Meti Human Patient Simulators
The Human Patient Simulator (HPS) system is designed by Medical Education Technologies, Inc (METI), and consists of a manikin and control rack. The model-driven manikin is a full sized lifelike body (adult or pediatric) whose pulmonary, cardiovascular and other systems respond automatically to a user's interventions and the environment. The control rack contains the physiologic and pharmacologic modeling programs and some of the simulated components.
The lab now has 2 METI HPS manikins and 2 control racks. The original system (ver 4)was acquired by by joint funding by the Department of Anaesthetics and the medical school in 2003 at a cost of around R400,000. The latest system (ver6) was acquired in 2008 at a cost of R2,800,000 funded by the Department of Education grant via the NRMSM.
Standard monitors are used to examine ECGs, blood pressures, expired breath and oxygen saturation. Thoracic pressures are generated in real time. Pulmonary artery catheter insertion can be simulated through the computer and measurements can be displayed as the catheter progresses, including wedge and cardiac output.
Users do physical examinations, airway manipulation, defibrillation / cardioversion, pharmacologic interventions, CPR and trauma procedures. Physical responses include heart and lung sounds, pulses, and real gas exchange. Real time blood gases can be read from the monitor and given to the trainees. Brain function is assessed by checking pupil size and reactivity to light. Consciousness is demonstrated by blinking or closing the eyelids.
The manikin is programmed with pharmacologic parameters for over 60 intravenous and gaseous drugs. When a drug is administered, the simulator takes into account weight and physical conditions to obtain onset and offset times and dose dependent systemic effects. Drug interactions are also calculated and reflected in the vital signs.
Teaching can be approached as an instructional format, where the disease is known ahead of time and various physiologic and pharmacologic points are discussed. Trainee-led treatments can be attempted. If the outcome is not favorable, the scenario is reset and the trainees discuss which treatments may produce a better outcome. Results of multiple treatment options can be examined and compared.
Diagnosis is also taught on the simulator. Trainees are given a case history and are asked to manage the patient. They are responsible for requesting appropriate tests and monitors, interpreting results, and making a diagnosis. The trainees then manage treatments to improve the patient's condition. These scenarios can be run in real time or can be slowed down to allow discussion before proceeding.
The simulator is used for research and training. The patient's voice is produced by speakers in the manikin's head. The AV system is used for recording and archiving research projects as well as for debriefing after a training or testing session.
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