By George, they've got it

October 15, 1999

A mannequin is at the centre of a pioneering computer-aided nurse teaching pilot. Olga Wojtas reports

George Morgan, 22, has been taken by ambulance to accident and emergency after being found unconscious by a motorist on the verge of a quiet country road. A chest X-ray shows a range of injuries and he is moved to respiratory intensive care where he is attached to a ventilator.

It is now up to Glasgow Caledonian University's nursing students to come up with a six-week treatment plan. Some 160 third-year Higher National Diploma students will be thinking just about George.

The reason is that George is a Pounds 2,500 mannequin and the focal point of a pioneering computer-aided pilot scheme being launched this week by Glasgow Caledonian's department of nursing and community health.

Lecturer Charles Docherty, one of the four-member team behind the project, says: "This is the first in possibly a series of developments that could transform existing curricula through integrating educational technology with traditional teaching methods."

Tutorials and lectures are combined with work in a clinical simulation laboratory, which includes an intensive care unit in a purpose-built "hospital".

Expert advice from hospital sister Anne Wynne has ensured that the unit is as realistic as possible. Not only does the equipment change from week to week, according to George's condition, but Get Well cards from George's friends and family appear on the walls.

Lecturer Helena Topp believes the simulation is not second best. "It puts students at the centre of learning. That's one thing you cannot do in a real situation, where the patient has to be central," she says.

Sister Wynne says the simulated unit is a good way of introducing students to the technology of intensive care, which they could find frightening and overwhelming were it for real.

"Here you can teach them things without them feeling they're doing any harm. They can ask questions in a relaxed environment. In a hospital, they may feel that they can't disturb the nurse when they're anxious about something."

But the key innovation is the computer. "We want the students to be self-directed, and discover and explore elements of caring for patients. We've seen a computer system being central to all this," says Ms Topp.

Groups of four students will book a weekly one-hour session in the clinical simulation lab, which includes a computer. When they log on they will get a report on George's condition and can use the computer to decide his care.

A help facility will define medical terms, backed by diagrams, photographs, sound and multimedia clips.

For example, George is diagnosed as having a "flail segment". Students can click on "flail segment" to discover that this occurs through multiple rib fractures. A diagram shows how the lung nearest the injured area is affected.

Students will be able to hear a wheeze as it would sound through a stethoscope, and a multimedia clip will show how nurses should turn an unconscious patient.

The students will also explore links which have been embedded in the computerised report as they look after George, with questions such as how a ventilator works and how to keep the patient's teeth clean. A short weekly quiz will not only lead them through the scenario but encourage them to think about what they have learned in previous weeks.

As well as having weekly lectures giving the theory, the students will have a two-hour group discussion with tutors.

But this will not be their first chance to seek staff help: while they work in the lab, they will be able to email tutors with any problems.

Staff can log these messages for further discussion in the face-to-face tutorials. They will also be able to judge how well students are progressing by seeing when they use the help facility.

The computer simulation lab also includes video cameras and microphones, and at least once during the module, students will video their work, which will be up for discussion in tutorials.

Ms Topp believes there are also advantages for staff, who would otherwise have to cope with 160 students being divided into small groups for work in the lab.

"It's not ideal for teachers to be in one situation, doing things repetitively. The quality of teaching goes down. How to deal with that problem involved turning to technology for a solution."

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