Medical Simulation Center Opens at TJU
To Christopher Ricci, MD, Chief Resident from Thomas Jefferson University Hospital’s Emergency Medicine Department, the accident victim lying semi-conscious on the stretcher seems in severe pain.
PHOTO: Paul C. Brucker, MD, President, Thomas Jefferson University, listens through a stethoscope to lifelike heart sounds in demonstration at the new MedSim-TJU Medical Simulation Center. Looking on is Amitai Ziv, MD, Medical Director of MedSim Inc., who is conducting orientation sessions at the Simulation Center. Don Walker Photography
The middle-aged man appears to have suffered head and chest injuries when his auto jumped a curb and struck a utility pole.
“Where does it hurt?” Dr. Ricci asks, leaning over the man’s body and peering into his half-closed eyes.
“My chest, my chest . . . really hurts,” says the patient, gasping between breaths.
The resident places his stethoscope on the patient’s chest. Not hearing breath sounds on the right side, he quickly suspects a collapsed right lung.
Dr. Ricci asks a nurse for a chest tube tray and starts to tell the patient he must insert a tube in his chest to reinflate his lungs.
Suddenly, the patient’s blood pressure plummets to 80/60, then to 70/50 and 60/30, while his heart rate soars to 120. And then the patient becomes unconscious and stops breathing. “He doesn’t have a pulse,” a nurse shouts.
“We have a Code,” Dr. Ricci urgently calls into the intercom so that more staff and equipment can rush in to help the victim fight for life.
A true scene at Jefferson’s Emergency and Trauma Center? Or an episode from TV’s “ER”?
Actually – neither. The scenario described above is one of literally hundreds that can be simulated at TJU’s new “MedSim -TJU Medical Simulation Center.”
Amazingly realistic simulations are carried out – with pinpoint accuracy – by a combination of highly sophisticated computer technology, medical expertise and human judgment. The “patient” is actually an extraordinarily fine-tuned computer-driven, lifelike “mannequin” capable of simulating multiple human symptoms and physiological and anatomical responses to treatments, medication and procedures. A second system simulates ultrasound procedures.
Both simulators were developed by MedSim Inc., a leader in developing medical simulators and simulation-based training programs.
The Simulation Center is one of the most sophisticated centers in the United States and the only one in the Delaware Valley. It was created at Jefferson as a unique partnership between industry and academic medicine through the leadership of Joseph S. Gonnella, MD, Dean, Jefferson Medical College (JMC), and Senior Vice President for Academic Affairs, TJU, and the energy and efforts of other JMC faculty.
“This new technology should go far to enhance Jefferson’s quality education to support our hospital’s advanced medicine and superior care,” says Dean Gonnella.
Key to physically establishing the Simulation Center at Jefferson were the roles of Joseph L. Seltzer, MD, Professor and Chairman of Anesthesiology, JMC, and Thomas J. Nasca, MD, Associate Dean for Academic Affairs and Affiliations, JMC, and Associate Dean for Education and Research for JHS.
Also paving the way to establish the Simulation Center was the pioneering work in diagnostic ultrasound by Barry B. Goldberg, MD, Director of Diagnostic Ultrasound, Department of Radiology, who was involved in MedSim’s new ultrasound simulator from its early days.
Innovative Teaching Tool
Medical simulation is seen as a highly innovative teaching tool, says Dr. Seltzer, whose department’s initiative in finding or developing such a tool for use in anesthesiology training led, with the involvement of Dr. Nasca, to the innovative joint venture with MedSim for a center as versatile as the Simulation Center.
“Initially used to teach anesthesiology, now medical simulation has broadened to other critical specialties, such as emergency or intensive care, and emergency obstetrics,” explains Dr. Seltzer.
“Still, most simulators focus narrowly on one or two disciplines, thus limiting their educational use and potential. We purposely wanted to open ours to all medical disciplines – from nursing to the whole range of trauma responses, dentistry, and other areas, especially team and crisis responses. This is virtually an open-ended tool, with unlimited teaching uses.”
Dean Gonnella takes the potential a giant step further, saying:
“One of our goals is that the Simulation Center become a national model for other teaching hospitals throughout the United States. Our joint venture with MedSim is the company’s first with an academic health center and, as far as we know, the first of its kind in the United States.”
Dr. Smullens recently testified in Washington, DC, before a U.S. Congressional committee hearing on the issue of medical errors.
From an academic overview of both JMC and the JHS, Dr. Nasca sees vast teaching potential.
“We hope to introduce medical simulation into all academic levels as soon as it’s feasible to do so. We envision the day when doctors will perform procedures on simulators before they do so on patients,” he says.
Timothy P. Brigham, PhD, Assistant Dean, Graduate and Continuing Medical Education, JMC, is helping to coordinate physicians’ training in medical simulation for Continuing Medical Education (CME) credit, as well as simulation training for residents.
First CME Activity
“A major benefit of using simulation in CME is that it eliminates the cost and management of human models,” Dr. Brigham says.
And Dr. Seltzer adds risk management to the many recertification uses medical simulation offers for the future.
For information on courses offered or to schedule a tour of the MedSim-TJU Medical Simulation Center, please call Amitai Ziv, MD, Medical Director of MedSim, or Thomas A. Dongilli, Chief Instructor of the Simulation Center, at 215-503-2222. Visit our website at www.jeffersonhealth.org or www.tju.edu or MedSim’s at www.medsim.com