The Washington Post

‘When the mission is patient first, we don’t try first on patients’

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On the table is a man's torso. Several doctors are gathered around the table and one grabs a needle, steadily presses it into the left side of the upper chest region and begins to draw out fluid.

“That’s nice clear fluid,” comments one of the other medical fellows. “Clearest fluid you’re ever going to get.”

The torso is a mannequin's, one with towels and raw chicken meat packed neatly inside. The fellows are practicing thoracentesis, a procedure that involves removing fluid from the space between the lungs and the chest wall, in a clinical simulation.

For the past decade, clinical simulation has steadily gained a place in medical education, thanks to technological advances. The appeal is clear: Practice makes perfect. By giving medical providers a chance to frequently rehearse a technique in a simulated scenario, they will be better equipped to respond appropriately in a real procedure. Or as Terry Fairbanks director of MedStar Health’s Simulation Training and Education Lab (SiTEL) in Washington, D.C. puts it, “Our mantra is: When the mission is patient first, we don’t try first on patients.”

MedStar SiTEL provides the lab space and technology for residents, fellows, nurses, and doctors to learn or revise procedures. Simulation can range from more basic scenarios, such as thoracentesis, to complicated procedures, such as cardiac arrest. Accordingly, the mannequins can vary in complexity and cost. Some are complex enough to visibly breathe, cry, sweat, and speak, according to Katharine Modisett, one of the critical care fellows at MedStar Washington Hospital Center.

That’s not to say simulation is becoming a replacement for clinical training. “Our goal is not to have people forget that they’re not in a real environment,” Fairbanks says, “Our goal is to have all of the cues be the same.” So whether it’s becoming familiar with equipment or learning how to rely on fellow doctors and nurses, simulation offers a space for trainees to learn vital cues.

“We used to joke with a faculty member that was in charge of our simulation that if you saw it in [simulation], you were going to see it in real life the next week,” Modisett says. “And it was true on several different occasions.”

Alice Li is a videographer for The Washington Post.

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