In this episode Deb and Jerrod sit down with Kristyn Gadlage and Betsy Holzwarth from The Society for Simulation in Healthcare (SSH). They share their mission and passion for helping organizations become accredited.

Kristyn Gadlage the Director of Accreditation and Betsy Holzwarth part of the accreditation leadership team, sit down and share their perspectives regarding the process of becoming accredited as well as the available support from the society. They discuss the differences between provisional and full accreditation and the pursuit of excellence.  We talk about the quality of the accreditation process and the value of the prestige of the acknowledgment of receiving this esteemed designation.

This episode is sponsored by our friends at iRIS "With iRIS standardizing simulations has never been easier"....   https://irishealthsim.com 
iRIS Website: irishealthsim.com 
SSH Website:  SSIH .org

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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.

Iris health Solutions Limited Ad: 0:13

Thanks to Iris Health Solutions Limited for sponsoring this week's podcast. Iris is a scenario design platform, which makes it really easy to design, set up, and run great scenarios in line with recognized best practice. Iris makes co-design and sharing of scenarios simple and the library and review. Ensure one high quality version is always maintained. You can also join the Iris Fair Share community and access, reuse, or repurpose over 700 scenarios from colleagues around the world. With IP always recognized, the new Iris mini Sim Wizard allows quick and easy scenario creation for simpler sims, such as in In- situ Primary Care and Paramedic.

Intro: 1:00

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: 1:40

Welcome to another episode of The Sim Cafe. Today Jerrod and I are here with some really special guests. We have Kristyn, Lizzie Brown, and Betsy from SSH Accreditation from the leaders of the council. They're the support of accreditation. So we have some questions we're gonna ask them and they're not our typical questions, but, um, why don't we get started with you. You've been on the council leading this charge for the longest time. Why don't you tell us a little bit about history and your perspective of accreditation, because once again, you've been here a long time.

Kristyn: 2:15

Sure. As Deb, thank you Deb. And that was an introduction that, a humbling introduction, should I say that? But yes, my name's Kristyn Gadlage and I started with s SSH back in 2011. And as I think about my career within SSH, I feel so fortunate because I did begin within the accreditation department at the beginning, at the inception, our first accredit programs that we accredited were in 2010. And so I came on really at the cusp of that, where we were the council and the group involved. Ultimately, the purpose of it was we saw an opportunity within the healthcare field of simulation where we wanted to create some type of standardization among simulation programs. We wanted to give an infrastructure to build their program, grow their program that vetted and validated and offered a quality to the programs. Um, so that's how it started. I mean, I believe 2009 or 2010, we launched it in 2010. So my guess is it began really in 2009 where a group of people got together who had massive experience and are true experts within this field. And many of them continue to be on the accreditation council and and support accreditation or our board of reviews or as reviewers. But they got together with really the purpose of trying to standardize this field. And with that, they created and launched, um, the first set of accreditation standards, which in 2010, they focused on the area of core, which again is your infrastructure, it's your mission and vision with your program, it's your policies and procedures, it's your HR who is staffing your program, who has oversight of your program, it's ethics and certainly it's growth amongst the professionals within your, within the program. And they had several different standards, teaching and education, research assessment, and then systems integration. So they built out those standards and they launched it. And I think in, I believe in 2010, we accredited five SIM programs. And when I joined in 2011, we had similar quantities. We offered two different application cycles in February and July. Back then, they were different, but we would see about 10 roughly per year. As I've come on board, uh, we've, we've seen growth. I look back, I just feel so tremendously proud and and grateful that I started in 2011 to see the growth that we've had. Now in, in 2023, we've gone through two renditions of the standard and standards and we've added an additional area fellowship programs. So if I think through statistics in terms of growth in 2010, 2011, we were accrediting five to 10 programs a year. 2023 we're projecting 70 this year. So you know, you can see that at minimal, that's about a 700% growth within the, the span of 13 years. So it's been a journey, it's been an adventure. And it, again, I think at its core, the importance of this is to create some type of standardization, contribute to a standardization of simulation programs and and within our profession.

Deb: 5:17

Wow. Jerrod, you're the stats guy. What do you have to say about that?

Jerrod: 5:21

Wow. Double wow.<laugh>.

Kristyn: 5:23

And I don't know if that 700, 700 was right, but if you think about 10 programs now we're at 70. Yeah, that's 700%. Yeah, I did that math, my degree's in engineering, so I should know this. Right<laugh>,

Deb: 5:35

That's, that's incredible. And it's certainly been a lot of fun to be on this journey with you guys. Betsy, why don't you tell us a little bit about when you came on and maybe about the types of accreditation that are offered by the society and how people would apply if interested.

Betsy: 5:52

Sure. I'm Betsy Holsworth and I've been with the Society for Simulation in Healthcare since 2018. It's even in the last five years, seeing the growth has been pretty incredible. It was wonderful to come on board and help Kristyn because at that time they were seeing accreditation really take off and seeing an increasing number of applications. And so it was wonderful to be added to staff and help in that effort of working with all of the programs and helping them navigate through the process. So we do offer two different types of accreditation. We offer provisional accreditation and full accreditation. Provisional accreditation is a great place for programs that are perhaps new or just getting their feet wet with the accreditation process to start. It's a two year period of accreditation if awarded. And it's in our areas of core and teaching. And the primary difference between IT and our full accreditation is that you don't necessarily have to have all of your ducks in a row in terms of the data that you're gathering within your program. So it's all of the same standards, just minus the 24 months worth of data that are required if you're going for core and teaching and full accreditation. Full accreditation also has other areas that programs can seek accreditation in. I like to think of core as our baseline standards that are mandatory for every applicant. And as Kristyn was speaking to, those are the very foundational things of your program. From there, they have a choice of applying for assessment research or teaching education. They can apply for one of those or they can apply for all three. And then beyond that, we have two sets of standards that I consider to be our add-ons. They are not something that can be applied to as standalone. So you can't just seek core plus systems integration. You have to have one of those other three areas, whether it's assessment, research, or teaching before you can look at systems integration or fellowship program, which is our, our final area of accreditation that we offer. So I do like that a lot about accreditation in that it can very much be customized to your simulation program and what you are doing at your simulation program. It's become a little bit cliche, but there is a, a phrase in the industry that if you've seen one program, you've seen one program. So there are a lot of interesting things that programs are doing and um, I think our standards help validate some of the, the great work that's happening in the various areas.

Deb: 8:40

Thank you. Betsy. If programs wanna apply, what would you suggest that they do? How do they get started on this journey?

Betsy: 8:47

So we have a lot of wonderful resources on our website. If you go to www.SSIH.org and go to the credentialing portion of our website, you'll see different webpages for both provisional and full accreditation. And so depending on which area you're looking to apply through, you can really read through those webpages and see our resources that we have available. We publicly post our standards and there is no charge to view them, they're just publicly available and you can read through them. And the other great thing that we have that we really encourage every applicant to look at is our companion documents. The companion documents were written by our current program reviewers and it's been done so in an effort to share some insight as to the intent of the standard and what programs can think about doing to demonstrate compliance with those standards, we pride ourselves on not being prescriptive in what we tell programs you have to do. Again, there's many ways to conduct simulation, there's many evaluation tools out there. And so we're, we're not specific with you in terms of, oh, you must use this particular evaluation tool. But what we do want to see is that you are using a tool that's been validated and that you have a process and that your process works for you. So it's all about ensuring quality healthcare simulation and ensuring that it's being done in a way that you're forward thinking and looking to improve continually.

Deb: 10:34

Yeah, it's been quite a journey. It's been incredible to watch the quality that is improved. And, and I think you talked about earlier, we talked about the core group of people that were involved. I know Dr. Mancini, Beth, she was released this week and talked about she's in retirement, but she calls it performance. So she does things that she prefers to do at this point of her life. And she's so passionate about the Society for Simulation and Healthcare as well as accreditation and once again, quality and excellence within organizations. And we do pride ourselves in being non-prescriptive. So do you wanna tell us a little bit about the online accreditation courses so that some of our listeners can learn if they wanna do that to help themselves get prepared?

Betsy: 11:18

Sure. So those are basically just another resource that we have available to applicant programs who are thinking about their work for consideration for accreditation. So beyond just reading the standards and reading the companion documents, you can take a course that is taught by one of our current program reviewers and that course will go through the different standards one by one help you understand a bit more about the intent of the standard, what can be done. There's some neat exercises that they do throughout the courses. Just our, our core course comes to mind. That particular instructor has an event that she does within it that's an escape room kind of theme. And so there's just some interesting things that you do and, and you meet once a week with fellow classmates in an online environment. But then a lot of the work that you do is, is asynchronous and you have it do on your own time, but then you come back together as the group and you have a very interactive environment with the instructor and opportunity to ask questions and things like that. It is not an opportunity to submit your application and have the instructor look through it. That's not the intent of the course, but it's more so to prepare you and help you know, if you're, you're on the right track in terms of what you're planning to include in your application. Would you agree, Kristyn? Yeah,

Kristyn: 12:52

I more than agree. Within the courses you see mentioned, you go through the standards and you have opportunities to submit the content that she would submit for the application and it gets peer reviewed. And so I think that's just a wonderful opportunity for programs who are considering applying, but but also want that validation and affirmation like, am I going in the right direction? In addition, you have the opportunity to meet peers within, you know, other programs that are considering applying and develop those relationships so that, you know, they can act as assistances or, and just develop those relationships as different programs are considering applying and, and going forward with developing your applications. So you have that opportunity to collaborate and create those connections that ultimately, um, will help you throughout the process. Um, they're, they're great resources and again, I think just the development of the resources speaks to the growth of the program. Several applicants reached out to us or programs that were considering applying and said, what resources are there? We developed the companion documents and now the courses were increasing our appearance at I M S H. We're doing a lot of courses at I M S H as well. So I think with the continuation of the development of all of these different offerings, again, it just speaks to the continued growth of accreditation.

Deb: 14:13

I agree. I think the continued quality as well as the standardization of reviewers, that we have a lot more interrelated reliability than we had originally. Essentially when I started as a reviewer. I think that that is really improved and we hold each other accountable.

Jerrod: 14:33

I also think to both your points, Betsy and Kristyn, it's, it's the prestige around it. It's become such a, a trophy because one, it is, there is of course a lot of effort and I mean time is, is one thing, but the amount of collaboration and involvement and engagement that it takes from any institution to go from, you know, step one to I'm making it up, right, a hundred. But all that just teamwork that it takes. And then once you kind of get, you know, these small wins, people are celebratory and then it goes over to finally that step a hundred and there's the, if it's provisional, that's, that's one thing. But if it's full accreditation, I mean that's another one. And, and you see this team kind of raise up their trophy. I put that in hypothetical terms, but they raised that up and it is just, it's so cool to see and, and everybody's so proud. So I think the buildup of that prestige is, is really high as well.

Kristyn: 15:26

Well we appreciate that. And I don't think you're so far off from step one to a hundred because it is with our standards, I mean I think people typically ask how long does this take? And it's like anything, it's dependent upon the number of people within your program that are working on the standards. But we've heard specific to full anywhere from 300 to 600 hours to put that application together. But we appreciate the prestige cuz I think ultimately the prestige is not our goal, but, you know, becoming, we hope that we're globally acknowledged and that acknowledgement is within accreditation to demonstrate that these programs are of the highest quality that ultimately is the goal. And, and what we wanna see and what we hope that when your program undergoes the process, that's what you feel you've achieved and attained.

Deb: 16:13

Excellent, excellent. And I'm gonna throw you guys a different question. I, I was thinking about this as we kind of got together here. I feel like during the pandemic it was almost like Mr. Toad's wild ride for you guys. It was just programs wanted to become accredited and things were just insane. Am I on base with that or off base?

Kristyn: 16:31

Yeah, I think so. There was tremendous growth during covid. I think the wild ride was you have to adopt, adapt, and evolve, right? And so we, we had to sit down as a council and, and with leadership and figure out how to navigate those waters because travel was part of our full accreditation process. You, we send two to three reviewers to your program to essentially validate that what you're saying you're doing on paper, you're doing, we weren't able to do that. We were kind of thrown into the world of simulation I think. And we had to figure out how to adapt and how to meet the needs of our programs and continue on. And so, you know, through people like Dr. Mancini, Tom LeMaster, uh, who is the outgoing chair of our accreditation council, we were able to develop a virtual review process and we learned from that virtual review process and we determined that in many ways we can continue on with that process for some reaccreditation app applicants. So yes, it was a wild ride, Deb, but I think it's been a wild ride for since I've joined, which is good. You know, the wilder the better I guess.<laugh>.

Deb: 17:36

Yep, yep, yep. Now do you guys, any of you guys have like a favorite story from either accreditation or from one of the imsh conferences? Cause when you go down to the conferences, you guys are working like dogs. I mean, I feel like I'm working like a dog too, but I mean, I see you guys and I'm like, whoa,

Kristyn: 17:55

I don't know if I have a favorite story. I do have a favorite quote. Yes, at I am a Saint. We are, it's a wonderful opportunity and we love to work like that because we are a virtual staff. We don't always get the opportunity to work together. And so for us it's a lot of team camaraderie and it's team building. Um, but we also love to see the growth, like just like accreditation has grown, the attendance at I M S H, the course offerings, the changes specific with plenary sessions we're, we're doing. Um, so new things at I M S H in 2024 that we're really excited to launch. It's great to see that growth too. And the, the members who attend, the people who attend, we, we love to see that growth as well. But going back to favorite story, I don't the favorite quote, Tom LeMaster again, who is our outgoing chair, has a famous co quote within accreditation. He has been part of accreditation since inception, I don't know, accreditation without him. And he has a famous quote saying, when you see one sim center, you see one sim center. Because again, every sim center is different, different your, your staffing, your education, your space, all the things. And so the quote just resonates with me because that in another way, we are not prescriptive in terms of our standards. In addition, there's not one sim center is gonna fit like this general mold, right? And so we kind of acclimate and adapt in terms of what, what we're really interested is, are you following foundationally the quality that we wanna see that's specific to your program. So I, I wanted to throw that out there because I don't think, Deb, I know you've heard that quote from Tom. I think everybody on the council, our reviewers, you see one sim center and you've seen one sim center. There's just, it's, you know, it just speaks so highly of I think our process. And I'm proud of that quote. It's not mine though,<laugh>.

Deb: 19:46

No, it's, if you think about the, you know, one of those big jars, you have to make sure that you put all the big rocks in, but then you can put all the sand on the outside to fill it up and your program can become accredited as long as you make sure that you have. And I really like the way that you explained at the beginning of this discussion about all the things that are necessary, the necessary elements. Thank you. Now I get to ask this question quite a bit and I wanna ask the experts here, and I didn't ask, uh, Bets, did you have any favorite story you wanted to share?

Betsy: 20:18

Well, when I think about when I started in healthcare simulation, I had the privilege of working for a beautiful center in Illinois. And, um, they had a quote on some of the walls in the lower level of the facility. And it, it really struck me how healthcare simulation is improving patient safety. Because to know that the, the common method within healthcare for a long time was see one, do one, teach one really, you know, when you stop and think about that, it's, it's pretty mind blowing that you could see a procedure done one time and then expected to do it yourself and then after doing it just once be expected to teach it to somebody else. So when you look at statistics within our country, within the world about medical errors and, and things like that, that are, are preventable to know that healthcare simulation is gaining the steam that it's gaining and really becoming integrated into educational programs in particular around the world in the training of medical professionals is, is just wonderful to see. I think we all who work in the industry or or in healthcare have that desire to see patient safety improve. And that's just one thing that's always been fascinating to me about the possibilities of healthcare simulation and I M S H is, is wonderful. It's like Kristyn was saying, we're a virtual environment so we as a staff don't get together face-to-face very often. So that's great about I M S H for us as a staff to get together and really interact with one another one-on-one. But it's also wonderful to interact with the people that we have had so many phone calls or, or Zoom meetings with throughout the year. And to actually meet them in person and the opportunity to meet some of the people, um, particularly internationally who come to our meeting is very humbling to know that they take the time off of their day jobs, so to speak, to travel all the way to whatever city we happen to be hosting our meeting in that they value it that much. So that's really amazing to me to just be able to interact with all of those folks. That's probably my favorite thing about being part of S S H

Deb: 22:53

I would agree. That is amazing. Now, if any of our listeners wanna become a reviewer, I alluded that I was gonna ask this question that I get asked it sometimes on. Once again, I'd like to ask the experts, how would you describe the process for if you're interested in becoming a reviewer for the Society for Simulation and Healthcare, what do you need to do? What are the steps and,

Betsy: 23:15

Well, we, we have started to require that our reviewers come to us from programs that have achieved accreditation. We really feel like that's important for our reviewers because it speaks to the fact that they themselves have been through the process. So not only do they understand it from the applicant perspective, but now they get to go to the other side and understand it from a reviewer's perspective. And the program reviewer subcommittee of the accreditation council has really been working hard the last few years in particular to standardize the training that we have taking place among our reviewers. So it's a really fascinating process. It's very intentional in terms of how we approach the standards and, and how we want the reviewers to approach the standards and look at programs from a lens that really always draws back to the standards. Sometimes it can be easy to, to look at things and go, oh, well that's not how we do it at my center. Well that's okay. Like we've said all throughout this interview, there are a number of ways to do healthcare simulation and programs have their own uniqueness wherever they tell from. And so if you're interested in being a reviewer, I think it's a wonderful opportunity to get to see that perspective as well because we can get very comfortable in our own working environments and very comfortable with how we do things. And it can be easy to think that because that's how we do something, that's the right way to do it. But if you become a reviewer and you get to look at the applications from different programs, not only around the US but around the world and see how they're accomplishing things and there are different ways of doing things, it's that collaboration and that just interesting perspective. And so if you are at all curious to see how other programs are doing something, being a reviewer is a great way to do that. And so if you are from an accredited program and you're interested in becoming an accreditation reviewer, we are gonna have more information about that, just basic details on our website coming soon. But in the meantime, you're welcome to email accreditation@SSIH.org and either Kristyn or I will get in touch with you and help you work your way through the application process and how all of that works.

Kristyn: 25:55

And we are, um, developing a website page under the accreditation tab that's specific to how people can apply to become a reviewer. We strongly encourage it and as Betsy mentioned, I mean it's, it's a two-way relationship. We are a volunteer-based organization. We could not be in the position we are within accreditation specifically, but most of the things in SSH without our members, without our volunteers, without our accreditation reviewers. In that same way, when they're able to go review applications and visit programs, they're able to then see exemplary practices within simulation programs and can go back to their program and help implement those exemplary practices. So we strongly encourage it and uh, as Betsy mentioned, contact us if you're interested, but also soon to be forthcoming, there will be a webpage where you can go to on our website about how to become a reviewer.

Deb: 26:48

That is exciting. Do you know when the webpage is gonna be up?

Kristyn: 26:51

We hope within a couple weeks it should be.

Deb: 26:53

Oh wow.

Kristyn: 26:54

And again, you would just go to SSIH.org, click on credentialing, um, doing this through remember, so I apologize accreditation. And then there should be a interested in becoming a reviewer how to become a reviewer tab hopefully within the next couple of weeks.

Deb: 27:09

And I can tell you from being a reviewer, the support that I received from both you and Betsy, and I'm sure it's gonna be Lizzie as well now, is absolutely amazing. I can't, you know, I'll text you guys and you always get right back to me and I appreciate that. So I think anybody who's out there on the fence, uh, you know, it's it's gonna be hard. There's so much support and your team makes it just an honor. And once again, going to the sites is just, it's just something that is indescribable. When you go there and you see the things that people are doing and how proud they are of their centers, it's very, very humbling. So I'm gonna ask one more question and if you have, people are interested in becoming accredited and then they have people saying, oh, you know, it's a lot of money. And how would you describe to somebody maybe the return on investment of the accreditation, what would you tell them to say to their stakeholders who, who may be saying, I don't think we're gonna get our money's worth from this?

Betsy: 28:12

Well, We do recognize that it is a significant investment that programs are putting into the process. I do think that we are priced in a way that is attainable for a variety of programs, whether, you know, you're a very small program to a, a very large scale program, but I think the accreditation, the, the biggest value is just validation of the good work that you're doing. And I was speaking earlier about the, the training that our program reviewers go through. Part of that training these last few years has really been honing in on the feedback reports that they develop for the programs that they go and visit. And that feedback we hope gets shared institutionally, not only with the simulation program itself, but the leadership that they report to. And I think that is big for a lot of programs because when you're working in the simulation program, you're very passionate about simulation. You know, the impact that it has the ability to create on either your educational institution or your hospital system. But I think it's a different thing when you can then turn around to your senior leadership and say, this is the feedback that we've received from our accrediting body. This is what they've identified as things that we're doing as exemplary practices, or these are the things that they recognize that we're doing with just a very small staff. And so when you can speak to that and show your leadership that then suddenly there get to be these aha moments and that might lead to opening doors for you in terms of increasing your staffing or perhaps additional financial support to get you more resources in terms of, you know, mannequins or, or other things that you might need to better meet the needs of your learners. So it's, it's those kind of things that I think people see the value in when they, they get the accreditation because in the sim program itself, they know their value, they know that what they're doing is important and has the ability to make a big impact, but taking it up the chain and being able to, um, get that increased support from leadership by showing them, you know, this is what we're doing, this is the, the Society for Simulation and Healthcare and they're the body that, you know, accredits, uh, a wide variety of healthcare simulation programs around the world. And this is what they recognize us as doing, uh, a good job in.

Kristyn: 30:58

Yeah, I I more than agree with Betsy and I think anecdotally we have, we've heard that throughout the years, you know, I can't tell you how many times we'll accredit programs and then we'll see because we have reaccreditation too. And so part of that reaccreditation process is we're able to see the differences between first time becoming accredited in, in five years, did we at all help increase your staff or spacing? Did we assist with your leadership making the decision, okay, it's time to develop a new center, it's time to expand. And we see that, again, it's anecdotal and hear it I guess at this point, but I think as Betsy communicated, the ROI is there, you know, there's several factors to it, but that that feedback report that you get does give you some type of validation to go to your oversight and say, this is what SSH is saying, this is what we're doing well, these are our areas of improvement and we need to consider how to improve them. It might be staffing, it might be evaluations, it might be spacing, it might be budget, you know, is your budget, your, we, one of the things we look at is do you have a sustainable budget in place? Does that budget need to grow? Um, it might be that programs need to reevaluate their strategic plan. Um, so they're getting this feedback and and ultimately hope, hopefully growing from that feedback. And again, we have seen that over the years, especially because we've had a few rounds of reaccreditation. I think what we wanna demonstrate is that from a research perspective, we want to be able to demonstrate that we have contributed to an increase in staffing spacing. But I think end goal, what we wanna demonstrate and what our desire to demonstrate is, does it lead back to an increase in patient safety? Are we doing the work that ultimately is what simulation is here for healthcare simulation? Which is, is there a link between becoming accredited and increasing patient safety? I can say I'm more than believe there is. I would assume Betsy and Lizzie would, would be in agreement. I know our council is in agreement. Ultimately that's what we're trying to demonstrate and showcase as a return on investment. And, and perhaps, you know, again, with simulation, that's probably one of the most important returns on in investment and likely is why the majority of people are in simulation.

Deb: 33:12

Absolutely. And I can say to the price, I mean it's less than, than a high fidelity mannequin. I think the price is about, about the same as a mid fidelity stimulator. So I don't think it's really out there when you put things into perspective.

Betsy: 33:27

And something too quickly just to mention that I think was really forward thinking of the council, uh, about a year, maybe two years ago at this point, time flies, we have heard concern from some programs regarding the cost of accreditation and particularly during covid, we know that that put a financial pinch on some organizations. And so the council heard that perspective from our programs and came up with a plan where you can have a payment plan across time when applying for s SSH accreditation. So, um, there is a way to work through that expense over the course of one to two years depending on how exactly we work that out and how many areas you're seeking. So if financial constraints are a concern for you, please approach us and, and let us know and we can share that information with you about the payment plans and see if maybe that makes it a little bit more workable for you.

Deb: 34:30

Thank you. Now is there anything you guys would like to add to this as we kind of wrap up this discussion?

Kristyn: 34:37

Uh, Deb? I don't think so, except I guess we are, if anyone out there is listening and are interested in and is interested in becoming accredited has questions about it, we have a staff of three, which is a huge improvement. Six months ago we had a staff of two<laugh>. So we're here to answer your questions, help walk you through the process, and, and we encourage you to go to our website, look at our standards and consider if, again, just following this innate infrastructure, which essentially is what our standards are. It's an infrastructure, it's a foundation that you build your program with. We encourage you to go and look at it and if you have questions or inquiries, we are here to, to be helpful and to provide assistance and we encourage you to apply.

Deb: 35:19

Thank you. Jared, anything you wanna add?

Jerrod: 35:23

Yeah, well I I had one last question and that was, do you see common pitfalls when institutions are applying? What do you think is the biggest deterrent why they don't apply? Or what advice would you give or that you've seen from provisional to fully accredited to reaccredited? And what kind of advice would you get to say like a, there's again, back to some data and statistically speaking, 33% of institutions don't make it because of x and and i I don't wanna generalize too much, but do you have any advice for that?

Kristyn: 35:58

Yeah, so I'm gonna take that into two different questions. So the first, what are the hurdles of why applicants would not apply? And I really think it simulate healthcare simulation. It's, we're busy, most programs are adequately staffed, but to add 300, 600 hours of work to that, they might just not have the bandwidth to do it. And so I think that's our biggest hurdle is it is, I mean it is a, an extensive process. It is a, it is a large undertaking that is so beneficial, but it's something to plan for. It's not something you can do in a week or a month. And so I always advocate that to programs. If you're interested, spend some time reviewing the standards, develop a plan for how you are going to, who is going to write to those standards, who's gonna pull the information, et cetera. Because it is an extensive process. So I think to me that's the biggest hurdle. And also buy-in, right? Most programs need to get buy-in from a monetary perspective to go down this avenue. And so with that, if there's issues there, we have a write-up of our perceived ROI on accreditation. And I would encourage anyone to come to myself or Betsy or Lizzie for that. The second question, from a statistics perspective, we have a pretty high rate within accreditation. I think it's well above 85% of programs who apply and ultimately become accredited because it is a process that we find the benefit to the healthcare sim community is that we don't want you to apply until we absolutely know you're as ready as you can possibly be. So there's a lot of back and forth. Now where we find hurdles and struggles with not becoming accredited is our different areas. So systems integration, they are pro, we see a lot of programs that meet the standards for core in teaching, but they might not be there for systems integration yet. So they might not become accredited in that specific area research assessment fellowship. And so within, we see that happen a little bit more frequently. I would say upwards of 20, 22% of the time when programs apply, they might not become accredited in all the areas for which they've applied, but they get the report, they get to meet with experts in the field and they understand what they need to do to grow that portion of our standards. And then we see them apply a year, two, three years later through our mid-cycle process or added on within five years. So we do see that, uh, success if that failure is met initially. So that's my response to that. Betsy, you probably have a different thought trajectory, but, um, yeah,<laugh>,

Betsy: 38:28

<laugh>, I think you're right that the key really is preparation. And I might have a bias as a communications major myself, but communicating really is important. Whether it's communicating with us, if there are things that you are not understanding or resources that you would like more information on, you know, we're just a call or an email away and we love interacting with interested programs. And so any kind of question that you have, please send it our way and we will work with you. Being a member of the society is not required. However, I think that a great benefit to being a member is opening up those networking opportunities with other people within the healthcare simulation industry. And, you know, we have a, a sim connect webpage that is a great resource for our members and it's a great way to kind of ping pong ideas off of other people that work in the industry. So you can put a question out there to your peers and get connected with other programs that have gone through the accreditation process and, and pick their brains a little bit about it. And so really just asking the questions that you have, there is no stupid question and really involving the appropriate subject matter experts on your own end when it comes to putting the application together. It's understandable that you may have a, a primary writer of the application, but just as you do when you build a simulation scenario, you need those subject matter experts to help advise what you're putting in. So if your program is interested in seeking core plus four or core plus five, and you might be an excellent expert in the realm of teaching education, but perhaps not so much in simulation research. So pulling in those people who are your experts within your own program to read through and, and help advise what you're putting into the application, it's just going to strengthen your application. So those are the things that I would encourage is really just communication with us as a staff, communication with your peers in the industry and the subject matter experts within your own program to help really boost your potential for success.

Jerrod: 40:54

And thanks for that. And to my best of my knowledge, there are some educational resources or support. I mean, as you've mentioned, reach out to you three or, or the, the email address you've mentioned before, but there is other prep work to say, Hey, this is, this is what you can do to be ultra prepared. So that's offered through the website too. Correct,

Betsy: 41:12

Correct. Um, we do offer the online courses in each of our areas of accreditation, but just a very baseline thing that everybody can do that is free of charge is to take a look at the companion documents. The companion documents have the standards listed one by one for each area, and then off to the right is where you get the additional insight that comes from our current program reviewers about how to demonstrate compliance with that particular standard. And so that's just an excellent resource if you are just getting started, you're just reading through the standards and trying to grasp what to do and potentially you're already looking at the cost of accreditation and then you, you see that there's an additional cost for the course. Well take a good thorough look at the companion documents first and, and see if that's enough to help you understand what you need to do to demonstrate compliance with the various standards.

Deb: 42:15

Well you guys, this has been wonderful and we're really grateful for your time and, and your contributions to healthcare. You, you make a difference and I wanna thank you so much. Thank you

Betsy: 42:26

Deb, very much for the opportunity, Deb and Jerrod. Appreciate it.

Deb: 42:29

Thank you. If you want any more details, you can go to the innovative sim solutions website where we have a little video with Kristyn speaking about how to do things and Andrew, about certification. So thank you very much and happy simulating.

IRIS Health Solution Tag: 42:45

Thanks again to Iris Health Solutions Limited for sponsoring this week's podcast. Iris Health Solutions Limited makes co-designing, sharing and creating sim scenarios. Quick and easy.

Outro: 43:04

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