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Photo by Annie O'Neill

Monitors and medical devices beep and whirr amid gurneys rolling down a terrazzo corridor. In a high-tech simulation suite at the �ǿմ�ý School of Medicine, a team of medical students are racing through a hospital—and against the clock—to reach their patient in the operating room.

They need to correctly answer questions to unlock the next stage of this escape-room-like scenario. To find the right answers, they interact with the clinical environment projected onto the walls that also act as touchscreens—letting students read electrocardiograms, calculate glomerular filtration rates and find other health data.

This hands-on, active-learning approach helps students sharpen their critical thinking and teamwork skills in real time.

“Students become immersed in the experience, handling all of the stressors simultaneously so they can be better prepared for real-life situations,” said Lia Logio, MD, professor and vice dean for medical education. “It also makes learning fun—and teams experience deep learning together.”

The medical school's new Zubizarreta Immersive Learning Suite (ZILS), completed in the fall 2023, is one of the only facilities of its kind in the country. Early-adopter faculty members are creating realistic medical scenarios to reinforce key concepts through gamification—turning learning into an interactive and engaging game.

The medical school has hosted demonstrations and workshops to showcase the suite’s potential and explore how to integrate its new technologies into the curriculum.

“This suite pushes the boundaries of learning, discovery and creativity,” said Miguel Zubizarreta (CWR ’90), the facility’s namesake and chief technology officer of Westlake, Ohio-based software company Hyland. “The technology allows us to continually expand comprehensive learning experiences for students.”

Future simulations could include a busy labor and delivery suite, a dialysis unit or even triage scenarios at the finish line of a marathon. By combining core medical knowledge with the latest technologies and teamwork, ZILS continues the School of Medicine’s tradition of innovative teaching methods in a culture that prioritizes inter-professional learning.

“It shows our innovative spirit and empowers students,” Logio said. “Encouraging a love of learning is vital, so we must provide the right tools to inspire curiosity while helping future doctors do their best work.”

Photo by Annie O'Neill

Realities of Residency

As ZILS continues to develop, students in the University Program—the traditional MD degree-granting track at the medical school—are already immersing themselves in intensive, simulation-based training.

The 15,000-square-foot Simulation Center at �ǿմ�ý’s Health Education Campus with Cleveland Clinic offers a realistic environment where students can practice high-acuity scenarios that are difficult to replicate in traditional classrooms.

This state-of-the-art facility includes ZILS and a mix of exam and acute care rooms that host a number of classes—including the newly launched “Transition to Residency” capstone course.

Designed to equip medical students with hands-on experience and prepare them for the next stage of their careers, the class is “sort of a boot camp of essential skills and knowledge,” said Andrew Golden, MD, assistant professor of emergency medicine and course designer.

“We hope it minimizes uncertainties for students as they start residency a few months later,” he added.

Relying heavily on manikins that mimic real human symptoms—including internal bleeding, seizing and cardiac arrest—that require students to intervene, the class allows students to practice procedures such as intubation, defibrillation and handling emergencies.

“You have to act in the moment,” said Jeff Butke, MD (MED ’24), who completed the course this spring and is now an intern at University Hospitals. “Your adrenaline actually starts going and you have to contend with your own physical and emotional reactions.”

Cameras and microphones record students as they practice examination and treatment. Preceptors observe students using two-way mirrors and control the manikin’s physical conditions as students choose treatment options.

“These are high-pressure situations that are very close to what would happen with real patients where there could inherently be some discomfort for students,” said Golden. “Students develop a sense of ownership for patient care, reduce errors and become more confident in their clinical reasoning.”

The new two-week course—which will become mandatory in 2025 for all University Program students— also emphasizes the physical practice of medicine, such as setting up monitors and devices and interacting with other medical professionals.

In post-simulation debriefing sessions, students reflect on their performance and provide and receive feedback with each other. “It forces you to sort through uncertainty, but there are guardrails,” said Butke. “It helps us better understand what to improve.”

Photo by Nicholas McLaughlin

Layers of Learning

All U.S. medical schools must adhere to core educational standards set by the Liaison Committee on Medical Education (LCME) to ensure graduates have a similar foundational knowledge base.

Still, schools differentiate with unique programs and opportunities. By design, �ǿմ�ý School of Medicine’s curriculum is crafted to blend various learning environments, catering to the diverse learning styles of its students.

“Medical school is not formulaic. We are trying to accomplish the same things but go about it in very different ways,” said Lina Mehta, MD, professor of radiology and associate dean for admissions. “We see our students as future colleagues; it’s our duty to train them to be the best doctors possible.”

In recent years, the medical school introduced an original educational model known as Gross Anatomy, Radiology, Living Anatomy (GARLA).

Stretching across the two-year pre-clerkship curriculum, it provides a framework for understanding the mechanisms underlying health and disease. Soon after enrolling, students spend two weeks performing conventional cadaver dissection, and then write reflections about the experience.

“Getting that connection with their first patient, the cadaver, helps build respect and professionalism they need,” said Logio. “It’s a very powerful learning experience as they enter the profession.”

Second-year students mentor first-years in anatomy and radiology basics before rotating through three unique learning experiences. They interpret radiology images, conduct ultrasounds on standardized patients, and use the HoloAnatomy software developed at �ǿմ�ý’s Interactive Commons. Wearing HoloLens headsets, students explore 3D holograms of the human body, studying bones, muscles, nerves and organs in unprecedented detail.

“On its own, HoloAnatomy is innovative, but what’s equally as innovative is combining it with ultrasound and radiology to learn about the exact same anatomical regions,” said Amy Wilson-Delfosse, PhD, associate dean for curriculum. “If students can learn subject matter in multiple ways, we see they’re better prepared for clinical practice.”

Pilot studies have found that �ǿմ�ý medical students learn anatomy twice as fast with the Wilson-Delfosse HoloAnatomy app as they do when dissecting cadavers. The approach has gained national attention, and now more than 20 universities and medical centers around the country are licensing HoloAnatomy from a �ǿմ�ý-created company.

“Our school is known for being at the forefront of teaching medicine in new ways,” said Wilson-Delfosse. “It’s become our bread and butter that other schools implement what we introduce.”

Climate in the Curriculum

The summer before James Sullivan, MD (MED ’24), graduated from Cleveland Clinic Lerner College of Medicine of �ǿմ�ý, smoke from Canadian wildfires blanketed Cleveland and many parts of the Midwest in a thick haze. Poor air quality triggered asthma and related health conditions, especially among vulnerable populations.

“We saw firsthand how climate can affect health in almost every part of the body,” said Sullivan, now a first-year resident in internal medicine at Brigham & Women’s Hospital.

In 2019, Sullivan—then a first-year student—had joined a special steering committee of students, faculty and residents to create the Climate Health Action Curriculum for Lerner College, which is a five-year, research-intensive program within �ǿմ�ý School of Medicine. Over the next half-decade, �ǿմ�ý’s Lerner College became one of the first medical schools in the country to fully integrate the topics into most aspects of its educational approach.

“Climate change has clear implications for clinical practice and healthcare delivery,” said J. Harry (Bud) Isaacson, MD, executive dean of Lerner College. “As the effects worsen, there will be more need for healthcare professionals to understand how to address these challenges.”

Rather than adding new content, climate change is integrated into the existing curriculum, with examples woven into both pre-clerkship and clerkship stages.

Students consider patient cases involving how extreme temperatures and pollution spur respiratory conditions, heat-related illnesses and vector-borne diseases. They also study broader public health implications—focusing on social determinants of health worsened by climate change, such as food security, clean water access and displacement from natural disasters.

“Our aim is that students feel equipped to deal with the strain [climate change] will place on people and our health system,” Sullivan said. “Right now, there’s a huge gap in medical education covering these topics.”

Sullivan—whose interest in health was influenced by growing up near a polluted area in Massachusetts designated as an Environmental Protection Agency Superfund site—served as lead author on a paper published in Academic Medicine detailing the curricular changes at the Lerner College.

“Other medical schools can see incorporating climate change into their curriculum is possible and help students learn how to navigate these very real complexities,” said Sullivan.

These innovative initiatives are part of a broader philosophy of preparing students for a wide range of future roles in healthcare.

“We want our students to be movers and shakers and understand that part of their job is to make healthcare better across the board,” said Logio. “We do that by preparing physicians to provide the right care for the right patient, at the right time, in the right place.”