In order to invent new medical devices to address problems in health care, the doctors and engineers in Stanford Biodesign’s year-long fellowship program spend up to six weeks immersed in the hospital or other health-care facilities, watching procedures and asking questions. For undergraduate and graduate students in Biodesign’s introductory classes, firsthand observation is much harder to accomplish because of time constraints and privacy issues.
To solve this problem, Lyn Denend, Biodesign’s director for academic programs, teamed up with emergency room doctor Alexei Wagner, MD, to develop a new approach for an introductory Biodesign Innovation class, which I describe in a recent Stanford News article. Drawing on the resources at the School of Medicine’s Center for Immersive and Simulation-Based Learning, Wagner developed three realistic scenarios around the class’s focus on health care needs related to aging. The scenarios included a chaotic, five-bed ER; a quiet palliative care room where an elderly woman lay dying; and a physical therapy consultation with an older fall victim and his wife.
The goal was to expose students to real problems in health care, an essential part of the Biodesign process for developing medical devices and other technology-based solutions.
On the first night of the class, students were randomly assigned roles as patients, caregivers, or observers, and plunged into these scenarios. Each one featured real doctors and nurses, high-tech mannequin patients with voices controlled by simulation staff, standardized patients (actors trained to play specific roles) and, most importantly, real problems in care delivery. As each simulation played out, the students struggled to offer appropriate care and make critical medical decisions against a frustrating backdrop of financial limitations, overburdened providers and conflicting family wishes.