Join Dr. Beth Mancini as she shares her history in simulation. Including her expereince with the Delta flight 191 crash in 1985. Dr. Mancini is a luminary in simulation and she generously shares her stories with Deb and Jerrod.

MARY ELIZABETH MANCINI, RN, PhD, NE-BC, FAHA, ANEF, FSSH, FAAN

BIOGRAPHICAL SKETCH

Dr. Beth Mancini is Professor Emeritus at the University of Texas at Arlington's College of Nursing and Health Innovation. Before retiring in 2019, Dr. Mancini served as the Senior Associate Dean for Education Innovation and held the Baylor Health Care System Professorship for Healthcare Research. From 2004 to 2017, she also served as Chair for the Undergraduate Nursing Programs.

Prior to moving to an academic role in 2004, Dr. Mancini served as Senior Vice President for Nursing Administration and Chief Nursing Officer at Parkland Health & Hospital System in Dallas, Texas, a position she held for 18 years. She is certified by the American Nurses Credentialing Center as a nurse executive.

Dr. Mancini received an Associate Degree in Nursing from the Community College of Rhode Island, a Bachelor of Science in Nursing from Rhode Island College, a Master of Science in Nursing Administration from The University of Rhode Island and a PhD in Public and Urban Affairs from The University of Texas at Arlington. She completed a Johnson & Johnson Wharton Nurse Executive Fellowship at the Wharton School of Business of the University of Pennsylvania and a National Association of Public Hospitals Management Fellowship program through the Robert F. Wagner Graduate School of Public Service at New York University.

Dr. Mancini is internationally recognized for her groundbreaking work in high quality, high volume, accelerated online education (distance education). Her work in this area resulted in UTA's College of Nursing becoming the country's largest college of nursing in a public university and led to the College of Nursing receiving the Texas Higher Education Coordinating Board's prestigious Star Award in 2012.

In recognition for her many contributions to the fields, Dr. Mancini was inducted as a Fellow in the American Academy of Nursing, a Fellow in the National League for Nursing's Academy of Nurse Educators, a Fellow of the American Heart Association, and as a Fellow of the Society for Simulation in Healthcare. In 2013, Dr. Mancini was recognized with a Regent's Outstanding Teaching Award from the University of Texas System and was appointed a Visiting Scholar in Innovation and Simulation at The University of Pennsylvania School of Nursing. In 2014, she was reappointed as a Visiting Scholar in Simulation and Curriculum.

Dr. Mancini is an active volunteer with numerous professional organizations. She has served as Vice Chair of the Basic Life Support Task Force for the International Liaison Committee on Resuscitation and Chair of AHA’s Education Science and Programs committee. She currently serves as a member of the National Academies of Science Global Task Force on Innovations in Health Professions Education, and member of AHA’s Get with The Guidelines - Resuscitation's Clinical Work Group, and Science and Clinical Education and Lifelong Learning committee. She has served as President of the international Society for Simulation in Healthcare as well as a member of the Royal College of Physicians and Surgeons of Canada's Simulation Task Force and the World Health Organization's Initiative on Training, Simulation and Patient Safety.

Dr. Mancini's research interests include innovations in education, interprofessional collaborative practice, and the development of high performing healthcare teams through the use of simulation. She has received over $6.5 million in competitive grants, has more than 100 publications to her credit, and is a sought-after speaker at local, national and international

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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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Intro: 0:46

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: 1:26

Welcome to another episode of The Sim Cafe. Today I'm here Deb Tauber, with my co-host Jerrod Jeffries, and we are truly blessed to have Dr. Beth Mancini join us. Dr. Mancini, would you like me to call you Dr. Mancini or Beth?

Beth: 1:41

Please call me Beth,

Deb: 1:43

I'm just gonna read a few things about you. Dr. Mancini is Professor Emeritus at the University of Texas at Arlington College of Nursing in Health Innovation. Before retiring in 2019, Dr. Mancini served as the senior Associate Dean for education innovation and held the Baylor Healthcare System Professorship for Healthcare Research. From 2004 to 2017, she also served as chair for the undergraduate nursing programs. She has done so much more and you can read about it in the show notes cuz I'll have all this information in there. Meanwhile, why don't you tell us a little bit about yourself, Beth, and how you got into simulation.

Beth: 2:24

Well, thank you Deb and Jerrod for inviting me to talk with you this morning. I've been involved in simulation actually now for 40 years. And my introduction into simulation was early on as a registered nurse, I became involved with a research group who was looking at how to best educate healthcare professionals in resuscitation. So this was work involving the American Heart Association and uh, my colleague, Dr. William Kay and I got actively involved and it just seemed clear to us that instead of simply doing, uh, stations in advanced cardiac life support where we did individual tasks and skills, how could we put that all together? And this notion we started to develop and work upon the notion of a summative experience for those people going through the ACLS course. And so we started with mega code and back then all you had was the recess and, and some IV equipment that we would take to the bed actually. And we would put people through that experience trying to make it more realistic, uh, higher fidelity. And, uh, we didn't have the equipment back then, but the learners just loved it. And so, uh, now when students go through health professions education, they embrace simulation because they grew up with it. But back then, 40 years ago it was novel and then working with a number of the manufacturers to really get things going and trying to figure out how to implement this not just in advanced life support courses, but in everything we do to make it the pedagogy simulation as pedagogy for health professions education. And I like to say, because I've been a nurse for 50 years, that beck, even 50 years ago we did simulation because what did we do? We learned how to, I learned how to give an injection by putting it into an orange. I learned how to put a patient on and off a bed pan by sitting on one and putting my colleagues, my, uh, fellow students on and off a bed pan<laugh>. So we used to do simulation even back then, but it has come so far. So that was the start of my journey. And um, I've stayed involved in simulation since then, 75 as a new graduate, as a nursing student. And through the eighties up until now with American Heart Association and since, uh, 2007 with the Society for Simulation and Healthcare, I've been involved with them in all sorts of different activities, including being a past president in, what was it now? 2012 was my presidency year. So I was involved in establishing the accreditation council certification and technology standards working groups. And I've been doing a lot of that work ever since. I still participate on accreditation site reviews because it is so exciting to go and see what other people are doing as they proudly show off how they ensure they're using best practices. And that's what it's all about, right? Making sure that the people who are using simulation are doing it according to the evidence that we have the best practices as they've been articulated. And making sure that at the end of the day, the health professional is able to give the best possible care to patients, families, and communities.

Deb: 6:13

Thank you. And I have had the honor of being with you on two accreditation site visits, one in person and the other one was a virtual. So I can speak to the quality that you bring to the review team, to the society, to the accreditation process. It's almost like ww what would Beth do, right,<laugh>, because I mean, you have a lot of experience in the way that you have the ability to look at a situation and analyze what people are potentially trying to articulate during a slight visit brings another dimension to the, to the visit. And I thank you for that.

Beth: 6:53

Well, it certainly is my passion. I have a long history and a personal history in working in situations where the benefit of simulation could have changed outcomes and have changed outcomes. And so my passion remains strong for helping people make this the very best experience they can make it for themselves as learners and for organizations.

Deb: 7:21

Do you wanna share a story about that? Do you have any special stories that you'd like to share with our listeners?

Beth: 7:27

I think there's, you know, we talk about one of the best benefits of simulation is having people ever ready, even for low frequency, high risk events. And that may be resuscitation, which is also one of my passions, basic and advanced life support. But I spent a number of years in the emergency department, um, at Parkland Hospital in Dallas, Texas and was director of emergency services there. And one thing we always talk about are mass casualty events, but they don't happen often. And yet, uh, we and others in the emergency medical system practice for it. And back in 1986, we had a crash of a Delta plane at DFW Airport. That was an incredible, uh, tragic event. But for the ER that night we were able to respond to it because we had practiced for it and simulation. And whether we're talking about a tabletop simulation for a disaster, we're talking screen-based simulations, whether we're talking about whole departmental simulations where we bring in standardized participants and have them play the role of patients and families and caregivers. However, you may do it when push comes to shove and you are there literally in the moment trying to make a decision that simulation allows you to go. I have been here before I can remember what it was<laugh> we had to do. I remember where I went to go to get that policy manual and to remember the codes to use to send out the onsite team to help at the, uh, crash site and to prepare the emergency department to what we hoped would be many survivors. Unfortunately, there were very few, and that was a whole other situation that had to be managed. And that is the debriefing of the caregivers, not just the caregivers who went to the site and saw things that they never thought they would have to deal with. But for those of us who were in the emergency department, the entire hospital staff who was prepared and ready and nobody came while very few came, about 27 people came, but over a hundred people were killed on site. And so that recognition of what, again, the importance of simulation to help prepare us to be the best we can be in high risk, low volume situations. I can say personally, I have experienced the benefit of that. And I more than ever after that event was committed to ensuring that our departments at Parkland later when I was at the nursing school, that we always embraced simulation so that we can give patients the best possible opportunity for survival in returning to help. Sometimes we can't return them to help, but we can give them the best chance they can have.

Deb: 10:39

Thank you. That had to be incredibly challenging to be in that situation when you're just kind of sitting there holding your breath, waiting for people. And then few came through,

Beth: 10:50

It was a quieter Friday night than we usually had actually in total number of patients in the emergency department. So, uh, yes, it was quite an event. And all I can say is it was remarkable in the moment and in hindsight to think about the job that ems uh, police, fire rescue, the entire health system response and the community response people lined up to give blood was remarkable. And it warms your heart to know that we were prepared, we gave it everything we had and that there are good people in this world.

Jerrod: 11:28

Beth, I also feel like, you know, the US Army has these different stories about we want you in the army or you need join the Navy or Air Force, et cetera. I feel like this is the story that should be like, you should be a nurse, you should be a simulationist. Why this is important. I can see the poster already for it,<laugh>, that's, that's one of the more incredible stories I've heard. And and to witness it firsthand and the power and the impact behind it, I think is so powerful.

Beth: 11:53

I was thankful for all of the training and experience and confidence that simulation had provided all of us in that evening. It wasn't, it was not something I would ever want to do again, but it is something that I felt the team could do because we were prepared for simulation. So if I had ever had any doubts and I didn't, it, it proved to all of us that simulation makes a difference.

Jerrod: 12:19

And was this when you kind of solidified, or were you already there with healthcare simulation being that's what you wanted to do? Or did this kind of make it that aha moment of saying, Hey, this is, this is so powerful, this is where I'm going.

Beth: 12:33

I, I think it was a reinforcement as opposed to initial aha because I had been doing it since the eighties and I had seen the difference in learners particularly, you know, you would get medical students or first year residents and you'd run them through resuscitation, advanced cardiac life support courses, and then you would see them as second year residents, third year residents, uh, they'd go on to become faculty and attendings and you would see how they would grow. And even they would tell you that the simulation experiences they had and the feedback, the incredible power of debriefing and helping them to become lifelong learners, introspective and able to do better next time than they did this time. I had seen that through my career and I continue to see it. So I am, you know, a a strong believer in this and it's why I always take every opportunity I have to sing the praises of this as a methodology, not just an event. You know, we get to go to simulation once during our capstone year or whatever. No, it's the way to learn it is the way to create a competency in being a self-directed lifelong learner. Simulation helps you to become that and develop that competency. And as an educator, I have seen that as a person. I have seen that. And I've also seen some personal benefits because the better I got at debriefing, the better I was with my children because what could you tell me what you were thinking when you did whatever it was we needed to discuss<laugh>. And it's, it's just a remarkable series of strategies that have come together in what we call health professions education, and has been studied as the benefits of simulation within health professions education, but is not in any way, I think, limited to that, but it's what it's grown up to be and where it's just, I think, remarkably helpful in all sorts of situations.

Deb: 14:39

Thank You. Do you have any other favorite stories or impactful simulation stories that you wanted to share with our listeners today?

Jerrod: 14:46

It's gonna be hard to top that one. I'll put it that way.<laugh>.

Beth: 14:50

I, I thought about that question actually, and it's really hard because every time, and, and I'm not being overly aggrandizing here, every time I participate in simulations, it's a moment. Somebody has an aha moment, I learn something, they learned something, the team learned something. And so I, I can't pick one amongst all of them. That's a good story, you know? But it's hard because when you look in the face of a learner and they go, oh, oh yeah, right, no, I didn't see that. I see what you mean. Let me try that again. That's impactful. That's impactful. And we see it with brand new students, medical students or nursing students or pharmacy students. The first time they do something when they're so afraid to touch a Foley catheter or an intravenous line and they actually have to hold it in their hand. And now in a simulation, they get to see how to do it the first time that they work in an interprofessional simulation where maybe they're getting ready to graduate as a nurse or they are in a postgraduate course as a social worker. And we might have a resident in as part of a team working on an issue, maybe patient safety issue. And they're learning about with and from each other. W h o definition, I believe both interprofessional education, learning about with and from each other. And I can assure you that 99% of the time somebody in that group will say, I never knew that's what you do. I never knew that's what you were thinking or why you asked me this question. And that's the power of simulation.

Deb: 16:37

Thank you. Now, you were a part of the, what I consider the, the simulation Bible defining excellence. Why don't you share with us how that started? You're sitting around and we decide we're going to<laugh>

Beth: 16:53

Put this thing together.

Deb: 16:55

Yeah.

Beth: 16:55

Yes. So the editors, uh, in addition, one in addition to it really was sitting around<laugh> talking about how is it that we can disseminate this information? When you are active within a professional organization such as s ssh, you hear wonderful stories. You hear what so many people are doing from around the globe. And we had that benefit, Janice Gannis and myself. And we thought about, wow, what could we contribute to the Society of Simulation Healthcare? And what could the Society for Simulation Healthcare contribute to the global community of Simulationist? If we put this all down and made it easy to do, if you didn't have to know all these people, we could know them. And that's how all of the authors, there were a lot of authors in these books, lots of chapters of, of important, of areas of interest and importance. But we wanted to make it very practical, give people the tips and the outlines and the evidence for how to use the best practices in simulation in whatever they were doing. And so we said, you think anybody would wanna publish a book like that?<laugh>? So it's interesting. And so would you know, who do I know? And we called up people we knew, and suddenly we had a book proposal. And the society was very interested in doing that. And we felt that important that it be, that while we would do the work of editing, it needed to be a product of the society because it was our belief that the society represented a global community more so than individuals. And so we decided that that's how we would get it started. And so I wouldn't say editing a book with that many chapter authors is an easiest thing to do, but it was a very satisfying thing to do. And it was so, so successful that we did a second edition and we added people as editors, one of them being Chad and Chad aps, who was at the time president of the Society. And so we had a very positive experience of working with Chad before his death. And he kind of became a vision for us that his commitment to best practices, his commitment to excellence in simulation would reinvigorate us to, to make sure that the second edition came out. Uh, we had wonderful people who stepped in to fill that void. But it is a, I think an opportunity for people to look and, and use that as a resource with a, a global perspective, uh, uh, international context for best practices in simulation and how they indeed make a difference.

Deb: 19:47

Thank you. Can you share with us where you see the future of simulation going?

Beth: 19:52

I'm not sure we can even envision it. Can we? You know, when you think about it from the, the perspective of technology, every time I walk through the exhibit hall at the international meeting for the simulation healthcare, every year, I think I can't get better than this<laugh>, you know, wow. How does somebody think about this? How did they put this together? It's remarkable, but I think it's more than more than technology. So yes, uh, augmented reality, virtual reality, remote simulation, all those things that were came out as necessary during covid. How could we do things differently than we'd done before? Screen-based simulation? So many things that are coming out technology-wise, but I think what's most important to me when I look to the future is the pedagogy of simulation, which is where I started simulation. I think with its emphasis on debriefing, self-directed learning, reflection, the ability to look for latent errors. I remember, I think the first place I had ever heard about an organization looking at using a simulation experience before they opened a new hospital was with Betsy at Johns Hopkins. And they were opening a new ER or whatever, and they had used it for that. So suddenly the technologies, methodologies of simulation have become an entire way of working. And so that's what I think is happening is that we are actually embracing simulation as pedagogy, as a way of learning, as a way of teaching, as a way of reinforcing and insurance ensuring competency. And it's growing into everything we do, not just in a sim center on the day you go there, it's becoming now, and I believe more into the future. It's becoming how we think as healthcare providers and as educators of the healthcare providers, organizations that employ healthcare providers are now embracing simulation for all it has to offer. So I think the future is bright so much that we can do because the new technology is going to be wisdom bang, exciting. But more than that, I think it's really going to make us live, our commitment to being self-directed, lifelong learners, constantly aware of our surroundings, looking for potential errors, latent errors, solving those before they harm patients. And when something untoward does happen, being able to look back on it in a way of safety and compassion and finding how we can do it different going forward. How important can that be? What we do is important work,

Jerrod: 22:49

Certainly. And, and I think, uh, as you were mentioned, you were doing simulation or form simulation 30 plus years ago, and now the millennials or Gen Z or whomever's, what they're doing, simulation, it's completely a different definition. And I think it just becomes more and more broad and which is great that it's not pigeonholed the one thing, but you're getting more of this larger scope of what simulation can constitute as, and thus more people are becoming more impacted in a, in a healthy way.

Beth: 23:16

Indeed. And if we teach people entering the health profession how to learn by using simulations so they become able to be debriefed, but also to debrief others so that they do it in their day-to-day practice when they've had a cardiac arrest, they debrief when they've had a tough day, they debrief when they've had a good day, they do a huddle. All these things that we're teaching them, this has to become part of the work we do every day. And that's how we'll maximize patient outcomes. We'll ensure efficiency and effectiveness in healthcare by trying to be better every day than we were yesterday.

Deb: 24:01

Thank you. Thank you. And I, I am very much agree. Now, what were some lessons that you learned during the pandemic and have your goals altered from the pandemic from 1, 3, 5 years?

Beth: 24:14

I think what the pandemic challenged us to do was suddenly we of course assumed we had to be face-to-face. It was just natural that of course, if you were going to learn, if you were going to be part of a team, wouldn't you have to be with your team in order to learn, in order to practice, in order to debrief? Didn't you all have to be face-to-face? And I don't in any way wanna say that isn't optimal. I believe it's, I think that there is something that happens when you're physically with people that doesn't quite happen when you are on screen, uh, or in what's now being studied under the notion of remote simulation where you might have a, um, a video that's on a mobile robot and can actually follow people in a room. Or I can watch you, I can be here in Italy and I can watch you in wherever you may be and actually participate simulations with you or debrief you. There's lots we can do on screens, but I, I do think face-to-face has unique benefits. That said, suddenly in a day we were told, shut it down, figure out some other way to do it. And people did. And those people who were doing more screen-based simulations, who were doing more remote simulations, who were doing certain programs where maybe schools were getting together for i p e doing case studies in different states or different portions of states, they suddenly took the lessons they'd learned and applied them for continuing people to get education. So in our school of nursing, we have been doing a lot of remote and distance simulation because we have students in over 50 clinical sites around our state of Texas, a big state. And so our students may be 300 miles away from us, and yet our faculty in interact and engage with them in learning experiences through simulation. So how could we apply that to everything we were doing? And what I walked away with, you know, now three years later, is the notion that the concepts of simulation are not limited to face-to-face. They can be done in all sorts of ways. And the creativity of our faculty who put standard standardized participants representing psychiatric patients, and the interviews were online faculty were watching, and the student and the standardized participant actually did telehealth visits to make sure that you, it was in some ways better than what we were able to do in the sim center because there was more time for it. Lots of different lessons learned, but I would carry away, it can be done. And simulation is an enabler, not a limiting factor. It is an enabler. The challenge of it, of course, is that we sometimes need to take the time to think it through. I think a lot of people just decided that what they had to do something, so they didn't necessarily know the literature of what the best thing was to do. And I hope that through de dissemination efforts such as what you're doing here, Deb and Jared, are things that people will get a better handle. That there are other people who have had experience that they could learn from and that they can share with. So coming together as a group, that is another lesson of the pandemic, is reaching out to people and saying, help. What are you doing<laugh>? And how could we, ooh, I can build on that. I've done this, you've done that. What if we both do this other thing? I think that's important for people to, to notice too. Simulation can be something that brings us together, makes us all better, and helps us move forward, whatever the challenge may be.

Deb: 28:23

Thank you. I agree. I think if our listeners are not aware, Beth is in Rome, Jared is in Mexico, and I am in Chicago<laugh>. So it makes it even interesting once again globally, what can we learn from each other? And it doesn't have to be that we're in the same room cause we're not even in the same country.<laugh>, I'm gonna go on to my next question, which is can you, and you've had so much experience, can you share with our listeners the biggest thing you'd like them to learn? Something that changed the way you practice, perhaps a personal aha moment?

Beth: 28:59

Oh, again, hard question. What would I want them to know? What I'd want them to know is that what you do, whatever it is you do, it matters. And our job as educators and simulationist is to help make you the best you, you can be and to help you feel as confident as well as as to be as competent as you can be. And where does that come from? Unfortunately, when I was 16, um, my mother passed away in a hospital where, you know, we're talking 1970s, nurses weren't prepared to stand up when they had concerns about a patient. Errors happened and they weren't talked about. And she was, as we sometimes euphemistically say, was a victim of a medical misadventure and she left three teenage children behind. But today, simulation, if she had experienced this today, it wouldn't have happened because nurses now through simulation, through the focus on patient safety and human factors study, they know they've practiced what happens when you think there's something wrong with your patient, but you can't get a doctor to listen to you. And so my aha moment is I look back and think there was no need to lose my mother when I was 16 today. That won't happen. It shouldn't happen. I hope it doesn't happen. So simulation matters. Aha. I'm committed to making sure that every healthcare provider has the power of simulation experiences to make them the strongest, most confident person they can be. So they can protect the patients they take care of. And I've seen it happen as a chief nursing officer of a large health system, I saw nurses who through simulation, knew how to address difficult conversations with physicians, with family members, with patients, and good outcomes happened. So every time I would see one of those happen, I would think, thank God for simulation. They were ready. They were prepared, and they carried it forward. They knew what to say, they knew how to say it, they practiced it. They had their script. Yeah. Isn't that one of the nice things about simulation? You practiced till you have a mental script that you know what you're gonna say and how you're gonna react. And it is, it's saved many lives. We know this to be true.

Deb: 31:39

Thank you. Go ahead, jar. Do you wanna,

Jerrod: 31:41

You really captivatedme to be there and thank you for sharing that. It also reminds me of a, of a story where's it's, it's a old wives tale I'm sure, but it's an old man was walking on the beach, small boy approaching him there, some, some storm. And a boy walked and he paused every so often to throw something in the sea. Boy came closer and the old man was like, Hey, what what are you doing? And the the young replied, throwing starfish in the ocean, tide washed them up and they can't return sea by themselves. When the sun gets high, they'll die unless they go back to the water. And then the old man states, there's tens of thousands out here, I'm afraid you're not really gonna make much of a difference. And the boy bends down and picks up yet another starfish and threw it into the ocean and turns smiles at the old man and says he made a difference for that one.

Beth: 32:24

Exactly, exactly. And for healthcare providers, I think is a nurse. It was one of my guiding principles, uh, from a new graduate to an experienced critical care nurse, to an educator, I mean to administrator than on to being an educator and a researcher. It was all I could do was to be the best I could be today and make a difference for this one. And whoever the one was, it was the one patient I was taking care of or the one unit I was responsible for, or the one class of students I was taking care of. It's the developing of an ownership of what you can do. And we will not individually necessarily save the world, but we can make a difference for this one, be it a starfish or be it a patient or their family. I always said, you know, as a critical care nurse, people said, don't you, didn't you get burned out being a critical care nurse? And I said, I never got burned out because I always said, if I've done the done the very best I can do, and my team or the doctors that I was working with, respiratory therapists, pharmacists, social workers, everybody, if we did the very best we could do and the patient still died, that we didn't lose that patient. We gave them the best opportunity they could have. And I could take satisfaction in knowing that if I helped their family understand that, that we did everything we could do and I gave them all the support they needed, that it was a success even if the patient died. So it's been a personal professional characteristic for me to, to believe that we make a difference for this one. And if you do, I think part of the challenge we have today is many nurses and doctors don't have even a moment to build that resiliency, to be able to deal with incredible stressors they're facing with every day today through the pandemic. It, there have been challenges always in healthcare, but the pandemic and today's shortages and the focus on, um, financial situations, it's certainly is a, is a challenge I, I can't imagine having to deal with every day. But simulation even helps that doesn't it, because it can help us prepare for how we will deal with those situations, be they ethical, be they physical, be they, how you can reflect upon what happened today and how to make things better tomorrow.

Deb: 34:53

Thank you. Thank you. We're gonna pivot a little bit here, and you're an accreditor. Were you on the first accreditation site visit?

Beth: 34:59

No, actually I was not. Uh, but I was part of the group that helped develop the accreditation site, the whole accreditation process. Janice Gans was the coordinator for that project and she actually led that team and I was coordinating from, uh, the home base. But no, I've been involved since the beginning, uh, since actually the first discussions around this were, that I was involved in, started in 2007 at Hershey, Pennsylvania, where I was invited by a group of physicians that I knew through American Heart Association to participate in discussions about how, what SSH could do for accreditation. Because the belief is accreditation is an important thing. Why accreditation helps organizations organize their thinking about the best practices. So whether we're talking about structure, process, or outcomes, you need an organizing structure. And so pulling together the best practices and developing an accreditation program and a set of guidelines for accreditation and agreements from experts from around the world, that these things are the things that matter. Now, an organization can pick up those documents and say, okay, these are the things we need to attend to as an organization holding itself out. The Society for Simulation and Healthcare held itself out for being able to organize a structured accreditation process, bring reliability, validity, rigor to that process and support it, it is, it requires a fair number of, um, people and money to do the infrastructure for such an undertaking, but organizations, some just use it for that and never go on to get the recognition, the imada of being accredited. Um, but when I go on an incre, when an organization decides it's going to do that, of course it gets everything does a self-study and gets itself set up, uh, so that you can, we can easily see that they are achieving the standards and they love telling the story. They're proud of what they do. And that's why I continue to do it because it is reinvigorating to go on an accreditation site visit, whether it virtual or be in person and hear these different programs for a program as small as two FTEs to programs that have 20, 30, 40 people who have multiple sites to one little site in a community college to one almost closet in a hospital system. They're proud of what they do and because they're seeking accreditation, they've measured the impact of what they do and they're so excited to tell you about it. And it is impressive what organizing according to best practices, seeking accreditation, using that organizing structure can actually help them do. And when you go on an accrediting site to visit, you get the opportunity to speak to the admin, the senior administrators of the parent organization that houses the sim program. And so whether they be CEOs or their presidents of the medical school, doesn't matter, the dean of the nursing school, we speak with them and when they can tell you the story of what a simulation program and what their simulation educated educators, so qualified simulation educators have been able to accomplish, you're a believer. So accreditation is a remarkable thing in this area. And it's been going on now for eight years, I think, um, about that, uh, 10. And it is I think going to continue well into the future.

Deb: 38:49

Now, do you know how many sight visits you've been in? Have you kept track?

Beth: 38:53

I don't. The one I'm on is always the best, so, you know, I don't think about the ones I've been to. I think about the next one up,<laugh> and I still do probably six a year.

Deb: 39:05

Six a year? Mm-hmm.<affirmative>, good for you. Yeah, I think I usually do about three. Good for you. Maybe I have to two more.

Beth: 39:14

Now that I am in Preferment, I wouldn't call myself retired. I'm in preferment, which means I get to do what I prefer to do with whom I prefer to do it. When I prefer to do it. I have the time to do the things that really bring me joy and accreditation. Uh, working with the Society for Simulation Healthcare are things that I truly enjoy doing. Brings me joy.

Deb: 39:38

I agree. I agree. Our last question is, are there any final words that you'd like to leave our listeners with to remember this conversation by

Beth: 39:49

Let's simulation be a guiding principle in your life. And I mean that in your personal as well as your professional life. The ability to debrief and be debriefed. The ability to look honestly and authentically at what we can do better. To not be upset about what we've done. Perhaps not as well as we would've liked to in the past, but to try to stay focused to the future. And I think simulation has become an integral part of my life. And so, um, I I hope that they will take that away from our time together this morning.

Deb: 40:25

Thank you so much. We're, we're very grateful for your time. And with that, happy simulating.

Sim VS Tag: 40:36

Sim VS sponsored this week's podcast, Sim VS, The Swiss Army Knife of available simulation products for everything you need.

Outro: 40:51

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