24 Oct 08

The dummies can be connected to a standard hospital monitor, have a pulse, heart and lung sounds, and appear to breathe.

A new simulation centre at Oxford University, with a state-of-the-art interactive dummy as a patient, will be used in training medical students, trainee doctors, and other health professionals in emergency medical care.

The users of the OxSim centre, based in the University’s Nuffield Department of Anaesthetics at the John Radcliffe Hospital, will include clinical students, foundation-year doctors, and a number of other clinical and external groups. Over 500 people are expected to benefit from the new facility in its first year.

‘The aim is to improve patient safety,’ explains Dr Helen Higham, OxSim’s clinical director. ‘Sessions in the simulation centre should enhance the ability to cope with medical emergencies without fear of harming patients.’

The centre consists of three rooms. The simulation room is in the middle and can be changed to represent an operating theatre, a bay on a ward, or even a GP surgery. A control room allows the session coordinator to adapt the dummy patient’s condition according to the actions of the trainees, while a seminar room offers space for briefing, feedback and lectures.

There are two dummies for the trainees to practise on. These can be connected to a standard hospital monitor, have a pulse, heart and lung sounds, and appear to breathe. The session coordinator can make the dummy talk and respond as a patient would. The mannequin can also be taken out into real world settings like a car park.

‘Whatever you can do to a real patient, you can do to the dummy,’ says Nick Thompson, the simulation teaching coordinator at OxSim. ‘You can give it fluids, injections, you name it.’

Previously, medical students have only been able to learn how to deal with a cardiac arrest on a simple plastic dummy, but have found it very unrealistic when confronted by the real thing.

Otherwise, experience had to be built up through long hours with real patients on wards as a junior doctor. The need for better preparation, along with the reduced hours of work for junior doctors following the European Working Time Directive, has required a more structured approach.

‘The simulation scenarios teach students to think on their feet and to follow procedures in the right order even in the most stressful situations. Basically, they need to be a little scared to make it real!’ says Dr Higham.

An example simulation scenario might be a patient with a chest infection who, when given an intravenous antibiotic on a ward, becomes critically ill as they go into anaphylactic shock. Another example might involve someone with a ruptured aortic aneurysm (where a bulge in the main artery coming from the heart bursts), but they’re a Jehovah’s Witness and so can’t have a blood transfusion.

‘The simulated scenarios are a great way of teaching how to handle emergencies and show how important communication is in a team response,’ says Dr Higham. ‘I wouldn’t be surprised if it led to changes in crisis management.’