In 2003, almost simultaneously and independent of each other, two organizations dedicated to the advancement of medical simulation were organized. One was the Society for Medical Simulation (SMS). In 2006, in recognition of the broader scope of medical simulation, SMS changed its name to the Society for Simulation in Healthcare (SSH). The other organization was the Advanced Initiative for Medical Simulation (AIMS), which came about as a result of interactions between various individuals interested in furthering the use of simulation for the public good. AIMS held its first public meeting in May 2004. The birth of these two groups so temporally close to one another and their shared focus has led to confusion in the medical simulation community regarding the role of each organization and their complementary value for the physicians, scientists, educators, and industry who comprise the medical simulation community. This commentary seeks to clarify the purpose of AIMS and explain the separate roles that AIMS and the SSH each can play in the growth and acceptance of medical simulation. ADVANCED INITIATIVE FOR MEDICAL SIMULATION Initially, AIMS was a loosely organized group of individuals, mostly physicians, who gathered to establish the strategic framework under which AIMS would operate to promote simulation. This Planning Committee included individuals within the simulation community as well as key policy strategists (Appendix 1). From the beginning, the organizers recognized that the rationale for government support of simulation would be strongest if AIMS integrated simulation’s users and developers with the manufacturers of simulation systems. Thus, from its early existence, AIMS included an Industry Council that engaged key industry leaders from Haptica, Immersion Medical, Laerdal, Medical Education Technologies Inc. (METI), Simbionix, and Simulab Corporation to work with the AIMS Planning Committee. As of July 2006, the AIMS Industry Council has grown from its original six members to 14, representing many of the commercial vendors of simulation equipment, including B-Line Medical, Gaumard Scientific, Haptica, Immersion Medical, Laerdal, Limbs & Things, Medical Simulation Corporation, Medic Vision, METI, Simbionix, SimMedical, SimQuest, Simulab Corporation, and Verefi Technologies. In 2005, AIMS was incorporated as a 501(c)(6) professional trade association to advance the adoption of medical simulation and to promote the industry. It has two overarching strategies: increasing the visibility of medical simulation among national policymakers and, through that activity, obtaining additional financial support for simulation research and development as well as funds for medical, nursing, and allied health institutions to purchase equipment and related items. AIMS is led by a Board of Directors that includes David Gaba, MD, Dale Alverson, MD, Steven Dawson, MD, and two representatives from the AIMS Industry Council. Gardner, Carton & Douglas LLP (GCD), a national law firm specializing in health care and advocacy, manage and represent AIMS. Jackie Eder-Van Hook, MS, serves as its Executive Director and Bob Waters, JD, serves as its General Counsel. Mr. Waters provides AIMS with expertise in government relations and guides its approach to policymakers. Two founding organizations, Center for Integration of Medicine and Innovative Technology (CIMIT) at Partners Healthcare and Information Resources and Technology (IRT)—Immersive and Simulation-based Learning at Stanford University, have enabled growth of the AIMS effort. Since its inception, AIMS has had an international perspective and has included participants and leaders from Ireland, Norway, Australia, Sweden, and Israel, despite the fact that the driving principle of AIMS’s work is to foster U.S. government investment in medical simulation. Since its very first moments, AIMS has had the philosophy that “a rising tide lifts all boats.” The international cooperation in creating and sustaining AIMS has been a testimony to that belief. AIMS is more than a trade association; it is an idea personified by a coalition of individuals, universities, the simulation industry, and other national organizations whose purpose is to educate and influence health policy and other national policy makers concerning the value of medical simulation. Success for AIMS will be measured by its ability to create the synergy for and the actualization of a long-term federal investment to support simulation development and implementation broadly across the health care arena. AIMS serves as the voice for medical simulation in Congress and in federal agencies, encouraging the awareness of simulation’s potential to reduce errors, improve the performance of health care personnel, and create an environment where the practice of medicine does not always occur on patients themselves. AIMS coordinates its efforts through regular meetings of its leadership and an annual conference and exhibition in Washington, DC, which is entering its fourth year. The conference is an opportunity to bring national leaders in simulation research, users, industry, organized medicine, federal regulators, payers, and insurers together to discuss the state of medical simulation in their respective areas. The AIMS presentations are intended to discuss policy issues and place simulation in a broader context within the national health care system. The AIMS meeting does not present peer-reviewed scientific papers. The annual Congressional exhibition provides a hands-on educational experience with a variety of simulation systems for Members of Congress, Congressional and Federal agency staff, the press, and the public. In 2006, the Third Annual AIMS Congressional exhibition had the bipartisan support of 134 Congressional Honorary Cohosts, representing 25% of the entire Senate and 24% of the U.S. House of Representatives. Information about the 4th Annual AIMS Conference and Exhibition is available at the AIMS website at www.medsim.org. AIMS’s capacity to hold this exhibition on Capitol Hill is greatly influenced by the ability to create Congressional champions of Members of Congress or staff. Senator Tom Harkin of Iowa has been a key supporter of AIMS’s efforts and has served as an Honorary Co-Chair of the Exhibition since its inception in 2004. In 2006, Virginia Congressman J. Randy Forbes, Chair of the Modeling and Simulation Caucus in the U.S. House of Representatives, also served as an Honorary Co-Chair. Congressman Forbes has taken an active interest in the medical aspects of simulation in addition to its applications in aviation and engineering. This level of Congressional interest represents significant progress in 3 years since the first meeting in 2004, when AIMS had one Honorary Cohost. Clearly, recognition of medical simulation is increasing on the Hill. AIMS: A VALUABLE COMPLEMENT TO SSH AIMS and SSH complement each other in a substantive manner, yet each has a unique mission. AIMS provides a national voice for medical simulation at the federal level. By realizing its mission to educate public and private policymakers, articulate the value of simulation to a broad national audience, and convene external stakeholders in an effort to find or create champions for medical simulation, AIMS will—and indeed already has begun to—change the face of medical simulation. In its short existence, AIMS has been at the forefront of raising awareness of federal agency staff to the potential of simulation. Among the early results of these efforts are a new program of $2.4 million in funds for research, the inclusion of medical simulation in the first Congressional Modeling and Simulation Exhibition in the House of Representatives in 2006, and success in adding language to the Fiscal Year 2007 House Appropriations Labor-HHS-Education Committee Report. AIMS has performed outreach to a number of federal agencies, such as the Institute of Medicine and the National Academies of Science in an effort to create synergy and to examine and define the value of medical simulation. Today, simulation’s science is presented at a growing number of meetings around the world, including the International Meeting for Simulation in Healthcare (IMSH), SIMTEC, the International Symposium on Biomedical Simulation (ISBMS), Medical Image Computing and Computer-Assisted Intervention (MICCAI), SIGGRAPH, and Medicine Meets Virtual Reality (MMVR). In the future, it is hoped that one organization, the SSH, will encompass the scientific leadership role for all of medical simulation in an expanded annual meeting. AIMS will then serve as a policy-oriented convener, educator, and advocate for medical simulation in the United States and around the globe. Together, AIMS and SSH can serve as focal points for convening the simulation science, practice, and development communities, thereby enhancing our scientific basis and extending our reach to a broader audience outside the health care arena. Both AIMS and SSH share the commitment that simulation as practiced now is only a hint of what will eventually be a much more widely used, broadly accepted, and institutionally integrated technology. Both organizations recognize that more research and development is necessary to create systems that answer healthcare’s evolving needs. As simulation expands from its original platforms to newer technologically advanced methods, trials will be needed to establish performance improvement in clinical settings. At this time, no one industry partner or institution is able to fund these studies adequately, yet working together AIMS and SSH can secure the visibility and funds for these efforts. As a nonprofit 501(c)(3) corporation, SSH is an international, multidisciplinary, academic society focused on education, assessment, and research. However, its nonprofit 501(c)(3) status precludes it from influencing public policy. AIMS, by contrast, was expressly incorporated as a 501(c)(6), a nonprofit designation that allows it to take a participatory role in government policy. AIMS can focus on areas where federal support would be crucial to further simulation integration, adoption, or development. SSH can then convene the users, educators, and scientists who will define the field. Although there is overlap among the individuals, organizations, and corporations interested in AIMS and SSH, some may find it more advantageous to affiliate with one or the other organization. Hopefully, most will appreciate the need for both organizations to be successful and participate in each, recognizing the important and unique roles that each organization plays in the future of medical simulation. In the end, these two organizations are working for the same goal: improved performance and reduced errors using broadly accepted, scientifically proven medical simulation systems to train providers. We look forward to jointly influencing many medical disciplines, as well as related fields from engineering and educational psychology to the insurers and our certifying boards. Together, AIMS and SSH can play synergistic roles in that future.
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Dawson et al. (2007) studied this question.
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