Education "On Demand": The Development of a Simulator-based Medical Education Service

High-fidelity patient simulation promises to revolutionize medical education by making "good teaching cases" available on demand. Faculty and residents from the Harvard Division of Emergency of Medicine have helped institute a simulator-based "medical education service" at the medical school-like any other clinical teaching service, but designed exclusively to help students "practice" on the simulator at anytime. Part of the new Program in Medical Simulation at Harvard, the medical education service assigns a dedicated pager to a physician-educator "on-call," including teaching faculty "on-service" and senior resident participating in a "medical education elective." Over 90% of our students (all levels, including all EM clerks) feel that simulator exercises should be a mandatory component of their medical training, and the program has become integrated into both basic science and clinical coursework. Not only do students enjoy the opportunity to practice medicine "on demand," but course instructors like "bringing to life" basic teaching cases on the simulator. By offering a medical education elective to residents, we have not only provided a "resident as teacher" experience, but fostered additional opportunities for cross-disciplinary collaboration throughout the medical school.