Practicing for medical practice

    Wilmington’s Christiana Care Health System has set up a virtual hospital where new doctors and nurses get a chance to play medicine — before they meet their real patients.

    Wilmington’s Christiana Care Health System has set up a virtual hospital where new doctors and nurses get a chance to play medicine — before they meet their real patients. Taunya English visited the hospital’s Virtual Education and Simulation Training Center.

    Remember all the mistakes you made the first time you had a “real job?” Imagine if your mess ups were a matter of life and death.

    Training center Director Glen Tinkoff says new doctors get lots of supervision, but he says practice is important too.

    Medical intern Dr. Erica Khan trains to care for trauma patients at Christiana Care Health System.Tinkoff: We make most of our mistakes early on in learning. If we can get 80 percent of our learning done on simulation we can reduce the errors we make.

    The surgery suites and trauma bays are the stage for elaborate dress rehearsals where life-like human simulators are the star. Training coordinator Chuck Fort introduces a quarter-million dollar mannequin to the newest crop of interns.

    Fort: This is JB, he’s going to be your patient today. You notice his eyes are blinking. If his eyes are closed he’s unresponsive, if he winks at you, he’s just being fresh.

    JB breathes, responds to medication and complains. Today he’s a high school student who got hit during football practice.

    Dr. Hari Khalsa is first up to care for JB, she and the other interns started just two weeks ago.

    Khalsa: Do you know where you are? JB: Yeah, the hospital. Khalsa: What day is it? JB: Tueday. Khalsa: Are you having any neck pain or back pain?

    New doctors say it is easy to suspend their disbelief when they train on Christiana’s quarter-million dollar human-patient simulator.Khalsa and her team quickly notice when JB stops breathing, but miss the signs that his spleen is torn.

    When you make that kind of rookie mistake, Dr. John Powell says it hurts the ego a little less if the patient is plastic.

    Powell: It’s much more easier for me to receive that and change my actions if there’s not a patient underneath the sheet listening to the person telling me well, “You should be a a little more right, you should be a little left, don’t do that.”

    Some say medical mistakes happen much too often in July, that’s when medical students morph into doctors and begin their on-the-job training. The evidence is mixed, but a new study suggests there may be some truth to the so-called “July Effect.”

    Researchers at the University of California, San Diego looked through U.S. patient records and found that fatal medication errors increase each July in counties with a teaching hospital.

    Surgery and emergency medicine are like an intricate dance. Center Director Glen Tinkoff says it’s nice to be able to practice with your partners, a little, before someone’s life is on the line.

    Drs. Elise Attardo (left) and Erica Khan “revive” a patient at Christiana Care’s Virtual Education and Simulation Training Center.Tinkoff: I may bark out an order, and a nurse may take it as being yelled at, and then maybe I need to soften my tone, or maybe the nurse needs to have a little thicker skin.

    Medical teams record their practice sessions and then do a postmortem, without having to kill anyone.

    Everyone has a role in preventing medical errors, and attending physician John Powell says those discussions help newbie doctors find their voice when a mistake happens in real life. Powell: If they see something wrong we want the most junior member of the team to feel comfortable speaking about it, so that we can alter our course.

    The virtual hospital rehearses both everyday and rare trauma cases. When that once-in-a-life time patient shows up in the ER, Powell says his trainees may have already managed a similar case five or six times.

    If they don’t know what to do, he says, they at least know when to ask for help.

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