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Simulator enables perfusion students to gain experience in critical cases

SYRACUSE, N.Y. — Students in the Cardiovascular Perfusion Education Program at Upstate Medical University are among the first in the nation to use the world's first fully interactive cardiac perfusion simulator — the Orpheus Perfusion Simulator.

Housed in a specially designed simulation center in Upstate's College of Health Professions, Orpheus functions as a complete patient substitute for the training of perfusionists in the use of heart-lung machines and other related equipment that is essential to conduct cardiopulmonary bypass procedures, such as open heart surgery.

According to Edward Darling, associate professor of cardiovascular perfusion in the College of Health Professions, perfusion educators have observed the loss of routine cases in the operating room, seeing a shift toward more urgent and higher acuity cases that make clinical instructors more reluctant to permit novice student participation.

"In this simulator room, we can standardize a realistic and reproducible clinical scenario and the experience can be evaluated by the use of strict objective end-points without rater bias," Darling said. "More advanced students can practice complex scenarios such as oxygenator failure diagnosis and change-out in this highly realistic setting."

Connecting the Orpheus Perfusion Simulator to a manikin model using standard patient leads, the device realistically recreates a variety of rhythms and outputs and permits display of ECG and arterial waveforms as well as body temperature. A secondary touch-screen display allows students to monitor the patient's blood gas and coagulation parameters and interact with the computer modules by administering clinically relevant medications that realistically change the patient's physiologic parameters, just as real drugs do in the operating room.

The software also allows a range of equipment failures to be introduced to the scenario, such as power or gas failures to kinking of the arterial line, allowing the student to be exposed to incidents that are not often encountered during cardiopulmonary bypass surgery.

"The fidelity of the physiologic monitoring is so realistic that our students will not be simulating bypass, they will be doing bypass on a simulated patient," said Bruce Searles, associate professor and chair of Upstate's Department of Cardiovascular Perfusion.

The Orpheus system was developed by Ulco Technologies of Australia. It was purchased by the College of Health Professions with support from the Office of the President at Upstate and the Advocates for Upstate Medial University.

"The device has a list price of $52,000 but Ulco Technologies gambled on the national and international reputation of our perfusion department and agreed to a discounted price," Searles said

In June, Searles and Darling traveled with the simulator to New Orleans to participate in simulation workshops at the American Society of Extracorporeal Technology's Best Practice meeting where they conducted clinical simulation modules for certified perfusionists and collected data on the experience for a future publication through a consortium of perfusion educators.

"While our Cardiovascular Perfusion Department is the first school in the nation to own an Orpheus, other schools have recognized the value of this device and are beginning to integrate high fidelity simulation into their curriculum as well," Searles said.

Upstate's Cardiovascular Perfusion program, offered through the College of Health Professions, is one of only 17 schools of its kind in the nation and one of the oldest programs in existence.