Harvey mannequin

Last updated
Harvey
InventorMichael Gordon MD
Inception1968
Manufacturer University of Miami
AvailableCurrently available
Current supplier Laerdal Corporation
Website http://www.gcrme.miami.edu/#/harvey-major-changes

Harvey was one of the earliest medical simulators available for training of health care professionals. [1] Harvey was created in 1968 by Dr. Michael S. Gordon at the University of Miami. Harvey is currently sold by the Laerdal Corporation. [2]

Contents

Background

Considered one of the groundbreaking products in medical simulation, the cardiopulmonary patient simulator Harvey provides a method of standardized testing for real-time procedures, and skills of the trainee, usually a medical student or resident. [1] [3]

First demonstrated in 1968, the Harvey simulator is a mannequin that performs more than 25 different cardiac functions of the human body, varying blood pressure, breathing, pulse, heart sounds and heart murmurs. [1] [4] [5] As years have passed, Harvey has been upgraded with the addition of more advanced cardiac functions, with the intention of creating a general and also in-depth program in cardiology. [1]

Harvey is used to teach all levels of medical education. For beginners, the simulator is used to teach blood pressure measurement techniques and help students recognize a heart murmur. For more senior level medical students, Harvey can mimic heart sound variation with respiration, along with a variety of cardiac issues, such as carotid or jugular venous pulsations. [6]

Medical students and cardiologists are not the only people who use mannequins such as Harvey to learn bedside techniques. Other specialties, such as anesthesiology, [4] internal medicine, and Emergency Medicine, [7] have also seen benefit from the trainer. Combat medics and other military personnel also use this technology to improve their skills. [8]

Educational rationale

The Harvey Simulator is a tool for medical education. Harvey was created mainly to improve cardiovascular bedside skills in medical personnel. By mimicking the basic cardiac functions of the human body, Harvey provides a much more realistic training exercise than a traditional classroom lecture. [1] By removing the risk of working on a real patient, simulators prepare medical students, or anyone else who uses the device, for real-world situations. [1] [9]

As the medical world becomes more complex, more demand is placed on the need for training techniques that do not rely upon living patients, and Harvey is one of the answers to this demand. [5] It and other similar simulators are very effective teaching tools, since medical students are more willing to attempt to learn on a mannequin than on a patient volunteer, and this saves both the teacher and the student valuable time. [7] [10]

Studies with medical students have shown a significant difference between cardiology elective scores for students who used Harvey and students who did not. [11]

History

The Harvey mannequin was named after W. Proctor Harvey, a physician at Georgetown University and mentor of the Mannequin's creator, Dr. Michael Gordon. [1] [6] [12]

Before the Harvey simulator, there were other models such as Resusci Anne, designed to teach mouth-to-mouth ventilation, which did not actually simulate much of anything, and the lesser known Sim One, one of the first computer-driven simulators designed to simulate an entire human patient. [1]

Originally, three Harvey simulators were created, each representing a different disease. Since then, Harvey has been advanced to the point where it can simulate multiple diseases. [6]

Harvey's inner functions went through three main stages of development. The prototype used telephone relays and a four track tape to create heart movement and sounds, respectively. The first commercial model used a series of cams and levers instead of telephone relays, but kept the 4-track tape recordings for sound. When the manufacturer of the tape recorder (Ampro Corp) went out of business, a sound card was integrated to mimic heart sounds. The third and current version of this simulator uses a servo motor and a sound card to mimic the cardiovascular functions of the human body. [6] [13] [14]

The first version of Harvey cost around $100,000, but the upgrades of a sound card and a servo motor cut the cost to around $50,000. [12] [15]

Along with the second version of Harvey came a set of slides to show images of echoes and other medical imaging pieces helpful when diagnosing the disease. These slide programs were around 1998 replaced with software that allowed for video recordings. This software came in 1985, around the time of the first aortic stenosis, and was designed around that case. Part of diagnosing aortic stenosis is listening to sounds in the neck, which in the first Harvey version was not possible because it had no neck sounds. [16] The software also contains the images and videos from the original slide programs, along with the history of the patient. [15]

Description

The current version of the Harvey simulator can mimic six different breath sounds, nine different cardiac auscultation areas, 30 different cardiac diseases, and 12 digitally driven impulses. The amplitude and intensity of the heartbeat is changeable. [2] The trainees utilize a built-in stethoscope to listen to the sounds. Trainees may also manually palpate the pulses.

When using Harvey, trainees also use the slide programs, which provide additional sources of instruction by giving patient history, examples of laboratory findings from real patients who had the disease, as well as therapeutic decisions, pathologic data, and epidemiological data. Slide programs have since been replaced with computer programs that provide video instead of still pictures. [17]

Both the hardware and the software for this simulator were developed at the Medical Training and Simulation Laboratory at the University of Miami School of Medicine. [13]

Related Research Articles

<span class="mw-page-title-main">Cardiology</span> Branch of medicine dealing with the heart

Cardiology is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease, and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

<span class="mw-page-title-main">Simulation</span> Imitation of the operation of a real-world process or system over time

A simulation is an imitative representation of a process or system that could exist in the real world. In this broad sense, simulation can often be used interchangeably with model. Sometimes a clear distinction between the two terms is made, in which simulations require the use of models; the model represents the key characteristics or behaviors of the selected system or process, whereas the simulation represents the evolution of the model over time. Another way to distinguish between the terms is to define simulation as experimentation with the help of a model. This definition includes time-independent simulations. Often, computers are used to execute the simulation.

<span class="mw-page-title-main">Aortic regurgitation</span> Medical condition

Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a consequence, the cardiac muscle is forced to work harder than normal.

<span class="mw-page-title-main">Cardiac stress test</span> Measures the hearts ability to respond to external stress in a controlled clinical environment

A cardiac stress test is a cardiological examination that evaluates the cardiovascular system's response to external stress within a controlled clinical setting. This stress response can be induced through physical exercise or intravenous pharmacological stimulation of heart rate.

<span class="mw-page-title-main">Laerdal</span> Multinational healthcare technology company

Laerdal is a multinational company that develops products and programs for healthcare providers, voluntary organizations, educational institutions, hospitals, and the military worldwide. Laerdal has almost 2,000 employees in 26 countries. The headquarters is located in Stavanger, Norway.

<span class="mw-page-title-main">University of Ottawa Heart Institute</span> Hospital in Ottawa, Ontario

The University of Ottawa Heart Institute (UOHI) (French: Institut de cardiologie de l'Université d'Ottawa ) is Canada's largest cardiovascular health centre. It is located in Ottawa, Ontario, Canada. It began as a department in The Ottawa Hospital, and since has evolved into Canada's only complete cardiac centre, encompassing prevention, diagnosis, treatment, rehabilitation, research, and education.

Stephen E. Epstein is the Head of Translational and Vascular Biology Research at the MedStar Heart and Vascular Institute, MedStar Washington Hospital Center and Clinical Professor of Medicine at the Georgetown University School of Medicine.

<span class="mw-page-title-main">Troponin I</span> Muscle protein

Troponin I is a cardiac and skeletal muscle protein family. It is a part of the troponin protein complex, where it binds to actin in thin myofilaments to hold the actin-tropomyosin complex in place. Troponin I prevents myosin from binding to actin in relaxed muscle. When calcium binds to the troponin C, it causes conformational changes which lead to dislocation of troponin I. Afterwards, tropomyosin leaves the binding site for myosin on actin leading to contraction of muscle. The letter I is given due to its inhibitory character. It is a useful marker in the laboratory diagnosis of heart attack. It occurs in different plasma concentration but the same circumstances as troponin T - either test can be performed for confirmation of cardiac muscle damage and laboratories usually offer one test or the other.

<span class="mw-page-title-main">Myocardial perfusion imaging</span> Nuclear medicine imaging method

Myocardial perfusion imaging or scanning is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium).

Cardiac rehabilitation (CR) is defined by the World Health Organization (WHO) as "the sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life". CR is a comprehensive model of care delivering established core components, including structured exercise, patient education, psychosocial counselling, risk factor reduction and behaviour modification, with a goal of optimizing patient's quality of life and reducing the risk of future heart problems.

<span class="mw-page-title-main">Redmond Burke</span> American surgeon

Redmond P. Burke is an American congenital heart surgeon, innovator, software developer, author, inventor, and founder of The Congenital Heart Institute at Miami Children's Hospital in Miami, Florida. He starred in the ABC pilot television show The Miracle Workers. Burke has been recognized as one of the world's most innovative surgeons, and for his use of information technology to improve surgical outcomes.

Computer-aided auscultation (CAA), or computerized assisted auscultation, is a digital form of auscultation. It includes the recording, visualization, storage, analysis and sharing of digital recordings of heart or lung sounds. The recordings are obtained using an electronic stethoscope or similarly suitable recording device. Computer-aided auscultation is designed to assist health care professionals who perform auscultation as part of their diagnostic process. Commercial CAA products are usually classified as clinical decision support systems that support medical professionals in making a diagnosis. As such they are medical devices and require certification or approval from a competent authority.

Neurocardiology is the study of the neurophysiological, neurological and neuroanatomical aspects of cardiology, including especially the neurological origins of cardiac disorders. The effects of stress on the heart are studied in terms of the heart's interactions with both the peripheral nervous system and the central nervous system.

<span class="mw-page-title-main">MSR – The Israel Center for Medical Simulation</span>

MSR – The Israel Center for Medical Simulation is Israel's national institute for simulation-based medical education (SBME) and patient safety training. It is located at the Chaim Sheba Medical Center in the Tel HaShomer neighborhood of Ramat Gan, in the Tel Aviv District. MSR is internationally recognized as leader in patient safety simulation-based training.

Douglas L. Mann is an American physician. He is currently the Ada L. Steininger and Lewin Distinguished Professor in Cardiovascular Diseases and professor of medicine, cell biology and physiology at Washington University School of Medicine in St. Louis.

<span class="mw-page-title-main">Shelby Kutty</span> Indian-born American cardiologist and professor

Shelby Kutty is an Indian-born American cardiologist, a professor of pediatrics and internal medicine at the Johns Hopkins University School of Medicine. He holds the Helen B. Taussig endowed professorship at Johns Hopkins and is Director of the Helen B. Taussig Heart Center at the Johns Hopkins Hospital. Prior to this, he held the title of assistant dean for research and development and vice chair of pediatrics at the University of Nebraska Medical Center College of Medicine.

<span class="mw-page-title-main">Mark E. Silverman</span> American cardiologist

Mark Edwin Silverman MD MACP FACC, was an American cardiologist, medical historian, medical educator and author of more than 200 medical articles and a number of books, who founded the cardiology program at Piedmont Hospital in Atlanta, Georgia.

<span class="mw-page-title-main">Riaz Haider</span> American physician (born 1934)

Riaz Haider is an American physician, cardiologist, author, and medical educator. He is best known for his work and research in the diagnostic cardiac ultrasound, heart pacemakers, exercise stress testing, and heart catheterization. He is the former President of the American Heart Association Nation's Capital Affiliate, and served as a Clinical Professor of Medicine at the George Washington University School of Medicine & Health Sciences from 1984 - 2011. He is an elected Fellow of the American College of Physicians, the American College of Cardiology, and the Royal College of Physicians. He retired in 2011 and currently resides in Potomac, Maryland.

<span class="mw-page-title-main">Jason C. Kovacic</span> Australian cardiologist and physician

Jason C. Kovacic is an Australian-born cardiologist and physician-scientist; the Robert Graham Chair and Professor of Medicine, University of New South Wales; Executive Director of the Victor Chang Cardiac Research Institute in Sydney, Australia; and Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai, New York.

Harvey Feigenbaum is an American cardiologist known for his life-long work in the field of echocardiography. He wrote the first textbook on the subject in 1972, which is currently in its 8th edition, and has published over 300 articles. He has trained generations of cardiologists including many of the world's pioneers in the field through his numerous visitors, frequent workshops, annual courses in Indianapolis, Indiana beginning in 1968, the year when he started formal fellowship training He founded the field of cardiac sonography in 1965 and the American Society of Echocardiography in 1975. His seminal article on the diagnosis of pericardial effusions published in 1965 with his technique "brought echocardiography to the attention of thousands of practitioners".

References

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