Medical Education & Research Institute

MEDICAL EDUCATION AND RESEARCH INSTITUTE (MERI) EARNS ACCREDITATION FROM THE SOCIETY OF SIMULATION IN HEALTHCARE (SSH) AND FROM THE COUNCIL FOR ACCREDITATION OF HEALTHCARE SIMULATION PROGRAMS

MEMPHIS, TN (January 13, 2012)- On December 31, 2011, The Medical Education & Research Institute became the first program in Tennessee to earn accreditation in the area of Teaching/Education from the Society for Simulation in Healthcare (SSH) and from the Council for Accreditation of Healthcare Simulation Programs. MERI will be internationally recognized for this achievement at the 12th Annual International Meeting on Simulation in Healthcare (IMSH) held on January 27, 2012 in San Diego. MERI is the only non-transplant whole body donor organization also accredited by the American Association of Tissue Banks (AATB). Accreditation is a voluntary test of the excellence of an organization. SSH promotes improvements in patient care and safety throughout the world through enhanced simulation technology, educational methods, health care student and practitioner continuing education outcomes assessment and research.

About MERI
The Medical Education & Research Institute (MERI) is a 501 (c) (3) non-profit medical training and research school located in Memphis, TN. The MERI supports hands-on training and research in all medical specialties for physicians, nurses, CRNAs, physicians’ assistants, paramedics, respiratory therapists, pharmacists, EMTs and other healthcare professionals and first responders from across the USA and around the world.

MERI’s state-of-the art “ Medical Simulation Center of Excellence” assists in the formulation and delivery of an educational strategy that supports enhanced patient caregiver competence and confidence by combining anatomic, physiology and simulation training. MERI is unique in that it can provide hands-on training and research using both anatomic donors and high fidelity human patient simulators.

Dr. Kevin Foley, MERI Medical Director and Board Chairman congratulates the MERI team on this important step in achieving MERI’s vision to “be the leading hands-on medical education and training institute in the world.”

For more information on the Medical Education & Research Institute (MERI), please call Diana Kelly at 901-786-8004 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it

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MERI training scenario prepares medical personnel for disasters

By Aisling Maki – Memphis Daily News
http://www.memphisdailynews.com/news/2011/dec/8/emergency-situation

In a dimly lit building, surrounded by emergency sirens and the loud hum of a waiting military transport aircraft, Memphis medical personnel adjusted their headlamps and checked their radios before navigating through the post-earthquake rubble to prepare their patients for evacuation.

Emergency personnel train for a mass casualty situation at MERI on Wednesday using medical personnel, military and civilians. Participants learned using real cadavers and simulated live disaster areas. (Photo: Lance Murphey)

It was the final simulated scenario in a two-day Civilian Aeromedical Evacuation Sustainment Training that took place at the nonprofit Medical Education & Research Institute (MERI) at 44 S. Cleveland St. in the Memphis Medical District.

It was the kickoff to a series of seven such trainings – funded by a grant from the U.S. Department of Defense – scheduled to take place between January and April.

MERI has collaborated with the University of Memphis and Wright State University National Center in Dayton, Ohio, to develop a training program to ensure effective interface between civilian and military medical personnel in the event of a disaster requiring aeromedical evacuation.

“We’re all trying to get on the same page, so that in the event of a true disaster, we can work together effectively,” said registered nurse Brenda Belk, MERI’s simulation training manager. “The military speaks their own kind of language, so when you’re handing off a patient you need to know how to give a report as to what the status of your patient is. A lot of this training, too, is about medical evacuation, so there are things you have to consider as you’re preparing your patient to be evacuated.”

The preparedness trainings are open to all types of clinical staff, including physicians, physicians’ assistants, nurses, paramedics and emergency medical technicians.

“Anyone you can think of who would have to interact in a disaster situation – all those different types of allied medical field personnel can come and participate,” Belk said.

After learning transport techniques and military terminology Tuesday, Dec. 6, trainees spent the first part of Wednesday, Dec. 7, working with donor cadavers in an anatomy procedure lab, where they studied techniques such as intubation and the use of intraosseous lines, used in emergency situations when intravenous access is difficult.

The latter part of the morning was spent evacuating high-fidelity patient simulation mannequins across the street in another MERI property, set up as a simulated hospital with an emergency room, medical surgical unit and intensive care unit.

The ICU had been manipulated to appear as if it had been badly damaged in an earthquake, complete with smashed computers on the floor and wires and insulation hanging from the ceiling. Lighting was sparse and sporadic, with the premise being the unstable hospital was running on a generator.

“We chose an earthquake because that would be the most likely thing to happen in Memphis, of the things that could happen,” said Diana Kelly, MERI’s manager of institutional development. “And if it were a bombing or another kind of emergency, the end result would be the same.”

A significant portion of the training involved teaching civilian medical personnel how to determine whether a patient is stable enough to fly at high altitudes and how to prepare patients in varying conditions for transport to other regional medical facilities.

Many civilian medical personnel, especially those who work in office practice environments, are not trained in regards to what type of equipment can be used at high altitudes, as in an airplane or helicopter.

Col. Cassandra Howard, a flight surgeon, medical route commander and commander of medical forces for the Tennessee Air National Guard in Memphis, said it’s vital to “train civilian providers or nurses to be sensitive or at least be aware of air-related problems.”

“We’re trying to inject a little challenge there, where they’re trying to hand off patients to us,” said Howard, also an emergency room physician at Methodist Le Bonheur Germantown Hospital. “Also very important are the key clinical issues when you aeromedically evacuate a patient and add altitude to the situation. There are key concerns, such as the way you would manage a cast or a patient that’s intubated on life support. There are some things that need to be done on the ground before patients are presented to us for flight.”

The hope is that the Memphis training, which was filmed, can be used as a model that can be replicated in cities around the country to improve disaster-time communications between civilian and military medical personnel.

The University of Memphis (UM), Wright State University National Center for Medical Readiness (NCMR), and the Medical Education and Research Institute (MERI) has developed a training program to ensure effective interface between civilian and military operations in the event of a catastrophe requiring aeromedical evacuation. The civilian aeromedical evacuation sustainment (CAEST) training will complement existing military training and will prepare civilian nursing, allied health, public health, and emergency responder personnel to appropriately assess and prepare patients in pre-hospital austere environments and in hospital or other clinical patient collection sites for aeromedical evacuation. Going beyond traditional community first responder training and health system and community disaster management planning, we will address significant issues associated with operations and practice differences between civilian and military systems, such as communications, medical triage, and patient evacuation and transfer protocols and provide hands-on experiences via disaster exercises.

This medical readiness course is free to all healthcare providers, disaster management teams and hospital administrators both military and civilian.

The course is delivered at MERI both days. 8:00 am – 4:30 pm for the first day and 8:00 am – 12:30 pm on the second day. This is the link for registration website:

https://epay.wright.edu/C21810_ustores/web/store_main.jsp?STOREID=4&SINGLESTORE=true

Suggested Prerequisites: ICS 100 & ICS 200
http://www.fema.gov/emergency/nims/NIMSTrainingCourses.shtm

Dates for the Civilian Aeromedical Evacuation Sustainment Training (CAEST) are listed below:

Course dates for 2011:

• December 6-7, 2011

Course Dates for 2012:

• January 10-11, 2012
• February 7-8, 2012
• February 21-22, 2012
• March 13-14, 2012
• March 27-28, 2012
• April 10-11, 2012
• April 24-25, 2012

Please contact Shirley R. Brown, RN,MSN, This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 901-674-4560, for any questions.

Courtesy: Memphis Business Journal – by Karen Ott Mayer

Medical specialists, meet “Harvey,” a definite sign of the future.

Basically an electronic mannequin, Harvey can replicate 40 different heart and lung sounds, representing just one example of how technology is changing the medical education landscape and providing ground-breaking learning opportunities for students.

At the University of Tennessee Health Science Center, the Kaplan Clinical Skills Center unveiled a medical testing software system known as the B-line in December, which equips 12 patient exam rooms with videotaping and audio capabilities that is streamlining observation and grading. B-line is a common term used in medical education to indicate software-based simulation training.

Until the B-line, instructors shadowed students as they worked with standardized patient simulators, observing from the corner of the room.

“The students were very aware of the faculty in the room,” says Rob Shreve, associate dean for medical education in the UT College of Medicine. “Now, we can monitor what happens in the room and record it for later observation.”

The new technology allows greater efficiency when it comes to grading, providing reports and creating feedback for the students and the people who play the “standardized patient,” Shreve says.

With the student population at UTHSC increasing from 150 to 165, Shreve says the school plans to expand to 18 rooms in the near future. While all residents use the B-line, it is primarily the first- and second-year students who spend about five times per year at the center.

The cost of implementing a high-tech interactive learning environment is expensive, but the benefits are far reaching.

“We have to pay the patient actors, provide supplies and pay the staff,” Shreve says. “It’s resource intensive but this is far superior for teaching and assessment. In the long run, the cost savings is to hospitals and clinics when students know more.”

UTHSC has been working for the last six years to put the B-line in place and this type of technology is now becoming standard in medical schools across the country.

Shreve says UTHSC is currently in the midst of a comprehensive curriculum revision that will double the number of student visits to Kaplan as it will require clinical work as early as the first year of medical school.

One major goal of the new curriculum, set to roll out this fall and over four years, is to better integrate basic science and clinical training.

“Part of the mix is to create more active learning models like the B-line and the other is to increase the use of medical simulators,” says Shreve.

Thus, Harvey and other simulators enter the picture with the ability to replicate real-life scenarios.

In late January, UTHSC announced the receipt of a $2.9 million grant from BlueCross BlueShield of Tennessee Health Foundation which will be specifically used to build team-focused simulation programs and will help purchase new medical simulators, computers and software for training.

In step with providing world-class training, the Medical Education & Research Institute works closely with many health care specialists, including UTHSC residents.

“We need our technology and equipment to be state-of-the-art,” says Diana Kelly, MERI’s manager of institutional development. “We are currently working to enhance our video streaming and webcasting.”

The organization’s biggest move to recently expand its training and research capabilities involves a virtual simulator from ImmersiveTouch to enhance software for pedicle screw placement.

Local doctors Kevin Foley, Jeffrey Sorensen, Jon Robertson and MERI staff are working to make the software modules more useful to post-graduate students.

“Right now, these doctors are working to make sure the software ‘feels right’ in use,” Kelly says. “It’s all about the visual and the feel.”

The potential training use is powerful.

“This will allow surgical students to actually load in a specific patient’s information and practice before surgery,” Kelly says.

MERI expects enhancements to the software by the end of March and plans to demonstrate the software at the American Association of Neurologic Surgeons in April.

Training with technology reaches beyond a student’s first years. Last year, the MERI trained 11,000 medical professionals, including 500 local paramedics and was named a simulator center for excellence by the Tennessee Legislature.

“It’s exciting to see the light bulb go off in a student when they learn a new technique or procedure,” says Kelly.

Courtesy of the Memphis Daily News, by Michael Waddell

The Medical Education & Research Institute has evolved into one of the elite medical training facilities in the country. The center’s list of faculty and students reads like a “Who’s Who” of medicine from all over the world.

Rebecca Brown, left, and Emily Cashman prepare the donor for a medical course in the anatomical lab at the Medical Education & Research Institute (MERI), a nonprofit medical teaching and training facility. MERI conducts state-of-the-art, hands-on educational courses for physicians from across the country and around the world. (Photo: Lance Murphey)

The nonprofit medical teaching and training school touts itself as a turn-key operation that is a one-stop shop for state-of-the-art, hands-on training using un-embalmed anatomic donors and human patient electronic simulators. The center has been open for 16 years and employs a staff of 44.

“It’s critical that physicians stay up to date,” said Diana Kelly, MERI manager of institutional development. “The more practice they get before surgery, the better for all of us.”

MERI educates 11,200 students from all medical specialties each year, plus another 4,000 people involved in the care process. Students include physicians, nurses, certified registered nurse anesthetists, EMS providers, respiratory therapists, health care professional students, pharmacists and physician assistants.

The center’s impact on the Memphis economy is substantial, with projections for 2011 to be $45 million brought into the area from physician’s visits and other MERI business. Donations to MERI in 2010 totaled approximately $1 million.

The facility features five stations equipped with the latest technology to replicate an ICU, an ER/Trauma, a general patient room, a labor and delivery room and OR suites. Researchers and students can experience more than 95 pre-developed customizable medical scenarios.

Several new human patient simulators were purchased at the end of last year thanks to a grant from The Assisi Foundation of Memphis Inc. MERI’s nine human patient simulators are able to cry and breathe; they have teeth, fingernails and bodily fluids; and their pupils even dilate. Each is wired to be voiced by someone from an outside control room.

“Working with the high-fidelity human patient simulators, we can establish everyday situations to practice intubations, trauma scenarios like car wrecks and disaster training,” Kelly said.

The simulation rooms are outfitted with AV equipment so training sessions can be recorded and then reviewed.

MERI works with 80 medical device companies, professional associations and societies. The center also supports students from the area’s three largest medical device companies: Medtronic Inc., Wright Medical Group Inc. and Smith & Nephew.

Partnerships with manufacturers like ImmersiveTouch and its virtual simulators will lead to the creation of three-dimensional models of patient anatomy and particular ailments. Working with the virtual simulators is designed to feel the same as performing real surgeries, and it also allows the surgeons to practice without exposure to radiation.

Shelby County Health Department workers take a course on patient tracking scanners at MERI, a nonprofit medical teaching and training facility. (Photo: Lance Murphey)

“Surgeons need time to practice with these devices,” said Elizabeth J. Ostric, MERI’s executive director. “The result is safer outcomes from surgical procedures, and we all benefit from that.”

Much of the center’s research and education is made possible by human donors. Genesis is the center’s willed body donor program for people that wish to donate their bodies for the advancement of science.

“Our donors enable the doctors to have real-world practice opportunities,” Ostric said. “It’s the donors’ final way to give one last thing back to their fellow human beings.”

More than 600 donors were received last year. Eighty percent of those donors came from Tennessee and the surrounding states, and 200 of the 600 donors had prior military experience. MERI has a morgue onsite, and they can keep as many as 300 donors at one time. The donors can be used for tests for between six months and one year.

MERI also conducts emergency preparedness training both at its facility on Cleveland Avenue and at 1381 Madison Ave. across the street, an older building that MERI bought in 2009. A recent training exercise involved Shelby County emergency responders getting a practice run through a bombing incident, with search and rescue, triage and anatomy sessions.

“It’s a great benefit for the community,” Kelly said. “This way, the entire county of first responders can work together, and it helps nurses and paramedics to communicate better as a team.”

The disaster training courses are funded by a $250,000 matching grant from the Plough Foundation and financial support from the U.S. Department of Homeland Security’s Metropolitan Medical Response System Program.

Dr. Joe Holley has been conducting volunteer training sessions at MERI for more than two years. He is director of the Emergency Department at Baptist Memorial Hospital-Collierville and is the medical director of EMS for Tennessee. He is also medical director of the Tennessee Task Force One’s FEMA Urban Search and Rescue team.

“It’s a fabulous place to do training,” Holley said. “The MERI is very unique in the type of training it offers thanks to its excellent simulators, cadaver labs, mock ups and test rooms. Plus, they can take their entire show on the road. The capabilities are amazing.”

The center’s Mobile MERI unit includes a refrigerated vehicle that transports donors and equipment. It allows the center to provide courses and support off-site anywhere in the U.S. The unit can be set up in spaces like hotel ballrooms, convention centers or corporate headquarters.

MERI upgraded its conference facilities in 2010 by building a 50-seat auditorium and multipurpose room and installing a kitchen. The center’s conference area can now accommodate two separate groups with as many as 80 people.

MERI also contributed to the community last year by providing roughly $200,000 in “in-kind” training for local community organizations like the Church Health Center and local paramedics.

Source: Elizabeth Cohen, CNN Senior Medical Correspondent
http://www.cnn.com/2010/HEALTH/10/28/body.after.you.die/index.html?hpt=T2

(CNN) — Like many Americans, you probably think you’re pretty charitable. Perhaps you donate money to the needy or ill, give away your old clothes, volunteer at your child’s school or participate in holiday gift drives in December.

But you may be missing something. As you’re charitable in life, you could also be charitable in death. This holiday season — Halloween — you could start thinking about a kind of ghoulish donation: your body.

J. Nathan Bazzel has already made his plans. In 2001, he signed all the necessary documents to donate his body parts to the Mütter Museum, a part of the College of Physicians of Philadelphia. A friend of his worked there, and he knew that researchers from around the world came to look at its vast collection of body parts.

Bazzel, 38, is HIV-positive, and he wants scientists to learn from his remains.

“If just one person can take a look at my skull and kidneys, which have suffered from HIV and the drugs used to treat it, and learn something from them — what a magnificent gift,” he said.

He’s so impassioned that the same year he signed the forms for his postmortem donation, he donated his right hip, which had to be replaced because of damage from an HIV drug, and then three years later, he donated his left hip.

Bazzel, who became the college’s communications director two years ago, has already seen the benefits of having real human body parts on display: When high school students come in and see his hips’ deformities, his lecture to them on the importance of safe sex takes on a whole new meaning.

Of course, being on display in a museum isn’t everyone’s cup of tea. So in the spirit of the season, here are 10 ways you can put your body to use after you die. In many cases, you can do more than one.

1. Donate your organs

Nineteen people die every day waiting for an organ such as a kidney, heart, lung, liver or pancreas. Learn about organ donation, sign an organ donor card, tell your family your wishes, and don’t be misled by myths about organ donation. If you like, you can donate some organs but not others.

2. Donate your tissue

Your bones, ligaments, heart valves and corneas might not be of use to you in the hereafter, but they can certainly help someone else. Learn about tissue donation, sign a card, and again, tell your family members you’ve done this so they won’t be surprised when the time comes. As with organs, you can specify what types of tissues you’d like to donate.

3. Will your body to a university

Help a future doctor learn about the human body by becoming a cadaver dissected by first-year medical students. A state-by-state list of medical schools can get you started. Be sure to ask exactly what will happen to your body. While you might be used for dissection, you could be used for other purposes within the school, and you might not have much control.

Here’s an interesting conversation about the respect shown by students to their cadavers.

4. Help doctors practice their skills

If you’d prefer to be worked on by folks with more experience, actual, not future, doctors can learn from your body. At the Medical Education and Research Institute in Memphis, Tennessee, doctors brush up on their skills and learn new techniques; it’s the training facility for organizations such as the American Association of Neurological Surgeons, the North American Skull Base Society and the International Spinal Injection Society.

Doctors get to practice (and possibly make mistakes on) the dead rather than the living. In return, the institute provides for transportation for your body to Memphis, pays for cremation once the work is done and returns the ashes to your family (or, if you prefer, to an interment facility in Memphis).

If you like the idea, you can fill out a donor form. If you’d prefer to first see where your body’s headed, the institute welcomes visitors.

5. Leave your body to “the body farm”

Did you ever wonder how, on TV shows, detectives know the time of death just by examining the body? Cops can thank the folks at the University of Tennessee’s Forensic Anthropology Center for helping them figure it out. “The body farm,” as it’s known, has “650 skeletons and growing” scattered over 2.5 acres in Knoxville, according to its website. Researchers and students study bodies in varying stages of decay to help anthropologists and law enforcement officials answer important questions, such as body identification and time of death analysis. (For a fascinating account of a visit to the center, see Mary Roach’s book “Stiff.”)

If you want to become one of those skeletons after you die, you’re in luck, as they make donation pretty easy at the Body Farm. Get their Body Donation Packet, fill out their Body Donation Document and complete the biological questionnaire. They’ll want a photo of you to help them learn more about “facial reconstruction and photographic superimposition as a means for identifying unknown individuals,” according to the center’s website.

If you live in Tennessee and within 200 miles of Knoxville, you’re really in luck, because they’ll take care of all the costs. If not, your family will be responsible for arranging transportation to the center.

Once they’re done with you at the Body Farm, your family doesn’t get your remains back, so if that’s important to you, this isn’t your best option.

6. Become a crash test cadaver

Plastic crash test dummies are all well and good, but there’s nothing like a real human body to simulate what happens in a car crash. You can will your body to the Wayne State University School of Medicine to become a crash test cadaver by filling out its Body Bequest Form. The form is for donation to the university, but “if a person specifically requests that their body be used in safety testing that is ongoing at the Bio-Mechanics lab, then we would honor that wish,” according to an e-mail from Barbara Rosso-Norgan, the school’s mortuary supervisor.

7. Give your body to a broker

We don’t mean a stockbroker; we mean a body broker, who will take your parts and get them to scientists who will use them for research, training and education.

There are several groups in this business, including Science Care, Anatomy Gifts Registry and BioGift Anatomical.

Generally speaking, here’s the upside of these groups: They pay to have your body transported to their facility, and with the parts that are not used in research, they pay for cremation and to have the ashes returned to your family (some will, if you prefer, distribute them at sea). This can save your family a lot of money.

The downside: You don’t know where your parts will go. “We don’t guarantee that we can use the body in any specific research program, and that’s because our research is always changing,” said Kristin Dorn, community relations manager at Science Care. “Your intent is to donate to science, not a specific research project.”

Some brokers will allow you to say what areas you’d prefer your parts not go to. If this is important to you, find the broker who offers this option. “If someone is ready to donate their body to science, they will definitely need to do some research,” Dorn said.

8. Send your body on tour

If you’ve been to the “Body Worlds” exhibit, you know what plastination is: a process of posing and hardening a body so it appears life-like.

You, too, could become one of these bodies on display by donating to the Institute for Plastination. If you live in the United States or Canada, your body will be embalmed on your own continent and then shipped to Germany, where technicians will perform the plastination process. They’ll remove fat and water, “impregnate” your corpse with rubber silicone and position it into a frozen pose (you might be, say, running or sitting cross-legged or performing ballet or perhaps riding a horse). Your body is then hardened into that position with gas, light or heat. The entire process takes about a year, according to the group’s website.

Your family pays to get your body to the embalming location, and the Institute for Plastination incurs the shipping costs to Germany.

There are rules about donation. You can be old, and you can be an organ donor, but if you died in a violent manner, it might not work out, as your body must be “largely intact” in order to donate, according to the institute’s website.

Also, there’s no guarantee your body will end up in one of the five exhibits. Some plastinated bodies are sent to medical schools and training programs, and you don’t get to decide the destination of your corpse, according to Georgina Gomez, the institute’s director of development.

If you’re interested in going on tour and you live in North America, read the Guide to Donors and fill out the Donor Consent Form. There are also forms for European donors.

9. Become a skeleton

Researchers from around the world visit the extensive skeleton collection at the Maxwell Museum of Anthropology at the University of New Mexico.

Here’s some information and the legal donor permission form and a donor information form.

The ground rules: Your family pays to get your body to the museum’s facility in Albuquerque, and your remains (besides your bones, of course) get cremated and disposed of; they don’t go back to your family. Researchers who want to work with the skeletons have to apply to the museum’s Laboratory of Human Osteology; the skeletons are not put on display for anyone at the museum to see.

If you’d like to be put on display, see below.

10. Be on display at a museum

Like Bazzel, you can donate parts of your body to the Mutter Museum at the College of Physicians of Philadelphia.

If you do so, you’ll be a part of a pretty rarified group. Anna Dhody, the museum’s curator since 2004, has received only three inquiries about donation after death, including Bazzel’s.

“One woman contacted me and said, ‘I have a 120-degree curvature of my spine. Would you like it when I’m done with it?’ and I said, ‘Yes, please,’ ” Dhody recalled.

Although the museum is particularly interested in bodies with abnormalities, it’ll also consider taking your remains even if there’s nothing particularly pathological about them. Either way, your family will have to foot the bill to get you to Philly. To learn more, send an e-mail to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

CNN’s John Bonifield and Renea Lyon contributed to this report.

Governor Phil Bredesen signed resolution #794 designating MERI as a Simulation Center of Excellence in the State of Tennessee. The resolution was introduced by Senator Mark Norris and signed on April 30, 2010.

“Tennessee is fortunate to have such an excellent resource as the MERI, which has distinguished itself as a pioneer in the field of simulation technologies and its employees and physicians continue to strive to exceed their students’ expectations by providing the highest quality medical education possible”

According to Norris, the General Assembly recognizes organizations that strive to improve the quality of life for Tennessee’s citizens.

Specifically, the MERI Simulation Center of Excellence provides hands-on medical education training and research to enhance patient safety, which results in saving lives and better patient outcomes. The MERI simulations create the best-practice hands-on training environment to develop and demonstrate individual and team care skills in all areas of medical care, emergency and disaster training. MERI’s Simulation Center of Excellence is partially funded by a donation from the Assisi Foundation of Memphis.

According to Norris, “MERI strives to provide the best-possible training experience for Tennessee’s Health Care professionals by supporting research in all specialties of medicine, introducing health care providers to the latest innovations in medicine, and providing all of its students with the opportunity to learn about the most up-to-date medical techniques and technologies. “

MERI being designated as a Simulation Center of Excellence reinforces Tennessee’s standing as the best place to live and work for health care professionals and for patients. MERI uses its resources to bring Homeland Security, Department of Defense, EMS and National Guard training to Tennessee, making Tennessee the best-prepared state for disasters.

“Tennessee is fortunate to have such an excellent resource as the MERI, which has distinguished itself as a pioneer in the field of simulation technologies and its employees and physicians continue to strive to exceed their students’ expectations by providing the highest quality medical education possible,” Norris said.

Source: Commercial Appeal in response to Sunday Feature Article, A Lasting Legacy: Body-Donor Program Helps MERI Train Doctors in New Techniques.

“I was pleased to see the article regarding the Medical Education Research Institute. My mother was diagnosed with terminal lung cancer in June of 2004 and made the decision to donate her remains to benefit medical research.

Apprehensively I began to investigate existing opportunities in the Mid-South.

The representatives I spoke with at MERI were professional, informative and empathic.

Information regarding the program was hand delivered to my mother’s hospital room a few hours after my initial inquiry.

My mother passed away just a few days after making her final decision. MERI made a very painful time a little less traumatic.

Funds generous enough to cover the memorial costs, flowers, the minister’s fee and the vocalist were provided without delay.

Almost a year to the date of her death, I received a phone call advising me that the research had been complete and that her ashes would be available soon.

The family chose to have her ashes interned. They remain in the original resting place with an engraved name plate on a marble memorial at a local cemetery, all of which is provided at no charge to the family.

Several weeks later I received a letter explaining how my mother’s donation had benefited many medical professionals in several different areas of research.

I knew at that moment that my mother’s wishes had been honored and that her “gift” would benefit others for years to come.”

Jackie Mooneyham

Bartlett

by Elizabeth Hofheinz, M.P.H., M.Ed. • Fri, May 7th, 2010
Source: http://ryortho.com/pictureSuccess.php?article=340_William-M-Mihalko-MD-PhD

A father of five, Chief Science Officer at the InMotion Orthopaedic Research Center, and Associate Professor at the Campbell Clinic, University of Tennessee Health Science Center, Bill Mihalko has little time for what doesn’t balance. Perhaps he learned to understand the interplay of many moving parts from his father.

“I was born in Jamestown, NY and moved up and down the east coast while growing up. My dad had been born in a coal mining town in Pennsylvania and he grew up without indoor plumbing. As soon as he graduated from high school my dad immediately moved out of the house and found a job in Jamestown where he met my mom. He worked in a steel forge shop by day and earned his business degree at night which eventually landed him a job as VP of Manufacturing in Buffalo, NY.”

Visits to the nexus of healthcare activity—his local hospital—left William Mihalko wanting to know more about medicine. “My mother was (and still is) a nurse and she worked at a nearby hospital. I recall the exciting times when we would all pile into the car to go pick her up at the hospital. It was obvious that she worked in a stimulating environment, and I could see that medicine was something very special and that not everybody was cut out for it.”

He had started asking “why” during his visits to the hospital. Bill Mihalko decided that his next step would lead him closer to the world of research…and more “whys.” “I developed a strong interest in using engineering principles to further medicine and enrolled in an interdisciplinary engineering program at the University of Rochester. I had completed all of my premed requirements but even after I graduated I was still uncertain about making a lifetime commitment to medicine. My fallback plan was to attend a masters program which was associated with a medical school in order to get more exposure and help me determine if medicine was ‘it.’”

In 1987 Bill Mihalko began a masters in biomedical engineering at the Medical College of Virginia (MCV), and soon had the MCV M.D./Ph.D. program in his sights. “Along the way, I always had orthopedics in the back of my mind. I had torn my ACL in high school and ended up under the care of the famed Dr. Ken DeHaven at the University of Rochester. I took part in the ACL deficiency studies in his gait lab which further sparked my interest in engineering and orthopedics. The more I thought about this while walking the halls of MCV, the more I felt that orthopedics was my future. I began participating in orthopedic grand rounds and after the first year of my masters I was completely sold on the field.”

Not content to “just” pursue an M.D., Bill Mihalko had the interest, confidence, and patience to earn a Ph.D. at the same time. “Dr. John Cardea was the chair of orthopedics and he sat on my masters thesis committee. He was terrifically supportive of the combined degree pathway and toward the end of the program he assured me that I would have a spot in his residency. Bill Krause, Ph.D. and Dr. Wilhelm Zuelzer were my research mentors and they opened my eyes to the rigors—and wonders—of research. I spent six years in the orthopedic biomechanics lab where I got to watch as investigations and answers were produced to many questions in orthopedics.”

Love and duty then came calling. “I did my internship year at MCV, but both of my parents soon became ill. Dr. Cardea graciously helped me transfer to SUNY Buffalo, where by chance I met Ken Krackow. He had ideas that he wanted to pursue in the lab…and I had the expertise. SUNY Buffalo did not have an immediate opening in their residency program, so I did a research fellowship with Ken. It was a prolific year as I ended up generating ten publications with Ken on soft tissue balancing and the effects of different techniques. During this research year I married the love of my life and fell in love with adult reconstructive surgery.”

Then it was the balancing of the knee that concerned Dr. Mihalko.

“During residency I continued work that I had done in my research year, which involved a system I created to measure the kinematics of the knee. Ken could see the potential in this, and said, ‘We need to get this into the OR to help align the knee during surgery.’ It was an electromagnetic system, however, and had some issues. So I found a company in Ontario, Canada, just across the border that made infrared tracking systems; Ken purchased it and much of my work transferred to the infrared system. In 1997 I participated in the first computer-assisted total knee replacement in the U.S.”

One look at a very special machine and it was love. “For fellowship I was torn between the Anderson Orthopaedic Clinic in Northern Virginia with Charlie and Jerry Engh or the Missouri Bone and Joint Center with Leo Whiteside. Once I visited the latter site, however, it was settled. Dr. Whiteside was extremely entrepreneurial, held multiple patents, and had the most unbelievable biomechanics lab. His advanced knee testing machine blew me away. I could immediately see that I could do the kinematic work that I was doing in Buffalo but to a more precise standard. (He ended up donating the knee machine to my lab years later.) Dr. Whiteside taught me to balance research and practice. (Most people I knew in academics did clinical research but weren’t going to the lab to perform basic science research.) Dr. Whiteside cautioned me against the temptation to ‘book one more case,’ and emphasized the importance of protected time for research.”

Choosing to be close to home, in 2000 Dr. Mihalko accepted a position at a private practice in Syracuse, New York. “This group was willing to give me at least half a day per week to do research at Syracuse University. I spent a lot of time at the school and became an adjunct professor in the department of neuroscience and bioengineering. My own research wasn’t exactly on fire at the time because while Syracuse had a lot of equipment, getting time on those machines was hard as a ‘lowly’ adjunct professor. I was only there one year when the University of Buffalo called and asked me to be Director of Orthopaedic Research. It was a smaller program, but it was home.”

But even home can be lonely sometimes. “I really could have used a senior research mentor there because I was literally the only one performing basic science research in the department. I had to wade through grant applications and funding issues solo. I was also Director of the Center for Advanced Technology at Buffalo, and had a substantial state grant to run the center. The purpose of the facility was to spawn new small business opportunities from joint ventures between the university and companies in the university’s incubator. Although this position distracted me in many ways it gave me experience as an administrator at an early point in my career, something which has been valuable.”

With no one to turn to and say, “Wow. We just discovered something amazing,” Dr. Mihalko was a bit disheartened. “In 2006 I left Buffalo in part because I didn’t have any research collaborators or mentors. I found my research home at the University of Virginia where Dr. Cato Laurencin was Chair at the time. He was heavily funded by the NIH and had an extensive biomedical engineering lab. While there I began collaborating with a Ph.D. colleague, Yusuf Khan, and looking at the mechanical aspects of the incorporation of a bone healing scaffold. We put rats on a mechanical testing and simulation machine and cycled the load across the scaffold on the tibia. About that time Cato announced that he was leaving. Shortly thereafter Dr. Jim Beaty here at the Campbell Clinic called and asked me to join their practice. They were starting an independent orthopedic research center and wanted me to come and be one of the directors. This was a plum opportunity and I accepted immediately.”

Now happily ensconced in his advanced laboratory, Dr. Mihalko spends his protected research time on two lines of inquiry, both of which are related to total knee arthroplasty outcomes. “We have a new retrieval program that was established with the Medical Education and Research Institute in Memphis. We learned that of their 1,000 cadaver donations a year between 200 and 300 have well functioning total knees in place.”

“Using our knee testing machine and knee simulator we are analyzing the kinematic patterns, soft tissue balancing, wear scars and surgical techniques that are associated with total knees that have functioned well over time. We map out the wear patterns and determine how much wear has occurred over the years that the implant has been in use. Then we plug the parameters into a 3D model and try to predict wear pattern.”

“We also take a 3D CT scan of the lower extremities, along with the implant information from the mechanical testing and plug it into a 3D dynamic computer model. Our goal is to get the model to come up with the same wear patterns as the retrieval specimens.”

“In addition, we are using interoperative data from computer-assisted knee surgery, taking the kinematics that I record in the OR, along with the position of the implants and anatomic registration data, to help validate the model. We recently began using a local gait lab and are taking postop patients there to see if the model can predict gait patterns as well.”

As much as he likes predictability, Dr. Mihalko knows that there is no predictive model for one’s family. “My wife and I have decided that at this point in life it’s all about balance. Between being a dad to five children, and trying to keep my clinical and research career as a top priority, it is difficult to say the least. My wife, a speech pathologist, has been unbelievably supportive. She has packed up the family and moved countless times and I am truly in her debt.”

Dr. William Mihalko…testing, re-testing, and then balancing—it’s about knees but also about life.

According to the Center for Medical Simulation in Cambridge, MA, Medical Simulation is a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions.

I recall my first week at the MERI (Medical Education & Research Institute). I was walking through our Simulation Center and heard iStan PediaSIM NOELLE® and Newborn HAL® breathing and saw their eyes blinking. Their rooms were and are still setup to look and feel just like a patient room at a hospital. Everything was just like you’d imagine it. Patient charts are on their room doors, white boards and vital sign monitors on walls, boxes of latex gloves and hand santizer are strategically placed as you walk in. It looks quite real, but still I was skeptical. How could these robot looking mannequins be of any real value to a surgeon or a nurse?

Let me tell you how wrong I was. Over the past 14 months I have seen MERI’s simulators save lives! Last November after attending a Difficult Airway Management course at the MERI, Donna Hunn, APN, a nurse practitioner at Methodist Le Bonheur successfully intubated and resuscitated a patient who had stopped breathing. “The intubation course that Methodist and MERI offered gave me invaluable hands on experience that cannot be duplicated with a mannequin,” said Hunn. “Had I not attended the course, I would not have had the confidence or skill to intubate the patient I found who was not breathing.”

Even more recently, through a Plough Foundation grant with matching funds from the Department of Homeland Security, MERI has teamed up with the Metropolitan Medical Response System (MMRS) to train first responding EMS and Fire Fighters in a simulated search and rescue bombing scenario. In this case the victims were MERI’s simulators that required assessment, triage and emergency care. “There are a whole lot of skill sets used,” said Joe Holley, Medical Director for the Emergency Medical Services in Shelby County. “They’re learning to manage a scene, make sure their own people are safe and conduct those live-saving interventions on victims.

MERI’s simulators are used almost daily to teach to teach patient safety, tough medical decision making, working in teams, and planned experience of rare events. Nursing students and physicians frequently get training on basic assessment, postoperative care, and skills practice in respiratory and pulmonary procedures. The simulators breath, bleed, urinate, have eyes that dilate, a pulse and a heartbeat. Those treating them have the power to save their lives or send them into cardiac arrest. The simulator’s human patient simulation technology not only mimics symptoms but also responds directly to treatment administered by trainees including oxygen, intravenous drugs and defibrillation. These complex machines can simulate hundreds of medical scenarios wirelessly from a computer.

Am I skeptical now? NO WAY!