I use these simulations to expand the student’s clinical exposure.

If a student is assigned to a real outpatient clinic for two weeks, the student might see several cases of yeast vaginitis, but no cases of trichomonas. By providing an electronic simulated clinic, I can give each student exposure to each of the 140 (or so) clinical problems that most commonly lead to an ambulatory visit or phone call.

Because I decide who is seen in my simulated clinic, I can be sure there aren’t any duplications.

This approach is effective and efficient. In a real clinic, one patient might occupy the student for 30-45 minutes, counting review,, seeing the patient, discussing the patient with the supervisors, and effecting clinical disposition. In the simulated clinic, the encounter lasts no longer than 5 minutes, while still covering most of the important issues.

This simulated clinic does not (and can not) replace the real OPD experience, but it augments it significantly.

I don’t believe that live encounters in an ambulatory setting can or should ever be totally replaced. There is too much of the human to human interaction that is important for students to learn. But liberal use of simulated clinic encounters can inexpensively broaden the student exposure and prepare them for real encounters.

In many clinics, there are fewer patients available for teaching, and the simulated clinic helps to overcome that problem. It also addresses any scarcity in supervising clinicians, since the simulated clinic requires no extra supervision…the supervision is built-in.

Wherever students are scattered among multiple training sites, the simulated clinic helps maintain a uniform training environment for all.

These simulations were produced using Adobe Captivate and originally published as Flash files. But because over half of the visitors to my websites arrive via a mobile device (pads and smart phones), I’m now in the process of converting them to HTML5 format that will work on their devices. (30% of my site visitors access the sites through an iPhone, and 10% access my sites through an iPad.)

These simulations allow for full audio and visual interaction with the user.

The students encounter a patient, make decisions, make mistakes, and see how the mistakes play out. As a matter of policy, I never let any of my simulated patients die. Most students have relatively fragile clinical egos, so even if the student makes a lethal mistake, there is always a resident or attending who happens to show up at the right time to save the day.

Click here to visit the simulated OPD at OBGYN Morning Rounds