The Sim Cafe~

The Sim Cafe~ Interview with Dr. Amar Patel

August 05, 2022 Season 2 Episode 30
The Sim Cafe~
The Sim Cafe~ Interview with Dr. Amar Patel
Show Notes Transcript


Amar Patel is a clinician, researcher, and renowned educator with a Doctorate in Health Science from Nova Southeastern University in Fort Lauderdale, Florida, and a Master of Science in Emergency Health Services Education from the University of Maryland Baltimore County. He currently serves as chief learning officer at CAE Healthcare.

Founder and past chair of the North Carolina Simulation Collaborative, Dr. Patel is a simulation expert and much-published key opinion leader with 60+ abstracts, articles and textbook chapter publications to date. With a professional history that includes stints as a firefighter, paramedic, educator, researcher, and curriculum developer, Dr. Patel maintains over 17 certifications and is involved in several healthcare quality committees.

Dr. Patel has most recently held the position of executive director of WakeMed Innovations at WakeMed Health & Hospitals, having been responsible for healthcare innovation, idea generation, innovation investments, technology-based educational programs (such as patient simulation and online learning), and simulation-based research.


LinkedIn; https://www.linkedin.com/in/dr-amar-patel/
Email: Amar.Patel@CAE.com



 

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Intro:

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Simsolutions, edited by Shelly Houser. Join our host Deb Tauber as she sits down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.

Deb:

Welcome to another episode of The Sim Cafe. Today, we're blessed to have Amar Patel from CAE. Join us as our guest Amar. Would you like to tell our guests some more information about yourself?

Amar:

Sure. Happy to thank you so much. And first and foremost, thanks for, uh, having me on and allowing me to be here with you on The Sim Cafe, super excited to, you know, certainly share some of the stories we're gonna talk about today. So my name is Amar Patel. I serve as the chief learning officer at, uh, at CAE Healthcare, been here about, uh, four years come out of the healthcare hospital system world. So spent the last, uh, 12 plus years of my life at WakeMed health and hospitals in Raleigh, North Carolina. And then, uh, even prior to that was at, was a firefighter paramedic in Baltimore, Maryland.

Deb:

Thanks, Amar. And I, I met him, our actually at IMSH I went to a presentation he was doing on return on investment. It was just fascinated by the things that he was doing at WakeMed, and we have known each other for a while and I've been following him and generally reach out to him if I have questions. Um, because Amar, I think you're brilliant.<laugh>

Amar:

Thank you. I appreciate that.

Deb:

Thanks. So Amar, we we'll start out with our first question, which is why don't you tell us about your journey into simulation? Cause we all have such unique journeys getting into simulation,

Amar:

Um, started in the world in 1999, 98, really working on the first Medi ECS one and 16, as well as, uh, the original, how I was at the University of Maryland, Maryland Farm Rescue Institute. And, um, I was an ALS instructor teaching and they had just purchased two brand new products in simulation. And I got the ask, right? The ask was, Hey, you're kind of tech savvy. We have these things, they call simulators, not really sure what we do with we, you know, we wanna move into mobile simulation. Will you, uh, will you just take a look at it? And from there, you know, really started to, to muck around with the patient Sims and try to figure out the educational methodologies that are utilized there. And we started to integrate'em into, into the courses and the programs that we were offering. And then we ended up, uh, saying, this is really cool. Let's build a mobile program cuz you know, the university of Maryland has these mobile trucks that they do fire service training with. And so we ended up building an entire trailer with, uh, mobile simulation. And from that point forward, it was kind of a, uh, here we go. I'm hope and that journey has continued since.

Deb:

Excellent. Thanks. Why don't you share with our guests your favorite or most impactful simulation story? This is always my favorite question.

Amar:

You know, I kind of have two, one ends up being a tear jerker and one ends up really, um, kind of showing the importance and impact simulation really has across the world. And this was when I was at WakeMed, we were doing residency training, um, with your first, second and third year emergency medicine residence. It was a trauma patient that needed to be sedated and intubated and like sim centers. We actually had a Pixus in the lab. And so part of the goal was the timeframe and required for the prescribing physician to wait for nursing, to obtain the medications from Theus as the scenario evolved, one of the orders that was present there was for the RSI kit to be pulled out. And the order that the resident had given at the time was can you provide the patient with a hundred milligrams of sus and calling the room hurt 800 milligrams? Cause he said it so fast and there was no read back that the entire space hurt 800. And even after the resident that was administering medication said, Hey doc, I only have two vials, right? So I only have 200 milligrams of docs. He goes, well, I told you to give 800 milligrams of, of the Cho. And he said it that fast. And so the resident went out to the Pixus grabbed one additional vial and realized that there was now only three vials in the entire sim center. Where does he get the other five? And so he, uh, he continued to call pharmacy or simulated pharmacy. And this entire process went through to the point where he ended up giving 800 milligrams of Cho's. The debriefings was impactful, right? There was no shout out flag call. There was no double check in the, in the notion, even after a, a verification, it was acknowledged and moved forward, but it just goes to show the importance of simulation of clear communication. What ended up being was the resident didn't know that each vial only had a hundred milligrams. The resident thought each VI was 10 milligrams or 15 milligrams. Right. And so in his head he's like, well, yeah, okay. Eight, eight VI, the math works for me. I don't understand. And the clear communication wasn't present. So it's such an impactful thing. It was a huge lesson learned across the board. And it's a story that I certainly share often. The second story, I think that's a huge tear. Jerker ends up being, we were running a, a complex multi vehicle accident scenario in the sim center and it was 100% focused on communications delivery of bad news. And we had a standardized patient that was the parent that was dad. We had a birthing simulator that was mom. And then we had an infant and in the story, mom ends up, uh, emergently coming in after a car accident, we ended up emergently delivering the baby and both the baby and the, the parent die. And it, it becomes a question of how do you tell the husband, he just lost his entire family and the communication pieces, the discussions around it, the entire room was crying, right? Like how do you have the conversation with the students who are delivering this bad news to a, a standardized patient and how you communicate that, how you deliver that information and that person's then gonna give you feedback on what they heard from you, what they felt from you. Right. And all of that to, to later discover that one of our students had recently lost was in a similar scenario with a family member where they recently lost mom and baby, right? So it ended up being even a more personal interaction in the space. Um, it's one that certainly shares the value, the, the personalization that simulation can have on the work that you do and, and the relevance it plays in, in, in the world that we play. And so it's a story that is so impactful that you tend to remember, remember things, and I often share people will forgive you for what you did, but they will never forget how you made them feel at the time.

Deb:

Absolutely. Absolutely. I think delivering bad news is just so incredibly challenging for the healthcare teams, especially in the age of this texting and the lack of communication. And I remember when I worked in the emergency department, we had a four year old that was struck by a garage door. We attempted to resuscitate him, but we were unable. And I remember, you know, we had done so much that by the time that we have the family come in, this little boy was he, he did not look good. And it was difficult, not only because of the situation, but because we had tried to do so many things that were unsuccessful, but delivering bad news is something that is very difficult. And I remember that was way, way before we did debriefings. Like at that time debriefings were thought of is weak. That that was something that only weak people did that you don't, you know, get together and talk about things. So they did the debriefing maybe two days later and the entire, you know, all the people that were involved showed up and it was, it was a challenge, you know? And, and I'm just glad that things have evolved now that people have an opportunity to kind of take a deep breath after these bad situations and actually discuss, seems like the culture's at least moving towards something like that.

Amar:

Being open to conversation. I think where the sim, you know, where educational methodologies starts to play a huge role where simulation plays a role is understanding the value it has. Because for me, I would love to make sure that people say I had an amazing conversation about what I had just experienced in simulation. Look, we had a horrible event, or we had a really good event at the bedside or in the unit, or, you know, in the street, let's talk about it, right? You should be debriefing after these complex cases or, or I would arguably say even the simple cases, because having the discussion is good for you. It's healthy for you as well as it puts closure and lessons learned for everyone across the board. So that the next event that you have is even that much better. Right. And you understand the good, the bad, right? You, you take something away from it. So whether it's in simulation or in the real world medicine, I'll call it the debriefings, the conversations, these discussions, the peer to peer recaps are such an important thing to ensure that we do.

Deb:

Yeah, absolutely. I couldn't agree more. I, in fact, my neighbor's house burned down on July 5th and it was, the houses are probably like 12, you know, maybe 20 feet apart. And during this, it was a box fire. And you're probably familiar with that where they just wanna keep it to one house and the flames were flying out of their, their house. My, my husband said, I think we might have to evacuate because their house is on fire and it's very close. And fortunately the firefighters came from 5, 6, 7 areas and were able to contain the blaze. But I called my friend, the chaplain to debrief about it the next day. And she said, you know, that's once again, what you mentioned, sharing that story, getting those feelings out, how blessed were we to be spared by this, this horrible event? Yeah. I think debriefing is so critically important in so many areas, not just simulation, but so many areas of our life where we share our story because we're all vulnerable.

Amar:

Yep, yep. Yeah. And especially now, right now, so you think about COVID and the impact COVID has on all of us. Right? The, the communication we can never under communicate. I would argue, we say we can sometimes overcommunicate, but at the same time, overcommunication is such a, such a key thing for us.

Deb:

Right. You know, being lonely from the pandemic, the pandemic created so much loneliness and isolation.

Amar:

For sure. Yeah.

Deb:

So Amara, what about anything that you wanna share during the pandemic? Any lessons you guys learned?

Amar:

Yeah. I mean, the world kind of stopped. I would say for us as an organization, we pivoted pretty hard into making sure that the needs of the community were addressed in real time. And we learned a lot of lessons in digital. I would say, I think the world learned a lot of lessons in digital as a company CAE pivoted pretty hard into making sure that everything from ventilator education to building ventilators, to, um, helping, to, to establish and set up vaccination sites all over north America to, to really just sitting down with friends and colleagues and customers and, and partners to really say, how can we help you? Is it a conversation? Is it an educational event? Is it a webinar? Is it just simply let's have a cup of coffee, you know, six feet apart from each other. Just, just, just to be able to, to see each other, to make sure everybody's okay. And, you know, there was just a lot of lessons learned in the human piece of it. Right? We oftentimes will, culturally, we often say, okay, to your point earlier, we're in silos. How do I make sure that the people that work with me every day are okay, right. We don't, we need them to be healthy both physically and emotionally. And so how do we make sure that we continue to engage them? Right. Um, so just a, a lot of lessons around interactions and communication and building teams and building rapports. And it's the little things that matter, right? It's your birthday, let me send you a basket. It's your anniversary. Let me send you in your spouse to gift card. It's just the little things that are such an important thing that oftentimes in the day to day chaos of things that we forget. Um, and so lots of focus on, on the little things is what we really I'm super proud of. Right? Just keeping the teams engaged and happy was where, you know, our, at least our head was really at. And, you know, as an organization pivoting to meet the needs of the community was a huge piece of this, right? From training development. As I mentioned before, building ventilators or going out in the community and putting vaccine sites in place, right. I spent weeks states just doing that. And that's the stuff that is needed. And that was the stuff that was needed at the time to make sure that we're all taken care of.

Deb:

No, you're a hundred percent right. Thanks someone for bringing that up. And I think when you meet with people and asking,'em, you know, how are you, how are you really, right? How are you really doing? And, um, you know, being open to, to hear what they have to say, because a lot of us have gone through a lot during this, this period of time.

Amar:

Yep. I mean, the loss of family members, the loss of, you know, lots of divorces for, or lots of friends, right. I mean, it's just been a crazy time. Um, lots of realizations for folks for work and jobs and the need for just space and, and mental health. And honestly, you know, the need for just to be able to say, you know what enough is enough? I'd love to come see you dinner. We'll do it 10 feet apart. I don't care. But at least I can see a face. Right. And I can have a, a level of communication. And so, yeah, it's such a hard time for folks. And I think it continues to be right, even in a current environment where yeah. Travel is open, people are out and about airports are absolutely crazy. And, you know, for some folks that haven't flown in two years or three years being in an airport, it's claustrophobic. It's super right now, it's overcrowded.

Deb:

<laugh>, I'm one of those people.

Amar:

It's not, you know, it's not good. Right. It's not it. And so having a hand to hold as you're walking through airports, right. Or we're onto a bus or a train is such a, a such a huge thing.

Deb:

Well, I'm gonna ask our next question. Thank you for that very kind of intense discussion, but I appreciate it. So where do you see the future of simulation going Amar? You've got a, a big role, so I'm sure you guys talk a lot about the future.

Amar:

Uh, well, pre pandemic, we always said, you gotta be in the lab, you gotta do the hands on component of it. You have to be in a controlled space all the time. Your competencies have to be done in, in the lab environment and you need to have an operator and a facilitator, and you have to have all these components to be able to drive education forward. The pandemic has taught us that the answer is you don't really right. There is a percentage in which you absolutely have to. And there's certainly a percentage in which there's other methodologies and modalities to be able to, to do the work. And we pivoted pretty hard right across the world. We went from this notion of about a hundred percent. I'd arguably say about 80% really of simulation and 20% of other things to 20% live and 80% other things, and institutions and schools were all trying to figure out how do I do virtual? How do I do this? How do I do that? How do I deliver simulation experiences to the same level of competency and depth and breadth. And, you know, as we think about the future, we don't know where that balance currently is. I don't know if it's still 80, 20 or 70, 30 or 50 50. Right. I think the world is still trying to figure itself out. There are two things that are absolutely a must, right? One is the future's gonna focus on virtual. We know that we've seen it. We're starting to see the pivot. I use this example, um, about a week ago where I said seven years ago, eight years ago, when you came to IMSH eight, there were hit or miss VR vendors out there. And some had some really cool stuff. They were trying to figure out. And some didn't have anything at all. They were just kind of early in English. And then a year later, it all went away. And then four years ago you came to IMSH and there was like, okay, it's a little bit more, there's a few other folks that are doing some really interesting stuff. Then the pandemic happened, all those people in law because the demand and the market grew astronomically fast because of the need to be not remote in nature. We saw a lot of really cool stuff come up this year. If you were at IMSH there were 33 different vendors, all focused on that, nothing but virtual or extended reality as a collective poll, whether it's augmented mixed or, or, um, virtual, that tells us a lot, right. As where things are. And in my head, I had just finished a research study that focused on looking at the last 19 months of where education has transitioned into. And you hear in learning experiences, the notion of flip classrooms all the time, there's a huge value in flip classroom, but it sits in this dead center of cost versus impact. Um, long term, we hear, you know, universities are using discussion boards and video based learning tool. And that really does sit in as it's a low cost element with a low return long term. Right? What you see in a video has an impact for you, maybe a few months down the road, you're like, oh, it's a whistle in the wind, right. It was just kind of something there that was there. It doesn't have that retention type to it. What we saw was the utilization of augmented reality, artificial intelligence and simulation became something that is a sustained long term residual memory. It has a cognitive and a practical application associated with it. And that has that long term impact for you as a learner. So as we think about the future of where learning is going, it is going to, to be virtual. There's a heavier emphasis on virtual. The, what the virtual is, is still to be decided is that virtual reality is that simulated equipment that is in a virtual capacity is that digital twins of technology. And you're seeing a lot of focus today across the market, not only in healthcare simulation, but in other industries and engineering and civil and other things where digital twining is a huge component for long term retention and knowledge. So while we in healthcare are seeing a change or a pivot, the world is shifting to digital education. Now there are, again, some things that are practical based. And so while I ever see the future change to be a hundred percent virtual, the answer is no, not even possible, right. Will we see a change in where it is virtual with simulation in a controlled environment and center with skills based in a clinical environment? Absolutely right. I don't know if that's a third, a third, a third yet, but will continue to see a significant emphasis on digital learning applications and digital learning technologies with the utilization of artificial intelligence is driving force behind that. Right? I need to know about you as a learner. We need to get away from the notion of thinking that we, as an educator, know everything about everything we need to become very, learner-centric very customized in the individual learning experiences, very understanding of where the needs of the individual learner are, because if you are super talented on the iPhone, but not so on the Android device, then I need to spend time teaching the Android, not iPhone versus most businesses will say, I should. I should just show you both to make sure you can drink our coffee all at the same time. Right. I do see, um, a future in digital as that forefront. The second piece I think is important to highlight is advocacy and legislation. Where do I see our future going a heck of a lot of effort and work focused on changing the rules and the policies that mandate and drive simulation to become at the forefront of quality in patients, we have got to change the rules that help us become safer in healthcare and help us as individuals stay safe. Right? And I think it's twofold, patient, patient safety and outcomes, but it's also provider safety and outcomes. And I think the future is going to focus on advocacy and legislative change that helps drive that. And we've seen great success in the transportation industry and the movie industry, you know, it's about time. Healthcare gets to focus on it.

Deb:

Excellent. Excellent response, Amar. Yeah. Thank you. I'm gonna ask another question and I, I shared it with you. So can you share with our listeners the biggest thing you would like them to know something that you learned and it essentially changed the way you practiced?

Amar:

I would say several, right? I think the, the biggest takeaway for me growing up in this space is patience. And we don't all have it. You know, when I first joined the education world, I was like, yeah, simulation, everybody should do it. Rock on. Let's make it happen. And I quickly got to a place where I was disappointed at the speed in which everybody else works. The biggest thing for me was patience. You gotta have patience. And primarily because people don't always understand what you're trying to accomplish. The CFOs of the world that you're working closely with. See numbers, see a spreadsheet, see finance, see data. You're talking to'em about quality outcomes. You're not talking to'em about data. Sit down for a moment, take a deep breath and talk to them about data. The CEOs of the world are looking for outcomes, right? Show them the outcomes stories, tell them the outcomes, narratives, share the outcomes, an elevator pitch, right? If, if I'm sitting in an elevator with somebody that I'm trying to get funds with taking that deep breath, having the patience and saying, I wanna tell you a story about a positive outcome that happened in the emergency department yesterday, all because of the work I did in simulation and sharing those stories, we sometimes pass off. But what I've learned is share the stories, take the time, take the deep breaths. It's changed the way I do things completely to the point where even in my own lectures, you'll start to see stories. Those stories are such an important thing because you may not remember the content material, but you're gonna remember the story.

Deb:

Absolutely. I couldn't agree more. Is there anything that you wanna ask me?

Amar:

You know, um, you've been traveling as well. I know. So how are you?

Deb:

I'm doing well. I, we moved into a new house about a year ago and uh, gave us a lot more space and we have, um, the two grand baby one's coming up on three and one's already three. And then I have my dog Maggie. And, um, I've been partnering with, through SKA depo. Yeah, on some consulting projects and that's been going really good. So I've had some met some people in simulation virtually and personally, and it's been, it's been, things are going well, the podcast has been fun. That's been the, you know, just something that I learned so much every time I do it. And once again, to your point of storytelling yep.

Amar:

Yep. Stories is such an important thing and you're doing that right. And I, I, I commend you for, for being on the podcast for bringing all the people in to share the stories and to share your experiences, right. You're, you've got such a wide, wide level of experiences and so much knowledge and you and I have collaborated on projects in the past as well. And so just, you know, sharing your experiences is such an important thing. Um, collectively, so thank you for doing that.

Deb:

Well, thank you. And I'll, you know, when you gave me that project in mobile, I learned so much from that. It was just an amazing opportunity. And once again, on a thank you, I'll shout out to the University of Mobile, uh, Alabama. Yeah. So if our learners would like to get ahold of you, is there anywhere they can get ahold of you?

Amar:

Yeah. So two places, you're welcome to reach out to me on LinkedIn. So I'm up on LinkedIn, usually out and about and uh, on messages. And then my email is Amar. Patel@cae.com. So both will hit me hard and, uh, feel free to reach out, connect, ask questions. I'm a night owls. I tend to respond at weird hours.<laugh> so feel free to reach out any time.

Deb:

Thank you. And that information will be in the show notes, happy simulating.

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Outro:

Thanks for joining us here at The Sim Cafe, we hope you enjoyed. Connect with us at www.innovativesimsolutions.com and be sure to hit that like and subscribe button. So you never miss an episode of The Sim Cafe.