannequins gives these aspiring health care providers opportunities to experience urgent and realistic medical scenarios where they can gain the valuable experience that aids them in providing successful and safe therapeutic outcomes for their future patients.
An (Un)simulated Eye Toward the Future
Simulation training has become commonplace at the Texas Tech University Health Sciences Center (TTUHSC) campus in Amarillo, where future medical, nursing and pharmacy practitioners have routinely utilized state-of-the-art mannequins to train at the SimCentral facility located at TTUHSC’s Wallace Building.
In an effort to take simulation training to a new level on the Amarillo campus, and to ultimately improve patient safety and save lives in West Texas, the Texas Tech University System Board of Regents approved construction of the Panhandle Clinical Simulation Center on May 19.
The 20,485-square-foot facility will provide space for teaching clinical simulations using high-tech, state-of-the-art mannequins and computer software. It also will include observation rooms, a large classroom that can be divided into two smaller classrooms and requisite space for support staff and equipment. The project has a $9.75 million budget primarily supported through tuition revenue bonds. The Amarillo Economic Development Corporation also contributed $500,000.
Student and Faculty Perspectives
TTUHSC student Melissa Ponder is completing her third year of medical school on the Amarillo campus and plans to eventually apply for an emergency medicine residency. She said TTUHSC medical students are introduced to simulation training in their first class, Clinically Oriented Anatomy, and for mock patient interactions for development of clinical skills (DOCS) sessions where they learn to conduct a proper history and physical and how to correctly utilize examination equipment.
“We used ultrasound and simulated many patient scenarios throughout all our two basic science years,” Ponder added. “We are often in the simulation center for each clinical clerkship, as well, to practice various procedures and run through scenarios like traumas and resuscitations.”
Ponder recalls a time when she wanted to gain more experience in an emergency medicine (EM) situation. Ponder sought help from School of Medicine Regional Dean Richard Jordan, M.D., and a classmate. Working together, the trio organized an EM simulation symposium for fellow medical students and nursing students.
“With the help of various faculty, we were able to spend a day in SimCentral running through common emergency scenarios in real-time, simulating our true roles and learning the pertinent procedures for the situation,” Ponder recounted. “Our simulation team here on campus is more than amazing, so if students have an idea, they can let the SimCentral team know and they can make it happen.”
Ponder believes simulation is an integral part of her medical training because it provides a hands-on learning experience. She said it’s especially important for learning skills and procedures that medical students may not have many opportunities to practice in real life, like suturing, intubation and placing IVs and lines.
“It’s not enough to merely read about a procedure or clinical scenarios in a book,” Ponder explained. “You won’t truly know how to do something until you physically go through the motions. Simulation allows students to become proficient at various skills and clinical scenarios prior to participating in real patient situations. We have also had many interprofessional simulation events, which allow us to learn each others’ roles and how we should interact in clinical settings.”
Ellen Hampsten, M.D., a member of the TTUHSC School of Medicine Department of Family Practice faculty for five years, agrees with Ponder about the positives associated with simulation. Hampsten, who serves as her department’s clerkship director, said she was introduced to simulation during the family medicine residency she completed in Amarillo following her time as a TTUHSC student. As an instructor, she uses simulation during the family medicine clerkship to help students feel more comfortable in health care settings.
“In a simulation setting, the students have the opportunity to use the skills and knowledge they learn in the classroom in a safe environment,” Hampsten said. “Many times they are able to practice leadership skills, teamwork and communication with students from other medical fields.”
Hampsten said students are highly supervised by professional practitioners during the simulation exercises. This means their procedural skills can be practiced and refined before they are asked to perform in an actual patient situation.
“When they are in actual clinical settings, they have more confidence, knowledge and skill to administer medical care and work with the health care team since they have been in the situation in a simulation before,” Hampsten added.
John Slaton, D.O., has been involved with simulation at TTUHSC for six years: three years as a family medicine resident and three years as a practitioner and teacher. Simulation also was part of his medical training at the University of North Texas Health Sciences Center College of Osteopathic Medicine.
“Medicine is all about experience,” Slaton said. “Didactic learning is needed, but students and residents never forget what they have seen in an actual patient. Simulation of common scenarios can help prepare students and residents for the stories they might hear in a patient history, symptoms they might see on a physical exam and responses they might see from a correct, or incorrect, treatment. It helps to solidify what they have been reading about and gives tactile learners something to visualize and participate in.”
Like Ponder, Hampsten and Slaton give high marks to the SimCentral staff and the facilities currently being used across TTUHSC at Amarillo. They are excited to see what else can be accomplished with the addition of the new simulation building and facilities.
“The Texas Panhandle is a unique community for medical education in that we have a large patient population in a vast region,” Hampsten said. “Simulation education brings students of different health care entities together to foster teamwork, communication and medical skills. A new building with more space, state-of-the-art technology and the dedication to teach simulation will not only improve medical care in our region, but also aid in the retention of health care professionals in our area.”
Slaton said the new building will expand the simulation opportunities on campus and remove some of the space restrictions that have cropped up as more departments begin to increase their use of the existing SimCentral facilities.
“Simulation will continue to be a vital part of our training so that we can give students and residents different experiences in a controlled setting,” Slaton concluded. “The more access we have, the more widely we can incorporate it into the curriculum.”