Using tele-simulation, which involves multiple cameras and a virtual meeting platform,
three physician faculty members present case scenarios to students who use a rotating
team leader, a scribe and the chat room to narrow the field of possibilities. In the
era of escape rooms and employing the same skills used by Hercule Poirot, Sherlock
Holmes, Lieutenant Columbo, and even Gregory House, MD, the students work together
to logically eliminate diagnoses.
This Tuesday, the case involved a 26-year-old woman, Sarah Williams, who presented
in the College’s simulated Emergency Department with sharp, stabbing pain radiating
throughout her abdominal region. Through their group leader, the students took the
patient’s history and directed their bedside faculty member to conduct a physical
exam through inspection, palpation and percussion. The instructor reported that there
were no visible scars or bruising and that the area was symmetrical.
As a team of ten, the students discussed symptoms, ordered a pregnancy test and appropriate
lab work and imaging. Through the process of elimination, the group considered and
dismissed the possibilities of an ovarian cyst, an ectopic pregnancy, gastroenteritis
and other conditions before concluding that appendicitis was probable. The students
made the decision to consult a surgeon and discussed the benefits of pain medication.
Technology contributes to robust teaching
According to Jeff Trawick, DO, ACOEP, ACOFP, a clinical assistant professor in the
Office of Clinical Education who also practices full time as an emergency department
physician, “Technology and the hard work of the Clinical Education and Simulation
Center teams have enabled us to provide virtual clinical problems with the same elements
contained in on-campus simulation exercises. The only missing component is the students’
ability to actually touch and examine the patient.”
He noted that with real-time vital signs, electrocardiograms, imaging and lab studies,
PCOM Georgia students continue to experience the immediacy and pressure of a patient
encounter and the decision-making needed to properly diagnose and treat the patient.
He said, “Some students have commented that they experience essentially the same ‘pressure’
and ‘rush of adrenaline’ that they would sense during an on-campus simulation lab.”
According to Trawick, the scenarios also “provide the students with exposure to the
benefits and limitations of telemedicine.”
He said, “Although having direct contact with the simulated patients is preferable,
tele-simulations provide a means of effectively continuing clinical education under
our current pandemic restrictions.”
Transitioning the Simulation Center to tele-simulation came naturally to Jeffrey Adams,
NREMT-P, MS, the director of the center. With a master’s degree in Medical/Health
Care Simulation from the New York Institute of Technology College of Osteopathic Medicine
and a bachelor’s degree in Radio and Television from Morehead State University, along
with his paramedic certification, Adams converted the Sim Center to a virtual environment
using appropriate software and multiple cameras.
Toni Musta, MS, the simulation manager who earned a Master’s degree in Biomedical Sciences with a concentration in Medical Simulation from PCOM Georgia in 2018, and Amber Meyer, the simulation administrator, provide
the voices for the mannequins answering the students’ questions with realistic expression.
Kanza Kabir, MS, the simulation technician who also earned a master’s degree from
PCOM Georgia in 2019, ensures that the mannequins’ vital signs are appropriate for
the cases.
Medical simulation is ‘transformative’
Along with Dr. Trawick, Donald Penney, MD, MSC, FACEP, a clinical professor of emergency medicine, and Frank Jones, MD, MPH, a clinical professor of surgery, also guide the students to the correct diagnostic
conclusions by urgently asking, “Is that all?” or, “Anything else you need to know?”
Debriefing sessions after the cases provide the faculty members more time to instruct
the students.
According to Dr. Penney, medical simulation has been “transformative” when introduced
into the medical curriculum. He said that PCOM Georgia has been “avant-garde and innovative
in creating a designated simulation laboratory for our medical students.”
“A challenge for first and second year medical students has been the application of
theoretical knowledge into the management of patients,” Dr. Penney said. “Deliberate
practice through medical simulation training on high fidelity simulators has allowed
the acquisition of clinical skills, thus enhancing clinical competence at the undergraduate
level. Studies have demonstrated that improved clinical competence has resulted in
improved patient safety and reduced healthcare costs.”
Student-doctor, Nishant Gogna (DO ’23) said, “The continued dedication of the faculty
members at PCOM Georgia to teach important clinical skills to its students even in
light of the COVID-19 pandemic is noticed and highly appreciated.”
He added, “Though nothing will replace in-person training, I recognize and value the
hard work, adaptation and innovation the faculty have put into their training to ensure
students are well-prepared for board exams, rotations and beyond. Participating in
Sim Center cases is my favorite part of the week!”
Established in 2005, PCOM Georgia is a branch campus of Philadelphia College of Osteopathic Medicine (PCOM), a private,
not-for-profit, accredited institution of higher education with a storied 125-year
history dedicated to the healthcare professions. Located in Suwanee (Gwinnett County),
PCOM Georgia offers doctoral degrees in osteopathic medicine, pharmacy and physical
therapy. Graduate degrees are offered in biomedical sciences, medical laboratory science
and physician assistant studies. The campus joins PCOM South Georgia in Moultrie in
helping to meet the healthcare needs of the state. Emphasizing "a whole person" approach
to care, PCOM Georgia focuses on educational excellence, interprofessional education
and service to the community. For more information, visit pcom.edu or call 678-225-7500. The campus is also home to the Georgia Osteopathic Care Center,
an osteopathic manipulative medicine clinic, which is open to the public by appointment.
For more information, visit pcomgeorgiahealth.org.
Contact Us
Jamesia Harrison, MS Assistant Director, News and Media Relations Email: jamesiaha@pcom.edu Office: 678-225-7532 | Cell: 470-572-7558