Third-year Nursing student, Kelvin Bei, checks vital signs on a computerized patient simulator - photo by Martin Dee

UBC Reports | Vol. 52 | No. 10 | Oct. 5, 2006

Nursing for Dummies

By Hilary Thomson

A high-class dummy has moved into the School of Nursing and he’s proving to be Mr. Popularity.

He is SimMan™, a life-sized computerized patient simulator that breathes, talks, and has a pulse and blood pressure. School of Nursing Asst. Prof. Bernie Garrett spearheaded efforts to purchase two of the  $50,000 simulators, now dubbed Gordon and Harry.

“Our goal is to improve the student experience so they are better prepared for practice,” says Garrett, who joined the School of Nursing in 2003 and has a research background in educational technology. “The mannequin also allows for consistency in the instruction and a standardized learning experience.”

There is growing interest in using high-fidelity teaching mannequins, says Garrett, who believes the School of Nursing is at the forefront among Canadian schools for interactive learning technologies.

The mannequin is almost creepy in its lifelike qualities: it can moan, wheeze and simulate vomiting; has interchangeable male and female genitalia for catheterization training; an airway system that can mimic complications such as tongue swelling or spasm of the larynx; and pliable skin for injection practice. It can describe its symptoms through pre-programmed vocalizations or instructors can record their own script.

An entire multi-faceted clinical scenario can be programmed into the simulator, and it is lifelike enough to respond to physical cues. For example, the mannequin can stop breathing or exhibit a weak pulse – with vital signs displayed on an adjacent computer monitor. When students resuscitate the patient, the mannequin starts breathing normally, pulse gets stronger and improvements are displayed on the monitor.

The simulator can also be programmed to reproduce emergency conditions -- such as anaphylactic shock or a punctured lung -- that students may not have encountered working with real patients. Videotaping students’ work and being able to precisely reproduce teaching scenarios allows instructors and students to better analyze and improve skill levels. In addition, teaching sessions can be filmed and streamed to the Internet for further review, and instructors can employ problem-based learning strategies using patient simulation.

“This is a powerful learning tool because it is so dynamic and interactive,” says Garrett. “What students learn from the mannequin stays with them -- it’s an immersive experience.”

Previously, students have practiced using immobile, rigid mannequins and instructors would describe patients’ responses to their actions or what the students should hear through their stethoscopes or feel when taking a pulse.

“You can watch patients suffering from pneumonia, arrhythmia or cardiac arrest on TV, or listen to your professor lecture in class, but the opportunity to practice my skills on a “patient” exhibiting those symptoms is valuable and rare,” says third-year Nursing student Jenny Szeto.

Despite his popularity, SimMan™  will not replace actual clinical experience, says Garrett.

“Even though simulations boost skills and confidence, students have to work with real patients to experience the unpredictability of dealing with a person, their reaction to care, the input of family members or unforeseen crises,” he says.

Garrett will be evaluating the simulators this year with both undergraduate and graduate students.