UF College of Veterinary Medicine
Public Relations Office

Human Patient Simulator May Help Animal Lives

By SARAH CAREY

Professional training through the use of simulators that imitate real-life situations has become a way of life in everything from emergency medicine to space flight. Now, thanks to a new anesthesia training program at the University of Florida College of Veterinary Medicine, animal care may be next.

This year's veterinary graduates are the first in the country to have studied anesthesia using a human patient simulator developed as a teaching tool by UF physicians in the 1980s. Educators feel the experience will make a huge difference in enhancing students' confidence in handling emergency situations, as well as their overall skill sets in administering anesthesia to animals.

“I believe Florida 's is the first veterinary school that has done this,” said Jan Ilkiw, professor and associate dean of academic programs at the University of California-Davis ' School of Veterinary Medicine . “They're the only ones with a publication about the human simulator's use in veterinary education.”

In 2002, the Journal of Veterinary Medical Education published a UF study in which 90 students took turns being the patient's clinician as real-life scenarios were played out on the simulator. The students induced and maintained anesthesia on their “patient”— a full-sized adult mannequin nicknamed Stan, for “standard man” — and monitored vital signs. This time, the simulator represented an animal patient. Several critical events were presented for the students to diagnose and treat.

The study's authors, faculty members from the Colleges of Veterinary Medicine and Medicine, included Jerome Modell, M.D., Shauna Cantwell, D.V.M., John Hardcastle, B.S.E., Sheilah Robertson, B.V.M.S., Ph.D., and Luisito Pablo, D.V.M.

“We concluded that the human patient simulator was a valuable learning tool for students of veterinary medicine,” said Cantwell, an assistant professor of anesthesia at the veterinary college who holds a joint appointment in the College of Medicine . Cantwell has since taken the simulator to professional meetings, including the World Congress of Veterinary Anesthesia in Orlando last October, to demonstrate its use to a group including veterinarians, students and veterinary technicians.

“It was exciting for students to work with, made them deal with real-life scenarios, permitted them to learn without subjecting live patients to complications and enabled them to retrace their steps when their therapy did not correct the simulated patient's problems,” Cantwell said.

Last year, UF's veterinary school began requiring that students be exposed to the simulator as part of their education. Students in the clinical training phase of their curriculum travel from UF's Veterinary Medical Teaching Hospital across the street to UF's McKnight Brain Institute, where they spend two hours working with the simulator as part of a two-week rotation in anesthesia. Students who desire additional training in anesthesia are able to sign up for another rotation before graduation.

Educators say situations encountered with the simulator can seem very real because of the patient and the actual anesthetic equipment that operates exactly like that in the hospital with a real patient.

“Students do get wrapped up in the situation,” said Eleanor Green, D.V.M., chair of the college's department of large animal clinical sciences. “It seems so real, some students have become truly upset and even cried if they ‘lost the patient.'”

The simulator uses a special computer program that controls the values for physiologic parameters, a bar-coded intravenous injection site, and a urinary catheter. Connected to a complete clinical anesthesia machine as well as to a mechanical ventilator, the simulator can monitor blood and arterial pressure, temperature, cardiac output, respiratory and anesthetic gases while an instructor controls what disease states or physiologic symptoms will be presented to the student. The simulator then adjusts the patient's response automatically.

“In school during their regular curriculum, students don't have the chance to be the primary caregivers in an emergency situation, making their own decisions and implementing them,” Cantwell said. “So when they are faced in practice with an emergency, not only will they have to evaluate and treat the patient in an appropriate time frame, they'll have to face any confidence issues they might have.”

Students exposed to the human patient simulator are better equipped to make important decisions and to deal with the consequences of their decisions, she said.