Temple Times Online Edition
    September 28, 2006
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Training Institute receives
highest level of accreditation

Temple’s center one of seven nationwide to be so designated by American College of Surgeons.


Temple University’s Institute for Clinical Simulation and Patient Safety is one of only seven nationwide recently accredited as a Level I Education Institute by the American College of Surgeons. Out of the seven, which are the first to be so designated, Temple is the only one located in the mid-Atlantic United States.


Accreditation lasts for three years and signifies the highest level of quality and standards in surgical education.


Level I Institutes must meet the following criteria:

  • The institute trains at least three different groups of learners: allied health professionals, nurses, physicians, residents and students.
  • The institute’s curriculum provides ongoing education and training that is both cognitive and procedural.
  • The institute meets specific space, technology and resource requirements.


Simulation Center

Medical and nursing students work together on a simulated medical emergency at the Institute for Clinical Simulation and Patient Safety at the Health Sciences Center. (Photo by Joseph V. Labolito / University Photography)

The ACS vision is to create a network of regional accredited Education Institutes that will offer practicing surgeons, surgical residents, medical students and members of the surgical team a spectrum of educational opportunities to build and maintain skills, as well as to learn new procedures and emerging technologies. The Education Institutes are also to serve as a resource for others who wish to start or advance their own programs.


Temple’s institute, housed in the former dental school building at the Health Sciences Center, is a $3 million, 15,000-square-foot facility, encompassing both simulation and standardized, or “actor,” patient programs. Believed to be the largest in the region, it’s also uniquely interdisciplinary, training the various health professions together.

The institute houses programmable, anatomically detailed and physiologically functional mannequins that are used to teach skills such as intubation, critical thinking and decision-making through simulated medical scenarios. Surgical simulation, carried out on equipment much like the cockpit simulators used in flight training, allows users to learn and practice everything from basic to advanced surgical skills, including knot tying, suturing, line and catheter placement, and laparoscopy.


Simulation allows students to practice taking care of patients in a safe environment and to make mistakes without any consequences.


According to Harsh Grewal, M.D., surgical director of the institute and professor of pediatric surgery at the School of Medicine, “The traditional model of teaching — see one, do one, teach one — involves real patients. We still use this model but now supplement with training and practice on simulators. We want to teach surgical skills, for instance hand-eye coordination, in a non-threatening, controlled atmosphere, where the level of anxiety is much lower.”


And practice definitely makes perfect in the field of surgery.


“Surgery is not necessarily an ability you’re born with, but you can become highly skilled by practicing. And just as important as practice is feedback. A de-briefing with colleagues and professors, which can include video playback, follows each simulation,” Grewal said.


The institute also houses the standardized patient program in what look like doctor’s offices. This program uses actors trained to be “patients.” They present symptoms of various illnesses or re-enact difficult medical scenarios and help students learn to take histories, conduct physical exams, make diagnoses and, most importantly, communicate in a caring manner.


The ultimate goal is improved patient safety. Grewal’s vision is to someday soon take learners through the entire medical experience, with a heavy emphasis on communications. In one possible scenario, student learners examine a patient in need of cancer surgery. They talk with the patient and family about the options, the advantages and possible complications of each procedure, and recovery and prognosis. Next comes the actual surgery, which might include a complication that the surgeon will need to handle and then discuss with the family after the operation.


“Research has found that if we communicate effectively with patients, we reduce the risk of malpractice suits, many of which arise out of a lack of communication. Patients need to feel that the medical team is on their side,” Grewal said.


Good communication is also vital in the operating room and plans are in the works to create a simulation exercise to improve interaction between members of a surgical team. All members of the team need to feel empowered to speak up and intervene if a problem arises.


The Institute for Clinical Simulation and Patient Safety is supported by Temple’s School of Medicine, Health System and College of Health Professions. Learning opportunities are also available to groups outside of Temple including first responders, firemen and policemen.

Upcoming events at the institute include:

  • Accelerated Senior Nursing Skills Review
  • Surgical Residents Laparoscopic Skills Lab
  • Pediatric Emergency Medicine Resident Program
  • Internal Medicine Clerkship Program
  • Emergency Medicine Clerkship Program
  • Surgery Clerkship Program
  • Nurse Practitioner Surgical Skills Program
  • Advanced Disaster Life Support Course
  • Pediatric Nursing Chemotherapy Assessment Program

The following programs were accredited as a Level I Education Institute by the American College of Surgeons:

  • Simulation and Skills Center, Beth Israel Deaconess Medical Center, Boston
  • Institute for Clinical Simulation and Patient Safety, Temple University School of Medicine
  • Center of Excellence for Surgical Education and Innovation, University of British Columbia, Vancouver, B.C.
  • Minimally Invasive Surgery Education Center, University of California Irvine, School of Medicine, Orange, Calif.
  • BATCAVE Medical Simulation Program, The University of New Mexico Health Science Center, Albuquerque, N.M.
  • Southwestern Center for Minimally Invasive Surgery, UT Southwestern Medical Center, Dallas
  • Institute for Surgical and Interventional Simulation, University of Washington, Seattle, WA

Eryn Jelesiewicz




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