The Sim Cafe~

The Sim Cafe~ Interview with Dr. Liz Robison

September 23, 2022 Season 2 Episode 38
The Sim Cafe~
The Sim Cafe~ Interview with Dr. Liz Robison
Show Notes Transcript

Dr Elizabeth (Liz) Robison, EdD, RN, MSN, CNE, CHSE-A, is Professor Emeritus at Northwest Florida State College in Niceville, Florida, and former Simulation Center Coordinator for the ASN program, which included opening a new center and providing simulation facilitation within all levels of the ASN program. She prefers to go by Liz.. Liz has presented at several simulation based educational conferences and meetings. Her dissertation research involved learning styles and clinical judgment in a simulated clinical experience. She is currently in her second term on the INACSL Board of Directors serving in the role as Secretary/Treasurer and board liaison for the Sustainability Special Interest Groups. Additionally, she is a facilitator for their Simulation Education Program (ISEP), which is a 6-month online educational program. Liz is actively involved with the Organization for Associate Degree Nursing (OADN) Task Force on Simulation since October 2020, having completed reviews of over nine products, presented at conferences related to this work, and has published regarding the work of this group, both in the OADN Journal and ACEN Bridges Newsletter. She is a member of the Society for Simulation in Healthcare (SSH) and involved in several interest groups, presenting at their national conference through work with one of the groups. She is actively involved with the NLN as a co-chair for the NLN Foundation Scholarship Selection Committee, with prior years serving as a scholarship reviewer. She is a manuscript reviewer for Clinical Simulation in Nursing. Certifications she holds include Certified Nurse Educator with the NLN since 2008 and Certified Healthcare Simulation Educator with SSH since 2018, obtaining the advanced designation in 2021. Prior to going into higher education, Liz was a member of the Air Force Nurse Corps retiring after 22 years of service in a multitude of roles in clinical areas and leadership. With her second retirement now from the state, Liz has remained engaged in healthcare simulation and higher education community, consulting for Unbound Medicine, Inc. and GLG Insights.

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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 are truly blessed to have Dr. Elizabeth Robinson from professor emeritus at Northwest Florida State College in Niceville, Florida and former simulation center coordinator for the ASN program, which included opening a new center and providing simulation facilitation within all levels of the ASN program. Dr. Robinson, would you prefer me to call you Liz or Dr. Robinson?

Liz:

Liz, please.

Deb:

Okay, thank you. Why don't you tell our listeners a little more about yourself, specifically all of your experience and contributions to an NASCIL and the different simulation groups that you've been involved with.

Liz:

Thank You, Deb. And I appreciate you taking time to, uh, interview me for this podcast. And, uh, I've enjoyed your journey on the podcast with the variety of individuals that you have shared, cuz all of us have a different unique journey and what brought us to simulation. When I look back at, uh, different things in my journey, it started actually in 2006, when I first started at the college, I was requested if I could come in before actually school started before I was in contract to come to a simulation workshop that was at the time provided by Medi. And it was really to understand how to use this large simulator. And I, that was my first experience exposure to something that looked very different, very human, like, but very large and run by a computer. Then we kind of put him once I became, uh, involved with the faculty, we kind of put him off to the side. We kind of referred to as in the boxes, we really didn't have a, a true understanding of how we were gonna integrate simulation within our program. But my journey, I think in simulation, it really started with me in the military. I, uh, served in the United States Air Force Nurse Corps for 22 years. And part of that was really medical readiness in getting experience on how to treat wounded in the battlefield. And we did simulation. We had actors, uh, many of us were actors as well as participants. And, but we didn't think about it. The pedagogy of simulation wasn't really discussed. It's just what we did. It was our military training. So that really, when I look back on it and I look at how we did it, we really did do things very much in line with what I refer to as the standards of best practice in doing simulation. Because after we were done with our medical exercise, we all were pulled together and we discussed what went well, how we could improve<laugh> how did that the same approach in terms of debriefing? We just didn't call it that. But yeah, I think my varied background in the military and being involved in other aspects, I was a flight nurse as well. And just that flight training that you go through in terms of simulation with flight aspects, we had to learn the same thing that the pilot's co-pilots and technicians had to, to be able to know what to do in an emergency. So all that came into play when I started really full time in the area of simulation, uh, and I'm on the NASCIL board as treasurer secretary, it's a new name and I'm finishing up my second term and that journey has been great. I've um, met so many wonderful individuals on the board. They have helped me grow as a stimulus, but also as a professional. So when you get involved outside of your community, your college, you really realize that it's a twofold benefit, you benefit them and they benefit you.

Deb:

So thank you very much for your service to our country. I appreciate all that you've sacrificed. Thank you. I had the pleasure of meeting you in Wisconsin as we presented at a conference. So I really got to know you and I really appreciated all your experience and your just down to earth presence. I think that's, you know, the other thing, I mean, you've accomplished so much and I learned so much from you in two days and once again, I'm very grateful to have you today. So why don't we go to our next question, which is share your favorite or most impactful simulation story?

Liz:

Yeah. And, uh, like many of your podcast members. There's so many. I think if you've been, when I look at the time I've been involved in simulation, you have so many. And so you try to think of what surprised me the most. And one of the situations that occurred within our community is the loss of pediatric acute care experiences for our students. And that's not unlike a lot of programs that have experienced changes in the ability to have certain populations in terms of clinical rotations. So I was asked to put together a maternal child. Uh, we would focus on OB and pediatrics in one day, I had, was fortunate to have another stimulus and subject matter expert in OB to assist with the OB. And I did the pediatrics cuz I do have pediatric experience in my military, both in the acute care as well as the clinic. So I felt very comfortable in that role, but I didn't realize the impact of that simulation on the learners until I talked with the learners, uh, several comments were, this is our only exposure to acute care pediatrics. I wish we had more and you don't realize that when you are doing something, you know, there's a gap, but when you're doing something that it impacts that student, because some of our students wanna go into pediatrics, but they wanna be able to have more experience in pediatrics before they make that decision because they would have to really move away from our community for acute care pediatrics. We just don't have it in this area. And when you make that kind of change to an individual and you impact them on their trajectory of what they're professional, where they wanna go and where they think their journey in nursing will be, you realize the impact of one simulation can influence and give them a taste of how that type of client, you know, working with kids would be something that they would enjoy doing. And some of them were surprised at how they handled it because they didn't have that experience. You know, not all of our learners come with that experience of having kids. And so being able to be around the, uh, patient population, outside of the wellness, you know, they, they go to daycares and things like that. But outside of that wellness approach, uh, how to handle a sick child, you don't really realize the impact you can have in simulation. Just one simulation on your arms. Yeah. That really provided me the impetus that when you're asked to do something, you may not think it's relevant, but it may be relevant to your learners.

Deb:

Thank you. I, I completely agree. You could either go one of two ways, find out this is really what I want to do or this is really what I don't wanna do. Mm-hmm<affirmative>

Liz:

Yeah, absolutely.

Deb:

Liz, where do you see the future of simulation heading?

Liz:

I tell you what, I just have been involved heavily with a variety of things. Uh, since I've retired, I think I've, uh, grown more in the last couple of months in terms of where I see simulation going, being at conferences, talking to other folks and really seeing what is coming out in industry, the virtual reality, mixed reality, augmented reality. Uh, I saw that in the, in Axel conference this year, we had more vendors than we ever had that were in that space. I see other vendors that are in that space in other industry, not just in healthcare coming into that space. And I see that more research is being done related to how that kind of reality can give our learners a different perspective and more in tune to practicing what their profession in a very safe environment. I mean, that's really the goal of simulation is to improve patients safety. And if you can simulate an environment virtually and provide that consistency of exposure to all of your learners and you can give them practice. I mean, just practice. We see that in medical education, too, practicing techniques, I listened to something yesterday where there was some research in the medical field and the outcomes of the learners in terms of practicing through VR was no different than the, the, in the learners practicing using a laboratory aspect when they went and did it on a real patient. And I think we see that we need more of that coming out in the literature to really show the value of VR mixed reality, augmented reality, to allow our learners to practice in that safe space in an, I think we have room for the face to face simulation as well, but this is just another opportunity to give our learners confidence. And I see that's where the future is going. Plus let's look at the learners coming up, you know, they're gamers, many of them have been exposed to gaming and they enjoy that kind of learning. So why not tie that into their education because we know if you enjoy your education and how you're receiving that education, you'll probably learn more. Yeah. That's really the future.

Deb:

Thank you very much for that. Can you share about your experiences during the COVID pandemic and lessons that were learned at your university?

Liz:

Yeah. Now I'm in the state of Florida and we returned pretty rapidly. We only stepped down for about half a semester when we closed in the spring, we were actually on spring break and then we came back. We did not have summer sessions that were significant summer sessions that we did have a summer session. The students still limited students still entered the summer session, but it's really more of integrating those students into clinical areas as a practicum, but we don't really have classes during the summer. So it gave us an opportunity to kind of, uh, shift a little bit and get things ready for the fall. So we came back and I am just blessed with the simulation community. There is so much in the simulation community to help everybody know how to do things safely. And I just went to the different forms that were available to say, how could I open up my simulation center safely? And so I restructured things, I set things a little bit differently for planning. Didn't have to do much shifting for number of students because we already had small amounts of students coming in. Uh, so I was able to meet the requirement of only three students in a space at any one time, but I did things differently that embedded technology, a lot more into the process. And what I mean by that is the planning we did over zoom. Instead of putting them in small cramped unventilated rooms where there'd be a higher exposure. If somebody was a carrier, I had them do their planning sessions via zoom. And I'm telling you, you don't realize until you are there, what you actually can learn from your learners over zoom that you can't learn when they're in a face-to-face room and you're not there sharing their thoughts and ideas and what they're progressing with your planning. And so it was, it was a blessing in disguise, you know, the pandemic, nobody wants to go through a pandemic, but you always have to look at what things came out that you probably would not have changed. You know, we tend to get set in our ways, if you had not been forced to change. And many of those things were great. They were positive for the students. They were positive for me as a facilitator to make that experience a little bit more engaging. So just, uh, a variety of things that I, you know, I continued even when we opened up where there was no restrictions that I continued with doing things, uh, the way that we started due to the pandemic,

Deb:

The silver linings of the.....

Liz:

Yes,

Deb:

Absolutely. We have to, you know, focus on what did come of it. That was positive. I think you and I shared a pretty intense conversation when we were at the meeting in Wisconsin for the technical college and it was all about suicide.

Liz:

mm-hmm<affirmative>.

Deb:

and it was about the things that you guys did in the military around suicide. Now we know that between 20 and 21 suicide is up 31 or 32%, which had been statistically on the decline. So why don't we talk a little bit about that? I know this is a tough subject topic for some people to talk about, but I think until we put mental health and depression, anxiety, and these different illnesses, right. Do into the space that gives it power to talk about and to understand that we're not okay, we're not all okay. Right. And it's okay to not be okay. Yeah.

Liz:

And that conversation in Wisconsin really came about with how I learned different things in the military that I was able to use in my current role as a stimulus, and really helped bring that perspective of the importance of debriefing. We had a unfortunate situation in one of my, uh, when I was at a medical center in the military where we had a young airman that was in a bad place. And we didn't know that. And this young airman decided to take his life. And as a result of that, the military also at that time was seeing a rise in suicide. And even though we were part of the medical community, this the way the military responded to suicide that occurred within a unit was consistent regardless of where you were located. And so the mental health, uh, team came to our unit because it was a pretty large squadron as the military called it and came to the squadron and did what they referred to as a critical stress incident debriefing. And it was an opportunity for all of us, regardless of how well we knew this airmen or not to be able to share our thoughts and our feelings and to talk about it, you know, to put that information out there for us to be okay, cuz there were some people in the squadron that were tremendously impacted by this young airmen. They felt guilty of not recognizing some signs that in hindsight they should have picked up on. And I think we all have different stories of individuals we know who have been impacted by suicide in their life. And I think the important thing that I took away is that you have to immediately talk about it in a very structured environment where the facilitators are trained and aren't we that way in simulation. That's why that psychological safety is so important. We are facilitators that are trained in that aspect of debriefing, no different than this facilitator was trained in critical stress incident debriefing. And we saw that in the pandemic with some of the organizations that had individuals that were involved. I remember listening to, uh, Elizabeth Horsley and talking about how their hospital had individuals meet at the end of the day and kind of de-stress themselves about what was going on with their day with COVID patients that they were losing. We can't forget that what we do. And some of the things that we do in simulation can transcend into other things that are happening in our life. And simulation is just one aspect of what we do, but we bring so much to the table when we think about our skillset and debriefing is something that is so important because especially when you're thinking about very tough, difficult situations like suicide, it impacts everybody. Even if you don't know that individual personally, it impacts everybody when it happens within your unit. So our family, whatever that unit is. So yeah, I was glad to share that story, uh, because you know, that happened over 15 years ago and I still remember the debriefing. So it was impactful,

Deb:

Right? No, I, I, I think mental health deserves a lot more attention and to be de-stigmatized

Liz:

Yes, absolutely.

Deb:

Now Liz, if you, um, can share with our listeners the biggest thing that you'd like them to know, something that you learned and it changed the way that you practiced maybe a personal aha moment.

Liz:

Yeah. I think, I think the biggest aha moment for me is when I decided to go back after retiring from the military, into the world of education and it wasn't until after that person left, that I really became an aha moment. To me. It was the leadership that I, that hired me into that role. She was such a game changer in terms of how she made me feel as a new faculty member and the way she brought other new faculty members into the fold. I remember getting the call saying you were hired and it was, I was in another job and I was just ecstatic, but I didn't realize the impact this person had on me until after the person retired themselves and, and left. And sometimes in leadership roles, you don't realize that until later on and shout out to Linda Weddington, she was a great director. She stood up the nursing program at the college. It was the, it's a very young program and she stood it up in 2002 and she couldn't have been a better pick. She was a great leader and she had a great way of unifying individuals and I've had other great leaders in the military, but this is, this is one that was in higher education and really impacted the way I felt about myself in continuing my journey into higher education and really wanting to impact, uh, learners. So sometimes you don't realize that until if the person has left the type of impact that they've had on you.

Deb:

Right. I agree. I think that you don't recognize until something's missing mm-hmm<affirmative> and then you realize and appreciate what you had when I was teaching nursing. Students would say, you know, if you're on a good team and you feel that teamwork of trust, respect, and appreciation recognize it as such, and it is a place that you wanna stay and belong to.

Liz:

Absolutely.

Deb:

Now, is there anything else, any questions for me?

Liz:

Well, I, uh, appreciate you sharing your journey as well while we were in Wisconsin. And just realizing that you commented on the fact that, uh, we seem to connect very well and talk to, and that goes both ways. I, I think, you know, sometimes when you meet individuals, you're, you are hesitant to share too much, but when you feel comfortable with that individual and you feel like you have the same life story, so I appreciate you opening up and sharing your journey with me. I think that's always important when you are growing as a professional that you don't truly retire. You're always available when you become an expert in some area to assist. And so thank you for sharing your growth with me and your continued growth. So where do you think you will be in the next year or so in terms your,

Deb:

I just, you know, I think the, the podcasts have been an incredible opportunity to share with the community and it's been very well received and I'm just humbled and honored that I've had that experience. I have the classes online, which I hope those will take off a little bit more. I have the telehealth and then the, the courses on simulation for clinical instructors. Cause I think when you start out in simulation, I remember when I started out, I didn't really understand that LAURDOL all had different platforms and I couldn't understand why you just couldn't use one computer for everything. I think having those classes can help people to recognize the different things in simulation and just get a shared mental model. Yeah. And once again, the dictionary was a, a great thing to have a shared taxonomy. Yeah.

Liz:

Right.

Deb:

Yeah. So we know, we all know, you know, yes. Means yes, no means no red means stop yellow means slow down. Green means go. Yeah. So I think having that made it a lot easier for all of us. And then the, the following thing, you know, I'd like to do is a little more consulting with organizations that wanna get started and help them to determine what they really need, what their outcomes are. And so that they don't waste resources, that they go ahead and get the best return on investment, as well as having people starting out with their programs, understanding and buying into simulation and it's value whether virtual reality. Yeah. But whether physical simulation, whether standardized patients there's value of it in all of them. Yeah.

Liz:

And because ultimately whether we're working in academia, in, uh, brick and mortar school or consulting, we all have the same goal improving patient safety. Right. That's for anybody in healthcare as a learner, our charter is patient safety.

Deb:

Agree. Well, do you have anything else you wanna leave our listeners with? I know that you have your CHSE-A yes. Yeah, yeah. How was that journey for you?

Liz:

It was great and interesting. Uh, somebody else reached out to me and asked me to look over their portfolio for, uh, putting it in for this upcoming consideration. And you realize that you have a different lens when you've been in that role. You know, it's a, it's confidence builder that other people recognize the work that you're doing. Cuz to me it's been fun. You know, I do things outside that I've done have been value added to me. If it wasn't fun, I don't think I would be doing it. Most of the stuff I do is volunteering with the NLN with the Oden, uh, with NASCIL is all volunteerism and you don't necessarily need to get what I call financial compensation for those things, because they're rewarding in terms of your growth. And it'll eventually make you stronger as a consultant to be able to share your knowledge with your exposure, to the different things that you were involved in as a volunteer. Yeah, it was, uh, it was a great experience. Not that it was hard work a lot of time, but a great experience because you really see all the stuff that you have done when you put a portfolio together is you're really developing that mental model and you really see everything on one application on how much you've done over the last five years.

Deb:

Yes.

Liz:

Even if you have to do it a couple of times, do it because, um, you don't realize your value until you put everything together and realize how much you've impacted others.

Deb:

Right. Thank you very much for that. And I'd also like to put a shot out to any of our listeners, if you're not involved in volunteering, go ahead and try and, you know, pick something that's near and dear to your higher, whether it's the society for simulation in healthcare, whether it's a NASCIL, whether it's SIMghosts, whether it's LN, but volunteer because the people who you'll be volunteering with you'll learn from them and you'll gain so much more experience and knowledge from volunteering for those positions.

Liz:

Absolutely. Totally agree.

Deb:

Thank you so much for this time and to our listeners, happy simulating.

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The Sim Cafe would like to thank inclusive consulting for this week's sponsorship. Inclusive consulting will teach your learners. What true. DEIA is through simulation.

Outro:

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