Students team up to Save Stan

(Edmonton) In the span of minutes, future nurses, health-care aides, pharmacists, respiratory therapists, doctors, paramedics and other health sciences students go from nervous anticipation to full-out action, triaging, diagnosing and treating a steady stream of patients in a busy emergency room.

A 78-year-old male with end-stage heart failure and a do-not-resuscitate order is bedridden across the room from a scared eight-year-old boy who can't breathe. "Can I get some help over here," his mom pleads over the din.

Soon the room fills. A woman in the throes of labour is wheeled in by a paramedic, followed by a patient complaining of a broken arm after a fall, and a woman with a migraine so intense she vomits in the waiting area. When a man in his 40s with mussed hair, bruises on his face and torn clothing shuffles into the ER, all hell breaks loose.

"They won't leave me alone-they're trying to kill me!" he screams, momentarily freezing the entire room.

Training effective health-care teams

The noise, energy and tension belie the fact the entire scene is a training simulation. In fact, half the patients are made of plastic and circuitry and the rest are playing the part. Though no lives are actually at stake, the lessons learned are as real as they come.

"Health care and providing health is messy, it's complex, it's really dynamic, and that's what we need to replicate for the students," said Sharla King, director of the Health Sciences Council's Health Sciences Education and Research Commons at the U of A, the creator and one of the main organizers of Save Stan.

The annual event brings together students from across the health sciences at the University of Alberta, MacEwan University, NAIT and NorQuest College. The four institutions and Alberta Health Services have formed the Interdisciplinary Health Education Partnership, which is committed to ensuring Alberta has well-trained professionals who understand how to work as part of a larger team.

"We are doing our very best to prepare our students to provide the best care, whether they go into an emergency room, into the community, in palliative care or in the inner city," King said. "We've given them the skill sets they need, in scenarios that require collaboration across disciplines."

This year's Save Stan saw 250 students from programs such as medicine, nursing, pharmacy, rehabilitation medicine and respiratory therapy participate in nearly two dozen training scenarios in the state-of-the-art HSERC simulation lab and the Nursing Learning Resources Centre in the Edmonton Clinic Health Academy.

The simulations ranged from working with high-risk inner city youth to palliative care to prenatal care to the ER "mashup," featuring the high-fidelity mannequin nicknamed "Stan." And though students do receive some preparation ahead of time, learning to deal with the unexpected is a valuable training tool.

Communicating as a care team

"We try to provide students with an opportunity where they really have to communicate with each other," said Colette Foisy-Doll, a nursing instructor at MacEwan and training facilitator for the ER mashup.

"For some of these students, this the first time they've had to manage these types of events. We're not looking for clinical competencies; what we're looking for is to engage in teamwork, to draw on the resources around them, to better understand the scopes of practice of other professionals."

Though health sciences students at the U of A do learn about other disciplines on campus, Save Stan is an opportunity to take those skills beyond the classroom, and learn about programs from other institutions, said William Lau, a nutrition student and co-president of the Health Sciences Students' Association.

"Case scenarios like this really help us put those soft skills learned in the classroom to use," said Lau. "They really reflect on what we've learned in class."

Learning to rely on other members of the care team is essential to patient care, as first-year medical student Tracy Zhang found out. During the mashup it was her job to diagnose an emotionally disturbed patient, although he refused, citing distrust of doctors.

"I couldn't talk to him, so it was nice to be able to rely on the other health professionals on the team, and see them step up to the plate," Zhang said. "It was an excellent chance to see what everyone does and how they work in a team with us."