Why This Teaching Hospital Only Has Fake Patients

CityLab Ι Dec. 9, 2016

University hospitals are often premier institutions for medical training. But a new school on the West Side of Chicago is promising advances in health-care education without students ever collecting a vial of blood or scrubbing in for surgery. It’s a community college, and its array of courses are supported by a suite of simulative technologies.

Malcolm X College (part of the City Colleges of Chicago system) was built to meet the projected need for 84,000 healthcare jobs in Chicago in the next decade. In a hospital, only one out of 10 staffers is a doctor, so Malcolm X offers degrees in radiography, nursing, phlebotomy, respiratory therapy, dental hygiene, and more. This all happens in a high-tech environment its architects at CannonDesign say is unmatched in community colleges.

This kind of hyper-specialization is the product of a system-wide “College to Careers” initiative, part of a dramatic turnaround effort called “Reinvention” that saw graduation rates rise from a dismal 7 percent to a better but still-treading-water 17 percent. “College to Careers” stresses subjects that make students immediately employable in growing career fields, and aims to support them with tailor-made facilities that emphasize job training.

Malcolm X College announces this new beginning from your first steps into the building. Its lobby uses hotel- or restaurant-style finishes and materials, like faceted wood panels, to break past associations with the frumpy institutional architecture you might expect from community colleges. Tiered stair seating overlooks the reception desk, where a sleek artifact of Civil Rights history sits on top: Malcolm X’s black 1963 Oldsmobile, donated to the school by his widow Betty Shabazz.

Timelines of the school’s history and Malcolm X’s life and a word-cloud mural of Malcolm X are bathed in light from large circular window above the car. It’s civic-scaled design for what looks more like a think tank focusing on the Civil Rights movement than a community college.

“We want to change the dynamics of what people think about community college,” says Malcolm X’s interim president, David Sanders, so that the school is seen as a “first-class institution that compares to the University of Chicago or Loyola.”

That goal is in reach in terms of the quality of the space and the instruction. (Nearby Rush University Medical Center is one institutional partner.) But the demographic realities at Malcolm X set it apart from Chicago’s elite and expensive private universities. It draws students from all over the city, but it abuts one of Chicago’s poorest quarters. The school is 52 percent African-American and 30 percent Hispanic, and serves a population that has dealt with impediments to education that many college freshmen never dream of.

For some, “being on campus might be the safest place they can be. The meal they have on campus may be the best meal they have all day,” says Jim Jankowski, one of the school’s architects.

In order to meet students where they are, CannonDesign condensed a range of student outreach services in the first two floors, creating a literal and metaphorical “heart of the building,” says the firm’s Tim Swanson. There’s a cafeteria, the student union, a daycare center, and on the second floor, academic support services and the library.

This mix of civic-scaled spaces and programs helps differentiate the new school from the old Malcolm X College, which, Jankowski says ,“felt like a high school.” (Demolished for a Chicago Blackhawks hockey practice facility, the 1971 steel-framed school in the style of Mies van der Rohe would have been discarded without a second glance in just about any other city than architecture-loving Chicago.)

“The old building was kind of like a box structure, so one class was on this side of the hall, and your other class was on the other side of the hall,” says nursing student Tahira Moon. “Now it feels like we’re in a bigger university. It feels good to go to college [here.]”

The biggest difference between the long, low old school and the new one is the eight-story hospital tower that offers increasingly more specialized instruction as it rises, along with impressive views of the surrounding cityscape. Lower floors here are general classroom spaces, and middle floors contain profession-specific simulation labs. The top floor is a mock hospital where students of different fields work together on real-life patient simulations.

“Your education culminates in a very physical manifestation at the top of this tower,” says Swanson. “By the time you’re completing your education, you’re looking out both at the city you’re a part of, and the Illinois Medical District, which is one of the many places you [might] go practice everything you just learned.”

The top floor is a petting zoo of different health-care environments. There are exam rooms with computers wired to a database filled with hypothetical patient records. There are pediatric wards, an emergency room, and a mock living room for home healthcare providers and paramedics in training. There’s also a set of doors that open to “the business end of an ambulance,” says Jankowski—its patient cabin.

The operating room puts instructors behind a two-way mirror for observation, and records students’ performance with a camera. When the lesson is over, they review the video together, or send it home with students on a thumb drive.

Connecting all of these simulation exercises together means the school focuses on areas where patient care falters most. “Statistically, most mistakes happen in a health-care environment at the handoff,” says Jankowski. “The EMTs passing a patient to the emergency room, the emergency room transferring the patient to the OR.”

What exactly do the students at Malcolm X College have to “hand off?” The real stars of the school: high-tech mannequins that dilate their pupils, bleed, or shake with a grand mal seizure. Programmed by instructors, they come with an IV jack, and will react to medication like a real patient. “If that medication would kill them, they’ll die,” says Sanders.

Syril Benitez, a respiratory therapy student, says they’re a key element of the school’s hands-on approach. “They can change their vital signs,” she says. “They can cry. They can put them in code blue [cardiac arrest].” Benitez is studying respiratory therapy because respiratory health has been a persistent issue in her family; her son has asthma, and her dad suffered from chronic obstructive pulmonary disease.

There’s a more specialized mannequin in the OB-GYN lab that can simulate breech births and other complications. “She can also yell at the father, the same way it happens in the hospital,” Sanders says.

All this adds up to an opportunity to “pressure-test students in the environment in which they would work,” he adds.

Again and again, architects Jankowski and Swanson were asked by local civic leaders how many jobs for the community the construction would generate. They had answers (1,000 in total, 120 for qualified applicants in nearby communities). But given the way Malcolm X hones skills required for life-and-death situations, the question might have been, how many lives will be saved?