The USF Health Center for Advanced Medical Learning and Simulation (CAMLS) first opened 10 years ago in March 2012, where leaders from the community, education, industry, and simulation partners from around the world met for the grand opening in downtown Tampa.

Under one roof, the 90,000 square-foot, three-story facility houses the latest simulation technology and experiences to train the full spectrum of health care professionals as one of the nation’s top medical simulation facilities.

Part of the mosaic of USF Health’s expanded presence in downtown Tampa, CAMLS, is within walking distance of the USF Health Morsani College of Medicine and Heart Institute in the Water Street Tampa urban development district.

CAMLS Grand Opening

“The goal was to build almost a Disney World for clinical providers who could travel from around the world to CAMLS to train with the best technology using simulation, incredible bio skills, fully realistic labs so that they can improve their procedural and clinical skills and then go back to their work and give the best practices both from USF Health experts but also utilizing the latest and greatest technology,” said Dr. Yasuharu “Haru” Okuda, MD, FACEP, FSSH, executive director for USF Health CAMLS and associate vice president for USF Health Interprofessional Education and Practice.

Until recently, CAMLS focused solely on training biomedical businesses and health care professionals. However, that initiative has expanded over the years to offer hands-on simulation training to USF Health students and faculty dedicated to advancing their clinical skills and improving patient safety and quality of care in Tampa Bay, Florida, the U.S., and the world.

“In the beginning, this advanced medical learning simulation was really focused around businesses and training and teaching health care professionals. But over the years, we’ve really evolved into a place where we conduct research in even more advanced training and education, like in virtual reality and augmented reality. We also now impact our future health care professionals by training students from our College of Medicine and College of Nursing both separately and as part of interprofessional teams,” Dr. Okuda said.

Dr. Charles Lockwood and USF President Rhea Law.

USF President Rhea H. Law and Charles Lockwood, MD, MHCM, senior vice president for USF Health and dean of the Morsani College of Medicine (MCOM), have been active participants and contributed greatly to the success of CAMLS. President Law has been on the board of directors over the years and has continued to support the organization. Meanwhile, Dr. Lockwood has helped support the efforts of CAMLS around education, research, and innovation.

EMS instructors participated in a training class hosted by the USF Health CAMLS at the Pinellas County EMS Training Center.

Recently, CAMLS has been working on a new community outreach program called “CAMLS Without Walls.” The program was developed so the facility could go out into the community and deliver training through simulation-based education.

“The future of CAMLS is really bright,” Dr. Okuda said. “We have some incredible partnerships with startup companies in Tampa, where we’re building on our business relationships to innovate in areas such as virtual reality and augmented reality. We are also building our research teams to identify new technologies for training and education, and we’re publishing articles on that research. Now we are building a mobile training program called “CAMLS Without Walls,” so we are not bound by training only within CAMLS but can now go out into our community and deliver the training in hospitals in our rural environments and bring USF Health Expertise to places that need it the most.”

Story and video by Ryan Rossy, USF Health Communications and Marketing

The USF Health Morsani College of Medicine Office of Student Diversity and Enrichment (OSDE) recently hosted a group of seniors from Tampa Bay Technical High School for a five-day immersive health care experience at the Center for Advanced Medical Learning and Simulation (CAMLS).

USF Health Morsani College of Medicine hosted 23 seniors from Tampa Bay Technical High School’s Academy of Health Professions for a five-day hands-on learning experience at CAMLS.

OSDE and the USF Health Experimental Learning Lab collaborated to provide clinical simulations for Tampa Bay Tech seniors.  Students participated in four modules including abdominal, cardiac, pulmonary, and neurological diagnosis before participating in an all-encompassing experience on the final day.  Additionally, students worked with patient actors to learn how to take medical histories of patients, and reach a diagnosis of their simulated ailments by asking relevant questions, monitoring body language, and applying all of the knowledge they’ve learned through the week to reach their conclusion.  Arun Roy, a Tampa Bay Tech senior and future University of South Florida student, described the experience as one of the most enlightening and informative experiences since he originally took an interest in pursuing a career in health care.

Arun Roy, Tampa Bay Tech senior, works the ultrasound probe with Josh Shultz, MCOM fourth-year medical student, during a five-day hands-on experience facilitated by the MCOM Office of Student Diversity and Enrichment and CAMLS.

“The hands-on learning and informational sessions from the students, faculty and staff were the best part of this experience,” Roy said. “I came with the expectation to learn something new every day and this experience didn’t disappoint me.  I look forward to staying in communication with the [OSDE} team and continue diving in to the details of what it means to have a career and health care.”

Fourth-year medical students served as instructors and mentors to the students.  Josh Shultz, one of the medical student volunteers, was impressed with how smart and intuitive the students were throughout the week.

“This is something I wish I had in high school,” Shultz said. “This is an incredibly bright group of students that have the advantage of participating in a great program like the one they have at their school and getting this opportunity for some hands-on learning.”

Cynia McDonald-McCall and Jonathan Figueroa, Tampa Bay Technical High School seniors, conduct a patient interview with a patient actor during the final day of a five-day hands-on experience facilitated by the MCOM Office of Student Diversity and Enrichment and CAMLS.

The MCOM Office of Student Diversity and Enrichment is dedicated to promoting an environment that welcomes and embraces diversity in the student and resident population in the medical school. The partnership between the high school and MCOM aims to help students persist in their pursuit of a career in the health professions.

“Medical schools across the country develop programs and services aimed at improving the diversity of the health care workforce. A workforce that is reflective of the population leads to better patient outcomes,” said Shirley Smith, OSDE director.

Additional images from the week:

Haru Okuda, MD, wears many hats at USF Health—and now he can add podcaster to his list.

“It’s really wonderful to be able to bring in my interest and my day-to-day work using simulation to train teams and go outside what’s in textbooks to interview folks with practical real-world experience,” said Dr. Okuda, who is executive director of the USF Health Center for Advanced Medical Learning and Simulation and assistant vice president of the Office of Interprofessional Education and Practice.

“Healthcare Superteams” is a podcast featuring conversations with both healthcare and non-healthcare experts on how to incorporate seamless communications and high-functioning teamwork into healthcare to improve patient safety, patient and provider satisfaction and health outcomes and to reduce health costs.

Dr. Okuda started the podcast in October 2020 with the first season featuring people outside of healthcare discussing best practices that could be used in healthcare. Season two focuses on how diversity strengthens teams as well as some of the challenges faced when adding diversity to a team. Season three will start recording in early 2022 with a focus on mental health in teams.

The podcast, which is sponsored by Tampa General Hospital, is found on most podcast platforms. It’s currently available in more than 40 U.S. states and 30 countries.

Listen to the podcast: health.usf.edu/ipep/podcast

Inside four bustling rooms at USF Health Center for Advanced Medical Learning and Simulation (CAMLS), emergency medicine residents from USF Health, emergency nurses from Tampa General Hospital, and paramedics from Tampa Fire and Rescue worked together in simulation exercises to improve how they work as a team during intense emergency situations. Over the course of the day, the residents rotated through four scenarios: a patient with undifferentiated chest pain, a 5-year-old with complications from a snakebite, an infant with an unstable abnormal heartbeat, and a patient in cardiac arrest.

Ryan McKenna, DO, director of the interprofessional simulation fellowship at USF Health CAMLS and director of simulation for Emergency Medicine, guides participants through the snakebite simulation.

A team of emergency medicine residents from USF Health work together to help a manikin with undifferentiated chest pain.

The interprofessional team involved in the cardiac arrest simulation, practiced the process and communication of the transition from the pre-hospital team to the emergency department. This scenario was intentionally cut short after the first five minutes as a part of its educational design, also called scaffolding, said Ryan McKenna, DO, director of the interprofessional simulation fellowship at USF Health CAMLS and director of simulation for Emergency Medicine. The goal of this kind of teaching method is to make the information more manageable to retain by breaking up the lesson into segments. Not only does scaffolding avoid students becoming overloaded, but it also allows learners to identify subtle ways to improve that might be missed in a larger scenario.

“When you have focused efforts, you have a chunk of a component of that training that can now be brought into clinical practice and everyone has the same mental model and is applying it in the same way,” said Yasuharu “Haru” Okuda, MD, FACEP, FSSH, executive director of CAMLS and executive director of interprofessional education simulation programming for USF Health.

Paramedics from Tampa Fire and Rescue helped to bring the cardiac arrest simulation to life.

During one of the run-throughs of the cardiac arrest simulation, an observing resident noticed that the nurse performing chest compressions on the manikin might benefit from standing on a nearby stool to improve her ability to perform compressions. He brought it over to her and placed it by her feet, but the message about the height-assistance was lost in the chaotic sounds of the emergency department and she did not notice the stool was there until the end of the simulation. That is just a simple example of the kind of communication gaps that can result in a missed opportunity or medical error in a hospital and it’s a small area for improvement that would have been missed in a more complex simulation. Many of the residents reported back to Dr. McKenna that they were already using the skills they learned to improve the hand-off in the subsequent days following the simulation-based training.

An interprofessional team including emergency medicine residents from USF Health, emergency nurses from Tampa General Hospital, and paramedics from Tampa Fire and Rescue, came together for simulation-based training.

In November 1999, the Quality of Health Care in America Committee of the Institute of Medicine (IOM) released a report called To Err is Hu­man: Building a Safer Health System that stated as many as 98,000 hospital deaths occur each year due to medical error. Communication error is described as the cause of 60% to 70% of those preventable hospital deaths.

“We’ve done a lot of amazing things in technology and medical knowledge and science, but I think one thing that we haven’t done well enough in health care is really learning to work together in teams,” Dr. Okuda said.

Twenty years after the IOM’s report, the statistics are still alarming. In an effort to make life better and combat medical errors, USF Health incorporates interprofessional education as a primary part of its curriculum.

“Especially in the ER, it’s a team discipline,” said Kelsey Hundley, MD, second-year emergency medicine resident with the USF Health Morsani College of Medicine. “Learning how to interact with people with different backgrounds and roles on the team is really important.”

Kelsey Hundley, MD, second-year emergency medicine resident with the USF Health Morsani College of Medicine, works with her team to help the infant with an unstable abnormal heartbeat.

Simulation exercises as a part of interprofessional education allows participants to practice in a realistic but safe environment, both for the learners and for the patients.

“It was a pretty enjoyable experience,” said Adam Koby, MD, second-year emergency medicine resident with the USF Health Morsani College of Medicine. “We see these scenarios all the time in real life, but there’s always the opportunity to improve and I feel the way that you would improve the most is to practice those situations. During these simulations, we learn about individual pathologies, but more importantly, about team building.”

Adam Koby, MD, second-year emergency medicine resident with the USF Health Morsani College of Medicine (right), listens to Dr. McKenna during the debrief of the snakebite simulation.

When the various medical professions came together and were working in a training environment, “I saw smiles, energy and enthusiasm and I’ll bet you, for many of these folks, they won’t forget this,” Dr. Okuda said. “They shared the passion and I think coming together outside the clinical environment often builds stronger teams. So beyond just the training, there are the personal connections and the bonds that were created through this environment and interaction.”

Participants shared laughs and smiles during the simulation-based training held at the USF Health Center for Advanced Medical Learning and Simulation.

USF Health Center for Advanced Medical Learning and Simulation (CAMLS) faculty and staff took their expertise – and their technology – to Pinellas County to give emergency medical service instructors hands-on practice they could then take back to first-responders across the county.

The “train the trainer” exercise was offered by the USF Health CAMLS, to Pinellas County EMS instructors for three days as a part of a new community outreach program. EMS instructors from across Pinellas gathered for an all-day instructor development class led by Yasuharu “Haru” Okuda, MD, FACEP, FSSH, USF Health CAMLS executive director and USF Health executive director for interprofessional education and practice, and Ryan McKenna, DO, fellowship director, the interprofessional simulation fellowship at USF Health CAMLS and director of simulation, Emergency Medicine. The course focused on how to properly use and troubleshoot the technology and the best practices for simulation-based education.

Dr. Haru Okuda, MD, FACEP, FSSH, USF Health CAMLS executive director and USF Health executive director for interprofessional education and practice, taught the EMS instructors how to program and use the computerized mannequins to simulate various medical emergencies when teaching classes of their own.

“Simulation-based education is well-known to be very valuable in emergency medical services and emergency medical care in general, and we are excited to have the expertise of the USF Health CAMLS staff here to help us do a train-the-trainer,” said Angus Jameson, MD, MPH, USF Health affiliate associate professor of emergency medicine and medical director for Pinellas County EMS.

The EMS instructors gathered into two groups and ran through various scenarios with their mid-fidelity Gaumard ^®manikins. Hidden behind the television monitor used to display vital signs, Dr. Okuda and Dr. McKenna began the first round for their teams by acting as the patient, or the voice of the manikin. After a debrief, the instructors got a chance to play the roles of patient, family, and learners, while some served as facilitators who ran the simulation software.

During debrief, Ryan McKenna, DO, fellowship director, the interprofessional simulation fellowship at USF Health CAMLS and director of simulation, Emergency Medicine, goes over best-practices with the participating EMS instructors.

Shawn Tatham, EMS training coordinator for Pinellas County said, “in simulations, we can slow things down a little bit, we can get them into a structured assessment pattern and ensure that they’re doing their treatments according to our standardized protocol, and we can create a nice learning environment so they can go out and apply that for the best patient care.”

At the end of the scenario-based training, the EMS instructors will take what they have learned and apply it to their continuing education training with emergency medical technicians and paramedics across the county.

Andre Nelson, certified healthcare simulation operations specialist at USF Health CAMLS, helps EMS instructors with the behind-the-scenes technology that controls the manikin.

Video by Torie Doll and photos by Allison Long

First-year students from the USF Health Morsani College of Medicine, College of Pharmacy and Athletic Training Program came together Oct. 16 and 18 at the Center for Advanced Medical Learning and Simulation (CAMLS) for a team simulation training involving 20 standardized patients portraying college soccer players suffering from compound leg fractures.

The simulation scenario starts with interdisciplinary teams triaging and stabilizing injured soccer players and transporting them to the emergency room.

In their first interprofessional education (IPE) experience, students broke into small groups, each overseen by a faculty preceptor. Each multidisciplinary team was assigned one soccer player to learn the transitions of care, from triaging a critical injury to rehabilitation.  Starting with stabilizing the injured soccer player on the field, the students worked together to transport the athlete to the emergency room, and then followed the patient to surgery, to the hospital floor, and finally to physical therapy. The IPE training also allowed students to explore the various roles and different strengths of health care professionals who care for injured college athletes.

“The overall goal is to have good communication between teams of health care providers,” said Dawn Schocken, PhD, MCOM director of Experiential Learning and Simulation. “No one takes care of patients in a vacuum anymore. Being able to rely on health care providers across multiple disciplines is the key to getting the best possible outcome for the patient, and that’s the message we are trying to teach.”

In the emergency room at CAMLS, team members pass along detailed information about the patient to help ensure the surgery team can make the best treatment decisions.

To complete the transition of care simulation, the physical therapy team follows up the with standardized patient post surgery and offers recommendations on rehabilitation.

Teams of students debrief with their faculty preceptors to discuss lessons learned from the simulation.

Video by Fredrick J. Coleman, and photos by Eric Younghans, USF Health Communications and Marketing