The small Dunwoody exam rooms are crowded. In one room, a seemingly inconsolable infant is crying non-stop, as three Georgia Perimeter College nursing students assess her condition. In another room, a young Hispanic boy with stomach pains is being monitored for signs of appendicitis; and next door a student adjusts an IV bag for a small child with a broken leg.

And today is a slow day—the patient with a heart attack just got back from repairs, and the woman with the recent mastectomy is off-line.

Welcome to Georgia Perimeter College’s Nursing Simulation lab on Dunwoody Campus where the pace is that of a busy hospital, but all the “patients” are fake. This is where GPC nursing students get real-life experience with manikins that simulate a host of ailments, thanks to programmable software. The software can produce hundreds of health incidents from respiratory distress to a heart attack—and even mimic reactions to medications.

The labs are the students’ rehearsal for the real thing—caring for patients during clinical rotations at Children’s Hospital of Atlanta, Grady, DeKalb Medical and Emory hospitals. All training is part of their nursing education, says Dr. Joann Smith, GPC’s director of nursing.

Students typically spend 48 hours over a four-week period in this lab, dealing with a host of medical issues—and patient types—that might arise during their clinical rotations, says GPC nursing professor Dr. Gloria Johns. Johns oversees the operation of the simulation labs and guides students through their post-analysis of their patient assessments, along with GPC nursing professor Diwana Lowe.

Nursing students go into these simulation labs knowing these are manikins, Johns says. But, she adds, they quickly forget once they begin their assessments: they talk to them as real patients and experience the ups and downs related to caring for a real patient.

 “They get very attached,” she says.

During a medical simulation, the nursing professors typically sit behind a two-sided mirror, watching while students perform their assessments on the manikins. During this time, the professor can change the vital signs of a patient abruptly, make alarms go off and even cause the patient to “flat line.”

“That’s what happens in real life,” says Johns.

All the students’ activity with the manikins is videotaped and then critiqued by both the students and the professors immediately after the patient assessment is finished, allowing students to reflect on what they could have done better.

The post-assessment debriefing talks are an important component of the labs, says Lowe. For instance, she purposely threw toys into the infant bassinet to mimic a real-life situation of an overcrowded crib, which could cause a baby to suffocate. She also queried students on how they would counsel an overwhelmed mother who didn’t know how to administer medicine properly. “Remember, keep a neutral face,” Lowe says.   

“This is a good experience for us,” says Shialla Warren, a GPC nursing student, who correctly ascertained that a child with stomach pains could not have pain medication until the doctor could assess his condition. The pain medication could have masked a ruptured appendix, Johns says.

Sometimes the simulated event is so real, it hurts. Johns recounted the student who inadvertently “crashed” an infant manikin. The experience was devastating—but memorable, she says. “I found the student in the room crying over the patient,” she says.

Bonding with the manikins is OK, she says. “Once a student ‘kills’ a manikin, they never forget it. They will never make that mistake again.”