Medical simulations prepare students for actual calls
A team of students — three paramedics and one emergency medical technician — received a call reporting a man experiencing congestive heart failure. The man was sitting on his bed and having trouble breathing. The team of students worked through this simulation Wednesday, Feb. 14, in a room set up to appear like an apartment at Oregon Institute of Technology (OIT).
"You shouldn't see traumatic things for the first time in the field when you're working, you should see them in school when you're allowed to fail, screw up, kill people and have it be a safe learning environment," said Jamie Kennel, program director for Paramedic Education and department chair for the Department of Emergency Medical Services at OIT.
The Paramedic Program is currently a joint department between OIT and Oregon Health and Sciences University. Students spend roughly 40 percent of their time at OIT and 60 percent of their time at OHSU in both classroom settings and clinical rotations. Students can choose between a two-year paramedics degree or a bachelor's degree in emergency medical services.
The biggest push, according to Kennel, is professionalizing this vocation and focusing on the medicine side.
"Oregon is one state that requires two-year degree in order to practice — most states don't," Kennel said. "We are trying to push it even further to say, 'We've got a bachelor's degree,' to say this is no longer a glorified taxi service, there's a full emergency department level of care that can happen in your home with medical providers. We need to start to think about this differently than just lights and sirens."
And to get students prepared for real-life scenarios, second-year paramedic students are required to participate in weekly simulations that start at a basic level and increase in acuity and severity. Students started out the year dealing with situations involving a person who fell off a ladder and suffered a simple fracture, heart attacks and drug overdoses.
"They're trying to put all of this knowledge that has been swarming around in their head into practice in a more realistic way," said Kennel, adding that the largest change in the last year or two has been an increase in the number of simulations and making the scenarios more real. "We do sims that are just on the outskirts of our students' knowledge. So usually incorporating concepts they've learned in the classroom, that they've seen in the hospital."
In the last couple years, OIT started using real people instead of plastic mannequins when possible — students can't always use a real person because of the more invasive procedures involving IV's and breathing tubes.
"Actors don't like that, nor should they, and doing other things like taking sims out of the school environment and embedding them into the community is even more real life," Kennel said. "We go and drive to a facility students aren't aware of. They don't have their student mindset on."
During the simulations, students need to think about how to manage a team while treating the patient on scene.
Cody Walker, a second-year paramedic student, said the congestive heart failure simulation he participated in was overwhelming because the patient wasn't very responsive.
"We learned that you need to have good team support because I don't think one specific person knew exactly what was going on so by talking to each other and feeding off each other we were able to gather a plan to move forward with," Walker said. "Even though maybe that wasn't the right plan, at least we all came together."
Nicholas Park, a community volunteer, has acted a dozen times over the last three years in the simulations and is involved because he believes it's the best way to teach students.
"They're going to see this stuff soon enough when they go out into the real world and I think it teaches them a lot," Park said. "The (congestive heart failure) situation is a very veiled one. It's a situation where I'm presenting as if I had some kind of congestive heart failure but the real thing is I've had a heart attack and that's morphed into these kind of symptoms that I have. It's very interesting and important they get a handle on this stuff before they get in the real world where they're gonna really see it and people are really sick."
Walker agrees and believes the simulations are invaluable for students.
"I have some previous experience on an ambulance and simulating calls like this is very beneficial, especially (to be) able to put you in really uncomfortable situations that you don't know the answer to," Walker said. "Being able to work through it and really struggle through it does help to put yourself in that situation without being able to actually harm someone."