Two floors of the new building are devoted to the Clinical Performance Education Center (CPEC) which provides clinical learning experiences across the continuum from patient-centered to technology-centered care. In addition to the Medical Simulation Center on the ground level, the CPEC also includes the Clinical Skills Center on the basement level where 16 out-patient environments and four in-patient rooms provide realistic settings where students can refine their interpersonal and physical examination skills as they work with real people functioning as standardized patients.
“We’re trying to make medical education more of a patient- centered, case-based educational process where the students are applying clinical information rather than just memorizing facts,” says Eugene Corbett, MD, assistant dean for clinical skills education and director of the CPEC. “The purpose of this process is to raise the bar on [clinical performance] both in terms of student learning and the assessment of it.”
SIM One, Do One, Teach One Raising that bar means going beyond the traditional “see one, do one, teach one” approach to clinical skills development. For the class of medical students who inaugurated the new medical education building this past August, that meant participating in simulation exercises beginning in the first week of classes. Not only does simulation-based instruction provide a valuable first step for new learners, it also offers a means for standardizing minimum competency for graduates. Even experienced clinicians can use simulation to maintain infrequently used skills, or develop new skills as technology advances.
According to Littlewood, the human brain works differently when learners are asked to perform a task surrounded by the sights and sounds of the actual environment, as opposed to reading the information or hearing it in a lecture. “We talk about muscle memory and situational memory,” he says. “These are very important to learning, so we want students to practice in a situation as close to reality as possible.”
In the Center’s mock labor and delivery room, for example, students practice caring for a laboring patient with “Birtha,” a birthing simulator. In this room, the electronic fetal heart monitor on the bedside stand, the Pitocin pump on the IV pole next to the bed, the neonatal warming bed in the corner, the emergency call button, and the furniture and cabinetry are all the same as in UVA hospital’s maternity unit.
When they complete a practice case in one of the Center’s simulation bays, students are much more familiar not only with the procedure they were working on, but with their role as part of the health care team. They know where they should stand in the room. They’ve had some experience interacting with the patient and other members of the team. And when the situation didn’t progress as planned, they’ve been able to problem-solve and chart a new course.
“We go to great pains to make sure it looks and feels just like the real clinical setting,” Wright says.
Even experienced practitioners, who may be more dubious about a simulation, start to forget it’s fake when the patient mannequin blinks, coughs and starts talking to them. “You see people leaning in, sweating, taking off their jackets,” Littlewood says. “Then they start reacting to the patient and the team members as if they really are in a clinical setting. It’s exactly what you want in an active learning situation.”
Something to Hang Onto Occupying the ground floor of the new Claude Moore Medical Education Building, the Medical Simulation Center includes realistic replicas of an emergency department resuscitation room and an ICU room, in addition to L&D and an OR. Each of these environments houses sophisticated mannequin simulators and all the accoutrements you would expect to find in a working hospital. An emergency vehicle entrance at the rear of the building, along with a triage area/nursing station and decontamination room, allow for scenarios that can also include community emergency response personnel.
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