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Medical Education Technologies, meanwhile, has developed the Human Patient Simulator, or HPS, which also enables instructors to train students with different scenarios. The HPS "blinks, speaks and breathes, has a heartbeat and a pulse, and accurately mirrors human responses to such procedures as CPR, intravenous medication, intubation, ventilation and catheterization," according to the company.

The HPS is so lifelike, the company said, that students have been known to cry when it dies. The company also offers a portable mannequin called the Emergency Care Simulator (ECS).

A key benefit of electronic mannequins is that they allow students to learn at a slower pace than is possible in managed care settings, Grumet said. But the high-tech mannequins can have a high price. The basic SimMan costs $28,980, the lowest-priced HPS model sells for $160,000 and the ECS sells for $37,750. Grumet estimates that less than half the country's nursing schools use electronic simulators. So far, about 90 U.S. schools of nursing have bought the SimMan, while 16 have purchased the HPS and one has bought the ECS, according to Laerdal and Medical Education Technologies.

Of course, patient simulators have limits. Carol Loveland-Cherry, Ph.D., RN, FAAN, executive associate dean for academic affairs at the University of Michigan School of Nursing, notes that her program hires human models for training students in pelvic and genital exams. "To be able to do that on a dummy isn't quite the same," she said.

Drawn into the Web

Michigan and many other nursing schools also are taking advantage of Internet technology to teach students and introduce them to patient education, 21st century style. Professors are now able to use the Web to do such things as post assignments, upload multimedia files such as respiratory sounds or fetal heart tones, set up student discussion forums and administer tests.

At Rush University, for example, Mitchell used networking technology to research course assignments from home. She lives 30 miles away from the Chicago campus, but Rush set up a computer link that allowed her to connect to the school's library. Moreover, Mitchell's training on evaluating Internet medical information sites prepared her for a clinical situation.

She had a patient recovering from a mastectomy and looking for exercises. Mitchell and her patient went to an Internet terminal at Rush-Presbyterian-St. Luke's Medical Center, where they found an appropriate Web site that provided exercise directions. "It really helped guide her after she left the hospital," Mitchell said.

Grumet believes Internet learning can be a great tool to help rural RNs with associate degrees earn BSNs. But novice nursing students should not do all their course work online, she said, because they need real-life interaction with professors to pick up skills such as communicating with patients and handling stressed-out doctors. "[It's] called 'socialization into the profession,' " Grumet said. "You really do need face time for that."

There may be a danger in relying too much on the Internet in nursing education, but Jan Nick , Ph.D., RN, associate professor at the Loma Linda University School of Nursing in Southern California would like to see the Web used more. Nick said not enough class quizzes or exams at Loma Linda are on the Internet, given that students eventually take the NCLEX exam using a computer.

"We're not preparing them for the exam if we continue with pen and paper," she said.