The Peter M. Winter Institute for Simulation,
Education and Research
WISER MISSION STATEMENT
The mission of the Peter M. Winter Institute for Simulation, Education and Research (WISER) is to: Improve medical
and public education through simulation training; improve patient safety and save lives as a result of this mission.
Additionally, WISER is committed to educational research to create the leading institute of its kind in the world.
Through natural partnerships we plan to take advantage of the economic spin-offs of these activities to further
support WISER in research on future forms of simulation (virtual reality, handheld computing, etc.)
INTRODUCTION
Nearly two years have passed since WISER in January, 2004, moved to its permanent location in the McKee Place Building.
In this 11,000 sq ft facility there are now 16 full size medical simulators ( all Laerdal SimMan ) and a large number
of partial task trainers, serving the simulation training needs of our 20 hospital medical center health system (UPMCHS)
and the University of Pittsburgh Health Science Schools, emphasizing medical and nursing training, patient safety and
educational research. Under the continued leadership of the WISER Medical Director, Dr John J. Schaefer, the expert
staff at WISER has further developed and improved the technical design and software programming, incorporated within
the SimMan platform.
In FY2005 WISER has experienced significant growth in our on line course content and in the recruitment of facilitators.
WISER currently has 118 active course facilitators. As a part of our growth, WISER has seen a large increase in
utilization by the School of Nursing and UPMC with increases in Mock Codes and off site training.
WISER continues to publish data on training and advancement in the field of Medical Simulation that is recognized
throughout the world as a premiere Simulation center. WISER continues to develop its infrastructure, and Simulation
Information Management System (SIMS).
WISER History Summary
In the year 2000 the University of Pittsburgh, Department of Anesthesiology/CCM, Human Simulation Center in
conjunction with the Schools of Medicine and Nursing and UPMC Health System agreed to combine resources to expand
what was then a small simulation center within the Department of Anesthesiology into a large multifunctional
facility serving medical education and patient safety missions. Nearly $1 million in external grant support from
the Laerdal Foundation in conjunction with approximately $1.7 million in internal support from various participating
groups were secured. A two-part plan for expansion began in the spring of 2002. In honor of the founder Dr. Peter M.
Winter, the center was renamed the “Peter M. Winter Institute for Simulation Education and Research” (WISER).
Academic year 2003-2004
WISER is one of the most active training institutes of its kind. WISER has been involved in medical simulation
since 1994, starting with one simulator. In calendar year 2003 with 10 simulators, WISER served over 6000 trainees.
In its new and much larger 2004 facility, 16 full size simulators are available as a resource for a twenty-hospital
health system (UPMCHS) and The University of Pittsburgh health science schools emphasizing medical and nursing
training, patient safety and educational research. The expert staff at WISER has fundamentally contributed to both
the technical design and software programming (including the 2.2 operating system) incorporated within the SimMan
platform. See appendix A (Floor Plan), B (Staff List), C (Course Directors List)
Academic year 2004-2005
A. EDUCATION
WISER trained over 8,000 trainees in more than 1400 classes and over 7000 simulations with immediate real time
trainee feedback. In our continued effort to provide quality education at all levels in various specialties,
WISER in conjunction with the School of Medicine Office of Continuing Medical Education developed CME accredited
courses for physicians, nurses, and other healthcare professionals. See appendices D (Course list), E
(Administrative and Financial Utilization)
B. WISER Tours
WISER demonstrated its facility and technology at approximately 146 visits by various local, national and
international groups of academic and industry leaders, the United States military forces, and University and
UPMC dignitaries. In an effort to provide quality education to new and current medical students, WISER offers
training using simulation tools in the medical student curriculum. Approximately 1200 medical school and resident
applicants from all over the world toured through WISER at more than 70 such events. Surveys are collected to
gather data to understand what attracts today’s medical students to any particular school. Most of the surveys
collected at the University of Pittsburgh School of Medicine indicate WISER as one of the most attractive educational
opportunities. These surveys are available in the WISER 2003-2004 Annual Report. See appendices F (WISER
Tour List)
C. Faculty Data Retention Analysis
As stated in last years report, the Department of Anesthesiology faculty at Magee-Women’s Hospital as well as
the first year Anesthesiology and Otolaryngology residents are the first groups to have participated in this
type of assessment. Preliminary results of validation scoring and standardized settings as well as retention
are promising. A grant was received from the Anesthesia Patient Safety Foundation related to this work. You
will find the results of this assessment in the appendices section of this report. See appendices G
Data analysis of knowledge and skill retention)
D. WISER Projects and Collaborations
Department of Defense
United States Army: WISER was invited to visit and provide a needs assessment for improvement of the current
91-Whiskey medic training program at Fort Sam Houston. This assessment was submitted and WISER was then asked
to provide a proposal for implementation of recommendations, all completed in the spring of 2004. WISER is currently
putting in motion the implementation of the recommendations provided by WISER in the spring of 2005.
E. WISER Funding Sources
Grants:
Asmund S. Laerdal Foundation for Acute Medicine Inc.
June 1, 2001 – June 30, 2006
Total Amount: $988,000
Fort Sam Houston
April 1, 2005 – October 1, 2005
$829,000
Anesthesia Patient Safety Foundation
Sponsoring Institution: Department of Anesthesiology, University of Pittsburgh
Using Whole Task Human Simulation to Improve the Difficult Airway Management Skills of Practicing Anesthesiologists
January 1, 2005 – December 31, 2006
$65,000
In addition to the Asmund S. Laerdal Foundation grant and the support from the University of Pittsburgh Schools
of Medicine and Nursing, the UPMC Health Systems and the Department of Anesthesiology are the major contributors
providing the resources to build WISER’s infrastructure to a state of the art facility. Together these sources
provided $450,000 in funding support as well as $154,283 in grants FY05. WISER itself generated $264,121 in
revenue during academic year 2004-2005.
UPMC also provided the capital for the Phase II expansion at the McKee Place totaling $1,147,800.
F. Publications
WISER has the ability to offer standardized training in various invasive procedures, the decision making process
of crisis management, and sophisticated team training. There are opportunities to acquire performance data online,
provide analysis and immediate feedback to the trainees. Individual scoring is also available. Most courses utilize
video-recording for accurate, direct and immediate feedback to the trainee. Without bias, the learner can see at
which points the technique was considered correct or a failure. Statistical analysis of group performance is
automatically available via a web-based centralized information management system, facilitating research in education.
See appendix H (Publications)
G. Journal Editorial Board
Strong University of Pittsburgh School of Medicine Faculty Presence on New Editorial Board
The five year old Society of Medical Simulation will hold its first freestanding annual meeting in San Diego, CA, in
January 2006. The event will be celebrated with the launching of a new journal, "Simulation in Health Care", to be
published by Lippincott, Williams & Wilkins. This will be the official journal of the SMS. Editorial Board Members
have already been appointed, including four physicians from our own medical school, i.e. John Schaefer, MD (Associate
Professor of Anesthesiology and Medical Director of WISER), Michael DeVita, MD (Associate Professor of CCM and Associate
Medical Director of UPMC), Paul Phrampus, MD (Associate Professor of Emergency Medicine and Assistant Director of EM
Programs at WISER) and Ake Grenvik, MD, PhD (Distinguished Service Professor of CCM).This is a promising development
for our prominent Peter M. Winter Institute for Education, Simulation and Research, so important in today's initial and
continuing education of medical students, residents, fellows and faculty members throughout UPMC and particularly in
Anesthesiology, Emergency and Critical Care Medicine.
Dr. DeVita Apppointed Associate Editor of New Medical Simulation Journal
The Society for Medical Simulation (SMS) is launching the new journal Simulation in Health Care in January, 2006.
David Gaba, MD, Editor-in-Chief, and Dan Raemer, PhD, President of SMS, have just announced that Michael DeVita, MD,
Associate Professor of CCM at Pitt, has been appointed Associate Editor of this journal, a very important position to
which we congratulate Dr. DeVita.
H. Public Relation News
Laerdal's New SimBaby Introduced at WISER
On July 1, 2005, the new Pediatric CCM Fellows began their training by simulation of critical conditions in infants
as programmed on SimBaby. This new Laerdal simulator has been developed in close collaboration with Dr John Schaefer
and his associates at the Peter M. Winter Institute for Simulation Education and Research (WISER). Dr Melinda Fiedor
(see photo), who serves as director of pediatric simulation is leading this new training program, featured in the July
31 edition of Pittsburgh Post-Gazette and also broadcast.
WISER Faculty Publish Lead Article In Prominent Journal
In August, 2004, the journal "Current Opinion In Critical Care" celebrated its 10th anniversary by inviting CCM
leaders worldwide to publish their most important experiences within the past decade. Drs Ake Grenvik, John J.
Schaefer, Michael A. DeVita and Paul Rogers paper entitled "New Aspects On Critical Care Medicine Training" was
selected as the lead article in this anniversary issue.
WISER Featured in Pittsburgh Regional Healthcare Initiative (PRHI) Executive Summary
In the July 2004 PRHI Executive Summary, the University of Pittsburgh WISER Center is featured in an article
titled Medical Simulators Come of Age.
Dr. Paul Phrampus Lectured at US Army’s Annual 91W Combat Medic Educators Training Conference
Dr. Paul Phrampus, Assistant Director of Emergency Medical Programs for WISER recently delivered an invited
lecture entitled “Embedding the Simulator into an Education Program” to the US Army’s Annual 91W Combat Medic
Educators Training Conference in San Antonio, Texas. The 600 conference attendees were involved in the training
and education of the Armies combat field medics. Wiser is involved in assisting the Army increase the efficiency
of their simulation training program for combat medics by a closer integration of the simulation based education
into the existing Army curriculum. The Army’s 91 W program trains about 7000 combat medics per year.
Dr Schaefer Featured in the September 2004 Issue of Pittsburgh Magazine
As Director of WISER, Dr John Schaefer is recognized for his importance in the creation of the widespread human
simulator, SimMan, manufactured by Laerdal Medical in Norway.Over the past 10 years, Dr Schaefer and his associates
have developed a unique integrated computer controlled simulator program for training of various health care
professionals with automatic data acquisition, collection and analysis using Internet, a system which provides
immediate feedback to both trainees and instructors. www.wqed.org
Tom Dongilli Popular Teacher and Speaker
August 17 - 18, 2004. Tom Dongilli as Operations Coordinator at WISER was featured as the invited teacher of a
two-day interactive workshop at Prince George's Community College in Maryland. This was a SimMan based session
sponsored through a MACC-TEC grant awarded by The Maryland Association Of Community Colleges. On August 19, Mr
Dongilli was invited to present "The WISER Project" at the
Advanced Technology Applications For Combat Care (ATACCC) 2004 Conference, sponsored by the US Army, Navy,
Air Force and NATO, August 16 - 19 at St. Pete Beach in Florida. This program was devoted to Medical Modeling,
Simulation and Advanced Techology for Combat Casualty Care.
Dr Shigeki Fujitani Lecturing in Japan
As a senior CCM Fellow at Pitt with special interest in medical simulation, Dr Fujitani recently was invited
by Laerdal Japan and Kobe University to lecture and discuss how our CCM Department uses WISER equipment and
technique in training of CCM fellows in invasive procedures and crisis management. Dr Fujitani gave presentations
at a continuing education program arranged by Laerdal, at the 55th Japanese Emergency Medicine regional meeting
in Kanto on February 19 and also in a faculty development program at Kobe University on February 21.
Leading the way in medical simulation
Increased patient safety and improved medical education are major goals behind a University of Pittsburgh Medical
Center (UPMC) program using human-like patient simulators that breathe, bleed, cough, and cry. The Peter M. Winter
Institute for Simulation, Education, and Research (WISER) is the largest medical simulation centerof its kind in
the world, second only to that operated by the U.S. military. For full article.
http://healthjournal.upmc.com/0205/Simulation.htm
The Train the Trainers Courses at WISER Exceedingly Successful and Popular
Ten years ago there were very few medical simulators. In 2004 there were close to 500 simulation centers and between
one and two thousand simulators at various hospitals, medical schools and training centers around the world. Dr.
John Schaefer, as medical director of WISER, early recognized the need for advanced training. In September, 2003,
the first Train the Trainers course was offered at WISER. The tenth such course was provided in late 2004. The main
teachers were John Schaefer and Tom Dongilli. By 2005 approximately 200 health care professionals from over 10
countries had attended. 76% were medical educators and 64% of the total being university employees. The tabulation
to the right demonstrates the widespread interest. The courses are based on Laerdal SimMan utilization and have two
components:
| 38% |
MD Faculty instructors |
| 14% |
Nurses |
| 7% |
Physician specialists |
| 12% |
Residents |
| 7% |
Paramedics |
| 22% |
Others
(e.g. Administrators, respiratory therapists and computer specialists) |
Day 1 is dedicated to facility design, infrastructure, budget, operation and personnel
job descriptions.
Day 2-3 involves curriculum development, scenarios, automation, data acquisition and feedback to
trainees.
Post course comments, so far collected from 55 participants include answers to specific questions and general
comments (reported by 46 participants). It should be noted that the vast majority were extremely positive in their
evaluation with only one disappointed person providing a negative impression.
I. WISER Meeting Activities
WISER faculty have participated in various conferences related to simulation education and research all over the world.
See appendix I (Abstracts)
2004 MEETINGS
International Meeting on Medical Simulation 2004
Albuquerque, New Mexico
The Peter M. Winter Institute for Simulation, Education and Research (WISER) made a strong showing at the annual
International Meeting for Medical Simulation recently held at the Hyatt Regency Tamaya Resort and Spa Albuquerque New
Mexico.
Presentations
- Members of the faculty and staff presented 6 poster abstracts.
- Schaefer JJ: Mandatory Competency-based Difficult Airway Management Training at the University of Pittsburgh
Department of Anesthesiology – Preliminary Findings.
- Dooley J, McIvor WR, Lutz JW, Dongilli T, Schaefer JJ: Determining the Static Lung Compliance of the Laerdal
SimMan® Simulator.
- Mahoney JF, Rogers PL, Dunmire SM, McIvor WR, Schaefer JJ: Longitudinal Integration of Simulation Technology
Throughout the Undergraduate Medical Curriculum.
- DeVita M, Schaefer JJ, Dongilli T, Wang H, Lutz J: Improving medical crisis TEAM performance using a computerized
human patient simulator.
- Dongilli T, DeVita M, Schaefer JJ, Grbach W, Fiedor ML, Grenvick A, Lutz JW: The Use of Simulation Training in a
Large Multi-Hospital Health System to Increase Patient Safety.
- Lutz JW, Dongilli Y, Schaefer JJ: The Integration of Performance Logs with Digital Video for Review of Simulation
Training Sessions.
Dr. Schaefer’s poster on “Competency-based Difficult Airway Management…” was selected for a follow-up presentation to
the meeting at large and received a second-place honor in competition for the best abstract.
New Simulation Society Formed
A new society was formalized at the meeting as well. The Society for Medical Simulation (SMS,
www.socmedsim.org) held its inaugural meeting to finalize Board
of Overseers membership and develop a mission statement. This society is a “broad-based, multi-disciplinary,
multi-specialty, international society with ties to all medical specialties, nursing, allied health paramedical
personnel and industry.” Members of WISER had significant input at this important new meeting. During the meeting
the decision to break from the Society of Technology in Anesthesia was made and the SMS will sponsor its own
independent meeting beginning in 2006.
Michael Devita Named as Chair of Future IMMS Meetings
Michael Devita was nominated by John Schaefer to chair the Abstract Committee at the 2005 IMMS meeting, which will be
held January 14-16 in Miami, Florida. As is tradition, Dr. Devita will then chair the Workshop.
WISER and SimMedical at Cerner Conference
10-13 October, 2004
Gaylord Palms Resort & Convention Center
Orlando, Fla.
SimMedical, the company that purchased the intellectual property of WISER and is currently assisting a number of
simulation centers around the world, participated in the Cerner Conference held at the Gaylord Palms Conference Center
in Orlando. SimMedical was part of the Cerner Learning Center booth as a partner in their new initiative towards
developing a medical education division. Tom Dongilli and John Lutz from WISER attended along with Steve Schmitt,
CEO of SimMedical. Tom & John helped explain how WISER does everything from course development to class management
to data mining for research to a large and enthusiastic audience. WISER looks forward to working with Cerner in
research collaboration to determine how training in simulator centers impacts clinical skills.
American Society of Anesthesiologist
Las Vegas, Nevada
October 23-27, 2004
Dr. Schaefer directed a simulation course on Difficult Airway Management at the Annual Meeting of the American
Society of Anesthesiologists in October 2003. The workshops being conducted are used for validation of simulation
in medical training.
University of Pittsburgh Faculty who contributed to the 2003 ASA conference for the Difficult Airway Workshops:
John Schaefer, MD, Associate Professor, ANES
David Metro, MD, Assistant Professor, ANES
Joseph Quinlan, MD, Associate Professor, ANES
Robert Krohner, MD, Associate Professor, ANES
Ryan Romeo, MD, Assistant Professor, ANES
Joseph Talarico, DO, Assistant Professor, ANES
Safar Symposium – Pittsburgh, PA
October 25, 2004
At the University of Pitt’s Second Annual Safar Symposium in October 2003, several WISER faculty members contributed
with presentations during the second half of the symposium dedicated to human simulation education. All these
presentations were published in the February 2004 Supplement to Critical Care Medicine (guest editors: Patrick M.
Kochanek, Ake Grenvik and John Schaefer) and are listed separately under Publications in this report.
New York State Society of Anesthesiologists’ Post Graduate Assembly (PGA)
New York, NY
December 10-14, 2004
Dr. Schaefer conducted a Difficult Airway Workshop at the PGA conference.
The New York State Society of Anesthesiologists, Inc. (NYSSA) through its Committee on Continuing Medical Education
and Remediation (CME&R) is a learning organization that is dedicated to enhancing the standards and practice of the
specialty by sponsoring quality, up-to-date and cutting-edge Continuing Medical Education (CME) activities designed
at encouraging education, research and scientific investigations, and improving quality and safety of patient care,
not only within the membership but also nationwide and extending to the international community. In addition, this
organization is committed to the remediation of anesthesiologists identified and referred by the New York State
Department of Health Office of Professional Medical Conduct.
2005 MEETINGS
International Meeting on Medical Simulation 2005
January 13-16, 2005
Miami, FL
The 5th International Meeting for Medical Simulation (IMMS) was again piggybacked onto the annual meeting of the
Society for Technology in Anesthesia (STA), which took place in Miami , January 13-16. SMS now has over 500 members
with nearly 300 participating in this 2005 meeting. Michael Devita, a member of the WISER Research Committee, was the
Research Chairman for the meeting. Next year, SMS will hold its first free standing meeting to take place in San Diego, CA.
In Miami, WISER faculty members presented six posters:
In addition to the poster presentations, John Schaefer lectured on performance assessment and Michael DeVita on
patient safety in the team work session. William McIvor provided a workshop entitled “Using the Lung Man Medical ASL
5000 Simulator for Mechanical Ventilation Training.” Tom Dongilli and John Schaefer conducted a workshop on “Everything
you didn't know that SimMan could do.” It was also of interest that a large Japanese group from 10 different universities
presented data on successful use of the WISER difficult airway management course.
Steven Schmitt and Steve Palumbo presented SimMedical through a colorful booth and information brochures. Michael DeVita
was elected Workshop Chairman for 2006 and Ake grenvik was invited to serve as a chapter reviewer for the next volume
of the textbook “Simulation in CCM and Beyond.”
SEA Annual Meeting
Washington, DC
June 3-5, 2005
At the 2005 meeting of the Society for Education in Anesthesia on June 3-5, presenting faculty members included Drs
Peter Davis, Rita Patel, Ryan Romeo and John Williams of the Pitt Department of Anesthesiology. WISER faculty contributed
with a poster on
"Training with Whole Task Human Simulator Improves Difficult Airway Competency in Anesthesiology
Residents" by Drs DG Metro, RC Romeo, JS Talarico, JJ Quinlan and JJ Schaefer.
J. WISER Committees – see appendices J (WISER Research Committee membership)
K (WISER Advisory Committee membership)
Research Committee
The WISER Research Committee acted through subcommittees to deal with problems related to Institutional Review
Board (IRB) issues, such as research on education when no patients are involved. Other issues discussed included use
of consent forms, right of trainees to withdraw from participation in studies of simulation training for potential
publication and the need for a regional conference on educational research.
Advisory Committee
The WISER Advisory Committee met on June 30, 2003. Meeting minutes were attached to the previous WISER annual report
of 2002/2003. During academic year 2003/2004 and 2004/2005, however, this Committee did not meet because of the
reorganization and relocation of WISER to its current facility in the McKee Place.
Appendices
Appendix A [pdf]
Appendices B - K [pdf]
Annual Report 2005 |Annual Report 2004 | Annual Report 2003 | Annual
Report 2002
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