Tiffany has suffered a heart attack and urgently needs a procedure called a coronary angioplasty to save her life.
An inexperienced doctor is called upon to perform the procedure. But something goes horribly wrong and Tiffany dies on the table. In this case, it's not time for a death certificate, but rather time for the doctor to try again.
Tiffany is not a real woman, but rather part of a medical simulation. In fact, Tiffany - short for tactile force-feel simulation technology - is a component of a Colorado company's attempt to create as realistic a training tool for doctors as current technology will allow.
"We call it realism without the risk. In fact, you can kill Tiffany, but with a push of a button she comes back to life again," said Bill Younkes, president and CEO of Englewood, Colorado-based Medical Simulation Corp., which created the simulator.
While pilots long have used flight simulators for training, doctors only now are embracing the use of simulation technology to help teach how to perform medical procedures.
Medical Simulation Corp.'s cutting-edge simulator, called the SimSuite Training System, is being demonstrated for doctors attending an American College of Cardiology (ACC) conference in Orlando, which opened on Sunday.
Simulators already are used in some medical training, such as in anesthesiology. But they are poised to become a vital part of training in many more medical fields, Dr. David Holmes of the Mayo Clinic said in a telephone interview.
"It's a terribly exciting field that is rapidly evolving. The technology is changing. It looks like it's going to be giantly important," added Holmes, who heads an American College of Cardiology task force examining how to train medical professionals in performing new procedures.
"There are multiple different companies and multiple strategies," Holmes added. "Some of them involve simulators. Some of them involve virtual reality. Some of them have totally different approaches."
REALISTIC SIMULATORS NOW POSSIBLE
Holmes said the value of using simulators has been recognized by other industries and professions. Until now, however, technology had not advanced to the point of creating truly realistic medical simulations.
"Simulator technology has been widely used in the airline industry and that's how we teach people how to fly planes. And then we give them periodic tests in terms of how well they're doing," he said.
"We can increase the rapidity with which people can learn and then we can have some measure on which to gauge how much they have learned and whether they have been satisfactory."
Simulators are designed to give doctors all the sights, sounds and equipment that they would see and feel when operating on a real patient. They must make all the decisions that they would face in a real operation.
Tiffany reacts to a medical procedure just as a real patient would, according to Medical Simulation Corp. An individual physician or nurse, or an entire lab team, performs the procedure - including preoperative patient evaluation - just as they would with a real patient.
Medication reactions and unexpected complications can occur during a simulation, as they do in actual clinical settings, testing a doctor's decision-making skills. Monitors display the patient's vital signs as well as fluoroscopic video of the actual procedure being performed.
"In the medical education spectrum today, there are currently no good models for teaching physicians, nurses and technicians how to do new procedures, handle adverse events - except on real persons," Younkes said. "Much as pilots in planes, until you've actually experienced things, you really don't have that learning indoctrinated into your practice."
Younkes said his company's simulator will be rolled out commercially in 2002 for use by hospitals, medical schools and medical device companies.