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When a paramedic rushes to the scene of an emergency, it may be the first time this provider will have to establish an airway on a real person. It's at that moment when the difference between thinking and knowing becomes crystal clear. With medical errors costing the healthcare system billions each year, the emphasis on competency and critical thinking in medical instruction has strengthened. At the Medical Education Research Institute (MERI) in Memphis, providing hands-on education and training has been their mission for the past 14 years. With students from 27 countries and in all 50 states, MERI trained more than 14,000 clinicians last year, 9,400 of which were physicians and surgeons. MERI instructors also provide courses off-site across the region.

The unique variety of courses introduce medical professionals to the latest advancements in medicine and offer first-hand opportunities to learn about the most up-to-date medical techniques and technologies, including invaluable hands-on operating experiences with cadaver specimens.

Often referred to as a well-kept secret, MERI is expanding their reach with a new venture in clinical training - the Simulation Center, which opened this month. Through a generous donation from the Assisi Foundation, MERI was able to purchase eight simulation mannequins, ranging from the tiniest infant to a full size adult male. Manufactured by METI (Medical Education Technologies Inc.) some of the products being used in training include the BabySIM®, PediaSIM® and iStan®, which are portable, fully anatomical and have human-like movement and physiological processes. Renovating their existing 29,000-square-foot building, MERI's simulation center will have four exam rooms and a debriefing room, as well as new staff to bring the training to life.

"Research is finding there is a real reduction of errors from healthcare providers who participate in simulation training," explained MERI executive director, Elizabeth Ostric. "So much so that not only is patient care improved, but they're able to reduce malpractice rates with physicians who participate in this kind of training and demonstrate their competency."

Now the combination of anatomic donors and mechanical simulators is expanding MERI's capabilities to direct additional training needs. The simulators are full-sized mannequins, operated by a computer, tether-less, and pre-programmed to mimic human body physiological responses. Students can practice a wide array of patient scenarios, from labor and delivery to intubations to simulating the body's response to an incorrect dosage of medication.

"In the classroom we call it theory, but in simulation, it really allows you to apply that theory," said Shirley Brown, simulation education coordinator for MERI. "It goes from what you think you know, to showing what you actually know."

Learning in MERI's non-threatening environment creates a reality where providers can make mistakes and learn from them before going into clinical practice. Providers can zero in on the incidences they want to train for or can focus specific errors.

"It really gives nurses, paramedics, doctors, respiratory therapists and everybody involved in the care process, a chance to enhance their skills and a new way of orienting that is more relevant than just studying in a classroom," Ostric maintained, adding that simulation training for nursing students can be a way to help reduce turnover rates.

All scenarios are recorded and after each clinical experience, students are debriefed to determine what was done well or what mistakes were made. This brings a heightened level of awareness and accountability to all students and participants in a scenario, regardless of their specific specialty or job. That critical thinking and accountability is vital to improving patient outcomes, especially in today's healthcare climate where the acuity of patients is high. Often healthcare providers are dealing with multiple disease processes at once, therefore it become necessary to enhance one's skills and be able to, Brown said, "take care of multiple things at once and think on the fly."

"They may not be able to carry out that entire therapeutic process on their own but they can sing out when they realize something needs to be addressed and feel confident in doing that," added Ostric.

That confidence has to be in every level of health provision, including paramedics. In August, MERI set up a one-day training course at Union University in Jackson, Tenn. Using actors and staged sets, paramedics and firefighters experienced diverse scenarios they may come across in an EMS situation, such as critical care, drowning and fire, complete with obstacles and distractions.

"The great thing is you can create the environment they would be in and make it as elaborate or simple as you want," explained Diana Kelly, manager of institutional development, adding that they have meetings to discuss needed scenarios such as courses on airway management.

Lt. James Lynn Thompson, paramedic program coordinator for the Memphis Fire Department, said his experience with the MERI program was "one of the best experiences I have ever had concerning educational opportunities in the EMS field." He added, "For paramedics, this is not the customary training class."

The paramedic course was enthusiastically received, with the president of the Tennessee EMS Educators Association (TEMSEA) inviting MERI to provide the course at the organization's national conference this year.

Initiatives at the MERI are always ongoing and they are in the midst of a $10 million capital campaign to develop a robotic surgery division where surgeons can practice on devices like the daVinci robot and gain greater expertise prior to performing in practice. They also hope to partner with local universities, hospitals and healthcare organizations to do research that will, Ostric said, "lead to better patient care not just here, but throughout the world."

Ultimately the simulation center, along with all of MERI's training courses and labs, is designed to do just that – improve patient outcomes and make a positive impact on healthcare. Through practice and exposure, students can enhance their skills and gain valuable confidence that will aid them in providing better care.

The simulation center is available to medical professionals across the Mid-South region. To learn more about MERI and the simulation center, visit: www.meri.org

Tags:

BabySIM, Elizabeth Ostric, iStan, Medical Education Research Institute, Medical Education Technologies Inc, PediaSIM, Shirley Brown, Simulation Center

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