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Governor's Newsletter, Fall 2000

Angeline Lazarus, MD, FACP
Governor, Navy Chapter

Chapter Annual Meeting:

17-19 Nov 2000 at the Hyatt Regency, Reston, VA, located approximately 10 minute drive from Dulles International Airport and about 55 - 60 minute drive from Baltimore-Washington Airport and 35 minute drive from Washington National (Ronald Reagan airport) Airport during non-peak traffic hours. Airport shuttle buses are available from all the three airports.

  • There will be 12 Category I CME credits for the meeting
  • Register early
  • Visit website for program information and registration
  • Don’t miss the Odyssey dinner cruise on 18th evening

The highlights of the program include:

  • Small group discussions
  • Clinical Implications of the Human Genome Project

New addition to our program:

Clinical skill module on:

  • Arthrocentesis and Joint Exam skills station
  • Radiology skills station
  • Breast exam skill station

Our College Representative is Sara Walker, MD, MACP, a renowned internist and rheumatologist from Missouri. She is currently one of the Regents of the College and brings with her a wealth of knowledge, experience and wisdom.

For the Associates:

  • We will have poster and podium competitions for our residents and poster competition for medical students
  • Most definitely, we will have our Medical dilemma competition on Sunday, 19 Nov.
  • Associates Luncheon on 18 Nov at 1200 hours

For the Medical students:

  • A poster competition will be held for the medical students

The staff and residents are encouraged to mentor medical students regarding scholarly activities during their rotation in your respective services.

PRE-COURSE: The Pre-course for the program directors, chief residents and training officers will be held at the Simulation Center from 0900 to 1530 hours on 16th Nov. The simulation Center is located in Forest Glen. Directions will be mailed to the program directors for distribution among participants. Breakfast and lunch will be provided. The agenda will include: Internal Medicine in The Navy, GME in the Navy, RRC site visits and clinical skills assessment using simulation center. CAPT. Richard Hawkins will lead the tour and discussion of simulation center.

Associate's Corner

News from LT. Seidensticker of Naval Medical Center, Portsmouth:

We have just finished with the grueling JCAHO inspection. The residents and a few staff have continued our voluntary services at the Chesapeake Care Clinic. Every Wednesday, the Navy volunteers see at least 5 internal medicine patients and up to 7 walk-ins. Also, the internal medicine department has provided a steady stream of supplies to the clinic, which has become an important fixture in the local community.

LT. Michael Herman is presenting a poster at the national AAFP meeting in September at Dallas, TX on " The Low Dose ACTH Stimulation Test". He also will be doing an oral presentation on " The Use of Alternative Medicines in Medicine Outpatient Clinics" at the Southern Medical Association meeting in Orlando, FL in November. LT. Glenn Arluk will be presenting a podium and poster presentation at the Southern Medical Association. He will be discussing "Endoscopic Ultrasound and Fine needle Aspiration of Mediastinal masses above the Aortic Arch."

News from LT. Capozza of Naval Medical Center, San Diego

The Department of Internal Medicine at NMC San Diego continues to play an active role in the American College of Physicians on national, chapteral and military levels. In April 2000, we sent several Associates to the Annual Scientific Session in Philadelphia. Drs. Rhodes, Capozza, Schwartzman, Tamayo and Maher returned with high praise from the session. Our residency is poised to play an even larger role at the chapteral level this coming year, after our Chairman, Program Director and Chief of Residents were invited to a recent Governor’s Council meeting for Southern California Chapter III. At the meeting, the chapteral Associates Dinner was planned for October 18th, with Dr. Sandy Fryhofer as the guest speaker. We also made preliminary plans for our Associates to attend the Southern California Chapteral Scientific Meeting in February 2001, participating in the Associates poster competition.

Elections were held for resident representatives to the ACP Associates’ Council of the Navy Chapter. Dr. Greg Francisco was voted as our PGY-2 representative, joining Dr. Saira Aslam, who is our Current PGY-3 Council.

News from LT. Keith of NNMC, Bethesda

All our PGY-2 residents have checked in and for the first time in the last 6-7 years, we have 9 residents at PGY-2 level. We are preparing for our upcoming Residency Review committee site visit in winter 2000. Our department lost three outstanding teachers this summer. Good news is that we have one replacement already on board and two others will be coming in by October 2000. We had our department annual retreat in June 2000. This retreat has provided a forum for annual review of our training program as well as other aspects of our department. The input and feedback from the staff and housestaff are carefully analyzed and plan of action to implement changes take place in the ensuing months. Our hospital has new administrative structure.

The Council representatives are: LT. Groff (PGY-1), LT. Lyons and LT. Wedam (PGY-3) and LT. Keith (Chief of residents)

National Capital Area Medical Simulation Center
By: CAPT. Richard Hawkins, Director of Simulation Center

The National Capital Area (NCA) Medical Simulation Center of the Uniformed Services University of the Health Sciences (USUHS) is a model medical training center/laboratory for emerging medical simulation technologies. Here students gain valuable clinical experience in an environment where there is no risk to patients’ safety.

Opened in 1999, the 14,000 square foot center supports the Uniformed Services University of the Health Sciences (USUHS) as well as a variety of service medical facilities throughout the Washington Metro area. The center is the first single location to integrate the use of virtual-reality technology, digitally enhanced mannequins and human standardized patients under one roof.

The NCA Simulation Center consists of three functional areas: the Clinical Skills Area, the Computer Laboratory and the Surgical Simulation Area. In addition to the three functional areas, the Center also has a Video-teleconferencing (VTC) room with capability for remote transmission of activities occurring in each of the functional areas.

The Clinical Skills Area includes 12 fully equipped examination rooms surrounding a central monitoring area. This area is designed for teaching and evaluating students in the basic clinical skills of history taking, physical examination and interpersonal and communication skills. Here standardized patient encounters provide an ideal transition from the classroom to real patient contact. Encounters with Standardized Patients (SP) may be videotaped and/or directly observed via individual monitors or through two-way mirrors. Each examination room contains two ceiling mounted video cameras, two wall mounted microphones, and a desktop monitor connected to the Simulation Center Local Area Network. Outside each examination room is a wall mounted computer workstation that is used to provide student instructions and post-encounter teaching and assessment materials.

The primary function of the Computer Laboratory is to develop medical training software and administer computer-based interactive examinations. The laboratory consists of 16 Pentium III Internet accessible Workstations that run a variety of medical educational CD ROM’s. Eight overhead cameras and a one-way mirror ensure that future examinees will conform to proper testing regulations. Presently, students use the computer laboratory to prepare for the NMBE exam by practicing test questions on the computers. Additionally, students work with interactive software programs that may be linked to activities occurring in other functional areas of the Simulation Center.

The Surgical Simulation Area consists of an Operating Room environment and a Virtual Reality laboratory. The Operating Room is furnished to represent either a typical hospital- or field-based OR, but can also be configured to simulate an ICU or ER setting. Here an electronic human patient simulator responds to various drugs and interventions in an appropriate physiologic manner. Driven by two computers, the patient simulator can be pre-programmed with patient characteristics or variables such as age, anatomic and clinical findings depending upon the teaching or assessment objectives. The OR also houses intravenous catheter, bronchoscopy and diagnostic ultrasound simulators.

The main purpose of the Virtual Reality Lab is to develop systems and software to meet the demands of the University and the DoD medical community. Research that advances simulation procedures is a fundamental directive, as is harnessing the capabilities of existing technologies. This area is the first site of its kind to be approved to use VR and mannequin simulators, instead of animals and cadavers, for the surgical skills laboratory of the Advanced Trauma Life Support (ATLS) course. In the VR lab, state of the art computer-based equipment enables students to view objects in 2 or 3 dimensions. A haptic interface allows the computers to recreate not only the tactile sense, but also provide force feedback that enables users to appreciate appropriate levels of resistance while feeling and manipulating 3D anatomic structures and instruments in a virtual environment. The VR lab is presently equipped with machines and programs for teaching vascular anastomosis techniques, pericardiocentesis and peritoneal lavage. Programs for teaching and evaluating other procedural skills are planned or in development.

For more information and images please contact our website at: http://simcen.usuhs.mil/

Simulation Center Staff:

Director: Richard E. Hawkins, MD
Assistant Dean for Simulation Education

Surgical Director: Christoph Kaufmann, MD

Administrator: Gilbert Muniz, PhD

Graphics Engineer: Alan Liu, PhD

Standardized Patient Trainer: Graceanne Adamo, MA

Systems Engineer: Joe Byrd

OR Technician: Thomas Ritchie

Administrative Assistant: Nicole Barnes

Dates To Remember

Chapteral Meeting
Navy Chapter
17-19 Nov, 2000

GME Selection Board
27 Nov-1 Dec 2000

Fellowship advancement applications due by
1 Dec 2000

Annual Meeting of ACP-ASIM
29 Mar-1 Apr 2001

For more information on our upcoming Chapteral Meeting, please visit ACP-ASIM website or call Dr. Anthony Barile at 301-295-4247 or Dr. O’Neil at 301-295-4217. For information regarding Associates Program, please contact Dr. Mike Keith at 301-319-4144

Closing Quote
(source unknown)
"Wisdom is knowing what to do.
Skill is knowing how to do it
Virtue is doing it."