Clinical procedures training

[im2b]

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Hi Everyone,

I'm a MS IV who's a little anxious about doing the procedures expected in residency (central lines, intubations, chest tubes, lumbar punctures, etc.). There isn't any formal training in these procedures at my school (at least, I haven't experienced any so far), and I want to practice on mannequins before I do them on patients. I'm considering buying a mannequin, however, they cost at least $1000 each. Does anyone know where I can buy used mannequins, or cheap mannequins that I can train on? Our hospitals don't have any old mannequins, so I can't go around begging for one. I was considering going to the anatomy lab to practice on cadavers, but their blood are already coagulated and wouldn't work for central lines, venipunctures, etc.

Any recommendations would be greatly appreciated.

Thanks!

 

[Midwest Medic]

First, Do not buy a mannequin, they are horrible for training on, especially the procedures that you are talking about.
Second, you will have an attending or senior resident near by for the first time you have done any procedure, and if they are not near, just ask. We all have had to do our first procedure of any type, and you are not expected to do these by your self for the first time. Relax!

 

[Winged Scapula]

Agree with the above.

I came from a medical school where the students didn't do any procedures outside of suturing in the OR. So while I had a rough time during the early years of residency learning to do central lines and chest tubes, my senior residents and attendings assisted me.

Unfortunately, mannequins are not really a replacement for learning on a real patient and you'll have to learn on live humans. Its scary but you'll get through it just like thousands before you.

Your residency may have a lab with a simulator which you can practice as well, but despite the expense of these things, for procedures, IMHO you can't beat a real patient.

 

[werewethere]

Additionally, there are a number of university hospitals that have adopted abundant simulator training approaches. The difference in this type of approach compared to the simple mannequin is that you get to do the procedure with instruction and observed, with variants based on specific common types of problems you might encounter, and you receive feedback on how to improve your approach and technique prior to actually trying it on a human being. This is often repeated and reinforced, so that you've done dozens to hundrends of simulations. Although it is true that it does not replace work on a real patient, it is helpful in developing your approach and method of doing things, so that when you're with a obviously worried patient, you'll be able to handle it better, and you will be less likely to be confused by unclear directions. This has been done with things as simple as IV lines/A lines, up to VP shunts, cataract surgeries, and carotid stent placements. What procedures you'd learn would be a function of what you're expected to do, since most people don't usually have to do cataract surgery.

One more thing, doing the procedures on mannequins by yourself you will be missing out on the necessary feedback to improve your skills and may learn bad habits that will be hard to break. I'd go to your clinic skills center, usually the same place where you have the standardized patients, and find out if you can access the lab and be trained on some of the basic procedures expected from MS (suturing, IV placement, phlebotomy, LP, etc). Failing that, try your surgery department.