ASPE Conference Saturday Plenary: Dr. Amitai Ziv

Submitted by: Dan Brown, Emory University

On Saturday of the 2019 ASPE Conference in Orlando, attendees had the pleasure of hearing a plenary by Dr. Amitai Ziv of the Sheba Medical Center in Israel. Dr. Ziv was introduced by Gail Furman as this year’s Howard Barrows Invited Presenter. He has worked across the world, including Israel, Palestine, Spain, Russia, Ukraine, and the US. In addition to his medical accolades, he is a former pilot of the Israeli Air Force.

His message for the conference attendees was that we are going through a revolution in medical education, that testing the competence of medical students is “embarrassingly recent,” and that there is still a lot we have to learn from aviation. In this century, there has been a call for a cultural change and a paradigm shift in medical education. He posited that simulation without debriefing is worthless, and that the field generally tends to focus on assessing what’s easy to assess, instead of what’s important to assess. He expressed his belief in “Training the Nightmare,” playing off of the “See one, do one, teach one,” learning method, adding “Kill one.”

He then showed a series of video clips of the ways human simulation is used at the Sheba Medical Center, not just for medical students and residents, but for all practicing doctors, even (or especially) those who are teaching the students. He said that this is important because “students will immediately absorb the bad habits of the centers in which they’re working,” an observation that got much of the room nodding along in agreement.

The encounters Dr. Ziv shared supported the title of the Plenary: Simulation-Based Training Utilizing Standardized Patients as a Cultural Change Vehicle in Healthcare Quality and Patient Safety Education. The scenarios were intensely challenging, “Training the nightmare,” and often the learner struggled. Dr. Ziv used one of these scenarios to point out that an error is always an unasked question, and that part of the culture change was ensuring that in medical environments questions are invited.

Dr. Ziv’s robust use of human simulation was very impressive and showed where our field can go with greater resources and buy-in, and with the full impact of the cultural change that is taking place within the realm of medical education.

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