Simulation Manikin helps teach student nurses at University of Wisconsin

Milwaukee 19 August 2004A student nurse walks into a hospital room to check on a patient and finds him coughing. She administers prescribed medication and takes vital signs, but notices the patient is gasping for breath and his tongue is beginning to swell. What's wrong? What should the nurse do? SimMan, a new high-tech virtual patient, will begin giving student nurses at the University of Wisconsin-Milwaukee College of Nursing a realistic feel for such situations this fall.

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SimMan, short for Simulation Manikin, is a realistic virtual patient that can be programmed to talk, gasp, have an allergic reaction, complain about pain and even vomit or at least make vomiting sounds. The new learning tool can be reconfigured and dressed to become either a male or female patient, fitted with a variety of realistic wounds and sores, and be programmed to reflect different medical conditions with changing blood pressure, heartbeat and other vital signs, according to Mary Paquette, director of University of Wisconsin-Milwaukee's (UWM) Nursing Learning Resources Center.

"SimMan doesn't ever replace a real patient", stated Mary Paquette, "but it's a lot closer than we have been before." And with SimMan, students can not only learn patient-care skills, but also build confidence in their own critical thinking and decision making skills without causing discomfort or danger to real patients.

The bionic manikin was developed by Laerdal Manufacturing for use in training anaesthesiologists, emergency medical technicians and Army medics, as Mary Paquette explained, but nursing schools have begun to use SimMan in their programmes. UWM is one of the first nursing programmes in the area to begin using the SimMan - the school has three simulated patients - but shared the technology in a demonstration for other nursing schools in the area earlier this year.

Nursing professors will use the advanced manikin in a variety of classes for beginning to advanced students. First-year nursing students might begin with simple blood pressure checks and physical assessments. Students can practise providing treatments, administering medications, or responding to patient complaints of pain or nausea. SimMan comes with a variety of interchangeable overlays and parts that reflect different physical problems and trauma, some of which are more appropriate for training EMTs and other emergency personnel, according to Mary Paquette.

SimMan's value to nursing educators is his/her ability to simulate changing medical conditions, reflected in physical changes and patient comments. The high-tech manikin can be hooked up to an IV and to monitoring equipment. Some nursing faculty have created scenarios that will allow students to participate in a case that develops through a semester. Students will treat SimMan as a real patient, greeting him/her as they enter the room and responding to the patient's condition, stated Mary Paquette. For simple simulations, the patient is even programmed to say "oops", when the student nurse does the procedure wrong. Mary Paquette is working on adding more vocalizations and acquiring some wigs and additional female voices to make the female version even more realistic.

SimMan can be programmed to simulate an almost limitless number of conditions and medical changes, explained Mary Paquette. Faculty members can develop complex and changing scenarios for the more experienced nursing students, programming the virtual patient's condition to change suddenly, developing a postoperative infection, an allergic reaction or a medical crisis while the nurse is working with him/her. If the student responds correctly, the patient begins to improve; if not, the condition worsens. Such scenarios help students develop their critical thinking, decision-making and assessment abilities, according to Mary Paquette.

"It's so important for nurses to be confident, competent and develop good critical thinking skills", concluded Mary Paquette, adding SimMan is a realistic tool to help them develop their abilities in a non-threatening environment that is better for students and "patient". "It's an opportunity to practise on a more lifelike manikin than has been available previously. We can safely begin to approximate what it's like to work with patients in a real environment."


Leslie Versweyveld

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