Teaching clinical opioid pharmacology with the Human Patient Simulator.
OBJECTIVE
Postoperative pain should be aggressively treated to decrease the development of chronic postsurgical pain. There has been an increase in the use of Human Patient Simulator (HPS) for teaching advanced courses in pharmacology to medical students, residents, and nurses. The aim of this educational investigation was to pilot the HPS for the training of medical students and surgical recovery room staff nurses in the pharmacology of opioids for the management of postoperative pain.


METHODS
The computerized HPS mannequin is fully monitored with appropriate displays and includes a voice speaker mounted in the head. Medical students and Postanesthesia care unit nurses, led by faculty in the Department of Anesthesiology in small groups of 4-6, participated in a 2- to 3-hour HPS course on the use of opioids for the management of acute postoperative pain. Trainees were asked to treat the acute and severe postoperative pain of a simulated patient. Opioid effects and side effects (such as respiratory depression) were presented on the mannequin in real time to the participants. Side effects of naloxone to reverse opioid depression were presented as a crisis in real time to the participants. Participants completed a 10-item course evaluation using a 5-point Likert scale (1 = strongly disagree; 5 = strongly agree).


RESULTS
Twenty-two nurses and nine medical students completed the HPS opioid pharmacology scenario. Almost all participants rated the HPS course very highly and rated every item as either agree or strongly agree. Most participants agreed that the simulator session improved their understanding of opioid pharmacology including opioid side effects and management of opioid complications. Course participants felt most strongly (median, interquartile range) that the simulator session improved their understanding of naloxone pharmacology (5, 0), simulators serve as a useful teaching tool (5, 0), and that they would be pleased to participate in any additional HPS teaching sessions (5, 0).


CONCLUSIONS
The HPS provides a novel educational format to teach essential information regarding opioid pharmacology for the management of acute postoperative pain. The HPS provides a realistic format to teach the pharmacology of acute opioid side effects and the management of acute and life-threatening side effects of naloxone therapy.
Hassan
Zaki
Z
Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
DiLorenzo
Amy
A
Sloan
Paul
P
D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D003864:Depression, Chemical; D004504:Education, Medical, Undergraduate / Q000379:methods; D004511:Education, Nursing, Graduate / Q000379:methods; D018961:Educational Technology; D006801:Humans; D008348:Manikins; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D010601:Pharmacology, Clinical / Q000193:education*; D010865:Pilot Projects; D016528:Postanesthesia Nursing / Q000193:education; D011182:Postoperative Care / Q000193:education; D015397:Program Evaluation
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone