Gordon Center and Department of Defense Conduct Study to Train Military Healthcare Professionals Remotely
- The Gordon Center was honored to conduct a research study sponsored by the Department of Defense (DOD) to evaluate technology to train military medics and healthcare professionals remotely.
- With trainees outnumbering faculty and being geographically separated, the DOD leveraged the expertise of The Gordon Center to test and evaluate whether complex procedures (e.g.chest tube) can be taught to trainees using telemedicine by a remote instructor. ArchieMD, a leader in creating innovative educational visuals, developed the technology, that incorporates augmented reality animations and superimposed anatomy to help the learner see and understand the procedure as the faculty member guides them through it.
- The results of this study will be generated by feedback from the learner and faculty participants regarding whether the methodology and technology will be helpful for teaching and learning.
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Gordon Center Research
- At the Gordon Center for Simulation and Innovation in Medical Education, we conduct outcome-based research to rigorously assess the effectiveness and impact of simulation- and technology-based training programs created at the center.
- We continually evaluate the effectiveness of outcomes associated with our Prehospital & Emergency Training programs, Harvey, the Cardiopulmonary Patient Simulator, UMedic Educational Software. Several multicenter research studies have demonstrated the educational effectiveness of our training systems.
- We also accept applicants to our simulation fellowship program with an aim to develop clinical educators in simulation education. This includes simulation curriculum development and outcomes assessment. This program is designed to provide participants with fundamental skills and abilities for delivering simulation-based healthcare education through a variety of techniques and technologies.
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Outcomes Research Evidence
- Multiple studies have shown that the cardiovascular examination is a sensitive highly specific and cost-effective skill. At the same time, national studies of Internal Medicine and Family Practice trainees have clearly demonstrated that cardiovascular bedside skills are sorely lacking.
- The solution suggested in these studies is repetition and feedback through simulation technology and testing outcomes.
- The use of "Harvey" provides a mechanism to remedy the problem. Multiple studies have demonstrated "Harvey's" effectiveness for teaching and testing. An NHLBI sponsored national multicenter study carried out at 5 medical schools clearly demonstrated that students trained with "Harvey" score significantly higher on examinations involving real patients. However, "Harvey" can only be effective if it is made part of the required curriculum and outcomes are tested. Add to this a faculty "champion" of "Harvey," and students will learn important bedside skills that will transfer to their live patients.
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- National multicenter studies have been carried out to assess the skills gained by using the UMedic system.
- The implementation of a four-year UMedic Multimedia Computer Curriculum in Cardiology involved six medical schools: Miami, Emory, Iowa, Illnois, Florida and Duke. A total of 1,586 students reviewed 6,131 programs. The 4-year curriculum was found to be feasible and highly accepted. Success was dependent upon local leadership and a willingness to change.
- Another study was carried out to determine if students trained with the UMedic system can acquire and retain core bedside cardiology skills. Five medical centers participated: Duke, Emory, Miami, Mt. Sinai and Northwestern, with a total of 208 senior medical students. Students trained in a clerkship that included UMedic has significantly higher increases in their pre to post test bedside skills scores than those trained in a standard clerkship. Taken together, these studies clearly demonstrate that the UMedic system will enhance bedside skills when made part of the curriculum and outcomes are tested.
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Prehospital and Emergency Training
The emergency programs we carry out are carefully assessed. The Gordon Center was among the first to train and demonstrate the ability of paramedics to diagnose acute heart attacks on the electrocardiogram, as well as their ability to diagnose and manage stroke victims.Selected research
The goal is to develop a cadre of trained healthcare educators with skills in curriculum development, outcomes assessment and research. This program will help ensure our leadership role in curricular development, technology, simulation and outcomes research while developing a pool of clinician-educators to carry out our mission in perpetuity.
During this one or two year program, research fellows at the Gordon Center will learn to:
- Develop curricula that emphasize self-learning and life-long learning.
- Learn effective teaching and testing techniques and then develop and implement programs that train faculty how to teach and evaluate their students.
- Use technology to enhance and complement traditional teaching through simulation & multimedia computer systems that include distance learning and web-based systems.
- Design and implement outcomes studies for both cognitive knowledge and skills traing to curricular changes based on best-evidence medical education.
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Cardiology - Harvey & Umedic
- Multak N, Newell K, Spear S, Scalese RJ, Issenberg SB. A multi-institutional study using simulation to teach cardiopulmonary physical examination and diagnosis skills to physician assistant students. J Physician Assist Educ. 2015;26(2):70-6. doi: 10.1097
- Lin W, Lee GK, Loh JP, Tay EL, Sia W, Lau TC, Hooi SC, Poh KK1. Effectiveness of early cardiology undergraduate learning using simulation on retention, application of learning and level of confidence during clinical clerkships. Singapore Med J. 2015 Feb;56(2):98-102.
- Butter J, McGaghie WC, Cohen ER, Kaye M, Wayne DB. Simulation-based Mastery Learning Improves Cardiac Auscultation Skills in Medical Students. J Gen Intern Med. 2010 Aug;25(8):780-5.
- Fraser K, Wright B, Girard L, Tworek J, Paget M, Welikovich L, McLaughlin K. Simulation training improves diagnostic performance on a real patient with similar clinical findings. Chest. 2010 Sep 9. [Epub ahead of print]
- Hatala R, Scalese RJ, Cole G, Bacchus M, Kassen B, Issenberg SB. Development and Validation of a Cardiac Findings Checklist for Use With Simulator-Based Assessments of Cardiac Physical Examination Competence. Simul Healthc. 2009 Spring;4(1):17-21.
- Jeffries PR, Groom JA, Settle J, Decker SI, Dlugasch, Beach M, OConnell JM, Issenberg SB. Development and Testing of a Cardiovascular Assessment Curriculum Model for Basic to Advanced Practice Nurses. Proceedings of the National League for Nursings Education Summit. Philadelphia, Pennsylvania. September 23-26, 2009.
- Wayne DB, Butter J, Cohen ER, McGaghie WC. Simulation-based Mastery Learning Improves Cardiac Auscultation Skills in Medical Students. Acad Med. 2009 Oct;84(10 Suppl):S94-6.
- Multak N, Scalese RJ. Simulation technology for Physician Assistant training and assessment in cardiopulmonary examination skills. In: Proceedings of the 2009 Physician Assistant Education Association [PAEA] Education Forum (Portland, OR), November 2009.
- Jeffries PR, Groom JA, Settle J, Decker SI, Dlugasch, Beach M, OConnell JM, Issenberg SB. Multi-center Development and Testing of a Simulation-based Cardiopulmonary Assessment Curriculum for Advanced Practice Nurses. Simulation in Healthcare 2009;4(4):265.
- Gordon MS, Issenberg SB, Esterson J, et al. UMedic Curriculum in Cardiology Series 4. University of Miami, 2009.
- Sengupta A, Todd AJ, Leslie SJ, Bagnall A, Boon NA, Fox KA, Denvir MA. Peer-led medical student tutorials using the cardiac simulator 'Harvey'. Med Educ. 2007 Feb;41(2):219.
- Issenberg SB, Scalese RJ. Simulation in Healthcare Education. Perspectives in Biology and Medicince, 51(1):31-46, 2008.
- Scalese RJ, Obeso VT, Issenberg SB. Simulation Technology for Skills Training and Competency Assessment in Medical Education. Journal of General Internal Medicine, 23(Suppl 1):46-49, 2008.
- Hatala R, Kassen BO, Bacchus M, Cole G, Issenberg SB, Does physical examination competence correlate with bedside diagnostic acumen? An observational study. Medical Teacher, 29(2):197-203, 2007.
- Hatala R, Issenberg SB, Kassen BO, Cole G, Bacchus CM, Scalese RJ. Assessing the Relationship between Cardiac Physical Examination technique and Accurate Bedside Diagnosis during and OSCE. Academic Medicine, 82(10 Suppl):S26-S29, 2007.
- Issenberg SB, Scalese RJ, Best Evidence on High-Fidelity Simulation: What Clinical Teachers Need to Know, The Clinical Teacher, 4:73-77, 2007.
Prehospital & Emergency Healthcare
- Brotons AA (Editor), Motola I (Editor), Rivera HF (Editor),Hernandez S (Editor), Esterson J (Editor), Issenberg SB (Editor). Acute Coronary Syndromes and 12-Lead ECG Interpretation Provider Manual. University of Miami Press 2015.
- Motola I, Jacoby Zigman A. Ectopic Pregnancy. In: Rosen and Barkins 5-Minute Emergency Medicine Consult, 5e. Lippincott Williams & Wilkins, Philadelphia. August 28, 2014.
- Miller GT, Brotons AA, Motola I, Issenberg SB. Preparing for the worst: a review of the ADDIE simulation model for disaster response training. Journal of Emergency Medical Services 2010;September.
- Miller GT, Schenk T, Motola I, Brotons AA, Issenberg SB. Development and integration of serious gaming into a prehospital mass casualty triage course. Accepted to the 9th Annual International Meeting on Simulation in Healthcare, January 2009.
- Fernandez R, Vozenilek J, Hegarty C, Motola I, Reznek M, Phrampus P, Kozlowski S. Developing expert medical teams: toward an evidence-based approach. Academic Emergency Medicine, 15(11):1025-1036, 2008.
- Motola I, Brotons AA, Rivera HF, Miller GT, Scott JA, Issenberg SB. Airway Management: Principles and Practice Practical Ski lls and Simulation Training for First Responders. University of Miami Press, 2008.
- Miller GT, Issenberg SB, Gordon DL, Gordon MS, Brotons AA, Scalese RJ. Promoting teamwork in emergency medical services through Advanced Life Support competitions. Society for Medical Simulation. Submitted to 6th Annual International Meeting on Medical Simulation, January 2006.
- Miller GT, Issenberg SB, Scott JA, Brotons AA, Gordon MS. Refresher training recommendations for emergency response to terrorism curricula. Prehospital Emergency Care, 10(4):532, 2006.
- Miller GT, Scott JA, Issenberg SB, Petrusa ER, Brotons AA, Gordon DL, McGaghie WC, Gordon MS. Development, implementation, and outcomes of a training program for responders to acts of terrorism. Prehospital Emergency Care, 10(2): 239-246, 2006.
- Scott JA, Miller GT, Issenberg SB, Brotons AA, Gordon DL, Gordon MS, McGaghie WC, Petrusa ER. Skill Improvement during Emergency Response to Terrorism training. Prehospital Emergency Care, 10(4):507-514, 2006.
- Brotons AA, Scalese RJ, Miller GT, Scott JA, Frometa O, Gordon DL, Gordon MS, Issenberg SB. Emergency Management of Acute Coronary Syndromes: Provider and Instructor Manuals, 5th Edition. University of Miami Press, 2005.
- Scott JA, Issenberg SB, Miller GT, Brotons AA. Fake it: how to create a simulation training program. Homeland First Response, 3(3):12-17, 2005.
- Rosenman ED, Fernandez R, Wong AH, Cassara M, Cooper D, Kou M, Lack TA, Motola I, Parsons J, Levine B, Grand J. Changing Systems Through Effective Teams: A Role for Simulation. Acad Emerg Med. 2017 Jul 20.
- Motola I, Burns WA, Brotons AA, Rodriguez RD, Withum KF, Hernandez S, Rivera HF, Issenberg SB, Schulman CI. Just-in-Time Learning is Effective in Helping First Responders Manage Weapons of Mass Destruction Events. J Trauma Acute Care Surg. 2015 Oct; 79(4 Suppl 2):S152-6.
- Decker SI, Anderson M, Boese T, Epps C, McCarthy J, Motola I, Palaganas J, Perry C, Puga F, Scolaro K, Lioce L. Standard of Best Practice: Simulation Standard VIII: Simulation-Enhanced Interprofessional Education. Clinical Simulation in Nursing. 2015 Jun; 11(6):293-297.
- Golden AG, Silverman MA, Issenberg SB. What medical educators can learn from nurse practitioner training to address the shortage of geriatricians: less is more. Academic Medicine. 2015. 90(9).1-5. [Epub ahead of print]. PMID: 26200581
- Devine LA, Donkers J, Brydges R, Perelman V, Cavalcanti, RB, Issenberg SB. An equivalence trial comparing instructor regulated to directed self-regulated mastery learning of advanced cardiac life support skills. Simulation in Healthcare. 2015. Jul 6. [Epub ahead of print]. PMID: 26154249.
- McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. The history, current status, and future of simulation-based medical education and research. Medical Education. 2015. In press.
- Motola IM, Burns, WA, Brotons AA, Withum KF, Rodriguez RD, Hernandez S, Rivera HF, Issenberg SB, Schulman CI. Just in Time Learning is Effective in Helping First Responders Manage Weapons of Mass Destruction Events. Journal of Trauma and Acute Care Medicine. July 1, 2015. Published ahead of print.
- Issenberg SB, Scalese RJ. Five tips for a successful submission on simulation-based medical education. Journal of Graduate Medical Education. 2014; 6(4): 623-625.
- Roh YS, Lim EJ, Issenberg SB. Effects of an integrated simulation-based resuscitation skills training with clinical practicum on mastery learning and self-efficacy in nursing students. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 2014. http://dx.doi.org/10.1016/j.colegn.2014.10.002
- Rasmussen MB, Tolsgaard MG, Dieckmann P, Issenberg SB, stergaard D, Sreide E, Rosenberg J, Ringsted CV. Factors relating to the perceived management of emergency situations: A survey of former Advanced Life Support course participants' clinical experiences. Resuscitation. 2014 Dec;85(12):1726-31. doi: 10.1016.
- Roh YS, Issenberg SB, Chung YS. Ward Nurses Resuscitation of Critical Patients: Current Training and Barriers. Evaluation & the Health Professions. 2014;37(3):335-348.
- McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB A critical review of simulation-based mastery learning with translational outcomes. Med Educ. 2014 Apr;48(4):375-85.
- Motola I, Devine L, Chung HS, Sullivan J, Issenberg SB. AMEE Guide 80: Practical Guide for Best Evidence Use of Simulation. Medial Teacher.2013; 35(10):e1511-30.
- Chung HS, Dieckmann P, Issenberg SB. It is time to consider cultural differences in debriefing. Simulation in Healthcare 2013;8(3):166-70.
- McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Translational Educational Research: a necessity for effective health care improvement. Chest 2012;142(5):1097-103.
- Issenberg, SB., Chung, HS., Devine, L. Patient Safety Training Simulations Based on Competency Criteria of the Accreditation Council for Graduate Medical Education. Mt Sinai J Med.2011; 78(6):842-53.
- McGaghie WC, Issenberg SB, Cohen ER, et al. Does Simulation-based Medical Education with Deliberate Practice Yields Better Results than Traditional Clinical Education: A Meta-Analytic Comparative Review of the Evidence. Academic Medicine 2011;86(6):706-711.
Stroke / Neurology
- Georgios Tsivgoulis, Salvatore Ascione, Andrea Zini, Estela Sanjuan, Ivette Motola, Nguyen Huy Thang. Three years of Angels: Delivering a vision of Consistent Improvements in stroke care, Internationally. 2019
- Motola I (Editor), Rivera HF (Editor), Brotons AA (Editor), Khan J (Editor), Reynolds PS (Editor). Advanced Stroke Life Support Hospital and Prehospital Instructor, edition 11. University of Miami Press 2015.
- Motola I, Gordon DL, Coleman J, Baker JW, Brotons AA, Miller GT, Rivera HF, Issenberg SB, Gordon MS. Advanced Stroke Life Support for Prehospital and Hospital Providers, v.10. University of Miami Press. 2010
- Gordon DL, Gordon MS, Issenberg SB, et al. UMedic Multimedia Curriculum in Neurology Essential Neurologic Examination, (CD-ROM program). University of Miami, 2009.
- Gordon DL, Gordon MS, Issenberg SB, et al. UMedic Multimedia Curriculum in Neurology Essential Neurologic Findings, (CD-ROM program). University of Miami, 2009.
- Gordon DL, Motola I, Coleman J, Baker JW, Miller GT, Brotons AA, Rivera HF, Issenberg SB, Gordon MS. Advanced Stroke Life Support (10th edition of Emergency Management of Acute Stroke). University of Miami Press, 2008.
- Gordon DL, Issenberg SB, Gordon MS, LaCombe DM, McGaghie WC, Petrusa EP. Stroke training of prehospital providers: an example of simulation-enhanced blended learning and evaluation. Medical Teacher, 27(2):114-121, 2005.
- Obeso VT, Gordon DL, Issenberg SB, Baker J, et al. A Multi-center study to provide evidence of construct validity in computer-based outcome measures of neurology bedside skills. Academic Medicine, 80(10 Suppl):S71-S74, 2005.