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Advanced Training for Health Care Professionals in Florida

In a pristine mockup of an operating room in a building in downtown Tampa, a young surgeon sits at a video game-like console, staring intently at a high-definition monitor a foot in front of her face. With two joysticks, she manipulates a nearby surgical robot whose giant arm looms over an operating table and extends down inside an anesthetized pig on the operating table.

Focused intently on the image of the pig’s insides on the monitor, the surgeon uses the joysticks to steer a pair of tiny scissors and minuscule pliers to hold and cut fine layers of tissue.

A technician employed by the robot’s manufacturer stands close by, watching the procedure unfold on another monitor, offering tips and instruction as the surgeon proceeds.

As medical devices, surgical robots and treatment procedures become more complex, the need to efficiently train doctors, nurses, medical students, biomedical engineers and medical company technicians grows along with the complexity of the machines and procedures.

Around the U.S., a handful of training centers has emerged where that entire spectrum of medical personnel — American and foreign — come to learn about cutting-edge devices and procedures using advanced simulation techniques. Notably, two of the most prominent are in Florida — Florida Hospital’s Nicholson Center in Celebration near Orlando and the University of South Florida’s Center for Advanced Medical Learning and Simulation (CAMLS).

Center for Advanced Medical Learning and Simulation / Tampa

Affiliation: University of South Florida

Key Personnel: Deborah Sutherland, CEO; Stephen Klasko, CEO of USF Health and dean of the Morsani College of Medicine

Cost: $38 million

Facility: 90,000 square feet in a three-story building; 200-person auditorium; one 21-station surgical lab; two seven-station surgical labs; operating rooms; 64-slice CT scanner; research area and conference rooms

Target: 30,000 medical personnel a year, including onsite and those reached through teleconferencing

Mannequins and role-playing scenarios are not new to medical education, but the “capacity to use high-fidelity simulations, virtual reality and concepts from the gaming industry” will play an increasing role in medical education in the 21st century, says Deborah Sutherland, CEO of CAMLS.

The practice helps reduce medical errors and costs, say proponents of health care simulation, and enables surgical teams to train as groups, often using actual patient data and X-rays. Often cited is a study showing that a Chicago hospital saved thousands of dollars and eliminated various bloodstream infections by high-tech training on catheter insertions.

Nadia Bassil, 29, a first-year resident at Morton Plant Hospital in Tampa, trained with a team of health providers on an “infant” simulator at CAMLS and was able to review their work on videos and by watching other students through two-way mirrors. The learning experience was true to life but without any consequences on an actual human patient. “Anxiety-provoking,” she says — “you read about it in the books and stuff, but in the heat of the moment, my mind went blank.”

The centers’ business models are complex and multifaceted. A hospital might contract with Nicholson to teach a group of surgeons on its staff, for example, the most current laparoscopic procedures. Meanwhile, as a part of USF, CAMLs can provide a component of the medical school’s instructional program for some residents and med students.

Nicholson Center / Celebration

Affiliation: Florida Hospital

Key Personnel: Rick Wassel, chief administrator; Roger Smith, chief technology officer

Cost: $35 million

Facility: 54,000 square feet with a 500-seat education center; 25 surgical stations; two fully equipped operating rooms; robotic training lab with space for at least six surgical robots; research area and conference rooms

Target: Ultimately, more than 20,000 medical personnel a year, including those reached onsite and through teleconferencing

Both centers have standing arrangements with medical device companies like Intuitive Surgery, Karl Storz and Stryker, which supply the centers with equipment, then send technicians and physicians to be trained and to train others. The companies also use the centers to garner feedback on devices and procedures still under development.

Both centers host groups of physicians from various specialities for training, which can include both classroom instruction and procedures on either sophisticated patient simulators or human cadaveric or animal tissue. Both centers do contract research; Nicholson is conducting research for the Defense Department, for example, involving how telesurgery can be used effectively.

And both centers see themselves as economic drivers at the local and state levels, attracting groups of affluent, influential physicians as “tourists” and highlighting the medical and high-tech profiles of their respective communities and Florida.

While both centers do work in training and education that make them competitors at some level, there are broader opportunities for the centers to collaborate in research and development on procedures and new technologies, says Rick Wassel, Nicholson Center’s chief administrator. The two organizations are in the process of signing a memorandum of understanding to collaborate on simulation projects, he says.