Dr. Jennifer Arnold opens up to Jerrod and Deb and inspires them in ways that will warm your heart. This episode is Sponsored by Interact Solutions and Inclusive Consulting.

Dr. Jennifer Arnold has been involved in simulation education, patient safety, and research for 20+ years. She has served as  NIH postdoctoral scholar at the University of Pittsburgh School of Medicine's Safar Center for Resuscitative Medicine. Dr. Arnold's simulation educational research has been funded by organizations such as the Laerdal Foundation for Acute Medicine, Cullen Trust for Healthcare, Texas Children's Hospital Educational Grants & MD Anderson Foundation. She has authored 20+ peer-reviewed articles and numerous book chapters on medical simulation.

As the founding director for Texas Children's and Johns Hopkins All Children's Hospitals, Dr. Arnold led pediatric healthcare simulation programs. Currently, she serves as Program Director of Immersive Design Systems (formerly SIMPeds) at Boston Children's Hospital, a Harvard Teaching Hospital.

Dr. Arnold's interests in simulation include utilizing it to assess new clinical spaces, provide team training, enhance quality and patient safety, improve home care and skills for primary caregivers of medically complex children, and develop educational curricula for various departments throughout the hospital.

Dr. Jennifer Arnold has received multiple awards throughout her career, including the Ray E. Helfer Award for Innovation in Pediatric Education from the Academic Pediatric Association, Compassionate Doctor Recognition, and Patients' Choice Award from Vitals.com, Norton, Rose, Fulbright Excellence in Education from Baylor College of Medicine, and Distinguished Educator Award from the University of Pittsburgh School of Medicine.

She is a member of the American Academy of Pediatrics, Society for Simulation in Healthcare, and International Pediatric Simulation Society. Dr. Arnold serves on the executive boards for the Center for Medical Simulation, INSPIRE (International Network for Simulation-based Pediatric Innovation, Research, & Education), OpHeart, and is a founding Board Member of Ready.Sim.Go. She is a national ambassador for Speak Now for Kids through the Children's Hospital Association.

Dr. Jennifer Arnold has given national and international presentations on topics related to healthcare simulation, overcoming obstacles, DEI in the workplace, cancer survivorship, and work-life balance for professional women. She has spoken at the Texas Conference for Women, SHRM, No Place for Hate, Shiners Hospital, Sloan Kettering, Pfizer, March of Dimes, as well as many colleges, universities, school districts, and corporations worldwide.

Dr. Jennifer Arnold takes great pride in her advocacy work and empowering individuals to become better advocates for their own healthcare. She has a unique perspective, having personal experience as a lifelong patient, a cancer survivor, a devoted mother of two young children with physical, medical, and social-emotional needs, a medical expert with two decades of experience caring for at-risk infants at top-tier institutions, and an experienced medical educator, including the use of advanced technologies such as medical simulation, 3D printing, and virtual reality.

Dr. Jennifer Arnold and her husband Bill have written two books. Purchase an autographed copy. "Life Is Short (No Pun Intended)," [https://bit.ly/booklifeisshort] is a memoir about Dr. Arnold's life as a little person and her experiences as a physician, cancer survivor, and mother. "Think Big: Overcoming Obstacles with Optimism," [https://bit.ly/buythinkbigbook] offers insights and advice on how to overcome obstacles in life with a positive attitude. 

Dr. Arnold's public persona and platform enable her to reach millions of people globally, and she uses her personal and professional experiences to connect with her audience and inspire them to be

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Transcript

Disclaimer: 0:00

The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors.

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This episode of The Sim Cafe is brought to you by Interact Solution. Interact Solution is a revolutionary and cost effective audio visual simulation learning management system developed for instructors to record, organize, schedule, annotate, and debrief student simulations, delivering timely evidence-based feedback. Interact solution is an ideal compliment to your existing curriculum and can be customized for your simulation center contact Interact solution today.

Intro: 0:50

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host, Deb Tauber and co-host Jerrod Jeffries as they sit 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: 1:31

Welcome to another episode of The Sim Cafe. Today we're here with Jerrod Jeffers as co-host. And I'm Deb Tauber, and we are so fortunate to have Dr. Jennifer Arnold. Dr. Arnold, why don't you tell our guests a little bit more about yourself and then we can begin our interview. Thank you again for being here.

Dr. Arnold: 1:51

Oh my goodness. Well, thank you both for having me today. I am super excited. I am like many people. Hi, guess I, I have a lot of hats. I am a neonatologist based on my clinical trainee and I am also a healthcare simulationist. I love what I do. I've been involved in simulation for, oh gosh, since I was a fellow trainee, so over 15 years. I don't know, I'm not really doing the math right now. And I've had the privilege to be able to lead two simulation programs before coming to my current position now at Boston Children's Hospital, where program director of what we have rebranded from peds to Immersive design systems.

Deb: 2:31

Why do you think they changed the name? What was the impetus of that?

Dr. Arnold: 2:35

Yeah, so I think the, the interest in rebranding and renaming the, the program here, it was really related to, in addition to a vision of Peter Winestock, who many might know, my colleague who I now get the privilege of working with, you know, was really the vision that simulation is becoming just so widespread in its applications. And so I think he wanted to help the hospital to see us as immersive sort of simulation activities, but also a part of our human factors and systems engineering work, uh, throughout the hospital education, also engineering and VR and device development. So I think the goal of changing the name, which is pretty exciting, is to really better describe the work that I think many of us in this field are already doing, but to hopefully broaden the term simulation.

Jerrod: 3:30

I think we're hearing that more and more often and, and correct me if I'm wrong, Deb, but do you see that more happening more often too, Dr. Arnold?

Dr. Arnold: 3:38

Oh, yes. You mean in terms of the broadening of the application?

Jerrod: 3:42

Correct. Yeah.

Dr. Arnold: 3:43

Yeah. And I think we're all trying, I mean, I, well, I, maybe I should speak for myself, but I feel like, you know, many of us we're trying to figure out how do we describe the different applications and what's that framework. And I feel like as I've been thinking about the different ways we can utilize simulation in healthcare as a, a tool for education, for safety, for innovation, as I think about all those different ways we apply it, you can sort of look at it through many lenses and still be doing this same thing. Meaning you could look at it from a patient safety lens, you could look at it from a training lens, you can look at it from a peer innovation lens. But I think what's best is when you put all those lenses together and then you really see the full value of what healthcare simulation brings to to medicine.

Deb: 4:29

It's the diversification of going ahead and making things more interoperable. My daughter just had a baby, the baby's five weeks today, or six weeks today, six weeks, and she got a Snoo, SNOO. And what it is like is, it's like a simulator of the womb< laugh>. So there's like noise in there and you get t he baby all tucked in and it, it's essentially, it's a simulated w omb.< laugh>.

Dr. Arnold: 4:58

Yes, simulation applies to everything in our world. It's not just healthcare. You're absolutely right. And I think that's pretty cool. I didn't know about this snoo, but I'm gonna have to check it out.

Deb: 5:08

<laugh><laugh>. Well, we're gonna get into our next question. And can you share your journey into simulation? Like how did you actually get there? What, what started that?

Dr. Arnold: 5:19

Well, you know, it's interesting, I, I think early on in my sort of career training as a clinician, I knew pretty early on that I love to teach. And in fact, it kind of actually started a little bit from the fact that I have, uh, a disability and I'm short statured. And when I was in my first year of residency, I actually sort of got this award for teaching and education. And I sometimes wonder because as a first year intern, you don't really have a lot of opportunity to teach others, right? Because you're so busy learning in your first year as an intern. But I had the benefit of having sort of an assistant help me. They, one of the accommodations we weren't sure if I was gonna need or not is just having a little bit of assistance pre-rounding and everything like that. So I actually had for half the year a medical student who was assigned to be with me as I was preparing for rounds so that I could, she could reach things and in turn I would teach her because she was pre-med or, or yeah, she was in medical school. She was really interested. And so I think I just learned very early on by happenstance how much I love to teach and educate and I only got to work with her for a year. And then I realized I really didn't need the assistance, but it sort of gave me that interest or very early on in my career of, of education. And then as I went on to my fellowship training, I realized that there was this whole field called simulation, which I hadn't heard about as a resident. And one of my mentors in my fellowship, when I was thinking about doing what kind of project I would do, because I knew I loved education, I knew I did not want to be in the lab. Like most of us in fellowship were doing, I, I really wasn't a researcher type. And so not to say that I'm not a researcher type because simulation can be applied in research, but at like the bench research I guess is what I'm referring to. And so my mentor, uh, that I found, she was actually the only faculty member that I knew of at the institution that was doing simulation in pediatrics at the children's hospital. And we connected and she showed me the simulation center. And of course this was at the University of Pittsburgh. They had the Wiser Center already there, amazing place. And I just knew right away that this is the way I wanna teach. I also knew because I wasn't interested in being in the lab that I wanted to get my master's in medical education. And so I did that. And then tying into my project for my fellowship and my master's, uh, I was able to create a, my first simulation project. And no one else had been doing simulation in neonatology at that point. And it just sort of grew from there. I knew that was my passion.

Jerrod: 7:54

Well that's fantastic, especially with an environment, you know, you can kind of bud and flourish with Wiser Center. That's quite a opportunity.

Dr. Arnold: 8:03

It really was. I'm definitely very fortunate.<laugh>.

Deb: 8:06

Well, I think though, just being in this space with you right now, you have the teacher voice, you have that kind voice that is opens, opens up a learner to feel comfortable to ask you a question. Just your, your facial expression, your non-verbals. And this is just through a zoom. So I think you have been given the gift.

Dr. Arnold: 8:28

<laugh>. Thank you. Thank you. That means a lot,

Deb: 8:31

<laugh>. You're very welcome. I'm gonna ask her next question and it is, do you have a favorite or most impactful simulation story?

Dr. Arnold: 8:43

Yes, it's almost hard to choose. Cause you know, I've been eat, sleep, breathing, uh, simulation for so much of my life. I feel like there's been various really impactful experiences. But I would say say probably the one that means the most have been those that I've delivered for our patients and families. And we actually had a, well, I should probably give a positive example. I would say I had a not so positive example that taught me as a simulationist just how important this work is and helped to guide me in how we frame simulation for patients and families. And then I've had others and one specifically where it was a very good outcome. So, you know, as a neonatologist, I'll just sort of give a little background. One of the things that I realized as a junior attending is that it was really scary to send home our babies with significant medical complexity and particularly those who had tracheostomies and ventilators. And I know many of us in the healthcare simulation field are familiar now today with this type of training. But back in 2012 when I first started thinking about this, I don't think, I think maybe one other institution at least that I knew of, had done any work with simulation directed at and for patients and families. And so I, you know, as I, I thought about the fact that I spent half of my life doing simulation, the other half of neonatology I got together with one of our fellows and one of our nurses who are very involved in patient education. And we said, why don't we develop a program for patients and families, specifically tracheostomy and ventilatory supported children. And so as we di did this, we basically, we started off with the needs assessment, like you do all of your education. And we met with different families who had already gone home from the NICU with children that had had tracheostomy support or ventilator support. And what we found in talking to them, we would try to identify what were some of the things that you felt unprepared for or what were some of the challenges that you had after you went home? Did you have any emergencies? And then we chatted with our tracheostomy nursing team and our clinicians and reviewed the literature and sort of put together a curriculum that what we felt where the gap was in education for these patients was related to emergencies and emergency care. And we actually didn't know how many babies we were sending home had emergencies at that time, but we assumed it was, you know, a, a risk, right? A life-threatening risk. And so based on the information that we had gathered, and so we created this four hour training program, we piloted it and I will start off with maybe the not so good. We had one infant out of the pilot study that actually died at home due to one of the emergencies that we trained that family in. And I thought, well that's a failure, right? Of what we just created. Well, I chatted with the mom after she came back, the baby actually came back into the hospital on life support. And then we had unfortunately suffered such a hypoxic injury that had to be redirected for care. And then chatting with the mom, she had said she felt like she knew what to do. We had trained her and that in that emergency, the child had actually had a blocked tracheostomy tube, which is one of the scenarios that we had created. And she said, I knew what to do, but she said my home health nurse that was next to me was very nervous to, to have me take out the tube and risk making the situation worse before 9 1 1 got there. And in the end she said she deferred to the nurse cuz she felt like she probably knew better than she did. Well in the end, mom was right, it was a block tube and had they replaced the tube, the baby probably, hopefully would've survived. It was one of the most impactful situations I've ever had in healthcare simulation. And what it taught me is number one, wow, there's so many things we can train to and that's an opportunity where maybe we need to train home healthcare teams to be more experienced because many of them are not prepared for medically complex children. Maybe we need to train the parents on how to not be afraid to speak up and to realize that they are the experts in the care of their children. Lots of different objectives that we could do to try and make that better. But I also realized that simulation is such a powerful tool and we really can save lives through the training. And so I've now, this program ended up becoming essentially required part of discharge education because families started talking about it, everyone wanted it. And we also found that 80% of the babies we sent home in that pilot study had one of the life-threatening airway emergencies that we trained them in. And the rest of the babies survived because their parents were trained. And I've also, even when my last institution, I had a family who went through the training program, came back in, had a life-threatening emergency, mom and dad had to do C P R, they had to change the trach, they had to provide bag ation and they save their baby's life and their baby came in but went home fully. Okay. And so I guess, um, what I'm saying, that's why we do what we do, right, is to save lives and, but we have to remember that there's just so much work that we still have yet to do, I think. And that's what my first patient, uh, reminds me of. We have a lot of work to do

Jerrod: 14:00

That. That gave me chills, honestly. That was, wow. Couple questions for you though is one would were lessons learned and I would hope so, but how quickly and what were the steps taken to to kind of address it?

Dr. Arnold: 14:13

Yeah, you know, we did reach out to that home health company and we shared with them some of our recommendations that they do for their training. Um, and then the home health nurse from the clinical team, not from us, I think got feedback on what had exactly had happened with the child. Cuz obviously it wasn't necessarily clear at the time when they were in the moment. And so I, I don't think we ever engaged that home health company with more training. I do know that there has become more of a recognition in home healthcare for the need for training related to these emergencies. And in fact, some home healthcare systems have actually either reached out to simulation programs to request training and or have created their own training programs, you know, in their companies. So I think Bayada Health is one of the ones that comes to mind that has done really remarkable work in embracing simulation to train their staff, but also patients and families.

Jerrod: 15:08

Yeah, and I mean, it's extremely impactful story, but with a five week old you would default, especially if it's your first child, you're, you're gonna default to the healthcare professional regardless. You don't know the difference or most probably don't know the difference between an LPN, LPN or a nurse anesthetist. Like they, there's a nurse is a nurse and hey, they know best. So Yeah.

Dr. Arnold: 15:32

Yeah. I d unno what the right answer is other than just like in healthcare, right? A lot of times errors happen because maybe one person thinks they might know what's going on and they actually hold the answer, but maybe they self-doubt, maybe they're afraid to speak up. I think that happens in our healthcare systems as well. It's that sort of that communication piece that's so important.

Jerrod: 15:53

And what year were you, did you create these different scenarios for, for this type of simulation?

Dr. Arnold: 15:59

Uh, we started developing the program in 2012, and then I think we implemented it in 2013 and 2014 as a pilot project. And then now it continues on to this day. And then as I've moved on to other institutions, we've, you know, recreated a program at, at All Children's and Johns Hopkins. And then we also have, uh, already have a program when I came here to Boston Children's. So it's great to see that.

Deb: 16:23

Dr. Arnold, I'm, I'm sure that some of our listeners, if they're not doing something like this at their organization and they wanted to start, I I'm positive that you guys want to share this, disseminate it throughout the world, what would you suggest that they do?

Dr. Arnold: 16:39

Yeah, no, thank you for asking. That's a really good question. Well, I mean, obviously one thing is for sure feel free to reach out to an institution like ours or others that are doing this work because I think in the field of simulation, we're really wanting to share and collaborate, share lessons learned how-tos, but on a more formal level, yes. It's actually interesting that you asked this question because I'm currently teaming up with Carol Rosenberg, who is a nurse at Johns Hopkins, the school of nursing. And she and I have been dear friends and collaborators in this space, and she, amongst other colleagues now have created, uh, she's created a company called Ready Sim Go. And it's just starting off, but hopefully come this fall Ready Sim Go will actually will be offering a training program to help other clinicians who want to develop programs or even just simulations effective simulation training courses for patients and families. We have individuals from all over the country that are doing this work, coming together as part of this effort. And so through Ready Sim Go, you'll be able to sign up and learn how to do this from those that are already doing it.

Deb: 17:47

Excellent. Excellent.

Dr. Arnold: 17:49

So thanks for letting me give a shout out to Ready Sim Go

Jerrod: 17:52

<laugh> and, and definitely no reason to recreate the wheel when it's been, I mean, you, you yourself just was at three different programs, so when you, we came into Boston Children's, of course they had one, but it's, uh, it's good to share that knowledge and disseminate it.

Deb: 18:05

No, I mean, I think about just, you know, my daughter is stated, came home with a normal healthy baby and just the, you know, the same anxiety, fear of, of, you know, am I holding it right? Is that okay?<laugh> And to have a, a medically compromised child that you're trying to, I I'm sure it's gotta be out of your mind anxiety, and this probably really does help the parents, but as you stated, you need to give them the confidence to be able to explain to the caregiver, you know, maybe if they have someone helping that Yeah. That they, they do know how to manage these things.

Dr. Arnold: 18:40

And, you know, I think if it's helpful not to, you know, go on too much about this, but it, it can be used for, like you said earlier, all different medical situations. And in 2013, I was, well, we had already been sort of developing this program, but in 2013, I myself was diagnosed with cancer and stage three choreo carcinoma. So I had a PICC line placed for my chemotherapy before I got a port. And I remember, so as a neonatologist, I actually put PICC lines in babies, right? I do that. We have lots of patients with PICC lines, but the first time, and even though the nurse before I let the hospital show me how to flush and care for my PICC line, I was petrified the first time I had to do it to myself. And that's something that I'm a healthcare clinician who deals with PICC lines, but it is still so much more frightening and you're so much more nervous when it's your own loved one. When it's yourself. And, you know, imagine you're not a healthcare provider or clinician and it's your family, your loved one, it's yourself. And so I think, you know, just like we teach each other, like we learn in healthcare with simulation, we know it's the best way to learn why, why not do that for our patients and families?

Deb: 19:53

Yeah. Why don't you share with our listeners something, um, that when you learned it, it changed the way you practiced perhaps a personal aha moment?

Dr. Arnold: 20:04

Ah, let me think. Yes. Okay. I might need a minute for that one. There's been a lot<laugh>.

Jerrod: 20:10

Don't worry, I'm, I'm still digesting your last story, so we're, we're good. You can take a minute if you need a minute.

Dr. Arnold: 20:14

< laugh>. Thank you. I know I'm like p ersonal aha moment that made me change things. O kay. U m, I probably have a couple that are just all kind of small ones, but f rom a personal aha moment, something that I had to change, uh, particularly related to simulation and how I teach, one of the things that I initially, when I was getting involved in simulation is I really loved the use of actors, right? Whether you call them simulated patients or standardized patients. And when I first started using actors, I think the intentions were good. I really did not strategically have an objective focused around them. So it was sort of, okay, you know, we know in the delivery room I'm creating a neonatal scenario. We can have parents that are difficult and maybe they, you know, they, they don't speak English, they speak a foreign language and maybe there's this and that and, and all of these different complexities. And so you're trying to throw curve balls to your learners. You want them to experience what it's like in the real world, right? And what I realized is that that's probably an unnecessary resource and d istractor, unless that's the objective of what I wanted to accomplish. And so, and then it takes a very thoughtful and rigorous way to prepare that actor a nd their engagement with the learners in a scenario. So I would say in the beginning, I was sort of just throwing' em as an extra in l ike, y ou k now, n o pun intended, with like extra extra, r ight? Extra actors. I was throwing them in as an extra in my simulations. And that's not a good utilization. I think what I've come to realize is that actors are powerful and incredibly necessary for training, but they have to be part of the learning objective and it needs to be strategic.

Deb: 21:58

Absolutely. Absolutely. That's, I could not agree more because they can be so distracting that it'll take the learner down, not the path that you're the intention for them to get, but you're once again, right? You know, there are times that, that they should be trained in. How do you handle this? Like, you know, crisis prevention, right?

Dr. Arnold: 22:19

Yep. Yeah.

Jerrod: 22:21

And, and so also I think of now probably pre pandemic, but these healthcare conferences, specifically I M S H or someone with an axle is the kind of the highlight of some of those conferences were always the actors and how they portrayed when they came out on stage. And that was always kind of the water cooler talk afterwards in the hallways of like, oh yeah, did you see that that was so funny? Or this did this. And, and so it always adds so much excitement to the situation of what the learning objectives were or, or what the, the conference was about.

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Deb: 23:19

Now you have, you've had challenges because the world is not made for people that are different. Do you wanna share with our listeners a little bit about what that journey's been like?

Dr. Arnold: 23:36

Yeah, no, I think it's definitely my, my trajectory has had obstacles along the way. I definitely feel extraordinarily fortunate to have been able to, you know, find a career that I love, utilize my abilities to the best of my ability like anyone else. But I think what many folks may not know is that when I was applying to medical school, I didn't know if I would actually be successful getting into medical school because of my disability. And so it's kind of funny, I was just in a, in a workshop earlier today about it, learners with disabilities in healthcare, education, nursing physicians, other allied health professions. And I think back to how much of a struggle it was when I was applying back in 1998, and it sounds like it's, we've made progress, but we have a long way to go. And so, you know, when I was applying to medical school, I submitted my application to 40 schools, which was not unusual. I guess my, most of my peers and that were pre-med were doing the same. But then I got a, a lot of secondary applications, which is sort of that next step. And then when it came to the secondary application process, what you do is you essentially put a, a personal statement out there, say why, why do you wanna go into medicine? And for me, it was really because I had been a patient so much in my life, had 30 orthopedic surgeries, I was a person of short stature with skeletal dysplasia, and I really wanted to give back to kids in a way that I had benefited. I felt like this was, and I love science, I love biology. So it just sort of seemed like a match made in heaven. I didn't like the lab<laugh> as you guys, uh, I already shared with you. So I, I wasn't really interested in becoming a researcher. I wanted to to care for others. And so when I applied and I, I put in the essay when it came time, the next round is getting interviews and my, my friends who were pre-medical were getting interviews after interviews, and I was getting rejection letter after rejection letter to the point where I didn't think, uh, I mean, I really was seriously contemplating what am I going to do with my life? Because I had put a lot of my eggs in that basket and still knowing that it was a risk, but I knew if I didn't put my all into it, it wouldn't happen. So long story short, I actually, if you wanna know the whole story, I, I got two interviews into medical school, but in a strange way. So my first interview actually I think came from the input of a colleague. So again, going into medical school, you have to do a lot of things to beef up your resume. And so I was involved in a lot of extracurricular activities. And so one of them was something called the President's 100, which is something you had to apply for, and only a hundred students in my university got in. And you're essentially a student ambassador for all the president's functions. So I got in to be at P 100, which is great. And again, standing out in the crowd as a little person, the president of the university knew me. And so whenever I was ambassador and he would say hi. And during this time where I was applying to medical school, Dr. Foot knew that I was applying and asked me how it was going. And at that time, I had been rejected from a good, you know, 60% of the schools I had applied to. But I said, you know, I'm hanging in there, haven't gotten in yet, but I'm remaining optimistic. Well, he said, you know, have you interviewed yet here at the University of Miami? So I had gotten to undergrad at the University of Miami, and I said, mm, what do I say then? Right? Because I had already been rejected. I did not want to lie, but for some reason I felt sort of guilty telling him that, ah, I didn't get in here, sorry. And so I, I was honest, of course, and I was like, well, Dr. Fo, and unfortunately I didn't get an opportunity to interview here. I said, but I'm still waiting to hear from some other schools, so I'm remaining optimistic. And he said, oh, well that's such a shame. And he said, well, you keep up the good work and see you next time. Well, two days later, I got a call from the University of Miami Office of Admissions at the School of Medicine offering me an interview. And I thought, I mean, I said them on the phone. I'm, I'm in my dorm room, right? This is before cell phones. I said, okay, are you sure you have the right Jennifer Arnold? Because I have a rejection letter that I'm looking at. And they said, no, no, no, we've reconsidered and we'd like to extend an invitation for you to interview. Well, at that point, I actually almost said no, because I, I just was really nervous about the fact that I probably didn't get on my own. And I, I figured Dr. Foot must have made a phone call. How else is this happening to this day? I actually never asked him and he never told me. But I am forever grateful to him for that cuz he saw, I think, something in me. But at the same time, I was nervous about going not on my own merit, but I also didn't have any other prospects,<laugh>. So I thought, well, can't hard to interview. Right? So I, um, graciously accepted the interview. Well, about two weeks later, I received one other invitation to interview, and that was at my dream school, Johns Hopkins School of Medicine. And so things were looking up, but out of all 40 schools, I only got two invitations to interview and you know, the story of one of them. And so I went to both interviews. The first one was at the University of Miami, and it was very much the good cop, bad cop. And in fact, I met with a trauma surgeon and an internal medicine physician. And they started off very normal questions and then got into sort of, do I drive a car and how would I expect to see patients? And then asked me how would I crack open the chest of a 50 year old MVA victim that comes in the ER? Well, of course that came from the trauma surgeon. And I said, well, no offense, I don't want to become a trauma surgeon. I could see that as being pretty difficult physically. I said, but I, oh, I, I watch er, which is what I did back then and looks like there's a lot of other physicians in the room doing different roles. And I said, I think with the step stool I could do different things. Well, in the end I felt like I spent the hour defending my, my decision to go into medicine and I didn't think I was gonna get in. I went on to the next interview and that time I didn't tell anyone. I was going like no one. I went up and I met one-on-one with a pediatrician and he never once asked me about my stature, my capabilities, to where I thought, oh gosh, this is going wrong. Not well in a different way. And so I brought it up and I was like, so, you know, I'd use a step so we'll see patients and blah, blah, blah. You know, I had this all planned by this interview. And he said, well, it's like that, that makes sense. He said, if you come here, just let us know what we can do to help, uh, help you be successful. And I was like, thank you. So, you know, to be quite honest, after those two interviews, I didn't think I was gonna get in either place cuz I thought, well, one clearly was pretty upfront about their concerns and the other one might have just been afraid to ask. And so I, I felt like it, it wasn't gonna go well. But I can tell you that in the end, I actually got two invitations to join the class of 2000 from both the University of Miami and Johns Hopkins. So I, it was a pretty close call whether or not I was going to be able to become a physician and, and overcome that barrier. Of course there were obstacles along the way in my training, but just like everything else, you, you just do it a different way. You adapt, you make it work. And I hope at least that myself having a, a physical disability brings something unique to the table for my patients

Jerrod: 30:49

And the amount of inspiration for so many others.

Dr. Arnold: 30:52

Thank you.

Deb: 30:53

Yeah, you you got me. Uh, my eyes were sweating

Dr. Arnold: 30:56

<laugh>. I know it's hard to tell that story without all the details cuz it was, it was, it was quite a time.

Jerrod: 31:06

<laugh>, I appreciate you sharing it. Thank you.

Dr. Arnold: 31:08

Yeah,

Deb: 31:08

Yeah. Thank you. Thank you. Now we're gonna ask a question. Do you belong to a program that has been accredited by the Society for Simulation and Healthcare? And were you involved during the time that they went through the process? And how do you feel that this has benefited your organization?

Dr. Arnold: 31:28

Yeah, great question. So I am a part of a center here at Immersive Design Systems that is accredited by the Society of Free Simulation Healthcare. And we're super proud of that. Unfortunately, I was not here though when they did that. They did that before I got here. Lucky me. And so we're actually about to be up for renewal though. So<laugh> I will be going through that process with them. What are the benefits though? Clearly I can see the benefits from the perspective of, number one, it helps us with legitimacy in our own organization. So I think when you start to have to, like, one of my major roles now is to advocate for resources and for funding like many of us, I think in this field. And so when you sort of can speak to these are requirements for certification, we need to be able to have this infrastructure, this level of staffing or support, it makes a huge difference. And most, I I think healthcare leaders understand accreditation and what that means and the importance of it. So I think that's really the number one way that I see the value of being an accredited center is to be able to really help us with legitimacy internally. Now there's also the benefits externally, right? From just a collaboration and sort of garnering others to be interested in learning from us or for us to help them with their simulation needs because they see us as meeting standards of excellence, which is so important, uh, especially in a field like ours where we haven't been around for a hundred years, like maybe general surgery or something like that. So I think the accreditation process just, it allows us to make sure we are holding ourselves to great standards and doing great work, but it also helps us to be recognized for that internally and externally.

Deb: 33:21

Thank you. Thank you. We have one more question and are there any final words that you would like to leave our listeners with to remember this interview?

Dr. Arnold: 33:32

You know, I hope that not only those of us in the field of simulation, but those of us who are involved in healthcare or not involved in healthcare, just individuals who care about the wellbeing of each other and others, I want everyone to be aware of the power of what simulation does. Simulation is not an extra, and my goal is that it becomes embedded into the very framework of everything we do in healthcare, in healthcare delivery. And I think what's important is to spread that word for people to understand that simulation does save lives. It makes healthcare safer, it makes healthcare more efficient and effective. And I think all of us, not only those of us in this field, not only those of us in healthcare, but our general public, I think it's time to raise awareness so that we're all demanding for simulation to be part of our healthcare institutions so that we can really deliver the best care possible.

Deb: 34:32

Now we really wanna thank you for, uh, for joining us and with that, is there anything else you wanna ask us?

Dr. Arnold: 34:40

Oh my goodness. Just, I wanna just commend you for doing this podcast, getting it out there. Your listener's listenership is really quite remarkably huge, which I think is fabulous. So I just wanna thank you for getting it out there about how important healthcare simulation is and how human it is and how learning from each other is, is so valuable. So thank you.

Deb: 35:03

Thank you.

Jerrod: 35:04

And it all comes from community members like you, Dr. Arnold. So it, it starts with Deb and I are nothing without those that come on and, and are able to help share their voice and their path and their challenges and their highs and lows. So it it starts with you. Yeah.

Deb: 35:18

Yeah.

Dr. Arnold: 35:19

Oh, Thank You.

Deb: 35:19

Thank you. And happy simulating.

Interact Solution Tag: 35:23

We'd like to thank Interact solution for sponsoring this week's episode of The Sim Cafe.

Outro: 35:50

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.