Smart dummies aid school

George Porter is not doing well.

He's having trouble breathing, lying on a stretcher surrounded by five licensed practical nurses in Carrington Hall of UNC's School of Nursing.

After steadily putting on weight during the last week, Porter now is coughing up a pink, frothy substance and talking nonsense about one of his dead dogs.

While Porter blinks, breathes, speaks, urinates and has a heartbeat, he can't change skin tone or sweat.

But Porter is just another alias for Stan the Man, or the Standard Mannequin. He is a human patient simulator, one of the nursing school's most innovative technologies.

The five LPNs charged with diagnosing the dummy were taking part in a recent workshop that culminated in a role-playing class with the simulator. Porter was found to be suffering from congestive heart failure.

Stan and his pediatric counterpart, Kenny, were purchased together in 2001 for about $215,000 from Medical Education Technologies Inc., a company in Sarasota, Fla.

UNC was the second nursing school in the nation to acquire Stan.

Carol Durham, director of the nursing school's Clinical Education and Resource Center, attributed this feat to having a dean committed to keeping a state-of-the-art school.

While the activity was a trial and error learning experience, with Durham encouraging the students throughout, any observer could sense the stress building in the room.

Once Porter's condition was stabilized, workshop participant Ruth Gee gave an audible sigh of relief at their accomplishment.

"I enjoyed that," she said. "We were a great team."

Durham, who first saw Stan at a nursing conference, said it took three years to get enough donations for the purchase.

The human patient simulator was developed in the late 1980s at the University of Florida's Department of Anesthesiology, said Tess Mitchell, director of marketing for METI. They were designed to give students hands-on experiences with both common and extraordinary diseases.

"In anesthesiology, there are many rare conditions that we may only see once or twice in our lifetimes but need to understand because they're fatal," she said.

At a community college in Pensacola, Fla., educators discovered yet another application for Stan - grief management.

"Students could not stop crying when the simulator 'died,'" Mitchell said. "When you start running a scenario, students realize that if they don't take care of this patient, it'll get real sick or die. ... It's real, what's happening is real."

The human patient simulator is a unique learning tool because it comes with mathematical models of physiology that run during simulations, Mitchell said.

"Every person is different," she said. "The body of a healthy 20-year-old will react differently to treatment than that of an asthmatic 20-year-old or an obese 20-year-old."

The models take all those different variables into consideration.

The human patient simulators are part of a required pass/D/fail capstone course for seniors in the nursing school.

"It's great because learners get so engaged, and you can try new things without worrying about hurting patients," Durham said. "With a mannequin, we can let them see the consequences (of choosing the wrong treatment). ... We would never practice like that on a real person."

Durham said Stan and Kenny simply remain teaching tools. For them to be effective, a teacher must be able to multitask - an experience Durham said she first found daunting.

"You've got to keep him running, engage students ... make sure they are treating him as a patient," she said.

But Durham said she feels Stan is worth his price tag.

"I think he's a wonderful learning experience. ... We're fortunate to be able to offer that to our students."

Contact the Features Editor at features@unc.edu.