Photos by Peggy Harrison

Reba Childress (far left), director of the nursing school’s Laboratories for Clinical Learning, and grad student Margie Blevins check SimMan’s blood pressure and heartbeat.

February 10, 2004

By Dan Heuchert

Reba Moyer Childress finally got her man … -nequin.

Childress, director of the U.Va. School of Nursing’s Laboratories for Clinical Learning, first came across the SimMan patient simulator more than two years ago at a clinical simulation conference in San Antonio, Texas, and it was love at first sight. “I’ve been coveting him ever since,” she said.

For two years, she scraped together nickels and dimes. Finally, word came last fall that she would receive grant money from the University’s Equipment Trust Fund to make the $44,450 purchase. SimMan — and a few suitcases worth of high-tech baggage — arrived over the semester break and moved into the Theresa A. Thomas Intensive Care Simulation Laboratory in McLeod Hall. Though there are more than 750 SimMan simulators in use worldwide, U.Va.’s model is believed to be among the first purchased by a Virginia public institution for use by both undergraduate and graduate nursing students.

The mannequin — which actually can be adapted to be either male or female — certainly stands out in the crowd of simulators (including three full-length models and several other “parts”) in the beds around it, most of which date back to the lab’s opening in 1995. SimMan may be a mannequin, but he’s no dummy.

He’s sophisticated, powered by a Dell laptop computer and an air compressor that provides remarkably life-like breathing. He’s a great communicator, with an array of pre-programmed vocalisms (“My chest hurts, and I can’t breathe”) and the capability to record an unlimited number of customized phrases. And he lets you know how he feels in other ways, too; he can be hooked up to a touch-screen patient monitor, and nursing students can check his carotid, radial and femoral pulses and listen to realistic heart, breathing and bowel sounds. He can take a lot of abuse, with ports for IV hook-ups and defibrillators, plus anatomically correct parts for chest tube insertions and catheterization.

He is, however, fairly sickly. He is prone to cardiac and pulmonary problems. Faculty programmers can cook up any number of patient-care scenarios on the laptop to be played out by students at the bedside. He can simulate a wide variety of symptoms — his handheld remote control has buttons for “cough, “moan” and “vomit,” and he can develop lockjaw or a swollen tongue at the stroke of a key, making intubations much more difficult.

“He does bite,” warned Joe Huse, a medical education specialist with SimMan’s manufacturer, Laerdal Corp., at a recent open house for Nursing School faculty, staff and students.

Childress and Huse eagerly showed off SimMan’s capabilities to an ever-shifting crowd of curious colleagues. His chest rose and fell with labored breathing as the heart-rate monitor beeped at varying paces. He coughed and moaned, complaining, “I’m so sick.”

Most visitors seemed content to keep their distance, despite Childress’ urging to try some hands-on nursing. Finally, a brave soul approached, stethoscope in hand.
“Go away!” an irritable SimMan ordered, obviously wary of being poked and prodded.

Soon, Childress had a few visitors responding to a pre-programmed crisis. His heart rate was up, but his oxygen levels were falling. Nurses made suggestions for altering his care, and the responses caused changes in his symptoms.

That’s the attraction of SimMan, Childress said. “It doesn’t just teach individual skills. When you look at the basic acquisition of clinical skills, there’s generally a mannequin for this and a mannequin for that. The whole point of SimMan is to provide an integrated experience. It’s very holistic, especially in light of the fact that you can communicate with him.

“He’s not one-task oriented. You’re not just performing skills, but employing critical thinking.”

SimMan’s effectiveness in educating registered nurses will be tracked in a three-year, multi-site study being sponsored by the National League for Nursing and by Laerdal. U.Va. was selected as one of eight sites (from a field of 156) to participate. Childress has already written a cardiac-crisis scenario for her second-year nursing students to tackle as part of the study. She can videotape their responses and gather the data generated by their efforts for later review.

At the open house, the would-be lifesavers, distracted by more demonstrations of SimMan’s capabilities, neglected his care and he flat-lined, only to be revived with a few clicks of a mouse.

New arrivals marveled at his features. “He’s got bowel sounds?” a professor asked admiringly.

As the crowd dwindled, two more adventuresome souls tackled the pre-programmed scenario. They upped the oxygen being fed through his nose, and his vital signs stabilized.

“Thanks nurse. You saved my life,” he said, in a voice that sounded suspiciously like Huse’s.

What a charmer.