[MUSIC PLAYING]
Stanford University.
How old are you again?
27.
27?
This is a 27-year-old male.
He's had positive for alcohol.
Has a few gram of coke today.
Are you having trouble breathing, sir?
OK.
We're going to help clear out your chest.
I'm going to put a needle in your chest.
OK?
I think your lung's collapsed.
We can actually put in a chest tube.
I asked if he's stable, yeah.
I feel like this was a bad placement,
because his heart could be right there.
A Team, could we get some IVs in him?
How're you doing sir?
He has a [INAUDIBLE] on hemothorax.
I'm going to walk with you, and then you're
going to talk with a trauma surgeon.
Is that OK?
That's a wrap.
[MUSIC PLAYING]
The Goodman Center is one of the family
of simulation centers at Standford.
There's a simulation room with its associated control room.
The simulation room can replicate
various different clinical environments
with a computerized mannequin standing in for the patient.
--all your weight down.
I couldn't put all the weight down.
All right.
I'm standing--
--your strength.
One and two and three and four and five and six and seven--
Students come to us with all this information
and all this knowledge.
They're book smart.
They know how to do procedures.
And they know how to take care of patients,
and they know how to interact with patients.
But they know how to do them all separately.
You're simultaneously talking to the patient,
examining the patient, treating the patient,
monitoring the patient.
That's a very difficult thing for people to learn,
especially when they're just beginning
in their medical career.
Typically, during the simulator cases,
we break it down into either a medical case or a trauma case.
So when the student comes in, they
don't know which case they're going to get-- a heart attack
or renal failure and high potassium.
Or they have a bleed in their brain or a broken spine.
The way that I like to run the scenarios
is we do what's called on the fly.
Meaning, I hear that they are going to try something,
and I will say, OK, physiologically this
is what's going to happen.
Their heart rate's going to go up or down.
Their blood pressure is going to go up or down.
And the patient's either going to get better or get worse.
And I will make the vital signs and the mannequin
adjust to whatever actions they are taking.
Can we get Dr. Shannon in here, please?
Sure.
OK.
Here he is.
So I'm just running a trauma we did.
I got his fast airways intact.
OK.
Do we have another chest x-ray yet?
I think Radiology 2, right?
In traditional apprenticeship training,
we can't allow early learners to make
errors that could harm the patient.
If they do make a decision or do something to the patient,
we see that it could cause harm, we
have to intervene to protect the patient.
Well, in simulation, we can let errors occur,
and we can let them play out to their ultimate conclusion.
People can see the results of their decisions,
even if those decisions are mistakes,
and the very powerful learning that comes from that.
OK.
I'm going to shock.
I'm clear.
Are you guys?
Everyone clear?
It's really nice to know that when
you walk into the simulator, you're
not going to be killing someone.
And if you mess up, it's not like real life
where you don't have a do-over.
The other great thing about simulation
is, you can actually scale it for the level of the student.
We can make the cases easier or more difficult by simply
adjusting things in the control room.
When they go in the simulator, they
know we're probably going to make bad things happen
and really stress them-- that that's what it's all about.
In fact the psychologists have a term for that,
it's called stress inoculation.
By exposing them to stress in the simulator,
we hope that they'll be better prepared for those kinds
of stresses when they encounter them with real patients.
I definitely get nervous.
I think it's definitely realistic in the sense
that you feel your heart racing.
You're trying to think as quickly as you can
on your feet.
And that part, I think it's very useful, because that's
contributing to training you to be a quick decision maker.
Yeah, it can get your heart racing.
Afterwards, we go through what's called a debriefing process.
And the debriefing process is probably
where most of the learning occurs.
You really can see, OK, I didn't know this.
I knew this.
I could have done this better.
And it's a really safe environment
to talk things through and talk mistakes through.
There's no multiple choice prompting you to say,
you have these options.
You really need to remember on your own.
That's good, because that's how you know,
I need you to read up on this after I come out
of the simulation.
It takes people from talking the talk to walking the walk.
So it's one thing to be able to regurgitate
the facts that you've learned or to have the ideas in your head.
But actually being able to use them
in a dynamic way at the bedside is
a skill that's really hard to learn.
I think the most important thing about the simulation experience
for me is increasing my confidence in my ability
to handle situations that are stressful
and that I actually know what I'm learning.
A lot of the time, students go through classes
and go through their clinics, and they don't really
feel like they've learned anything
at the end of the month.
And I really find that the simulator really gives them
a chance to say, wow.
I really did learn a lot, and I really
am learning things in medical school.
This is awesome.
Someone can come in.
And I can be by myself, take care myself
and no one to ask for help, and know what to do.
The preceding program is copyrighted
by the Board of Trustees of the Leland Stanford Junior
University.
Please visit us at med.standford.edu.
For more, please visit us at stanford.edu.