Medical Education Infrastructure

Why we invest in infrastructure

The alarming statistics in errors that plagues medicine has been attributed to inadequate education and inappropriate skills training. Modern medical education calls for critical thinking and collaborative problem solving, using state-of-the-art technology. Despite the tremendous advances in medical technology and education, medical schools still teach using traditional methods, where meaningful clinical exposure does not begin until late in the student’s education. This results in a lack of clinical skill integration and a poor understanding of the concepts that form the basis of modern clinical practice. The Simulation Complex constitutes a significant departure from the traditional teaching generally applied.

The School’s systems-based spiral curriculum achieves vertical integration with the early introduction to clinical skills, thinking and clinical reasoning from the first year of studies. From their first through their sixth year, simulation training guides students through progressively more complex skills and scenarios, preparing them for increasing patient care responsibilities. The School’s simulation complex uses various technology modalities to create highly realistic scenarios for procedural training that is appropriate for each year of studies.  Over 300 simulation scenarios support the student training; instructors have devised over 60 scenarios, specific for the teaching needs of students.  Each scenario is designed to imitate real patients, anatomic regions, clinical tasks, and/or mirror the real-life circumstances in which medical services are rendered. Simulation training in the 3 complex simulation rooms, and task training using over 20 dedicated task trainers cover an average of 43 hrs simulation teaching per week across both preclinical (e.g. physiology, clinical practicum, pathophysiology, semiology, etc.) and clinical courses (respiratory medicine, cardiology, etc.)  Fully trained and devoted technicians and nurses provide technical support during student simulation and task training.  True to the concepts of modern medicine, the Simulation Complex embraces an interdisciplinary approach to both teaching and training, involving various disciplines. At the School of Medicine, simulation plays a central role in a student-directed learning model.  By mimicking real life medical situations, the Simulation Complex gives students the opportunity to practice clinical procedures, within the safety of a controlled environment.  Students, and ultimately their future patients, are the primary beneficiaries of this advanced technology.  Mastery of clinical tasks follows a steep learning curve, with implications for patient safety. The complex allows students practice the latest clinical skills, while mitigating the ethical dilemma of patient exposure to inexperienced trainees.  The later often results in high liability costs to medical institutions, and extensive care to patients inappropriately treated by inexperienced trainees.  Simulation improves student performance across the healthcare continuum.  Students trained in the Simulation Complex perform competitively [Award: Best Prototype, Image-Guided Minimally Invasive Surgery, Business Engineering Surgical Technologies Innovation Course]. Practical and skills training facilities are designed for pre-clinical practical teaching cohorts are about 20 students and clinical teaching cohorts (during clerkships) are about 3 to 6 students.

Our Educational Spaces

Simulation & Clinical Skills Training Complex EUC’s systems-based spiral curriculum achieves vertical integration with the early introduction to clinical skills, thinking and clinical reasoning from the first year of studies.  From their first through their sixth year, simulation training guides students through progressively more complex skills and scenarios, preparing them for increasing patient care responsibilities.  At EUC simulation plays a central role in a student-directed learning model.  By mimicking real life medical situations, the Simulation Complex gives students the opportunity to practice clinical procedures, within the safety of a controlled environment.  Students, and ultimately their future patients, are the primary beneficiaries of this advanced technology. The Simulation & Clinical Skills Training Complex is comprised of: 1)    High-fidelity Simulation Complex rooms (three), each with dedicated Debriefing and 3)    Control Rooms, 3)    Simulated Outpatient Consulting Rooms (two), each with dedicated Debriefing Rooms, 4)    Procedural Skills Training Room with advanced Task Trainers to provide hands-on practice in essential skills and procedures, and 5)    Standardized Hospital Training Suite (6 teaching-beds and nursing station).   Simulation training in the 3 complex simulation rooms, and task training using over 20 dedicated task trainers cover an average of 43 hours simulation teaching per week across both preclinical (e.g. physiology, clinical practicum, pathophysiology, semiology, etc.) and clinical courses (respiratory medicine, cardiology, etc.) Fully trained and devoted technicians and nurses provide technical support during student simulation and task training.  True to the concepts of modern medicine, the Simulation Complex embraces an interdisciplinary approach to both teaching and training, involving various disciplines. I. High-Fidelity Simulation Complex Simulation is advantageous in providing safe, controlled environment that eliminate risk to patients.  The EUC Simulation Complex provides authentic, realistic contexts for learning, allowing students to put the latest clinical advances into immediate practice.  It mitigates the traditional ethical dilemmas of medical training by reducing patient exposure to inexperienced trainees. The School of Medicine uses four high-fidelity patient simulators that can be programmed with patient characteristics, and can mimic physiological conditions (vital signs) and disease processes. In the adjacent control rooms, instructors, through headsets and video monitoring communicate with and observe their students, as they manipulate vital signs to respond appropriately to various drugs and interventions performed by the students.  Instructors can tailor simulators and scenarios to train specific technical skills or other abilities and attitudes, including teamwork, communication skills and leadership. The EUC simulation complex uses various technology modalities to create highly realistic scenarios for procedural training that is appropriate for each year of studies.  Over 300 simulation scenarios support the student training; EUC instructors have devised over 60 scenarios, specific for the teaching needs of students.  Each scenario is designed to imitate real patients, anatomic regions, clinical tasks, and/or mirror the real-life circumstances in which medical services are rendered.

1. Simulation Rooms (3 high fidelity simulation rooms, 4 high fidelity simulators)
2. Debriefing Rooms (3 debriefing rooms dedicated for simulators)
3. Control Centers (3 centers)

II. Simulated Outpatient Consulting Rooms Two outpatient rooms, each with the respective observation/debriefing rooms for simulated patient encounters. Additionally, this 15 seats space is also used for objective structured clinical exams (OSCE) for observing and acting in patient simulated scenarios using trained actors. Both rooms are equipped with the standard equipment of a doctor’s office, such as blood pressure meter, weighing balance, temperature meter and a stethoscope.

1. Consulting Rooms (2 consulting rooms)
2. Debriefing Rooms (2 debriefing rooms dedicated to consultation rooms)

III.  Procedural Skills Laboratory Clinical skills acquisition is a central cornerstone in the MD curriculum.  The skills training lab contains 6 skills stations with 39 skill trainers (for catheterization, intubation, auscultation, blood collection/drawing and surgery/laparoscopy), which allows 20-24 students be trained each time.  All courses that involve skills training use this lab for the practice and skills demonstrations. Students have access to the skills lab for independent study to improve their basic and complex clinical skills.

1. Skills stations (6 stations, 3-4 students/station)
2. Various Skills Trainers (39 skills trainers)

The School offers advanced skills training, including an ultrasound trainer, ALS trainer, ….. (ask andreas & george to fill in)

1. Standardized Hospital Training Suite (Hospital Ward)

The simulated hospital ward contains six patient beds fully equipped with standard hospital bed equipment, and a centralized nursing station.  Standard equipment includes blood pressure meter, temperature meter, and x-ray viewers and some advanced equipment, such as ultrasound, and electrocardiograph.

1. Simulated Hospital Ward (6 beds)
2. Nursing Station (1 nursing station)
3. Special Care Station (1 special care station)

Other Practical Teaching Infrastructure

1. Wet Laboratory Complex

The rationale of students performing wet-lab experiments is that it transfers skills (experience-based learning), including critical thinking required in research and/or reviewing evidence-based medical practices. Pre-clinical course (yrs 1-3), such as Biochemistry, Cell Biology, Genetics and Microbiology, have wet lab activities. Each wet lab is able to accommodate about 20 students who are trained with the latest technology and apparatuses in sessions that give them the opportunity for hands on practice. Students learn the latest techniques for DNA isolation, biochemical analysis, cell and bacteria culturing, among others.

1. Cell Biology / Biochemistry Laboratory (2 wet labs)
2. Microbiology / Pathology Laboratory (1 wet lab)
3. Research Laboratory (1 research lab)

1. Structural Sciences Laboratories

Anatomy laboratories contain high fidelity models for all anatomical structures. The rationale of plastic models is that they show internal organ relationships and allow students to repeatedly study a specimen with minimal wear & tear.  Models are molded to represent the standard and normal shape in a color-coordinated fashion, which make initial learning of complex anatomical structures easier.  In addition, plastic models teach 3D comprehension and anatomical reasoning by showing the spatial relationship of the structures, which strongly correspond to the human body.  Although these models are associated with a low fidelity and show only a small number of structures, which often lack accurate representation of shape and surface details, they remain an important teaching adjunct.  The Anatomy and Embryology laboratories at EUC are equipped with a wide range of anatomical models, bone boxes and full skeletons for effective laboratory instruction. Histology provides a primary bridge from the macroscopic field of gross anatomy to the molecular sciences, including biochemistry, physiology and pharmacology.  In addition to linking the visible and submicroscopic dimension, it serves as a gateway to pathology.  As a scientific field, it has always relied on technology, with high quality microscopes enabling students to interpret tissue structure and function. Microscopes are used to teach students the intricacies of manipulating a light microscope. The main advantage of the real microscope over virtual microscopy is it provides the vestige of three-dimensionality obtained using the fine focus knob on the regular microscope.  For this reason, students at EUC are exposed to light-microscopes.

1. Anatomy Laboratory with High fidelity model room (3 model rooms)
2. Formalin Fixed Cadaveric specimen
3. Microscopic Anatomy Room (1 microscope room)

III.  Computer-Assisted Learning (CAL) – Virtual Learning Laboratories Computer assisted learning augments, enhances and improves instruction of all structure and function modules. It promotes independent learning, problem solving, and allows schedule flexibility. The increased collaboration between disciplines has led to advances in anatomical informatics, three-dimensional modeling and virtual reality methodology, which in turn, have made computer-based structural visualization a new and practical tool for structure and function education. The value of CAL is that it allows individual students to learn at their own personal pace. 3D engagement tools provide interactive models of the human body for students using the web browsers provided in the computer lab or mobile apps.  To enhance our educational program at EUC, computer-based instruction and other interactive computer-related activities have been effectively integrated into the total instructional process. We are Expanding: (Andreas to check)   In a bold initiative, EUC constructed a new Medical Sciences wing for Medicine, Dentistry and Veterinary Medicine.  The spaces will be available for students the Fall of 2024, and for Medicine include:

• 4 Simulation & debriefing rooms
• 4 Standardized Patient (OSCE) & Moulage
• Skills room
• Interdisciplinary Lab
• Virtual Imaging Lab
• Computer Assisted Learning Room
• Wet Labs for Biochemistry, Cell Biology and a future Microbiology lab
• Biomedical Sciences Research Lab

Awards for Infrastructure The state-of-the-art infrastructure has received two Creston International Awards: “Best Educational Installations” and “Best Medical Solutions”.  The complex and high-fidelity simulators have been upgraded continuously. The original simulator (SimMan) was upgraded (new patient monitor, 2015); the Simulation Pad (wireless simulator) was upgraded with pre-made scenarios (new patient monitor, 2016); the high-fidelity simulator (Victoria) was acquired (2017) and additional parts were added to improve fidelity and enrich scenario options.  Moreover, academic leads and senior technicians attend advanced training sessions with new non-human high-fidelity simulators.  The School also hosts a yearly “Train-the-Trainers” (Appendix 10.1.4) seminar dedicated to teaching instructors simulation, task training, and updating on new scenarios.