In a University of Central Florida classroom, a robotic mannequin named David lay on a hospital bed moaning in pain like a sick animatronic Disney character.
"Oooooh. It hurts. It hurts," the dummy groaned, its chest rising and falling with the help of inflatable balloons, its plastic eyes blinking rapidly.
"I think I'm sick, Doc," said Moshe Feldman into a microphone wired into David.
From his laptop, Feldman, a postdoctoral fellow at UCF's College of Medicine, selected from a bulleted menu of body movements for David that included convulsions, shallow breathing, rapid to slow blinking, and even swelling of the tongue.
"I'm like the man behind the curtain," Feldman said. "I make him talk and can make him simulate everything from a heart attack to asthma."
At the UCF Simulation Learning Resource Center — working with the university's College of Medicine — state-of-the-art automated mannequins, avatars, virtual reality and other futuristic simulations are being developed to give students hands-on experience that will better prepare them for the real world of medicine.
When the medical school's inaugural class begins Monday, instructors will be ready with the latest instructional methods and high-tech tools.
Along with human-patient actors, simulations will be used to give students increasingly difficult cases to diagnose and treat. Just as important, the fake and virtual patients will help train students how to talk to and glean information from patients during examinations and other procedures.
"It lets students experience a rich variety of medical situations without bringing harm to anyone. It's sort of a take off from flight training," said Randy Shumaker, director of the Institute for Simulation & Training. "You want to practice as many takeoffs and landings and be able to make mistakes, which you wouldn't want to do when you're really flying a plane."
UCF worked with ArmyTo prepare for the incoming class of medical students, UCF College of Medicine faculty toured medical schools and other facilities throughout the country to find the latest teaching equipment and methods, said Feldman, hired to help integrate simulation approaches and tools into the College of Medicine curriculum.
It turned out UCF had a tremendous resource in its own backyard: Central Florida is home to about 150 high-tech-simulation businesses that largely cater to the military.
UCF collaborated with the U.S. Army, which has a research facility on campus, in the design of the robotic mannequins, which are used by the military for field-training exercises. Costs for the dummies range from $50,000 to $80,000 and more for untethered models.
"They model the physiology of humans," said Laura Cuty-Ruiz, director of the medical school's Clinical Skills Center, where simulated exams take place.
Feldman continued his demonstration of David, a tall, muscular mannequin dressed in a T-shirt and cotton shorts.
"He breathes, he pees, he bleeds, he coughs. You can hear his heartbeat, his stomach rumbling. He can have a tracheal. We can defibrillate him. You can give him an IV, and he'll respond," Cuty-Ruiz said.
David can also become Davida.
"You can change out his genitalia so he can be female," Cuty-Ruiz said.
Video-game-style programs, tooUCF also is collaborating with the University of Florida, University of Georgia and Northwestern University to come up with a hybrid computer/mannequin that helps students to correctly perform a breast exam. The "mixed-reality human" is composed of a life-sized computer avatar on a flat screen and a mannequin with a prosthetic breast.
The team intends to explore prostate exams and other intimate procedures as well.
"This is more in the R&D phase," said Mike Eakins, a recent graduate of the Institute for Simulation & Training who is working with other students and faculty to develop the virtual program. "We're working on taking this out of the research phase and implementing this into the curriculum."
The project is important because correct examinations and good doctor-patient communication are critical to successful medical treatment, said Benjamin Lok, a UF assistant professor heading the effort.
"Studies have shown that communication skills are actually a better predictor of outcome than medical skills," Lok said.
Other high-tech instructional tools will be ready for use by students, including Web-based video-gamelike programs such as the one developed at UF that uses a computer-animated character named Bobby Jackson that allows users to type in questions to diagnose medical problems. Another simulation program that features a virtual patient who collapses at a health club gives users a possible score of 2,800 for the right diagnosis.
Feldman calls these programs "serious games" modeled after ones that have been created for entertainment but can be used for instructional purposes.
For a new generation of students weaned on iPods, smart phones and three-dimensional video games, these new instructional approaches speak their language.
"They're not going to come into a classroom and have a blackboard lecture," Shumaker said.
No substitute for realityStill, these advances in technology are meant to enhance, not replace, traditional teaching methods.
"The mannequins, Web-based and computer-based aids are not intended as a replacement for a real patient," said Cuty-Ruiz, who also recruits community volunteers to work as standardized patients — people who are specially trained to portray medical conditions from broken bones to heart attacks.
"But the high-tech tools provide opportunities for practice and learning early on," she added. "They're learning good technical skills under clinical supervision. That's our ultimate goal."
Fernando Quintero can be reached at 407-650-6333 or firstname.lastname@example.org.Copyright © 2014, Los Angeles Times