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

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.

For the first time, the exercise brings together students from all USF Health colleges.

Living in the moment is a way of life that countless people strive to achieve, but for those living in poverty, the concept takes on a much more somber meaning. If someone is struggling to make ends meet, their daily life is so stressful that they’re probably not thinking about or planning for the long term.

Every day, health care professionals come face-to-face with patients in poverty and in order to teach students empathy and an understanding of these barriers, USF Health Morsani College of Medicine Office of Student Diversity and Enrichment hosts poverty simulations. This training is in its sixth year, but this year is the first with an interprofessional mix of athletic training, medical, nursing, public health, pharmacy, physician assistant, and physical therapy students, as well as residents, and fellows. At the end of 10 sessions provided in the 2018-19 academic year, about 840 people will have participated.

The local American Legion Post donated its community hall to accommodate the large groups of students and volunteers.

Based on a simulation activity from Central Missouri Community Action, participants have the opportunity to experience life in the shoes of a fixed, limited-income family.

Shirley B. Smith, MA, Director of the Office of Student Diversity and Enrichment for MCOM, begins the activity by instructing the group to take it seriously because, “these are real people who have lived this experience.”

The students were assigned to fill various family roles, with identities ranging from seniors living alone to single-parents and blended families. Each family struggles with barriers such as unemployment, disabilities, and transportation. Over the course of a simulated four weeks, the families’ priorities are shelter, electricity, food, and keeping the family together.

The assigned identities range from single seniors living alone to single parents and blended families. Some are recently unemployed or struggling with disabilities.

A variety of resources are offered to the families by volunteers stationed around the community center room.  The volunteers simulate the roles of bankers, grocery store clerks, hospital staff, social service workers, and a pawn broker. Over the course of the activity, participants may run out of time or money, or even just forget to pay rent or buy groceries. One family was visited by law enforcement after she forgot to pick up her child from day care. Another family pawned their furniture for extra money. At least three families were evicted.

“This experience gives insight to health care workers, because sometimes we don’t know what is going on in a patient’s life and how it’s affecting their treatment or compliance,” said Brolivia Harvey, an adjunct faculty member in the College of Nursing.

Volunteers staff the resource tables that represent businesses such as banks, groceries, social service agencies, pawn brokers, and quick cash operators.

Participants without private transportation have to budget for public transportation passes needed to get to each resource station.

Just like in real life, when the rent is not paid, families are evicted.

At the end of the interprofessional education simulation, the participants sit down for a debrief. More than half of the students raised their hands when asked if they felt stressed or anxious during the experience. One student shared that she felt a “sense of insecurity” the entire experience and how you don’t realize the mental health strain it’s having on you or your children.

“I think the poverty simulation made everyone more aware of the struggles that people go through. We saw how much had to be accomplished in one day and that someone living in poverty may have to choose to pay rent instead of buy their medication,” said Rumour Piepenbrink, a first-year public health student.

“It was an eye-opening and humbling experience. I felt an array of emotions from frustration to gratitude for what I have,” said Ashley Reed, a fourth-year nursing student.

First-year public health student Rumour Piepenbrink visits the payday advance quick cash station.

Fourth-year nursing student Ashley Reed speaks with the volunteers at the simulated hospital.

During debrief, the group discussed how they can apply the lessons they learned from the poverty simulation to their health care careers:

• Don’t judge your patients.
• You have to consider the situation your patient is coming from to best help them.
• Be aware of local resources to refer a patient in need.
• Besides providing a resource to help a patient right now, empower them for the future.
• Teach patients the importance of long-term health.
• Physician burnout can happen when you do not deal with not being able to help everyone.

“Don’t ever get to the point where you’re numb to the poverty or problems of the people in the community,” said Priscilla Perez, a case manager for Positive Spin, a community-based social service agency that assists children and families to live healthy, and long-time poverty simulation community partner. “Helping a patient is more than just taking care of the reason for their visit,” she added.

Students are not the only ones participating in the poverty simulation. A session in April will include USF Health leadership and faculty.

“At USF Health, we are committed to preparing health professionals who recognize the importance of interprofessional team-based care, not only in the clinical setting but also in working together to address the social determinants of health in the communities we serve. Engaging our faculty in this intensive training will help us be better teachers and encourage us to recognize and emphasize the important role that every member of the team plays, including our patients and our community partners,” said Donna Petersen, ScD, senior associate vice president of USF Health and dean of the College of Public Health.

USF Health students, residents, and fellows debrief after the poverty simulation.

-Multimedia story by Torie Doll.

//www.youtube.com/watch?v=fUoZUWfff5k

To work together effectively as practitioners in a 21^st Century health system students must learn together.  And, equally important, the coordinated, team approach to patient care that today’s students aspire to must be modeled across clinical settings where they will practice after graduation.

That was the overarching message of USF Health’s inaugural Interprofessional Education Day held Nov. 16 in the USF Marshall Student Center.

The event brought together more than 250 graduate students, faculty and deans from all USF Health colleges, along with alumni and Tampa Bay community partners, to discuss the advantages and challenges of preparing students for a future that includes greater use of interprofessional health services.

The inaugural IPE day was attended by students, faculty and deans from all four USF Health colleges, along with alumni and community partners.

Interprofessional education, or IPE, is the essence of the USF Health brand. As the region’s only academic medical center, USF Health is uniquely positioned to organize, integrate and focus the capabilities of many health disciplines on behalf of the Tampa Bay community.

“This day highlights the power of USF Health – with its colleges of medicine, nursing, public health, and pharmacy, school of physical therapy and rehabilitation sciences, as well as athletic training and physician assistant programs – to take the lead in how interprofessional health education can be implemented,” said Victoria L. Rich, PhD, RN, FAAN, senior associate vice president of USF Health and dean of the USF College of Nursing.

Dr. Rich co-chaired IPE Day with Jay Wolfson, DrPH, JD, associate vice president of health law, policy and safety at USF Health and distinguished service professor of public health, medicine and pharmacy. They planned the inaugural event with a committee comprised of faculty members from all four health colleges and a student representative.

USF College of Nursing Dean Victoria L. Rich, PhD, welcomes speaker Chad Epps, MD, executive director of healthcare simulation at the University of Tennessee Health Sciences, to the Oval Theater stage.

“By sharing knowledge and training together, we create an environment ready for creativity and innovation,” USF System President Judy Genshaft said in her welcoming remarks. “In patient care, as we better understand each other, we provide more thoughtful care when we work as one team. Many times a patient’s life depends on it, as there is no single person or specialization that can ever address all the complexities of a patient’s needs… Truly the team-based approach embraced here at USF represents the future of health care.”

Charles J. Lockwood, MD, MHCM, senior vice president for USF Health and dean of the Morsani College of Medicine, has championed improved patient care and outcomes through stronger interdisciplinary collaboration. In his introduction, he painted a picture of the national health care challenges creating an impetus for IPE – including mounting pressure to reduce unprecedented health care costs.

The U.S. spends more on health care – nearly 18 percent of its GDP – than any other developed country, and with largely worse health outcomes, Dr. Lockwood said. This has led to a health care system transitioning from fee-for-service (care based on volume of services provided) to a focus on reducing cost while improving quality of care, known as value-based care.

From left: Kevin Sneed, PharmD, dean of the USF College of Pharmacy; Jay Wolfson, DrPH, IPE Day co-chair; Scott Newell, MAS, IPE Day speaker; Charles Lockwood, MD, USF Health senior vice president and dean of the Morsani College of Medicine; Victoria Rich, PhD, dean of the College of Nursing and IPE Day co-chair; Donna Petersen, ScD, dean of the College of Public Health; and Chad Epps, MD, IPE Day speaker.

“The only way we can provide that type of care is together. It can’t possibly be accomplished by the doctor alone, or the nurse alone, or the pharmacist alone,” Dr. Lockwood said. “In order to have that very efficient, tightly knit health care delivery system, we must train together, practice together, and do research together.”

Medical errors are the third leading cause of deaths in the U.S. after heart disease and cancer, according to a Johns Hopkins patient safety analysis. “Not only is there an economic imperative for IPE, but also a moral and ethical imperative to ensure we maximize patient safety,” he added.

The morning program featured two national speakers. Both emphasized the important role that simulation-based interprofessional activities can play in reducing medical errors by teaching health professionals at all levels how to think and act as a mutually supportive, problem-solving team.

IPE Day speaker Scott Newell, standing, interacts with Frederick Slone, MD, (blue shirt), who has a teaching appointment with the MCOM Department of Medical Education.

In the first presentation, Scott Newell, a commercial pilot and paramedic turned health-care simulation educator, drew parallels and distinctions between aviation and health care teams and explained how team training with simulation and crew (crisis) resource management techniques are critical to more effective communication, improved safety and quality outcomes.  All human beings, no matter how well trained and competent, make mistakes – but many medical errors result from a chain of events that can usually be averted at several points, preventing the medical error from causing severe patient harm, Newell said.

The second presentation by Chad Epps, MD, executive director of health care simulation at the University of Tennessee Health Science Center and past president of the Society for Simulation in Healthcare, provided examples of how other academic institutions across the country are structuring their simulation-enhanced IPE.   Dr. Epps said IPE is not students from different health disciplines sitting alongside each another in the same classroom and learning in parallel, but rather “students in two or more professions learning about each other’s professional roles, learning how to communicate with one another, and learning to provide mutual support to other members of the team.”

An interprofessional team looks over their mission during the collaborative escape room exercise. From left:  Amy Schwartz, faculty member, College of Pharmacy, Zemelia Miller, student, Physician Assistant Program; Anne Marie Buford, student, School of Physical Therapy; Chris Chrosniak, student, College of Nursing; Andrew Armstrong, student, College of Nursing; Anna Torrens Armstrong, faculty member, College of Public Health; and Kanisha Jenkins, student, Athletic Training Program.

At the morning session wrap-up, Dr. Lockwood challenged faculty to develop an IPE curriculum that takes full advantage of USF Health’s state-of-the-art simulation resources as well as clinical opportunities with primary teaching hospital Tampa General Hospital and other community partners.

A lunchtime panel discussion, moderated by Dr. Wolfson, featured the deans of all four USF Heath colleges and other key leaders, and the IPE Day guest speakers.

The afternoon culminated with a fun, interactive escape room exercise – a spy game designed to build camaraderie and teamwork within the 15 interdisciplinary student groups participating.

From left, top row: USF System President Judy Genshaft and Dr. Rich with the winning USF Health student team Michael Woolard, College of Nursing; Tyler Mauzy, School of Physical Therapy; Daniel Segarra, Morsani College of Medicine, Dr. Emily Hall, a faculty member for the Athletic Training Program; Matt Allman, College of Public Health; and Dr. Lockwood. Bottom row with the winning trophy: students German Herrera Alzate (left), Physician Assistant Program, and Jennifer Willms, School of Physical Therapy. Not pictured: Lucinda Shaw, adjunct faculty member, College of Nursing.

What They Said: 

We’ve known that poor communication and system errors are major causes of preventable death in 1999 and here we are in 2018, and we still haven’t made a whole lot of advancements…  We have a tremendous opportunity to impact patient safety and change the way we deliver health care.

Speaker Chad Epps, MD, referring to the Institute of Medicine’s landmark report “To Err is Human” published in 1999

Dr. Epps: IPE activities created with shared, linked outcomes and objectives can improve patient safety and care. Interprofessional faculty development also has to be a priority for IPE to work.

One difference between the airline industry and health care is that when a pilot screws up, the first place he ends up is a smoking hole in the ground… In health care we still tend to bury our mistakes… How many of you have filed an incident report and never found out what happened with it?

Speaker Scott Newell, MAS, NREMTP, CHSE, talking about the motivating factors for the safety culture in aviation driving crew members to speak up when they see a potential error

***

Today’s IPE Day helps us think about how we can take our current IPE offerings to the next level. There is little doubt that if we use the energy and momentum generated at events like this, USF Health can become a model of IPE across the education continuum, and our patients and the community will be the better for it.

Bryan A. Bognar, MD, MPH, FACP, vice dean for educational affairs, USF Health, Morsani College of Medicine

The lunchtime panel discussion included deans and other key leaders from USF Health, and the two featured IPE Day speakers.

I am committed to working with the deans and their respective IPE experts to build the best interprofessional education experience possible for our students so they will graduate to become IPE champions in their future practice environment.

Haru Okuda, MD, FACEP, FSSH , USF Health’s first executive director of interprofessional education simulation programming and CAMLS executive director

***

Part of the reason to engage the practice community is to push the environment toward IPE. We hear from our graduates who are well trained (in interprofessionalism) that when they get out in the workforce sometimes they are told “We don’t do that here.”

Donna Petersen, ScD, USF Health senior associate vice president and dean of the USF College of Public Health, on the gap between enthusiasm for interprofessional learning and interprofessional practice

***

Today begins to define the culture of what USF Health will be moving forward. Every program will begin to define how they are part of massive health care-related changes… We’re asking for buy-in for IPE from everybody.

Kevin Sneed, PharmD, USF Health senior associate vice president and dean of the USF College of Pharmacy

Dr. Kevin Sneed comments during the panel discussion.

Research indicates that the effects of IPE for graduates do not not typically persist in the practice area. Partnering with employers and patients has the potential to address this “missing link,” with the goal of improving the quality and effectiveness of health care. We are committed to developing and sustaining these vital collaborative partnerships.

Laura Lee (Dolly) Swisher, PT, MDiv, PhD, FNAP, FAPTA, associate dean, USF Health Morsani College of Medicine, and director of the School of Physical Therapy & Rehabilitation Sciences

***

It was great to see the diversity of health disciplines represented within USF Health… This day helped broaden our ability to collaborate, be problem solvers, lean on people’s strengths to do the best we could to succeed in our mission.

Michael Woolard, third-year nurse anesthesia student and member of the winning team for the IPE Day escape room exercise

Alyssa Radel, (center) an athletic training student in the MCOM, reacts to an IPE Day speaker.

Students pick up the dossiers and burner phones their teams need to begin the IPE Day escape room exercise, which involved a mission to rescue their “kidnapped” leader (played by Dr. Charles Lockwood) from an evil robot (played by USF Health’s Joe Ford). The “mission” promoted collaboration and problem solving while encouraging the students to have fun.

Team leader Rohit Iyer (far right), a second-year medical student, works on a clue with fellow team members.

For one of the escape room activities, teams were asked to create a “spy tool.” Here, one team uses an Apple watch and the team leader’s bow tie to make a “bow-tie spy cam.”

-Video by Torie M. Doll and photos by Eric Younghans and Freddie Coleman, USF Health Communications and Marketing.  Jessica Samaniego, USF College of Nursing, also contributed photos to this story.

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

//www.youtube.com/watch?v=Ua_NOHEmQkQ

USF College of Pharmacy is transforming pharmacy practice to meet the demands of the ever-changing field of health care.

The USF Health college strongly emphasizes interprofessional education to prepare the pharmacists of the future and improve patient care.

That’s one of the biggest transformations happening at the USF College of Pharmacy.

“We believe team care is the best care,” said Kevin Sneed, PhamD, founding dean of the USF College of Pharmacy. “So, we’ve incorporated interprofessional education into our curriculum to prepare students to work closely together with doctors, nurses, physical therapists and other health professionals to improve health outcomes.”

Kevin Sneed, PharmD, dean of the USF College of Pharmacy, demonstrates emerging technology in pharmacy to fourth-year students Sidorella Gllava and Tyler Cureton.

The USF College of Pharmacy collaborates with the USF Health Morsani College of Medicine and other USF Health colleges to provide hands-on training to students in clinical settings and simulation environments. Richard Roetzheim, MD, professor and chair of the Department of Family Medicine at the USF Health Morsani College of Medicine, has helped USF College of Pharmacy move that idea forward since the college opened its doors in 2011.

“An effective relationship and communication between pharmacists and physicians starts at health colleges,” Dr. Roetzheim said. “As physicians, we can’t take care of patients alone. Pharmacists bring a different perspective. So, we have to train students in medicine and pharmacy to work together as one team to provide adequate care. And we’ve done that successfully here at USF for years.”

Pharmacy continues to grow and evolve — allowing pharmacists to become part of a team-based healthcare delivery. Now, more than ever, they play a big role in the patients’ recovery and contribute to better health outcomes.

“Pharmacy is not what it used to be,” Dr. Sneed said. “Once the diagnosis has been made, the pharmacists now follow the patients all the way through recovery — administering medications, providing medication education and counseling, communicating with their families, giving lifestyle and diet tips, and consistently checking in with the doctors to help manage patient illness and recovery.”

The USF College of Pharmacy has embraced that change. That’s why the college trains students alongside USF Health Morsani College of Medicine students and physicians in a high-tech environment at the USF Health Morsani Center for Advanced Healthcare. They look at patients together, discuss the diagnoses and lay out a plan of care.

“Practicing what we learn in the classroom alongside medical students and doctors helps us become better prepared,” said Dorissa Cortes, a fourth-year student at the USF College of Pharmacy. “It also reminds us about what each person brings to the table, and how we use that to help provide better care for our patients.”

Second-year students, Raisah Salhab, USF College of Pharmacy, and Hannah Shin, USF Health Morsani College of Medicine, read a patient’s medical history during a simulated medical consultation.

Barry Silverstone, a patient who suffers from a blood disorder, has visited Dr. Sneed and other USF Health doctors in the USF Health Morsani Center for Advanced Healthcare for years. Silverstone said a close collaboration between his doctors, nurses and pharmacists has kept his health in check.

“I feel a sense of wellbeing when my doctor and pharmacist communicate about my recovery process,” Silverstone said. “I speak to Dr. Sneed regularly about my medication, what to take and when to take it. Our communication has kept me healthy longer and my blood level consistent.”

The USF College of Pharmacy is leading the way in team-based training. The college’s ultimate goal is to continue to prepare the best pharmacists in the country to meet the needs of tomorrow’s health care and improve patients’ lives.

“The future of pharmacy is right here at USF Health,” Dr. Sneed said. “Our college is ready to face whatever challenges health care brings. We’re committed to our students’ success for the benefit of the patient. This is the best place to be.”

Story and video by Vjollca Hysenlika
Photos by Fredrick Coleman 

The Suncoast Chapter of the Association of Fundraising Professionals (AFP) recently recognized the USF Health BRIDGE Clinic as its 2016 Philanthropic Service Organization of the Year. The award was presented at the AFP’s celebration of National Philanthropy Day on Nov. 15 at Lowry Park Zoo.

Staffed entirely by volunteer USF Health students and overseen by volunteer faculty advisors, the BRIDGE Clinic provides free primary medical care on Tuesday evenings at the Morsani Center for Advanced Healthcare to more than 850 underserved patients each year from the University Community Area.

From left: Dr. Lucy Guerra, a BRIDGE Clinic medical director; Emily Goodwin, USF medical student; Kristin Prewitt, MD/MPH student and executive student director of BRIDGE Clinic; and Dr. Frederick Slone, a clinic medical director; recently accepted the AFP Suncoast Chapter Philanthropic Service Organization of the Year award on behalf of the USF Health BRIDGE Clinic.

What began nine years ago as the vision of four USF medical students has grown into a robust, interdisciplinary resource for both USF and the community it serves. USF Health students, social work students, and attending physicians accomplish its namesake mission of “Building Relationships and Initiatives Dedicated to Gaining Equality” by volunteering more than 13,500 hours each year at an estimated benefit of more than $1 million in health care services.

The clinic collaborates with community partners to provide routine care for non-emergency medical needs for uninsured adults who make 200 percent or less of the federal poverty guidelines. Its partnership with Florida Hospital has allowed the the clinic to operate at a nearby second location inside the Florida Hospital Pepin Heart Institute one Thursday night each month.

“We are honored and humbled to receive this award from AFP and are inspired by the efforts to better the Tampa community from the other recipients,” said Kristin Prewitt, executive student director of the BRIDGE Clinic and an MD/MPH student. “We couldn’t do this work without the countless faculty, students, and USF community members who dedicate their time to serving our patients. We owe any recognition to them and our patients.”

Two other University of South Florida benefactors, Kate Tiedemann and Ellen Cotton, were recognized as philanthropists of the year at the event. The couple’s generosity to the USF St. Petersburg campus has been recognized through the naming of the Kate Tiedemann College of Business and the Ellen Cotton Atrium.

Story and photo by Davina Gould, USF Health Development

Construction is underway for the new WELL Student Center, a one-stop student services location for all USF Health students. While student fees have covered 75 percent of construction costs, urgent philanthropic support is needed to complete the current phase of construction in 2016.

The WELL (Wellness, Engagement, Leadership and Learning) Student Center fosters an interprofessional, collaborative learning environment for students in medicine, nursing, public health, pharmacy, physical therapy and the biomedical sciences.

Artist’s rendering of the WELL Student Center exterior.

The new student center will be located in the heart of the USF Health section of the main University of South Florida campus at the site of a former medical clinic. The renovated building will feature an expansive dining facility, a fitness center, a performing arts and aerobics studio, a meditation room, a lactation room for nursing mothers, multipurpose and study space, and a convenience store.

“The WELL is a great investment for USF Health students because it provides a private, quiet, central location to study, work on group projects together, or meet other students on a similar track,” said Chereka Singh, president of USF’s Undergraduate Public Health Student Association.

“Immediately as a student at USF Health I realized the need for interprofessional teams to maximize patient care.  The WELL Student Center offers aspiring health professionals an environment like nowhere else to communicate and develop together,” said USF College of Pharmacy student Matt Schneller,

For more information or make a gift, visit the WELL Student Center website today.

Rendering of the WELL’s dining facility.

Article by Davina Gould, USF Health Development

Watch City of Tampa TV show on Genomics at USF Health 

Genomics, the study of genes and their function, is a burgeoning field that is changing the face of medicine and other health professions as it gives practitioners, and even patients, unprecedented detail about diseases, conditions and even levels of health risk.

Beginning fall semester, USF Health will offer its first course in human genomics designed specifically for health professionals without advanced research training, including those in medicine, nursing, public health, pharmacy and physical therapy.

Human Genomics in Medicine and Public Health (PHC 6943/GMS 7930) will introduce genomics and modern genetic technologies to master’s-level and senior undergraduate health students with limited training in molecular biology and biochemistry.  The course, taught by genomics experts from the colleges of Medicine and Public Health, will integrate these rapidly developing technologies into the real-world practice of personal health decisions and public health initiatives encompassing population health.

The curriculum will cover information needed to meet nursing as well as public health competencies in genomics.

Michael White, PhD, professor of global health and technical director of the new course, says the human genome is an instruction manual for building and maintaining a human being.

Michael White, PhD

“Only very recently has medicine had the tools to translate the DNA language of the complete instruction manual. The manual for each of us has unique pages that together make up our individual book of life.  Today, understanding each book of life is within our grasp, and this has profound implications for our health,” said Dr. White, a practitioner of genomics and bioinformatics in research.

“It will fall to health professionals at all levels to help us navigate this new world of genomics and teach us to confidently read and understand our own book of life.”

Dr. White designed the curriculum with course clinical director Judith Ranells, MD, chief of the Division of Genetics and Metabolism in the USF Health Morsani College of Medicine and a practitioner of clinical genetics.

Judith Ranells, MD

“In this course we will train front-line health professionals how the new DNA decoding tools work and how genome-based knowledge will impact the future of individual health decisions, including the diagnosis, treatment and prevention of disease,” Dr. Ranells said. “We will also consider strategies for preventing the potential misuse of genomic information and ensuring patient confidentiality.”

Registration in currently open for Human Genomics in Medicine and Public Health, which will be held 5 to 7:45 p.m. on Wednesdays at the Interdisciplinary Research Building in the USF Research Park.  For more information, please contact either of the course directors: Dr. White at mwhite3@health.usf.edu or Dr. Ranells at juranell@health.usf.edu