Magazine article Newsweek

Wiring the New Docs: Today's Medical Students Use an Unprecedented Array of Sophisticated Teaching Aids. but How Does That Translate into Action When a Patient's Heart Rate Soars and His Blood Pressure Plunges?

Magazine article Newsweek

Wiring the New Docs: Today's Medical Students Use an Unprecedented Array of Sophisticated Teaching Aids. but How Does That Translate into Action When a Patient's Heart Rate Soars and His Blood Pressure Plunges?

Article excerpt

Byline: David Noonan

At UCLA Medical Center last month, three medical students stopped by to say hello to a patient about to undergo routine gallbladder surgery. They were making small talk when the 55-year-old man, who was connected to a heart monitor and had IV lines in place, suddenly stopped breathing. The students were the only medical personnel present, and their collective stress level soared as they scrambled to figure out what was wrong. They administered a sedative and ran a tube down the man's throat to aid his breathing. As the situation stabilized, the testy surgeon, unaware of the emergency, called the room looking for her patient. "I have clinic in the afternoon," she barked at the students over the intercom. "I can't be futzing around here all day." Just then, the crisis deepened as the patient's heartbeat raced out of control and his blood pressure plunged. Later, the students would discover that he had suffered an allergic reaction to the sedative they had given him and gone into anaphylactic shock. But they didn't know that at the time. All they knew was that the patient was dying and they had only minutes to save him. They gave him fluids and epinephrine to increase his blood pressure and shocked him twice with a defibrillator to restore his normal heart rhythm. When the surgeon called again, fourth-year student Janet Huamani took an extraordinary step. "I'm canceling your case," she said, and told the doctor the patient was going to the ICU, not the OR.

In a small room next door, associate clinical professor Dr. Rima Matevosian, who had watched on a video monitor, nodded in approval. "That's the appropriate response," she said. Then she turned to the technician seated beside her. "OK," she said, "complete recovery." The technician tapped away at her keyboard, the same one she used to generate the near catastrophe, and in a matter of seconds the traumatized patient's vital signs were all back to normal. Stan (short for "standard man"), the life-size, computer-controlled Human Patient Simulator, had survived yet another close encounter with simulated death. And the students, whose stress was clearly not simulated, had sweated through yet another nerve-racking lesson about the inherently unpredictable nature of medicine and patient care. As she prepared to join the students for a videotape review of their performance, Matevosian summed up her opinion of this dramatic approach to medical education: "Simulation saves lives."

Just as technology is transforming the practice of medicine and the experiences of patients, it is also changing the way tomorrow's doctors are being trained. Today's medical students have an unprecedented arsenal at their disposal--from simulators that breathe and respond to treatment like real patients (and sometimes even die), to pocket-size personal digital assistants (PDAs) that can hold entire medical texts, to CD-ROMs that enable students to listen to the sound of nearly every known heart condition, and more. Medical schools around the country are turning to technology to help their students learn even as they recognize the need to emphasize the human touch. At Tufts University, the entire curriculum for the first two years has been transformed into the Tufts Health Sciences Database, a massive, integrated online system. The University of Louisville School of Medicine has created a state-of-the-art patient-simulation center.

At UCLA's David Geffen School of Medicine, where PDAs are required for students but microscopes are optional, the students, faculty and administrator are surfing this technowave with gusto. Since 1996, when the school first required medical students to have computers, UCLA has spent millions turning itself into the very model of a 21st-century medical school. "Every patient is a little different," says Zane Amenhotep, who just completed his third year, "so there's always going to be a limitation to technology. You can't use it as the only tool, but it's an excellent foundation. …

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