March 8, 2007

Surgeon honored for exam simulation inventions

By Marla Paul

Carla Pugh, M.D., remembers her fluttery stomach before she had to do her first pelvic exam as a medical student.  In fact, the exam provokes universal anxiety among students.

“It’s tricky,” said Pugh, an assistant professor of surgery at the Feinberg School of Medicine. “The anatomy is complex, students are afraid they are going to hurt the patient, and there is a lot of embarrassment.” The first prostate exam isn’t far behind for provoking student jitters.  

How do medical students know if they are being gentle enough? How can they figure out where all the important parts are when they can’t see them?

Pugh, also an associate director of Northwestern’s Center for Advanced Surgical Education, deftly solved those problems. She invented new teaching tools — exam simulators with sensor technology — to show students whether they have the right touch in these sensitive exams without a patient ever having to yell “Ouch!” When students place their hands inside the pelvic or prostate simulators, internal sensors measure their pressure and detect if they’re in the proper spot.

The pioneering sensor technology for the pelvic simulator is a patented product now being used by 60 nursing and medical schools around the country.

Pugh is recognized for her accomplishments in an exhibit titled “New Frontiers in Academic Surgery” at the National Library of Medicine in Bethesda, Md. The exhibit honors African-American trailblazers and educators in contemporary medicine. 

Another trail Pugh blazed was to help students perform better breast exams. “Breasts all look and feel different, so it’s hard to know what’s normal,” Pugh explained. “Breasts vary as much as facial features.” She recently designed a breast with interchangeable inserts, enabling students to feel the many varieties of healthy tissue and worrisome masses.

Inspired by the students and surgical residents she teaches in the operating room, Pugh is turning out still more innovations. One prototype with sensor technology teaches residents and obstetricians how to properly deliver a baby whose shoulder is stuck in the birth canal, a rare and difficult procedure at which they don’t get much training.

Another simulator she developed helps students learn how to insert a breathing tube down a patient’s airway in an emergency. It’s a tricky procedure and “a lot of things can go wrong,” she said.

One of only an estimated 386 African-American female surgeons in the country, Pugh decided to become a doctor when she was five years old. “My uncles told me stories about my great-grandmother who was a midwife and a veterinarian. They talked about her with such high regard. They said I had her eyes,” Pugh recalled. As child, she thought her great-grandmother was a physician. “I decided I’m going to be an awesome physician,” she said.