Maybe you’ve seen a baby doll that cries or hiccups, but how about one with a pulse? At University of Texas Arlington’s College of Nursing, teachers put students through the paces of emergency scenarios remotely, using computer programmed baby manikins.
Sound Medicine contributor Lauren Silverman runs through a simulation:
Silverman: Here's the scenario: We’re inside a newborn nursery and a baby boy is having trouble breathing. A nurse places a flexible plastic tube into his windpipe to open the airway. It helped, but his heart rate is still declining.
Leflore: If they don't intervene in a timely manner, he will continue to decompensate to where his heart will eventually stop.
Silverman: Don't worry. This is all fake.
Leflore: Healthcare providers don’t learn on patients anymore. You don’t practice procedures on new patients, they learn about it in a simulated environment.
Silverman: Judy LeFlore is Associate Dean at UTA’s nursing school. She coordinates this remote-control simulation project with grant support from Pediatrix Medical Group. She’s watching the nurses from a split screen in her office, using software to control the vital signs and physical response of the baby manikin in another building.
Leflore: In the beginning, I create the scenarios. I’m like Oz.
Silverman: She might make it so the baby needs CPR, or extra fluids. In this case, she’s creating the scenario of a blocked airway and damaged lung. When she selects those variables on her computer, it alters the manikin baby’s heart and breathing rate appropriately. When the nurses provide oxygen, the high-fidelity manikin responds.
Leflore: He is computerized, his chest rises and falls, he has breath sounds, a heart sound, you can do procedures on him. You can put a breathing tube in his airway, you can stick a needle in his chest…
Silverman: And of course, the little guy cries.LeFlore uses this six pound anatomically correct doll with her students at UTA, and to train nurses across the state and the country all from her office.
Aebersold: What a unique way to bring the expert to the people doing simulation.
Silverman: That's Michelle Aebersold. She directs the Clinical Learning Center at University of Michigan’s School of Nursing. She says simulation has become a popular teaching method, but until August, there wasn’t much evidence it worked. That’s when the National Council of State Boards of Nursing released results from a two-year study of more than six hundred nursing students.
Aebersold: What they found was that we can use simulation as a replacement for hands on clinical practice effectively.
Silverman: That is important, Aebersold says, because logging clinical hours is competitive, and there’s no guarantee students will have the chance to treat a baby with rare, serious conditions. That can all be orchestrated with software and a manikin. And while you can find a vintage Betsy Wetsy doll on eBay for 29 bucks, a baby like the one at UTA goes for thirty thousand. And that's just the start.
Aebersold: Not every school of nursing can afford to outfit their simulation center with several $75-thousand-dollar simulators. And you have to buy an adult simulator and a birthing simulator and a pediatric simulator and an infant in order to provide your students with all those experiences.
Silverman: But factor in the cost of hiring experts to teach new procedures, and the potential cost of practicing on real, live patients, and there could be savings Aebersold says.
Aebersold: So we really need to start thinking about what is the return on investment of those simulators, how long are they lasting, how many simulations can we run through. I think that’s next steps.
Lauren Silverman is a reporter for KERA Public Radio in north Texas. This story was produced as part of its "breakthrough" series.
