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MEDICAL SCHOOL                                                                                                                                                                                                 MEDICAL SCHOOL
            TRAINING                                                                                                                                                                                                      TRAINING




        Medical Simulation:


        The Next Frontier of Medical Education


        By Fatima Ali and Patryk Tomaszkiewicz

               t the University of the Incarnate Word School of Osteopathic   that can connect to a machine that administers anesthesia. On the
               Medicine (UIWSOM), it’s not uncommon to see first-year   other side of the room is a one-way mirror where professors can con-
        Astudents deliver babies by themselves and then perform the   trol the mannequin to replicate real-life scenarios, and monitor the
        newborn’s APGAR assessments. Occasionally, students also treat  students via audio and video and provide suggestions for improvement
        patients suffering from acute heart attacks. These lifesaving measures   without getting in the way.
        are routinely performed in the safety of the medical school’s SIM Lab,    Not too long ago, medical schools relied on actual patients with                                                           UIWSOM’s simulation
        a specialized space dedicated for students to learn clinical skills before   real presentations to volunteer at schools for students to learn from                                                   lab features high-fidelity
        they must use them in the real world                   them via incessant poking and prodding. “Mannequins don’t com-                                                                                pediatric mannequins
             UIWSOM is an osteopathic medical school located in the south-  plain,” remarked Dr. Robert Allen, the Medical Director of CIELO                                                                 capable of providing
        side of San Antonio where the U.S. Air Force School of Aerospace   (Center for Interprofessional Experiential Learning & Observation) at                                                             medical students with an
        Medicine formerly stood. The campus boasts four state-of-the-art   UIWSOM. The SIM Lab boasts a variety of mannequins with differ-                                                                   opportunity to practice their
        facilities in the Brooks City Base, including its high-fidelity SIM Lab.   ent purposes. Along with the mannequin that can simulate a live birth,                                                    pediatrics.
        The SIM Lab is an instructional facility aimed at giving medical stu-  there are mannequins you can perform surgery on, listen for various
        dents realistic training opportunities for their future careers, regard-  heart and lung diseases, use ultrasound to view various pathologies in
        less of what specialty they go into. Utilization of the SIM lab takes  3D, insert IVs and central lines, as well as authentic trainers on which
        place during all phases of the curriculum and is integrated as a part of  students can learn how to perform more sensitive but imperative
        learning and partaking in a low-stakes environment where students can   exams, like breast and rectal exams, physical exams and pap smears. 
        learn from their mistakes and strive to become great physicians.   Once students enter their clinical years, the more practice they have
           The lab consists of four rooms, two of which perfectly emulate full   before having to perform clinical skills on real patients, the better. Ali-
        surgical suites, complete with everything you would see in an operating   cia Cortez, the Clinical Outreach and Standardized Patient Manager
        room in any hospital. When you walk into the operating room, you’ll   of CIELO, emphasized, “Once student doctors go out into clinics and
        see your patient — a mannequin that has a heartbeat, lungs and can   hospitals, they become part of the rapid response teams. Students need                                                          The simulation lab also
        even talk — in an adjustable electronic surgical bed. Behind the bed  to know these skills now so they become more used to it, and are ready                                                         contains 12 functional
        is a fully functioning headwall with medical gas and electrical outlets  to go when the time comes.” When the mannequin actively complains                                                           clinic rooms where
                                                                                                                                                                                                             medical students practice
                                                                                                                                                                                                             important clinical skills
                                                                                                                                                                                                             such as taking a history,
                                                                                                                                                                                                             performing a physical
                                                                                                                                                                                                             exam, and performing
                                                                                                                                                                                                             osteopathic manipulative
                                                                                                                                                                                                             medicine (OMM) as well as
                                                                                                                                                                                                             osteopathic manipulative
                                                                                                                                                                                                             treatment (OMT).
                                                                                                                                 of crushing chest pain and you can hear their shortness of breath, there’s  birthing canal so that they can better understand the mechanics of the
                                                                                                                                 much less pretending and much more focused assessment — it becomes  birthing process. CIELO also is working on expanding the SIM Lab
                                                                                                                                 so much more real. The experience breeds familiarity and allows stu-  to its own building so that all of UIW’s health professional schools
                                                                                                                                 dents to handle the situation in a more professional and efficient manner.   can use them and collaborate to simulate interdisciplinary teams that
                                                                                                                                 Graduates of UIWSOM find the simulations relevant and applicable   doctors rely on during their clinical practice. As the years pass, it will
                                                                                                                                 to their experiences working as doctors in the field, and feel as if the   be exciting to see what vital skills medical students graduate with. After
                                                                                                                                 simulated encounters strengthened their confidence for when the time  all, the mannequin is the limit.
                                                                                                                                 came. If anything, Mark Zuniga, the Simulations Operations Specialist,
                                                                                                                                 claims that “learners don’t get enough.” With so many possible outcomes   Fatima Ali is a San Antonio resident and is currently a second-year
                                                                                                                                 doctors come across, there is no such thing as too much practice. 
                                                                                               UIWSOM’s state-of-the-art                                                                     medical student at UIWSOM.
                                                                                               simulation lab, featuring            As medical technology advances, so will the SIM Lab. As artificial
                                                                                               interactive mannequins            intelligence becomes more prevalent in the field, the CIELO team
                                                                                               capable of simulating             hopes to incorporate the technology into the simulations. Right now,   Patryk Tomaszkiewicz is from Houston, Texas. He is a second-year
                                                                                               critical patients and             sights are on incorporating virtual reality so that student doctors can   medical student at UIWSOM interested in pursuing Radiology or
                                                                                               allowing medical students                                                                     Internal Medicine.
                                                                                               to simulate patient care.         see through the birthing mannequin as the baby proceeds through the

         22     SAN ANTONIO MEDICINE  • June 2024                                                                                                                                                                    Visit us at www.bcms.org     23
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