The Scarlet

Not Your Average Exam Room

Worcester Medical School Implements Unique Training Techniques

Brendan Pauley, Contributing Writer

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Inside the Interprofessional Center for Experiential Learning and Simulation (iCELS), at the University of Massachusetts Medical School in Worcester, there is an exam room that looks like any other, and soon it will be filled by a patient and the doctor assigned to treat them.

But this is not any exam room. It is outfitted with a camera that records every minute of the exchange, and the patients are not actually sick. They are Standardized Patients (SPs), lay people trained to present symptoms of real medical conditions in order to train students and working doctors who are called “learners.” These simulated scenarios allow learners to practice skills without the danger of practicing on real patients.

Ray King, Education Program Specialist at iCELS, oversees these simulations. The staged exams are part of the iCELS Standardized Patient Program, established at UMass Medical School in 1982 as an evaluative and instructional tool for its medical students. Since its inception, the program has been implemented at medical schools across the state and has served as a model for Standardized Patient programs around the world.  

King explains the process to a group of “learners” in a conference room in a corner of the third floor. The learners are then brought to exam rooms, at which point King announces over a PA system that they will have 25 minutes to talk with their patients.

After the exchange, the learners write up their diagnoses and management plans in a small nook just outside the exam rooms before returning to the SP to review the encounter.  

King, a former SP known for his role as a multiple stab wound victim, is a strong believer in the efficacy of Standardized Patient programs.

“It’s better for learners to see my SPs than to see a patient,” King said. “SPs are better than reviewing cases, talking with proctors, or reading a textbook.”

King says the key is for SPs to give learners useful feedback after the simulation is over. The SPs are trained to present symptoms, but to also evaluate learners based on their approach. If a learner is lacking in bedside manner, or their management plan was unclear, the SP will let them know.

The second floor houses an even wider range of simulations. In the technical skills wet lab, six stations are set up, each with what looks like a small patch of skin in front of a monitor where learners can practice sutures.  

Many of the simulations utilize patient human simulators called manikins. Manikins are able to mimic symptoms that SPs can not replicate, like irregular heartbeats, specific breathing patterns, and blood-oxygen levels. These manikins, unlike actual SPs, range in age from newborns to the elderly.

 

With the manikins, learners practice everything from starting an I.V. to emergency room scenarios, and even surgery. For some of these procedures, an entire manikin is not needed; one room has tables of disembodied arms lying on wheeled tables, some with I.V.s hanging out filled with an orange liquid.

“The mechanical ones are talented too,” King said.

This story first ran the Telegram and Gazette as part of the collaboration between that newspaper and Clark’s Urban Community Journalism class.

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Not Your Average Exam Room