April 3, 2017
YCMS provides a low-pressure setting for medical students and residents to practice clinical skills. Photo credit: John Curtis
The new state-of-the-art center offers hundreds of possible scenarios to help teach and practice clinical skills
Over the past two decades, simulation has become an important tool in medical education, providing a safe, low-risk learning environment for medical students and residents to practice clinical skills.
Students are excited to learn via simulation, and I am delighted that the Yale Center for Medical Simulation (YCMS), opened in 2015, provides such a rich learning environment. The new center has four simulation rooms: a trauma resuscitation room; an emergency room/intensive care unit; a pediatric resuscitation room and a multipurpose procedural room that simulates an operating and delivery room; plus a scrub room for learning sterile technique. Students practice on four robotic manikins—an adult male, an adult female, a baby and a newborn—that produce realistic heart, lung, and bowel sounds, as well as a palpable pulse and responsive pupil size. There are also partial-body “task-trainers” that can be used to perform procedures. By practicing on sophisticated manikins, students have the opportunity to acquire real-world clinical skills without worrying about whether they’re doing harm, which allows them to build confidence and learn from their mistakes, as well as their successes. They are also exposed to cases—critically ill children or complicated deliveries, for example—that they might not see often, but need to practice nonetheless.
Medical simulation had been a part of the School of Medicine curriculum for over a decade, but it originally took place in a small office in the emergency department and was limited to a 12-week period during which students worked through 24 cases with a single manikin. When we decided to build a new center, Leigh Evans, MD, HS ’02, executive director of YCMS, spent a year researching similar programs and facilities at other institutions. Students are now exposed to simulation during the first week of medical school and throughout the entire year of their clinical rotations, which begin halfway through their second year of medical school and most of which have a simulation module. We believe that ours is among the largest medical school simulation programs in the country and it now serves as a model for other institutions.
It’s also a fantastic resource for faculty interested in pursuing innovative clinical education or broadening exposure to cases that have educational potential. Although residents and faculty have helped develop hundreds of simulated cases over the years, the center welcomes the opportunity to help faculty develop new cases and novel uses of its facilities. The Department of Psychiatry, for example, uses the center to teach how to manage delirium and the one-way mirror setup has been used to observe interviews of asylum seekers. Faculty need only their clinical expertise; the center’s staff handles the technical aspects of simulation, including programming the manikins and integrating diagnostic test results into simulations. Faculty are also encouraged to conduct education research at the center. For example, it’s currently being used for a project that uses simulation to assess medical students’ mastery of the core competencies they need to graduate.
It’s gratifying to see that students, residents, and faculty are utilizing YCMS to improve both their skills and their teaching. I encourage faculty in particular to take advantage of the expertise offered at the center and incorporate simulation into their coursework as a valuable experiential learning tool.