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Associate dean aims for simulations to provide 'pathology on demand'

Work by David Gaba led to mannequins that bleed and exhale

Mitzi Baker

David Gaba, associate dean for immersive and simulation-based learning, shows off a high-tech training mannequin.

BY MITZI BAKER

Back in the 1980s, David Gaba, MD, noticed how the aviation and nuclear power industries used simulators to train personnel and thought, why not for doctors? He and colleagues at the Veterans Affairs Palo Alto Health Care System went on to develop the first modern interactive mannequins for medical education, eventually inspiring the Department of Veterans Affairs to declare him a “founding father in medical simulation.”

Gaba, an anesthesiology professor, now has achieved another first: In July he assumed the newly created position of associate dean for immersive and simulation-based learning at the School of Medicine. He is responsible for overseeing a number of programs that use simulation techniques, ranging from responsive mannequins involved in emergency scenarios to Internet-based interactive procedures.

“I have on my plate pretty much the entire spectrum of simulation,” said Gaba. “Our plan is to be able to deploy simulation wherever it can best fill the gaps in education and training of health-care personnel, pretty much from the beginning throughout their entire career.”

Simulation can be a critical supplement to clinical training by providing what Gaba called “pathology on demand,” as well as uncommon emergency situations. Simulators have the added bonus of providing opportunities for less-experienced trainees to take charge of a situation.

Over the last two decades, Gaba has been at the forefront of bringing simulation ever closer to reality. Mannequins based on his original prototype can now reproduce many features of human physiology, including a heartbeat, pupil dilation and constriction, as well as exhaling such gases as carbon dioxide that can be detected by real medical monitoring equipment. They can produce blood and urine. They have limbs that can move and thumbs that respond appropriately to nerve stimulators. They can even “talk” – via an instructor in a separate viewing area.

“Students or residents pretty much only get to see the conditions that patients roll in with, and for some of the conditions that are not that common they may never see them in their training,” Gaba said. “Simulation can allow us to present these situations whenever and wherever we want.”