Teaching Medical Advances, And Humility

Tuesday Amitai Ziv, recipient this week of the $100,000 Charles Bronfman Prize, would like to see his work in medical simulation — a discipline that trains doctors and other health professionals to avert errors in times of crisis — expand to the entire Middle East, and well beyond the field of medicine.

Ziv, 48, was honored here on Tuesday for his work as founder and director of the Israel Center for Medical Simulation (MSR) and as deputy director of the Sheba Medical Center , the largest medical center in Israel.

The prize, in honor of philanthropist Charles Bronfman and created by his children, has been given each of the last three years to an individual or team of people under the age of 50 "whose Jewish values infuse their humanitarian accomplishments and provide inspiration to the next generation." The founders said that Ziv "represents the best of the young generation's values, commitment, creativity and energy" through his work in "reshaping the way medical care is delivered throughout the world."

A ruggedly handsome and friendly man, Ziv told The Jewish Week the honor came as a total surprise to him and that he hopes the recognition will give added credibility to a form of medical education that can be applied in many creative ways on a global scale.

A former combat pilot in the Israeli Air Force, Ziv applied flight simulation training to the field of medicine by putting doctors and others through situations of great stress. Using actors in some cases and mannequins in others, the MSR program offers up scenarios as varied as bombings and warfare, patients and families who need to be told of a devastating prognosis or dealing with a difficult and constantly complaining patient.

Such simulation has been used in medical facilities before, but MSR was the first program to employ it in a systematic way and on a national level, according to Ziv. "We were the first to apply it as a must-have program, not just a nice-to-have program," he said.

During last summer's war with Hezbollah, Israeli medical teams that went into the battlefield were first trained by MSR and said the preparation helped them save lives.

MSR has worked with medical professionals from around the world, including several Jordanian health officials and more than 30 Palestinians who came as individuals, just before Hamas took power last year, and were trained in dealing with medical trauma. "We put politics aside and talked medicine," Ziv said, "and they were extremely enthusiastic."

His goal is to set up a regional center that he hopes would serve as "a bridge to peace." But the political front on the Palestinian side "is a barrier," he said. "I wish we could do more."

MSR is partnering with the Mayo Clinic in Rochester, Minn., which could be used as a "back window" for states hostile to Israel to benefit from the medical training.

In light of the current headlines about the political meltdown in Israel, could simulation techniques be taught to government officials who deal with matters of life and death?

Definitely, according to Ziv, who pointed out that it is human nature for one to simulate a scenario to help prepare oneself for a situation, whether it is imagining the questions in advance of a job interview or thinking through a crisis in piloting a plane.

"It's mostly applicable to high-stakes professions where there are grave consequences for error," he said.

Simulation teaches a person not only to be a more efficient professional but a more humble person, said Ziv. "It creates situations where you have to push yourself to your limit and make errors. The hidden agenda is to see how you respond, to give you a sense of humility, caution and safety."

Ziv noted that Judaism has much to say about learning from one's mistakes, and he applies his work to his participation in Kolot, a pluralistic beit midrash, or study group, in Israel. In addition to offering study sessions on the notion of error, Kolot has a program, funded in part by UJA-Federation of New York, for medical professionals, who go through scenarios designed to highlight "the broken moments" between doctors and patients dealing with mistaken diagnoses and other errors, according to Ziv. They then "discuss it and link it" to Jewish texts.

"We are building a new language of simulation, medicine and Jewishness," he said, applying the notion of learning from mistakes, appreciating Jewish values and "preparing ourselves for difficult moments."

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