IDF medics practice treating injuries they would likely see on the battlefield on realistic, computer-controlled mannequins.
Israel’s response to the October 7th attacks and the war with Hamas has required civilians and military personnel to take on roles that look far different from their once “normal” lives. Pediatricians, ob/gyns, and oncologists called up to serve needed to become combat medics. Hospital staff had to provide unprecedented care for returning hostages. Mental health professionals volunteering in hotels with evacuees from the Gaza envelope often lacked the specific trauma-informed skills required to do no harm.
These pivots needed to happen almost overnight, in real time and under duress. In such cases, MSR, the Israel Center for Medical Simulation (MSR) mobilized to provide just-in-time training. MSR, established in 2001 at Sheba Medical Center to provide simulation-based medical education and patient safety training, has worked with more than 300,000 health care professionals. In 2013, with Russell Berrie Foundation and Helmsley Charitable Trust support, MSR launched its mobile unit – MSR on Wheels – to deliver on-site training to medical teams throughout Israel.
Below, Deputy Director and Chief Operating Officer Kim MacMillan describes how MSR’s team got to work on October 8, deploying MSR on Wheels and Sheba’s resources on a round-the-clock basis to supply urgent training to more than 1,400 medical and mental health providers to date.
Using highly realistic, computer-controlled mannequins that mimic human bodies and other simulation tools, MSR on Wheels built up soldiers’ competence to treat injuries and do emergency procedures that would be needed on the battlefield.
Preparing IDF medical reservists for a ground war
Immediately after October 7th, MSR put out feelers and responded to direct requests for assistance from many IDF units. MSR on Wheels traveled to bases all over Israel to provide “urgently needed, just-in-time trauma training prior to entering Gaza,” MacMillan said. The team would leave around 5:00 a.m., serve two to three units – some in the North but most in the South – and return at 10 or 11 at night to repack the van for the next day.
Using highly realistic, computer-controlled mannequins that mimic human bodies and other simulation tools, MSR on Wheels built up soldiers’ competence to treat injuries and do emergency procedures that would be needed on the battlefield. They also found that many units lacked key medical equipment, so Sheba Medical Center opened its warehouse to allow anyone from the army to stock up on supplies.
Helping officers break devastating news
In Israel, typically female officers notify the next of kin if a relative is killed in duty. On October 7th, so many kibbutzniks and festival attendees were murdered that more help was needed immediately to carry out this tragic function. The army sent 35 women and men to MSR for a full-day training to impart the skills and sensibilities needed to deliver tragic news to families.
Training hospital staff to care for returned hostages
As the prospect of hostage releases became more real, hospitals – their first stop for evaluation and care – realized there was no precedent for treating Israelis who had been held in brutal captivity. They had no idea what condition the hostages would be in. Should they talk to the children when they arrive? Would adults want to be hugged?
MSR quickly adapted its training approaches to help Sheba’s doctors, nurses, and staff rise to this extraordinary challenge. First, the center supplied actors who navigated the logistical steps hostages would take upon arriving. Based on this exercise, hospital staff designed their route to be discreet and set apart from other patients and staff.
MSR experts then walked hospital teams through how to interact with hostages and their families, instructing care providers to wait for hostages’ cues to guide their actions. These exercises were so valuable that the IDF asked MSR to provide soldiers and psychologists with tailored training on receiving hostages at the Gaza border and transporting them to Israeli hospitals.
Sheba Medical Center staff engage in a simulated encounter with actors playing the role of returned hostages.
Readying mental health providers to address trauma
No one in Israel has been spared the trauma of the October 7th atrocities and war with Hamas. The need for mental health support is especially acute among Israelis who were uprooted from their communities and are living long-term in hotels and other housing. Therapists and psychiatrists across Israel rushed to evacuees’ hotels to volunteer their help; however, experts worried that their varied specialties and levels of training might inadvertently cause more harm than good.
In response, Sheba Medical Center, together with Reichmann University, launched a two-week intensive course for practitioners holding at least a master’s degree in psychology, which includes days spent at MSR to practice on simulated patients the trauma-informed skills they were learning. Still, MacMillan describes the overwhelming number of Israelis who will need help dealing with trauma as “a tsunami of need.”
Heightened impact in the future
MSR’s agile model and just-in-time training has been widely well-received by its partners and participants. Leaders overseeing the IDF officers who deliver news to next of kin and the soldiers who accompany returning hostages have requested MSR to conduct another course because they viewed the training as critical. The Ministry of Defense has asked the center to continue its simulation-based training on an ongoing basis, not just in times of catastrophe. At such an intensely difficult time for the nation, this feedback, MacMillan says, “really makes us feel like we’re doing significant good and we shouldn’t stop.”
As the demand for advanced simulation training continues to grow, MSR anticipates being able to double its existing capacity through the construction of a new building on the Sheba campus. This expanded facility should open in late 2024 or in 2025, depending on war-related construction delays.