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Today's Lesson: Major Disaster
Military Medical School Simulates Chaotic Situations
By Jackie Spinner
Washington Post Staff Writer
Monday, March 10, 2008; Page B04

Elisabeth Pimentel positioned two

metal wands in front of a pink, fleshy
gall bladder. With a couple of clean
strokes, she snipped at the tissue
surrounding the pear-shaped organ,
gently cutting it away from the liver.
Then she cut a little too deeply,
drawing a stream of bright red blood.
Eric Singdahlsen of the Uniformed Services University applies makeup to
an actor who is portraying a burn victim. (By Sarah L. Voisin -- The
She seemed unconcerned as a small Washington Post)
monitor nearby showed images of the Buy Photo
cut to the patient's innards. "It will
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But Pimentel, a research coordinator at the Surgical Print This E-mail This
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University of the Health Sciences, wasn't operating on a COMMENT
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Today's Lesson: Major Disaster - Page 2 of 5

was practicing on a computer model in one of the more

sophisticated medical classrooms in the country -- a POST A COMMENT
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The medical school sits in the back yard of the National Naval Medical Center; the

simulation center is a few miles away at a Walter Reed annex.

At both, men and women in civilian scrubs or military uniforms practice clinical and surgical
skills on computer simulations or on actors posing as patients, getting experience they might
need to treat mass casualties from war or a public health crisis such as the aftermath of
Hurricane Katrina.

The university, established by Congress in 1972, is operated by the Defense Department but
also trains civilian doctors in public health. The four-year program is year-round and roughly
700 hours longer than those of traditional medical schools. Medical students pay no tuition or
fees in exchange for a seven-year active duty commitment.

Over the years, critics of the university have said students should attend other medical
schools and not have their tuition covered. But the university appears to have powerful
supporters. The film's credits, listed on a promotional Web site, indicate that "Fighting for 3/10/2008
Today's Lesson: Major Disaster - Page 3 of 5

Life" was made with support from "many members of the Friends of USU." USU Surgical
Associates provided a grant to help fund the film. So did ITT, an engineering and
manufacturing company, Northrop Grumman Foundation, Johnson & Johnson Health
Care Systems and others.

The simulation center, which conducts about 8,000 virtual operations each academic year,
opened in 2000.

"This is batting practice before the big game," said Air Force Col. Charles W. Beadling, vice
chairman of the university's Department of Military and Emergency Medicine. "In aviation,
they've been doing this for years. Why can't we do this in medicine?"

In one of the simulator's operating rooms, a mannequin on an examining table appeared to be

taking deep breaths. It had a pulse, and its face was scratched and bloody.

Students practice on mannequins in groups that simulate a chaotic trauma situation in which
doctors and nurses have to collaborate, often to save the lives of severely wounded patients,
as in combat.

"This new technology allows for hands-on training in a high-fidelity environment for crisis
management as well as repetitive experience for advanced procedures such as intubations for
general anesthesia," Schoneboom said.

Students also practice on "real patients," actors and volunteers who pose with a variety of

On a recent lunch break, actors in hospital gowns gathered outside a bank of examining
rooms, where professors could watch medical students conduct routine examinations.

One actor portrayed a patient with gastrointestinal distress. "I have trouble swallowing,"
another chimed in.

Alice Mark, 75, a former director of a rehabilitation facility for the Howard County Health
Department, sipped from a container of lentil soup while waiting to be examined.

"It's worthwhile," she said. "It's something I can do that's giving back, and it's fun. I make a
little bit of money."

As she pulled on a pair of hospital booties, Mark listed ailments she has simulated: diabetes,
gangrene, a leg cut off from the knee down. 3/10/2008
Today's Lesson: Major Disaster - Page 4 of 5

"Our students learn more than just knowledge, but to integrate that knowledge and apply it in
a dynamic, stressful situation," Beadling said. "This could be in combat or a domestic
disaster. Bottom line, they learn to make difficult decisions and take charge in times of

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