Respiratory Simulator, PBL, and Clinical Skills

Today was a really long day since we had clinical skills in the afternoon. We started out in the respiratory simulator lab, which is used to train anesthesiologists. Basically they have a dummy that can mimic a patient who is being put to sleep, given drugs, intubated, and other anesthesiological procedures. I had seen dummies like these when I visited some other schools last year while interviewing, but I didn't know that we had them here. They're pretty cool and kind of eerily life-like. They breathe, blink, have heart and lung sounds, and you can even feel their pulse. We were split into two groups. One group worked with the dummy first while the other group went over lung anatomy, and then we switched. The anesthesiologist who went over lung anatomy with us was really good also. There was apparently an optional pulmonary physiology book that covers the material in today's seminar, but somehow I missed seeing that on the portal. I am going to order the book and read it later though, because it seems like it will be really helpful.

We continued on with our PBL case from Monday. I don't think I mentioned before that I am the computer scribe this week. My job is to take the notes for the group and then send them out to everyone so that we know what was covered and what our learning objectives are. I'll also make the final concept map on Friday. We make concept maps every week at the end of each PBL case. Basically, they are diagrams that show how all of the concepts that we've covered that week are related to one another. We do a rough draft of the concept map on the board first, and then the computer scribe does the final copy. Next week I'll be the board scribe.

In the afternoon, we had clinical skills class. Today we learned how to take more pulses. I seriously never realized that there were that many pulses in the human body. Besides the ones that everyone is accustomed to taking, like in the wrists and neck, we also learned how to take the pulse in the jaw, arm, groin, back of the knee, and foot. After that, we learned how to see the jugular vein pulse using a pen light and to measure how high the waveform travels. What you do is get the patient to lie on his back with his head turned somewhat away from you, and you shine the pen light on his neck at an oblique angle. If you look on the pillow under his head, you will actually see the light move with the pulsation of the jugular vein. Kind of weird, but cool. The last thing we did was to listen to the heart sounds and to feel for the place where the maximum heart beat can be found. When you listen to heart sounds, you can listen for each individual valve in the heart, four in all. There are two kinds of valves in the heart, and they actually do sound different. After the physical diagnosis part, my group did mock interviews with standardized patients. We got taped doing them this week, and we'll be going over the tapes with one of the instructors at the end of the month.

I am really tired today, but I have to say that I really like clinical skills class. I feel like I'm learning a lot and starting to actually be able to do something useful. But of course this is just a drop in the bucket in the whole scheme of things.