Proceedings of The Physiological Society
University of Cambridge (2008) Proc Physiol Soc 11, PC45
Using a human patient simulator to demonstrate the autonomic control of the cardiovascular system.
P. D. Maskell1, K. Brandom1, E. Lloyd1, E. J. Robinson1
1. Department of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom.
The METI Human Patient Simulator (HPS) is a state-of-the-art, life-sized, high fidelity mannequin linked to a computer through a host of electro-mechanical equipment. This integration of software-driven electro-mechanics allows the modelling of a wide range of physiological and pharmacological states. The data from the HPS is projected in the format of a clinical monitor and includes heart rate, systolic and diastolic arterial pressures and cardiac output. Drugs can 'interact' with the underlying HPS model via predefined pharmacokinetic and pharmacodynamic parameters. In this study we describe the development of an HPS session integrating pharmacology and physiology in order to demonstrate sympathetic and parasympathetic control of the cardiovascular system. A 30 minute HPS scenario for around 20 students is integrated into the existing first year MBChB and second year BSc practical classes in cardiovascular pharmacology. The students, using their knowledge of the cardiovascular system have to predict the effects of various drugs (phenylephrine, propranolol, atropine and dobutamine) that act to influence the parasympathetic and sympathetic nervous system on heart rate, blood pressure and systemic vascular resistance. The students then give i.v. administrations by ‘injecting’ the drugs into the HPS using a drug recognition system that detects different drugs using a barcode reader. Under the guidance of a member of staff the students discuss the responses obtained from the HPS. The students also learn about the tonic control of the heart by the autonomic nervous system via chemical denervation using atropine and propranolol. The effects of the drug dosages ‘given’ to the HPS on the cardiovascular parameters correlate well with published human data (Atropine and propranolol for intrinsic heart rate1, phenylephrine2, atropine3, propranolol4, and dobutamine5.) The session was rated highly by students with 85% (n= 164) scoring the value at 4 or above (scale of 1-5, 5 being very well), when responding to the question how well did the HPS session help you understand the control of blood pressure? The students also thought the session helped improve their understanding of the clinical relevance of drugs acting on the CVS with 78% of students (n= 164) scoring the value of this session at 4 or above (scale of 1-5, 5 being very well). We conclude that this HPS session enhances the current physiology and pharmacology student learning experience and gives accurate qualitative physiological changes to the drugs administered.
Where applicable, experiments conform with Society ethical requirements