Human patient simulation is used for education in anesthesiology, critical care, pediatrics, emergency medicine, surgery, trauma, cardiology, pharmacy, nursing, and others. The list is continually expanding as this tool is used more and more.
We use human patient simulation as a teaching tool in a variety of ways. For example, we teach pharmacy students how to do a physical assessment on a patient. The students learn about normal and abnormal sounds from the heart, bowels and breath, and how to check blood pressure, pulse, blood glucose, and cholesterol.
Simulation challenges students to think critically when caring for a patient with a complex medical condition, and allows educators to provide immediate feedback on student performance. This method allows continued practice in a controlled environment without adverse consequences, but gives students a variety of realistic experiences and exposure to high consequence, low occurrence events like medical emergencies.
About the Manikins
The high fidelity manikins can be programmed to display a variety of disease states and also can exhibit appropriate responses to medication therapy. The manikin might have cardiovascular disease, respiratory disease or exhibit a swollen tongue. Students not only learn and practice physical assessment skills, but also practice communicating with patients because the manikin can be programmed to respond to questions. The 3-G manikin we use is highly sophisticated with expanded fidelity: the eyes blink and the manikin can cry or sweat, and is operated wirelessly.
Performing physical assessment skills with the use of a high fidelity manikin is one functionality of human patient simulation, but there are many others. It is one of the many tools we use to teach our students how to deliver safe and high quality care to patients.
We continually create new simulated scenarios to challenge students and to test the most effective ways to use this technology.
Student pharmacists work in groups of 3-4 during these realistic, hospital-based scenarios to implement a therapeutic plan for the patient. Immediately following the simulation, the faculty facilitator conducts a debriefing. Using a detailed grading rubric, the facilitator addresses communication efficiency, professional attitude, clinical skills and knowledge, error identification, and critical thinking in each of the simulation participants.
Current hospital based scenarios include:
- Pain Management
- Advanced Cardiac Life Support/Code Team
- Clostridium difficile Infection
- Infectious Disease – Pneumonia
Emergencies in the Pharmacy Community
If a customer begins to display signs of a heart attack in the check-out line at your drugstore, what do you do??
Recognition and appropriate treatment of medical emergencies is an important patient care skill for pharmacists. Human patient simulation scenarios in a community pharmacy setting give student pharmacists the chance to use their patient assessment skills and clinical knowledge to implement appropriate treatment.
Effective emergency preparedness and response planning equips emergency responders to be ready for any type of incident, emergency or catastrophe, including natural or man‐made situations. Healthcare providers and emergency responders involved in acute care also require training and practice in recognizing and treating rare, but potentially devastating, exposures to toxic agents.
Below are a few of the scenarios SimMan has participated in to assist with emergency preparedness training.
Spokane Valley Active Shooter Exercise
The mock incident, staged between midnight and 8 a.m. at the Spokane Valley Mall in May 2013, involved two shooters, hundreds of bystanders, and a few casualties. The 3-G high fidelity simulator "victim" was hit by bullets and bleeding. The victim was evaluated by emergency responders, treated by paramedics in the parking lot and taken by ambulance to a hospital for resuscitation in the emergency room. The manikin scenario was put together by fourth year pharmacy students as a special project, and was about 2 hours of the entire exercise.
This scenario gives participants the opportunity to recognize cyanide exposure and differentiate it from other biological or chemical exposures. Additionally, the scenario allows participants to design and deliver the appropriate therapy to effectively treat cyanide toxicity – both pharmacologic and non-pharmacologic for treatment and support of the patient.
Read more on our cyanide scenario:
Case Report: Recognizing and Treating Cyanide Exposure
Rumble in the Rubble
In April 2012, the College of Pharmacy worked with emergency response agencies including American Medical Response, Spokane Fire Department, Spokane Department of Incident Management Teams, and Spokane county fire districts at the Spokane Fire Department training facility near Spokane Community College to simulate a hospital building collapse. The event involved several simulated injuries, including our simulation manikin as a blast injury victim from an oxygen tank explosion.
Medical Reserve Corps
We support the training efforts of this group by designing education workshops for the Spokane members. The Medical Reserve Corps in Spokane is a volunteer, community-based unit that collaborates with existing emergency and public health resources to prepare for and respond to emergencies and promote healthy living.
Read more about the Medical Reserve Corps here »
Using a high fidelity manikin creates the opportunity to develop scenarios for commonly encountered medical diagnoses. This provides student learners the opportunity to gain the repetition and familiarity needed to respond quickly in a professional health care setting. The interprofessional collaboration gives students the chance to not only practice interacting with patients, but also valuable experience working in a professional team made up of several health care disciplines that is emerging in modern health practice environments.
Faculty from the College of Pharmacy, College of Nursing and the University of Washington physician assistant program collaborate to conduct interprofessional simulation scenarios for students. Eastern Washington University’s dental hygiene program also uses human patient simulation, and recently students from WSU’s Program in Nutrition and Exercise Physiology used the simulation manikin to practice acute care in a rehabilitation health care setting. Pharmacy students are also included in interprofessional simulations involving pediatric issues with a baby simulator owned by the WSU College of Nursing.
View some of our program results (link to be updated) from the cardiac rehabilitation simulation.
These team-based scenarios last approximately 20 minutes and are immediately followed with a 30 minute debriefing session facilitated by faculty from all disciplines.
The simulations focus on the content areas of adult shortness of breath, Advanced Cardiac Life Support (ACLS), and pediatric respiratory distress. Global learning objectives for each simulation include:
- Demonstrate appropriate discipline-specific skills.
- Diagnose and implement appropriate initial treatment plan.
- Demonstrate professional communication skills in a health care team.
- Communicate effectively when giving a patient case report for nursing change of shift and/or a clinical case presentation to a consultant or preceptor.
Here are a few comments from our students on interprofessional simulation:
“It was beneficial to see how different professions interact with each other, and how I can contribute myself to emergency situations.” –NEP student
“I learned how important it is to come together as a multidisciplinary team and communicate effectively to keep the patient safe. Thank you and please lets do this more often!!!”
Read more on interprofessional simulation:
We periodically participate in health sciences camps in the Spokane and surrounding areas, using human patient simulation with teenagers to introduce them to what a pharmacist does beyond counting pills. Campers get a hands-on opportunity to interact with the high-fidelity manikin, are allowed ask him questions, and are taught how to use basic physical assessment skills (i.e. blood pressure, pulse, respiratory rate, heart and lung sounds).
Read more on WSU health sciences camps for high school students:
WSU News Article: Health science camps promote careers and college
Photos from these and other simulation events are posted on our Photo Gallery web page.