Israeli center models medical training

RAMAT GAN, Israel (JTA) – Army medics hover over the soldier with a bullet wound to his chest. The sounds of helicopters buzzing and mortars falling surround them. “Give him morphium, liquids,” the commander snaps.The soldier’s vital signs do not look good and he has gone silent.”Are you still with me?” one of the medics shouts, kneeling closer. A few steps away, a medical student in a soundproof booth makes the casualty’s blood pressure and oxygen levels plunge with a few clicks of a computer mouse. The injured soldier is actually a $200,000 high-tech plastic dummy, and the medical team is in a windowless training room of the Israel Center for Medical Simulation.The center is the brainchild of Amitai Ziv, a fighter pilot turned pediatrician whose accomplishments won him the 2007 Charles Bronfman Prize for humanitarian work. Ziv, 48, has a mission: to reduce the number of medical errors. Drawing from his Israel Air Force experience and his medical training, he created the center – known as MSR – in the hope that it would change the culture of medical training not just in Israel but internationally.The national center, which uses a technology based on flight simulators, is unique in its scope worldwide and has served as a model for other training programs. Ziv’s eyes grow wide as he cites findings from a U.S. National Institutes of Health study that some 100,000 Americans a year die due to medical error.”That’s as if a jumbo Boeing 747 crashed into the sea every day,” he said. Of the center, which is located at the Sheba Medical Center near Tel Aviv, Ziv said, “This is a place to make mistakes in order to learn from mistakes. We need to have low tolerance for errors and no tolerance for not learning from errors.”At MSR, one enters a world of virtual patients – the computerized mannequins react like humans, with heart rates, blood pressure, and the ability to bleed and even go into shock. Sessions are videotaped and followed by debriefings with a doctor. Ofir Raz, a 28-year-old medical student who helped conduct the training session with the army medics, sits in the control room marveling at the technological capability of the equipment. He demonstrates on the computers how to determine heart contractions in either the left or right ventricle. The goal is to make the scenario as challenging as possible, Raz said. Since its founding in 2001, the center has become a model at institutions worldwide, including the Mayo Clinic in Minnesota, McGill University in Montreal and Case Western Reserve in Cleveland. “Methods developed and implemented by MSR are revolutionizing the manner in which physicians and allied health personnel are trained,” William Dunn, medical director of the Mayo Multidisciplinary Simulation Center, said in a statement. At his desk, Ziv opens file after file on his computer, offering a sampling from hundreds of scenarios: from training a doctor to break the news of a terminal illness to a patient, to managing chemical and biological warfare. In May, Ziv traveled to New York to receive the $100,000 Charles Bronfman Prize, which celebrates the vision and talent of an individual or team younger than 50 years old and whose humanitarian work has contributed significantly to the betterment of the
world.In their announcement, the award founders said, “Dr. Ziv represents the best of the young generation’s values, commitment, creativity and energy. His insightful and innovative work responds to the imminent need for reshaping the way medical care is delivered throughout the world.” In addition, Ziv serves as the deputy director of the Sheba Medical
Center, Israel’s largest medical institution. An internationally
recognized expert in medical education, he also has testified before
the U.S. Congress on how MSR trains professionals to respond in the
event of mass casualties caused by a chemical or biological attack.

Ziv also has briefed the U.S. Department of Homeland Security on ways
to use medical simulation in training for medical emergencies.