This exercise puts you in mind of the old school board dexterity game Operation, although the students were learning by using with medical equipment rather than tweezers and they were operating on candy skeletons with music playing overhead. Instead of buzzers going off for veering to far in one direction or the other, fellow students would chime in, “go right,” “back up,” “move forward” as the “surgeon” connected one candy bone to another.
These summer surgeons were aided by video monitors and special wands – and it took more eye and hand coordination than expected to reconstruct the candy appendages. While watching a video screen as they proceeded, students had to overcome their intuitive instinct to move one direction versus the other.
A collective “Woo-hoo!” preceded applause from one group, whose mass efforts finally connected one tricky joint to another.
The simulated procedures were part of culminating activities for about two dozen high school students from the St. Louis area, who recently completed three-weeks of enrichment at the Saint Louis University School of Medicine Summer Scholars Program.
Produced by the Office of Multicultural Affairs, the program introduces youth to a medical education, through interaction with medical students, professors and other health professionals, along with academic prep and hands-on training through medical simulation.
Michael Railey, M.D., associate dean/associate professor
Multicultural Affairs and Family and Community Medicine at Saint Louis University School of Medicine said this year’s program was particularly successful.
“The Summers scholars program sponsored by SLU through the Office of Multicultural Affairs seeks to motivate, inform, and mentor high school adolescents (particularly minority) who have experienced a desire to enter the health care field as future physicians or other health leadership positions in allied health care,” Railey said.
“We try to follow these students and support their development towards excellence in health care and therefore reducing health disparity.”
Simulated surgery
Students were learning the basics of laparoscopy – minimally-invasive surgery.
“They have to use a surgical instrument to try to reconstruct a skeleton,” Greg Smith, M.D. SLU professor of surgery, said.
One student was the camera driver for the video monitor while another used another instrument to move place the bones.
“That’s the arm,” one girl said.
“Four minutes,” a timekeeper chimed in.
“That one is too close to the other part,” another student said.
“I had a first year medical student who put that whole skeleton together in under three minutes,” Smith said.
Simultaneously, another student used items that would seem more befitting for a tool box or a hardware store. Amber Crittle, an incoming freshman at Hazelwood West High School, practiced eye-hand coordination on a separate monitoring station by using a tool to pick up washers and place them on wooden pegs.
“It teaches you how to move stuff without actually looking at it – kind of moving your hands without seeing what you’re doing,” Crittle explained.
“One of the most difficult skills you have left with laparoscopy is suturing inside the body while looking at a two-dimensional screen,” Smith told the students.
Matt Parasch of John F. Kennedy High School was selected to demonstrate surgical precision using a type of stapling wand called an ENDO-GIA, short for endoscopic gastrointestinal anastomosis device. The laparoscopic linear stapler has a two-pronged clamp on one end that was loaded with a cartridge of staples.
Smith told the students, “When he fires this device, it’s going to lay down six rows of titanium staples.”
Expensive titanium staples. Smith said each cartridge costs $200.
“I mention the price only because everything in surgery is expensive,” Smith reminded the potential surgeons-in-training.
Parasch’s mission was to excise one appendage from a water-filled Latex glove tied at the wrist. The pseudo medical condition requiring surgery was poly-appendicitis.
“If we do this correctly, when the appendage comes off, we shouldn’t lose any water on that side and the glove shouldn’t leak on the opposite side,” Smith said.
“If I were the surgeon doing this case, I would go with the smallest one – make it easy,” the teacher hinted.
“It’s only awkward because you’re finding that your sense of depth is off – you are doing a three-dimensional procedure in a two-dimensional plane.”
After some finagling to get in place and open the clamp over the finger, the moment of truth arrived followed by the crunch of the staples.
“Did you hear it?” the professor asked. “Now pop the button.”
They heard it, all right.
The student almost got it, but the water in the bowl told the story. It still made for a teaching moment.
“You see these titanium staples? They will stay in the body forever,” Smith said.
The staple clamping device is one of the instruments used to remove kidneys, for example.
“It cuts between the third and the fourth row – kaboom, fire and it takes the kidney out,” Smith said.
Next Willow Pastard, a student at Metro High School in St. Louis, gave it a try. She looked serious and determined.
After repeated attempts, Pastard’s surgery assistant couldn’t quite get a grip, literally. She was using a separate instrument to grab hold of the digit targeted for removal.
It was Professor Smith to the rescue using another tool.
“Clamp now! Perfect,” Smith said, as Pastard took hold and triggered the stapler.
“Now pop that button,” Smith said. “There’s the appendix right there.”
Students applauded as they inspected three perfect rows of staples on either side of the cut – except the cut didn’t quite go all the way through to the end of the finger.
“See how hard this is to do?” Smith asked.
The students concurred.
“Now imagine taking somebody’s gall bladder out,” Smith said.
Learning the basics
The summer scholars also learned the basics of how to suture by stitching together synthetic skin that mimics the feel and quality of real human skin.
Classroom instruction included human anatomy, ACT preparation, American Red Cross CPR and interviewing techniques. Students also learned what is expected from medical students and were introduced to specialty fields in medicine.
Students also watched the film, “Something the Lord Has Made,” to give them an historical perspective on health disparities, said Colette McLemore, diversity manager for the School of Medicine.
Every year, the SLU Office of Multicultural Affairs notifies area high schools for student participation in the program, which is open to any student in the St. Louis area.
Attendance is expected at all sessions and transportation to and from the program is the responsibility of the student. For more information, contact McLemore at 314-977-8730 or visit www.slu.edu.
