Students to Train on Computer-Controlled Medical Manikin

"SimMan" may wheeze, his pulse may race, his blood pressure may soar, and he may even go into cardiac arrest, but no matter how grave the medical malady, he always recovers.

The 6-foot-tall computer-controlled patient simulator from Laerdal has taken up residence in the School of Health Sciences at Pennsylvania College of Technology, where students in nursing and other health-care majors will be able to test their diagnostic and decision-making skills in realistic training scenarios.

SimMan can be programmed to make audible heart, lung and bowel sounds, he can exhibit multiple airway complications, and he can cough, vomit, moan and speak to those providing his care.

Students can take his pulse and blood pressure, perform CPR on him, insert a chest tube, insert IVs into his veins and perform urinary catheterization with the add-on genitalia that's available. SimMan can even complain when he's not happy with the care he's receiving.

"With scenarios, faculty can control his responses to, for example, a cardiac arrest," said Ann V. Reichelderfer, learning laboratory coordinator for nursing. "He can 'get better' with the correct response from the student, or 'get worse' if the student chooses an inappropriate intervention. This type of feedback is invaluable to the student."

While SimMan will "live" in the Nursing Lab, any of the health-science majors can make use of him because of his portability, Reichelderfer said. She notes that faculty in the Physician Assistant major attended a recent demonstration session offered by a Laerdal representative. SimMan may also be incorporated into Radiography students' training.

"We've started to use him in the BSN (bachelor-degree Nursing major) physical assessment course," Reichelderfer said. "I anticipate using him in fall to help with teaching heart sounds, breath sounds and bowel sounds. I also anticipate using him to teach vital signs (pulse, respirations, blood pressure), pulse oximetry and ECG interpretation."

Using SimMan complements having students practice diagnostic procedures on one another, Reichelderfer said.

"When I set his blood pressure at 124/82, and turn up his volume, there should be no reason, other than the student isn't grasping the skill, for the student not to hear the blood pressure," she explained. "When we use each other, there are other variables, such as the proximity of the brachial artery to the skin, the length of the BP cuff tubing and the fit of the stethoscope earpieces. While all of these variables are not eliminated, they are certainly reduced with SimMan."

More advanced clinical scenarios are available with SimMan's standard software package, and faculty will also be able to create their own specialized training circumstances for students. While there already is a hands-on clinical aspect to the nursing students' training, SimMan can offer some situations that were previously unavailable, Reichelderfer suggested.

"His abnormal breath sounds, bowel sounds and heart sounds may be something that a student never had the opportunity to hear," she said. "Most of the nursing students are healthy, so the sounds aren't available in the lab. Patients in clinical don't always present with the particular abnormalities that the students are learning about. So, for example, if there are no wheezing students in lab, and the students see no wheezing patients in clinical, they can finish up the program without ever hearing wheezing. SimMan wheezes."

SimMan joins "CathSim," another software-driven simulator used in the Nursing Lab to teach venipuncture (collecting blood from a vein). Reichelderfer said students have enjoyed using CathSim, even coming back to practice after meeting the objectives for their lab experience.

"This generation of students is, for the most part, very computer literate - some have described using CathSim as 'a fun computer game,' " she said. "The audiovisuals are fantastic, adding another dimension to student learning."