Tell Me Where You Hurt...

Dr. Martin Eason, director of the Center for Experiential Learning at the ETSU James H. Quillen College of Medicine, discusses a medical scenario, programmed into a mannequin that speaks, with nursing students from the Tennessee Technology Center at Elizabethton, from left, Ashley Trombley of Greeneville, Scott Collier of Kingsport, Terra Whaley of Johnson City, Eddie Thomason of Elizabethton, Misty Isaacs of Mountain City and Kim Davis of Jonesborough.

Students enrolled in the 12-month Practical Nursing Training Program at the Tennessee Technology Center at Elizabethton are dealing with life and death situations without putting patients at risk.

They are diagnosing complex medical conditions programmed into mannequins in the Simulation Lab at the ETSU James H. Quillen College of Medicine. As a result, graduates of the nursing training program will be better prepared to treat diabetes, heart disease and cancer, the most common diseases in the region and nationally, as well, according to Dr. Martin Eason, director of the lab.

Eight mannequins, including five adults, a child, baby and birthing mannequin, are used in the Simulation Lab. Students interact with mannequins, acting as patients, which simulate medical emergencies usually seen at trauma centers or in surgery. The mannequins have pulses, heart sounds, bleed and can speak to their caregivers..."my chest hurts, my leg is broken."

The Simulation Lab teaches "certain levels of complexity" in the diagnosis and treatment of patients. There are two labs, designed for two different purposes. One is more for a hospital room type environment. The other one is for more ICU, Operating Room, Emergency Room type training.

Terri Blevins, director of the Practical Nursing Program at TTC-Elizabethton believes the hands-on training students receive in the Simulation Lab boosts the student's level of confidence and expertise in providing proper health care to patients.

Training in the Simulation Lab offers another dimension to the experiences students receive in hospital and nursing home settings two months into the training program.

Lisa Blackburn, TTC Nursing Instructor, said "The first day we came, it made a difference in giving the student's confidence. It was amazing. There was a tremendous increase in their skills and students are more interested in learning. The are more willing to jump in and try to find out what is wrong with the patient."

From the nursing student's perspective, how is Simulation Lab training beneficial?

Ashley Trombley of Greeneville--"It offers experiences you never get to do in clinicals."


Kim Davis of Jonesborough--"It offers more training in one day than you would get in one week in clinicals. Because it is hands on, you get to think and do and the patient talks back to you. We get to make decisions here. You learn a whole lot more by doing than just observing."


Eddie Thomason of Elizabethton--"Students are placed into more critical situation scenarios and learn how to react and what to do. You build your confidence by doing that. You learn what to address first, respiration or circulation. Dr. (Martin) Eason explains, in layman's terms, students can understand."


Scott Collier of Kingsport--"The simulation lab allows students to place their hands on a patient. They can put any scenario in front of us to diagnose. The sky is the limit. That's what is exciting about it. We get to work with the patient. You can learn a lot more from your mistakes than from doing the right things. Mistakes will not jeopardize the mannequin as it would a live patient."

Since 2004, when the lab opened, hundreds of trainees, including medical students and residents in internal medicine, surgery, family medicine, obstetrics, psychiatry and allied health personnel, such as nurse anesthetists, nurses and respiratory therapists, have been trained in the lab.

The Quillen College of Medicine, which began operation in the early 1980s, graduates an average of 60 doctors, and an even greater number of doctors in residency, each year.

"My goal is to make this (Simulation Lab) available on a regional basis...to involve medical students and allied health professionals, as well." In 2007, TTC-Elizabethton expressed an interest in having nursing students participate.

Lab simulations last about 20 to 30 minutes. "We usually have a scenario depending upon the learning objective of the instructor. For example, last week, one scenario for nursing students at TTC-Elizabethton involved recognition of low blood sugar or hypoglycemia. The student's goal was to talk to the patient and based on their conversation and examination of the patient, determine what is wrong with the patient and arrive at a treatment plan.

"Pretty much anything you need to simulate we can do. We have a surgical simulator that we developed ourselves. We run an emphysema scenario quite often. We also do acute coronary syndrome or heart attack and another scenario on diabetic complications. Because this is a Level One Trauma Center, we do a lot of trauma scenarios, as well.

"All sick patients react the same way, whether you are a physician, a registered nurse, respiratory therapist, or LPN. The key is to recognize the problem and to understand the process of the disease. We try to teach the thought process in appropriate patient care," Dr. Eason said.

Dr. Eason, an anesthesiologist by training, was involved in simulation training at the University of Louisville prior to coming to ETSU in the summer of 2003 to establish a Simulation Lab. The lab was up and running six to seven months later.

The Simulation Lab at the Quillen College of Medicine is already providing distance-learning training to nurse anesthetists at Virginia Commonwealth University, Richmond, through its satellite campus in Abingdon, Va.

"We are in the process of acquiring new equipment to provide distance learning training to first responders. I have always felt technology should be used for all health care personnel. Having them involved makes their level of expertise that much greater.

"Students like the Simulation Lab. It is a way to expand their knowledge. It is not that the material is different...it is just taught differently," Dr. Eason added.