Medical simulation a serious business

Mimicking an illness is far more than play-acting.

"It's absolutely key to medical student training," said Dr. Paul Paulman, professor of family medicine and assistant dean for clinical skills and quality at the University of Nebraska College of Medicine. The clinical training department oversees the use of "standardized patients" to help teach medical students.

"The students can make errors, and they're not going to cause harm," Paulman said. "You can be observed and get feedback, and you can stretch out the encounters.

Doctors must have good communication skills, he said. "People who are fearful and ill are not at their best. If there's not a relationship developed, the physician isn't going to give good care and the patient is not going to receive good care."

Standardized patients work one-on-one with medical students and also come to classrooms, where students practice dealing with difficult situations such as talking about reproductive issues, delivering bad news and dealing with adolescents or angry patients.

Sometimes students will use a manikin to practice a procedure, such as chest compressions, while simulated family members become upset and do things that might distract a doctor or nurse — a realistic situation that students must learn how to manage.

"We pull our training from real life," Paulman said, and the students love it.

"Would you rather do a paper case or would you rather talk to a human?" he said. "This is what we're going to do for the rest of our lives, so let's practice the real thing. We want to be able to parallel the real world as closely as we can."

To add more reality to the training and bolster its cast of about 70 standardized patients, the college is seeking more minorities, including Hispanics, and young people who are available during daytime class hours.

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