Virtual surgery, actual knowledge: new educational technology opportunities at the UP Medical School

16 February 2024

Medical education has been fundamentally transformed in recent years by the revolutionary development of simulation education, which allows today’s medical students and specialist doctor candidates to participate in training sessions that significantly improve future patient care safety by developing skills in practical interventions. We visited the University of Pécs Medical School as guests of the Medical Skills Education and Innovation Centre using state-of-the-art simulation and virtual reality technology, where we saw for ourselves how the doctors of the future are trained using tools that would only be seen in sci-fi not so long ago.

(This article was initially published on on 6 February 2024.)

The acquisition of practical skills is an essential part of medical training. In the past, these skills could only be acquired at the bedside in actual patient care situations at universities and regional university teaching hospitals. Today, the increasing number of medical and health science students, changes in the legal environment, and the need to improve the quality of patient care and ensure adequate patient safety standards limit the direct relationship between students and patients. 

Continuing the long-established tradition of simulation education in medicine, students can now experience the development of their technical and non-technical skills in a modern environment, away from the patients, but still in a realistic setting, using state-of-the-art information technology tools. Of course, the simulation environment can never replace actual bedside practice, but the new approach to the training provides the opportunity for unlimited and safe repetition of numerous realistic patient care situations, monitoring and objectively analysing and evaluating the care process.

“Simulation education provides an objective and standard environment to begin clinical practice and make the patient care process safer”

Simulation medical education involves modelling real clinical situations and solving practical and integrated theoretical tasks using simulators, various educational tools, and computing solutions so that the student learns medical thinking in the most realistic environment possible. At the University of Pécs Medical School, innovative technologies of our time provide the opportunity to practice daily patient care processes, interventions, and communication situations.

“The predecessor of the centre, MediSkillLab, was established as part of the UPMS in January 2016, when there were only three rooms for simulation training. In time, the university won two EFOP tenders so we could start expanding the lab. Currently, there are almost 1600 square metres available for teaching in the centre, which is now called the Medical Skills Education and Innovation Centre (MSEIC),” says Dr. Szilárd Rendeki, director of the centre.

The facility offers training using virtual reality, augmented reality, and simulation dummies, among other things. These methods also indicate a trend towards engineering increasingly providing the answers to the needs of medicine. It is typical of MSEIC that most of their research takes place at the medical-engineering frontier.

“Of course, simulation education cannot replace bedside training entirely, but it serves as a strong bridge between theory and practice," emphasises Dr. Szilárd Rendeki. The primary aim of simulations is to increase patient safety, as the resident doctor will be much better prepared and more confident when performing practical interventions if they have already had the opportunity to learn how to use the equipment safely. “In simulation education, different medical tasks can be repeated, standardised, and measured, giving students objective feedback on their performance. The various rewatchable camera recordings that support teaching also serve this purpose.”

Dr. Szilárd Rendeki draws attention to one more factor. Teaching Generations Z and Alpha requires an entirely different approach and devices than the other generations, as their skills are also completely different. They have already learned to use smartphones proficiently at a very early age; they can multi-task, and their visual memory is excellent. Using a wide range of technological innovations, simulation education is better suited to their needs. At the Medical Skills Education and Innovation Centre, teaching is based on the principles of a supportive approach to education. The primary aim of the simulations is to experience the success of “patient care,” with the teacher guiding the situation so that the student can find an appropriate solution to the professional challenge.

Education in an internationally outstanding environment

Five so-called matrix rooms are integral to the Medical Skills Education and Innovation Centre. Until recently, medical students could only learn the basics of various interventions under limited simulation conditions. The acquisition of practical skills in a natural patient care environment may have depended on several factors.

The matrix rooms are set up according to the needs of a particular medical specialty, adapting to the requirements of the given course in terms of both medical equipment and simulators, allowing the UPMS students to practice procedures on dummies and special preparations, thus gaining knowledge and confidence for when they will be working as graduated doctors.

The rooms are equipped with state-of-the-art facilities. Operating microscopes, drills, and a wide variety of medical equipment are all the highest categories currently available. “Recently, a delegation of doctors from Austria was amazed at what they experienced in Pécs, saying that they do not have such well-equipped facilities serving several complex educational purposes at the same time,” says Dr. István Szanyi, head of the University of Pécs Department of Otorhinolaryngology. “It felt good that we could show something outstanding to our colleagues.”

The operating theatre and dental lab are also important places for students to gain proper professional experience before meeting patients. All instruments are original, and operations are performed on special preparations in the operating theatre. “Modelling the operating theatre environment is highly important,” says Dr. Szilárd Rendeki. “You have to learn how to behave there, the rules of communication, and the isolated concentration vital for a successful operation, even with the noises accompanying the procedure.”

The simulators in the dental lab include modules for a wide range of dental pathologies, the units developing the undoubtedly critical practical skills of dentistry students are designed to teach them the quality and standard of care of conservative and prosthetic dental procedures.

A high degree of realism is an essential part of simulation education, and many times, when you walk through the rooms of the centre, you can feel for a moment as if real people surround you.   The special mannequin-looking tools can mimic human life activities, i.e., they breathe, their pulse and blood pressure can be measured, and the parameters of these functions can be set with software.

“The dummies can also be used to simulate prehospital or intensive care,” explains Dr. Szilárd Rendeki. “Based on the setting, the patient can be in shock, have a heart attack, or can be in a state of asphyxiation. The student examines it and then decides what to do. The physiological parameters change depending on the interventions.” The simulator is also equipped with a microphone, and the person controlling it can speak through it, so doctor-patient communication can also be practiced with the device.

“We scanned an entire floor of the clinic”

Virtual reality (VR) and augmented reality (AR) are often mentioned as innovative technologies, and these solutions are also a great help in training doctors, as they provide an excellent opportunity to create various simulated situations.

Staff from the Medical Skills Education and Innovation Centre scanned an entire floor of the 400-bed clinic, and students can use VR glasses to “tour” the rooms in 3D, learn where things are, and thus arrive prepared. Anatomical models can also be displayed in the virtual space, allowing interactions with them, demonstrating physiological functions, or even “slicing” them by moving the different layers or creating an “exploded illustration” so that students can learn more about the structure or function of organs. Virtual reality can also be used as a venue for exams, using an uploaded healthy or pathological model to test students’ knowledge objectively.

The skills needed for surgery can be learned and practised in the space created by computing. The world’s largest manufacturer of flight simulators has also developed simulation medical devices that can be used to operate on patients in virtual space. These devices are available in Pécs as well. Dr. Szilárd Rendeki points out that when using the devices, the student works in three dimensions but sees in two. “The device has force feedback: touching the liver during virtual surgery, for example, is a softer sensation than touching the bone. It is as if the operation is happening in a living body. To make this realistic is a huge engineering challenge, combining medical and engineering expertise,” adds Dr. Péter Maróti, deputy director of the skill lab.

A so-called “VR treadmill” is in the corner of the VR room. This particular treadmill is only used in a few places in Europe. “You can not only walk and run on the device, but you can also rotate it in a circle at three hundred and sixty degrees,” explains the centre’s director. “It can simulate all real situations and environments, lifesaving and intervention, even disaster conditions and special situations. This situation can then be repeated countless times and measured and evaluated in a standard way with objective parameters. The doctor's behaviour can also be continuously observed in each situation, and their workload and intervention capacity can be determined.”

Anyone can become a lifesaver

A special unit of the UPMS MSEIC is the Operational Medicine room, where not only medical students but basically anyone can learn medical skills that play a significant role in stabilising the condition of patients and injured people before hospital treatment. The professional team of the University of Pécs Medical School organises various programmes, some of which are aimed at members of uniformed services, police officers and firefighters.

Anyone can participate in the Rural Lifesaving Programme. It is a frequent experience that civilian bystanders at the scene of an accident do not rush to the aid of the injured because they feel they do not have the necessary skills, which would only worsen the situation. However, quickness can save lives, and people who have completed the eight-hour Rural Lifesaving Programme can effectively keep an injured person alive until the ambulance arrives on the scene.

In the frame of the programme, participants can learn how to rescue injured people, recognise certain critical internal medical conditions, treat various traumatic injuries, and learn the basics of protection against hypothermia. The simulation dummy, also used in military medical training, is integral to the practical training. It can be used to learn how to treat severe bleeding from the extremities, locate arterial pressure points, and use a CAT tourniquet. In the case of injuries to the extremities with heavy bleeding, death occurs quickly, so assistance cannot wait until the ambulance arrives; it must be given immediately by the people on the scene. (The amount of bleeding and other physiological parameters can be adjusted with software on the simulation dummy.) Thermal protection, or the use of an isothermal blanket, is also an important point, as many people are not aware of its correct application, although it is straightforward. As it reflects the heat of the human body, you should remove the wet clothes before covering yourself or others with it (even if this is not how they do it in the movies). It is essential to wrap the head, as this is the part of the body with the most blood, so heat loss is also the most significant there.

Other, more extended programmes include the application of a medic bag, used by armed forces and law enforcement agencies, to treat and keep alive even severe trauma victims until the arrival of a higher-level medical team. The contents of the bag include a combat application tourniquet as well. Firefighters and police officers often have it, which can be applied in thirty seconds to stop severe bleeding.

The Rural Lifesaving Programme is open to anyone. The teachers at the Medical Skills Education and Innovation Centre also use the state-of-the-art simulation devices to develop citizens’ trauma care skills through team-building programmes. Age and lack of basic medical training are not barriers to participating in the training, and the programme is offered from the age of ten, but the youngest participant so far was seven years old.

We were sure of one thing at the end of our visit to the UPMS Medical Skills Education and Innovation Centre. Whether you are a future doctor or a “simple” citizen, the practical knowledge you gain here will make you more confident - and more successful - in saving lives when needed.



Szabolcs Csortos/University of Pécs


The item is already in the list!
You cannot add more than 5 items to the list!
Saved successfully
Error during the save!