Artificial patients, real learning

The patient’s blood pressure had reportedly crashed in the ambulance; a gunshot wound had damaged the heart. In the operating room, a medical resident, Dr Dan Hashimoto, slid a knife into the patient’s chest and sliced horizontally , thrust his hand into the gash, grasped the beating heart and squeezed, to the tempo of 100 beats a minute. Noticing bleeding from the right ventricle, Dr Hashimoto stopped pumping to sew up the hole. The pulse recovered, and blood pressure climbed.

Concerned there might be more bleeding in the belly , he moved to stop blood flow to the aorta. “Remember your anatomy ,“ attending physician, Dr Marc de Moya, said and soon pronounced the procedure a success.

Simulator dummies, popular props in Hollywood, are being used to train medical students on dealing with emergencies

Yet no one’s life had been saved. Dr Hashimoto, a third-year-resident at Massachusetts General Hospital, had been practicing what is known as an emergency department thoracotomy on a rubber and plastic dummy that felt and acted like a human body .

Simulations have been part of medical training for centuries. But technological advances in computing, materials and production, and 3-D printing, are driving trainers to a level of realism previously unimaginable.artificial.heart

On Monday , at its annual Global Pediatric Innovation Summit, Boston Children’s Hospital unveiled two new simulators. One had the real feel of a newborn’s skin, muscle and pulsing veins that will be used to simulate a heart-lung bypass; the other allows doctors to practice adding a drain to a brain overwhelmed with fluid. Underneath the mannequins’ silicone-covered torsos and necks are hand-sculpt ed and molded muscles and blood vessels filled with mock blood.

The Children’s Hospital simulators and the dummy simulating the thoracotomy at Mass General were created by people with an expertise in movie special effects. Fractured FX, which won an Emmy for its special effects in the American Horror Story , designed the mannequins for Children’s. The Mass General mannequin was made by the founders of The Chamberlain Group in Great Barrington, who worked on special effects in films like The Matrix. The materials are the same used on movie sets and to make prosthetics look real, said Justin Raleigh, chief executive of Fractured FX, but he added that the company’s standards of realism were far higher on the simulators than in Hollywood.

Such cutting-edge realism enables medical teams to better learn, said Dr.Peter Weinstock of Boston Children’s.At Mass General, simulation has become a regular part of the practice of medicine, to train students and to keep the skills of its 10,000 clinical employees up-to-date, said Dr James Gordon, the director of the hospital’s MGH Learning Laboratory .

Although simulator participants know they are working on plastic dummies, they often lose themselves in the moment. The bleating monitors, open wound and pressure to diagnose or treat correctly make it feel like the real thing. Both Boston Children’s and Mass General plan to sell their simulators and educational training programs to hospitals across the world.

Children’s Hospital’s simulators will soon have a plug-and-play component where a surgeon preparing to operate, say , on a brain tumor will be able to 3-D print the child’s cancer from a CT scan, and then insert it into the trainer for a run-through. Dr Gordon of Mass General said his vision for the future of simulation came from Star Trek’s holodeck. He wants to see a trainee walk into an empty room, push a button and be immersed in a virtual version of surgery , while feeling the sensation of cutting through real flesh.“People are beginning to build the building blocks of what this might look like,“ he said. NYT NEWS SERVICE