[July 30, 2020 – Parker, CO] In anticipation of the start of their clinical externships, third-year students in Rocky Vista University’s College of Osteopathic Medicine (RVUCOM) participated in Fundamentals of Clinical Medicine (FCM), a course that prepares them, through hyper-realistic simulations and virtual reality, to meet with patients in a clinical setting. Due to the coronavirus pandemic, this year’s course also included online sessions, Personal Protective Equipment (PPE) workshops, and social distancing.
The objective of the course is to test over 270 students from both campuses on all of the knowledge and skills they have accrued over the past two years. “Students must demonstrate their skills in clinical reasoning and critical thinking, reviewing a patient’s history, physical examinations, and oral presentations,” explained Joseph Stasio, DO, FACOFP, Chair of the Department of Primary Care Medicine. “Every student is evaluated on their communication skills and professionalism from their Standardized Patient [encounter] through an Interpersonal Skill Evaluation.”
A key emphasis of the simulations—whether a standardized patient encounter, a VR workshop, or hyper-realistic simulation—is the presentation of the diagnosis in a SOAP note format (SOAP being an acronym for subjective, objective, assessment, and plan). David Ross, DO, FACEP, Director of the Rural and Wilderness Medicine Track, who designed and supervised the hyper-realistic manikin simulation cases, said that the simulations were fairly complicated—more than what students would ever see as third- or fourth-year students—which they would need to compartmentalize into a four-minute-long presentation. “We wanted them to complete [the presentation] in that SOAP format because they will do that every time they see a patient.”
To assess their tactile skills, students rotated through workshops on surgical knot tying and suturing, critical thinking, donning gowns and gloves in a sterile field, and Advanced Cardiac Life Support/Basic Life Support (ACLS/BLS) and Intensive Care Unit skills. For the first time, local Emergency Medical Services personnel were also present to assist in the ACLS/BLS simulation workshops. During one-on-one sessions, students honed their muscle memory using manikins and demonstrated their skill in successfully executing ACLS/BLS life-saving techniques.
This year, the FCM course also included the use of virtual reality. In a dedicated workshop, students wore Oculus Rift VR headsets that displayed 2D and 3D images of an interactive hospital room. Seth Peacock, MD, Assistant Professor in the Office of SIMS, who supervised the VR workshop, said that its strikingly real interface was such an effective teaching tool it was almost as if the students had seen their first patient. “The students at RVU are fortunate to have this program. It really sets them up for a successful clinical experience [by] taking the time to lay that foundation for learning more and being better prepared to take care of [patients].”
David Langley, OMS III, was particularly impressed with the VR workshop. “I’ve never done it before so there was an element of new and exciting.” During the workshop, SD Langley managed a patient who had an acute asthma attach. “The attending is in the room with you, and though they might tell you which boxes to check, [the student] is managing the patient themselves.”
The hands-on component of VR has also been proven to aid in retention of skills for longer periods of time. For that reason, RVU will continue to integrate virtual reality technology, including a women’s health module later this year, and more immersive augmented reality experiences into its curriculum delivery. Students will also have access to their own VR subscription. Ultimately, the goal is to make VR standard practice at RVU.