Simulation center has lifesaving goal

Greg Beall, simulation specialist at the MUSC Health Care Simulation Center's operating room, places an endotracheal tube into a manikin Wednesday.

A nurse midwife brushed Noelle's hair from her eyes and calmly encouraged her to push. During Noelle's two-minute labor, she did not cry out or break a sweat.

Noelle is a robot. So is her baby, Hal, who is pushed out by a motor. Hal cries and uncurls into a student's cupped hands.

Although mother and baby may lack the fluids and membranes of birth, they are able to go through the process dozens of times in one day and in various scenarios — head first, breech and C-section. The baby's rubbery cheeks glow blue if he does not get enough oxygen.

Noelle and Hal are among 50 adult and infant manikins populating Medical University of South Carolina's Health Care Simulation Center, which opened this week as part of a statewide network of simulation centers. The network is under the umbrella of Health Sciences South Carolina, a public- private partnership among universities and health systems.

The 11,000-square-foot center, housing more than $900,000 in simulation technology, is the second of seven patient safety centers opening over two years. Manikins can simulate scenarios from emergency-room trauma to critical-care patients who crash without warning.

Dr. John Schaefer is director of the network known as the Education and Research Center of Economic Excellence in Clinical Effectiveness and Patient Safety. Part of the S.C. Centers of Economic Excellence, the center uses lottery funds matched with federal money and private investments to attract top professors.

Schaefer has worked with manikin-based simulators since they were introduced in medical education in the U.S. in the early 1990s. He co-holds several patents for human simulators and has developed

accompanying software.

Traditionally, the mantra of medical training is "See one, do one, teach one." Simulators allow students to practice one before they try it on a real patient, Schaefer said.

The dilemma in medical training is "how to practice without opening patients up to risk," he said. Other high-risk fields, such as aviation, have used simulators and repetitive training for decades.

Further, training students in an operating room costs about $50 a minute, Schaefer said. Using simulation, the cost drops to $60 an hour.

Located in the College of Nursing, the lab will be interdisciplinary. Nursing and medical students as well as other health care staff will practice in teams.

"I've been to clinics all over the world. I helped build some of them," Schaefer said. "This center is the best in the world right now. Hopkins, Harvard, Stanford can't compare." While students at MUSC have worked with simulators for years, having so many of such quality is a first, he said.

Schaefer holds the Lewis Blackman chair for patient safety, named for a 15-year-old boy who died in 2000 after an elective surgery at MUSC to correct a congenital condition called pectus excavatum, or a sunken chest.

Near the center's entrance, a plaque recognizes Lewis' life.

"We will remember his loss and strive to never lose a patient unnecessarily," Medical University President Ray Greenberg said.

Lewis' mother, Helen Haskell, attended the ribbon-cutting ceremony Tuesday.

"One of our big issues has been along medical training," said Haskell, a patient-safety advocate. "Simulation is a big part of that, so medical students don't have to practice on patients. It's just common sense."