ISL for Students

Students are an important and growing “target population” for a variety of applications of immersive and simulation-based learning at Stanford School of Medicine. ISL is deployed at every level of medical student education and training.

Pre-clinical Education and Training

Virtual Hand

Visualization and Virtual Reality: The SUMMIT group has developed and deployed some interesting applications of interactive (often 3-D) visualization software for teaching anatomy using virtual reality techniques

Computer-screen and Internet-based Simulation: SUMMIT has also prepared a number of web-based or computer-based modules, for example on nutrition, and “virtual patients” that can be seen and queried on the computer screen. Students are also encouraged to use third-party interactive web-based teaching resources made available by others in the world-wide ISL community.

Standardized Patients: Based on the premise that, in many situations, the best simulation of a human being is a human being, Stanford has a very active Standardized Patient (SP) program. A cadre of more than 75 standardized patient actors are available for SP teaching exercises. The actors can portray a large number of diseases and conditions and a diverse set of patient-physician interaction challenges.


videoStanford’s Standardized Patient program…

SP exercises are an important part of students’ learning and practice in the art and science of interviewing patients to obtain a medical history, or conducting physical examination, and of communicating with patients in a variety of encounter settings. Over the course of medical school students will be exposed to about 25 SP encounters – half in the pre-clinical phase of learning, and half in the clinical phase (there are SP exercises or simulation sessions in nearly all core clerkships)

Venipuncture

Part-task Trainers: Learning specific “psychomotor” skills such as the elements of conducting a physical examination, or procedures such as blood drawing (“venipuncture”) or spinal tap (“lumbar puncture”) can be greatly assisted by the use of “part-task trainers” that address only the aspects of the skill or procedure. Second-year medical students in the Practice of Medicine course (POM) use part-task trainers in the Fleischman Learning Laboratory and the Clinical Procedures Training Facility to learn various procedures including:

  • Cardiac auscultation
  • Pelvic examination (part-task mannequins and ePelvis)
  • Venipuncture/IV insertion
  • Airway management
  • ECG interpretation
  • Lumbar puncture
IMIP Bagging Listening CPR

Mannequin-based Simulation: Second year students in the POM course undergo the simulation-based Introduction to the Management of the Ill Patient (IMIP) course. This entails a 2 hour session with small groups of students and an instructor interacting directly with high-fidelity mannequin-based simulator portraying an acutely ill patient in a setting like an emergency room.

Unlike an actor, the simulator can have life-threatening illnesses, can be given invasive treatments such as IV drugs, needles and tubes, and can even have cardiac arrest (e.g. from a heart attack) or cardiovascular collapse (e.g. from severe allergic reaction). The IMIP course is designed to introduce students who have largely been exposed to patients and exercises in relatively static environments like the outpatient clinic or ward to the world of acutely ill patients as might be seen the emergency department or the intensive care unit.

Clinical Education and Training

A variety of the same modalities indicated above are also used during clerkship rotations and sub-internships in the clinical phase of education and training.

Clerkship Simulations

Part task trainers for specific procedures performed in the clerkship, for example:

  • Obstetrics and Gynecology -- fetal delivery part-task trainer
  • Anesthesiology -- endotracheal intubation part-task mannequin

Standardized Patient Scenarios

  • Internal medicine
  • Ambulatory medicine
Critical Care Clerkship

Mannequin-based Simulation Exercises: Clerkships in highly dynamic and high hazard settings have scenarios using mannequin-based simulators:

  • Critical Care Clerkship (1 half-day session)
  • Anesthesia Clerkship (2 half-day sessions)
  • Surgery Clerkship (under construction)
  • Obstetric and Gynecology Clerkship (under construction)

Surgical and Procedural Simulation: Some clerkships and sub-internships offer the ability to begin to learn the rudiments of highly invasive surgical and endovascular procedures:

  • Surgery
  • Vascular Surgery