Medical school surpasses peers in offering real-life simulations

Media Credit: Donna Armstrong | Contributing Photo Editor

The School of Medicine and Health Sciences provides simulated clinical training for patient interactions, maintaining a goal set in 2012 to offer clinical spaces for student practice.

Updated: Feb. 26, 2019 at 9:28 p.m.

After updating its clinical lab spaces four years ago, the medical school is ahead of its peers in exposing medical students to training simulations early on in their college career.

The School of Medicine and Health Sciences provides simulated clinical training for patient interactions, maintaining a goal set in 2012 to offer clinical spaces for student practice. Officials said having updated lab spaces and equipping students with knowledge and skills for patient interactions better prepares students to enter the medical field and makes students more competitive in the health care job market.

Medical school spokeswoman Lisa Anderson said medical students work in a traditional classroom setting for their first 15 months, then switch over to clinical experience – working with real patients by shadowing or volunteering – until graduation.

GW starts clinical lab training earlier than nine of GW’s 10 peer institutions that have medical schools.

“We have a revised curriculum where students are now getting clinical experience sooner because we find that as you study in books and in the library it is important to also get that practice while you are doing that,” she said.

At least seven peer schools – Tufts University, Wake Forest University, New York University, the University of Rochester, the University of Pittsburgh, the University of Southern California and Boston University – have students engaging in clinical simulation practice early in the first two years of medical curriculum, according to their websites. But Tufts University is the only school that will start training its students in simulation labs at the 15-month mark after implementing a new curriculum this fall.

Officials said the medical school’s 17,500-square-foot class center, located in Ross Hall, opened in 2014 and houses four different types of practice rooms for students. Students have access to 14 examination rooms to practice with standardized patients.

Starting in a student’s first year, students practice patient care in examination rooms, operating rooms, high fidelity rooms and procedural skills labs using mannequins and simulated or standardized patients or people playing a patient role, officials said.

John Mahoney, the associate dean for medical education at the University of Pittsburgh, said students in the university’s medical school begin working with standardized or simulated patients in the fall of their first year, devoting at least one afternoon per week to patient interaction practice for the first year and a half.

“This overall approach helps students become comfortable and skilled with speaking with and examining patients at an early point in their medical education,” Mahoney said in an email.

Sondra Zabar, the director of the standardized patient program at New York University, said NYU’s medical school starts with 18 months of basic science before students begin clerkships, where simulation practice is integrated throughout all four years.

“They have a chance in a low-stakes environment to be able to talk to a patient and deliver very difficult news or lead a team in a resuscitation,” Zabar said. “Simulation is an ideal educational strategy to accomplish this because by the time learners finish medical school, they are not only confident but they are competent in being able to do all these things.”

The University of Southern California’s medical school teaches students how to interact with patients in a class called Introduction to Clinical Medicine in the first year. The University of Miami starts patient practice in the third year of the curriculum and also uses mannequins for student practice.

Wake Forest University’s medical school curriculum begins exposing students to in-person clinical care in the second phase of the curriculum, which starts after 18 months, according to the medical school’s website. Before students begin clerkships, they practice “clinical and patient care with simulated and actual patient care experiences and assessments” in the first phase, according to the school’s website.

Karen Lewis, the director of administration for the Clinical Learning and Simulation Skills Center in the medical school, said students receive about 160 contact hours, and the first two years consist mainly of “how to interview patients and how to do basic head-to-toe physical exams.”

The examination rooms feature one-way glass, enabling faculty and classmates to watch students practice with standardized patients. The operating rooms, high fidelity rooms and procedural skills labs utilize mannequins as a part of the learning process. The mannequin’s symptoms and reactions to student care are controlled by the faculty, she said.

Lewis said the center tries to maintain equipment consistent with what is used in the field. She said the examination rooms feature ophthalmoscope sets – equipment used to examine the retina and other parts of the eye – that most doctors use in their offices. She said other practice rooms are consistent with what can be found in hospitals.

Lewis said students often receive feedback on their standardized patient interactions from colleagues, the patient and the faculty. Each room is equipped with three cameras filming the students for post-practice debriefing.

“It is common for most schools to have two cameras, but we wanted to add an extra camera so we could focus on capturing more of the communications skills,” Lewis said. “Sometimes we weren’t getting the subtleties of behaviors in our camera views because of where they were placed, so we added another camera in all of our exam rooms.”

This post was updated to reflect the following corrections:
The Hatchet incorrectly reported that the class center in Ross Hall is 500 square feet. It is 17,500 square feet. A previous version of this article also misattributed information provided by Karen Lewis and Lisa Anderson. We regret these errors.

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