Simulator machines at $320,000 facility in NUH mimic patients' responses, allowing trainees to make mistakes

By Yvonne Koh

UNLIKE universities in Toronto and Hong Kong, the National University of Singapore (NUS) went ahead with training medical students in clinical skills at the peak of the Sars outbreak this year. It could do so because it used patient simulation, or the use of machines that mimic functions of the human body. This is now set to play a bigger part in medical education here, with the inauguration of a new simulation training laboratory in the National University Hospital (NUH) yesterday.

While students were not allowed contact with patients during the Sars outbreak for safety reasons, professors held lessons using electronic stethoscopes for a month in March.

All 234 second-year medical students at NUS listened to pre-recorded sounds of cardiac and respiratory conditions on 10 stethoscopes, learning to identify conditions such as cardiac murmurs and faulty heart valves.

Simulator training was introduced here in 1998 to train students in administering anaesthesia, but the $320,000 lab will adopt a broader multidisciplinary approach, training students in areas like abdominal surgery, gynaecology and clinical skills.

The National Healthcare Group (NHG) and NUS spent a year working out plans for the lab.

Professor Yeoh Khay Guan, vice-dean of the medical faculty and head of training at the NHG College, said: 'Sophisticated simulators that can replicate patients' responses from heartbeat to blood pressure only took off in the last few years, and we want to tap cutting-edge technology for training our doctors.'

The new equipment includes a computerised virtual human simulator that permits students to examine a person's internal organs, eliminating the need for cadavers.

There is also a plastic model of a man that mimics a range of medical problems, allowing trainees to manage common medical situations such as asthma and emergencies such as heart attacks.

Medical students say simulator training boosts their confidence. Final-year student Ng Wei Fern, 23, said: 'It's good for honing skills as we can try over and over again on a model, which is hard to do when many students examine one patient.

'And we can make mistakes and learn from them, without worrying that we will harm patients in the process.'

All the 1,400 or so medical students and interns here will benefit from the lab, with training starting next month. According to Prof Yeoh, the lab can train about 350 students and 70 doctors in a year.

He added that the new lab will also help to position Singapore as a regional training hub for doctors. For example, 20 doctors from countries such as China, South Korea and Thailand will use its facilities for training in laparoscopic surgery during a two-day conference next month.

Laparoscopic surgery, commonly known as keyhole surgery because of the tiny cuts made to insert surgical instruments, is an alternative to open surgery for problems like appendicitis and hernia.

About 100 foreign doctors are expected to train using the new lab's equipment next year.