Simulation-based medical education

Simulation-based medical education is a powerful tool in addressing patient safety

Update from Prof. Amitai Ziv MD, MHA founder and director of MSR, the Israel Center for Medical Simulation.

Prof. Ziv is a veteran combat pilot in the Israeli Air Force where he was first exposed to simulation-based training. Prof. Ziv is also the director of Sheba’s Rehabilitation Hospital.

MSR, the Israel Center for Medical Simulation was established at the Chaim Sheba Medical Center in 2001. The Center’s purpose is to lead a nationwide effort to introduce new standards and innovative approaches to health care training and patient-safety education for the benefit of the people of Israel. Reports on patient safety (e.g., To Err is Human, the US National Institute of Medicine report, 1999) have indicated that health care is far less safe than it should be, and that medical errors are the third cause of death in the US after heart disease and cancer. Simulation-based medical education has been recognized as a powerful tool in addressing patient safety and quality-care training. MSR is a safe place to err and reflect on our errors.

MSR is designed as a virtual healthcare environment and encompasses the whole spectrum of medical simulation modalities. These include simulated patients (role-playing actors for communication and clinical skills’ training), advanced task trainers (for training of complex manual skills), virtual reality surgical simulators and computer-driven, full-body mannequins, that enable team training for challenging/high risk clinical conditions. State-of-the-art audiovisual equipment and one-way mirror observation booths ensure effective debriefing and constructive feedback to trainees. A central component in the Center’s founding vision was to become a national resource, serving the needs of all sectors of health providers, both professional and in-training, in full collaboration. MSR’s educational approach emphasizes the message of patient safety by focusing its training on crucial safety aspects. These include teamwork, error reduction, transparent debriefing to produce more reflective practitioners, as well as proactive and structured exposure to extreme and challenging clinical conditions.

In response to critical national needs, MSR is heavily engaged in preparing Israel’s medical and military establishments to respond to mass trauma from conventional as well as unconventional threats (chemical and biological). Likewise, MSR trains healthcare professionals in important national communication skills programs, such as Discussions at End of Life with Patients and Families and Improving Patient Experience in Israel’s Emergency and Internal Medicine Departments. Moreover, in collaboration with the 5 Israeli Medical Schools, the Ministry of Health and the major general hospitals, MSR conducts a 4-day intensive hands-on simulation-based training course for all medical school graduates prior to starting their internship. MSR also conducts competence-based board exams for Anesthesiology, Emergency Medicine & Radio-therapy Residents and licensing exams for all advanced nurses in Israel.

Staffed with a dedicated, multidisciplinary team of 60 and equipped with a wide variety of medical simulators, MSR has trained over 220,000 trainees and over 5,500 instructors and raters of various health professions from all over the country in a variety of vital courses and exams. These courses have been carried out in collaboration with major medical institutions, including health professional schools, the Ministry of Health, Israeli Defense Forces Medical Corps, emergency medical services, medical associations, HMO’s, major hospitals, risk management bodies and medical simulation, medical device and pharmaceutical industries.

MSR is currently planning a new facility, which will break ground in the spring of 2020 and will serve the expanding needs of the Israeli healthcare system and in the development of new curriculum, innovative educational technologies and mandatory programs.

MSR (Messer) in Hebrew means a message of value, the value of being humble and well prepared.