Simulating surgery for med students

December 08, 2006|By Dennis O'Brien | Dennis O'Brien,Sun Reporter

Stan lies on a seventh-floor surgical table, his chest rising and falling with each breath.

His eyes blink as doctors approach. Prone to fevers, muscle aches and chest pains, Stan is hooked to a monitor that tracks his blood pressure, heart rate and other vitals.

But no one at the University of Maryland Medical Center worries much about Stan's health. That's because he's a mannequin - albeit a very expensive one. He's one example of the high-tech teaching tools the medical school unveiled this week to train students, residents and doctors without risking the health of patients.

Practice in the new Maryland Surgical Simulation Training and Technology Center will be a required part of the medical school curriculum. The hospital's medical staff will also use it to brush up on skills.

"We know there's a demand for this, not just from the medical students, but from surgical residents, emergency medical technicians and the nurses. We've got it scheduled for use a year out from now - and we're not even opened yet," said Dr. Adrian E. Park, head of general surgery at the hospital and director of the simulation center.

Simulation centers, opening at medical schools around the country, are based on a common philosophy: novice doctors will be less likely to kill patients if they practice their techniques on simulators first.

The Johns Hopkins School of Medicine uses mannequins and other simulation equipment and plans to open its own simulation center in May, said Dr. Elizabeth Hunt, director of simulation training at Hopkins' medical school and hospital.

"Ultimately, I think patients are going to start demanding this kind of thing," said Dr. David Gaba, an anesthesiologist at the Stanford University School of Medicine who developed one of the first mannequin simulators in 1986.

Advocates compare medical simulation centers to the flight simulators that train airline pilots. "They're a good way of providing feedback on developing the kind of skills that are good for the patient," said Dr. Carol Aschenbrener, a vice president of the American Association of Medical Colleges.

Maryland's simulation center, which cost several million dollars, is spread across three former operating rooms and includes simulators that are becoming increasingly popular elsewhere.

For example, doctors can practice removing a gallbladder with a laparoscopic trainer, designed to mimic the instruments surgeons insert into a patient's belly. Medical students can see and feel what it's like to insert an endoscopic trainer to probe for tumors (graze the electronic "throat" and you hear a cough).

Novices and experienced doctors alike can have their movements tracked by a battery of infrared cameras to analyze their laparoscopic surgical techniques.

The infrared cameras are intended to help them develop techniques that will reduce the muscle aches they experience after surgeries that require cutting into organs and blood vessels with precision instruments.

"Right now, you can have your golf swing assessed, you can have your fast ball analyzed, but nobody's ever used this technology to look at how surgery should be performed," Park said during a tour of the center this week.

Officials couldn't put an exact price tag on the center, according to Ivan M. George, the medical center's director of advanced technologies.

But none of the equipment is cheap, he said. For example, the endoscopy trainer cost $120,0000 and the laparoscopic trainer about $35,000. Grants from the Verizon Foundation, the Swirnow Charitable Foundation, the Army and the Air Force helped fund the center, he said.

Stan's operating room is funded by the Air Force, and is used to train military doctors, nurses and other medical personnel bound for Iraq and other hot spots, said Dr. Thomas E. Grissom, an Air Force colonel based at the medical center.

Up to 30 Air Force medical personnel rotate through the University of Maryland Medical Center each month for training, he said.

With the opening of the center, Stan and a less-sophisticated mannequin are likely to get more use by UM medical students and doctors, Grissom said.

Stan alone cost about $250,000. "This is the most expensive Ken doll you'll ever see," Grissom said.

dennis.obrien@baltsun.com

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