A nursing student practises CPR on a training manikin, developing essential clinical skills to respond confidently in emergencies. Image: Supplied

A donor investment made in 2009 is still training UWC nurses today to care for patients who blink, breathe, bleed and can't be harmed.

Mr Jacobs is recovering from surgery. His pulse is climbing, and his breathing is quickening. A group of first-year nursing students take his observations, spot the pattern, and with some help from their facilitator, realise that the patient is bleeding postoperatively. Guided by their facilitator, they act swiftly to intervene.

Mr Jacobs isn't real. He is a high-fidelity manikin in UWC's School of Nursing skills lab, programmed to respond to the care students give him. Mistakes here cost nothing, and that is the point.

The manikins were made possible by a R16 million grant from The Atlantic Philanthropies in 2009, part of the nationwide University-based Nursing Education Development in South Africa (UNEDSA) project. The grant aims to strengthen nursing scholarship and practice in the Western Cape and to position the School as a centre of excellence in teaching and learning in South Africa and across Africa.

Through the grant, the School bought three adult high-fidelity manikins and a paediatric manikin for general nursing training. It also bought five high-fidelity birthing manikins, each with a newborn, for midwifery training. These are far more than practice dummies. Their eyes react to light. They have heart and lung sounds, pulses, chest movement and airways that can be intubated. The birthing simulators can deliver normally, or develop life-threatening complications such as postpartum haemorrhage.

In one scenario, third-year midwifery students care for a mother who begins to haemorrhage after a healthy birth. They massage the uterus, set up an oxytocin drip, monitor her vital signs every 15 minutes and find the source of the bleeding. Fourth-years resuscitate a baby in anaphylactic shock after an immunisation, while a computer scores the quality of every compression and breath.

Two nursing students monitor a simulated patient’s oxygen saturation using a bedside monitor, developing essential skills for confident clinical care. Image: Supplied

"This allows students to practise their nursing skills in a safe environment without risking patient safety," says Wendy Rosenthal, Clinical Simulation Manager in UWC’s Faculty of Community and Health Sciences.

All 650 undergraduate nursing students, from first to fourth year, train on the manikins, with senior students using them most as they master complex, critical skills. Postgraduate Midwifery and Primary Care students use them too.

The benefits follow students onto the wards. Practising critical skills without fear of harming a patient builds confidence and competence, and research shows that students trained through simulation tend to make fewer mistakes in clinical settings.

More than 15 years on, The Atlantic Philanthropies' investment has helped build simulation capacity that will outlast the original manikins.

Now, UWC faces an urgent need to replace its ageing high-fidelity manikins. Although these simulators have served generations of nursing students exceptionally well, they have exceeded their expected operational lifespan, and technological advances have significantly expanded the possibilities for simulation-based clinical training. With growing demands on healthcare services and increasing pressure on clinical training platforms, access to modern simulation technology is more important than ever.

However, the substantial cost of replacing this equipment, coupled with declining state funding for higher education, has placed this investment beyond the University's available resources. A single new high-fidelity manikin costs approximately R8 million, and although the Faculty has secured R1 million towards replacement, a considerable funding gap remains.

The institution is therefore seeking philanthropic and corporate partners to help renew this critical training infrastructure. By partnering with UWC, donors can build on the enduring legacy of The Atlantic Philanthropies and ensure that the next generation of nurses has access to the advanced clinical training required to meet the country's evolving healthcare needs.