Simulation

For a number of years I worked at the Riverland Clinical Simulation Centre - part of  Flinders University Rural Clinical School in Renmark. I was admin assistant but was very much aware of the role simulation played in the medical education of student.doctors and nurses. Some of the basic skills were taught eg how to insert a cannula into an arm.
To start with there were disembodied arms that students stuck needles into, but as things progressed we realised it was not just the mechanical skill of getting that needle in the right place but also a matter of approaching the people (who may hate needles) and explaining the procedure. So the later fake arms came with attachments so a real person could 'wear' it and the student developed a good bedside manner.
The use of Standardised Patients was common in the education process and also as part of the exams where students would be confronted with about 15 different scenarios in a row, as per a normal consultation process, and would need to find out the history and ascertain a diagnosis. I played various roles - the mother of a teenager with migraine, someone with pains in the chest and someone demanding antibiotics whether needed or not.
Perhaps the most memorable was the 'breaking bad news' scenario. After 9 different students had had to tell me that the surgery on my husband had not been successful I was wrung out. I had wondered, as I approached  the session, whether I would cry on hearing the news. The first student came in and explained the situation and I burst into tears. Because the nature of the thing is that the patient is 'standardised' ie has to be the same for each student I needed to burst into tears every time after that.
The GP who was the examiner awarded the points for the day but as patient I got to give an empathy score. Some students obviously didn't know how to handle a patient in tears. Although we put a pack of tissues in a prominent position and I didn't reach for my usual hankie, I was left a number of times wiping tears with my finer. (I notice this happens in films. Where is their hankie? My Mum always made me carry a hankie and I still do!) The very best of the students indicated their care by a simple move forward slightly and were comfortable with silence for a month. By the end of the training session I had to go and find my husband, who worked in the same building, to shake off the melancholy of the morning.
So when Adelaide University (my old uni in the days when it was THE uni) called for volunteers to be involved in simulation education for nursing students I answered the call. To be a 78 year old (that was hard!) subject to Elder Abuse. The scenario was explained and the scene set. The educator stressed that we had to put ourselves 'in their shoes'. Of course. You actually have to become that person and enter into their experience if you are going to do a credible job. I even went so far as to invent names for the two husbands and daughter mentioned in the story. Because if the nurse asked about family you look pretty silly not knowing their names.
A week or so ago we were away for a few days and went out for a game of tennis. Ten minutes into the match I twisted my knee and could barely walk for the next few days. I discovered what it was like to need to park close to the hotel we were dining at and to avoid steps or else to approach very carefully and lean on something to get up and down. At the netball a few days later I had carefully climbed up the few step of the 'grandstand' and then realised how hard it would be to get down. A lovely young woman I didn't know kindly lent me her shoulder to help me down each of the three large steps. How much I take for granted my mobility. On this occasion I wasn't simulating anything. It was real - and not fun. I wondered if perhaps I should spend a  few more weeks having to use a stick or a walker or even a wheelchair. Perhaps that simulation would really help me (not) walk in someone else's shoes.
I'm so glad my knee is nearly all better and that I'm not really 78 - yet...