[After reading Katia's post, check out the slideshow at the bottom of the page for more pictures from the simulation!]
The medical team huddles around my stretcher, looking attentively at how I respond to their questions. “When did you first start feeling weakness on the right side of your body?” “Can you lift your right arm for me please?...Hold it...Hold it...Ok.” “Can you tell me today’s date?”
The little slip of paper Dr. Burton handed me earlier notes that I’m assuming the persona of a 57-year-old woman who’s experiencing a stroke. After three weeks of immersive shadowing experiences that let us glimpse into the different phases of the stroke continuum—from acute care to rehabilitation—we’re making our first very modest attempts to understand what it’s like to “walk in the shoes” of a person who’s experiencing stroke.
Taking this first step is incredibly formative for us as fellows. Our goal is to create innovative, patient-centered design aimed at improving stroke care, and if there’s a bridge that will help us reach that goal, its name is design thinking.
Empathy is the first block of design thinking that paves the path to creating patient-centered design. Simulations are a chance for us to engage with what it feels like to face some of the challenges stroke patients and survivors encounter day-to-day, on a very human level.
It's humbling to realize that spending a few hours or a few days electing to confront challenges that stroke survivors navigate on a daily basis is really only giving us a small glimpse into the peaks and valleys of life after stroke. However, sometimes taking the time to walk a mile in someone’s shoes can really open your eyes, and I hope that for us, this will mean discovering opportunities for how we can improve quality of life for stroke patients and survivors.
The next opportunity for us to dip our toes into an empathy-building immersion exercise takes place in a Clinical Simulation Center of SiTEL (MedStar’s Simulation Training and Education Lab). Under the guidance of MedStar Clinical Educator Les Becker, Stephanie, Mike, King, and I experience what it might feel like to go about some activities of daily living (ADLs) after experiencing stroke.
First, we gear up. To simulate the one-sided weakness a stroke survivor might experience, Les helps each of us immobilize the knee and wrist joint on our dominant side, adding a triple layer of medical gloves and 2 pound weights for our ankle and wrist to further reduce dexterity.
We each have a chance to fill a weekly pill box with medication, fill out a medical history form for a doctor’s appointment, walk around with a cane, get in and out of bed, fold laundry, and brush our teeth while wearing this gear. We also try to simulate one-sided facial droop while speaking by holding toothpicks in one side of our mouth.
It quickly becomes apparent how differently we have to approach activities of daily living that we might not have thought twice about before. Filling out a doctor’s appointment form now takes thrice as long and getting out of bed to get a glass of water transforms from a simple task into an activity that takes planning and concentrated coordination. The effect of facial droop on my speech makes me self-conscious to speak up—I withdraw and try to minimize the length of my responses to simple questions.
Our SiTEL simulation feels like a success. The main objective has definitely been accomplished —we gain a deeper sense of empathy for stroke survivors and some of the challenges they face in the daily life activities we often take for granted.
In the coming weeks, we will dive into two more simulations: we will each adopt the persona of someone recovering from stroke for a 72-hour simulation focused on rehabilitation and 7-day simulation focused on primary and secondary prevention. We’ll experience what it is like to follow medication regimens, monitor our blood pressure, keep a careful eye on possible comorbidities such as diabetes and high cholesterol levels, follow a low-sodium diet, and generally navigate our daily lives in the context of stroke-related mobility challenges.
In our journey thus far and in planning for future activities, we are incredibly grateful that so many MedStar colleagues have dedicated their expertise, time, support, and even equipment to enable us to learn in these unique ways. Keep an eye out for more stories of our experiences!