Controlled chaos: Training with surgical simulators

Exercises in coping with worst-case scenarios are designed to heighten patient safety.

By Andis Robeznieks, AMNews staff. Feb. 25, 2002.

The surgery is going smoothly. It's almost over and then ... all hell breaks loose. The patient is having a heart attack on the table -- as well as an allergic reaction to the medication. His tongue is swelling and his heart rate is slowing.

To make matters worse, equipment is malfunctioning and providing false readouts.

No problem. With a calmness that defies the chaos, the well-oiled surgical team stabilizes the patient and successfully completes the surgery.

Were these medical miracles performed by a veteran surgical team who has seen it all and done it more times than they care to remember?

No. This team is made up of young physicians polishing their skills with a patient simulator.

Simulated surgery sessions are becoming more common, and they are another medical safety technique -- such as checklists and team training -- that's been borrowed from the aviation industry. Just as flight simulation is used to train pilots and allow them to make mistakes without threatening lives, surgical simulations, with mannequins that mimic human functions such as breathing and bleeding, put novice and experienced doctors into realistic crisis situations where they can hone and refine their skills.

"It's easy to do things when everything is going smoothly," said Louis P. Halamek, MD, an assistant professor in pediatrics at the Stanford University School of Medicine in Stanford, Calif. "What we're really preparing people for are these rare times when things go wrong that you may only experience a couple times in your career." [...]