Faculty Profile: Leo Kobayashi, MD

Leo Kobayashi
Leo Kobayashi, MD
Associate Professor of Emergency Medicine
Emergency Medicine
Work: +1 401-444-6237
Dr.Kobayashi has research interests in the application of high-fidelity medical simulation as a useful and valuable methodology for acute care healthcare systems probing and systems improvement. Current research programs focus on sudden cardiac arrest resuscitation (resuscitation quality; automation), medical informatics / point-of-care information design (checklisting, situational awareness), patient monitoring telemetry systems (alarm fatigue) and procedural sedation.

Biography

LEO KOBAYASHI, MD, a graduate of Brown University School of Medicine, has been on staff at Rhode Island Hospital since 2002. Residency Training: Emergency Medicine at Harvard Medical School (BWH / MGH) Board Certified: Emergency Medicine, 2003 Research interests: Healthcare systems probing and improvement through application of human factors and in situ medical simulation; medical education and medical error reduction through applied medical simulation; other interests: snowboarding and mountainbiking

Research Description

Dr.Kobayashi is working on objectively assessing the utility of high-fidelity medical simulation for healthcare systems improvement-- in-hospital sudden cardiac arrest (SCA) response improvement (earlier defibrillation / AED use, equipment + logistics enhancement, and systems performance optimization). Additional ongoing work for acute care environment and operations optimization through human factors engineering and medical informatics.

Grants and Awards

Outstanding Reviewer, Simulation in Healthcare 2008

1st Place Research Abstract, International Meeting on Simulation in Healthcare, January 2009

Outstanding Reviewer, MedEdPortal 2009, 2011

Paul Calabresi Faculty Research Award, Rhode Island Hospital Department of Emergency Medicine 2010

Editor's Choice manuscript, BMJ Quality and Safety, 2013: 22(1)

Editor's Choice manuscript, AAMC MedEdPortal, Feb.2013

Outstanding Physician Award, Dept. of Emergency Medicine
Alpert Medical School of Brown University, 2013

Affiliations

American College of Emergency Physicians (ACEP), Fellow status
Massachusetts Medical Society (MMS)
Rhode Island Medical Society (RIMS)
Society for Academic Emergency Medicine (SAEM); Simulation Academy (Board Member-at-Large)
Society for Simulation in Healthcare (SSH); Accreditations Council (Program Site Reviewer)

Funded Research

ACTIVE

Resident Research Grant (PI: N.Asselin) 8/1/2013 to 7/30/2014
Department of Emergency Medicine, Alpert Medical School of Brown University; $ 2,500.
Standardized Treatment and Optimal Resuscitation through Mechanical Automation (STORM) study- workflow + workload substudy.
Substudy of STORM program to assess EMS provider workload (physiologic and cognitive) during simulated pre-hospital sudden cardiac arrest resuscitation with and without experimental automation-enhanced protocol.
Role: Co-investigator / Mentor

Special Projects Grant (PI B.Choi) 7/1/2013 to 6/30/2014
Lifespan Risk Management; $7,500.
Aerosol Environmental Toxicity in Healthcare-related Exposure and Risk phase 2 (AETHER2) study.
Followup 1-year observational study of emergency department ambient gas toxicity assessment for particulate matter (PM2.5, PM0.3), CO, H2S, LEL.
Role: Co-investigator / Mentor

Special Projects Grant (PI B.Choi) 7/1/2012 – ongoing
Lifespan Medical Simulation Center fellowship research seed grant; $ 11,000 (LMSC cost center internal funds).
Standardized Treatment and Optimal Resuscitation through Mechanical Automation (STORM) study.
Application of high-fidelity simulation to examine experimental automation-enhanced protocol (with devices and "go-kit") for pre-hospital sudden cardiac arrest resuscitation.
Role: Co-investigator / Mentor

Special Projects Grant (PI B.Choi) 8/1/2011 to 6/30/2012
Department of Emergency Medicine, Rhode Island Hospital + Research Committee; $ 1,000.
Ambulance Exhaust Toxicity in Healthcare-related Exposure and Risk (AETHER) study.
Emergency department ambient gas toxicity assessment for particulate matter (PM2.5, PM0.3), CO, H2S, LEL.
Role: Co-investigator / Mentor

R18 HS020286. (PI Brown) 7/1/2011- 6/30/2014
Agency for Healthcare Research and Quality (AHRQ). $ 749,560.
Improving Pediatric Resuscitation: A Simulation Program for the Community Emergency Department (PRECISE) study.
Assessment and training of community Emergency Departments in pediatric resuscitation capabilities through use of in situ simulation.
Role: Co-investigator

Special Projects Fund 10/1/2010 - ongoing (no cost extension)
Department of Emergency Medicine, Alpert Medical School of Brown University; $ 1,000 (+ Lifespan Network Services $16,000 capital expenses)
Accessible Real-time clinical Guidance through Updated Signals (ARGUS) Study.
Examination and optimization of Emergency Department bedside and telemetry monitoring systems functions.
Role: Principal Investigator

Special Projects Fund 8/1/2005 – ongoing
Lifespan Risk Management; $ 6,000 / year
In-hospital Cardiopulmonary Resuscitation Team and System Performance during Simulated Events (SimCode)
In situ simulation probing of in-hospital sudden cardiac arrest resuscitation systems.
Role: Principal Investigator



COMPLETED

Special Projects Grant 9/1/2011 to 6/30/2012
Rhode Island Hospital Medical Simulation Center fellowship simulation development seed grant; $ 5,180 (RIHMSC cost center internal funds)
CPR Instructor Real-time Review through Use of Simulation (CIRRUS) study.
Applied simulation with ventilation/chest compression-assessing manikin system to evaluate CPR instructor performance and judgment.
Role: Co-investigator

Small Projects Grant 10/1/2009 – 9/30/2010
Department of Emergency Medicine, Rhode Island Hospital + Research Committee, Department of Emergency Medicine, Brown University; $ 1,500.
Provider Role in Patient Experience / Latent Lapses in Emergency caRe (PRoPELLER) Study.
Websurvey-based assessment of provider perceptions of roles in Emergency Department as they relate to patient safety and patient experience.
Role: Principal Investigator

Faculty Development Grant 7/1/2009 – 12/2012
Department of Emergency Medicine, Alpert Medical School of Brown University; $ 20,000
Simulation Learning Initiative for Procedural Sedation Training for Routine Engagement of Anticipatory Maneuvers (SLIPSTREAM)
In situ simulation study of Emergency Department procedural sedation practice and clinical informatics-based intervention.
Role: Principal Investigator

Small Projects Grant 4/1/2009 – 3/31/2010
Lifespan Network Services, RIH; $ 3,000
Bedside Electronic Tablet Application (BETA) project
Evaluation of tablet PC devices for ED bedside clinical flow and function improvement.
Role: Principal Investigator

Small Projects Grant 2/1/2009 – 1/31/2009
Department of Emergency Medicine, RIH; $ 3,000
Emergency Unit Chart Location, Identification and Differentiation (EUCLID) project
Investigation of human factors engineering application to clinical charting system modification.
Role: Principal Investigator

Special Projects Grant 1/1/2009 – 7/30/2009
Rhode Island Hospital Medical Simulation Center nursing simulation development seed grant; $ 40,423 (RIHMSC cost center internal funds)
Arrhythmia Simulation / Cardiac Event Nursing Training AED (ASCENT AED) Study.
Application of intermediate-fidelity simulation in situ to examine AED-enhanced in-hospital sudden cardiac arrest first response.
Role: Principal Investigator

RCMST-RIH-05-001 (PI Shapiro -> Williams) 8/1/2005 – 7/31/2006
Telemedicine + Advanced Tech. Research Center (TATRC), Subcontract through Dynamics Research Corp.; $ 605,899
Reserve Component Medical Skills Readiness Training Program
Assessment of Web resources and civilian high-fidelity medical simulation centers for Army Reserve Medical Component combat casualty care training
Role: Co-Investigator

18-P-92332/1-01 (PI Shapiro) 8/1/2004 – 8/31/2006
Centers for Medicare and Medicaid Services (CMS); $ 98,000
SAFER Project
Development, testing and dissemination of high-fidelity medical simulation modular curriculum for patient safety training in acute care medical fields.
Role: Investigator

Teaching Experience

Advanced Cardiac Life Support – Warren Alpert Medical School
July 2002 to Present
Facilitator and instructor in simulation case development and training for pre-clinical medical students (70 learners x 1 session / yr).

Brown University Residency in Emergency Medicine
July 2002 to Present
Course, content, and equipment developer at RI Hospital Medical Simulation Center. Currently educating healthcare personnel in basic and advanced acute care medicine, difficult airway management, teamwork training, and medical error reduction. Courses:
-Acute Care Training Simulations (adult)
-Acute Care Training Simulations (pediatric)
-Acute Care Training Simulations (supplemental)
-Advanced Airway Course
-Critical Care Room Orientation
-Curriculum in Simulated Pitfalls of Overdose Toxicology (C-SPOT)
-Emergency Medical Services / Critical Care Transport Training
-Intern MedTeams Course
-Intern Simulation Orientation / Airway Course
-Oral Boards Preparation Simulations
-Resident Evaluation Simulations
-Ultrasound Simulation (U/SS) Program

Mammalian Physiology - Brown Medical School
Fall 2002 to 2004 (course made non-sim by BMS)
Developer and controller of laboratory exercises in cardiovascular physiology (BI / 0117) with human patient simulator (for students averse to canine lab; 3-4 learners x 1-2 sessions / yr).

Elective in Emergency Medicine - Warren Alpert Medical School
Dec. 2002 to Jan. 2006 (course leadership transitioned to Dr. E.Sutton)
Simulation specialist and content developer at RI Hospital Medical Simulation Center for medical students enrolled in one-month Emergency Medicine elective (BI / 0562). Training in acute care medicine, airway management, teamwork training and medical error reduction provided through high fidelity medical simulation scenarios (4 learners x 12 sessions / yr).

Medicine in Action Program - Warren Alpert Medical School
Oct. 2003 to Present
Coordinator of shadowing opportunities in Rhode Island Hospital Emergency Department for pre-medical students at Brown (1-2 learners / yr).

Simulation Training for Emergency Preparedness (STEP)
June 2004 to Nov. 2005 (project completed)
Developer and course facilitator of a high-fidelity medical simulation educational program for Weapons of Mass Destruction (WMD) and Mass Casualty Incident (MCI) preparedness in Rhode Island hospitals. Funded by Health Resources and Services Administration (HRSA). Participating hospitals (10 learners x 10 sessions / yr):

-Kent County Hospital -South County Hospital
-Landmark Medical Center -St. Joseph's / Fatima Hospital
-Memorial Hospital of Rhode Island -The Miriam Hospital
-Newport Hospital -Westerly Hospital
-Rhode Island Hospital -Women + Infants' Hospital
-Roger Williams Medical Center

Medical Simulation Elective
June 2005 to Present
Elective director, coordinator and instructor for month-long Brown University Residency in Emergency Medicine elective in medical simulation.
-Robert Tubbs MD (July 2005)
-Juan Vernon MD (Nov 2005)
-Christopher Zabbo MD (Oct 2007)
-Sara Lozano MD (Jan 2008)
-Anika Parab MD (Jan 2008)

"Doctoring" Simulation - Warren Alpert Medical School
Fall 2005 to Spring 2007 (course made non-sim by BMS)
Simulation course organizer and curriculum developer for integrated Warren Alpert Medical School pre-clinical curriculum, designed to demonstrate and reinforce didactic teaching points with simulated clinical encounters (70 learners x 2 sessions / yr).

Technical Skills Training Session - Warren Alpert Medical School
June 2006 to Present
Instructor for Warren Alpert Medical School 3rd year student clinical transition preparation (70 learners x 1 session / yr).

Emergency Medicine Resident Mentor - Warren Alpert Medical School
July 2006 to Present
Faculty mentor for Emergency Medicine resident.
-Douglas Hartman MD (2006-9)

Thesis Reader - Brown University Program in Public Health
Aug. 2006 to Sept. 2007 (mentee MPH program complete)
Clinical faculty project mentor and thesis reader for MPH student.
-Hardeek Shah MPH (2006-7)

National Youth Leadership Forum on Medicine
June 2007 to Present
Simulation instructor for interactive experiential education summer sessions for secondary school students (50 learners x 3 sessions / yr).

"Doctoring" Physician Mentor
Oct. 2007 to Present
Mentor to Warren Alpert Medical School first-year student. Introduction to clinical patient care, acute care medical settings, simulation education (1 learner for 16 x 4 hr sessions / yr x 2 years, then longitudinal experience with 8 hrs / 2 wks).
-Daniel Cho MD PhD candidate (2007-Present)

Emergency Medicine Interest Group Simulation Session
Nov. 2007 to Present
Event organizer and simulation / skill station coordinator + instructor to expose Brown pre-med and medical students to the practice and procedures of Emergency Medicine (60 learners x 1-2 session / yr).

Medical Simulation Elective
June 2005 to Present
Elective director, coordinator and instructor for month-long Brown Medical School Residency in Emergency Medicine elective in medical simulation.
-Robert Tubbs MD (July 2005)
-Juan Vernon MD (Nov 2005)
-Christopher Zabbo MD (Oct 2007)
-Sara Lozano MD (Jan 2008)
-Anika Parab MD (Jan 2008)
-Douglas Hartmann MD (Oct 2009)
-Ron Van Ness-Otunnu MD (Oct 2011)
-Paul Roszko MD (Apr 2012)

"Doctoring" Simulation - Alpert Medical School
Fall 2005 to Spring 2007
Simulation course organizer and curriculum developer for integrated Warren Alpert Medical School pre-clinical curriculum, designed to demonstrate and reinforce didactic teaching points with simulated clinical encounters (70 learners x 2 sessions / yr).

Technical Skills Training Session - Alpert Medical School
June 2006 to June 2009
instructor for Warren Alpert Medical School 3rd year student clinical transition preparation (70 learners x 1 session / yr).

Emergency Medicine Resident + Fellow Mentor
July 2006 to Present
Faculty mentor for Emergency Medicine residents.
-Douglas Hartman MD (2006-10)
-Nicholas Asselin DO (2011-present)
-Bryan Choi MD (2011-2012; research AETHER project + STORM program)

Thesis Reader
Aug. 2006 to Sept 2007
Clinical faculty project mentor / thesis reader for Brown University MPH student.
-Hardeek Shah MPH (2006-7)

National Youth Leadership Forum on Medicine
June 2007 to Present
Simulation instructor for interactive experiential education summer sessions for secondary school students (50 learners x 3 sessions / yr).

"Doctoring" Physician Mentor
Oct.2007 to June 2010
Mentor to Warren Alpert Medical School pre-clinical student. Introduction to clinical patient care, acute care medical settings, simulation education (1 learner for 16 x 4 hr sessions / yr x 2 years, then longitudinal experience with 8 hrs / 2 wks x 6 months).
-Daniel Cho MD PhD candidate (2007-2010)

Emergency Medicine Interest Group Simulation Session
Nov.2007 to Present
Event organizer and simulation / skill station coordinator + instructor to expose Brown pre-med and medical students to the practice and procedures of Emergency Medicine (60 learners x 1-2 session / yr).

Medical Simulation Fellowship
Feb. 2008 to Present
Co-director of non-ACGME medical simulation fellowship designed to provide training in sophisticated, validated and innovative simulation, foster a knowledgeable simulation expert, and encourage the development of a healthcare education researcher.
-Dr. Fang Yuan (Franklin) Wei (Chinese emergency physician visiting US for one-year observational Emergency Medicine fellowship, 2008)
-Dr. Anita Kestin (Lifespan Patient Safety + Medical Simulation fellow, 2008-2010)
-Dr. Rakan Al-Rasheed (Medical Simulation fellow, 2011-2012)
-Dr. Catherine Pettit (Medical Simulation fellow, 2012-2013)
-Dr. Sami Yousif (Disaster Medicine fellow; sim. research, 2012-2013)
-Dr. Yasser Al-Aska (Medical Simulation fellow, 2013-2014)

Medical Simulation Interest Group
Oct.2011 to June 2012
Interest group faculty mentor (with Dr. Frank Overly) to expose Brown pre-med and medical students to the methodology, practice, application and research of medical simulation (30 learners x 1-2 session / yr).

Selected Publications

  • Kobayashi L, Parchuri R, Gardiner FG, Tomaselli NM, Paolucci GA, Bertsch KS, Boss RM, Gibbs FJ, Goldlust E, Monti JE, O'Hearn B, Portelli DC, Siegel NA, Hemendinger D, Jay GD. Use of in situ simulation and human factors engineering to assess and improve emergency department clinical systems for timely telemetry-based detection of life-threatening arrhythmias. BMJ Quality and Safety, 2013; 22(1):72-83. (2013)
  • Al-Rasheed RS, Devine J, Dunbar-Viveiros JA, Jones MS, Dannecker M, Jay GD, Kobayashi L. Development of simulated chest compression videos for objective evaluation and training of instructor / coordinators in CPR learner performance assessment. J Contin Educ Nurs, 2013; 44(2):59-63 (2013)
  • Al-Rasheed RS, Devine J, Dunbar-Viveiros JA, Jones MS, Dannecker M, Machan JT, Jay GD, Kobayashi L. Simulation Intervention with Manikin-Based Objective Metrics Improves CPR Instructor Chest Compression Performance Skills without Improvement in Chest Compression Assessment Skills. Simulation in Healthcare, 2013; 8(4):242-52. (2013)
  • Kobayashi L, Dunbar-Viveiros J, Devine J, Jones MS, Overly FL, Gosbee JW, Jay GD. Pilot phase findings from high-fidelity in situ medical simulation investigation of Emergency Department Procedural Sedation. Simul Healthc, 2012; 7(2):81-94. (2012)
  • Kobayashi L, Sweeney LA, Cousins AC, Bertsch KS, Gardiner FG, Tomaselli NM, Boss RM, Gibbs FJ, Jay GD. Web survey and intervention on Emergency Department personnel perceptions of role in patient experience. Eur J Emerg Med, 2012; 19(2):112-6. (2012)
  • Kobayashi L, Boss R, Gibbs F, Goldlust E, Hennedy M, Kestin A, Monti J, Siegel N. Use of a color-coded chart binder system to improve patient safety characteristics of Emergency Department clinical paper documentation and materials. Healthcare Environments Research and Design 2011; 4(4): 79-88 (2011)
  • Kobayashi L, Dunbar-Viveiros JA, Sheahan BA, Rezendes MH, Devine J, Cooper MR, Martin PB, Jay GD. In situ simulation comparing in-hospital first responder sudden cardiac arrest resuscitation with semi-automated defibrillators and automated external defibrillators. Sim Healthcare 2010; 5(2): 82-90. (2010)
  • Kobayashi L, Lindquist D, Jenouri I, Dushay K, Haze D, Sutton E, Smith J, Tubbs R, Overly F, Foggle J, Dunbar-Viveiros J, Jones M, Marcotte S, Werner D, Cooper M, Martin P, Tammaro D, Jay G. Comparison of sudden cardiac arrest resuscitation performance data obtained from in-hospital incident chart review and in situ high-fidelity medical simulation. Resuscitation 2010; 81(4): 463-71 (2010)
  • Kobayashi L, Boss R, Gibbs F, Goldlust E, Hennedy M, Kestin A, Monti J, Siegel N. Use of a color-coded chart binder system to improve patient safety characteristics of Emergency Department clinical paper documentation and materials. Accepted for publication, Healthcare Environments Research and Design, May 2010. (2010)
  • Kobayashi L, Overly FL, Fairbanks RJ, Patterson M, Kaji AH, Bruno EC, Kirchhoff MA, Strother CG, Sucov A, Wears RL. Advanced medical simulation applications for Emergency Medicine microsystems evaluation and training. Acad Emerg Med 2008; 15(11):1058-70. (2008)
  • Kaji A, Bair A, Okada H, Kobayashi L, Khare R, Vozenilek J. Defining systems expertise: effective simulation at the organizational level- Implications for patient safety, disaster surge capacity, and facilitating the systems interface. Acad Emerg Med 2008; 15(11):1098-103. (2008)
  • Kobayashi L, Patterson M, Overly F, Shapiro MJ, Williams KA, Jay G. Educational and research implications of portable human patient simulation in acute care medicine. Acad Emerg Med 2008; 15(11): 1166-74. (2008)
  • Kobayashi L, Shapiro MJ, Gutman DC, Jay G. Multiple encounter simulation for high-acuity multi-patient environment training. Acad Emerg Med 2007, 14(12): 1141-8. (2007)
  • Kobayashi L, Frund Z, Jan D et al. "Design Challenge: Simulation of Human Physiology." In: PETMAN Committee (Tomizuka M, Akeel HA, Atkeson C, Brosseau L, Frund Z, Jan D, Jayaraman S, Kobayashi L, Newman D, Sanderson A, Schaudies RP), National Academies. Soldier protective clothing and equipment: feasibility of chemical testing using a fully articulated robotic mannequin. Washington, DC: National Academies Press, 2007: 21-47. (2007)
  • Kobayashi L, Shapiro MJ, Sucov A, Woolard R, Boss RM, Dunbar J, Sciamacco R, Karpik K, Jay G. "Portable advanced medical simulation for new Emergency Department testing and orientation." Acad Emerg Med 2006, 13(6): 691-5. (2006)
  • Kobayashi L, Suner S, Shapiro MJ, Jay G, Sullivan F, Overly F, Seekell C, Hill A, Williams KA. "Designing multi-patient advanced medical simulation disaster scenarios for civilian pre-hospital medical response training and evaluation: a "dirty bomb" case study." Simulation in Healthcare 2006, 1(2): 72-8. (2006)
  • Kobayashi L. "Vertebrobasilar Insufficiency." In Schaider J et al. (eds): The 5 Minute Emergency Medicine Consult, 3rd edition, Philadelphia, PA: Lippincott Williams + Wilkins, 2006. (2006)
  • Harvard Online Continuing Medical Education (WebCME) Project [2003] Kobayashi L, Mermel L. Civilian Bioweapon Exposure case, Biological and Chemical Warfare Agents module, "Current concepts in emergency medicine" course. ) ()
  • Society for Academic Emergency Medicine (SAEM) Simulation Interest Group (SIG) Emergency Medicine Simulation Resources Online- Simulation Case Library [2006]. "U.S. Army Reserve Component Medical Training Simulation Scenarios" package. Ed. Kobayashi L. Available at http://www.emedu.org/SimGroup/casedetail.asp?UploadID=91 ()