Winter 2013

GORDON CENTERFor Research In Medical Education

Michael S. Gordon, M.D., Ph.D.Director Emeritus

Visionary • Innovator • Educator

Michael S. Gordon, M.D., Ph.D.Roles: Director Emeritus, Gordon Center for Research in Medical Education Professor of Medicine, University of Miami Miller School of MedicineResearch Interest: Application of simulation technology to multi-professional medical education

Education: Cardiology Fellowship, Georgetown University Doctor of Philosophy, University of Minnesota Internal Medicine Residency, Mayo Clinic Post Doctoral Research Fellow National Institutes of Health Medical Degree / Master of Science / Bachelor of Science, University of Illinois

Awards: Alumni Achievement Award, 2012 University of Illinois

Doctor of Laws honoris causa, 2003 University of Dundee

Laennec Society Special Recognition Award, 1998 American Heart Association

Gifted Teacher Award, 1996 American College of Cardiology

Biography: Dr. Gordon joined the faculty at the University of Miami in 1966. In pursuit of a way to improve cardiac bedside examinations, he created Harvey®, the longest continuous university-based simulation project in medical education. The Cardiopulmonary Patient Simulator realistically simulates nearly any cardiac disease at the touch of a button by varying blood pressure, pulses, heart sounds, murmurs and breath sounds. To collaborate on the development of the Harvey® curriculum, Dr. Gordon formed a worldwide consortium of physicians, nurses, engineers, and educators known as the M.I.A.M.I. Group. The group’s role expanded over the years to encompass computer-based and hands-on skills training programs in cardiology, neurology, and emergency medicine.

Few people have affected the education of students and healthcare practitioners as profoundly as Dr. Michael S. Gordon. Because of his “dedication, extraordinary vision and world leadership in developing advanced technology for medical education,” in 2007, the University of Miami established the state-of-the-art Michael S. Gordon Center for Research in Medical Education.

A visionary is one who sees what most others

miss, an individual whose laser-like focus on what can be is not deterred by the various reasons it might not be. From early in his 50-year career

in medicine, Michael Stanley Gordon

established himself as a visionary and an innovator.

He did not simply foresee the integral role of simulation in medical education; he had the will, the tenacity to make it happen. As a pioneer in the application of technology to medical training, he developed systems and programs that have been used at nearly 2,000 medical institutions worldwide. In doing so, he helped shape a new paradigm, leaving an indelible imprint on the way generations of healthcare professionals are educated.

Even while capitalizing on the latest advances in mechanics—and, ultimately, computerization—Dr. Gordon kept central the approach to teaching he learned from his mentor, Dr. W. Proctor Harvey. His goal was to thoroughly involve his students, utilizing sight, touch, and sound to better communicate his lessons, emphasizing these senses as the best primary means of diagnosing heart disease in patients. Recognizing that all the gadgetry in the world is only effective when used with a well-devised curriculum, Dr. Gordon has ensured all programs adhere to the highest of educational standards, including outcomes-based evaluations.

As a faculty member at the University of Miami School of Medicine, Dr. Gordon first designed his curricula for medical students and residents, but he envisioned the benefits his programs could bring to primary care physicians and nurses who could be better able to identify heart disease in

their patients. Since the 1970s, he saw the potential to expand programmatically to other healthcare professions. Thus began multi-professional training of emergency personnel, including paramedic-firefighters, U.S. Army surgical teams, and even law enforcement. The simulation techniques used so successfully to teach bedside cardiology led to hands-on training beyond basic and advanced cardiac life support, encompassing trauma, disaster response, airway management, heart attack, and stroke. Not to be limited by the number of providers that could be accommodated on campus, Dr. Gordon, with support from the Florida legislature, invited paramedic instructors from across Florida to be trained to teach their own classes using curricula developed at the University of Miami. This “train-the-trainer” approach opened the door to a new means of broad-based dissemination that has led to hospitals, prehospital systems, and educational institutions throughout the United States, Mexico, Great Britain, and Hong Kong implementing their own Advanced Stroke Life Support® training.

When Dr. Gordon joined its faculty in 1966, the University of Miami was one of only 86 medical schools in the United States and relatively new, having graduated only 11 classes of physicians. Just a few years later, the era of managed care began and resulted in students having reduced access to live patients for learning. This, together with predictions of a physician shortage, prompted a 50% increase in the number of

medical schools and a bourgeoning of programs to train advanced practice nurses and physician

assistants. Dr. Gordon’s vision for alternative ways to teach medicine was prophetic. At the time, however, he faced resistance and skepticism, as he challenged the long-held tradition that students could only learn from real patients. He was undaunted and repeatedly proved the doubters wrong, paving the way for simulation to grow into an accepted—now expected—means for teaching and evaluating clinical skills and an invaluable resource for research in medical education.

For more than four decades, Michael Gordon’s efforts have influenced healthcare education worldwide by providing practical solutions to real problems. The most notable hallmarks of his success are described on the following pages, each with its own story, all a demonstration of his uncanny foresight, bold determination, and relentless pursuit of excellence. As he assumes a new role as Director Emeritus, his legacy grows, not only at the University of Miami and at the center he founded and bears his name, but in healthcare institutions all over the world.

Visionary, Innovator, Educator

ward, 1998

A visionary is one who sees what most others

miss, an individual whose laser-like focus on what can be is not deterred by the various reasons it might not be. From early in his 50-year career

in medicine, Michael Stanley Gordon

established himself as a visionary and an innovator.

He did not simply foresee the

Visionary • Innovator • EducatorThe Gordon CenTer for researCh in MediCal eduCaTion 1

In the beginning, Harvey® was capable of simulating only one cardiac disease, so to teach different diseases required a series of mannequins.

The prototype for the initial cardiology patient simulator was developed in 1967, when scientists and engineers were still using slide rules. Aware of its use of animatronics, Dr. Gordon first contacted Disney about creating a robot for educational use. He was referred to the New York firm that built many of the floats in the Macy’s parade and would become the developer of the initial Harvey®. Actually, three different simulators were built: an

older-looking one emulated a heart attack patient, a middle-aged one had

valve narrowing, and a younger-looking model had a hole in

the heart. A few years later, another patient connection led Dr. Gordon to the engineers who would take Harvey® to the next level. A woman whose heart disease he stabilized in the middle of the night happened to be the mother of the chairman of

International Telephone & Telegraph. ITT’s

Defense Communications Division in Nutley, New

Jersey helped develop a single mannequin capable of simulating

many different diseases.

A patent for Harvey® was granted on May 9, 1972.

Within five years of being granted a patent, Dr. Gordon had a recast Harvey® capable of simulating 20 different cardiac diseases, which he demonstrated before the United States Congress in 1977 (pictured at left).

Harvey®’s use throughout the U.S. draws the attention of Ripley’s Believe It or Not.

The novelty of the human-like Harvey® was also featured in an episode of the popular television show, “That’s Incredible.” While exposure in mass media during the 1980s was entertaining, it was Dr. Gordon’s efforts and academic credentials that led to Harvey®’s installation in a growing number of medical schools and teaching hospitals across the country.

Harvey®’s first overseas home was in Japan.

The new generation of Harvey® is 500 pounds lighter.Looking to the future, Dr. Gordon entrusted Dr. Barry Issenberg with developing a new generation of Harvey®. He and engineering expert David Lawson employed advanced digital technology to facilitate the addition of breath sounds and 30 cardiac diseases in a significantly more portable system. Their efforts were recognized in 2008 with the award of a new patent for a Cardiopulmonary Patient Simulator.

A two-year collaboration with the Royal College of Physicians and Surgeons of Canada resulted in a rigorous evaluation of the reliability, validity, and feasibility of using simulation for high-stakes assessment. The successful results led to Harvey® being used in the initial certification of cardiopulmonary bedside skills for internal medicine specialists in Canada.

marks the first time a simulator was adopted into a national certification exam for physicians.

patient, a middle-aged one had valve narrowing, and a younger-

looking model had a hole in the heart. A few years later,

another patient connection led Dr. Gordon to the engineers who would take next level. A woman whose heart disease he stabilized in the middle of the night happened to be the mother of the chairman of

International Telephone & Telegraph. ITT’s

Defense Communications Division in Nutley, New

Jersey helped develop a single mannequin capable of simulating

many different diseases.

While a fellow of the renowned cardiologist,

W. Proctor Harvey, M.D., Dr. Gordon was inspired

to devise a way to combine the precise discipline

of his basic science research with the art of the

bedside examination. He conceived of “building”

a patient even then. In Miami, as consultant for

the Airlines Pilot Association, whose members were

trained and tested using flight simulators,

Dr. Gordon was energized by the potential of

a comparable device for teaching medicine.

His work with airline pilots led to chairing

the committee that wrote the guidelines for

cardiovascular health and aviation safety,

jointly sponsored by the Federal

Aviation Administration and the

American Medical Association.

Use of Harvey®

The idea for Harvey® is born.

1972 2008

3Visionary • Innovator • EducatorThe Gordon CenTer for researCh in MediCal eduCaTion2

Dr. Gordon invited a select few academic cardiologists and a Ph.D. educator to join withhim in developing an NIH model for medical education using Harvey®. He sought thebest, asking for referrals from leading educators at well-respected institutions. In addition to Dr. Gordon and colleagues Barry Materson, M.D. and Joan Mayer, M.D. at the University of Miami, the original group included faculty from the Universities of Arizona, Florida, Illinois, and Nebraska, Duke and Emory Universities, and from the Mayo Clinic. To this day, many of the same colleagues are part of what is now the M.I.A.M.I. Group (Miami International Alliance for Medical-education Innovation). They meet semi-annually to ensure all programs developed at the center satisfy stringent standards of educational excellence and that they are beneficial for use by a variety of institutions.

Expansion of the M.I.A.M.I. Group facilitated an increase in programs and a broadening of target audiences.

Over the years, Dr. Gordon added to the consortium to recruit a more diverse body, adding emergency medicine physicians, neurologists, nurses, and physician assistants. His vast network of esteemed colleagues helped identify aspiring and dedicated academicians to consider.

Nurses had learned with Harvey® for years, but with the profession’s expanding healthcare role, the time was right to tailor a Harvey® curriculum specific to their needs. Dr. Gordon recognized early on that his educational programs would benefit nursing professionals, enlisting benefactor Joan K. Stout, R.N., to establish a Nurses Training Program in her name. With the addition of nurses recognized as international leaders in simulation education, the M.I.A.M.I. Group was able to customize the Harvey® curriculum to reflect the way nurses approach the bedside exam. Two multi-center studies showed the new curriculum led to significant improvements in bedside skills for advanced practice nurses (2009) and undergraduate nursing students (2010).

Experience teaching physician assistant students led to a national multi-center study.

About the time the world was preoccupied with

Y2K, Dr. Gordon showed again he was ahead of the curve, opening the 4-week Harvey® elective to the Miami Dade College Physician Assistant (PA) program. A decade of success encouraged him to establish a sub-group of PA educators to create a curriculum specifically geared to their learners. He asked faculty member Ross Scalese, M.D., to oversee the ensuing four-center study that confirmed its effectiveness and was presented at the 2011 PA Education Association forum and the International Meeting on Simulation in Healthcare held in January 2012.

Dr. Gordon met Dr. Ian Hart when he was

engaged by the University of Miami to evaluate

its new medical student curriculum. His fortuitous

introduction to the founder of the Canadian

Association of Medical Education led to his meeting

Dr. Hart’s close colleague and co-founder of the

Ottawa Conference for Medical Education, Dr.

Ronald Harden, who also pioneered the Objective

Structured Clinical Examination (OSCE). Dr. Gordon

immediately recognized their impact when he

invited them to be part of the M.I.A.M.I. Group’s

Evaluation and Assessment team.

The Harvey® Group was a collaboration of expertsformed in the 1970s from eight medical centers throughout the United States.

International outreach adds world- renowned experts in outcomes measurement to M.I.A.M.I. Group.

4 The Gordon CenTer for researCh in MediCal eduCaTion 5Visionary • Innovator • Educator

The publication of a multi-center study on teaching with Harvey® establishes its effectiveness.

Installing a Harvey® at

each Group member’s

institution provided Dr.

Gordon with access to a

greater number of medical

students in cardiology

electives for a series of

published multi-center

studies. An initial article

in 1974 was followed in

1980, also in the American

Journal of Cardiology. The

data showed an average

gain in student bedside

skills of 32%, with as little

as one hour of study per

disease. Further studies

involving hundreds of

practitioners of varying

skills levels showed

93% giving Harvey® an

excellent rating and all

wishing to be taught with

the device in the future. A

seminal study funded by

the NIH and independently

evaluated was published

in September 1987 in the

AAMC Journal of Medical

Education. The results

clearly demonstrated

that students taught

with Harvey® not only

mastered lessons better

than conventionally

trained peers but that

the knowledge and skills

they gained effectively

translated to their

diagnosis and interaction

with live patients.

Before there were personal computers,

Dr. Gordon offered students access to electronic media.In the early 1980s, a terminal at the MTSL connected to a mainframe computer at the Miami Heart Institute—a leader in its use of computerization—to provide students access to a computer program for independently learning to interpret electrocardiograms.

In the classroom, while Dr. Gordon demonstrated on Harvey®, the roughly 30 slides for each disease—

presenting the patient’s history, physical findings, and diagnostic test results—were projected on a large screen. To achieve the same results in the confined booth of an exhibit hall required a different configuration. A special cabinet was designed to house a carousel of slides, rotated to conserve space, and project the images from the rear to be visible on the other side, above Harvey®’s head. That portability would later evolve to facilitate student self-study.

An unused lot behind what was then the National Children’s Cardiac Hospital was eyed as the site to house a state-of-the-art research and training laboratory, with classroom space, curricula development, and Harvey® production all under one roof.

Once he determined the site was available and was given the okay by Dean Bernard Fogel, Dr. Gordon set about obtaining the necessary authorizations, raising funds from private donors, and working on a design that could accommodate upward expansion.

In 1978, ground was broken on the Medical Training and Simulation Laboratory (MTSL). The following year construction was completed, and Dr. Gordon had a central location in which to teach and conduct research.

The new facility was built to accommodate the addition of new technologies as they became available.

An auditorium equipped with video monitors showing Harvey® close-ups and, later, infrared and mechanical pulse transmission technology allowed students to see, hear, and even touch the simulator using palpating boxes. Similar innovations are still used today to teach students in the cardiology elective, led by cardiologist Joseph Esterson, M.D.

The MTSL afforded space for student self-learning.

An avid proponent of deliberate practice, Dr. Gordon made sure to provide students with the space and tools to study on their own, reinforcing the lessons taught by faculty. Pathology text boxes held a real human heart with the location of disease flagged, and drop-down panels gave students a patient’s history and how the patient presented. The same teaching methodology was used with Harvey® and later the UMedic Multimedia programs, which are available for student access in the Self-Learning Laboratory.

The Training and Simulation Laboratory was also known to many as Harvey® House, an apt description, not only because Harvey® was a centerpiece for teaching, but because the mannequins were also assembled there.

Increasing the elevation of the lot prior to construction enabled the MTSL to have a feature highly unusual in Miami: a basement. With room to store equipment below ground and space for a workshop above ground, Dr.

Gordon was able to relocate the fabrication

of Harvey® from New York to more closely supervise its production through critical stages of its development. Several years

later, the basement was

built out in phases to provide additional

instructional areas for emergency response training programs.

Confident that seeing is believing, Dr. Gordon hosted myriad legislators, donors, and other VIPs, giving them a first-hand look at his educational innovations.

Among the many to be impressed by Dr. Gordon’s use of technology and simulation was Sen. Dempsey Barron, whose 32-year career in the Florida legislature, including the senate presidency in the mid-1970s, earned him a reputation as one of the most powerful

political figures in the state. Dr. Gordon gained insight into the workings of the legislature, which became a source for grants for statewide training. Over the

decades, Dr. Gordon has personally hosted every Speaker of the Florida House and President of the Senate, all gaining insight into the importance of the center’s programs. Pictured with

Harvey is current Senate President, Don Gaetz.

The advent of the Laserdisc made possible a new multimedia computer curriculum known as UMedic®.

A reflective disc the size of an LP record album came on the market in 1978. Its capability for playing high quality audio and video made it feasible to package full-color video clips of actual catheterizations and surgeries. A case-based program for each disease was designed for students to use on their own or in small groups.

UMedic® had the added bonus of enhancing a live faculty presentation with Harvey®. Few medical centers in the mid-1980s had the equipment necessary for UMedic®, so Dr. Gordon made it available as an entire package, cart included.

By 1998, all UMedic® programs were fully converted to the newly available Compact Disc.By the end of the 20th century, most computers came with a CD-ROM drive, eliminating the need for expensive specialized equipment. This meant a significant reduction in cost and much greater accessibility to the programs. Today, UMedic® can be used on Apple as well as PC systems and is viewable through the Internet, giving health science schools greater flexibility in how they make the curricula available to their learners. In 2011, a three-program series on the identification and interpretation of electrocardiographic and arrhythmia findings was

introduced that includes dynamic graphic animations and modern navigation tools.

On-campus space was scarce in 1966 whenDr. Gordon came to the medical school and began training the cardiology students and fellows.

Dr. Gordon taught as students

followed him from patient

to patient. His office was

in the Alamo Annex, the

hallway connecting the

historic building to Jackson

Memorial Hospital. He worked

on Harvey® development in

a backroom secured from

Veterinary Services, just

beyond the live animals on

the first floor of the Rosenstiel

Medical Sciences Building.

working on a design

accommodate

addition of new technologies as they became available.

practice, Dr. Gordon made sure to

and later the

Gordon was able to relocate the fabrication

of HarveyNew York to more closely supervise its production through critical

development. Several years

later, the basement was

built out in phases to provide additional

The Gordon CenTer for researCh in MediCal eduCaTion6 7Visionary • Innovator • Educator

The effectiveness of the train-the-trainer method made it possible for curricula developed by the center’s faculty to be implemented all over the U.S. and internationally.As the only 8-hour, hands-on stroke course for healthcare professionals, Advanced Stroke Life Support® is used by hospitals, EMS agencies, and educational institutions in 25 states. It is taught in Hong Kong and Great Britain, and the Red Cross in Mexico trains all of that country’s paramedics in ASLS®.

Whether locally or at more distant locations in Florida, off-site training became more feasible with the use of a customized Mobile Simulation Unit.

The air-conditioned, 20-foot trailer is fully outfitted with the same equipment as the center’s permanent simulation training areas. The sim lab-on-wheels facilitates skills training at hospitals, where personnel can be scheduled by appointment with minimal time away from clinical service.

Dr. Gordon established a rapport with his constituencies that continues yearly with a meeting of the Emergency Medical Skills Training Advisory Board.

Leaders in emergency medicine, fire rescue, emergency response, nursing, law enforcement, military, public health, and education offer valuable insight on curricula, scheduling, and long-term planning to what is now known as the Division of Prehospital and Emergency Healthcare. The division is under the direction of emergency medicine physician Ivette Motola, M.D., M.P.H.

Among Dr. Gordon’s proudest accomplishments is the long-term collaboration with the U.S. military and the Army Trauma Training Center (ATTC). Beginning only one month after the attacks of September 11th, forward surgical teams have been prepared for deployment to Afghanistan and Iraq in 2-3 week rotations at the UM/Jackson Memorial Medical Center. In addition to clinical sessions at Ryder Trauma Center, the physicians, nurses, physician assistants, and medics also undergo

hands-on training at the Gordon Center, including realistic mass casualty simulations. The Gordon Center is evaluating for the Army the effectiveness of its mobile applications for patient assessment in the field. In a moving tribute on Veterans’ Day 2010, the center paid homage to Staff Sergeant Ronald J. Spino, a member of the 274th Forward Surgical Team who died in Afghanistan while serving his third tour treating wounded soldiers. The large training room used by the ATTC was dedicated in his memory.

8 The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 9

and educational institutions in 25 states. It

Kong and

Red Cross in Mexico trains all of that country’s paramedics

off-site training became more feasible with the use of a customized Mobile Simulation Unit.

The air-conditioned, 20-foot trailer is fully outfitted with the same equipment as the center’s permanent simulation training areas. The sim lab-on-wheels facilitates skills training at hospitals, where personnel can be scheduled by appointment with minimal time away from clinical service.

that continues yearly with a meeting of the Emergency

Leaders in emergency medicine, fire rescue, emergency response, nursing, law enforcement, military, public health, and education offer valuable insight on curricula, scheduling, and long-term planning to

The City of Miami Fire Department, the nation’s first to have a paramedic program, approached Dr. Gordon about training its personnel at the University.

Leading the effort was Carlos Gimenez, who went on to become fire chief and is now mayor of Miami-Dade County. In response, Dr. Gordon, in 1985, embarked on a program that included teaching paramedics to recognize symptoms of heart attack, administer and interpret an electrocardiogram, and initiate treatment during transport. Training soon extended well beyond local departments and has since included the development of other curricula in airway management, stroke, and disaster response. To provide realistic simulation scenarios, Dr. Gordon obtained a real rescue vehicle and a car for extrication practice. Along with a mock emergency department and decontamination shower, they were accommodated by the construction of new training space in the MTSL basement that established the only center in the country at the time dedicated to life support and critical care training.

The MTSL presented its first Advanced Life Support Competition in 1992, and within five years, there was a waiting list of paramedic crews wanting to take part.

Realistic scenarios have involved a variety of outside agencies, including the FBI, Drug Enforcement Agency, Coast Guard, Urban Search and Rescue, and CIA. Interest in the event grew due, in great part, to the efforts of Stephanie Browne, nurse coordinator of EMS training, who died of cancer at the age of 43. The event was renamed in 1997 to honor her memory. In the ensuing years, teams from as far as North Florida have tested their skills in patient assessment, critical thinking, and decision making. In 2007, the center established the “EMS Futures Scholarship,” awarded to a worthy student selected by the first-place team to be used toward the expenses of EMT or paramedic school.

Looking for a way to extend the impact of prehospital training beyond Miami, Dr. Gordon facilitated the teaching of the center’s heart attack curriculum to paramedic providers across Florida.

By training instructors from state-funded paramedic training programs to teach the course and providing them the curricular materials, thousands more responders were better prepared to treat patients with acute coronary syndromes. The model of collaborating with state colleges and vocational institutions also proved effective for Advanced Stroke Life Support® (ASLS®), as well as Emergency Response to Terrorism (ERT). Among the locales for ERT training was Tallahassee Community College (pictured above).

The seed for emergency training was planted in 1982. At the request of Dean Bernard Fogel, Dr. Gordon instituted medical student courses in Basic and Advanced Cardiac Life Support (ACLS), training that continues to this day. The American Heart Association published the first ACLS guidelines only a few years earlier, in the mid-

instituted medical student courses in Basic and Advanced

1970s.

“Hands-on” is not only a description of Dr. Gordon’s educational philosophy; it is also emblematic of his leadership style and certainly true of his active role in the design of the two floors that would be the center’s new home.

Concurrent with his fundraising efforts, Dr. Gordon arranged regular meetings with the architects and designers under contract for the new Clinical Research Building, beginning in 2002. He researched other simulation and training centers, identifying the features to emulate, noting shortcomings and mistakes to avoid. He involved key faculty members and staff every step of the way. The goal was to create a spacious, cutting-edge facility to accommodate training, Harvey® and UMedic®, research projects and curriculum development—and have room to grow as needed.

The groundbreaking ceremony for the Clinical Research Building was held January 20, 2004.

Thus began a three-year project, the progress of which was viewable live on the Internet thanks to a series of webcams.

After two decades, the facility that had seemed so spacious could no longer accommodate the diversification and growth of the center’s programs.

By the early 2000s, the center’s emergency training had branched out education-ally and geographically, students from Miami Dade College’s physician assistant program joined UM medical students in rotating through the Harvey® elective, and advances in computer graphics and processing speed fueled by the gaming industry opened new opportunities for UMedic. Added to that was the prospect of the British Heart Foundation equipping all 27 medical schools in the United Kingdom with their own Harvey®, placing unprecedented demands on the production process. Not one to be confined by walls, Dr. Gordon set about devising a solution.

Dr. Gordon shared his passion about the accomplishments afforded by a new center with long-time supporters.

The late Harry and Bea Feldman were enthralled the first time they met the enthusiastic doctor from the University of Miami who demonstrated a human-looking device named Harvey®. That was in 1974. In the years that followed, Harry and Bea

remained among the center’s strongest supporters. When Dr. Gordon explained the lasting impact on the education of healthcare providers that was within reach with a new facility, the Feldmans committed to make the dream a reality.

Years of navigating the halls of government in Tallahassee gave Dr. Gordon insight, and the contacts,

to seek funding at both the state and federal level.

Dr. Gordon made the case to Florida leaders for a one-time commitment beyond its programmatic allotment to the center, securing a multi-million dollar grant to underwrite some of the capital costs for the new facility. He also contacted three key members of the Florida delegation to the U.S. House of Representatives, already well acquainted with the work of the

center from their tenure in the Florida legislature. Representatives Lincoln and Mario Diaz-Balart and Ileana Ros-Lehtinen were

instrumental in helping Dr. Gordon secure federal funds toward equipping the new facility.

Dr. Gordon included a hard-hat tour of the construction site on the M.I.A.M.I. Group meeting agenda in June 2006.

By then, the rescue vehicle had already been disassembled so the parts could be taken from the basement of the old building and brought to the new trauma room before the glass walls were erected. Likewise, the new Mini-Cooper, its fuel lines removed for safety reasons, also had to be on-site in time to be walled into the building. Both vehicles were to be placed on pedestals to allow easy reconfiguration of the room.

The Grand Opening Gala on Dec. 2, 2006 celebrated the opening of the new facility and the renaming of the Center for Research in Medical Education in tribute to Founding Director Michael S. Gordon.

Dr. Gordon thanked his colleagues, who attended from 14 medical centers worldwide, for working with him to create the center’s programs over the years. He also thanked the generous donors that together contributed a total of $12 million to build the new 34,000 square foot facility. Over his career, Dr. Gordon raised more than $130 million toward the center’s mission. To the University of Miami he expressed his gratitude for “providing the environment where ideas can become the reality,” resulting in the saving of lives.

An opportunity arose toget in on the ground floor. With the launch of the University of Miami’s landmark Momentum capital campaign in 2002, the timing was right for Dr. Gordon to dovetail his own fundraising efforts to finance a state-of-the-art facility. The result: Dean

John Clarkson’s offer to occupy space in a new high-rise planned for clinical research. The

simulation center’s unique

criteria—including outdoor training exercises and an indoor rescue vehicle and car—clearly required a first floor location. Add the floor above, and the total square footage in the new Clinical Research Building would be more than double that of the original center.

John Clarkson’s offer to occupy space in a new high-rise planned for clinical research. The

simulation center’s unique

criteria—including

Years of navigating the halls of government in Tallahassee gave Dr. Gordon insight, and the contacts,

to seek funding at both the state and federal level.

Dr. Gordon made the case to Florida leaders for a one-time commitment beyond its programmatic allotment to the center,

key members of the Florida delegation to the U.S. House of Representatives, already well acquainted with the work of the

center from their tenure in the Florida legislature. Representatives Lincoln and Mario Diaz-Balart and Ileana Ros-Lehtinen were

instrumental in helping Dr. Gordon secure federal funds toward equipping the new facility.

square footage

the original

10 The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 11

Even with the number of new simulation centers growing, guidelines on the requirements for the role of simulation educator were lacking, prompting the Gordon Center to create a Healthcare Simulation Instructor Development Program.

Simulation instructor development courses were developed in collaboration with the Peter M. Winter Institute for Simulation, Education and Research (WISER) at the University of Pittsburgh. The programs provide healthcare professionals with the skills to design, develop, and integrate simulation-based instruction; devise and apply effective measures for assessment and evaluation; and carry out research studies. Participants outside the U.S. have come from Hong Kong, South Korea, Austria, France, the United Kingdom, and Spain.

Recognizing a growing need for the critically important simulation educator, the Gordon Center instituted a fellowship program in 2001.

Since the program’s inception, fellows from the U.S., Canada, and South Korea have been able to bring the skills learned at the Gordon Center back to their respective nursing and medical schools. The one-to-two-year fellowship program is competency-based and has a framework encompassing all roles of a simulation clinical educator: those of a clinical teacher, resource developer, curriculum planner, and facilitator of learning.

While English has become the language of choice at international conferences, students often prefer learning in their native language, so the Gordon Center took steps to make its programs available in other languages.

The Harvey® curriculum has already been translated into Spanish, Russian, Korean, Mandarin Chinese, and Japanese. To facilitate instruction during three weeks of simulation training of faculty from Kazakhstan, the GCRME enlisted a colleague to translate into Russian, a more familiar second language to their native Kazakh (pictured above). Led by internist Hector Rivera, M.D., the Advanced Stroke Life Support® curriculum was translated into Spanish for use in prehospital training by the Mexican Red Cross. The curriculum was also modified for use in Great Britain to accommodate cultural and idiomatic distinctions in English between the two countries.

The Gordon Center’s contribution to the global future of simulation includes guiding others on systematically integrating simulation into medical education.

As acceptance of simulation has grown, requests for the Gordon Center to share its expertise have increased. Center faculty have advised academic leaders in South Korea, Brazil, and Kazakhstan. In Russia, the Gordon Center has been counseling the Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Medical Sciences. Pictured with Dr. Barry Issenberg is Professor ShigeakiHinohora, an early user of the simulator in Japan and, at more than 100 years of age, the world’s longest practicing physician.Tokyo’s Life Planning Center was recipient of the first international Harvey® in 1981.

Dr. Gordon’s leadership in the use of simulation in healthcare educationcontributed to growing acceptance and ultimately to its routine role in the training of physicians, nurses, and allied health professionals.

More than 40 years ago, Michael Gordon was one of a handful of medical educators willing to challenge conventions and substantiate simulation as a valid teaching tool. In September 2011, according to Medical Simulation in Medical Education:Results of an American Association of Medical Colleges Survey, markers indicate “close to 100 percent usage of simulation across many of the competencies that represent core undergraduate learning.”

The Gordon CenTer for researCh in MediCal eduCaTion12 13Visionary • Innovator • Educator

Taiwan

Dr. Gordon’s 50-year career has seen a required physical presence yield to the virtual world, as technological breakthroughs, multiple platforms, and mobile applications allow use of the center’s programs around the world.

Many of the same advances that made it possible for computerized equipment to simulate the human patient with such accuracy also eliminated physical distance as a barrier to the benefits. Harvey®, UMedic®, and the center’s emergency response training programs are in use in nearly 2,000 medical centers in 41 countries on six

continents. Via the Internet, UMedic® is available to learners from the far reaches of the globe. The

MEND stroke checklist can be administered on a mobile phone,

while the U.S. Army uses hand-held devices to access Gordon

Center-developed content. An unlimited number of learners can take part in

online courses on pediatric trauma, mass casualty triage and emergency response to terrorism.

Collaboration with others is a hallmark of the Gordon Center that has enhanced both its outreach and imprint. Multi-center studies, academic partnerships, joint initiatives, and professional alliances have led to significant progress in advancing the field of simulation, improving the quality of education, and, ultimately, saving lives. Some notable accomplishments include more sophisticated skills-testing in competency assessment, contributing to the International Association for Medical Education in Europe, and disaster preparedness training with both civilian and military applications. In conjunction with UM colleagues in trauma, the Gordon Center has been training physicians and nurses from Brazil in advance of that country’s hosting of the 2014 World Cup and the 2016 Olympics (pictured above).

The Gordon CenTer for researCh in MediCal eduCaTion 15Visionary • Innovator • Educator14

Dr. Gordon, with University of Illinois Chancellor Paula Allen-Mears and President Bob Easter, was presented with the Alumni Achievement Award Oct. 12, 2012, “for outstanding professional success and national distinction” as the Pioneering Inventor of Medical Simulation Technology.

Michael Gordon has “a long track record of professional excellence. Among his important contributions are his extraordinary leadership, tireless efforts to conduct vital medical research, and devotion to helping others.”

Hon. Ileana Ros-LehtinenUnited States House of Representatives

“The true value of the educator is the number of lives improved

directly and indirectly by his work. Michael Gordon’s efforts in the field of simulation technology

have rippled beyond the academic setting and far beyond the borders

of our state. It is astonishing to consider the incalculable number

of people worldwide whose successful treatments are owed in

part to his innovations.”

Speaker Will WeatherfordFlorida House of Representatives

“American medicine and the University of Miami are fortunate to have such dedicated and innovative medical professionals and educators as Dr. Gordon. His commitment to excellence, leadership and service is to be admired, and may it inspire others to follow in his footsteps.”

Hon. Daniel WebsterUnited States House of RepresentativesAs quoted in the Congressional Record, Dec. 5, 2012

Visionary • Innovator • Educator

Accomplishing more than others think is possible

17Visionary • Innovator • Educator16 The Gordon CenTer for researCh in MediCal eduCaTion

“What is once well done is done forever.” Henry David Thoreau

In honor of Michael S. Gordon, M.D., Ph.D.December 7, 2012

“Dr. Michael Gordon has always been at the cutting edge—ahead, way ahead of his time. He is responsible for improving the quality of life of countless people. What better thing to do in life?”

Miami-Dade County Mayor Carlos GimenezRetired Fire Chief, City of Miami Fire Rescue

“He is an extraordinary cardiologist who really understood the importance of what you learn from the patient and was able to use that intelligence to create a model that has trained more individuals around the world than any model ever invented by an educator. Michael is simply bigger than life.“

Dean Pascal J. Goldschmidt, M.D. Senior Vice President for Medical Affairs and Dean University of Miami Miller School of Medicine

“His refusal to be bound by the status quo and his capacity for seeing what eludes the more literal minded is what has made Michael Gordon such a transformative leader.”

Barry Issenberg, M.D. Director, Gordon Center

“We honor Dr. Gordon as our Distinguished Chief, for providing not just our community, but the entire country, with the best education they will ever receive. The most valuable lesson Dr. Gordon taught each of us is, ‘Always give your best no matter what and always do the right thing.’”

Angel A. Brotons, EMT-PAssociate Director, Prehospital & Emergency HealthcareBattalion Chief, Monroe County Fire RescueOn behalf of Gordon Center paramedic instructors

Michael Gordon…”put together a group of individuals who contribute their time, who contribute their energy—with no return other than knowing the educational material that is produced will last as long as medical education lasts.”

Ira H. Gessner, M.D.Professor Emeritus, Pediatric CardiologyUniversity of Florida College of Medicine

“Michael Gordon has demonstrated over his career the ability not only to do, but to do things that needed to be done. As a leader in the field, he has inspired others to dream more, to do more, to learn more, and to become more. Lynda has supported Michael by encouraging and strengthening him, I think by shedding sunshine on his path and by lightening his problems in adversity.”

Ronald M. Harden, M.D.Centre for Medical Education, University of DundeeGeneral Secretary, Association for Medical Education in Europe

“I consider him the consummate physician. I still call him on a variety of subjects, even outside of medicine, because he can think through anything and give you a wonderful and treasured opinion as to what you should do.”

Robert B. Tober, M.D.EMS Medical Director, Collier County, Florida

Dr. Gordon surrounded by his family.

Harvey® on not one but two cakes presented to a surprised Michael Gordon at a gala dinner in his honor on December 7, 2012.

Left to right, Bob Waugh, Gordon Ewy, Ira Gessner,

Michael Gordon, David Lawson

20 The Gordon CenTer for researCh in MediCal eduCaTion

Health

• Education • Innovatio

n

Th

e Gordon Center

We have accomplished so much over these more than 40 years, because we went together. Our faculty and staff are bright and motivated and fully committed to our mission of “saving lives through simulation technology.” We also have a unique advantage with the members of the M.I.A.M.I. Group. They are experts from prestigious medical centers who are the gold standard for the very best in patient care. It is they who developed our curricula.

You need the right people for success, but you also need funding. Our donors have been extremely generous, especially Harry and Bea Feldman. The State of Florida has been our partner for over 30 years, and we would not have been able to carry out our life-saving work without their support.

While our center is remarkably productive, it’s all carried out with a culture of consideration for each other. We truly are a family, and that spirit was created by my best friends and colleagues, Diane and Harold Issenberg. Of course, all good things are due to Lynda, my wife and my love.

The M.I.A.M.I. Group

ARIZONA

Gordon A. Ewy

CHICAGO

Stuart Rich

DREXEL

Nina Multak

DUKE

Robert A. Waugh

DUNDEE

Ronald M. HardenStuart S. Pringle

EASTERN VIRGINIA

Geoffrey T. Miller

EMORY

Joel Felner Jaffar Khan

FLORIDA

Ira H. Gessner

FLORIDA INT’L

Jeffrey A. Groom

HARVARD

Emil Petrusa

JOHNS HOPKINS

Pamela R. Jeffries

ILLINOIS

George T. KondosAbdul Sajid*

IOWA

Donald D. Brown

LOYOLA

William C. McGaghie

*deceased

MAYO

Keith R. OkenRobert E. SaffordScott M. Silvers

OTTAWA

Ian Hart*

PITTSBURGH

Paul E. Phrampus

TEXAS TECH

Sharon Decker

WAKE FOREST

Patrick S. Reynolds

MIAMI Angel A. BrotonsJuliette E. ColemanNabil El SanadiJoseph B. EstersonPete A. Gutierrez S. Barry IssenbergDavid LawsonBarry MatersonJoan W. MayerIvette MotolaHector F. RiveraRoss J. ScaleseRobert SotoJohn E. SullivanRobert B. Tober

FELLOWS

Hyun Soo ChungLuke DevineLoryn S. FeinbergNora GonzalezRosana MillosVivian ObesoYoung Sook Roh

“If you want to go fast, go alone. If you want to go far, go together.”

F R O M T H E D E S K O F

Michael S. Gordon, M.D., Ph.D.

Michael S. Gordon Center for Research in Medical EducationP.O. Box 016960 (D-41), Miami, Florida 33101 • Phone: 305-243-6491 • www.gcrme.miami.edu

Faculty and Staff of the Gordon Center