MUSC’s Simulation Center: The Beginning
Guest: Dr. John Schaefer – College of Medicine, MUSC
Host: Dr. Linda Austin – Psychiatry
Dr. Lind Austin: Dr. John Schaefer is Professor of Anesthesia and Perioperative Medicine, and he’s Director of the MUSC Healthcare Simulation Center. Dr. Schaefer, what a pleasure to talk with you today about the Simulation Center, a very special facility that we have here at MUSC on the ground floor of the College of Nursing; although students from all colleges use the Sim Center. I would love to learn about your background in this area. I understand you’re one of the pioneers in the development of these models. Maybe what we should first do, though; most people listening this will not have actually seen the models, is have you describe what they look like.
Dr. John Schaefer: Sure. Human simulators are essentially manikins that are run by computers that act roughly like humans. They talk. They breathe. They exhale carbon dioxide. You see their chest rise. You can feel pulses on them. If you listen to them with a stethoscope, you would hear them breathe; their breath sounds and stomach sounds, things like that.
Dr. Linda Austin: Now, do they literally take in air and make that exchange of oxygen for carbon dioxide?
Dr. John Schaefer: No, not truly. They do take in air. In other words, they do have sensors to actually measure the amount; the force and frequency, of air going in and out of the lungs, but they don’t actually do an exchange. They model that through a computer based on some of the measurements. So, you see on a typical patient monitor things like carbon dioxide going in and out, but in reality, it’s actually just be done on a computer.
Dr. Linda Austin: Now, I know we have many models in our center. How many models do we have?
Dr. John Schaefer: We have approximately 25 full-scale simulators. And that’s adult males, adult females, kids, infants, neonates. We have one’s that deliver babies. And those are the human simulators. We also have what they call task trainers. And that’s the part to teach particular tasks. Like, an IV trainer would just be an arm. So, we have a range of those too.
Dr. Linda Austin: Right. It’s pretty impressive when one goes down there. How did you get involved in this? Tell us about the early years of developing these most incredible simulated models.
Dr. John Schaefer: Well, about 15 years ago, I was a new faculty member up at the University of Pittsburgh. I have a background in chemical engineering. And, in the Anesthesia department, at that time, there was an initiative to purchase a simulator. One of my mentors was interested in it, and he kind of tagged me as the person to go out and look at the two models that were available. They were about a quarter million dollars a piece, so it was a pretty significant investment. So, I was asked to compare and contrast those simulators. And, at that time, when we bought one, it was about the fourth actual human simulator purchased in the United States. So, that’s how I got started.
Dr. Linda Austin: And, something about that must have really piqued your curiosity.
Dr. John Schaefer: Well, ironically, it was mostly about teaching. I enjoy teaching a lot and one of my biggest interests is teaching difficult airway management. So, we were hoping to use this very expensive simulator to teach medical students and residents; and, to some degree, faculty. But it was, really, teaching that got me interested in all of this. And, if you can imagine, the opportunity of having a fake patient in front of you, you get to do things that you don’t get to do in the operating room, and you get to do things that are a whole lot safer, if you’re trying to practice in the operating room; which isn’t always something you can do.
Dr. Linda Austin: I guess the closest most people have come to seeing something like this are those of us who us who’ve had CPR training; which many lay people have. That’s a form; a rather primitive form, I guess, of a simulation.
Dr. John Schaefer: Well, interestingly enough, that’s a focused area of simulation, and it’s very important. But the simulator that I ended up designing, and patenting, was actually purchased by one of the main companies that make Resusci Anne. So, what they sort of did was put Resusci Anne on steroids, and ended up with what we call, today, these human simulators.
Dr. Linda Austin: Give some examples of what the simulators can do.
Dr. John Schaefer: Well, if you think about the CPR, and you extend that, what you can do in the hospital, for example, there are hospital teams that manage an acute cardiac arrest; and they have to do much more than CPR. They have to give drugs. You have to, sometimes, shock the patients; they have to do things like that. And so, one of the training courses here is team training for the actual hospital code teams, where they do everything from give drugs to procedures. And, of course, they’ll do CPR, in an integrated exercise; and we measure their performance.
Dr. Linda Austin: Very exciting. Let’s stop there and in the next podcast, I want to talk with you more about all the different sorts of capabilities that these simulated models have. Thank you.
Dr. John Schaefer: Thank you.