UofL's patient simulation center sets new benchmark

The School of Medicine set a new educational benchmark with the October opening of the Dr. John M. and Dorothy Paris Simulation Center: UofL now has more human patient simulators than any other academic training site in the world.

The center boasts four training suites, each comprised of a classroom, videotaping equipment and a laboratory featuring a state-of-the-art, computer-controlled manikin.

The manikins mimic human responses in an amazingly realistic manner, says Gary Loyd, M.D., clinical director of the lab and an associate professor of anesthesiology at UofL's School of Medicine.

They can, for example, constrict their airways, alter the rise and fall of their chests, produce various vital signs or breath sounds -- even respond to anesthesia and drugs.

The main purpose of the simulators is to give students hands-on experience in a variety of scenarios -- including emergency situations -- without compromising the safety of a real patient.

"This is a wonderful new innovation in education," Loyd says. "It raises education from just information to actual application at the highest level."

In addition to medical students, other users include practitioners of anesthesiology, pediatrics, emergency medicine and internal medicine.

So far the lab's primary purpose has been instruction in patient-care scenarios for anesthesiology and the teaching of basic introduction to anesthesia for medical and non-anesthesiology residents.

Loyd also is developing an airway-management course that will be available to all residents in the School of Medicine.

For each patient scenario, instructors can program a simulator on three levels. First, they can select a basic patient profile, including physiological condition. Second, they can superimpose a series of responses indicating the course of a disease or injury. Third, they can specify "what-if" consequences.

Each choice made by the instructor or student is recorded by a computer and can be replayed on a monitor.

"The simulators' protocols are programmed for real-time patient care," Loyd notes. "The consequences of the practitioner's efforts cause the simulated patient to either live or die, to improve or get worse. So the learning process is very direct and exciting for the students and residents."

The center already is used for teaching first- and second-year medical students in cardiac physiology, respiratory physiology and blood gas analysis.

Classes in pharmacology are slated to begin in January, and a geriatric curriculum is scheduled to get underway sometime in 2002.

Loyd says first-year anesthesiology residents spent the first 11 days of their 2001 residencies working with the manikins, demonstrating their competencies each day while taking on progressively more difficult cases.

"They loved it because they could see themselves learning," he says.

Dustin Hamilton, a second-year medical student, says the manikins allow him to learn more through practical experience than he would simply by observing an instructor perform procedures.

"You're given situations that you yourself have to think through rather than watching another doctor do it," Hamilton says. "You just don't learn as much unless you're actually thrown into the situation yourself."

For Takasha Stewart, another second-year medical student, the simulators offer a margin of safety that lets her concentrate solely on education.

"The simulators feature real-life scenarios, but the patients themselves aren't real," Stewart notes. "That allows me to get treatment experience without having to 'practice' on a real person."

The simulation center was made possible in part with a $500,000 gift from UofL School of Medicine alumnus John Paris Jr., a retired New Albany, Ind., physician, and his late wife, Dorothy, a nurse and graduate of the old St. Joseph's Infirmary in Louisville.