Realistic dummies for nurses

A pioneer in using training dummies, Associate Professor Arne Rettedal celebrates 25 years of making nursing education more realistic.

Students in mock hospital ward Nursing students get to try saving lives in a risk-free environment

In a mock hospital ward, five master students on the intensive nursing programme patient are taking care of «Bernt». Having suffered a heart attack, Bernt has been transferred from the emergency room for surveillance.

«I have chest pains,» he complains to the nursing students.

The voice belongs to Assistant Professor Otto Aareskjold in the adjoining control room. Using a microphone connected to speakers in the dummy, Aareskjold can communicate as Bernt in the sick bed.

The patient is worried because his brother has had heart problems in the past. The students try to calm the man down and start administering pain medication.

After a few minutes, however, Bernt’s condition gets worse. The monitor above the bed shows that the heart rate is on the rise. The heart rhythm is uneven and soon goes into ventricular fibrillation. The monitor next to the bed starts beeping. The condition is serious!

All changes are manually controlled by the professors in the control room. With the aid of electronics a range of clinical symptoms, for example blue lips, rashes and breathing difficulties, can be simulated physically on the doll.

Gradually, the students slip into the illusion that they are dealing with a real patient – not a piece of rubber and wiring.

The system enables teachers to control the proceedings as needed. It should be challenging, but not too stressful as that will hamper learning outcomes.

Feels real
«After the simulation we go through what happened and discuss what worked as well as what we could have done better. That makes for good learning. It makes us better equipped for knowing what do to in real medical situations», says student Hilde Kristin Steinsbø.

«How real does the simulation feel?»

«We get a bit stressed out when we’re in the middle of it», admits Steinsbø.

«Some come out of the practice ward saying they forgot it was only training,» says Aareskjold.

«It is important that we can create realistic learning situations in the safe surroundings. Here, it is possible to drill good routines for assessment of patients and cooperation in a complex everyday setting» says Aareskjold.

«This is the nearest we come to reality, outside and actual internship. And it works well as preparation for the student internship», adds his colleague, Dagrunn Dyrstad.

25 years
Dyrstad and Aareskjold are responsible for dummy training in the UiS Master's programme in nursing, intensive care specialization.

Associate Professor Arne Rettedal adds electronic and computer expertise. He also started this interdisciplinary cooperation 25 years ago. The very first dummy used was a modified version of Laerdal Medical’s famous «Anne» doll.

Rogaland University College, as it was called then, was the first institution in Norway to start using dummies in nursing education.

Completely new
«Adopting advanced simulators to train doctors and nurses in education was completely new at the time,» says Rettedal, who works at the university's Department of Electrical Engineering and Computer Science.

Outside USA, the universities of Copenhagen and Leiden were probably the only ones doing the same as Rettedal in Stavanger. Scientists from the three institutions found out about each other and met in Copenhagen in 1994.

In a harbour tavern, they laid the foundation for a long-lasting cooperation. The first statutes of the SESAM conference were scribbled on a napkin.

Best outcomes
From those humble beginnings, SESAM is now an established international conference with 600 participants. At the 20th anniversary this summer, Arne Rettedal and the other pioneers were honoured for their contributions to the conference and their academic community.

Through those 25 years, Rettedal and colleagues have conducted research and development to find out how dummies can be best used for teaching.

«It's not about having the most electronically advanced dummy. It’s about having the right equipment for the learning outcomes you want to achieve. And to be able to train students without risk,» says Rettedal.

Close-up of the «Patsim

The «Patsim» dummy