Technology Transforms the Teaching Environment
Peering over a surgeon's shoulder to see what is happening in the operative field has long been part of a medical student's experience. So too, has straining for a line of sight to the small fixed monitor showing images fed from the video camera affixed to the lead surgeon's cap.
"Those days are gone," said University of Chicago Medicine surgeon Kevin Roggin, MD, associate professor of surgery at the Pritzker School of Medicine, program director of the general surgery residency and associate program director of the surgical oncology fellowship. "The new surgical suites in the Center for Care and Discovery are designed to easily share information with all the learners in the room."
Large video screens in the 21 operating rooms of the new hospital not only display a high-definition image of the operative field -- transmitted by cameras mounted on overhead surgical lights -- but also CT and MR scans, pathology, the patient's medical records, and even the operative checklist.
"All these data sources have always been available to surgeons, but not necessarily in the surgical suite and not easily seen by everyone," Roggin said. "The video screens have transformed the environment. Now everything is there and shared with a push of a button."
Roggin and the medical students he works with felt the transformation immediately during the first surgeries performed in the Center for Care and Discovery the week after it opened on February 23, 2013.
Vikrant Jagadeesan, MS3, was halfway through his surgery clerkship when the service moved to the spacious surgical suites in the new hospital. One of the first operations he participated in involved a multidisciplinary team of surgeons including Roggin; urologist Norm Smith, MD, associate professor of surgery; and vascular surgeon Ross Milner, MD, associate professor of surgery and co-director of the aortic diseases program.
"The room was crowded, but no one was crowded out," Jagadeesan said. "All I had to do was turn my head and look at the screens. Any number of staff and students could have watched the procedure, every step of the way, from beginning to end, with no impairment to the process."
During the surgery, Roggin used one of the overhead cameras to take an intraoperative still frame of the mass in the patient's abdomen. Milner clicked a picture of his reconstruction. The attending physicians will use these photos for future talks to trainees and colleagues. "This will be very helpful for learning, especially for cases that are complex or rare," Jagadeesan said.
Ellen Rebman, MS3, described the experience of looking at a frozen section from an intraoperative biopsy that was projected on one of the new monitors during her first surgery in the new hospital.
"We simultaneously could see what the pathologists were looking at under their microscope," she said, "and listen to them interpret the pathology. As we were seeing the microscopic detail of the mass we had just removed, we were still directly engaged in a procedure that could completely change this patient's life trajectory.
"I can still remember the image on the screen," Rebman added. "I won't forget it."
Examining the pathology, communicating the results and discussing the diagnosis in real time, without leaving the operating room, add a new dimension to teaching at the University of Chicago Medicine, Roggin said. "It brings the pathologist into the suite. And it blends everything together."
Patient rooms enhance teaching
For Rimas Lukas, MD, assistant professor of neurology and co-director of the neurology clerkship at the University of Chicago Medicine, taking his students on rounds used to involve visiting several floors in the hospital, including the cardiac unit where acute stroke patients were cared for if they needed telemetry.
In the Center for Care and Discovery, every neuroscience inpatient room on the eighth floor is equipped for telemetry and high-level neuro-monitoring. The rooms are adjacent to the Neuro-Intensive Care Unit, which has continuous brain wave monitoring and portable CT imaging capabilities.
"Having all of this technology available on one floor allows the team to be more efficient and gives me more time for teaching," Lukas said.
Lukas believes the thoughtful design of the patient rooms also lends itself to a better experience for the medical team and the patient.
"Because the patient rooms are private and large, it's much easier for us to complete a full and reliable neurological exam," he explained. "And the quiet environment is more conducive to having in-depth, serious conversations with patients and families."
This story originally ran in the Spring 2013 issue of Medicine on the Midway, a publication of the University of Chicago Medicine and Biological Sciences Division.
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