Stories about: medical training

In search of young medical geneticists

Nina Gold, MD, is Chief Resident of Medical Genetics at Boston Children’s Hospital.

During a quiet stretch of my final year in medical school, I read Sir Arthur Conan Doyle’s Sherlock Holmes stories. A master observer, the detective found secrets in wrinkles of clothes, tints of hair, scents of perfume, never satisfied until the truth was revealed. Sherlock was, simply, an expert diagnostician.

In the spring of 2014, I became the first student in my medical school to pursue residency training in a combined pediatrics and medical genetics program. Like Sherlock, pediatric geneticists are stalwart investigators. They are often called into a case long after other consultants and tasked with bringing a family’s diagnostic odyssey to an end. But unlike the emotionally obtuse fictional detective, geneticists must describe their findings with empathy and clarity to concerned families after they solve a mystery.

Read Full Story | Leave a Comment

Moulage meets medicine: Making simulations feel real with special effects makeup

medical moulage - Maeve Geary at work
Photo: Katherine C. Cohen/Boston Children’s Hospital

Maeve Geary, BDes, to our knowledge, is the first PhD candidate to specialize in medical special effects simulation. A native of Belfast, Ireland, she completed a Bachelor of Design degree in Special Effects Development at the University of Bolton (Manchester, England). She has been with Boston Children’s Hospital’s Simulator Program, SIMPeds, since April 2016. At SIMPeds, she has contributed to a variety of custom “trainers” and is exploring whether increasing the realistic look and feel of mannequins impacts training and trainees’ ability to learn. Recently, she led the development of a trainer for urinary catheterization in infants — complete with visually and haptically accurate genitals, urethral opening and fat rolls.

It’s now apparent that treating medical mannequins with greater visual and haptic realism makes medical simulation training more effective for clinicians. Moulage, or special effects makeup, is an important part of making simulations feel real.

Here’s a quick tutorial in some very basic effects achieved with simple, readily available drugstore ingredients. Although much of my research is on complex fabrication techniques adapted from the film and television industry, these techniques are simple and accessible to all. (If you’re in Boston, attend our live demos this week!)

Read Full Story | Leave a Comment

GALLERY: Custom-built ‘trainers’ help clinicians master procedures

medical mannequins manikins trainers medical simulation
Andrew Hosmer (left) and Noah Schulz at the bench, building parts for medical trainers.

Walking into the SIMPeds Engineering Studio, a few blocks from Boston Children’s Hospital, the first thing you notice is body parts — high-fidelity replicas of human anatomy in various sizes. Some are in a glass display case, while others are laid out in various states of assembly, from a lone finger to the complete abdominal cavity of a newborn, packed with diminutive organs. Six newborn-sized, hollow duodenums, cast in rubber over a plastic mold, hang ready near a workbench.

These aren’t your usual medical mannequins.

In the adjoining InventorSpace, three 3D printers stand ready to fabricate additional custom parts. Some will be used by surgeons to rehearse an upcoming complex operation. Others are used for general training and preparedness purposes.

Read Full Story | Leave a Comment

Hollywood SFX take medical training to a new level of realism

When critical care physicians at Boston Children’s Hospital practice cannulating an infant going on cardiopulmonary support, they’ll no longer have to cut through hard plastic mannequins with tubes for blood vessels. Instead, they’ll puncture a soft layer of realistic baby skin, dissect through subcutaneous fat and spread muscles that look and feel like the real thing.

They’ll insert the cannula into an internal jugular vein and carotid artery that are thin and flexible, after dissecting through their covering sheath. As they advance the cannula, the blood will have the right viscosity.

These mannequins are not your father’s Resusci-Anne. They’re the creation of the special make-up effects company Fractured FX, whose current credits include Cinemax’s The Knick, and Boston Children’s simulator program, SIMPeds.

Read Full Story | Leave a Comment

OPENPediatrics: A blueprint for big innovation

My father had a favorite bit of advice as we embarked on our adult lives: “Go big or go home.” Going big is exactly what OPENPediatrics is doing, empowering physicians and nurses to care for children across the globe.

The Web-based digital learning platform was conceived 10 years ago by Jeffrey Burns, MD, MPH, chief of critical care at Boston Children’s Hospital, and Traci Wolbrink, MD, MPH, an associate in critical care. It concluded a year-long beta test in April 2014, and version 1 has now been launched.

Developed to impart critical care skills, OPENPediatrics uses lectures, simulators and protocols to deliver training. In the process, it has helped save lives.

Read Full Story | Leave a Comment

Surgical Sam, a beating-heart mannequin, takes the stage

Surgical Sam beating heart pediatric trainer mannequin simulation Simulator Program The Chamberlain GroupWe often see medical magic in Hollywood, but it’s not often we see Hollywood magic brought into medicine. Now, Boston Children’s Hospital’s Simulator Program and special-effects collaborators at The Chamberlain Group (TCG) have done just that.

Simulation has become a key component in team training, crisis management, surgical practice and other medical training activities. With simulation, medical teams can add to and hone their skills in an environment where people can make mistakes without risking patient harm—”practicing before game time,” says Boston Children’s critical care specialist Peter Weinstock, MD, PhD, who runs the Simulator Program.

Mannequins are a key part of simulation, and Weinstock’s team, working together with companies, designers and engineers, has developed eerily lifelike ones that can bleed and “respond” to interventions based on computer commands from a technician.

But there are some things Weinstock’s mannequins haven’t been able to capture up to now, like the movements of a beating heart.

That’s where TCG and a new mannequin called Surgical Sam come in.

Read Full Story | Leave a Comment

I-PASS this patient to you: Can standardizing “handoffs” make care safer?

(Kenny Louie/Flickr)

National data suggest that up to 70 percent of sentinel events—the most serious errors in hospitals—stem at least in part from miscommunications. Communication problems are especially apt to occur during hospital shift changes, when a patient’s care is transferred to incoming doctors and nurses—known in health care as the “handoff.”

More than a year ago, a team led by Amy Starmer, MD, MPH, of the Division of General Pediatrics at Boston Children’s Hospital, developed and began testing a bundle of interventions to ensure that the hospital’s residents were thoroughly and accurately briefed on each patient’s medical history, status and treatment plan in a standardized way.

Through measures such as communications training, a mnemonic to help residents remember key information to pass on and a computerized handoff tool that integrated with the patient’s electronic medical record, they managed to move the needle: Medical errors fell by 40 percent—from 32 percent of admissions at baseline to 19 percent of admissions three months after the program started.

But that wasn’t all.

Read Full Story | 1 Comment | Leave a Comment

“See one, do one, teach one” goes global

[Ed. note: Tune in to the livestream Monday at 9:30 a.m. ET]

Can the inventors of Watson help save sick children in the developing world? A “cloud-based” pediatric learning module, conceived by Children’s Hospital Boston and built by IBM Interactive, is being beta-tested this year in 20 countries. Provisionally called OpenPediatrics, it will give 1,000 doctors and nurses on five continents the next best thing to hands-on training. (Above is just a preview).

Read Full Story | Leave a Comment

Removing global bottlenecks in medical training

This post, final of a three-part series, is adapted from a talk by Jeffrey P. Burns, MD, MPH, Chief of the Division of Critical Care Medicine at Children’s Hospital Boston, at the IBM Impact 2011 Global Conference. (See posts one and two.)

We have a healthcare gap in the United States and around the globe: There aren’t enough doctors and nurses trained in how to take care of a critically ill child. Children are not little adults; you can’t just cut the doses.

So we need a solution. But the solution that we need in a resource-limited environment is not the same solution that we need in a resource-advantaged environment. We need to find a platform that addresses the needs of both.

Several years ago, one of my colleagues, Traci Wolbrink, went to a camp in sub-Saharan Africa,

Read Full Story | Leave a Comment

“Dosing” medical knowledge: Beyond passive learning

Jeffrey P. Burns, MD, MPH, is Chief of the Division of Critical Care Medicine at Children’s Hospital Boston. He established and is Executive Director of the Children’s Hospital Simulator Program, one of the first hospital-based pediatric simulator programs in the U.S., and also co-chairs the hospital’s Ethics Committee. This post, second of three parts, is adapted from his recent talk at the IBM Impact 2011 Global Conference.


“Practice makes perfect” is an axiom that holds for most tasks, including providing health care to a critically ill patient.  And yet even if I’m in training for several years, the experiences I get and the experiences the person next to me gets are radically different – in fact, they’re very random.  I’m on one night, you’re on the next night, and what I saw last night, you won’t see tonight.

That’s no way to dose and sequence knowledge; in fact, no one would set up an educational program where you learned randomly.  There’s a troublesome paradox: Medical crises are relatively rare events in children, as compared with adults, and thus there are fewer physicians and nurses with the necessary experience in caring for critically ill children.

Every month, I get letters from all over the world – “Dr. Burns, can I observe in your ICU?” Last month, we’ve had somebody from Iran, Pakistan and Turkey. And yet we often must say “no,” because the walls are only so big. How can we best spread our knowledge and expertise?

Read Full Story | 1 Comment | Leave a Comment