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Simulators could play a growing role in doctor training, now that medical residents are limited in the number of hours they can work to avoid fatigue-related errors.
Seeing the mistakes
Dr. Travis Pagliara, a third-year resident, said the machines are incredibly lifelike.
“I’m moving in every direction of space, whether I twist my wrist, whether I push in, pull back, both hands are doing things separately,” he said. “It’s an actual interaction with my body with what happens on the screen.”
Pagliara, 29, had trained on a simulator before he stepped into the operating room to work under Sweet’s supervision on his first real case of benign prostatic hyperplasia. Normally, Sweet said, first-timers last less than a minute before he has to take over.
“Travis blew me away,” Sweet said, praising Pagliara’s natural skills but adding that the simulator made an important difference.
Travis agreed. “I wouldn’t have lasted 15 seconds if I hadn’t done that,” he said.
Residents in neurosurgery get to train on a simulator called NeuroTouch Cranio, which was developed by the Canadian National Research Council for surgeons to practice with a device that uses sound waves to liquefy brain tumors and then sucks away the debris.
“They have more self-confidence and maybe more importantly, they learn their own limitations,” said David Hananel, associate director of the medical school’s simulation programs. “We actually are trying to teach them the errors, the mistakes, the things that shouldn’t be done. Let them do it, see the consequences, and then show them how to recover.”
Better than a cadaver
Dr. Daniel Guillaume, a neurosurgeon and associate professor at the U, said the 3-D graphics in NeuroTouch visually mimic what surgeons see in the operating room. The tactile feedback is very good, so tumors feel different from brain tissue, he said.
“Before this kind of thing came along, the only way to teach people to operate was in the operating room on a human who’s alive, because cadavers don’t have the same tissue property,” Guillaume said. “So this is actually better than a cadaver and it’s safer than operating on a patient.”
Hananel said the market for simulators, simulator training and lifelike body parts has been slow to develop in private industry and is still relatively small, but the military has shown a strong interest. Three years ago the U won an $11.2 million contract to research combat-medicine simulators and training methods. And the U’s simulation center is now developing an artificial airway to train for intubation procedures, a project that’s on track for commercialization.
Hananel said he envisions a full-body simulator that residents and practicing physicians could use to practice any number of procedures. The technology exists to pull it off, he said, but it’s a mammoth engineering project that would take a lot of time and money.
“So we have a 10-year vision of where we need to go,” Hananel said.
Dan Browning • 612-673-4493