With virtual and augmented reality becoming more prominent, the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) is expanding its research efforts to explore the use of virtual and augmented reality in medical simulation training. 

“Traditionally, health care simulation has been actors, task-trainers, and mannequins. Virtual reality allows us to be fully immersed in an alternate world and that world can be an operating room, an outpatient clinic, or an ambulance, and be changed quickly. You will really feel like you’re there, which is challenging to do in a simulation center.” said Yasuharu “Haru” Okuda, MD, FACEP, FSSH, executive director for USF Health CAMLS and associate vice president for USF Health Interprofessional Education and Practice.

As the research mission at CAMLS develops, the goal is to easily export its virtual medical simulation trainings to different parts of the world so other medical professionals can take advantage of the research expertise there.

“You can connect to VR training scenarios from anywhere. You will be able to bring it to your home, bring it to your classroom, and conduct a training within only a headset that is just as powerful as anything in person,” Dr. Okuda said.

Shannon Bailey, PhD, Sr. Human Factors Scientist for USF Health CAMLS and assistant professor for the Department of Medical Education at the Morsani College of Medicine.

To help expand its research efforts, CAMLS hired a PhD, tenure-track researcher, Shannon Bailey. She has over 10 years of experience designing and testing extended reality (XR) training simulations and educational games. In her research, she explores how augmented, virtual, and extended reality technology can be used to inspire effective student learning through adaptive training and natural user interfaces.

Before coming to CAMLS, Dr. Bailey worked for the Naval Air Warfare Center Training Systems Division (NAWCTSD). After gaining extensive experience in military simulation training, she transitioned to the field of medical simulation training as a researcher director for a technology company called Immertec, which develops medical simulation training to impact how medical professionals learn.

“This research is important because it is moving the field forward by systematically testing different ways to approach simulation training and finding ways to optimize the training for both the learner and the medical professionals, which could lead to better outcomes for patients,” said Dr. Shannon Bailey, assistant professor for the USF Health Morsani College of Medicine.

“VR at CAMLS will not replace real-world mannequin-based training,” Dr. Okuda said, but offering a resource to those who lack access to high-fidelity simulation centers allows them to experience the same level of training and experience in a virtual environment. 

“We are thrilled to have Dr. Shannon Bailey as our first PhD tenure-track researcher at CAMLS. What she brings to CAMLS is the ability for us to really lean into this area of extended reality and then apply it into a health care academic setting,” said Dr. Okuda. 

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

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

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

The research teams will use Immertec’s live virtual reality (VR) platform to train USF Health resident physicians in critical emergency scenarios as a part of their overall graduate medical education, measuring learning outcomes and user experience.

TAMPA, Fla. (August 17, 2021) – Immertec, a medtech startup company, and the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) were recently awarded a $150,000 Small Business Innovation Research (SBIR) grant from the National Institutes of Health (NIH) through the National Center for Advancing Translational Sciences (NCATS) to examine the effectiveness of training emergency medicine physician residents using Immertec’s virtual reality (VR) platform.

The NIH-funded research will allow Immertec to conduct an experiment in collaboration with USF Health CAMLS to assess the feasibility of live VR training for specific medical tasks carried out by emergency medicine residents from the USF Health Morsani College of Medicine. The immersive experience will allow remote professionals from any location to wear the VR headset and train as if they are in the room, with access to timely medical feeds, including X-rays, vitals, and endoscopic cameras.

Medical simulation training with an expert instructor is known to improve patient outcomes, yet expertise and resources are not always available at the point of need. And with limitations on face-to-face instruction, educators previously relied on 2D teleconferencing technology for telementoring, which is limited by lack of depth and field of view.

Immertec’s technology enables medical professionals to train immersively from a remote location by streaming real-time stereoscopic video of the clinical setting to a VR headset. The stereoscopic video provides additional visuospatial information, including multiple medical feeds, compared to 2D displays, providing a greater feeling of immersion while training.

This study will compare Immertec’s live VR training platform to traditional 2D teleconferencing technologies and determine how it impacts the quality of learning, training outcomes, and user experience of remote learning.

The research effort will be led by Shannon Bailey, PhD, human factors scientist at Immertec and principal investigator on this grant, and will be in collaboration with USF Health CAMLS, led by Haru Okuda, MD, executive director of CAMLS, assistant vice president of the USF Health Office of Interprofessional Education and Practice, and professor in the USF Health Morsani College of Medicine.

“The research conducted in collaboration with USF Health CAMLS will provide empirical evidence on how immersive remote technologies compare to traditional telementoring methods in medicine. We look forward to leveraging the extensive knowledge of the USF Health team and CAMLS’ state-of-the-art facility to better understand how to improve our technology to train medical professionals,” Dr. Bailey said.

Such collaborations between industry and academic medicine have the potential to accelerate innovations for improving healthcare education and ultimately patient outcomes.

“We’re excited to collaborate with an innovative startup like Immertec,” Dr. Okuda said. “We believe strongly in the potential of immersive training technology and now have the opportunity to conduct research to better understand how virtual reality can change the way medical professionals learn in today’s climate.”

Immertec’s platform includes a desktop portal that allows companies and organizations to schedule training events, a mobile app that allows attendees to register for events and request a VR headset, and a hardware camera cart present in a clinical setting to stream live content. Immertec’s platform allows medical professionals to be immersed in a live clinical setting, communicate with attendees, and view multiple medical feeds while wearing a VR headset from a remote location.

USF Health CAMLS, located in downtown Tampa, Florida, is one of the world’s largest, free-standing simulation facilities exclusively dedicated to training healthcare professionals. The CAMLS facility is a 90,000-square-foot, three-story facility that provides a state-of-the-art, high-fidelity clinical environment that includes surgical skills labs, operating trauma suites, and patient exam rooms.

The first phase of the research project will validate Immertec’s immersive technology in medical training and provide empirical evidence of the technical and scientific merit of this remote training approach for future commercialization in the health care field.

Images highlighting the technology that will be used in the study, courtesy of Immertec:

On-site at CAMLS, Dr. Luis Llerena demonstrates a procedure on a mannequin while camera and audio equipment record and send the info to trainees on the program.

A trainee uses the VR headshot and controls to participate in Dr. Llerena’s demonstration.

The viewpoint within VR headset include visual, data, and interactivity options.

Cross-discipline and inter-agency efforts are likely to have the greatest impact on the current opioid epidemic. That was the take-away message at this year’s USF Health Interprofessional Education Day, focusing on the opioid crisis and held Nov. 13.

To a capacity crowd in the USF Marshall Student Center’s Oval Theatre, experts and advocates from across the region offered insight on the impact opioids have on our communities and how health care teams can work together to offer better identification, better treatment and better outcomes.

IPE Day is meant to help professionals across multiple disciplines work more effectively together to improve the outcomes of patients, said Haru Okuda, MD, FACEP, FSSH, Executive Director, USF Health, CAMLS; Executive Director, USF Health Interprofessional Education and Practice.

Dr. Haru Okuda.

“Today’s theme is really about getting to know each other,” Dr. Okuda said. “Traditionally over the years, many of our health care disciplines worked in silos. Working together is the only way we can truly have an impact.”

Dr. Okuda, along with Terri L. Ashmeade, MD, MS, CPHQ, Chief Quality Officer and associate dean for Continuing Professional Development for USF Health, moderated panel sessions with experts who offered a range of expertise and experience.

Charles J. Lockwood, MD, MHCM, senior vice president of USF Health and dean of the USF Health Morsani College of Medicine, offered welcoming remarks and set the stage for the day’s interaction.

Dr. Charles Lockwood.

“At USF Health, we have named interprofessional education a core value, because we truly believe that every person, regardless of their discipline or unique expertise, benefits by learning together and working alongside colleagues from other professions,” Dr. Lockwood said. “Teams perform much more effectively than individuals do, and the more diverse the teams, the more effective they are. A more comprehensive, team-based approach is needed to eradicate opioid addiction once and for all. We owe it to all of the victims and all of the families that are affected to do everything we can.”

City of Tampa Mayor Jane Castor gave the keynote address. Her 31 years in local law enforcement and experience as Tampa police chief gave her a unique perspective of the overall law enforcement system, learning early on that the system could not handle drug crime alone. After sharing harrowing stories of drug crime since the 1980s, Mayor Castor said the takeaway was “clearly, trying to arrest our way out of this problem was not the answer.”

City of Tampa Mayor Jane Castor.

“Law enforcement, USF and other community partners will have to work together from a variety of approaches in order to make progress in this issue,” Mayor Castor said. “We must approach addiction in a variety of ways, identifying physiological and psychological causes, as well as taking steps to avoid putting people in addictive situations. Interprofessional education is the key if we want to make a difference in this community. Events like IPE Day bring professionals and experts from across disciplines together, so that we can tackle the opioid crisis in a meaningful way, from a 360 degree approach. We must all recognize that opioid addiction is a national crisis and it does not discriminate between race, sex, or socioeconomic class. Drug addiction destroys families and lives. In the final analysis, effectively addressing the opioid crisis is going to take our entire community.”

The morning session included two panels. The first included experts giving insight into the current crisis. A local judge, a former nurse who was addicted to drugs, a mother whose son accidentally overdose, and a supervisor of health services for the school system.

From left, Jack Stem, Dr. Maria Russ, Judge Thomas Palermo, and Cindy Grant.

The second session delved into how professionals across multiple, varying disciplines can pool their talent and resources to take this crisis head on. See below for an overview of panelists’ remarks.

Kenneth Petrillo, Dr. Troy Quast, Dr. Belinda Hurley, Katherine Drabiak, and Dr. Maya Balakrishnan.

A pharmacist and an attorney, Sarah Steinhardt, PharmD, JD (Esq.), MS, assistant professor in the USF Health Taneja College of Pharmacy, provided an overview of how current and pending law affects how effectively interdisciplinary teams can impact the opioid epidemic, as well as guidance on best practices for working in interdisciplinary teams.

Dr. Sarah Steinhardt.

“Keep in mind that the patient is your most important concern,” Dr. Steinhardt said. “You have to think about the patient first, and what is the best thing to do for the patient. In terms of collaborative leadership, we want everyone to take responsibility with your place on the team. Know that you have an important role. And know who’s on your team, what they can do… I challenge you students, I want you go out into your practice settings to be good role models. Be someone so that when they look at you, they’re going to say ‘this person understands what I do. This person values me and respects my feedback. This person is open to new ideas. This person is intellectually intelligent and emotionally intelligent. And this person came from USF.’“

USF President Steven C. Currall, PhD, urged the audience of more than 1,000 to take immediate action to work together to help quell the tragic impact of opioid addiction.

Dr. Steve Currall.

“What you’ve heard this morning is a call to action,” Dr. Currall said. “Across our region and our country, the tragic realities of opioid addiction are driving us to find innovative approaches that go across all disciplines. This event is designed to break down silos, which prevent advancement of new and innovative approaches to address issues like opioid addiction. It shouldn’t take a crisis to bring us all together. Today I want to encourage you to continue to work together across professional boundaries and learn from each other to develop outstanding interventions that benefit our patients, our families, and our communities across the region.”

An afternoon session was for students from USF Health colleges and included an exercise for them to put into action some of the details they heard in the morning session. The group was divided into teams, each receiving a case study and tasked to create a systems map to offer a 3-dimensional model for showing how patients might navigate the health system and community resources.

The winning team!

FIRST PANEL: The Impact of the Opioid Epidemic on Our Community

“On stigma, the first thing we can do is change the language we use. Don’t call them the addict. Use person-centered language. We want to refer to them as people with a substance use disorder. They are patients, they are not addicts. They are people. They are human beings. They are your brother, your sister, your mother, your father, your cousin, your aunt. They are every-day people.” by Cindy Grant: executive director of the Hillsborough County Anti-Drug Alliance (HCADA) and serves on several Boards and Councils in the Tampa area, including NOPE of Hillsborough and MADD Hillsborough. In 1997, Grant’s son, Dan, died from an accidental overdose at the age of 19. In honor of his memory, she has devoted herself to substance abuse prevention.

“One of the biggest difficulties we have, there isn’t really a course of treatment for substance abuse available to me as a dependency judge…There’s not a lot of good data that any of the substance abuse treatment programs that are out there actually work…Things that frustrate me or things I wish I could do differently or better is to have some sort of tool available to me where I could more effectively help parents with their substance abuse problems, so whatever I could do to save some of the kids I’m seeing.” by Judge Thomas Palermo: Circuit Judge presiding over a juvenile dependency division, involving abused and neglected children and frequently the abuse of licit and illicit drugs, including all opioids. Prior to serving as a judge, Palermo served as a federal prosecutor and had strategic and tactical anti-opioid responsibilities as the MDFL District Opioid Coordinator. He also recently wrote an article for the American Bar Association entitled “The Opioid Crisis.”

“People continue writing multiple prescriptions. It’s a problem when we have 3-year-olds with opioids in school – we give out a million pills in schools…We need to look at a bigger picture with what we do…We can all get involved with the schools. They’re hungry for that…We work in interdisciplinary teams, so we’re not just working with the individual students, we’re working with families, with (USF Health Morsani) College of Medicine and Tampa General…I appeal to you that, when you go back to your communities, make sure you’re involved. Think outside just your patients. It’s bigger than just your patient. You have to reach your community because it will affect you one way or another.” by Maria Russ, PhD, APRN, CPNP, is the supervisor of School Health Services for Hillsborough County Public Schools and a visiting professor at Chamberlain University, with 25 years of nursing experience. A fellow in the National Association of Pediatric Nurse Practitioners, Russ is a published presenter on the health and safety of the school-age child and adolescent.

“One of things I discovered as a dependence counselor is that health care professionals are a pain in the butt to treat because they think they have the answers. But what I discovered is that you don’t think your way out of this disease…People need treatment. It’s a chronic disease. You don’t go into treatment for 28 days and you’re fixed. I have to do something every day to make sure I’m clean and sober. I’m 24-plus years clean. I’m looking forward to the day when we can expect people to recover…It’s a chronic, progressive disease that kills you if you don’t get treatment. There are no other options than jail or dead…This is a human issue and we need to treat people as humans.” by Jack Stem, CDCA, CRNA (Ret.), is the program manager for the University of Cincinnati Grant overseeing the Opioid Use Disorder Consortium in Highland County, Ohio. He is also a chemical dependency counselor, former emergency room nurse, and Certified Registered Nurse Anesthetist. Stem brings a unique perspective as a recovering opioid addict dealing with the disease of addiction. He is a national speaker and presenter on Substance Use Disorders.

SECOND PANEL: An Interprofessional Response to the Opioid Crisis

“I’m passionate about improving the care we provide mothers with substance use disorder and babies who are experiencing NAS. From a local perspective, we’ve used quality improvement and the power of interprofessional teams to address that. With quality improvement methods, locally, we’ve tried to standardize management of these infants. From an interprofessional nature, we formed a diverse interprofessional committee to address this locally, involving everyone, from physicians to nurses to occupational therapists to lactation specialists, and we have community partners on our teams. By doing that, we are able to gain perspectives from all of these different stakeholders, and were able to address in a comprehensive way how we could better the lives of these babies and moms while they were in our care…We were able to use what we learned locally and at Tampa General Hospital and USF Health Pediatrics and were able to spread it throughout the state.” by Maya Balakrishnan, MD, CSSBB, is an associate professor of pediatrics at the USF Health Morsani College of Medicine and a certified Six Sigma Black Belt, teaching statewide interprofessional health care quality improvement courses. She serves as a Process Improvement Specialist at Tampa General Hospital, director of Quality and Safety for the USF Graduate Medical Education, and associate director of Clinical and Quality Management for the Florida Perinatal Quality Collaborative.

“When we’re talking about substance use disorder, we have to change the conversation of how we’re looking at it, not just as a disease but as something we can recover from…We need to ask whether the policy of pushing one type of treatment for all patients is the best policy. These are questions we have to ask. Is this type of treatment best for all patients?…Are we treating with compassionate care if the treatment isn’t working?” Katherine Drabiak, JD, is an assistant professor at USF College of Public Health and USF Health Morsani College of Medicine, and a co-director of the Law and Medicine Scholarly Concentration Program in the Morsani College of Medicine. Drabiak’s teaching and research is focused on health law, public health law and medical ethics. She is a published author and consultant in the areas of research ethics and clinical ethics.

“Over the past seven years of working with the VA, I’ve see a lot of changes in how we approach pain and treatments. I’m coming from the conservative side of treatment… so if opioids are banned then what is the answer to treating pain? From my point I see the conservative treatment, so if the pills aren’t the answer, trying to instill veterans and patients the active coping strategies to help them get through what they’re going through. Pain isn’t an easy thing to go through…trying to instill in them that pain is normal but we need to help them cope with that in an active manner versus turning to more passive coping strategies of avoidance…I’ve seen the shift from more of a biomedical focus, the find-it-fix-it model, to the more bio-psycho-social model, trying to take into consideration everything that’s affecting their lives and how we can actively help these veterans and patients who have pain.” by Belinda Hurley, PT, DPT, OCS, TPS, is a board-certified clinical specialist in orthopedic physical therapy at James A. Haley Veterans’ Hospital. She serves as faculty for the American Board of Physical Therapy Residency and Fellowship Education accredited PT Orthopedic Residency Program, and works as the primary physical therapist on the inpatient and outpatient Chronic Pain Rehabilitation Programs interdisciplinary team.

“We’re not going to arrest ourselves out of this problem. You can arrest people and you can put them in jail and it’s not solving the root of the problem, and all the things your doing is making it worse for this individual…We respond out to every single overdose citywide, 24 hours a day, seven days a week… One of the biggest issues I saw, more of an internal issue, was changing the culture in law enforcement…we thought it wasn’t a law enforcement issue, it was a medial issue. So we’ve had to change the culture of law enforcement over the past couple of years to explain to new officers that this is a law enforcement issue. It’s an issue we need to be involved in and it’s an issue we need to investigate like we would investigate a homicide because, in all reality, an overdose is to some extent, an attempted homicide…so changing the culture has been one of my biggest issues, trying to educate and get it out to the street officers on how they need to respond to these types cases and that they need to investigate it as a crime and not just a medical issue. The greatest thing I’ve seen so far is the relationship that we’ve developed with a lot of the ER nurses…We’re building the interprofessional relationships with the hospitals is fantastic.” by Kenneth Petrillo is a corporal in the Violent Crimes Bureau with more than 23 years of law enforcement experience. In July 2018, Petrillo was tasked to lead the newly formed Opioid Task Force. Previously, he worked in Patrol, Juvenile Investigations, K-9, and Undercover Street Crimes, among others.

“In areas that higher rates of opioid prescriptions, they have higher rates of child removals…In terms of looking at data, I think that’s a big issue here. In monitoring programs and how those have been rolled out around the country, we’ve seen differing levels of success with them … So I think it’s going to be very important to use data to try to answer those questions. Unfortunately, there is not a great single measure of opioid use that we can point to and say that’s what I’m going to use. Even with death counts, there’s a paper in review right now that would say that those death counts aren’t entirely accurate. So for us to say this policy is working, this policy is not it’s important to look at an array of measures to try to get inside of that…In terms of health care utilization, the issue of well-care is why we’re seeing first-hand that resources need to be devoted to treating overdoses and also treatment programs. Keeping up with policies is definitely a challenge.” by Troy Quast, PhD, is an economist whose research interests include the impact of economic conditions on health status, Medicaid policy, and the impact of natural disasters on health status and the utilization of health services. He was awarded research funding by the National Institutes of Health to examine the treatment of children displaced after Hurricane Katrina.

Video by Torie Doll, photos by Freddie Coleman, USF Health Office of Communications

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.

Called the Women’s Health Mini Residency Program, the sessions will help prepare VA health care teams who treat our nation’s women Veterans.

USF Health CAMLS (Center for Advanced Medical Learning and Simulation) was selected by the U.S. Department of Veterans Affairs to be the dedicated facility to host sessions that train VA health care providers from across the country who treat women veterans.

In the five-year agreement with the VA, CAMLS is hosting VA health providers up to twice yearly for training focused on breast and pelvic health, when more than 300 physicians, nurse practitioners and other health professionals travel to Tampa to tap into the expertise offered at CAMLS, including team training facilities, standardized patients and simulation training.

Called the Women’s Health Mini Residency Program, the effort is meant to bolster the expertise of the VA’s primary care health teams for a range of medical needs specific to women veterans.

In a press release sent out earlier this week, VA Secretary Robert Wilkie said: “More women Veterans are choosing VA for their health care than ever before. This mini residency program provides a unique learning opportunity for our clinical teams while addressing the extraordinary growth in VA services to women Veterans.”

Dr. Haru Okuda shares details about CAMLS and the Women’s Mini Residency Program with local reporters.

“We are proud that the VA has tapped into the expertise here at USF Health and at CAMLS for their efforts to enhance care for women veterans,” said Haru Okuda, MD, FACEP FSSH, executive director of USF Health CAMLS, executive director of USF Health Interprofessional Education and Practice, and professor in the Division of Emergency Medicine in the USF Health Morsani College of Medicine.

“For CAMLS, for USF Health, and for the greater Tampa Bay region, this is a significant achievement. We are now the national training site for incredibly important training for the coming five years, when health providers in VA medical facilities and clinics from across the country will train at USF Health CAMLS so they can return to their facilities to provide enhanced care for our increasing population of our nation’s women veterans.”

The number of women serving in the military is growing significantly, and a flagship training program is key in VA’s effort to have a workforce prepared to care for women Veterans, said Christine Kolehmainen, MD, director of Women’s Health Education, Women’s Health Services for the Office of Patient Care Services/Veteran Health Administration.

Dr. Christine Kolehmainen, director of VA Women’s Health Education, is interviewed about the Women’s Mini Residency Program hosted at CAMLS.

“Women veterans is the fastest growing veteran population in the VA and accounts for 30 percent of all newly enrolling Veterans,” Dr. Kolehmainen said. “Since 2001, women veterans seeking care within the VA has grown 200 percent from 160,000 to over 500,000 patients. The Women’s Health Mini Residency Program is part of VA’s continued effort to provide cutting-edge health care to the ever-increasing number of women Veterans seeking VA health care. The facilities at CAMLS, including their standardized patients, are invaluable to these trainings and are often cited on evaluations as the best part of the training.”

Central to the success of these training sessions are the standardized patients offered through CAMLS. Gynecologic teaching associates (GTAs) are specially trained standardized patients who helps facilitate medical scenarios during medical histories and examinations for these VA training sessions.

Barb Palmer, deputy field director for Women Health Services, describes the standardized patients used in the VA training.

“GTAs are such a critical component of this training,” said Barb Palmer, deputy field director for Women Health Services at the Veterans Affairs Central Office. “Their efforts contribute significantly to improving providers’ ability to perform or assist with a breast and pelvic exams and help them modify their approach in practice to completing pelvic exams for patients who have military sexual trauma.”

Central to the VA training sessions are standardized patients, offered through the USF Health Morsani College of Medicine. In an early practice session at CAMLS, Marcia Weller (center), meets Heather Rogers (right), a nurse practitioner, and Liane Marshall, a nurse, both with the Hershel Woody Williams VA Medical Center in Huntington WV. Photo by Allison Long.

Other scenes from the media event at CAMLS:

Rhea Law, chair of the Board of Directors for the USF Health Professions Conferencing Corp, which oversees CAMLS.

Dr. Susan Perry, vice dean for Faculty and Community Affairs, USF College of Nursing, and a retired Colonel from the U.S. Air Force., with Josh Harris, associate director of sales for Hilton Tampa Downtown.

Dr. Lisa Hardman, deputy director of VA Women’s Health Education, and Elizabeth Jackson, a veteran who shared details of her health care experience with a provider trained through the Women’s Mini Residency Program.

Photos by Freddie Coleman, USF Health Office of Communications.

Charles Lockwood, MD, MHCM participated in a poverty simulation on Monday, April 1, 2019, at the American Legion Seminole Post #111 in Tampa. Some of the objectives of the simulation was to engage USF Health faculty experience struggles faced by low-income families.

Donna Petersen, ScD, MHS, CPH (facing camera, right) participated in a poverty simulation on Monday, April 1, 2019, at the American Legion Seminole Post #111 in Tampa. Some of the objectives of the simulation was to engage USF Health faculty experience struggles faced by low-income families.

Haru Okuda, MD, USF Health CAMLS executive director and USF Health executive director for interprofessional education and practice, took a photo during a poverty simulation on Monday, April 1, 2019, at the American Legion Seminole Post #111 in Tampa. Some of the objectives of the simulation were to engage USF Health faculty experience struggles faced by low-income families.

Multimedia story by Allison Long.

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

Medical students, staff and faculty gathered Nov. 30 at the USF Health Auditorium for the 9^th Annual Student Symposium hosted by the Morsani College of Medicine Office of Research, Innovation and Scholarly Endeavors (RISE). With 52 presenters, a 67-percent increase from last year’s symposium, this was the largest student symposium in MCOM history.

“This event is a great way for the students to get some experience presenting their research in an environment that is more suited for learning and feedback,” said Roberta Collins, director of the Office of RISE. “Our job is to make our students better and more competitive for when they are applying for residencies.”

The students, judges and coordinators of the 9th Annual Student Symposium including Dr. Haru Okuda, keynote speaker for the event.

The annual event is an opportunity for medical students to showcase their research interests and highlight the benefits of lifelong scholarship. The format for this year’s event changed with the large number of student presenters – students were given just three minutes to explain the topic of their research, their findings and next steps.

“I enjoyed the chance to share the important things I’ve learned in the process of treating patients and reminding current practitioners of the importance of considering additional diagnoses to best benefit patients,” said Jordana Herr, third-year medical student who presented a case report for the first time.

CAMLS Executive Director Dr. Haru Okuda was the keynote speaker for the 9th Annual Student Symposium.

Center for Advanced Medical Learning and Simulation (CAMLS) Executive Director, Haru Okuda, MD, served as keynote speaker for the event. He spoke about how his passion for music was a driving force behind his passion to become a doctor and his career path to becoming the executive director of CAMLS.

This year’s winners are:

Joseph Balbona: 1^st place Group A: “Oncologic Gastric Resection for Adenocarcinoma: Robotic approach is safe and reproducible”
Mathias Nittman: 1^st place Group B: “Relationship between stimulus size and different components of the electroretinogram (ERG) elicited by flashed stimuli”

From left: Steven Malachowski, fourth-year medical student; Patricia Kruk, PhD; and Bryan Bognar, MD, MPH, vice dean for educational affairs, served as judges for one group at the 9th Annual Student Symposium.

Jordan Karsch and Leigh Hatch, third-year medical students, present during the 9th Annual Student Symposium.

Kapland Owens, third-year medical student, takes questions from the judges during the 9th Annual Student Symposium.

-Photos by Fredrick Coleman, USF Health Communications and Marketing