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Robotic Patients Used to Help Train Doctors
skeletor935 writes "Due to the increase in the number of medical students in Mexico, medical schools have turned to the use of robotic patients to assist in training." From the article: "The robots are dummies complete with mechanical organs, synthetic blood and mechanical breathing systems."
An image of one of these robotic patient training kits can be found here.
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~ |rip/\/\aster /\/\onkey
There was a nice demonstration of such a system a couple of weeks ago on UWTV (University of Washington TV).
The robot was used for instruction for surgeons and anaesthesiologists.
I smell an opportunity to commercialize this "mechanical organs" technology with another well-known product. Oooh la la!
Hopefully they get enough practice so I don't have a ton of holes in my arm while they try multiple times to take blood!
Zoidberg: Oh, the hypochondriac's back. So what is it this time?
Fry: Well my lead pipe hurts a little-
Zoidberg: That's normal. Next patient.
A robot may not injure a human or, through inaction, allow a human to come to harm, even if that human has jabbed him repeatedly in the arm with a practice needle
a robot must obey orders given to it by a human, except where it would conflict with the first law, and except when that order is "Hey, get better quick before the professor comes back, and then say I did it!"
A robot must protect itself, as long as that protection doesn't violate either the first or second law. Hmmm, this one sort of limits how many robots will be in the ICU in the first place eh?
Don't anthropomorphize computers: they hate that.
Why are they using our politians? They should use their own.
Train Doctors?
Do you see what I see!!
I remember reading an article in a scientific magazine back in the late eighties / early nineties, about animatronic dummies designed to train medics. I think it was in germany or the UK
Since we're discussing medicine in México, I would like to chip in my two pesos about the experience of receiving medical care in México versus getting care in the US; I got care in both countries in the last month or so.
In México, the care I received was excellent. After being sick for three days with Montezuma's Revenge, my friend's cousin, who happens to be a doctor came by, asked me a number of questions in Spanish, looked me over, and gave me some antibiotics to stop the sickness along with a couple other medicines to help me. The examination and care was done very well. Total cost: $25 for house call doctor visit, $5 for medicines. By the evening, I felt great again.
When I came back to the US, I saw a doctor through Kaiser. The nurse treated me like a mechanical doll instead of a person. The doctor was good, but only very briefly examined me before telling me I had a virus and that there was basically nothing they could do. The cost for this care $25 co-pay, plus $200 a month to be on insurance to get this kind of care.
In México, they don't have to worry about malpractice lawsuits. A person can be a full-up doctor at 26 years of age (such as the doctor I saw down there). Here, one has to be about 30 before they can be a doctor; they spend more time in medical school and less time getting real-world hands-on experience. Most drugs can be obtained without prescription (the exception being addictive drugs like valium and what not)--this causes people to get antibiotics when they have viruses, unfortunatly.
Which one is better? I prefer the Mexican system; less HMO BS and more real care.
Why was I programmed to feel pain!!
The article is, of course, extremely light on details. The only difference between this and "SimMan" which has been in use for years and years seems to be the inclusion "artificial blood," whatever that means.
Also, this is pretty funny: "I would feel nervous if this was (a) real patient," said Mendoza after drawing blood from a plastic arm.
"With this (dummy patient) I can practice many times."
Because jabbing a needle into plastic is just like jabbing a needle into human flesh.
The sorts of simulators are very useful for simulating emergency situations, but aren't really suitable for things like surgery. It's nice to have the motions of checking pulses, barking commands for IVs and epinephrine, and setting up a defibrillator down pat for when a patient is crashing before your very eyes. Since there is very little actual manipulation of the patient, this is exactly for what we use SimMan (cardiac arrhythmias, emergency intubations, and the like). The monitor values (projected on a screen for all to see) are changed by a preceptor as you do things like move from nonrebreathing masks to bag mask ventilation or add a second IV. I just don't see how this would be used to do surgical simulation at all.
Do the robotic patients come paired with robotic lawyers so students can get used to the malpractice lawsuits?
Doctor, He's Crashing!
Give him 5 mg of ativan, start an epi drip, and somebody get me an emergency boot disk, STAT!
Sigs are for lusers. Hey! wait a second...
Poor people in mexico have to go to the IMSS (a hospital system dedicated exclusively to Social Security). The service is awful, the medicines you have to buy them yourself, and most of the money is leeched for retired workers. There was a case where a woman had to buy the oxygen for her mother because there weren't O2 tanks at the hospital :-/
The management system is so bad that it needs a billionaire rescue before it collapses. And you thought the american social security was hard to maintain. Heh.
I'm not sure exactly what program you are talking about. But there is currently a program, though both the Army and the Navy, that will pay for your medical school in exchange for your service. It works out that you serve one year of active duty for every year they pay, with a minimum of three years. They not only cover your tuition, but they also pay for your books and supplies, and give you a living stipend. So while it might not be the exact program you describe, it seems pretty close.
I listened to a story about this on NPR in the Spring. It was very interesting. The simulator will give a blood flow response, etc. It's not perfect - no blood vessels, rubbery skin, ... but the simulator still feels pretty much like it does in real life when you feel it through surgical gloves. While prepping each simulator for a new trainee is expensive, it's possible to make mistakes (and learn from them) on a dummy without actually killing anyone.
The audio story has Nell Boyce running through a surgical procedure on an actual dummy. Her reaction was that it feels very much like a live person.
Very interesting, I thought.
We have currently have two of these at my medical school. I'm a first year medical student (started in August), so my exposure is limited, but I've already had one "human patient simulator" encounter. Although it was fascinating froma technological standpoint, the usefulness seems to be pretty limited. My school is working hard to implement it into the curriculum, but it's not as practical as they seem.
The first issue that arises is that you only have first and second year students on campus (usually). Many third year students spend most of their time in the hospital, and fourth year students often do "away" rotations at hospitals they are interested in doing their residency yet. Unfortunately, first year students don't know enough to gain any real practice from the simulator. We don't know any pathophysiology or pharmacology, so when it comes time to start managing the patient we're useless. And case managment is what simulators are best for. For the first years, my school seems primarily focused on teaching students what kind of reasoning and thoughts need to be running through our head. The simulator was not used to give us any sort of medical experience. Although we had free reign on the patient, we had no idea where to even begin. And even if we did, we don't know any pharmacology. So pretty much our experience was sitting in the room and listening to the resident advise us on how to develop our thought process. That could be done without a half a million dollar patient simulator. Although the second years would certainly be in a better position to gain something valuable from the HPS, they still don't have the aquired knowledge base to get any real practice in. As I've already mentioned, 3rd and 4th year students are usually too busy to come back on campus and mess with a simulator. They're getting better experience watching real physicians treat real patients.
The second issue with the simulator is how limited it is. Although it is very technologically advanced, it is primarily useful for simulating emergency medical situations. Sure, you can check his pupils, or take his blood pressure, or hook up EKG leads. All the physical signs are there. You can give him medication (by scanning the barcode before you inject) and he will respond. Again, great for emergency medical situations, but not so hot for trauma and medical management. It's one thing to manage someone's diabetic coma, it's another game completely as an internest dealing with someone's changing medical needs over the course of a week while they're in the hospital.
In summary: they're a nice technological toy, but they are quite difficult to integrate them meaningfully into a medical curriculum.
In addition to manikin 'robots' there are also VR simulators that are used for training. On the whole these are not as effective but are good for some procedures. The major manufacturer of these is Immersion.