Michael A. F rakes, APRN, MS, CCNS, CFRN, CCRN, EMTP: LIFE STAR Hartford Hospital, Hartford, Conn.

While Michael is a leader caring for patients during critical care transport, CNS practice differs from expert clinical practice away from the bedside.On a recent afternoon, two of our new staff cared for patients with an aortic dissection, an expanding subdural hematoma, a pediatric seizure and cardiogenic shock. This high-intensity, high-acuity experience was completely safe, as the encounters took place in a very realistic, high-fidelity human patient simulator program that Michael has helped to develop and operate. More important than the scenarios are the debriefings, which always begin with the team "talk(ing) about three things that went really well" before discussing improvement opportunities. Experienced staff benefit from an equally thorough program of "high-risk, low-frequency" cases for recurrent education.

Clinical education and consultation are not limited to the sophistication of the simulation center. We often turn to Michael for answers to clinical questions, to which he invariably answers either "a recent paper says ..." or "great question, let me look around," followed soon by an e-mail summarizing the current literature. This evidence-based approach extends to ensuring that our practice standards consistently reflect best practices and to nonclinical features of team performance, such as patient safety, documentation and transport operations.

Michael is also a contributor to the medical literature. In the past year, he has edited a book, written three chapters, published seven clinical articles and four abstracts, and made seven national presentations. More importantly, he has helped us to develop skills in clinical inquiry. Michael either helps us to develop an idea into a workable project ("any idea can be a great project:") or asks for "a little help with something" to get us involved in research. Currently, 14 members of our multidisciplinary team are involved in projects, along with a college student seeking research experience.