Student record

Today’s high-tech patient simulators help develop student skills and healthcare workforce

At Central Maine Community College in Auburn, a high-tech model named Victoria is pregnant with her baby, Tory.

Also called a simulator, Victoria can give birth and give birth. Both models have realistic blood pressure, pulse, bowel sounds and blinking eyes. They can give the impression that they are talking.

“We monitor the rate of labor, we have the contractions on one screen, and we will have the fetal heart rate on another screen,” says Kathy McManus, chair of the college’s nursing program. “Students can see how mum is doing, how baby is doing in utero – and the benefit is that we can stop and start again. These are teachable times.

Simulators and other high-tech equipment used to train students for health professions are becoming increasingly sophisticated.

And the simulation capability is expanding. For example, new simulation technologies and simulation coordinator positions are among the key components as Maine’s community college system seeks to double its nursing program to 480 students per year, through a 2,000-year stipend. $5 million included in Maine’s supplemental budget earlier this year and matched by MaineHealth and Northern Light Health.

The expansion is part of an ongoing effort to use simulated environments to provide near-real-world experiences for students in supervised training settings, says Jessica Dreves, chair of the department of nursing at Southern Maine Community College in South Portland.

Leading institutions use advanced simulation technology to enhance graduate skills, especially in high clinical risk, low occurrence situations, Dreves says.

“The technology used in a simulation lab combines real clinical equipment, robots, full-body simulators, simulation-specific monitoring, wireless controllers, communications equipment, and audio-visual recording devices,” explains Todd Dadaleares. , a healthcare simulation operations specialist at Southern Maine Community College. “Sometimes clinical actors or standardized patients will be trained to play specific roles as a patient, family member, or embedded participant to guide the simulation and/or learners through the scenario.”

He adds, “A well-executed simulation should have all the elements of a well-rehearsed one-act play.

Photo/Courtesy of York County Community College

Advanced Emergency Medical Technician students at York County Community College practice scenarios on sophisticated mannequins recently purchased through a partnership with Southern Maine Community College.

Debriefing

Simulation has many advantages. Unlike real life, instructors can stop and restart scenarios, giving students time to ask questions and practice maneuvers.

The quality and ease of use of today’s simulators has improved dramatically, requiring portable computer tablets and monitors.

“Before, there was a huge computer,” says McManus. “Our first simulator had a room that ran the compressor. All the wires and compressor hoses went through the wall and hung on the dummy.”

The ability to record simulations is also useful, allowing for constructive reading and criticism.

Dreves says the simulation is used in a variety of ways in Southern Maine Community College’s nursing program.

“During our first semesters, simulation is a great way to safely demonstrate assessments, medication administration, procedures such as intramuscular injections and urinary catheter insertions,” says Dreves.

In later semesters, high-fidelity mannequins can simulate scenarios such as childbirth and life-threatening scenarios throughout life, from infant to adult, to assess how students use the nursing process. and clinical judgment to intervene.

The emphasis on simulation increased during the pandemic, when some clinical areas were no longer able to accommodate clinical experiences such as pediatrics, maternity and mental health areas, Dreves notes.

New equipment costs for high-tech body simulators can be $60,000 to $70,000, Dadaleares says. But there remains another hurdle – not enough space to expand simulation capability and, therefore, workforce development capability.

Building Trust

Dreves says studies show that adult learners absorb and retain more information if it’s presented with an appropriate amount of stress and realism.

“Perhaps the student is making a mistake or the storyline was designed to progress to a decision that forces a difficult conversation or action,” she says.

Students who simulate learn more from their mistakes than from their successes. The lab provides a safe space to do this, building trust.

“It gives students the ability to come to a certain level of comfort with more complicated intervention and assessment skills, so when they’re with a patient living in a real-life scenario, they have skills and the confidence that ‘they know how to intervene appropriately,’ says Erin Soucy, dean of undergraduate nursing at the University of Maine at Fort Kent.

The Fort Kent campus recently acquired a holographic midwifery simulator, allowing students and the instructor to don helmets to study fetal development.

Another benefit of simulation, Soucy says, is that people can practice “low-frequency but high-risk patient care situations.” For example, especially in rural areas, a nurse may go years without seeing an obstetric complication – but if it does occur, she needs to know how to intervene immediately.

Photo / Courtesy of Maine Community College System

The simulators are arranged in a hospital-type environment in Kennebec Valley Community College mass casualty simulation laboratory.

Realistic scenarios

In Wells, York County Community College has partnered with Southern Maine Community College to implement new high-fidelity simulators for the York County campus’ Advanced Emergency Medical Technician program, funded by the Maine Jobs & Recovery plan and a grant from the Harold Alfond Foundation. (Training, including books and supplies, is free for Maine residents who qualify for the grant.)

The money allowed the program to purchase simulators for adults, children and mothers and babies, says Donald Sheets, co-chairman of the Southern Maine Department of Emergency Medical Services. “We use these in our lab settings to create scenarios that are as realistic as possible,” says Sheets.

For example, students can check the pulse, listen to lung sounds, and monitor heart rhythms. “We’re creating different scenarios where students can test things on the simulator that we’d want them to check on a living patient,” he says.

Leah Mitchell, a former simulation instructor and currently co-chair of the department, says simulators help provide students with the experience needed to meet training requirements. “For our EMT students to graduate, they have to do 10 patient encounters,” says Mitchell.

Due to the pandemic and EMT labor shortages, this number could not be guaranteed by fieldwork in recent years. Simulators fill the void. Sheets credits state funding to advance education and workforce development.

“These simulators are very difficult for us to budget for,” he says. “When the grant funds come in, it gives us the ability to buy new simulators that we wouldn’t be able to buy otherwise.”

There is a world of difference between the simulators of today and those of the past.

“You’re looking for a more realistic experience for all the senses,” says Mitchell. “Twenty years ago you could do airway management and basic heart monitoring. Now you can do surgeries.

Photo / Courtesy of Maine Community College System

A virtual anatomy table Central Maine Community College helps students visualize complete anatomical systems in 3D.

Virtual anatomy

Another educational tool is the virtual anatomy table. “Using this technology, we are able to visualize complete anatomical systems in 3D and show how they function as a unit,” said Trena Soucy, professor of biology at Northern Maine Community College. “The table brings anatomy to life and on the pages of a textbook, increasing students’ understanding of how the body functions in parts and as a whole.”

Technology should never replace actual clinical work, McManus says.

“But there are things students aren’t allowed to do in real clinical situations that they can do here,” McManus says. “For example, students are not allowed to donate blood in the hospital. As a nurse, the first time you donate blood is the first time you do this procedure. But students can gain this experience in our simulation lab. This allows us to teach skills that students cannot learn as students. This better prepares graduates for what they will face in the real world. »

She adds: “It’s very exciting to be a student or a teacher in the health professions.

Photo / Tim Greenway

The Simulation center control room monitoring medical surgical patient room seen through window at Central Maine Community College Nursing Program in Auburn