Improved clinical facilities wow returning alumni

Yale School of Medicine alumni who toured facilities on campus during reunion saw how realistic practice settings and technology have improved instruction since their day.

Those tours were part of the medical school’s reunion on May 31 and June 1. On the first day of reunion, alumni were shown the recently renovated clinical skills practice spaces in the basement of the Edward S. Harkness Memorial Hall along with the Yale Center for Medical Simulation.

“I’m jealous, I would like to come back and do some of this,” Dena Springer, MD ’04, said after watching medical students work in the simulation center. She was sorry the facility was not available when she was in medical school. The simulation center was created five years ago.

In the simulation center, residents and medical students practice evaluating and treating patients in an emergency. The classrooms are set up as they would be in an ED and mannequins that can mimic sweating, bleeding, crying, and even delivering a baby take the place of patients. An audio connection to another room lets staff speak for the mannequin, so students can have the sort of conversation with a patient that they would if the situation were real.

Visiting alumni watched one session where students were given the scenario of an elderly woman who complained of abdominal pain. The eventual diagnosis was that the woman suffered from a bowel obstruction and needed emergency surgery.

Springer said the learning and practice the simulation center provides would have been a benefit.

“I feel like I would have had more confidence when I started working with patients,” Springer said. “This integrates book knowledge so you can use it clinically and it just gives you the confidence that you can do this.”

“This was a great way to learn in a realistic scenario,” said Johnathan E. Henderson, MD ‘99. “It helps you remember what you have learned in class and from your textbooks.”

Debriefings are held after every session and that is a crucial part of the program at the simulation center. Joy Grabow, a supervisor there, said students review what was and wasn’t done during the simulation. This gives them the opportunity to discuss other ways to approach the simulated situation in the future. Henderson said he did not receive that kind of regular feedback when he was in school and it would have helped.

Henderson said visiting the simulation center also gave him ideas for improving instruction at the Floyd Medical Center Family Medicine Residency in Georgia, where he is director of the family medicine clerkship.

The new clinical practice spaces in Harkness Hall opened in January after a nine-month renovation, said Michael Schwartz, PhD, associate dean for curriculum. The rooms there are equipped like those in a medical office where patient exams are done and have ultrasound imaging equipment. Having students use ultrasound technologies to help them develop their physical exam skills and understanding of anatomy was an important goal for the renovations, Schwartz said.

“I wanted to see how clinical skills are taught now and I did not expect to see so much. It exceeded my expectations,” said Larry Yeatman, MD ’69. The ultrasound equipment was one of the things that particularly impressed him. Yeatman said technology that lets students see what is going on inside a patient’s body when they are just learning how to use their hands and sense of touch can be a tremendous help.

Sandy Genser, also MD ’69, agreed and said much of what he saw greatly improves education for students who are at the medical school now, especially technology that gives visual feedback.

“Ultrasound validates the accuracy of the clinical exam that you have just done, the only thing better than that is a senior clinician saying they feel the same thing you just felt with your hands,” Genser said. “That immediate feedback reinforces learning. I came here because I was interested to see how technology is being used to augment the education process. There are a lot of opportunities to make classes more effective with technology and that is what I find impressive.”

Yeatman said the space where the clinical practice spaces are now had a student lounge with a snack bar when he was in medical school.

“We wanted to take a space that was substandard and renovate it to allow us to use cutting-edge learning pedagogies and technology in a way that was not possible in the old space,” Schwartz said.

Another goal was to make the space more appealing for learning. “It was a spartan experience and felt like you were in a basement,” Schwartz said.

The tour of the practice spaces started out in a newly renovated classroom that instructors can configure in different ways depending on what they are teaching. “The goal of all these teaching spaces is flexibility,” Schwartz said.

Another feature of the clinical skills suite is video equipment to record sessions. Individual recordings are saved to a thumb drive so students can review and reflect on their work afterward, Schwartz said.