GORDON CENTER

GORDON CENTERWinter 2013For Research In Medical EducationVisionary • Innovator • EducatorMichael S. Gordon, M.D., Ph.D.Director Emeritus

Michael S. Gordon, M.D., Ph.D.Roles:ResearchInterest:Director Emeritus, Gordon Center forResearch in Medical EducationProfessor of Medicine, University of MiamiMiller School of MedicineApplication of simulation technology tomulti-professional medical educationVisionary, Innovator, EducatorEducation: Cardiology Fellowship,Georgetown UniversityDoctor of Philosophy,University of MinnesotaInternal Medicine Residency, Mayo ClinicPost Doctoral Research FellowNational Institutes of HealthMedical Degree / Master of Science /Bachelor of Science, University of IllinoisAwards: Alumni Achievement Award, 2012University of IllinoisDoctor of Laws honoris causa, 2003University of DundeeLaennec Society Special Recognition Award, 1998American Heart AssociationGifted Teacher Award, 1996American College of CardiologyBiography: Dr. Gordon joined the faculty at the Universityof Miami in 1966. In pursuit of a way to improvecardiac bedside examinations, he createdHarvey ® , the longest continuous university-basedsimulation project in medical education. TheCardiopulmonary Patient Simulator realisticallysimulates nearly any cardiac disease at the touchof a button by varying blood pressure, pulses,heart sounds, murmurs and breath sounds. Tocollaborate on the development of the Harvey ®curriculum, Dr. Gordon formed a worldwideconsortium of physicians, nurses, engineers,and educators known as the M.I.A.M.I. Group.The group’s role expanded over the years toencompass computer-based and hands-on skillstraining programs in cardiology, neurology, andemergency medicine.Few people have affected the educationof students and healthcare practitioners asprofoundly as Dr. Michael S. Gordon. Because ofhis “dedication, extraordinary vision and worldleadership in developing advanced technologyfor medical education,” in 2007, the University ofMiami established the state-of-the-art Michael S.Gordon Center for Research in Medical Education.A visionary is one whosees what most othersmiss, an individualwhose laser-likefocus on what canbe is not deterredby the variousreasons it mightnot be. From earlyin his 50-year careerin medicine, MichaelStanley Gordonestablished himself as avisionary and an innovator.He did not simply foresee theintegral role of simulation in medical education;he had the will, the tenacity to make it happen.As a pioneer in the application of technologyto medical training, he developed systems andprograms that have been used at nearly 2,000medical institutions worldwide. In doing so,he helped shape a new paradigm, leaving anindelible imprint on the way generations ofhealthcare professionals are educated.Even while capitalizing on the latest advances inmechanics—and, ultimately, computerization—Dr. Gordon kept central the approach toteaching he learned from his mentor, Dr. W.Proctor Harvey. His goal was to thoroughlyinvolve his students, utilizing sight, touch,and sound to better communicate his lessons,emphasizing these senses as the best primarymeans of diagnosing heart disease in patients.Recognizing that all the gadgetry in the worldis only effective when used with a well-devisedcurriculum, Dr. Gordon has ensured all programsadhere to the highest of educational standards,including outcomes-based evaluations.As a faculty member at the University of MiamiSchool of Medicine, Dr. Gordon first designed hiscurricula for medical students and residents, buthe envisioned the benefits his programs couldbring to primary care physicians and nurses whocould be better able to identify heart disease intheir patients. Since the 1970s,he saw the potential to expandprogrammatically to otherhealthcare professions. Thusbegan multi-professionaltraining of emergencypersonnel, includingparamedic-firefighters, U.S.Army surgical teams, andeven law enforcement. Thesimulation techniques usedso successfully to teach bedsidecardiology led to hands-on trainingbeyond basic and advanced cardiac lifesupport, encompassing trauma, disaster response,airway management, heart attack, and stroke. Not tobe limited by the number of providers that could beaccommodated on campus, Dr. Gordon, with supportfrom the Florida legislature, invited paramedicinstructors from across Florida to be trained to teachtheir own classes using curricula developed at theUniversity of Miami. This “train-the-trainer” approachopened the door to a new means of broad-baseddissemination that has led to hospitals, prehospitalsystems, and educational institutions throughoutthe United States, Mexico, Great Britain, and HongKong implementing their own Advanced Stroke LifeSupport ® training.When Dr. Gordon joined its faculty in 1966, theUniversity of Miami was one of only 86 medicalschools in the United States and relatively new,having graduated only 11 classes of physicians.Just a few years later, the era of managed carebegan and resulted in students having reducedaccess to live patients for learning. This, togetherwith predictions of a physician shortage,prompted a 50% increase in the number ofmedical schools and a bourgeoning of programsto train advanced practice nurses and physicianassistants. Dr. Gordon’s vision for alternative ways toteach medicine was prophetic. At the time, however, hefaced resistance and skepticism, as he challenged thelong-held tradition that students could only learn fromreal patients. He was undaunted and repeatedly provedthe doubters wrong, paving the way for simulation togrow into an accepted—now expected—means forteaching and evaluating clinical skills and an invaluableresource for research in medical education.For more than four decades,Michael Gordon’s efforts haveinfluenced healthcare educationworldwide by providing practicalsolutions to real problems.The most notable hallmarks of hissuccess are described on the followingpages, each with its own story, alla demonstration of his uncannyforesight, bold determination, andrelentless pursuit of excellence.As he assumes a new role asDirector Emeritus, his legacygrows, not only at the Universityof Miami and at the center hefounded and bears his name,but in healthcare institutionsall over the world.The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 1

While a fellow of the renowned cardiologist,W. Proctor Harvey, M.D., Dr. Gordon was inspiredto devise a way to combine the precise disciplineof his basic science research with the art of thebedside examination. He conceived of “building”a patient even then. In Miami, as consultant forthe Airlines Pilot Association, whose members weretrained and tested using flight simulators,Dr. Gordon was energized by the potential ofa comparable device for teaching medicine.His work with airline pilots led to chairingthe committee that wrote the guidelines forcardiovascular health and aviation safety,jointly sponsored by the FederalAviation Administration and theAmerican Medical Association.Theidea forHarvey ®is born.In the beginning, Harvey ® was capableof simulating only one cardiac disease,so to teach different diseases requireda series of mannequins.The prototype for the initial cardiology patientsimulator was developed in 1967, when scientistsand engineers were still using slide rules. Aware ofits use of animatronics, Dr. Gordon first contactedDisney about creating a robot for educational use.He was referred to the New York firm that builtmany of the floats in the Macy’s parade and wouldbecome the developer of the initial Harvey ® .Actually, three different simulators were built: anolder-looking one emulated a heart attackpatient, a middle-aged one hadvalve narrowing, and a youngerlookingmodel had a hole inthe heart. A few years later,another patient connectionled Dr. Gordon to theengineers who wouldtake Harvey ® to thenext level. A womanwhose heart disease hestabilized in the middleof the night happenedto be the motherof the chairman ofInternational Telephone& Telegraph. ITT’sDefense CommunicationsDivision in Nutley, NewJersey helped develop a singlemannequin capable of simulatingmany different diseases.A patent for Harvey ® was granted onMay 9, 1972.Within five years of being granted a patent,Dr. Gordon had a recast Harvey ® capableof simulating 20 differentcardiac diseases,which he demonstratedbefore the UnitedStates Congress in 1977(pictured at left).Harvey ® ’s use throughout the U.S. draws theattention of Ripley’s Believe It or Not.The novelty of the human-like Harvey ® was alsofeatured in an episode of the popular televisionshow, “That’s Incredible.” While exposure in massmedia during the 1980s was entertaining, it was Dr.Gordon’s efforts and academic credentials that led toHarvey ® ’s installation in a growing number of medicalschools and teaching hospitals across the country.Harvey ® ’s first overseas home was in Japan.Use of Harvey ®The new generation of Harvey ® is 500 pounds lighter.marks the firsttime a simulatorwas adopted into anational certificationexam for physicians.A two-year collaboration with theRoyal College of Physicians andSurgeons of Canada resulted in arigorous evaluation of the reliability,validity, and feasibility of usingsimulation for high-stakes assessment.The successful results led to Harvey ®being used in the initial certificationof cardiopulmonary bedside skills forinternal medicine specialists in Canada.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 breathsounds and 30 cardiac diseases in a significantly more portable system. Their efforts were recognized in 2008 withthe award of a new patent for a Cardiopulmonary Patient Simulator.1972 20082The Gordon CenTer for researCh in MediCal eduCaTionVisionary • Innovator • Educator3

The publication ofa multi-center studyon teaching withHarvey ® establishesits effectiveness.Installing a Harvey ® ateach Group member’sinstitution provided Dr.Gordon with access to agreater number of medicalstudents in cardiologyelectives for a series ofpublished multi-centerstudies. An initial articlein 1974 was followed in1980, also in the AmericanJournal of Cardiology. Thedata showed an averagegain in student bedsideskills of 32%, with as littleas one hour of study perdisease. Further studiesinvolving hundreds ofpractitioners of varyingskills levels showed93% giving Harvey ® anexcellent rating and allwishing to be taught withthe device in the future. Aseminal study funded bythe NIH and independentlyevaluated was publishedin September 1987 in theAAMC Journal of MedicalEducation. The resultsclearly demonstratedthat students taughtwith Harvey ® not onlymastered lessons betterthan conventionallytrained peers but thatthe knowledge and skillsthey gained effectivelytranslated to theirdiagnosis and interactionwith live patients.The Harvey ® Group wasa collaboration of expertsformed in the 1970s from eight medicalcenters throughout the United States.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 additionto Dr. Gordon and colleagues Barry Materson, M.D. and Joan Mayer, M.D. at theUniversity 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-annuallyto ensure all programs developed at the center satisfy stringent standards of educationalexcellence and that they are beneficial for use by a variety of institutions.International outreach adds worldrenownedexperts in outcomesmeasurement to M.I.A.M.I. Group.Dr. Gordon met Dr. Ian Hart when he wasengaged by the University of Miami to evaluateits new medical student curriculum. His fortuitousintroduction to the founder of the CanadianAssociation of Medical Education led to his meetingDr. Hart’s close colleague and co-founder of theOttawa Conference for Medical Education, Dr.Ronald Harden, who also pioneered the ObjectiveStructured Clinical Examination (OSCE). Dr. Gordonimmediately recognized their impact when heinvited them to be part of the M.I.A.M.I. Group’sEvaluation and Assessment team.Expansion of the M.I.A.M.I.Group facilitated an increasein programs and a broadeningof target audiences.Over the years, Dr. Gordon addedto the consortium to recruit a morediverse body, adding emergencymedicine physicians, neurologists,nurses, and physician assistants. Hisvast network of esteemed colleagueshelped identify aspiring and dedicatedacademicians to consider.Nurses had learned withHarvey ® for years, but withthe profession’s expandinghealthcare role, the timewas right to tailor a Harvey ®curriculum specific to their needs.Dr. Gordon recognized early on that his educationalprograms would benefit nursing professionals, enlistingbenefactor Joan K. Stout, R.N., to establish a NursesTraining Program in her name. With the additionof nurses recognized as international leaders insimulation education, the M.I.A.M.I. Group was ableto customize the Harvey ® curriculum to reflect the waynurses approach the bedside exam. Two multi-centerstudies showed the new curriculum led to significantimprovements in bedside skills for advanced practicenurses (2009) and undergraduatenursing students (2010).Experience teachingphysician assistantstudents led to anational multi-centerstudy.About the time the worldwas preoccupied withY2K, Dr. Gordon showed again he was ahead of the curve,opening the 4-week Harvey ® elective to the Miami DadeCollege Physician Assistant (PA) program. A decade ofsuccess encouraged him to establish a sub-group of PAeducators to create a curriculum specifically geared to theirlearners. He asked faculty member Ross Scalese, M.D., tooversee the ensuing four-center study that confirmed itseffectiveness and was presented at the 2011 PA EducationAssociation forum and the International Meeting onSimulation in Healthcare held in January 2012.4 The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 5

On-campusspace wasscarce in1966 whenDr. Gordon came tothe medical schooland began trainingthe cardiologystudents and fellows.Dr. Gordon taught as studentsfollowed him from patientto patient. His office wasin the Alamo Annex, thehallway connecting thehistoric building to JacksonMemorial Hospital. He workedon Harvey ® development ina backroom secured fromVeterinary Services, justbeyond the live animals onthe first floor of the RosenstielMedical Sciences Building.An unused lot behind what was then the National Children’sCardiac Hospital was eyed as the site to house a state-of-the-artresearch and training laboratory, with classroom space, curriculadevelopment, and Harvey ® production all under one roof.Once he determined the sitewas available and was given theokay by Dean Bernard Fogel, Dr.Gordon set about obtaining thenecessary authorizations, raisingfunds from private donors, andworking on a designthat couldaccommodateupwardexpansion.In 1978, ground was broken on the Medical Training andSimulation Laboratory (MTSL). The following year constructionwas completed, and Dr. Gordon had a central location inwhich to teach and conduct research.The new facility was built to accommodate theaddition 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 tosee, hear, and even touch the simulator using palpating boxes. Similar innovationsare still used today to teach students in the cardiology elective, led by cardiologistJoseph Esterson, M.D.The MTSL afforded space forstudent self-learning.An avid proponent of deliberatepractice, Dr. Gordon made sure toprovide students with the spaceand tools to study on their own,reinforcing the lessons taughtby faculty. Pathology textboxes held a real human heartwith the location of diseaseflagged, and drop-down panelsgave students a patient’s historyand how the patient presented.The same teaching methodologywas used with Harvey ® and later theUMedic Multimedia programs, whichare available for student access in theSelf-Learning Laboratory.The Training and SimulationLaboratory was also known to manyas Harvey ® House, an apt description,not only because Harvey ® wasa centerpiece for teaching, butbecause the mannequins were alsoassembled there.Increasing the elevation of the lot prior toconstruction enabled the MTSL to have afeature highly unusual in Miami: a basement.With room to store equipment below groundand space for a workshop above ground, Dr.Gordon was able torelocate the fabricationof Harvey® fromNew York to moreclosely superviseits productionthrough criticalstages of itsdevelopment.Several yearslater, thebasement wasbuilt out in phasesto provide additionalinstructional areas foremergency response training programs.Before there werepersonal computers,Dr. Gordon offeredstudents access toelectronic media.In the early 1980s, a terminalat the MTSL connected to amainframe computer at theMiami Heart Institute—a leaderin its use of computerization—to provide students accessto a computer program forindependently learning tointerpret electrocardiograms.In the classroom, while Dr.Gordon demonstrated onHarvey ® , the roughly 30slides for each disease—presenting the patient’s history, physical findings,and diagnostic test results—were projected on alarge screen. To achieve the same results in theconfined booth of an exhibit hall required a differentconfiguration. A special cabinet was designed tohouse a carousel of slides, rotated to conserve space,and project the images from the rear to bevisible on the other side, above Harvey ® ’s head.That portability would later evolve to facilitatestudent self-study.The advent of the Laserdiscmade possible a new multimediacomputer curriculum knownas UMedic ® .A reflective disc the size of an LP recordalbum came on the market in 1978.Its capability for playing high qualityaudio and video made it feasible topackage full-color video clips of actualcatheterizations and surgeries. A casebasedprogram for each disease wasdesigned for students to use on their ownor in small groups.UMedic ® had the added bonus ofenhancing a live faculty presentation withHarvey ® . Few medical centers in themid-1980s had the equipment necessaryfor UMedic ® , so Dr. Gordon made itavailable as an entire package, cartincluded.Confident that seeing is believing, Dr.Gordon hosted myriad legislators, donors,and other VIPs, giving them a first-handlook at his educational innovations.Among the many to be impressed by Dr. Gordon’suse of technology and simulation was Sen. DempseyBarron, 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 powerfulpolitical figures in the state. Dr. Gordongained insight into the workings of thelegislature, which became a source forgrants for statewide training. Over thedecades, Dr. Gordon has personallyhosted every Speaker of the FloridaHouse and President of the Senate, allgaining insight into the importance ofthe center’s programs. Pictured withHarvey is currentSenate President,Don Gaetz.By 1998, all UMedic ® programs were fully convertedto the newly available Compact Disc.By the end of the 20th century, most computers came with a CD-ROMdrive, eliminating the need for expensive specialized equipment. Thismeant a significant reduction in cost and much greater accessibility tothe programs. Today, UMedic ® can be used on Apple as well as PCsystems and is viewable through the Internet, giving health scienceschools greater flexibility in how they make the curricula availableto their learners. In 2011, a three-program series on the identificationand interpretation of electrocardiographic and arrhythmia findings wasintroduced that includesdynamic graphic animationsand modern navigationtools.6 The Gordon CenTer for researCh in MediCal eduCaTionVisionary • Innovator • Educator 7

The seed foremergency trainingwas planted in 1982.At the request of Dean Bernard Fogel, Dr. Gordoninstituted medical student coursesin Basic and AdvancedCardiac Life Support(ACLS), training thatcontinues to thisday. The AmericanHeart Associationpublished the firstACLS guidelinesonly a few yearsearlier, in the mid-1970s.The City of MiamiFire Department, thenation’s first to havea paramedic program,approached Dr. Gordonabout training itspersonnel at theUniversity.The MTSL presented its first AdvancedLife Support Competition in 1992, andwithin five years, there was a waiting listof paramedic crews wanting to take part.Realistic scenarios have involved a variety of outsideagencies, including the FBI, Drug EnforcementAgency, Coast Guard, Urban Search and Rescue,and CIA. Interest in the event grew due, in greatpart, to the efforts of Stephanie Browne, nursecoordinator of EMS training, who died of cancerat the age of 43. The event was renamed in 1997to honor her memory. In the ensuing years, teamsfrom as far as North Florida have tested their skillsin patient assessment, critical thinking, and decisionmaking. In 2007, the center established the “EMSFutures Scholarship,” awarded to a worthy studentselected by the first-place team to be used towardthe expenses of EMT or paramedic school.The effectivenessof the train-thetrainermethodmade it possiblefor curriculadeveloped by thecenter’s faculty tobe implemented allover the U.S. andinternationally.As the only 8-hour, hands-onstroke course for healthcareprofessionals, AdvancedStroke Life Support ® is usedby hospitals, EMS agencies,and educationalinstitutions in25 states. Itis taughtin HongKong andGreatBritain,and theRed Crossin Mexicotrains all ofthat country’sparamedicsin ASLS ® .Whether locally or at more distant locations in Florida,off-site training became more feasible with the use of acustomized Mobile Simulation Unit.The air-conditioned, 20-foot trailer is fully outfitted with the sameequipment as the center’s permanent simulation training areas.The sim lab-on-wheels facilitates skills training at hospitals, wherepersonnel can be scheduled by appointment with minimal time awayfrom clinical service.Dr. Gordon established a rapport with his constituenciesthat continues yearly with a meeting of the EmergencyMedical Skills Training Advisory Board.Leaders in emergency medicine, fire rescue, emergency response,nursing, law enforcement, military, public health, and education offervaluable insight on curricula, scheduling, and long-term planning towhat is now known as the Division of Prehospital and EmergencyHealthcare. The division is under the direction of emergency medicinephysician Ivette Motola, M.D., M.P.H.Among Dr. Gordon’s proudest accomplishments is the long-term collaborationwith the U.S. military and the Army Trauma Training Center (ATTC).Leading the effort was Carlos Gimenez, who went onto become fire chief and is now mayor of Miami-DadeCounty. In response, Dr. Gordon, in 1985, embarked on aprogram that included teaching paramedics to recognizesymptoms of heart attack, administer and interpret anBeginning only one month after the attacks of September 11th, forward surgical teams have been prepared fordeployment to Afghanistan and Iraq in 2-3 week rotations at the UM/Jackson Memorial Medical Center. In additionto clinical sessions at Ryder Trauma Center, the physicians, nurses, physician assistants, and medics also undergoelectrocardiogram, and initiate treatment during transport.hands-on training at the GordonLooking for a way to extend the impactTraining soon extended well beyond local departmentsCenter, including realisticand has since included the development of other curriculaof prehospital training beyond Miami,mass casualty simulations. Thein airway management, stroke, and disaster response. To Dr. Gordon facilitated the teaching ofGordon Center is evaluating forprovide realistic simulation scenarios, Dr. Gordon obtained the center’s heart attack curriculum tothe Army the effectiveness of itsa real rescue vehicle and a car for extrication practice. Along paramedic providers across Florida.mobile applications for patientwith a mock emergency department and decontaminationshower, they were accommodated by the construction of newtraining space in theMTSL basement thatestablished the onlycenter in the countryat the time dedicatedto life support andcritical care training.By training instructors from state-funded paramedictraining programs to teach the course and providingthem the curricular materials, thousands moreresponders were better prepared to treat patientswith acute coronary syndromes. The model ofcollaborating with state colleges and vocationalinstitutions also proved effective for AdvancedStroke Life Support ® (ASLS ® ), as well as EmergencyResponse to Terrorism (ERT). Among the locales forERT training was Tallahassee Community College(pictured above).assessment in the field. In amoving tribute on Veterans’ Day2010, the center paid homage toStaff Sergeant Ronald J. Spino,a member of the 274th ForwardSurgical Team who died inAfghanistan while serving histhird tour treating woundedsoldiers. The large training roomused by the ATTC was dedicatedin his memory.8 The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 9

Anopportunityarose toget in onthe groundfloor.With the launch of theUniversity of Miami’slandmark Momentumcapital campaign in 2002,the timing was right forDr. Gordon to dovetail hisown fundraising efforts tofinance a state-of-the-artfacility. The result: DeanJohn Clarkson’soffer to occupyspace in anew highriseplannedfor clinicalresearch. Thesimulationcenter’s uniquecriteria—includingAfter two decades, the facility that had seemed so spacious couldno longer accommodate the diversification and growth of thecenter’s programs.By the early 2000s, the center’s emergency training had branched out educationallyand geographically, students from Miami Dade College’s physician assistantprogram joined UM medical students in rotating through the Harvey ® elective,and advances in computer graphics and processing speed fueled by the gamingindustry opened new opportunities for UMedic. Added to that was the prospectof the British Heart Foundation equipping all 27 medical schools in the UnitedKingdom with their own Harvey ® , placing unprecedented demands on theproduction process. Not one to be confined by walls, Dr. Gordon set aboutdevising a solution.Dr. Gordon sharedhis passion aboutthe accomplishmentsafforded by a newcenter with long-timesupporters.The late Harry and Bea Feldmanwere enthralled the first timethey met the enthusiastic doctorfrom the University of Miamiwho demonstrated a humanlookingdevice named Harvey ® .That was in 1974. In the yearsthat followed, Harry and Bearemained among the center’s strongest supporters. When Dr. Gordon explainedthe lasting impact on the education of healthcare providers that was within reachwith a new facility, the Feldmans committed to make the dream a reality.“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 inthe 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 undercontract for the new Clinical Research Building, beginning in 2002. He researched other simulation and trainingcenters, identifying the features to emulate, noting shortcomings and mistakes to avoid. He involved key facultymembers and staff every stepof the way. The goal wasto create a spacious, cuttingedgefacility to accommodatetraining, Harvey ® andUMedic ® , researchprojects and curriculumdevelopment—and haveroom to grow as needed.The groundbreaking ceremony forthe Clinical Research Building washeld January 20, 2004.Thus began a three-year project, theprogress of which was viewable live on theInternet thanks to a series of webcams.Dr. Gordon included a hard-hat tour of theconstruction site on the M.I.A.M.I. Group meetingagenda in June 2006.By then, the rescue vehicle had already been disassembled sooutdoor training exercisesthe parts could be taken from the basement of the old buildingand an indoor rescue vehicleand brought to the new trauma room before the glass walls wereand car—clearly required aerected. Likewise, the new Mini-Cooper, its fuel lines removed forfirst floor location. Add thesafety reasons, also had to be on-site in time to be walled into thefloor above, and the totalbuilding. Both vehicles were to be placed on pedestals to allow easyreconfiguration of the room.square footagein the newYears of navigating the halls of government inThe Grand Opening Gala on Dec. 2, 2006 celebrated theClinicalTallahassee gave Dr. Gordon insight, and the contacts,to seek funding at both the state and federal level.opening of the new facility and the renaming of theResearchCenter for Research in Medical Education in tribute toBuildingDr. Gordon made the case to Florida leaders for a one-timeFounding Director Michael S. Gordon.wouldcommitment beyond its programmatic allotment to the center,securing a multi-million dollar grant to underwrite some ofDr. Gordon thanked his colleagues, who attended from 14 medicalbe morethe capital costs for the new facility. He also contacted threecenters worldwide, for working with him to create the center’sthankey members of the Florida delegation to the U.S. House ofprograms over the years. He also thanked the generous donors thatdoubleRepresentatives, already well acquainted with the work of thetogether contributed a total of $12 million to build the new 34,000that ofthe originalcenter from their tenure in the Florida legislature. RepresentativesLincoln and Mario Diaz-Balart and Ileana Ros-Lehtinen weresquare foot facility. Over his career, Dr. Gordon raised more than$130 million toward the center’s mission. To the University of Miamicenter.instrumental in helping Dr. Gordon secure federal funds towardhe expressed his gratitude for “providing the environment whereequipping the new facility.ideas can become the reality,” resulting in the saving of lives.10 The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 11

Dr. Gordon’sleadership in theuse of simulation inhealthcare educationcontributed togrowing acceptanceand ultimately to itsroutine role in the trainingof physicians, nurses,and allied healthprofessionals.TaiwanRecognizing a growing need for the criticallyimportant simulation educator, the GordonCenter instituted a fellowship program in 2001.Since the program’s inception, fellows from the U.S.,Canada, and South Korea have been able to bringthe skills learned at the Gordon Center back to theirrespective nursing and medical schools. The one-to-twoyearfellowship program is competency-based and hasa frameworkencompassingall roles ofa simulationclinicaleducator: thoseof a clinicalteacher, resourcedeveloper,curriculumplanner, andfacilitator oflearning.Even with the number of new simulationcenters growing, guidelines on therequirements for the role of simulationeducator were lacking, prompting theGordon Center to create a HealthcareSimulation Instructor Development Program.Simulation instructor development courses weredeveloped in collaboration with the Peter M. WinterInstitute for Simulation, Education and Research (WISER)at the University of Pittsburgh. The programs providehealthcare professionals with the skills to design,develop, and integrate simulation-based instruction;devise and apply effective measures for assessment andevaluation; and carry out research studies. Participantsoutside the U.S. have come from Hong Kong, SouthKorea, Austria, France, the United Kingdom, and Spain.More than 40 years ago,Michael Gordon was oneof a handful of medicaleducators willing tochallenge conventions andsubstantiate simulation asa valid teaching tool. InSeptember 2011, accordingto Medical Simulation inMedical Education:Results of an AmericanAssociation of MedicalColleges Survey, markersindicate “close to 100percent usage of simulationacross many of thecompetencies thatrepresent coreundergraduate learning.”The Gordon Center’s contribution to the globalfuture of simulation includes guiding otherson systematically integrating simulation intomedical education.As acceptance of simulation has grown, requests for theGordon Center to share its expertise have increased.Center faculty have advised academic leaders inSouth Korea, Brazil, and Kazakhstan. In Russia, theGordon Center has been counseling the BakoulevScientific Center for Cardiovascular Surgery of theRussian Academy of Medical Sciences. Picturedwith Dr. Barry Issenberg is Professor ShigeakiHinohora, an early user of the simulator in Japanand, at more than 100 years of age, theworld’s longest practicing physician.Tokyo’s Life Planning Center wasrecipient of the first internationalHarvey ® in 1981.While English has become the languageof choice at international conferences,students often prefer learning intheir native language, so the GordonCenter took steps to make its programsavailable in other languages.The Harvey ® curriculum has already been translatedinto Spanish, Russian, Korean, Mandarin Chinese, andJapanese. To facilitate instruction during three weeks ofsimulation training of faculty from Kazakhstan, the GCRMEenlisted a colleague to translate into Russian, a morefamiliar second language to their native Kazakh (picturedabove). Led by internist Hector Rivera, M.D., the AdvancedStroke Life Support ® curriculum was translated into Spanishfor use in prehospital training by the Mexican Red Cross.The curriculum was also modified for use in Great Britainto accommodate cultural and idiomatic distinctions inEnglish between the two countries.12 The Gordon CenTer for researCh in MediCal eduCaTionVisionary • Innovator • Educator 13

Collaborationwith othersis a hallmarkof the GordonCenter thathas enhancedboth itsoutreachand imprint.Multi-center studies,academic partnerships,joint initiatives, andprofessional allianceshave led to significantprogress in advancingthe field of simulation,improving the quality ofeducation, and, ultimately,saving lives. Some notableaccomplishments includemore sophisticated skillstestingin competencyassessment, contributingto the InternationalAssociation for MedicalEducation in Europe, anddisaster preparednesstraining with both civilianand military applications.In conjunction with UMcolleagues in trauma,the Gordon Center hasbeen training physiciansand nurses from Brazilin advance of thatcountry’s hosting of the2014 World Cup andthe 2016 Olympics(pictured above).Dr. Gordon’s 50-year career has seen a requiredphysical presence yield to the virtual world,as technological breakthroughs, multipleplatforms, and mobile applications allow useof the center’s programs around the world.Many of the same advances that made it possible forcomputerized equipment to simulate the human patientwith such accuracy also eliminated physical distanceas a barrier to the benefits. Harvey ® , UMedic ® , and thecenter’s emergency response training programs are inuse in nearly 2,000 medical centers in 41 countries on sixcontinents. Via the Internet, UMedic ® is available tolearners from the far reaches of the globe. TheMEND stroke checklist can be administeredon a mobile phone,while the U.S. Army useshand-held devices to access GordonCenter-developed content. An unlimitednumber of learners can take part inonline courseson pediatrictrauma, masscasualtytriage andemergencyresponsetoterrorism.Visionary • Innovator • EducatorAccomplishing more than others think is possibleMichael Gordon has “a longtrack record of professionalexcellence. Among hisimportant contributions arehis extraordinary leadership,tireless efforts to conductvital medical research, anddevotion to helping others.”Hon. Ileana Ros-LehtinenUnited States House ofRepresentatives“American medicine and the University ofMiami are fortunate to have such dedicated andinnovative medical professionals and educatorsas Dr. Gordon. His commitment to excellence,leadership and service is to be admired, and may itinspire others to follow in his footsteps.”Hon. Daniel WebsterUnited States House of RepresentativesAs quoted in the Congressional Record, Dec. 5, 2012“The true value of the educatoris the number of lives improveddirectly and indirectly by his work.Michael Gordon’s efforts in thefield of simulation technologyhave rippled beyond the academicsetting and far beyond the bordersof our state. It is astonishing toconsider the incalculable numberof people worldwide whosesuccessful treatments are owed inpart to his innovations.”Speaker Will WeatherfordFlorida House of RepresentativesDr. Gordon, withUniversity of IllinoisChancellor Paula Allen-Mearsand President Bob Easter, was presented withthe Alumni Achievement Award Oct. 12, 2012,“for outstanding professional success andnational distinction” as the Pioneering Inventorof Medical Simulation Technology.14The Gordon CenTer for researCh in MediCal eduCaTion Visionary • Innovator • Educator 15

In honor ofMichael S. Gordon, M.D., Ph.D.December 7, 2012“What is once well doneis done forever.”Henry David ThoreauDr. Gordonsurroundedby his family.“We honor Dr. Gordon as our Distinguished Chief, for providing notjust our community, but the entire country, with the best education theywill ever receive. The most valuable lesson Dr. Gordon taught each of usis, ‘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“I consider him the consummatephysician. I still call him on a variety ofsubjects, even outside of medicine, becausehe can think through anything and giveyou a wonderful and treasured opinionas to what you should do.”Robert B. Tober, M.D.EMS Medical Director, Collier County, Florida“Michael Gordon has demonstrated over his career the ability not onlyto 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, andto become more. Lynda has supported Michael by encouraging andstrengthening him, I think by shedding sunshine on his path and bylightening his problems in adversity.”Ronald M. Harden, M.D.Centre for Medical Education, University of DundeeGeneral Secretary, Association for Medical Education in Europe“He is an extraordinary cardiologist who really understood theimportance of what you learn from the patient and was able to usethat intelligence to create a model that has trained moreindividuals around the world than any model ever invented byan educator. Michael is simply bigger than life.“Dean Pascal J. Goldschmidt, M.D.Senior Vice President for Medical Affairs and DeanUniversity of Miami Miller School of Medicine“Dr. Michael Gordon has alwaysbeen at the cutting edge—ahead,way ahead of his time. He isresponsible for improving thequality of life of countless people.What better thing to do in life?”Miami-Dade County MayorCarlos GimenezRetired Fire Chief,City of Miami Fire RescueMichael Gordon…”put together a group of individuals who contribute theirtime, who contribute their energy—with no return other than knowing theeducational 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 MedicineLeft to right, Bob Waugh,Gordon Ewy, Ira Gessner,Michael Gordon, David Lawson“His refusal to be bound by the status quo and his capacity forseeing what eludes the more literal minded is what has madeMichael Gordon such a transformative leader.”Barry Issenberg, M.D.Director, Gordon CenterHarvey ® on notone but twocakes presentedto a surprisedMichael Gordonat a gala dinnerin his honor onDecember 7, 2012.16 The Gordon CenTer for researCh in MediCal eduCaTionVisionary • Innovator • Educator17

The M.I.A.M.I.GroupARIZONAGordon A. EwyCHICAGOStuart RichDREXELNina MultakDUKERobert A. WaughDUNDEERonald M. HardenStuart S. PringleEASTERN VIRGINIAGeoffrey T. MillerEMORYJoel FelnerJaffar KhanFLORIDAIra H. GessnerFLORIDA INT’LJeffrey A. GroomHARVARDEmil PetrusaJOHNS HOPKINSPamela R. JeffriesILLINOISGeorge T. KondosAbdul Sajid*IOWADonald D. BrownLOYOLAWilliam C. McGaghie*deceasedHealthThe Gordon Center• Education•InnovationFROM THE DESK OFMichael S. Gordon, M.D., Ph.D.“If you want to go fast, go alone. If you want to go far, go together.”We have accomplished so much over these more than 40years, because we went together. Our faculty and staff arebright and motivated and fully committed to our mission of“saving lives through simulation technology.”We also have a unique advantage with the members of theM.I.A.M.I. Group. They are experts from prestigious medicalcenters who are the gold standard for the very best in patientcare. It is they who developed our curricula.You need the right people for success, but you also needfunding. Our donors have been extremely generous, especiallyHarry and Bea Feldman. The State of Florida has been ourpartner for over 30 years, and we would not have been able tocarry out our life-saving work without their support.While our center is remarkably productive, it’s all carried outwith a culture of consideration for each other. We truly area family, and that spirit was created by my best friends andcolleagues, Diane and Harold Issenberg. Of course, all goodthings are due to Lynda, my wife and my love.MAYOKeith R. OkenRobert E. SaffordScott M. SilversOTTAWAIan Hart*PITTSBURGHPaul E. PhrampusTEXAS TECHSharon DeckerWAKE FORESTPatrick S. ReynoldsMIAMIAngel A. BrotonsJuliette E. ColemanNabil El SanadiJoseph B. EstersonPete A. GutierrezS. Barry IssenbergDavid LawsonBarry MatersonJoan W. MayerIvette MotolaHector F. RiveraRoss J. ScaleseRobert SotoJohn E. SullivanRobert B. ToberFELLOWSHyun Soo ChungLuke DevineLoryn S. FeinbergNora GonzalezRosana MillosVivian ObesoYoung Sook RohFaculty and Staff of the Gordon CenterMichael S. Gordon Center for Research in Medical EducationP.O. Box 016960 (D-41), Miami, Florida 33101 • Phone: 305-243-6491 • www.gcrme.miami.edu20 The Gordon CenTer for researCh in MediCal eduCaTion