Patient Simulation Labs Really Effective?

[Chemist0157]

Could someone shed some light on the results of going to a school with a patient simulation lab (ex. those dummies students can practice on)? One of the schools I've been accepted to does not have one, and I was hoping a medical student or two could talk about whether they think these labs really help them in medical school. This may be a little anal because the same school does have standardized-patient training, but my other schools have both, and I just want to know if it really makes a difference.

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[Altruist]

Could someone shed some light on the results of going to a school with a patient simulation lab (ex. those dummies students can practice on)? One of the schools I've been accepted to does not have one, and I was hoping a medical student or two could talk about whether they think these labs really help them in medical school. This may be a little anal because the same school does have standardized-patient training, but my other schools have both, and I just want to know if it really makes a difference.

I can't speak to how your average med student sees things, but I'm a paramedic and teach some classes (mainly ACLS) using a simman patient simulator, so I know a bit about them. The advantage over standardized-patient training is that you can do a lot of things to them (e.g. CPR, intubating, and starting IO lines) that standarized patients probably wouldn't let you do. A simulator also lets you hear abnormal lung sounds and heart tones you might not otherwise run into. It might also let you practice setting up/assisting with more invasive procedures like central lines and chest tubes, but that depends on what simman they have and 1000 other factors.

From what I know, I'd be hesitant to pick a school based on presence or absence of a simman. It may make you more useful in a few situations by the time your 3rd year rolls around, but not incredibly so. If you really want, you can probably find an ACLS or similar class at a simulation lab somewhere near your school of choice... there are quite a few these days.

 

[SouthernSurgeon]

At least at my school, the dummies are a cool toy to brag about on admissions tours and to donors.

They factor into our actual education very minimally - we did some CPR and intubation demos, and you can "listen" to breath/heart sounds (which sound ridiculously loud and obvious). You can do intubation demos just as easily with those old school fake head and necks that almost every school has.

The only time they get used relatively heavily is for running through the ACLS guidelines.

I certainly wouldn't let the absence/presence of a sim-man factor into my med school choice.

 

[Law2Doc]

At least at my school, the dummies are a cool toy to brag about on admissions tours and to donors.

They factor into our actual education very minimally - we did some CPR and intubation demos, and you can "listen" to breath/heart sounds (which sound ridiculously loud and obvious). You can do intubation demos just as easily with those old school fake head and necks that almost every school has.

The only time they get used relatively heavily is for running through the ACLS guidelines.

I certainly wouldn't let the absence/presence of a sim-man factor into my med school choice.

Agree -- they have minimal impact on education. They are nice tools on which to learn things like intubation, putting in a foley, etc. but you never really know what you are doing until you try it a few times on real patients. There are also some simulation labs that are helpful for practicing hand-eye coordination skills with laproscopic surgery tools. But I probably wouldn't base my choice of med school solely on the quality of the sim lab. It's a nice plus but shouldn't be a maker or breaker because the 1-5 hours you spend doing simulations over the course of your 4 years simply won't be that big a deal, and likely won't leave the same kind of lasting impression you get the first time you do such skills on a real patient.

 

[URHere]

We don't have simulators at my school (or if we do, they hide them very well), but I definitely don't feel like we're missing out on anything. Sure we don't get to hear the dummies make abnormal heart sounds, but our school lets us go on ward walks to listen to the hearts of real patients with severe disorders. Sure, we may not be able to practice invasive procedures on the dummies, but we do have a live-animal lab so we can practice them on real, living animals which I think is even better.

I guess my point is, that if you are truly concerned that you may be missing out on something without the simulators, try to find out what programs that school has in place to make up for it. They may have some opportunities that are even better than some of the schools that do use the dummies.

 

[SouthernSurgeon]

We don't have simulators at my school (or if we do, they hide them very well), but I definitely don't feel like we're missing out on anything. Sure we don't get to hear the dummies make abnormal heart sounds, but our school lets us go on ward walks to listen to the hearts of real patients with severe disorders.

That's pretty much the heart of it - the amount of time spent in "sim labs" pales in comparison to the amount of time on the wards with real patients. As Law2doc said - you spend maybe 5 hours in these types of facilities, and that gets dwarfed in comparison to the 2 years you spend in the hospital.

I had an attending on my general medicine service who said that one of my "jobs" as the med student was to auscultate every patient with a murmur on our census (whether they were my patient or not) - no better way to learn than by hearing the real thing.

 

[Chemist0157]

Heh, just to be clear these labs don't make/break a school to me; I was just curious how much of an impact these labs really have because the tour guides are really keen to point them out and talk about all the stuff they can do, but they don't tell us interviewers how much time students actually spend using these dummies. Thanks for the insight.

 

[Valvool]

I interviewed at a school with patient dummies and was not impressed by them. Then I interviewed at the school where I now attend, and toured the Standardized Patient Lab, where all the patients are real live people trained to play a role. They are paid well and trained extensively and the situations are very realistic. In first year we have learned how to take histories, vitals, and recently to counsel patients on lifestyle changes. The second years recently learned how to do prostate exams on patients trained to help them find the prostate, etc. Once the interaction is over, the patient comes out of character and gives feedback, tips, and whatnot. If you interview at several schools ask about a standardized patient program as opposed to 'dummies'. Many schools now have them.

 

[JHopRevisit]

Medical dummies and standardized patients (that is, actors playing sick) are both equally worthwhile and worthless, IMHO. They're great for your first or second experience, but you outgrow them quickly. Still, it improved my confidence heading out onto the wards, but you are not gonna be at a loss as far as clinical skills if you don't get to do it, you just might spend more time being the embarrassed, bumbling medical student, whereas I got most (definitely not all, as many of my patients can attest) of that stuff out of the way on fake patients.

The amount of resources a school devotes to standardized patients, however, might be a good indicator of how seriously they take medical student education. I would focus less on money spent (ie do they have the latest cardiology dummy, or how many plasma screens) and more on how much administration and how many faculty they have put into place for these teaching sessions. How many students per faculty member? Are they trying to shove clinical teaching onto untrained actors or are you actually gonna get consistent feedback from a doctor early in your clinical skills teaching?

 

[njbmd]

Could someone shed some light on the results of going to a school with a patient simulation lab (ex. those dummies students can practice on)? One of the schools I've been accepted to does not have one, and I was hoping a medical student or two could talk about whether they think these labs really help them in medical school. This may be a little anal because the same school does have standardized-patient training, but my other schools have both, and I just want to know if it really makes a difference.

Would I use the fact that a school has a human patient simulator (HPS) to make a decision as to where to attend? No, because HPS is just one tool (and a minor one) that can be used for learning. HPS can be used to test and demonstrate things without putting a human being at risk but they are not essential to becoming a competent and knowledgeable physician.

Standardized patients (SP) are currently a requirement for USMLE Step I CS. Any pre-exposure can only help you in this situation and thus, SP experience is valuable at some point before you take Step II CS. Can you pass Step II CS without SP exposure? Yes, you can but having it is good.

HPS is useful but not essential and SPs are essential because you WILL be encountering SPs for your licensure exam (USMLE Step II CS).