“This is the worst pain ever!” screams a woman in the delivery ward, her eyelids fluttering as the baby’s skull crowns. Adding to the cacophony, an infant nearby in the neonatal unit jerks his arms and cries in distress, his tiny chest heaving under his striped onesie. In the operating room, an unconscious motorcyclist lies on the table with a blue drape circling the open fracture in his shin. Blood also oozes from the bandage around his forehead, adding to the urgency. Surgical instruments lined up on a tray gleam under the bright light. A crash cart equipped with a defibrillator stands by.
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| Dr. Michael Sopher (RES ’87, FEL ’88), clinical professor of anesthesiology (center), assists students in the UCLA Simulation Center as they practice necessary skills on mannequins before they move on to care for living patients. |
But it’s not just an average day at Ronald Reagan UCLA Medical Center. All of the “patients” are life-sized, computer-programmed mannequins in the newly renovated, 9,000-square-foot UCLA Simulation Center. The facility blends the latest in technology with life-or-death scenarios to help healthcare trainees polish their clinical-decisionmaking and teamwork skills before treating living patients. “Simulation-based learning embeds the lessons of the teaching experience deeply into the participants without risk to patients,” says anesthesiologist Randolph Steadman, MD (RES ’94), who founded the center and continues to serve as its medical director.
Eerily life-like, the center’s 14 full-body mannequins range in age from newborn to adult. Computerized variables control the sounds of the mannequin’s breathing, heart rate and rhythm, blood pressure and other vital signs. Noelle, the mannequin in labor, occasionally has her baby born breech. Or the simulation specialist can swap out her belly — equipped with an umbilical cord and placenta — for a C-section birth. To add realism, human actors or staff members are sometimes recruited to portray Noelle’s hysterical husband and worried family members. By causing a commotion, they force trainees to practice their bedside manner while juggling technical skills.
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| Mannequin heads and torsos allow students to practice a broad range of hands-on skills, such as placing a breathing tube, imaging the heart with ultrasound or performing a colonoscopy. |
The simulations are run from a central control room, from which instructors and students can observe, as those involved in the scenarios try to keep their wits about them in the fast-paced, roleplaying lesson. Nearby, in the center’s task-training room, mannequin heads and torsos lie on tables, allowing students to practice hands-on skills needed to place a breathing tube, image the heart or lungs via ultrasound, perform a colonoscopy or remove polyps, an appendix or a gallbladder. Virtual-reality ultrasound and surgical simulators with hand-held instruments allow a detailed view of the organ, which bleeds onscreen if a would-be surgeon nicks tissue or a blood vessel. At the end of the procedure, the trainee must achieve a certain score to advance to the next level.
“Surgeries used to last considerably longer at teaching hospitals,” Dr. Steadman says. “That’s because trainees would hone their skills on real patients. With high-tech simulation, UCLA healthcare providers can now achieve a certain level of proficiency before caring for their patients.”
