Oct. 22, 1998 A Penn State researcher has shown that a robotic patient simulator can be an effective stand-in to teach doctors how new drugs affect real patients.
W. Bosseau Murray, M.D. associate professor of anesthesiology in Penn State' College of Medicine, recently conducted physician training programs using a patient simulator and the relatively new drug, remifentanil, an anesthetic manufactured by Glaxo Wellcome. The drug was introduced in 1996 after FDA approval. Its effects are strong, fast acting and last only five to 10 minutes. The drug's side effects appear equally quickly.
"This is an excellent drug, but because it is so potent, this training was very valuable for the physicians," says Murray, also an anesthesiologist at Hershey Medical Center of the Penn State Geisinger Health System.
"If you have never seen these side effects, and if the heart rate slows, you would grab medication to speed the heart rate and then it would go too fast. You would have this seesaw between slow and fast and this would not be good for the patient. With this training, the physician can accept a drop in heart rate, knowing it will come back in a minute or two."
Murray was one of several instructors who taught physicians the proper way to use the drug. He reports that a human patient simulator helps train physicians as it reacts in real time just as a human patient would react. By using different scenarios, physicians can get experience just as if they were treating human beings.
He explains that a human patient simulator was transported to 58 cities across the U.S. in 1996 and 1997 so physicians could learn how to use the drug. A total of 836 anesthesiologists and residents participated. Nearly 80 percent had no prior experience with a full human patient simulator. Remifentanil was available at 36 percent of the participants' hospitals, available on a trial basis at 18 percent, under review in 19 percent, and not available at 23 percent of those surveyed.
"There was a significant difference in comfort level after the training session. Eighty-one percent said clinical simulation experience was an excellent way to learn about new drugs like remifentanil, " says Murray.
The Penn State researcher, who coordinates a simulation lab at the medical center, presented his findings, "A Novel Application of a Full Human Simulator: Training Users of a Newly Introduced Drug (Remifentanil) Prior to Human Use," this week at the annual American Society of Anesthesiologists meeting in Orlando, Fla.
"Being able to present these potent side effects and different scenarios is very valuable. We liken this to flight simulation. There is no substitute for experience," says Murray. He believes patient simulation is an excellent way of introducing new drugs to the medical community.
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