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Training for the Future: Dr. Ernest Wang on Practicing the Practice of Medicine

Monday, June 08, 2015 7:59 AM

Ernest Wang, MD, Emergency Medicine and Director of the Grainger Center for Simulation and Innovation (GCSI), loves to learn. He loves learning more about his patients, from hearing their stories to researching their medical histories. He loves learning about new procedures and the application of new technologies from his colleagues at the GCSI.  He loves sharing this new knowledge with the next generation of medical professionals during school visits and tours of the Center. He’s even one of NorthShore’s most active physicians on social media (follow @DrCommonSense). But, at the heart of all this learning is the patients because Dr. Wang might love to learn but his passion is providing the best possible care to his patients.

Dr. Wang shares his experiences in emergency medicine and tells us why the Grainger Center for Simulation and Innovation is so important to the future of medicine:

What attracted you to the field of medicine?
I have always been fascinated with the human body, people and stories. Through medicine, I get to meet all sorts of interesting people, hear their stories and help make a difference in their lives by addressing their medical conditions. I also enjoy the practice of medicine—taking in history, performing a physical exam and figuring out what tests and therapies are needed for each patient. 

Why emergency medicine?
Emergency medicine was a natural fit for me. I enjoy a wide variety of medicine; I like taking care of kids and adults. I love the stories. I like the immediacy and urgency of emergency conditions. I like performing procedures. I like the challenge of being able to think quickly on my feet. As a third-year medical student, I spent many call nights just going down to the emergency department to see what was going on. It was real humanity. And, emergency medicine is egalitarian; we treat you as best as we can because you're sick, regardless of your station in life.

What is the most challenging aspect of your job?
The intensity of the work is both the attraction and the challenge. Being ready to perform under pressure and remaining composed. It can be exhausting because sometimes it feels like the patients just keep coming; the waiting room is full and everybody is very sick. For you, it might be the 30th patient of the shift, but for them, it might be their first visit, and they're scared and concerned. It’s the job of the doctor and staff to remember that—do your best to be empathetic and make sure that you communicate effectively. 

What is the most rewarding part of the job?
For me, it’s getting feedback from a grateful patient. Often when people come into the emergency department critically ill, we stabilize and resuscitate them; however, they might be too sick to remember the care they received. Every now and then, it's nice to hear back from patients that you treated with, say, an acute heart attack/stroke/severe infection, and find out they are doing well and recovering.

One of the most memorable cases I ever had was when I first started as an attending physician in 2001. It was the middle of the night and a woman came in and quickly decompensated (or stopped breathing), so I had to intubate her very quickly and place her on a ventilator. The intubation was extremely difficult. Had I not been able to do it she would've died. 

Well, about nine years later I saw her in the emergency department for an unrelated problem. She had no idea who I was but her husband did. He said that she was his primary caregiver and that he would not be alive without her. That was a good story.

In addition to your work in emergency medicine, you are also the Director of the Grainger Center for Simulation and Innovation, where physicians, surgeons and medical staff are able to practice real-life medical scenarios. Why is a learning center like this important?
Simulation centers like GCSI are extremely important to the continuous patient safety and practice improvement efforts of any health system. It allows doctors and nurses to practice and be ready for patient conditions that they see every day, and in which they have to do things correctly every time. It also allows for training in life-threatening, high-stakes situations using highly realistic scenarios. These are cases that you may only see once in a lifetime, but, by training for it, your chances of being able to perform successfully when the condition presents itself go up significantly. Our mission statement and motto is: "We take care of our simulators, so we can take better care of you." That says it all.

What programs does the Center offer? What makes the Grainger Center unique?
Our program is unique in that it is a truly multidisciplinary, inter-professional simulation center. What I mean by that is we have committed physicians and nurses from around the organization in every discipline and patient care area (ED, anesthesia, ICU, surgery and surgical subspecialties, OR, pediatrics, OB/GYN, neurology, in-patient and out-patient medicine) working and training together with the shared goal of improving healthcare, from the time the patient arrives in the emergency department until they are discharged.

In addition to running regular training classes, we have developed a reputation as a Center for simulation curriculum innovation. We run cutting-edge surgical courses that people from all over the world come to attend. We are involved with the development of new emergency and obstetric ultrasound simulators. We create our own simulators when one doesn’t exist, and we work with vendors to develop new types of simulators to improve the experience for trainees when performing intricate procedures. We are working on innovative ways to use technology in the operating room to make operation safer. In the past five years, we’ve conceived and launched the two biggest simulation training programs in the specialty of emergency medicine. We now offer a fellowship in simulation through the Division of Emergency Medicine to continue and build on what we have created.

Who works there and what impact does their work make?
Our staff is a dedicated team of individuals from a variety of backgrounds—nurses, researchers, administrators, technicians. Our physicians who run the training come from many different departments. Each department provides physician support for their simulation educators so that they can make time to teach in the lab. The impact has been huge, from physicians and nurses reporting improved self-confidence to demonstrable improvement in skill and improved outcomes for patients.

You’ve done tours of the Center with young people and students. What have their reactions been?
I love doing the tours. Young people are the future. They are absolutely blown away by the technology in the lab and the training capabilities. They have a natural curiosity about medicine and want to learn as much as they can. Much of medicine is moving towards minimally invasive and screen-based/digital technologies. These kids grow up in this environment and are quick to learn how to use the equipment and understand medical concepts. 

The future of medicine will be very bright if we continue to show this next generation how to link simulation-based technologies with the human side of medicine. I want to encourage them to go into medicine by getting them excited not only about the technology but also with the prospects of becoming excellent physicians and nurses who are great at connecting with patients.