By Liz GrangerContributing Writer
When Feinberg student Sagar Shroff removed the speculum while performing his first live pelvic exam, one of his fears came true. His "standardized patient," an instructor who is trained to simulate a real patient, flinched because Shroff removed the tool without properly closing it.
Shroff practiced the exam before, but only on rubber models.
Feinberg Prof. Dr. Carla Pugh, the associate director for the Center of Advanced Surgical Education, invented a pelvic exam simulator that includes tiny sensors, which feed information to a computer monitor.
The sensors are placed inside models of vaginas and rectums. As students' fingers move along the anatomy, they can see the location of their hands on a screen.
"When you put your finger in someone's rectum for the first time, you think you know where the prostate is, but you don't," Pugh said. "Several things in medicine are assumed to be learned in time, but I think we can do better than that. You can't teach everybody everything in a lecture format."
She said she believes the medical school curriculum does not adequately prepare students for hands-on work and that they need a "fill-in" between written tests and real patients.
"Graduating from medical school, your skills have been tested with pen and paper," Pugh said. "But that doesn't show if you know how to make an incision."
Pugh's pelvic exam simulators are commercially available and are used in more than 60 medical and nursing schools. They cost between $16,000 and $20,000 each.
She also created breast and prostate prototypes, which she uses in NU's curriculum.
Greg Auffenberg, a second-year Feinberg student, is enrolled in Physical Examinations, a course that uses Pugh's models.
"You do the exam like it were any normal person," Auffenberg said. "You see a picture on a computer screen (and) dots light up representing the area you're in. It's not a 100 percent replication, but it's pretty nice."
Viewing Comments 1 - 2 of 2
Carla Pugh
posted 4/26/07 @ 11:56 AM CST
Liz,
Congratulations on a great story. It is clear that you really spent quality time in this classroom.
Your observations with student Dr. Shroff underscore at least two things: 1) his experience with the patient could have been worse if he had not had any practice and 2) that 15 minutes with a rubber model is not enough!
Unfortunately, the medical school curriculum is so jam packed with numerous things that students have to learn it would be difficult to justify more class time on this single skill. (Continued…)
Maynard Perkins
posted 5/08/07 @ 12:31 AM CST
Sagar Shroff is a fine physician and a great man. If he thinks it sounds terrible, it probably is.
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