Perspectives Winter/Spring 2018

22 Nova Southeastern University Anesthesiologist Assistant Tampa Students Get Lifelike Practice on Simulators By Richard Mudd, M.M.Sc., CAA, Assistant Professor AS AN ANESTHESIOLOGIST ASSISTANT with nearly 25 years of experience, I was thrilled when I became a member of the teaching staff in the NSU Anesthesiologist Assistant (AA) Program at the Tampa Campus. It has been quite some time since I first walked into an operating room with real patients, yet I remember it as if it was yesterday. I remember it more due to the significance of my potential involvement in actual patient care. Even though I had received hundreds of hours of classroom lectures, and a licensed anesthesiologist assistant was super- vising me, the reality was that I had no anesthesia experience with a living patient. Everything I had read and learned in the classroom had finally come to this moment. It was an exhilarating, humbling, and frightening experience. In the good old days of anesthesia training, we were taught everything we are teaching our students today, but the methods of that training are somewhat different and very much improved. We still have lectures to cover anatomy, physiology, pharmacology, EKG interpretation, and many other courses. That will never change. What has changed, however, is the significant growth in technology and its subsequent use in AA education. With such growth, the students are now far better prepared than I could ever have been. For several years now, the AA programs in Tampa and Fort Lauderdale have used a high-fidelity simulator that allows our students to practice intubating and running an anesthetic, as they will be expected to do when they begin their clinical rotations. This high-fidelity simulator has helped us train our students, while minimizing instructor input to match the physiological response to the drugs given and changes in vital signs. As advanced as our original high-fidelity simulator is, NSU has now provided our anesthesiologist assistant programs with the latest-generation, high-fidelity simulator for training our students. In April 2017, several instructors from the Tampa AA Program and I were given the opportunity to visit the facility where it was developed, assembled, and tested. The purpose of the visit was to receive training in its use. Our visit to the facility reminded me of an unreal and ghastly movie scene. There were tables with arms, legs, and torsos stacked like cordwood, with each limb being meticulously assembled by a highly trained technician. The simulators are then assembled by body sections, with internal organs replaced by mechanical actuators, tubes, pumps, blood by complex, integrated circuits, and very lifelike skin. An unusual sight for sure. Our high-fidelity simulator allows our students to practice providing a complete anesthetic. The new computer system is the heart and soul of our simulator, which breathes spontaneously and stops when muscle relaxants are given. He blinks with pupils that constrict and dilate as a human would and can be ventilated by mask or intubated. If done incorrectly, he reacts with hypoxia and a decreasing satura- tion, as expected. He has heart and breath sounds that can be auscultated and changed from normal breath sounds to a patient with severe respiratory distress.