Trial and error has its place in clinical training but not in the emergency room, where one false move can result is loss of life. To teach veterinary students how to handle emergencies without endangering a critical patient's well-being, a Cornell veterinarian has designed a sophisticated "rescue dog" mannequin and software program -- the first of its kind in veterinary medicine.
"I present lectures on shock and resuscitation to veterinary students in the fall of their third year," said Dan Fletcher, assistant professor of emergency and critical care. "But when those students are confronted with a real-life crisis for the first time in the hospital, they often freeze up like deer in the headlights."
The simulator provides a safe environment to make mistakes and, even more importantly, to learn from experience, he added.
The system is based on a reverse-engineered human model that Fletcher adapted for canine use in collaboration with engineering and architecture students.
Multiple embedded speakers and actuators within the "smart" dog dummy emit heart and lung sounds, and create pulses that can be felt. A balloon within the chest cavity simulates chest movements to mimic spontaneous breathing. All of these features are driven by programmable and adjustable software. Simulated system monitors report on such vital indicators as EKG, pulse oximetry and blood pressure. Students can also try to save their simulated patient if he stops breathing by inserting a breathing tube and giving breaths with an Ambu bag and can try to restore blood circulation by compressing his chest, just as they would with a real dog in crisis. All of these interactions are recorded by the system and can be reviewed afterward.
The use of simulator technology is already well established in human medical education. In fact, the Society for Simulation in Health Care, which was founded in 2004, already boasts more than 2,000 members.
Fletcher worked with colleagues in the Emergency and Critical Care section of the Cornell University Hospital for Animals to develop teaching scenarios for the simulator, all of which follow the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation released in recent weeks. After each scenario is played out with the mannequin, the student group reviews a video of what transpired. A trained facilitator then leads a discussion, and students draw conclusions about what they could have done differently. According to Fletcher, these debriefing sessions are where the real learning occurs.
Fletcher hopes to develop continuing education programs aimed at stabilizing injured animals for veterinarians, emergency and military personnel who rely on working dogs, as well as pet owners. He is currently working with licensed veterinary technician team leaders Andrea Battaglia and Deb Watrous to create training simulations for veterinary technicians.
Recent research in psychology demonstrates that experiential learning is more effective than lectures for adult learners, Fletcher says: "It's important to understand that this is a bona fide teaching modality. In fact, this is how adults learn best."
Stephanie Specchio is director of communications at the College of Veterinary Medicine.