An interview with MITIE’s Dr. Brian Dunkin

This is the third, and final, part of our three-part series on MITIE, the Houston Methodist Institute for Technology, Innovation and Education. To recap, MITIE is one of the largest and most comprehensive surgical education and research facilities in the world. Our first blog was a photo tour of MITIE. In our last blog, we talked about how MITIE provides physicians with a comprehensive training facility to learn new surgical techniques.

To finish our time together, I sat down with Dr. Brian Dunkin, the medical director of MITIE, to ask him why MITIE and the work done there is so important. When Dr. Dunkin isn’t at MITIE, he is an endoscopic surgeon, which means he performs surgery through small incisions or natural body openings to make surgery safer and recovery faster.

Me: Why is MITIE so important and why are you so passionate about MITIE that you’d move your family and practice to Texas to build it?

Dr. Dunkin: Passion is the right word to describe MITIE for me. In medicine, we have a pressing need to support the ongoing training of practicing health care professionals. With how quickly things are changing and constant advancements in technology, it’s become a real crisis. You could be in practice after your training for a relatively short period of time and you’re not up to date anymore and you have nowhere to go.

Dr. Brian Dunkin headshot
Dr. Brian Dunkin is MITIE’s medical director and an endoscopic surgeon.

I’ve developed training programs at several institutions, but nowhere did I see the opportunity to develop an educational facility of the scope and scale available at Houston Methodist. That’s what convinced me to move to Texas and become a part of this. I don’t think anyone else on the planet, and certainly in the U.S., could have done what we did with MITIE. No one else had the resources, the space, the commitment from hospital leadership, the people – it took a lot of things coming together for MITIE to be what it is. For example, I recently had the opportunity to give my mentor, a worldwide leader in surgical education, a tour of MITIE, and he was completely blown away by the facility, the scope of programs available, and the timeline in which we accomplished this. Even with our initial success, we still have a lot of things we want to do in MITIE, so we aren’t done yet.

Also, some practicing surgeons don’t understand the importance of or the value of educating other clinicians. I’ve been taught that you teach others what you know. I’ve found that in the process of educating others, you learn, too.

Me: You have a lot of ongoing projects, but what are some of the bigger projects you are working on right now?

Dr. Dunkin: The educational project I’m most excited right now is the MITIE Lapco program, which teaches laparoscopic colon surgery. Learners spend four days in MITIE doing hands-on training with experts from around the world. In most courses, that’s where the learning stops, leaving an educational hole where the surgeon goes back to his or her home institution and is alone in the operating room when trying to start doing this new procedure. I’ve always thought technology was the way to fill this gap.

We added telementoring, or the practice of using a videoconferencing system in the operating room to allow an expert surgeon to virtually mentor another surgeon, to the MITIE Lapco program. Learners have an expert with them virtually for their first 10 cases at their home hospitals. We believe that telementoring will help the learning surgeons perform better, safer surgeries and will help increase the U.S. adoption rate of laparoscopic colon surgery.

Microsurgery training at MITIE
Microsurgery is commonly used to reattach severed nerves and blood vessels. Microscopes are needed for these procedures to ensure that the cells in the nerve ending or blood vessel are lined up properly.

Telementoring is doable and every bit as powerful as in-person mentoring. I have hospital CEOs asking for us to offer telementoring for more courses because they’ve seen the outcomes. They know their surgeons will be able to do these advanced procedures safely and effectively and will have happier patients. I think five years from now, we’ll look back on this conversation and laugh because telementoring will be so common.

Me: What’s your favorite MITIE class or research project so far?

Dr. Dunkin: I think the clear favorite is MITIE Lapco. It wasn’t just the course we put on for the learners, but it was the thoughtfulness, time and effort we put in to designing the program from developing the curriculum and organizing telementoring opportunities after the course. And the feedback we got from learners during the course was unlike anything we’d heard before. Almost everyone in our first MITIE Lapco course had been to a previous course on laparoscopic colon surgery at another institution, and they were just blown away with the difference in their confidence level in performing this surgery at the end of our course compared to the others.

Me: What are some upcoming MITIE classes or research projects that you’re most excited about?

Dr. Dunkin: I’m most excited about the next stage of growth for MITIE because we’re right at the threshold of it.

The first stage was designing and building a physical structure. The next stage was building an infrastructure that could support volume and a variety of programs. In the seven years that we’ve been open we’ve had more than 28,000 learners here.

Now, we are at the point where I want to create more programs like MITIE Lapco that address the full spectrum of surgical education. I can’t tell you how many people have told me that no other place is doing what MITIE is doing. What’s really great is that where we want to go with MITIE fits with Houston Methodist’s goal of leading medicine rather than just practicing it. There are a lot of great courses and research projects in MITIE’s future, but it’s the whole MITIE package that I’m most excited about.

The more I see MITIE evolve, the more confident I am that we are going to change the medical world by creating better educational tools and providing them to colleagues from around the world.

Why the work done at MITIE matters

mitie2-featured
MITIE provides training to not only doctors, but law enforcement and emergency medical service providers, too.

elcome to part two of a three part series on MITIE – the Houston Methodist Institute for Technology, Innovation and Education. To recap, MITIE is one of the largest and most comprehensive surgical education and research facilities in the world. The first blog was a photo tour of MITIE, and the next blog will feature a Q&A with Dr. Brian Dunkin, the medical director of MITIE.

If you don’t work in health care, you might be wondering why you should care about MITIE and the work we do here. Well, I’ll tell you! There are two main reasons:

  • MITIE is a medical education facility. MITIE provides surgeons and surgical nurses with an opportunity to learn, practice and perfect new surgical techniques.
  • MITIE isn’t just for health care providers. MITIE also partners with other organizations to provide classes with curriculum tailored to their needs. Think law enforcement, emergency medical service providers, etc.
You want surgeons to know the latest techniques and perform them safely. That's the role of MITIE. Click To Tweet

After nursing school or residency, there are few educational facilities surgeons and nurses can go to learn new techniques. Cue MITIE. New surgical techniques are being developed all the time that make surgeries safer and more successful while decreasing the amount of time needed for recovery. You want your surgeons to know these latest and greatest techniques, but to perform them safely and successfully, the doctors need to practice them.

The alternative to practicing in MITIE is practicing on you – any volunteers? I didn’t think so. One example is laparoscopic colon surgery. Laparoscopic surgery, also known as minimally invasive surgery, uses several small incisions instead of one large incision. A laparoscope, or camera, is inserted through one incision and special laparoscopic surgical instruments are inserted through the other incisions. Laparoscopic colon surgery has been practiced in the United States since the 1990s and has been proven to be less painful with less scaring and allows patients to get back to their normal lives faster.

However, the US adoption rate of this procedure hovers around 40 percent because performing a colon surgery laparoscopically is a difficult procedure that is tedious to learn. In October 2014, MITIE hosted a laparoscopic colon surgery course for seven surgeons and their operating room staff. After spending four days training at MITIE, these surgeons returned to their hospital and were mentored by an expert surgeon during their first laparoscopic colon surgery. Several of the learning surgeons noted that the hands-on class at MITIE coupled with mentoring during their first surgeries at home helped increase their comfort level with the procedure and has benefitted their patients with safer surgeries and faster recovery times.

MITIE also partners with other organizations to provide classes with curriculum tailored to their needs. MITIE recently collaborated with the Harris County Sheriff’s Office (HCSO) Tactical Medicine Program to create the HCSO’s first tactical medicine school. Tactical medicine is the delivery of emergency medical care in a law enforcement special operations scenario. 

“Most people don’t know that the Sheriff’s Office is staffed with deputies who are physicians and paramedics who respond to emergencies to provide care to their fellow officers and citizens until EMS can arrive,” explained Dr. Aashish Shah, a HCSO deputy and administrator over the HCSO’s Tactical Medicine Program. 

During the first tactical medicine school, the HCSO Academy hosted the tactical trainings, such as gun safety, medical extraction, building clearing and distraction devices. At MITIE, the students covered a variety of tactical medical tactics, such as triage, airway management, hemorrhaging and burns.

After a week of lectures and practice, the students put it all together with a live High-Risk Operations Unit (HROU) exercise at MITIE. We simulated an active shooter in a hospital scenario to test the participants’ new understanding of tactical medicine. The learners were assigned to teams of SWAT officers. Each team entered the building and took the stairs to the 5th floor where MITIE is located, just like they would do in a real situation.

MITIE doesn't just educate doctors. The institute also trains law enforcement in tactical medicine. Click To Tweet

When they arrived on the 5th floor, they were greeted with a variety of scenarios, including blaring music, a sound track of dogs barking, rooms that were dimly lit or completely dark and random MITIE staff who would act like innocent people caught on the floor or the suspect the team was looking for. Their mission was to locate an injured Oscar or Mayer (you remember the SimMan patient simulators from part 1, right?), provide care to help stabilize the patient then continue to look for the suspect. At the end of the exercise, the students were credentialed by the HCSO to provide tactical medicine support. 

While you may never take a class at MITIE, the work done here affects you. Next week, we’ll sit down with Dr. Brian Dunkin, the medical director of MITIE, for a Q&A about his work and why he’s so passionate about the MITIE.

New year, new resolutions

he holiday parties have ended, decorations are coming down and the Thanksgiving-to-New Year’s food fest has come to a screeching halt. The start of 2015 is here and with that means an opportunity for many to start fresh. 

Most of us make New Year’s resolutions but can’t seem to make them stick. In fact, according to Forbes, 90 percent of Americans make a New Year’s resolution every year and only 8 percent follow through. 90% of Americans make a New Year’s resolution but only 8% follow through Click To Tweet

I asked several of my colleagues at Houston Methodist Hospital what their New Year’s resolutions were. Here’s what they said.

  • I want to beat last year’s FitBit total. – Dr. Marc Boom, president and CEO of Houston Methodist

2015blog

  • Take advantage of the bike trail in my neighborhood and use it at least 30 times in 2015. – Dr. Angel Rodriguez, breast medical oncologist
  • Run at least 1,000 miles this year. – Dr. Mauro Ferrari, president and CEO of Houston Methodist Research Institute 
  • Take all my allotted vacation days and advance the field of telementoring in the OR. – Dr. Brian Dunkin, endoscopic surgeon and medical director of MITIE
  • Have less “electronic” time and more family time with my fiancé, Lisa and my two dogs, Cinny and Toti. – Dr. Joshua Harris, orthopedic surgeon
  • Strengthen my spirituality, strive to be a better person and participate in triathlons, injury-free so I can competitively participate in 2016. – Dr. Gavin Britz, chairman of the department of neurosurgery at Houston Methodist Hospital
  • I would like to spend more time brainstorming with my postdocs, reviewing their data, troubleshooting protocols and critiquing their scientific communications. I also intend to learn a dozen new BBQ recipes.– Dr. John Cooke, director of the center for cardiovascular regeneration and chair, department of cardiovascular sciences

Don’t forget to check back with us next year to see who kept up their resolutions throughout 2015.