High-tech medical simulation training arrived ‘just in time’ for IDF medics

When war broke out between Israel and Hamas on October 7, Israeli military paramedics and doctors knew they were going to be treating wounded soldiers in the field as soon as Israel’s ground invasion began.

“The problem was that reservist combat medics get minimal refresher courses every year. Furthermore, the physicians who get called to the reserves usually don’t know anything about trauma medicine. An obstetrician who treats pregnant women day in and day out probably isn’t going to know how to treat a gunshot wound under fire,” said Ravid Segal, chief technology officer at MSR – Israel Center for Medical Simulation.

MSR is a global leader in simulation-based medical education. Located at Sheba Medical Center in Ramat Gan, it was founded in 2001 by Prof. Amitai Ziv to promote a safer, patient-centered approach to care without placing patients at risk. The goal was to significantly reduce medical errors and improve and assess healthcare providers’ core medical and communication skills with colleagues, patients, and their families.

MSR achieves this through advanced simulation-based training modalities that include sophisticated robotics, surgical simulators and role-playing actors. The center trains Israel’s civilian medical community, the military and healthcare colleagues from around the world.

In any given year, many Israeli paramedics and doctors use MSR’s training programs at Sheba and other centers around Israel. However, with the ground invasion looming, there was no time for IDF reservists to come to the hospital to learn or sharpen their knowledge of key trauma medicine procedures.

“So we put our ‘MSR on Wheels’ program into action. Shay Laufer, head of the program, and Ran Rubenstein, head of clinical simulation, packed up trailers with our high-tech task trainers and supplies and headed to the IDF staging areas on the border with Gaza,” Segal said.

MSR trainers and trauma physicians, including some who had come from abroad to volunteer at Sheba, used high-fidelity, computer-controlled mannequins to mimic real human bodies and prepare the reservists for various scenarios.

“We call this our ‘Just in Time’ initiative because we did this training next to Gaza on the day before the troops went in. It turned out to be perfect timing because the knowledge was fresh,” Segal said.

Ran Mimouni from MSR’s high-tech simulator unit told The Times of Israel that the training in the staging grounds focused on gaining competency in four key trauma medicine procedures: intubation (putting a breathing tube down a person’s throat); tracheostomy (making an incision into someone’s throat to insert a breathing tube); thoracostomy (inserting a thin plastic tube into the space between the lungs and the chest wall to remove excess fluid or air); and staunching major bleeding.

IDF soldiers preparing to enter Gaza use high-tech wounded ‘body parts’ during MSR training simulations on the Gaza border, October 2023. (Courtesy of MSR)

Segal noted how important it is to teach medics how to properly pack bleeding wounds and avoid using tourniquets when possible, as they can lead to the need for amputations if they are applied incorrectly or for too long.

Photos taken during the training show soldiers gathering around “dismembered” high-tech heads, torsos and limbs gushing blood as the trauma experts demonstrated and guided them through the various procedures. The high-tech nature of the models provided the soldiers with real-time feedback on how they were doing.

Unlike at Sheba, where simulations are done in a hospital setting, near Gaza the task trainers were placed on plastic tables or on the ground.

“We set up three stations for soldiers to rotate through. They learned and practiced for one hour at each one,” Mimouni said.

“Then we set up scenarios with the mannequins spread out with different injuries in the ‘battlefield.’ The soldiers had to quickly triage them and decide the order in which to treat them and how.”