In real life, nursing students may be pulled away from the action to observe the professionals take care of seriously ill or injured patients. In simulation labs, students get to "treat" computerized mannequins, known as simulators, suffering everything from hemorrhages to psychiatric episodes.

Several nursing schools around the state have sim labs. Riverland Community College in Austin, Minn. (www.riverland.edu) was able to establish a first-class facility through a collaborative effort, according to Kari Busch, academic dean of Health, Sciences and Services at Riverland. Funded by a $2.2 million U.S. Department of Labor grant and contributions from Owatonna Hospital and Clinic, Albert Lea Medical Center and Austin Medical Center, Riverland's lab opened in January 2007. It has eight beds and nine simulators, including a baby.

Just like humans the simulators may bleed, breathe, speak or bite down, depending on how they are programmed. They have heart, lung and bowel sounds that students must monitor. Nursing students take turns playing the roles of licensed practical nurses, registered nurses and family members. Riverland also includes nursing assistant students as well as those in radiography, healthcare administration, law enforcement, theater and cosmetology to make the scenarios seem as real as possible.

"Every simulation is different," explains Jane McKinley, the laboratory specialist who programs the scenarios. "They have to recognize what's going on with them and what's the priority."

Instant replay helps streaming video allows the students to watch their performance within minutes, debrief and run it again, usually with response time cut in half. "They find they're pretty eye-opening," McKinley adds. "They're usually pretty nervous when they come in, but they're always glad they went through it. They learn a great deal."

The scenarios teach students critical thinking skills they cannot attain from books or classroom instruction, according to McKinley and Danyel Helgeson, Nursing Program director at Riverland.

"The simulation lab and the simulated patients offer the students a chance to practice in a non-threatening environment," Helgeson explains. "They can practice their skills, thinking and apply theoretical knowledge, and they don't have to be afraid of hurting somebody."

The grant also required changes in academics, and Riverland took the opportunity to convert from separate LPN and RN programs to a pathway program, which LPN students attend for one year, and RN students for two. Riverland is also working more closely with other colleges in the Minnesota State Colleges and University system that have sim labs.

Says Helgeson: "We're really, really growing since we've had access to this lab."

Nancy Crotti is a freelance writer who lives in St. Paul.