The University Clinical Skills and Simulation Center (UCSSC), formed in January, 2002, initially was comprised of one Sim-man, one Harvey, five clinical exam rooms and one classroom. Dean Thomas Nasca, MD, issued the charge to develop both human and electromechanical simulation support for undergraduate medical education across the entire medical school curriculum as well as to develop a multi-station, formal high stakes Objective Structured Clinical Examination (OSCE) for all third-year medical students. The Co-directors of the Center, Katherine and Dale Berg, along with Administrator Carol Trent responded by creating de novo the Jefferson Standardized Patient (SP) program which would become a major factor toward meeting this charge.
For the next four years, the focus was on maximizing and optimizing simulation support for the Jefferson Medical College (JMC) curriculum and on improving evaluation. The SP program increased to over 100 actors; scores for standardized cases and checklists were developed for teaching and evaluation; the Co-Directors worked intimately with the JMC Curriculum Committee and by 2004, a 10-station OSCE was in place, that by 2005 every student was required to pass to enter into 4th year. This program was integrated into each class and almost every course, preclinical and clinical at the Medical College. More than 1600 students have gone through the OSCE which consists of simulation components and structured checklists for Anatomy, History-taking, Basic Physical Examination, Foundations of Clinical Medicine, and rotations in Surgery, Medicine, Family Medicine, OB/GYN and Pediatrics. An Advanced Physical Examination Course, a one-month immersion course for 4th year students, is currently approaching 1000 alumni.
By 2004, the program had outgrown its facilities and moved to a floor in a medical office building which permitted the facility to expand to 12 clinical rooms, two classrooms, and two simulation rooms (one for Harvey and the other for Sim-man). The program further expanded to include the ability to video record teaching and evaluation; to use administrative software systems in support of the logistics behind these programs; and to further evolve simulations using electro-mechanical and plastic models. More low fidelity models were purchased in order to teach and provide structured practice of minor procedures and to develop post-rotation OSCE for clinical rotations.
Building upon the close relation with the late Philip Wolfson, then, Program Director of Surgery, the first post-rotation OSCE in surgery was developed. In 2005, UCSSC further diversified and expanded teaching and evaluation into Graduate Medical Education developing a pilot OSCE for Jefferson surgery interns as well as the development of simulation support for other residency programs. This growth necessitated another move as the programs of UCSSC had expanded beyond the capacity of these facilities.
The Dorrance Hamilton Building (aka the Hamilton building) was built, in part, to support the expansion of the University Clinical Skills and Simulation Center ("UCSSC"). The 3rd, 4th and 5th floors were designed to support and foster the development and implementation of simulation in teaching and evaluation.
Since the Hamilton building opened in October 2007, the UCSSC has continued to support and refine all of its pre-existing programs, but now has markedly increased the amount of Graduate Medical Education simulation training, practice and evaluation sessions. These GME venues of skills attainment and structured practice have further expanded, evolved and diversified the programs of UCSSC.
With monies from the Measey Foundation and under the charge given by then interim Dean Michael Vergare, and current Dean Mark Tykocinski, the UCSSC has developed and implemented a curriculum which, in a structured manner, teaches all incoming house staff (n = 127) basic clinical procedures including, but not limited to central line placement (with and without ultrasound guidance), arterial lines, and orotracheal intubation.
In addition, the Center supports simulation programs across the campus including programs from Occupational Therapy (OT), Physical Therapy (PT), Family Therapy, Nursing, both in the School of Nursing and hospital-based as well as the new School of Pharmacy have been given support to develop simulation for teaching in their programs and to, in as many ways as possible, develop interdisciplinary training at both the undergraduate and graduate levels. Although the School of Nursing simulation program is administratively separate from the other programs, UCSSC works with individual hospital-based nurses and leaders, including the Co-Directors of JCIPE, from all other disciplines to develop AAMC and ABIM competency-based simulation driven interdisciplinary teaching and evaluation programs. As a result of UCSSC, faculty from OT and PT teach undergraduate medical students clinical skills in collaboration with faculty from the Medical College.