BIOGRAPHY

Giuditta (Judy) Angelini received her Bachelor of Science degree from Michigan State University, later graduating from the University of Wisconsin School of Medicine and Public Health. Judy also completed her Internal Medicine and Anesthesiology residency training at the University of Wisconsin. Following residency she completed a Surgical Critical Care Fellowship at Johns Hopkins in Baltimore, MD.

Judy is currently an Assistant Professor at the University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology where she has developed a variety of curricula for both medical students and residents. She is also one of the instructors in the Department’s simulation-based resuscitation elective. Judy is no stranger to the utilization of technology to deliver and enhance the educational process. As a teacher Judy utilizes several types of simulation ranging from desktop and palm software to high fidelity simulation. Judy is a strong proponent of integrating technology such as simulation into the health sciences curricula.

ABSTRACT

Computer-Based Simulations for Medical Students in Anesthesiology

Medical schools today strive to keep pace with the accelerating growth of medical knowledge and technology. Since lengthening the years of medical education is unlikely, medical schools must find ways to teach more effectively. Fortunately, the rapid advance of technology has provided effective computer-based simulators for medical education. We are using this type of simulation with medical students in our anesthesiology clerkship. Students work collaboratively in small groups to manage an anesthesia patient in a computer-based simulation.

The Anesthesia Simulator uses mathematical models of physiology and pharmacology to present authentic patient cases. The patient’s vital signs (heart rate, respiration, temperature, blood pressure and oxygen saturation) are displayed throughout the simulated case. The student has complete control over the management of the case. The program allows the medical students to communicate with the virtual surgeon and choose from a number of treatment options including: airway management techniques, drug administration, monitors to be employed, and fluids to be administered. As the case progresses and students make patient management decisions they are able to see how those decisions would play out in the operating room. Studies have found that similar computer-based simulations are effective educational tools (1-4). A key benefit of medical simulation is that students can practice their skills repeatedly without ever compromising a patient’s safety.

The Anesthesia Simulator is a learner-centered tool. The authenticity of the simulator provides an opportunity for students to integrate their medical knowledge, clinical reasoning, and patient management techniques outside of the clinical setting. The authenticity and level of complexity in the simulator scenarios facilitates students’ understanding of the abstract concepts underlying clinical practice. Further, students can use the simulator to focus on their particular learning needs. Studies have demonstrated that deliberate practice accelerates the acquisition of expertise (5-7) and the portability of the simulator program allows students to gain this deliberate practice at their convenience.

The simulator is a flexible tool that provides valuable teaching options. Instructors can choose from several patients and initiate any one of dozens of clinical procedures for students to manage. Case difficulty can be adjusted by choosing to run a standard case or have a random complication arise. Also, the simulation can be run real-time or automatically advanced to the next significant event or teaching point. Since students’ clinical experiences in the operating rooms vary considerably during the clerkship, the simulator helps the instructor ensure that all students cover essential course material.

Well-designed simulation has the potential to make teaching and learning more precise and effective. We plan to catalog the most common learning problems students encounter during the simulations and then adjust course activities to address those areas. We believe this computer-based simulation will prove to be a valuable complement to other simulation efforts in our department. Individuals attending our presentation will have the opportunity to run the simulation program.

References

1. Schwid HA, Rooke GA, Michalowski P, Ross BK. (2001). Screen-based anesthesia simulation with debriefing improves performance in a mannequin-based anesthesia simulator. Teaching and Learning in Medicine, 3, 92-96.
2. Issenberg, S.B., Petrusa, E.R., McGaghie, W.C., Felner, J.M., Waugh, R.A., Nash, I.S. (1999). Effectiveness of a computer-based system to teach bedside cardiology. Academic Medicine, 74, S93-S95.
3. Issenberg, S.B., McGaghie, W.C., Brown, D.D., Mayer, J.W., Gessner, I.H., Hart I.R. (2000). Development of multimedia computer-based measures of clinical skills in bedside cardiology.(pp. 821-29). In: D. E. Melnick, Ed. The Eighth International Ottawa Conference on Medical Education and Assessment Proceedings. Evolving Assessment: Protecting the Human Dimension. Philadelphia: National Board of Medical Examiners..
4. Nyssen, A. S., Larbuisson, R., Janssens, M., Pendeville, P., Mayne, A. (2002) A comparison of the training value of two types of anesthesia simulators: Computer screen-based and mannequin-based simulators, Anesthesia and Analgesia, 94, 1560-1565.
5. Ericsson, K.A., Krampe, R.T., Tesch-Romer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100, 363-406.
6. Ericsson, K.A., Charness, N. (1994). Expert performance: Its structure and acquisition. American Psychologist, 49, 725-47.
7. Ericsson, K.A., Lehmann, A.C. (1996). Expert and exceptional performance: Evidence of maximal adaptation to task constraints. Annual Review of Psychology, 47, 273-305.