Learning about new anesthetics using a model driven, full human simulator.
OBJECTIVE
New pharmacological agents are introduced into medical practice at an ever-increasing pace. Teaching how to use new medications in the clinical setting presents educational challenges and puts patients at risk.


METHODS
Patients and clinical settings in which remifentanil might provide clinical advantages over existing anesthetics were identified. A simulator curriculum was developed to demonstrate the use of remifentanil in the sample cases. The simulation was designed to highlight the clinical advantages and potential side effects of remifentanil. A screen displaying the concentrations of remifentanil in plasma and in the hypothetical effector site was developed. A simulator was modified (addition of an infusion pump and a pharmacokinetic screen display) and transported to several cities in the U.S.A. An instructor guided small groups of anesthesiologists and anesthetists through a structured program that enabled participants to observe drug effects in simulated patients.


RESULTS
There were 836 participants in the remifentanil program, which was offered in 58 cities in the U.S.A. Surveys were completed by 574 anesthesiologists. There was a significant difference in comfort level for using remifentanil after the session compared to before (Chi-square, p < 0.001.) The statement: "Clinical simulation experience is a means to learn about new agents like remifentanil" was rated as "excellent" by 81% and as "good" by 19% of participants. No participant found the experience to be "not useful."


CONCLUSIONS
Patient simulation is a novel method of introducing new drugs to the medical community and is perceived by anesthesia providers as a valuable addition to available teaching methods.
Murray
W Bosseau
WB
Department of Anesthesiology, Pennsylvania State University College of Medicine, Hershey 17033, USA. WBMurray@PSU.EDU
Good
Michael L
ML
Gravenstein
Joachim S
JS
van Oostrom
Johannes H
JH
Brasfield
W Glover
WG
D000776:Anesthesiology / Q000193:education*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003198:Computer Simulation; D004502:Education, Medical, Continuing; D006801:Humans; D007396:Internship and Residency; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil; D012984:Software; D014584:User-Computer Interface
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil