High-tech mannequins help doctors, nurses practice procedures, make diagnoses

That’s an old joke, but it’s also true: Practice is needed for anyone who wants to become proficient in their chosen field.

It’s especially true in health care, but practicing on people isn’t ideal. That’s where the Milwaukee VA’s Simulation Center comes in.

To that end, Milwaukee VA doctors and nurses got to try their hand at the latest ultrasound-capable task trainers during an open house recently in the medical center’s Simulation Center.

New high-tech mannequins allow practice of various needle procedures with ultrasound guidance, which increases safety for Veterans.

During the open house, attendees were able to practice procedures ranging from central line insertion to lumbar puncture.  Ultrasound machines gave the practitioners an inside view of the “patients” to avoid complications

“This is pretty critical training,” said Dr. Theodore Jensen, a Milwaukee VA hospitalist who tried out the training mannequins. “Ultrasound is very beneficial in certain procedures. In fact, it’s a must.

“Especially when doing central lines, we know the outcomes are better with ultrasound. It gives me a heck of a lot more confidence knowing I’m not going to hit any critical structure, doing harm to the patient.”

Some diseases are rare, but important to be diagnosed and treated emergently. Several ultrasound trainers can not only show healthy patients, but also different life-threatening illnesses, which can be used for teaching on demand. 

Surgeon Dr. Todd Neideen, who is in charge of training surgery residents, agreed.

“From our standpoint, it makes training the residents easier because they get to train on the simulated dummies before they start training on people,” he said.

While ultrasound technology has existed for decades, it keeps getting better, Neideen said, and has become easier to use.

“The machines are getting smaller and more portable. You can just plug it into your phone and see what’s going on,” he said.

The importance of ultrasound

“Ultrasound has changed medicine a lot,” said Dr. Jutta Novalija, medical director of the simulation center who guided the open house along with Tina Smith, simulation center program director. “A lot of things can be done very safely because instead of doing things by feel, now we can see what we are doing with our eyes.

“Almost everybody uses ultrasound now to put in a central line; there really is no justification not to. It is so safe and simple. The new equipment will help to provide more training opportunities for our hospitalists to then do ultrasound-guided procedures at the bedside. This increases safety and improves access to needed procedures.

“The need for point-of-care ultrasound training is very high. Everybody wants to practice the skill, and the availability of portable ultrasound machines is increasing. We enable our learners to get more practice and help them with what they don't see in clinical care.”

Vital part of training

The Simulation Center, with its array of high-tech mannequins and patient room theater, is vital to the training of residents and the teaching of new skills and techniques.

But the training goes beyond the center. Smith and Novalija regularly take their act on the road, going to different parts of the hospital to stage simulations.

This spring, real-life simulations were staged in the Intensive Care Unit and the Emergency Department as part of the National TeleStroke Program.

Smith noted that simulations go beyond the mechanics of how to do a procedure or how to use technology to make a diagnosis. And it’s more than “see one, do one, teach one.”

“We really want teams to work together to learn how to communicate together, because that's where errors happen,” Smith said.

“That's where simulation gets really powerful because we work on that communication. Anybody can do a task, but can you communicate what you need? Why do you need it? What's happening with the patient? Can you keep the team informed? That's where we really want our simulation program to go.”

Novalija agreed.

“I do believe we are really exceptional in the interdisciplinary part,” she said.