On a recent trip to California, CMS’ Dan Raemer had the opportunity to meet one of his personal heroes, Dr. Stephen Abrahamson.  Dan reports that he spent a wonderful afternoon with Dr. Abrahamson and his wife reminising about his career in medical education and the development of the first computerized mannequin simulator, Sim One. 

In the late 60’s Dr. Abrahamson, an engineer and medical educator, and Judson Denson, MD led the team from the University of Southern California that developed Sim One.  Sim One was initally developed with the idea of training anthesthesia residents in endotracheal intubation.  This was later expanded in the early 70’s to include training interns, medical students, nurses, inhalation therapists and other healthcare professionals.  Although studies showed simulator training to be effective in improving student performance, Sim One and simulator training were ahead of their time.  In the early 70’s there was too much resistance to anything outside of the traditional apprenticeship model of medical training, and Sim One was felt to be too limited in scope and expensive for commercialization.  After Sim One, Dr. Abrahamson went on have a distinguished career at the Kerr School of Medicine at USC where he led the Division of Medical Education serving as a change agent and innovator who helped transform the entire field of medical education.

Dan Raemer, PhD is the Director of Research and Development at the Center for Medical Simulation. In 2003 Dan received a unique award from the Harvard Department of Anaesthesia for “excellence in teaching”. Using simulation as a research tool to investigate healthcare worker’s behaviors and thought processes has been his most enduring passion.  Dan has published work in these areas and has given numerous keynote addresses for specialty societies and other healthcare organizations on simulation as it has blossomed in the last several years. Dan is the founding trustee and a Past-President of the Society for Simulation in Healthcare (SSH).  In 2008, Dan received a “Lifetime Achievement Award” from SSH for his contributions to the field. He is also a Past-President of the Society for Technology in Anesthesia.

CMS’ Jeffrey B. Cooper, PhD was elected to receive the 2013 Distinguished Service Award at the recent annual meeting of the American Society of Anesthesiologists in Washington, DC.  Dr. Cooper is the first non clinician to receive the Society’s highest award which is given for meritorious service and achievement and is based on his outstanding career and his impact on anesthesia and patient safety.

Jeffrey B. Cooper, Ph.D. is the founder and Executive Director of the Center for Medical Simulation, which is dedicated to the use of simulation in healthcare as a means to improve the process of education and training and to avoid risk to patients. He is also Professor of Anaesthesia at Harvard Medical School. He received his BS in Chemical Engineering and MS in Biomedical Engineering from Drexel University in 1968 and 1970 respectively and completed a PhD in Chemical Engineering at the University of Missouri in 1972. Starting soon thereafter with the Bioengineering Unit in the Department of Anesthesia at Massachusetts General Hospital, he led the team that conducted seminal studies of critical incidents and human error in anesthesia. During the same time, he was leading a team that developed one of the first microprocessor-based medical technologies, the Boston Anesthesia System, aimed at integrating functions for the ultimate purpose of reducing human and system errors. Both of these efforts have catalyzed changes in anesthesia practice in the ensuing years. In April, 2009, Dr. Cooper retired as Director of Biomedical Engineering for the Partners Healthcare System, Inc., a technology development and service department that he organized and led for 15 years.

Dr. Cooper was a lead member of the group that created the first safety-related standards for anesthesia, equivalent versions of which have since been adopted in the US and throughout the world. He is a co-founder of the Anesthesia Patient Safety Foundation (APSF), serving continuously on its Executive Committee and for 13 years as Chairman of it Committee on Scientific Evaluation. He is now an APSF Executive Vice President. He serves on the Board of Governors of the National Patient Safety Foundation and founded its Research Program, which he chaired for seven years.

Dr. Cooper is one of the pioneers in diffusion and innovation in healthcare simulation. He has led CMS to become one of the premier simulation programs in the world. Among the more innovative programs he has created or co-developed are the Institute for Medical Simulation, live, interactive simulation video-teleconferencing and the novel Healthcare Adventures (program for training healthcare administrators and leaders in teamwork via realistic simulation). He has mentored the faculty of CMS since its inception and has stimulated, participated in and advised on various research projects.

In addition to the ASA’s Distinguished Service Award, Dr. Cooper has received numerous honors for his work in patient safety, including the 2003 John M. Eisenberg Award for Lifetime Achievement in Patient Safety from the National Quality Forum and the Joint Commission on Accreditation of Healthcare Organizations and the 2004 Lifetime Achievement Award from the American Academy of Clinical Engineering. In 2009 the Department of Anesthesia and Critical Care of the Massachsetts General Hospital established the Jeffrey B. Cooper Patient Safety award in his honor.

Congratulations Jeff, from all your teammates here at CMS!

Boston Simulation Community Research and Education Meeting Next Tuesday, November 13th from 5:30-7pm at the MGH Institute of Health Professions

Janice Palaganis, RN, MSN, CRNP, CEN
Exploring Healthcare Simulation as a Platform for Interprofessional Education

Janice Palaganis is a faculty member at the Center for Medical Simulation, Boston.  She was previously the Chief Operations Officer and Director for Research & Development for the Medical Simulation Center at Loma Linda University.  Janice is also Chair of the Interprofessional Education Affinity Group and a member of the Certification Committee and Technology & Standards Committee in the Society for Simulation in Healthcare, as well as an author for the National League for Nursing’s (NLN) study on high-stakes assessment using simulation for nursing students.   

Upcoming Meetings::

December 11th, 2012 at STRATUS, BWH:  Nicole Kissane, MD ”Coaching surgical residents using simulation: A randomized controlled trial”  

January 8th, 2013 Location TBA: Preview and practice for 2013 International Meeting on Simulation in Healthcare

February 12th, 2013 at the Center for Medical Simulaton: CIMIT Boston Consortium Quarterly Meeting 

The Boston Community Simulation Community research and education meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. If there is a work in progress or other project you would like to present on our fall schedule, please contact Jenny Rudolph, PhD at jwrudolph@partners.org .

Please join us for the next Boston Simulation Community Research and Education Meeting this coming Tuesday, September 11th from 5:30-7pm at the Center for Medical Simulation, 65 Landsdowne Street, Cambridge MA.

September 11th, 2012: “Prop Chart” a cost-effective, visual model to analyze the effectiveness of simulation training courses

Annemarie Fransen, MD and Guid Oei, MD PhD

Training of medical staff is essential for safe patient care. The nature of a medical training can range from lectures to medical simulation with expensive simulators. However, training of medical experts can be challenging. Not only, because of hierarchical problems, but also because of fear of failure and unwillingness to change, or play a role. To support deliberate practice in learning by simulation as while simultaneously controlling costs, we developed a visual model, named the Prop chart. This chart can also be used for evaluating existing medical simulation programs. The background and the use of the Prop chart will be presented by a videoconference during the research meeting on the 11th of September.

More about Drs Fransen and Oei

Annemarie Fransen, MD

• Resident at the department of Obstetrics & Gynecology of Máxima Medical Centre, Veldhoven, The Netherlands.
• PhD student

 Guid Oei, MD PhD.

• Obstetrician at the Máxima Medical Centre, Veldhoven
• The Netherlands and Professor at the department of elektrotechnical engineering of Eindhoven Technical University, The Netherlands
• Medical director at the simulation centre Medsim, Eindhoven, The Netherlands

The Boston Community Simulation Community Research and Education Meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. Please join us!

The Center for Medical Simulation welcomes Janice Palaganas, PhDc, RN, MSN, CRNP, CEN as its newest Faculty member. Prior to joining CMS, Janice was the implementing Director of Accreditation and Certification for the Society for Simulation in Healthcare and continues as a member of the Board of Review for the Council for Accreditation of Healthcare Programs.  She was previously the Chief Operations Officer and Director for Research & Development for the Medical Simulation Center at Loma Linda University.  Janice has experience as faculty for schools of nursing, public health, MBA programs, emergency medicine and medicine.  She received her Bachelor’s of Science in Nursing, as well as two Masters degrees as an Adult Nurse Practitioner and Geriatric Nurse Practitioner; and one Masters certificate in Home Health Management from the University of Pennsylvania.  She is currently completing her PhD in Nursing at Loma Linda University exploring healthcare simulation as a platform for interprofessional education (IPE).  Since 2008, Janice has been involved nationally and internationally researching healthcare simulation for interprofessional education and was the Meeting Chair of the 2012 Healthcare Simulation and Interprofessional Education Symposium in San Diego, CA, participating in the Invitational Meeting that brought together 22 major healthcare professional organizations to come to consensus on how healthcare simulation can be a vehicle for IPE.

Janice has extensive Emergency Department experience at multiple facilities ranging from level I trauma centers, community hospitals, and fast tracks as an Emergency Nurse, Fast Track Nurse Practitioner, Clinical Educator, Clinical Nurse Specialist, Trauma Nurse Practitioner, Manager, and Director for Emergency and Critical Care Services, as well as Legal Nurse Consultant and House Supervisor.  She has presented at conferences regarding projects in simulation and on behalf of the Council for Accreditation of Healthcare Simulation Programs.  She has been an invited keynote speaker nationally and internationally to discuss simulation, patient safety, and/or accreditation. Amongst other leadership roles, she is Chair of the Interprofessional Education Affinity Group and a member of the Certification Committee and Technology & Standards Committee in the Society for Simulation in Healthcare, as well as an author for the National League for Nursing’s (NLN) study on high-stakes assessment using simulation for nursing students.  From her work with the NLN and SSH Accreditation, Janice has a particular interest in video assessment tool development.  She is also lead editor for the upcoming textbook, “Defining Excellence in Simulation Programs.”

On a more personal note, Janice enjoys anything that comes out of her kids’ mouths, photography, digital art, charcoal and acrylic art, and dance.  She is a techie at heart. She is also a classically trained pianist and (in a former life) was a dancer, choreographer and hip-hop instructor.

Please join all of us here at CMS in welcoming Janice to our team!

Taught by CMS’ Harvard faculty, the “Simulation as a Teaching Tool Workshop” is a 4-day intensive immersion in healthcare simulation that is specifically designed for those educators seeking to develop high quality simulation programs. It covers high level elements and concepts involved in using simulation as a teaching tool.

Drawing on the disciplines of aviation, healthcare, psychology, experiential learning, and organizational behavior, participants learn how to teach clinical, behavioral, and cognitive skills through simulation. Participants explore simulator based teaching methods applicable across the healthcare education spectrum, including undergraduate and graduate medical, nursing and allied health domains.

The daily formats vary and include simulation scenarios, lectures, small and large group discussions, and practical exercises with feedback. Ample opportunities are provided for networking and sharing experiences. Attendees join a growing community of Institute graduates who are positioned as leaders in the field.

Register Now – Seats are limited!

Dates: October 2-5, 2012
Tuition for this workshop is $4,225

To learn more about the workshop, or to apply, visit the Center for Medical Simulation (CMS) website’s IMS webpage at
http://www.harvardmedsim.org/ims/html. You can also email CMS at info@harvardmedsim.org , or call Gary Rossi, CMS’ COO at 617.768.8267

IMS New York Flyer

The Jay W. Forrester Award was recently presented to John Carroll, Brad Morrison and Jenny Rudolph at the 30^th International System Dynamics Conference, held at the University of St. Gallen, Switzerland.  The Forrester Award recognizes the best work in the field of system dynamics published in the previous five years.  Doctors Carroll, Morrison and Rudolph were recognized for their paper, “The dynamics of action-oriented problem solving:  linking interpretation and choice,” published in the Academy of Management Review in 2009  (full citation:  Rudolph, J, Morrison, J. B., Carroll, J. (2009) The dynamics of action-oriented problem solving:  linking interpretation and choice.  Academy of Management Review.  34(4): 733-756.)  It was based on Dr. Rudolph’s doctoral dissertation conducted at the Center for Medical Simulation (CMS).

The paper develops and tests a formal system dynamics model of sensemaking and action, using anesthesia as the empirical setting.  The data for the study came from simulated cases carried out at the Center for Medical Simulation and provides a large sample of fine-grained observational and quantitative data from a controlled environment.  The model is tightly grounded in the data and gives insight into the feedbacks between sensemaking and action that can cause anesthesiologists both to discover and fail to discover and correct a common diagnostic problems.

Everyone at CMS congratulates Dr. Rudolph, Dr. Carroll and Dr. Morrison on this outstanding achievement.

Taught by CMS’ Harvard faculty, the Simulation as a Teaching Tool Workshop is a 4-day intensive immersion in healthcare simulation that is specifically designed for those educators seeking to develop high quality simulation programs. It covers high level elements and concepts involved in using simulation as a teaching tool.

Drawing on the disciplines of aviation, healthcare, psychology, experiential learning, and organizational behavior, participants learn how to teach clinical, behavioral, and cognitive skills through simulation. Participants explore simulator based teaching methods applicable across the healthcare education spectrum, including undergraduate and graduate medical, nursing and allied health domains.

The daily formats vary and include simulation scenarios, lectures, small and large group discussions, and practical exercises with feedback. Ample opportunities are provided for networking and sharing experiences. Attendees join a growing community of Institute graduates who are positioned as leaders in the field.

Dates: October 2-5
Tuition for this workshop is $4,225

To learn more about the workshop, or to apply, visit the Center for Medical Simulation (CMS) website’s IMS webpage at
http://www.harvardmedsim.org/ims/html. You can also email CMS at info@harvardmedsim.org , or call Gary Rossi, CMS’ COO at 617.768.8267

IMS NEW YORK October 2012 Flyer

The next Center for Integration of Medicine & Innovative Technology (CIMIT) Boston Simulation Consortium Quarterly Meeting will be held on Tuesday, July 10^th from 5:30-7pm at the Center for Medical Simulation at 65 Landsdowne Street, Cambridge MA.  Light snacks will be served.  This quarterly meeting is scheduled during the standing time for the Boston Simulation Community Research and Education Meeting on the 2^nd Tuesday of the month.  These meetings provide a friendly and informal venue for simulation educators and researchers to present work-in-progress, acquaint each other with relevant ideas from other disciplines and connect with others. Please join us! 

Whether the medical practitioner is a new resident, an ICU nurse, a young battlefield medic or an experienced surgeon, the traditional method of learning a new technique has been to observe or read about a new technique, then attempt it on a patient. Simulation and using the “virtual environment” can accelerate the introduction and integration of new technologies into the clinical care. Simulation integrates tools, team training and virtual environments for scenario testing into one compressive philosophy intent on improving confidence, competence, operational performance and patient outcomes.

A collaborative partnership across CIMIT member hospitals and universities, the CIMIT Boston Simulation Consortium builds upon the success of the individual institutional simulation centers and Risk Management Foundation (RMF/CRICO) of the Harvard Medical Institutions and unifies the Boston community as a worldwide hub for healthcare simulation. The collective experience and resources of these premier simulation centers offer an unparalleled opportunity to partner with academia, government and industry to advance the field of healthcare simulation and to fully integrate clinical simulation as a quality and safety tool in health care practice.

Upcoming meeting of the Boston Simulation Community Research and Education Meeting:

September 11, 2012:  We will have a Work-in-Progress presentation about “Prop Chart” a visual model to analyze the effectiveness of simulation training course.  Our presenter will be: Annemarie Fransen, an obstetrician from the Netherlands.

The Center for Medical Simulation’s Institute for Medical Simulation celebrated a milestone this weekend with the first faculty development retreat for its Spanish-language simulation instructor courses.  The collaboration among the Virtual Hospital Valdecilla, in Santander Spain, Fundación INSIMED (Bogotá, Colombia), and the Center for Medical Simulation promotes excellence in healthcare simulation design and debriefing for Spanish speaking clinician educators world-wide.  Meeting this weekend in Potes, Cantabria, Spain, faculty from the three institutions developed skill in peer-to-peer debriefing feedback, principles for working together as a community of practice and course designs. 

Pictured below are Demian Szyld (IMS and New York Simulation Center for the Health Sciences), Robert Simon (CMS), José Maestre, (IMS and Virtual Hospital Valdecilla), Guillermo Ruiz-Ortiz, (INSIMED – Instituto de Simulación en Medicina), José Luis Rábago (Virtual Hospital Valdecilla), Alejandro Martinez (Virtual Hospital Valdecilla), Ignacio del Moral (IMS and Virtual Hospital Valdecilla), and Jenny Rudolph (CMS).