 Airplane
pilots often train extensively on simulators to develop
their flying skills in a safe, consequence-free environment.
So why not doctors? After all medical errors, much like
aviation screw-ups, can end in fatality. Unfortunately,
there's been little opportunity for physicians to rehearse
for a real situation. They're usually faced with a sink
or swim scenario with not much room for error. There hasn't
been much on the technology front geared towards training
physicians in this innovative way — until now. A
team at Johns Hopkins University has developed a birth
simulator to help healthcare professionals practise deliveries.
THINK
OF THE POSSIBILITIES
Not surprisingly, obstetricians are quite keen on the
idea. Dr Michael Maruncic, a professor of obstetrics
at the University of Western Ontario, expressed enthusiasm
at the model. "I would certainly find it useful in training
both medical students and residents," he claims. "At
this point, however, I would first like to physically
examine the simulator to ensure its practicality."
Currently, birthing procedures
are taught early on in medicine through observation
of deliveries and the use of manual models. Training
doesn't end there but continues throughout the formative
years of a medical professional's career. This approach
equips healthcare providers with the skills they need
to perform normal deliveries — but when the going
gets tough, inexperience could lead to negative outcomes.
Shoulder dystocia in particular can be one of the most
frightening emergencies in the delivery room. It isn't
common but when it does occur it involves some pretty
tricky manoeuvering.
Enter the birth simulator. The
Hopkins team has put together a life-sized model of
a uterus made from foam materials to simulate soft tissues
and a pleather-like skin. The replica of the uterus
and birth canal is anatomically correct right down to
the pelvic bones and legs. The simulator also includes
a mannequin of a baby, made of springs for nerves and
wood for bones. And the pièce de résistance
— a pump to imitate uterine contractions.
BABY
AND MOMMY MONITOR
The simulator is meant not just to simulate difficult
deliveries, but also to objectively measure the forces
involved. To achieve this latter goal, several monitors
are built in; some in the baby mannequin to assess the
force on the neck and nerves, and others are built into
the fancy glove to measure traction used in delivery.
A computer processes the data, records the numbers and
gives a sophisticated analysis of the practice run.
This allows critical decisions to be made about what
could be altered in subsequent deliveries to minimize
harm to both baby and mom.
At this point, the simulator is
in the midst of being evaluated more closely by the
American College of Obstetrics and Gynecology, so there's
still a ways to go before clinical practice guidelines
change and the device becomes available on both sides
of the border. However, it's possible that in the near
future deliveries will go more smoothly thanks to this
new technology. Like aviators, obstetricians and trainees
alike will be able to hope for the best, but prepare
for the worst.
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