MUSC’s Simulation Center: The Making of a Model
Guest: Dr. John Schaefer – College of Medicine, MUSC
Host: Dr. Linda Austin – Psychiatry, MUSC
Dr. Linda Austin: Dr. John Schaefer is Director of the MUSC Healthcare Simulation Center. Dr. Schaefer, in an earlier podcast, you started to tell the story of getting involved with the purchase of a simulator, but what was the next step of development for you?
Dr. John Schaefer: The expensive simulator that we got, like I mentioned, was about a quarter million dollars. I wanted to use it to teach some very advanced, difficult, airway management, and it didn’t, actually, do that very well. We knew that when we got it. The company that was building it actually said they were going to improve it, but they didn’t. And it ended up that my mentor pushed me to see if I could do it.
I had a pretty good workshop down in my basement, at home. So, I actually was able to modify the simulator, through some trial and error, so that it could do that. And then we had one very expensive simulator that would work. My mentor, then, at that time, said: Okay. Now we have one. Let’s see if you can make it cheaper. And, we’re going to need about ten of these things if we’re going to be able to teach all the people we need to teach. So, it ended up that, again, with a little bit of work, and playing around, I was able to actually make something that was a lot cheaper. And, it was funny. I cannibalized parts of my kid’s toys to make it work. It made for an interesting transfer of technology.
Dr. Linda Austin: Like, what parts of your kid’s toys?
Dr. John Schaefer: Well, probably the funniest one was one of my kid’s Toys “R” Us chew keys. The material; the type of material, the plastic, worked very good for certain function in creating laryngospasm. And it actually worked very well. Even today, it still has a variant of that in there.
Dr. Linda Austin: That’s amazing. So, what are some of the different disease conditions, or procedures, that the simulation models are able to mimic?
Dr. John Schaefer: Well, what they’re used best for, probably, is a range of best practices that are out there that require a combination of knowledge, skill, and judgment. So, if you think of something like asthma, you have to recognize it, diagnose it. You have to, then, treat it. Things like that are fine.
There are multiple nursing best practices, in terms of assessment, patient care, and pediatric care. I just left a simulation that was going on with neonates, and nursing evaluations. When you start talking about hospitals, and things like that, you get into procedural-type of simulations, and team training is particularly good. Those are acute-type problems; the high risk-type of things, such as obstetrics, pediatric emergencies, or adult emergencies. It’s the full gamut. You can actually program it to do a wide range of clinical conditions.
Dr. Linda Austin: It is pretty amazing to go down there. There’s a labor and delivery suite, for example, with a manikin that’s giving birth.
Dr. John Schaefer: Right.
Dr. Linda Austin: There’s an operation room that’s set up to do operations. There are all sorts of disembodied limbs kind of lying around. I’ve heard one of the instructors there say that one of the great things about it is that because it’s controllable, while on a typical rotation, a medical student may or may not get exposed to, let’s say, the top 20 most common, or most important, diseases to understand, and something you really can control in the simulation lab. So, it really gives the instructors a great degree of control over the content that students are exposed to.
Dr. John Schaefer: That’s correct. And that’s true whether it’s a nursing student, a medical student, or a resident, or a physician. You can pick your shots in terms of what you’re specifically trying to teach. So, for example, recently, there’s a pediatric emergency medicine residency training course. The teacher that’s running that, Dr. Joe Dobson, surveyed the residents. He found out that they didn’t get many experiences in certain areas. He was able to recreate those experiences in the simulation lab. And, instead of doctors that are being trained with very infrequent exposure to these important areas, in their residency, they’re able to get multiple times. So, in one day, he can get more than four years of experience, typically, that a resident might see. And that’s true, like I said, in some of the other areas.
One of the things we hope to get out it, over time, is to improve the efficiency of learning. You can take advantage of creating experiences that would take a long time to accumulate in a short time
Dr. Linda Austin: Dr. Schaefer, what have been some of the most challenging clinical problems for you to simulate using these models?
Dr. John Schaefer: The most challenging, I believe, are some of the team-training exercises. What you’re trying to do is set up an exercise where multiple groups, multiple individuals, multiple roles get evaluated within a clinical scenario. The clinical side of programming is not hard. The educational side, to me, is the bigger challenge, particularly in the area of performance assessment.
Dr. Linda Austin: Do you have a favorite model?
Dr. John Schaefer: I’m biased. My favorite, going back to the years when my kids were younger and I stole some of their toys, is probably the Sim-man. That’s the one that kind of was born early on in my basement.
Dr. Linda Austin: And, I’m curious, is there any kind of animal equivalent of these for vet schools? Any work going on there?
Dr. John Schaefer: I’m not aware of equivalence in vet schools. Although, there are some simulators you may not think of, like dental simulators. There are some in which you can actually do dental work on teeth. And they’re pretty good simulators; rather than practice on other people’s teeth. I thought that one was kind of unusual. I haven’t seen them yet, per se, on the vet side. Certainly, they’ve replaced the use of animals in many areas as simulators.
Dr. Linda Austin: Thanks so much for talking with us, Dr. Schaefer.
Dr. John Schaefer: Thank you.