By Wendy Sarubbi | May 1, 2014 11:41 am

Most students spend their first two years of medical school in a classroom listening to lectures on the science they need to become doctors. At the UCF College of Medicine, that basic science learning is supplemented with innovative hands-on, critical thinking simulations, thanks to a patient who goes by the name of “Sim Man.”

Sim Man has a beating heart, an intravenous drug line, and can breathe, sweat, excrete and even talk. In many ways, he’s the perfect patient for a doctor in training because he’s a mannequin. UCF medical education faculty are using Sim Man to present diseases so medical students can learn to diagnose and treat a problem before they ever hit the hospital wards. And some of those faculty are looking at ways to develop simulations that are more like video gaming – with point thresholds and knowledge levels that students must achieve.

“These students are coming from a different generation and a different way of learning; we as educators have to evolve with that,” said Dr. David Harris, assistant professor of Physiology. “We have a chance here, as a new school, to redefine medical education, and really put our stamp on it.” As many medical students grew up with computers and video games, they are increasingly comfortable in a high-tech, competitive environment. In the future he also hopes to encourage more interprofessional simulated education of medical, nursing and pharmacy students through the use of simulation.

In addition to helping students apply their scientific knowledge in the clinical setting, simulations help encourage teamwork, as students must work together to identify problems and solutions. “There was a huge difference from the first time that we went into the simulation room, to the last time,” said first-year student Jaclyn Reinemann. “We got to the point where we were effectively communicating and working toward a solution or treatment much faster.”

During one of Dr. Harris’ recent simulations, that teamwork extended beyond physicians. In it, a hospital janitor found a patient in distress. Students had to get clues from the janitor about what might be wrong with their patient. “We want the students to realize that the housekeeping staff is part of what we do, as well,” Dr. Harris said. “If they weren’t a part of the team, it would all crumble.”

Medical simulations had such an impact on Reinemann that she decided to research their effectiveness for her FIRE (Focused Inquiry and Research Experience) project. Several collaborative research projects on simulation are ongoing with Dr. Juan Cendan, assistant dean of simulation, and his team. These projects include research on teamwork training led by Dr. Harris and research focused on the learning advantages of simulations in teaching led by pharmacology assistant professor Dr. Laurel Gorman. Early results have been promising. “For medical students to really learn things, evidence suggests that they need to learn it in the context of how they’ll use it clinically.” Dr. Gorman said. “We have data showing that the test scores are higher on pharmacology content reinforced in simulations, and that students recall this pharmacology better than other content months after the experience.”

Dr. Gorman uses simulations to get second year students to make tough decisions that require selecting between varieties of medications working through complex mechanisms. They must use their pharmacology training to make the right choices after making a diagnosis based on Sim Man’s presenting symptoms. Computerized mannequins can respond to many pharmaceuticals. “Every time they administer a drug, they get to observe the effects of it on the mannequin; that’s a very powerful tool.” Dr. Gorman said.

In one recent simulation, students had a patient who was experiencing symptoms of shock, including rapid breathing and an elevated, weak heart rate. On a real human patient, the effects of some drugs could take hours to manifest, but Sim Man began reacting within minutes, allowing students to see immediately if they had made the right choice, and have the opportunity to remedy a negative reaction. Dr. Gorman said simulations are especially helpful in teaching pharmacology because they reinforce scientific information in a hands-on way.

“The power in this is that you can simulate illnesses that you can’t do with a standardized patient,” said Dr. Harris “We’re hoping that the simulations provide a safe place for students to make mistakes and learn from them.”

Students say such interactive learning is invaluable as they head into third- and fourth-year clerkship rotations at hospitals and clinics. “I had a fourth-year student who’s graduating tell me that the simulations were extremely valuable because they gave her practice making medication choices and observing effects” Dr. Gorman said. “Now that she’ll be prescribing those drugs for real, she really appreciated having that opportunity two years before.”

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