1 the pulse Aug. 11, 2016

Learning to Care for Those in Harm’s Way

Volume 11, Issue 12 n Aug. 11, 2016

www.usuhs.edu

The Official USU Newsletter
2 the pulse Aug. 11, 2016

Dr. Richard W. 

Thomas was officially 

sworn in as the sixth 

President of the Uniformed Services University of the Health 

Sciences (USU) in a 

small ceremony on 

the university campus on July 25.

As president, Dr. 

Thomas is responsible for the academic, 

research and service 

mission of the university. He advises 

the Assistant Secretary of Defense for 

Health Affairs and 

the four Surgeons 

General on a wide 

array of issues related to graduate health 

professions education and healthcare research.

“I am honored to be your sixth 

President. I look forward to the opportunities we will have to advance 

education, research, clinical care 

and readiness for our nation’s military and federal health systems,” 

Thomas said. 

Thomas retired from the Army in 

May 2016 at the rank of Major General. He is a physician and dentist 

whose last assignment was as Chief 

Medical Officer and Director of the 

Defense Health Agency Healthcare 

Operations Directorate. Among his 

many military assignments, Thomas has served as the Surgeon General for the U.S. Forces – Afghanistan, and Senior Medical Advisor 

for the International Security Assistance Forces Joint Command – Afghanistan; assistant Army Surgeon 

General for Force Projection; and 

commander of Blanchfield Army 

Community Hospital at Fort Campbell, Ky. 

“USU is an outstanding organization with a strong tradition of 

interdisciplinary collaboration,” 

Thomas said. “This reputation is 

well deserved and directly attributable to our outstanding faculty, staff 

and students. I specifically want to 

thank Dr. Rice for his wise and inspiring leadership of this great university over the past 11 years.”

Sharon Holland

Deputy Vice President for External 

Affairs and Managing Editor

Christopher Austin

Writer and Interim Editor

MC2 Laura Bailey

Writer and Photographer

SSgt. Stephanie Morris, USAF

Writer and Photographer

Sarah Marshall

Contributing Writer and 

Photographer

Tom Balfour

Photographer

Production

Editorial content is edited, prepared 

and provided by the USU Office of 

External Affairs unless otherwise indicated. The Pulse staff may include 

or exclude articles based upon news 

value, impact on the university and 

space availability.

Submissions

The Pulse is published biweekly on 

Mondays. The deadline for submissions is at 4 p.m. Tuesday prior to the 

publication date. Submissions can be 

sent to christopher.austin.ctr@usuhs.

edu or by calling 301-295-3338.

Dr. Richard W. Thomas, the sixth President of the 

Uniformed Services University of the Health Sciences. 

(Photo by Tom Balfour)

Thomas Sworn in as New USU 

President

By Sharon Holland

On the cover

Dr. Richard W. Thomas is sworn in as 

the sixth President of the Uniformed 

Services University of the Health Sciences 

(USU) by Ms. Shaquinta McDonald 

from USU's Civilian Human Resources 

Office. See story on pg. 2. (Photo by 

Sharon Holland)
3 the pulse Aug. 11, 2016

The Craniofacial Clinic at 

Walter Reed National Military Medical Center (WRNMMC) is aiding children and 

adults with facial differences 

under the guidance of Uniformed Services University 

of the Health Sciences (USU) 

surgery faculty member and 

graduate, Air Force Lt. Col. 

(Dr.) Kerry Latham. A craniofacial plastic surgeon, WRNMMC craniofacial team director and Naval Medical Center 

Portsmouth craniofacial team 

co-director, she decided that 

this would be her career path 

back in 1999. 

“I was a third-year medical 

student and had completed 

all my medicine, pediatrics, 

and family medicine rotations, which is what I thought 

I wanted to do. I had not yet 

done surgery but I went on 

this humanitarian mission 

to the Philippines and was, 

at that point, a bit worried I 

hadn’t fallen in love with a certain field of medicine yet,” Latham said. 

“I was worried that medicine wasn’t going to work out for me as a career.”

Latham said this changed for her 

when she met a teenager who was going 

to have his cleft lip fixed. He was in love 

with a girl in town who was his best 

friend. He wanted her to become his 

girlfriend, but was held back by his facial difference. He intended to have his 

lip fixed when he was seven but got sick 

and could not get the surgery. He had 

been hoping to have it fixed since then.

“I asked the surgeon if I could observe this surgery and she invited me 

to scrub in. The surgery took about an 

hour. He was the last one of the day so 

I didn’t get to talk to him after the surgery about how he felt because he was 

groggy from the anesthesia,” she said. 

“The next morning I bolted into the 

hospital to talk to him and couldn’t wait 

to see his reaction to how wonderful he 

looked. When I got there, sitting with 

him was a teenage girl holding his hand 

and they were smiling at each other and 

happy. She was probably his girlfriend 

and he was delighted and I couldn’t 

be happier for him. I had no idea you 

could change somebody’s life in an 

hour of your time.”

After returning to the States, Latham 

went on to do general surgery at Wilford Hall Medical Center in San Antonio, Texas, plastic surgery at Jackson 

Memorial Hospital in Miami, Fla. and 

craniofacial surgery at Seattle Children’s Hospital in Seattle, Wash.

”I really enjoy taking care of kids 

with congenital facial difference and 

adults who still have issues that pertain 

to their facial differences. I was fortunate enough to be assigned to Walter Reed and to direct the team here,” 

Latham said. “I think people who are 

drawn to the team feel a passion for 

taking care of kids and adults with facial differences.”

The team at WRNMMC is composed 

of specialists in different areas including audiologists, speech and language 

pathologists, social workers, geneticists, pediatric dentist, orthodontists, 

prosthodontists, developmental pediatricians and psychologist, plastic surgeons and oral surgeons. Students from 

USU have the opportunity to work with 

the multidisciplinary team.

Latham suggests that USU students 

reach out to her if they are interested in 

pursuing a career in plastic surgery or 

on a craniofacial team.

Air Force Lt. Col. (Dr.) Kerry Latham scrubs before surgery at Walter Reed National 

Military Medical Center (WRNMMC). Latham leads the Craniofacial team at the 

hospital, repairing cleft lips and palates in children and adults. (Photo by Air Force 

Tech Sgt. Tony Tolley) 

Alumna leads WRNMMC craniofacial surgery

By Christopher Austin
4 the pulse Aug. 11, 2016

Research team awarded grant for work 

in simulation study

By MC2 Laura Bailey

A $1.6 million grant was awarded to a team of researchers to study 

new methods for measuring clinical reasoning. The research team 

is led by Dr. Steven Durning and 

Navy Cmdr. (Dr.) Anthony R. Artino, Jr. They serve, respectively, as 

the director and deputy director for 

Graduate Programs in Health Professions Education in the Department of Medicine at the Uniformed 

Services University of the Health 

Sciences (USU) where they are also 

professors. 

Word that the team had been 

awarded funds came in March from 

the Department of Defense’s Joint 

Program Committee 1, which focuses on medical simulation and 

information sciences, and the Congressionally Directed Medical Research Programs. 

The project titled, “Developing 

Assessment Tools to Better Understand the Mechanisms of Clinical 

Reasoning in Military Medical Simulation,” stands alone for one simple 

reason. 

“What makes the project unique 

is its emphasis on the development 

of new ways to measure clinical reasoning, both individual clinician 

reasoning and team or collective 

reasoning,” said Artino. “Ultimately, we want to better understand the 

nature of clinical reasoning and how 

contextual features in a given situation may impact how physicians 

decide and act. The project aims to 

help us better understand the nature of clinical reasoning and how 

features of the clinical environment 

influence physicians.” 

While some research 

projects may be done 

completely under the microscope, their project 

unfolds in front of a video 

camera. 

“First, we want to examine how theoretically-derived variables are 

related to clinical reasoning performance in a 

simulated setting using 

videotapes and live scenario-based simulations,” 

said Artino. “Then we can 

evaluate whether a novel 

intervention based on the results of 

specific aims one and two improves 

clinical reasoning performance.”

“The project aligns with a recent 

report from the Institute of Medicine about improving diagnosis in 

healthcare,” said Durning. “In particular, we need to better understand how and why the problem of 

context specificity occurs.”

Context specificity is the idea that 

when a physician sees two patients 

with the same clinical presentation 

and the same underlying diagnosis, 

the physician often comes to two 

different diagnostic and/or therapeutic decisions. 

“The scientific relevance of this 

project is expected to be very high 

because our understanding of the 

factors influencing the quality of 

clinical reasoning is still very limited,” said Durning. “Additionally, 

the societal impact of this project 

could be significant, as it could lead 

to the development of more targeted educational interventions to help 

reduce unwanted variation in clinical reasoning performance. Reducing medical errors is a must in the 

current healthcare system because 

personal consequences and the error-related system costs are a huge 

burden for society.”

The study is estimated to take 30 

months from start to finish and begins this year with completion estimated to take place in 2019. 

The team is comprised of several 

other individuals from the Department of Medicine, including retired 

Air Force Col. (Dr.) Paul Hemmer, 

Air Force Maj. (Dr.) Jeffrey La Rochelle, associate professors Dr. 

Dario Torre and Dr. Alexis Battista, and senior research associate Dr. 

Katherine Picho, as well as national and international collaborators: 

Army Col. (Dr.) Jeff Mikita from 

Walter Reed National Military Medical Center, Dr. Tim Cleary from 

Rutgers University, Dr. Lambert 

Schuwirth from Flinders, Australia, 

and Dr. Pim Teunissen and Dr. Jeroen van Merreinboer from Maastricht University, the Netherlands. 

Air Force 2nd Lt. Omojo Odihi (foreground) 

and Army 2nd Lt. Raymond "Michael" Meyer 

review clinical scenarios at the Val G. Hemming 

Simulation Center. (Photo by Tom Balfour)
5 the pulse Aug. 11, 2016

As August 1st marked the tenth 

anniversary of the Uniformed Services University of the Health Sciences (USU) Center for Deployment 

Psychology (CDP), Dr. David Riggs, 

the director of the CPD, reflected 

on the accomplishments and future 

goals of the center.

The CDP was formed in 2006 as 

military and civilian psychology 

experts met to design a three-week 

course that looked to educate both 

military and civilian providers to 

better care for military personnel 

and their families dealing with the 

stress of deployment. 

“One of the things we learned 

early on was that combining groups 

of military and civilian providers led 

to some frustration on both sides. At 

that time if you think about it, 2006-

2007, a lot of our military providers were anticipating deployment 

to go to Iraq or Afghanistan. A lot 

of their questions revolved around 

what they should take, what it’s going to be like out there, and how do 

you do therapy in the desert?” Riggs 

said. “Most of our civilian providers 

weren’t going to see Iraq or Afghanistan and they were asking basic 

questions about military culture and 

rank. They were starting from a very 

different place.” 

The solution to this was to create separate but overlapping programs; each focused on the military or civilian providers, giving 

them the knowledge they needed 

to serve their patients while taking 

their backgrounds into consideration. Riggs said there is plenty of 

overlap between the two categories 

as military providers attend civilian 

courses and civilians attend military courses.

Over the past 

10 years, both 

military and civilian providers 

have been trained 

through CDP's 

courses, which 

include Training 

for Military Providers, regional civilian oneweek training, 

evidence-based 

workshops, the University Counseling Center Core Competency, the 

Star Behavioral Health Providers 

with the National Guard and the 

Military Family Research Institute at 

Purdue University, online courses, a 

certificate program with Widener 

University in Military and Veteran's 

Behavioral Health, the Summer Institute-Preparing for Military-Focused Career, and Online Military 

Culture: Core Competencies for 

Healthcare Professionals. 

A major push in recent years has 

been to make learning materials 

accessible online to providers. This 

way, Riggs said, they can save time 

and energy in educating providers 

located across the country.

“We are transitioning to materials 

that can be shared online with providers and also through instruction 

that can be offered on site,” Riggs 

said. “Instead of flying interns from 

San Antonio here, for example, we 

have our instructors in San Antonio 

deliver some of the courses.”

In addition, Riggs wants to encourage providers to change their 

procedures in hopes of adopting 

new practices that will benefit patients. 

Riggs estimates that about 40,000 

providers have been trained by the 

CDP in the last decade. That is only 

part of the CDP story though. As 

Riggs said, “the thing that I find 

most gratifying about what we have 

accomplished in the last ten years is 

that providers tell us that they use 

things we taught them to better care 

for service members or veterans.” 

He hopes that the lessons learned by 

the center will be disseminated out 

into the public to better help those 

suffering from psychological issues 

in both the military and civilian 

communities.

Center for Deployment Psychology looks 

back on 10 years

By Christopher Austin

Staff of the Uniformed Services University of the Health 

Sciences (USU) Center for Deployment Psychology 

(CDP) are celebrating the center's tenth anniversary 

this year. (Photo by Damien Salas)
6 the pulse Aug. 11, 2016

Barrington Burnett, Ph.D., an 

assistant professor in the Uniformed Services University of the 

Health Sciences (USU) Department of Anatomy, Physiology and 

Genetics, was awarded a $50,000 

grant by Cure SMA for his work on 

spinal muscular atrophy (SMA). 

The award is a drug discovery grant 

for Burnett’s project, “Slowing SMN 

degradation to treat SMA.” 

According to the National 

Institute of Neurological Disorders and Stroke at the National 

Institutes of Health, SMA “is one 

of several hereditary diseases that 

progressively destroy lower motor 

neurons—nerve cells in the brain 

stem and spinal cord that control 

essential voluntary muscle activity 

such as speaking, walking, breathing, and swallowing. Lower motor 

neurons control movement in the 

arms, legs, chest, face, throat, and 

tongue. When there are disruptions in the signals between lower 

motor neurons and muscles, the 

muscles gradually weaken and may 

begin wasting away and develop 

uncontrollable twitching (called 

fasciculations). When there are 

disruptions in the signals between 

the upper motor neurons (located 

in the brain) and the lower motor 

neurons, the limb muscles develop 

stiffness (called spasticity), movements become slow and effortful, 

and tendon reflexes such as knee 

and ankle jerks become overactive. 

Over time, the ability to control 

voluntary movement can be lost.”

Individuals with SMA don’t produce survival motor neuron (SMN) 

protein at high enough levels due 

to a mutation in the survival motor 

neuron 1 (SMN1) gene. Much of 

the early research into SMA has 

focused on increasing the levels 

of SMN protein by targeting the 

underlying genetics of SMA. The 

goal is to prompt the body to make 

more SMN protein by replacing or 

correcting SMN1, or by modulating 

SMN2, the low-functioning SMA 

“backup gene.”

Another potential way of increasing SMN levels is to target the 

SMN protein directly. Burnett and 

his team are investigating ways to 

slow the degradation of SMN protein, causing it to stay around for 

longer length of time and effectively 

increasing the overall levels of SMN 

protein in cells.

The goal of this project is to 

characterize and validate a novel 

SMN protein modulator for possible treatment of spinal muscular 

atrophy. This modulator regulates 

the degradation of the SMA protein. The team will utilize cell-based 

assays and animal models to investigate safety, efficacy and selectivity of a new compound identified 

using a high throughput screen that 

modulates SMN protein degradation. The project aims to help 

develop molecules that possesses 

a unique mode of action to treat 

SMA.

Researchers believe this approach could be used alongside 

other treatments that boost SMN 

levels by other mechanisms, such 

as SMN2 splicing modulators, 

allowing the body to both produce 

more protein and make that protein 

last longer. This would open up yet 

another possible avenue for combination therapies, which are needed 

to develop treatments for all ages, 

types and stages of SMA.

Burnett awarded $50,000 cure SMA drug 

discovery grant

Article courtesy of Cure SMA

USU assistant professor of Anatomy, Physiology and Genetics, Barrington 

Burnett, Ph.D., explains his research on Spinal Muscular Atrophy during a 

research symposium. Burnett was recently awarded a $50,000 drug discovery 

grant by Cure SMA to study the disease. (Photo courtesy of Cure SMA)
7 the pulse Aug. 11, 2016

Researchers have discovered a regulatory system in 

the ulcer-causing bacteria, 

Helicobacter pylori that can 

control the formation of biofilm – a “fortress-like” cluster of cells that can become 

resistant to antibiotics and 

cause major medical problems.

Helicobacter pylori, or H. 

pylori, thrives in the stomach. In a study published July 

18, 2016, in the Journal of 

Bacteriology, scientists from 

the Uniformed Services University of the Health Sciences 

(USU) found that its regulatory system helps it adapt to 

stressful conditions, which 

controls the biofilm formation.

“This is the first paper to describe 

regulation of biofilm formation by 

H. pylori,” according to D. Scott 

Merrell, Ph.D., professor of Microbiology and Immunology at USU.

The team of researchers led by 

Merrell, which includes Stephanie 

Servetas, a graduate student in Merrell’s lab, began their study in hopes 

of better understanding how H. pylori adapts to stresses it may encounter within the human body, such as 

changing levels of acidity – a particular stressor for this stomach-dwelling microbe, Merrell explained.

The researchers created a series of 

H. pylori strains, containing combinations of mutations in three known 

important regulatory systems, 

which they believed would be involved in adapting to stressors. One 

in particular was the ArsRS system, 

which has been known to sense and 

adapt to acid stress.

The investigators were surprised 

to find the strains that lacked the 

ArsRS system formed a thick biofilm-like ring, and formed clumps of 

cells. Subsequently, the researchers 

found that the biofilm was forming 

more quickly and to a greater degree 

in the strains that lacked ArsRS, as 

compared to non-mutated strains. 

This appears to be a result of changes in the expression of the genes that 

affect surface adherence and bacteria aggregation, according to Merrell. They now believe this system, 

ArsRS, uses pH sensing as a way 

to tell the bacteria when they have 

reached the stomach surface. There, 

the bacteria would need to turn on 

genes that allow them to adhere to 

the host cell surface and potentially 

form biofilms, Merrell said.

The investigators did not set out 

to study biofilm formation, he noted, but the results were so striking 

that they originally thought that 

their cultures might have been contaminated with another bacteria. 

After following up on this observation, they came to a previously 

unknown role for an important and 

well-studied regulatory system. The 

discovery was made by Servetas.

“This has opened up several areas for future investigation,” Merrell said. “The research gives us the 

opportunity to explore the role of 

biofilms in H. pylori biology. It also 

gives us clues about signals that may 

affect biofilm formation, and these 

avenues may ultimately lead to better control of this pathogen.”

Researchers identify regulatory system in ulcer-causing 

bacteria that controls formation of bacterial communities

A Helicobacter pylori (H. pylori) biofilm formation after 48 hours. The heavy biofilm 

created by the bacteria H. pylori helps the it to adapt to stressful conditions, including 

making resistant to antibiotics. (Photo by Jennifer Gaddy)

By Sarah Marshall
8 the pulse Aug. 11, 2016

The Military Tropical Medicine 

course offered at the Uniformed Services University of the Health Sciences 

(USU) taught service members from 

around the country how to treat and 

respond to exotic diseases.

The course is an introduction for 

students into the field of tropical medicine, providing them with the knowledge they need to respond to a variety 

of different conditions that U.S. forces 

could be exposed to abroad.

“I think the main benefit for me is 

not that I’ll walk away from this and 

know all these diseases, it’s to educate 

my forces that go overseas on what specific threats there are and how to prevent them,” said Navy Lt. Cmdr. (Dr.) 

Alfred Owings, who took the course 

this summer.

In addition to lectures, students took 

part in labs including entomology, bacteriology, parasitology and participated 

in a simulated outbreak investigation. 

“It’s a lot of information to take in, 

even for myself. I took the course in 

2012 and you can’t, of course, retain 

everything,” Navy Lt. Cmdr. (Dr.) Nehkonti Adams, the course director said. 

“We hope that students will have the 

basic resources to implement measures 

for threat reduction, identify cases, provide primary management, and be able 

to effectively communicate with subject 

matter experts so they can obtain timely and appropriate assistance.”

The four-week course ran from July 

5 to 29 and is followed up by a field mission for those who elect to further their 

education abroad in Ghana, Guyana, 

Honduras, Peru or Argentina. 

“It’s an academic exchange,” Adams 

said. “Our host nation partners would 

tell us how they treat malaria and we 

tell them how we would treat it and 

compare notes.”

The class focuses primarily on malaria and other common tropical diseases 

that service members are more likely to 

encounter while abroad, but the course 

also briefly touches on viruses such as 

Ebola and Zika.

The tropical medicine course is updated every year as new diseases become issues for soldiers and techniques 

of treatment are revealed. 

“The outbreak investigation and lab 

and entomology lab are new additions 

to the course. We take feedback from 

students and faculty to make changes 

that make us more relevant and up to 

date,” Adams said.

USU Hosts Military Tropical Medicine Course

By Christopher Austin

Air Force Major (Dr.) Scott Crabtree presents a lecture on Leptospirosis for 

Kintampo District Hospital hospital staff in Ghana. (Courtesy Photo)

Navy Lt. (Dr.) Andrew Peacock and Air Force Capt. (Dr.) David Lindholm 

review malaria slides at the Kintampo District Hospital laboratory in the 

Brong-Ahafo Region of Ghana. (Courtesy Photo)
9 the pulse Aug. 11, 2016

The National Capital Consortium 

(NCC) pediatrics residency has begun a program this academic year 

allowing residents to design their 

own individualized longitudinal 

curriculum. This program allows 

residents to focus on a specific topic in pediatrics that they will pursue 

alongside their standard curriculum throughout their training. The 

program is called the Advocacy-Research-Medicine (ARM) Pediatric 

Longitudinal Curriculum.

The program was established last 

fall in response to a nationwide call 

from the Accreditation Council for 

Graduate Medical Education and 

its Pediatrics Residency Review 

Committee to include programs in 

residencies that allow for individualization and flexibility in the curriculum.

Through the ARM program, residents are able to shape their own experiences with aid from pediatrics 

faculty to guide them during their 

residency. While they would normally shift between multiple fields 

of pediatrics during their postgraduate medical education, ARM allows residents to have one area they 

will pursue longitudinally over the 

course of their program.

Navy Capt. (Dr.) Gregory Gorman, the NCC pediatrics residency 

program director, said he hopes the 

program will inspire residents to 

pursue initiatives complementary 

to general pediatrics that they will 

continue after they have completed 

their residencies. He also hopes it 

will aid in decreasing occurrences of 

burnout in residents. 

For example, Gorman said, previously 

“when residents were 

on pulmonology, they 

would go to one or two 

cystic fibrosis clinics 

and that was it,” he said. 

“One resident chose to 

[add to] their curriculum that no matter what 

their rotation would be, 

they would come back 

to do a cystic fibrosis 

clinic and see those patients over the course of 

two years.”

Other areas that residents are focusing their 

curriculum on include 

patient advocacy, research, community outreach and public policy. 

Another resident’s plan 

is tailored to becoming 

fluent in medical Spanish and includes seeing 

pediatric patients at the 

Spanish Catholic Center’s clinical center.

Army Capt. (Dr.) Jennifer Falcon is a third-year NCC pediatrics 

resident at Walter Reed National 

Military Medical Center who chose 

to focus her longitudinal curriculum on community outreach. She 

is working with Mary’s Center in 

downtown Washington, DC, that 

offers free health care and dental 

care in addition to social services.

“I work specifically with the teen 

program,” Falcon said. “What we do 

is go once a month and hold a workshop with teenagers and we just talk 

about different health-related topics 

while trying to help them develop 

skills like taking pulses, hands-only CPR, the importance of the flu 

vaccine and things they wouldn’t 

get otherwise.” Falcon hopes to organize opportunities for the teens to 

shadow doctors at WRNMMC this 

summer.

“I hope this program will help 

military pediatrics in general because we will have a more varied 

and experienced workforce where 

everyone can express their own interests and [we can] retain better 

people,” said Gorman.

Pediatrics program allows residents to 

tailor learning

By Christopher Austin

For her longitudinal curriculum, Army Capt. 

(Dr.) Jennifer Falcon volunteers at Mary's Center 

in Washington, D.C. Along with other NCC pediatric residents, she teaches best health practices 

and encourages young people to pursue careers in 

healthcare. (Courtesy Photo)
10 the pulse Aug. 11, 2016

The Society for Simulation in 

Healthcare recently published a new 

Healthcare Simulation Dictionary 

and retired Navy Captain (Dr.) Joseph Lopreiato, medical director of 

the USU Val G. Hemming Simulation Center, served as editor-in-chief 

on the project. The dictionary was 

a joint effort by 70 volunteers and a 

dozen international societies.

“The dictionary is an attempt to 

define terms that are used all the 

time in healthcare simulation and 

includes concepts and several examples so that people can understand 

what the term means,” Lopreiato 

said. “The whole idea is to make sure 

everybody understands the concept 

no matter what term you use.”

The need for this dictionary, Lopreiato says, is because there is no 

standard unifying definition for 

many of the terms used in healthcare simulation. Different countries 

may have different definitions for 

the same term, academic papers 

may come up with their own unique 

definitions and different medical 

societies may have medical glossaries with different definitions for the 

same word.

“In this country, standardized 

patients are people who we hire to 

portray a patient that can be interviewed. We call them standardized 

patients because they’re heavily 

standardized. They have a script. 

In Europe they call them simulated 

patients,” Lopreiato said. “These are 

people that are hired to play patients 

but aren’t trained very rigorously. 

They just use their own history to 

tell their a story about their illness." 

Rather than rigidly define a term 

with a sole definition, the dictionary 

explains the concept and its interpretations.

USU faculty contribute to healthcare 

simulation dictionary

By Christopher Austin

USU GSN Faculty, Alumnae to be inducted as AAN Fellows

The American Academy of Nursing recently announced its slate of 

2016 Fellows and four members of 

the USU community are among the 

new class.

Laura Taylor, Ph.D., RN, ANEF, 

associate professor and director 

of clinical education for the Phase 

II Doctorate of Nursing Practice 

program in USU’s Daniel K. Inouye 

Graduate School of Nursing (GSN) 

was selected for the prestigious 

honor, along with Public Health 

Service (PHS) Rear Admiral Susan 

Orsega and retired PHS Captain 

Roberta Lavin, both graduates of 

the GSN’s programs. Cara J. Krulewitch, Ph.D., CNM, FACNM, who 

is an adjunct associate professor in 

the GSN, was also selected. Orsega, 

a 2001 alumna of the Family Nurse 

Practitioner program, is the Nurse 

Chief Professional Officer for the 

PHS. Lavin, who earned her Ph.D. 

at USU in 2008, is the associate 

dean for Academic Programs at the 

University of Missouri St. Louis 

College of Nursing. Krulewitch is 

director of Women's Health, Medical Ethics, and Patient Advocacy in 

the Office of the Assistant Secretary 

of Defense for Health Affairs. 

The four were among 164 highly 

distinguished nurse leaders from all 

50 states, the District of Columbia 

and 28 countries, who will be inducted into the Academy during its 

annual policy conference in October in Washington, D.C. They were 

selected based on their significant 

contributions to nursing and health 

care, and the extent their nursing 

careers have influenced health 

policies and the health and wellbeing of all. They join 2,400 current 

Academy Fellows who are considered nursing’s most accomplished 

leaders in education, management, 

practice, and research. 

By Sharon Holland

The cover to the Healthcare Simulation Dictionary published by the 

Society for Simulation in Healthcare. 

The dictionary can be downloaded 

for free from 

http://www.ssih.org/Dictionary
11 the pulse Aug. 11, 2016

The U.S. Navy Flight Demonstration Squadron, the Blue Angels, recently announced the newest team 

members for the 2017 air show season and a Uniformed Services University of the Health Sciences (USU) 

alumnus is among the officers selected.

Navy Lt. (Dr.) Juan “David” Guerra, who graduated in 2011 from 

USU’s F. Edward Hebert School of 

Medicine, will serve as the flight 

surgeon for the high performance 

aircraft squadron. He is currently 

serving as a flight surgeon assigned 

to the Naval Strike Fighter Squadron 106 (VFA-106), the “Gladiators,” based at the Naval Air Station 

in Oceana, Va.

Guerra was one of eight new officers chosen for the 2017 season. 

In addition to the flight surgeon, 

the group included three F/A-18 

demonstration pilots, an events coordinator, a C-130 demonstration 

pilot, a supply officer, and an administration officer. A ninth new 

member, the executive officer, had 

been selected earlier and previously 

announced.

Navy and Marine Corps officers 

interested in becoming a member of 

the team, which is based at the Naval 

Air Station in Pensacola, Fla., submit applications to the Blue Angels, 

who then review the packets and 

choose finalists to interview during 

the Pensacola Beach Air Show week 

in mid-July each year. At the end 

of the week, the final selections are 

made.

Guerra joins fellow USU alumni 

Navy Lt. Cmdrs. (Dr.) Ted Steelman and (Dr.) Johannah Valentine, 

and former Cmdr. (Dr.) J. Patrick 

McMahon as a member of the Blue 

Angels. Steelman was an F/A-18 pilot selected in 2004 and McMahon 

joined the team as flight surgeon in 

1999, followed by Valentine in 2008.

In June 2014, USU class of 2009 

alumnus Air Force Maj. (Dr.) Christopher Scheibler was selected to 

serve as “Thunderbird 9,” the flight 

surgeon for the Thunderbirds, the 

Air Force’s sharply choreographed, 

premier jet squadron.

Scheibler provides medical care 

for more than 120 squadron members and keeps the team in optimal 

health. He also advises the commander on aeromedical issues. Before joining the team, he was the 

flight surgeon for the 555th Fighter 

Squadron at Aviano Air Base, Italy. 

He has logged more than 500 flight 

hours on 10 different aircraft, with 

more than 200 hours in the F-16. 

Scheibler is the second USU graduate to join the Thunderbirds. Col. 

(Dr.) Kimberly Slawinski, a class of 

1984 alumna, was a member of the 

prestigious team in the late 1980s. 

For more info on the Blue Angels, 

visit: 

https://www.blueangels.navy.mil/

show/. 

For the Thunderbirds, visit: 

http://afthunderbirds.com/site/

show-season/.

USU alumni care for high performance flight 

Demonstration Teams

By Sharon Holland

USU School of Medicine alumnus, 

Navy Lt. (Dr.) David Guerra, was 

selected to serve as flight surgeon for 

the Navy's high performance aircraft 

demonstration squadron, the Blue 

Angels, for the 2017 season. (Courtesy of the U.S. Navy Flight Demonstration Squadron)

Air Force Maj. (Dr.) Christopher 

Scheibler, a 2009 Uniformed Services University of the Health Sciences graduate, was selected to join the 

Thunderbirds, the Air Force's premier 

jet squadron in 2014. (Courtesy of 

The U.S. Air Force Air Demonstration Team)
12 the pulse Aug. 11, 2016

The Uniformed Services University of the Health Sciences (USU) 

University Family Health Center 

(UFHC) is providing service members assigned to USU and their families with immunizations against a 

variety of illnesses.

“At the UFHC we do full-scope 

care and a significant portion of 

our practice is pediatrics, so we do 

all routine immunizations for newborn to school-age children. It helps 

provide a one-stop shop for our patients. We also do a fair amount of 

adult immunizations in the clinic as 

well,” Navy Capt. (Dr.) Jeffrey Quinlan, director of the UFHC, said.

In addition to immunizing children for diseases like tetanus, 

hepatitis A and B, polio, measles, 

mumps, rubella, chicken pox and 

human papilloma virus, the UFHC 

also provides second and third-year 

students with blood titers to ensure 

the effectiveness of vaccinations 

that occurred earlier in their lives. 

All members of the military must be 

immunized.

 “The medical students are coming fresh out of college, some have 

never been in the military. We have 

to make sure that, before they go to 

take care of patients, they get [vaccinated],” said Fatima Bashir, the 

UFHC clinical nurse. 

Around September, the UFHC 

will begin notifying service members that this year’s flu shots will be 

available. 

Initially, we try to immunize all 

active duty and patients that are eligible for care. In the past, we’ve been 

able to provide support for the other 

employees as well,” Quinlan said.

Depending on the availability of 

the vaccine, other USU employees 

will be notified if they are eligible for 

immunization as well. 

“One of the things I like about 

the military is that immunization 

is required. No one in the military 

can refuse to be immunized. That 

gives a willingness to immunize 

their spouses and children; we get 

very little push back,” Bashir said. 

“We don’t think about it because we 

think we’ve treated a lot of illnesses, 

but I’ve seen a child die because of 

chicken pox. It’s not necessary.”

Navy Petty Officer 3rd Class Christopher Wetherill, a medical technician at 

the Uniformed Services University of the Health Sciences (USU) University 

Family Health Center (UFHC) gives an infant an immunization. (Photo by 

Tom Balfour)

By Christopher Austin

Family Health Center provides immunizations 

for service members and their families
13 the pulse Aug. 11, 2016

Faculty and staff looking for new 

ways to engage your students – look 

no further. The Uniformed Services 

University of the Health Sciences 

(USU)’s Education and Technology 

Innovation (ETI) support office is 

sure to be of assistance. The ETI was 

established at USU in 2006 to support teaching development, advance 

best practices, and expand the reach 

of the University’s programs.

Maybe you’d like to create a fun, 

educational game to help students 

remember the material better? Or 

maybe you want to develop interactive, small group activities, or an 

animated scenario for an online 

course? With a team of instructional designers, graphic designers, 

medical illustrators, and developers, 

ETI can create strategies and innovations, which continue to support 

teaching and promote learning, explained Dina Kurzweil, Ph.D., director of ETI.

“Our focus is on making sure we 

meet the educational needs of our 

faculty and students,” Kurzweil said. 

Over the last decade, the office has 

assisted countless personnel, collaborating on more than 50 unique 

courses, and nearly 175 innovative 

projects, not including numerous 

papers and presentations they’ve 

supported, she said.

Associate Dean for Simulation 

Education, Dr. Joseph Lopreiato, is 

among the many satisfied ETI customers. Lopreiato called on the ETI 

team to help develop an interactive 

module for medical and nursing 

students learning about pediatric 

otoscopy, an examination of a patient’s ear drum, and one for learning about pediatric and infant development.

For both projects, the ETI staff 

met with Dr. Lopreiato, as the subject matter expert, to create content 

and then package it in a way that 

By Sarah Marshall

USU’s ETI Supports Faculty and Staff, 

Promotes Learning and Innovation 

A rough sketch and the finished product for a series of animations made by 

the Education and Technology Innovation (ETI) Support Office for a Daniel 

K. Inouye Graduate School of Nursing course that used to illustrate a case 

study that used the framework of a zombie outbreak to teach students in a 

population health course. (Art by ETI)

continued on pg. 14
14 the pulse Aug. 11, 2016

was both interesting and challenging to learners, he said.

“I feel the collaboration between 

an educator and experts in instructional design was the key to success,” 

he added.

Navy Cmdr. (Dr.) Alexander 

Galifianakis, commandant for the 

School of Medicine, also worked 

with the ETI team on two projects.

“They went far beyond simply 

translating our educational content 

into a web-based platform,” said 

Galifianakis, who is also an assistant professor of Radiology. “ETI 

brought in computer and graphics 

experts to expand the interactive offerings of our module and delivered 

a nicely polished product.” 

He recommends their services to 

anyone interested in exploring new 

ways to develop educational material. 

“They were extremely responsive to our input and could not have 

been easier to work with,” he said.

Faculty and staff can contact the 

ETI Support Office with ideas or 

questions about course redesign, 

or if they’re looking to develop new 

activities to meet learning objectives, Kurzweil said. The team will 

help design a variety of educational 

resources for the classroom, or for 

distributed learning (DL) environments, which might include webbased instruction, video work, or 

online course development. 

When students or faculty are not 

on campus, while deployed or completing a residency, DL offers greater 

flexibility. The ETI team works with 

faculty to implement DL tools and 

techniques, and supports the transition of moving course content from 

the classroom, online.

The team also works with faculty 

to develop audio content, simulations, online products and animations, such as the award-winning 

zombie apocalypse scenarios. They 

can design tests and other assessments – formal and informal – to 

help determine whether students 

are meeting course objectives 

throughout the semester. They can 

also provide course and program 

evaluation support to help faculty 

and staff understand the strengths 

and weaknesses of their courses or 

programs. 

Two members of the Uniformed 

Services University of the Health 

Sciences-Walter Reed National Military Medical Center Department 

of Surgery (USU-Walter Reed Surgery) were recently inducted into 

the Association of Bone and Joint 

Surgeons.

Army Lt. Col. (Dr.) Benjamin 

“Kyle” Potter and Navy Cmdr. (Dr.) 

Jonathan Forsberg, both orthopaedic oncologists, were selected by the 

ABJS in recognition of their academic excellence. Potter, a professor, serves as the USU-Walter Reed 

Surgery department vice chair for 

Research, and Forsberg, who is a 

professor of Surgery, serves as the 

director of the department’s Osseointegration Program. 

Their selection marks the first 

time that two members of the same 

department and specialty have been 

inducted in the same year. In addition, the pair are the only active duty 

military physicians in the 90-member international organization.

The ABJS is comprised of thought 

leaders in orthopaedic surgery and 

manages “Clinical Orthopaedics 

and Related Research,” the premier 

orthopaedic journal. Membership 

is by invitation only, is highly competitive, and requires a thorough 

vetting process based on international reputation, leadership and academic productivity.

“Both Drs. Potter and Forsberg 

represent the best of military and 

academic surgery. They excel in 

every respect – clinical care, education, research and leadership,” said 

Navy Capt. (Dr.) Eric Elster, surgery 

department chair. “It is an honor 

and privilege to work with them in 

USU-Walter Reed Surgery.”

Surgery Faculty Inducted into 

Orthopaedic Association

By Sharon Holland

ETI, continued from pg. 13

FOR MORE INFO

USU’s ETI Support Office is 

Located in Building D, Room 

1001

Email: eti@usuhs.edu

Phone: 301-295-3980

Website: www.usuhs.edu/eti
15 the pulse Aug. 11, 2016

Postgraduate Dental College Faculty 

Member Provides Humanitarian Care

Air Force Lt. Col. (Dr.) Nicholas 

DuVall was a member of a team of 

U.S. military health care providers 

who participated in a humanitarian 

mission to Central America recently. DuVall holds a Uniformed Services University of the Health Sciences (USU) faculty appointment 

within the Air Force Postgraduate 

Dental School as an associate professor of Comprehensive Dentistry 

in the Advanced Education in General Dentistry (AEGD) 24-month 

residency program at Keesler Air 

Force Base, Miss.

DuVall, who is also the deputy 

program director of the AEGD residency program, along with two other Air Force dentists, joined medical 

providers and technicians in a Medical Readiness Training Exercise 

(MEDRETE) from May 21 to June 5 

in La Blanca, Guatemala.

During the two-week mission, 

the MEDRETE team provided a variety of dental and other health care 

services to more than 9,500 patients. 

The dental team led by DuVall cared 

for many patients with dental emergencies, extracted more than 1,200 

teeth and provided oral health instructions to the local villagers. Exercises such as this MEDRETE are 

an invaluable training platform for 

the providers and technicians while 

also fostering friendly relations with 

Central American allies.

"It can be unsettling to see many 

children living with oral infections 

and pain due to a lack of access to 

care. However, it is gratifying to 

know you are making a difference 

by providing this access to care and 

goodwill,” DuVall said. “I saw a local family and a few of the children 

each had a dental abscess that we 

treated. The following day, the children came back to the dental clinic 

site and gave us each a hand written 

‘thank you’ drawn in crayon, as well 

as blessings and a hug for taking 

away their pain.” 

By Sharon Holland

Air Force Lt. Col. (Dr.) Nicholas DuVall examines a patient in La Blanca, 

Guatemala, during a recent humanitarian mission. (Courtesy photo)

Members of the MEDRETE dental 

team, including USU faculty member 

Air Force Lt. Col. (Dr.) Nicholas 

DuVall (right), addressed many 

dental emergencies, educated patients 

on proper dental care, and received 

the gratitude of local villagers. 

(Courtesy photo)
16 the pulse Aug. 11, 2016

Final Frame

Service members at Uniformed Services University of the Health Sciences (USU) put on cut suits to simulate battlefield 

injuries as part of the Advanced Combat Medical Experience (ACME) teacher assistant course. These volunteers role 

players simulate wounded soldiers in a mock war zone and university students are tested on the proper way to treat 

their simulated patients. (Photo by SSgt. Stephanie Morris)