Matt Charnetski speaks with Deb and Jerrod about his most recent appointment as secretary for SSH. He shares information about the Mt. Everest Summit experience at SimGHOSTS. This episode is sponsored by Interact Solutions a full video solution.

Matthew Charnetski is the Director of Simulation-Based Education and Research & Inter-Professional Continuing Education (SBERI) at Dartmouth-Hitchcock Medical Center in Lebanon, NH.  Matthew is also faculty to the Massachusetts General Hospital Institute of Health Professions Masters in Health Professions Education Program in the Simulation Operations Track. He is involved extensively with The Society for Simulation in Healthcare and The International Nursing Association for Clinical Simulation and Learning.

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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: 0:50

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. Thank you so much for joining us. And I'm here Deb with uh , co-host here , Jerrod Jeffries. And today we have the most interesting man, Matt Charnetsky <laugh> with us. So welcome Matt.

Matt: 1:47

Thank you guys for having me. I really appreciate it. It's good to talk to you again, being here .

Deb: 1:51

Why don't you tell our guests a little bit about yourself in case they're not familiar.

Matt: 1:56

Sure. Well, first I would direct you back to an earlier episode of The Sim Cafe where I did talk a lot about the long version of my path into simulation. But the abbreviated version is I'm the director of simulation based education and research and interprofessional continuing education at Dartmouth Health based here in New Hampshire, the Northern New England. And then also I serve as the secretary of the board for the Society for Simulation and Healthcare . And then kind of maintain a lot of relationships and work with Mass General Hospitals, Institute of Health Professions, where I teach in their Master's of health Professions education, focus on simops. I do some work with INASCL. I still stay in touch with SimGHOSTS obviously, and have a lot of opportunities to just keep up with that whole community.

Deb: 2:42

Thanks, Matt . Thanks for your service. And why don't you tell us a little bit more about your role with SSH? How does that look?

Matt: 2:49

Yeah, so last year I was elected as secretary of the board and I had previously served as an appointed director at large. And one of the things I really enjoy about working with these organizations is really being able to get in deep. And so previously I had been secretary of the board of SimGHOSTS secretary of board of SSH now and, and then just all the things that come with that. So I serve as the liaison to the technology committee of SSH I worked pretty closely with the simulation operations and technology section. I still keep up with the education committee and then also I'm working really closely with the D E I committee that is newly formed for SS s h . And then beyond that I do a lot of other things where I help out with, uh, accreditation site review. I'm an item review member for the committee, for the CHSO S and CHSE exams and that kind of thing. B ut, but ultimately just participate at a fairly high level, helping to determine the direction of ss s h , the priorities of SSH and kind of how we all grow and move together as a unit.

Jerrod: 3:52

It's a lot of ads .

Matt: 3:54

Yeah.

Jerrod: 3:55

So how from Dartmouth to Mass General and from the New England population does, do you help supplement with s s h ? Meaning does your role within SSH help you perform there? Do you have to split time or how do those kind of overlap between the two?

Matt: 4:13

So my role with SSH is really independent of my work roles. There is interest from both M G H I H P and from Dartmouth Health that I be engaged in the leadership level, in the simulation community. I mean, it's just advantageous when you can stay involved with those organizations and, and really be able to understand trends in sim and trends in even particularly the logistics operations and administration of SIM programs. Anytime I get the chance, I'll talk about how SIM has become a unique body of knowledge and that it's really unrealistic to expect that clinical folks can just move into SIM and then that's, that's that. There you go. And so being connected with these groups and with other people who are really engaging just in sim , they may have clinical backgrounds, they may not have clinical backgrounds. Um, but connecting to that group just helps us do what we actually do better, which is support the delivery of SIM and the design of SIM for our unique organizations. So for the most part, my time for SS s h is largely external to my regular 40 hour work week <laugh>. Um, there's some wiggle room on that, obviously, because I serve on the board, particularly at my full-time job. There's some accommodation for if I have board meetings or things like that, but by and large, it just makes for a very busy, busy time.

Jerrod: 5:35

Yeah, that reminds me of shirts . You see that say live, breathe, eat or sleep. U h, so that's, that's you with s im? Yeah,

Matt: 5:42

Yeah, definitely.

Jerrod: 5:43

Going on, you know, some of these involvement that you're in with the professional organizations, we were able to see each other at SimGHOSTS 2023, which was in beautiful Omaha, Nebraska. Mm-hmm . <affirmative> . Uh , can you share a little bit about your time and experience there?

Matt: 5:57

Yeah, I , uh, first of all, Omaha's one of my favorite cities in the country. I've always loved it. I grew up in central Iowa. I used to run over there to see concerts all the time and, and had some friends kind of in that area and , and spent a great deal of time there. So it was cool to go back. I hadn't been back in a really long time. And SimGHOSTS had worked with the IXL center at University of Nebraska Medical Center, so their sim center there, which is a , just a fabulous facility, really center phenomenal. Unbelievable. Yeah. And it , it's kind of one of those sleeper centers that you never hear about. Uh , and nobody thinks about the Midwest often anyway. But even in sim , you know , when you think of the big centers, you think of the big names that we all know, and yet the IXL Center is out here and it's enormous. It's state of the art . It's doing a lot of really interesting and cutting edge things, both in terms of education, research, in terms of the way they run their operations. It's, it's really a , a remarkable place . And so super cool that SimGHOSTS was there and, and that they hosted and collaborated to put that together. The conference itself was what I expect from every SimGHOSTS that I go to. It's a really great time. There's a lot of really wonderful information. I particularly enjoy getting to see people that are digging deeper into the technical side of Sam than maybe I see at least not in the same volume at other other conferences. And it's a lot of people that don't often come out of the woodwork to, to talk about what they're doing or to share what they're doing, which has always been one of my things in operations that I feel like we solve a lot of problems and we don't talk about it to the rest of the world because we sort of live in this world where we just think, yeah, I'm sure everybody else has just solved that problem. It's not a big deal. And we miss the opportunity to understand how groundbreaking and revolutionary a lot of the work people are doing is so, so it was great to see people who are sharing that kind of thing.

Jerrod: 7:48

Certainly, and this is the highlight of so many people's jobs throughout the year, because they're absolutely, you know, even I dub myself this, but these sim geeks are just really able to connect with someone else in their same sort of environment. And so they don't feel as lonely or siloed, but because there's only one, or usually there's only one position within their organization for this type of role, they then realize that there's someone else in the middle of Iowa, middle of Nebraska, middle of Indiana, right? And of course there's, there's plenty across California, but even met some incredible people from Argentina and then Ireland and, and across the world, even though this was the US-based conference and those connections and that type of collaboration is so fruitful for every member, but even more important attendees and then, you know, really solidifying and , and collaborating within that, that sim ops role, so to speak.

Matt: 8:43

Yeah . Yeah. Go ahead, Deb .

Deb: 8:45

No, I'm gonna echo that. And this was my first SimGHOSTS conference, and it was intimate, learned a lot about different people, was able to really explore the vendor hall and the new products out there. So it was, it was a lot of fun.

Matt: 9:00

Yeah, it's great. And you know, I , I think we sometimes forget that North America is a little bit more simulation forward than a lot of the rest of the world. Europe does a lot of Sam , but particularly once you get outside of that, it is these smaller pockets with these individual contributors who are really, they're doing great work, but it's taking so much effort to get there. And, and it's, it's hard to run a one person show in North America or outside of North America. And so for all these folks to be able to make it to these conferences and, and it's travel all that way and all that expense is really remarkable. And then to hear what they're doing and what, you know, the problems they encounter, the problems they've solved and how they're doing it, I , it really opens up that perspective. And I , I think that sharing both of perspective and specific solutions is hugely important to any of these conferences, but particularly at SimGHOSTS.

Deb: 9:51

Yeah . Now I'm gonna ask you about the Mount Everest experience at the conferences. I've heard a lot about it just like , like little bits and pieces, but I know with your background in Antarctica, you probably had a lot to add. So why don't you give us a real visual of this experience so that hopefully in the future some of us will get to experience it?

Matt: 10:10

Yeah, absolutely. This year I was fortunate enough to somehow, I don't think I was elected exactly, but funneled into being the mc for the experience. And it , it's a , a program that Peter Deman and Suzie Kardong-Edgrin had put together originally to basically create a , uh, an experience where people actually get to test their non-technical skills. So for people who aren't familiar, in 1996 , uh, it was a particularly difficult year on Mount Everest for the, the climbing teams. There, there were more people than there had ever been before. The weather was kind of wonky. There were all sorts of different problems. And this is something that I've been interested in since I was a kid. I , I'm not sure that there was a 10 year span where I probably read every book about any mountaineering surrounding the seven summits that one could find and had the opportunity. Then I think after my second season in Antarctica, I went to Nepal, hiked to base camp, saw Everest, you know, really got the, the full picture of it. Obviously didn't climb it, but the picture of kind of the leadings up to it. So anyway, a , a couple of years ago at Sim GHOSTS, Suzie and Peter had put together this experience where we take a conference room and we try and create a simulated experience that's a little bit uncomfortable, that's meant to provide a limited, but really an attempt at what that last push to the summit is on Mount Everest. So what it's like being on a rope team, climbing from camp four to the summit, some of the logistical challenges that you run into, some of the health challenges that you run into. And I won't give away too much of it because I want people to come when we offer it in the future, but you get a chance to really kind of dig in and suspend your disbelief and be climbing this mountain together as a team. And then we take that and each individual's given, you know, a set of directions and motivations and all this kind of stuff, and we ask them to really dive in. And then throughout the experience where there's wind howling over the speakers, we've turned off the lights we're , you know, giving people earplugs and things. So it's harder to communicate and , and really testing that. Then we pull 'em together afterwards and we just debrief how they formed their team, how they were able to communicate, what issues they had throughout that and how they navigate it. And I think it's just a really great opportunity to engage in storytelling is simulation. I think we forget that simulation isn't just a mannequin, a standardized patient , uh, or a task trainer. It's storytelling, it's videos, it's anything that provides that opportunity to reflect on an experience and integrate that experience into your practice moving forward. So if you are going through a simulated experience to climb Mount Everest, that can have really great and direct applications to everything else you do. I climbed Mount Baker years ago. I went with a guy because I just didn't know the area very well and he, I dunno if you're familiar with Finding Nemo, but in Finding Nemo there's crushed the Turtle, right, who talks like a , a surfer dude the whole time and crushed the turtle. And this guy spoke identically , uh, he had that affect . And I remember as we were climbing down, you know, we learned these technical skills for rope travel and self uh , rests and things like that. And we had worked together as a team to get to the summit and get back down. It is not a complicated mountain, but a lot of the people had very little experience climbing up this. So we're sitting and we're looking out, you know, looking out over Washington state and it's just this beautiful view. And he turns and he says, just remember everything you learn up here, you can take down there. And somehow like that just sticks with me. And in this experience it's the same, right? You get to have this simulated experience and then you get to take it and carry it forward. How do you form teams? How do you communicate clearly? And I don't think we do that enough at these simconferences. And, and we as Simulationist don't do this enough where we actually use SIM to help us get better at our jobs. We use simto help other people get better at their jobs, but we don't use SIM when we're interviewing. We don't use sim . Well, not some people do obviously, but you know, we're not commonly using SIM for interviews. We're not using sim for professional development. This is a great opportunity to do that. So super fun experience. I really recommend it to anybody who gets the chance to attend.

Jerrod: 14:21

I love it. That's a good segue too because take for example, everything you learned up here you can use down there. From where we are today, where do you see the future of simulation really heading and moving towards?

Matt: 14:32

Yeah, you know, it , it's funny, every time something new comes up from AI or vr, something like that, a lot of people in the hospital world come to me and they say, well, too bad, I guess your job won't exist in the near future. And I just think that couldn't be further from the truth. I think AI and VR are some really interesting tools and I think they'll be really prominent in what we do moving forward, as will AR and I , I think what we'll see is, we'll see increased accessibility , um, as we move to virtual environments or augmented environments. As we're able to use AI to supplement skill acquisition or communication. Instead of needing an enormous standardized patient program, we might need a much more narrow band of, of individuals to support that and still provide the same level of training. We may be able to use AI to be able to assess skill acquisition and make sure people are able to do the things we need them to do without having to take a faculty member or a , a teaching assistant or whatever it is, standing over their shoulder and watching. And I think for me, when I think about a lot of the places I've been and have the opportunity to work and live the ability to take equipment with you, that's much more portable. I don't need an $80,000 mannequin. I can take a headset and maybe a couple of other pieces of equipment and I can get there. It becomes less expensive, it becomes more portable. We have greater reach through distance sim and being able to collaborate through that. So I think accessibility is going to be be really interesting. And the thing I hope for, the thing that I think we're really missing right now, I was reading an interesting article a few days ago about how whenever a new method, whether it's technology or whatever, when a new method comes around, particularly in education, we tend to use that method just to replace what we used to do. So when simulation came around, the first thing we did was we recreated patient experiences, which is great that it's, it's safer, it's more efficient, everything about it is a positive. What I'm kind of watching for though is then that next step, and the really interesting next step is when we actually start truly embracing the technology and no longer just replace the experiences that we had when we did clinicals in the apprenticeship model. And instead we move towards whatever we're able to learn through educational research and educational theory to create these more efficient and effective ways of teaching people to be better at what they do. And that's, that's where I think we're headed. I think we're headed towards a really interesting technology, rich , efficient, and effective space.

Jerrod: 16:59

Yeah, and it reminds me also at SimGHOSTS, Lieutenant Colonel Damon Wagoner, who's this commander at this Air Force base, right outside Omaha. He was the simulation director for, for lack of better word, he kind of started up right . He, I'm sure we all saw this thing, but for some of our listeners started up, you know , really young doing , trying to be a pilot, then kind of created, was on the ground floor of the simulation site for the Air Force base , uh, there and then in New Mexico and all these other places. And a lot of the insights were like, man, if you're not utilizing your simulator, and these were like 20, $25 million, these, these machines. And it was like, if you're not using them, you're losing money. And that's the same thing with pilots, right? Or airline companies. They're like, if the plane's not on the air, you're not making money. It's perplexing to me how in healthcare you buy these extremely expensive machines, human simulators, whatever they are, and they're not being utilized to the fullest extent . But with your point, the standardized patients are probably more comfortable and confident about using. And then I think with vr, ar be more intuitive. There's the potential, you know, time will tell where it goes, but there's the potential of people becoming more , uh, confident or comfortable using this tool for simulation because it's so intuitive and you just throw a mask on your face and or whatever else that might be happening. But it is always interesting when you come to these, the different perspectives that you get and to , to your, to your point of where the future might go. Uh, hopefully it is that way. 'cause 'cause I know , I know that we can only improve and, and we've come a long way. But of course there's still a lot way to long way to go.

Matt: 18:38

Yeah.

Deb: 18:39

Yeah. Thank you. Now, Matt, can you share with our listeners the biggest thing you'd like them to know? Something that when you learned it, it changed the way you practiced maybe a personal aha moment?

Matt: 18:51

Hmm . Uh , there've been so many , uh, you know, it's, it's funny because the thing we teach in Sam, right, this reflective practice and this idea that, that you should kind of constantly be learning this growth mindset and you should be taking all these little bites and all that. I, I think there's two that have really stuck with me more than any other. And one of them is , uh, I had a paramedic instructor, paramedic preceptor when I was in school who talked about his ball of length theory. And the idea was, as you travel through the world, you're constantly just getting little bits of information. And, and we don't always know what we're going to take from an experience or from a lecture or from a, whatever it is, but you're always taking these things and that you then take those things and you just put them in your pocket and you keep putting them in your pocket as you go. And eventually you collect this ball of lint in your pocket that when it's time, you're able to pull it out and you can then look at it and hopefully your ball of link contains what you need. And it was better stated by, by Sully , uh, in his book when he says something to the effect of, I had been making continuous deposits into my bank account of knowledge, experience, and skill with the understanding that in this moment I was actually able to make a sufficient withdrawal and had enough stored up in there that I was able to accomplish this task that under other circumstances I might not have been able to. And for those of you who haven't read the full story about him landing on the Hudson, then it goes on to talk about how for, I don't know how long it took it , I think it was years they kept having people trying to evaluate and saying, well, he should have done this, he should have done that. This would've been better. That would've been better. But as they tried those things out through simulation, through these kind of thought experiments, they found that no , he actually did pretty much the only one thing he could have done to safely get the people out of that. And so it's that, take little bits with you everywhere you go. The other thing that I, I think has really resonated with me over time and, and this started when I was in college. It came through when I was in paramedic school and when I was working as a paramedic, it certainly followed me through my early simulation career. And it's that it's really important to share and to find your professional community. And when you can do that, being able to get perspective and to understand, especially when you're struggling. And I think for a lot of us in sim , particularly in those individual one person shops where you're all by yourself and it's, it's sometimes difficult because you're working with people who don't have the same experience and knowledge of sim that you do. And it can feel like an uphill battle all the time. And I know my experience has been, and , and a lot of folks I've talked to, their experience has been, you go to a conference, you go to a workshop, you go to a webinar and you leave feeling rejuvenated because you've had this chance to be around somewhat like-minded people who are able to help you kind of relaxed a little bit. You don't have to to try and convince them of things or encourage them to do something, they're already there with you. It's super valuable. And outside of those specific events, 'cause it's , it's great when there's specific events because they're easy to find. The problem is specific events aren't always there right when you need them. And so building that, that professional community and having those folks that you can talk really explicitly with and get advice from or give advice to or just share, just it takes that load off of your shoulders, helps you solve problems. You just have this group of people, I have a group of folks that I actually meet with every Wednesday or or almost every Wednesday whenever we can for a couple of hours. And we just get together and we do a bunch of different things, not least of which is we actually play a role playing game in an effort to, one of our folks is working on creating rolling games to be able to use them as a way to practice non-technical skills for simulation. So he's working on being a game master in that sense. We get to have fun and play around, but we also have this opportunity to meet and share and just kind of prop each other up in those moments when we need it.

Deb: 22:47

That sounds wonderful. I think one of the things that was great about SimGHOSTS this year was it was taped on Beaker Health platform. So all of the sessions are gonna be available to awesome. Yeah. To check out.

Matt: 22:59

Well if you get the chance, you should check out Will Belk's session on using role playing games for teaching non-technical skills.

Jerrod: 23:06

Yeah , I like your ball of lint theory from those much wiser. But when you have that just in time knowledge bank, so to speak, you're then able to retrieve it when it's necessary and needed. And so when it goes to these siloed pieces, it's, you're never really feeling alone. There's a lot of the times where you're saying, okay, you need to find something. And when it's this user-generated expertise that's able to be created, it doesn't put a burden on organizations, but it also just adds to the voice and the ability for, for the , all the individuals within the organization or those academic institutions.

Matt: 23:37

Yeah, absolutely.

Deb: 23:39

Well thanks I , we appreciate this time. Now are there any final words that you would like to leave our listeners to remember this conversation by ?

Matt: 23:47

You know, I , I think I just reiterate getting involved with your professional communities, however you choose to do that, whether it's with SimGHOSTS Society for Simulation Healthcare, the Facebook groups that are very active, whatever it is, I, I think that's such a great opportunity. And the cost of entry to those things typically is fairly low, relatively speaking, takes time, it takes effort. Some of them require some amount of money, but that investment is going to come back to you over and over and over again. It certainly changed my life and my career in sim and really like helped things take off for me. So look for those opportunities. Listen to podcasts, reach out to people that are interesting to you. I've never met a group of people that are more collaborative and ready to help out than folks who, who are in the simulation community.

Jerrod: 24:33

I just hope Matt, that that doesn't require people to go to Antarctica or climb mount at risk to base camp or do any of these other crazy stuff , but

Matt: 24:41

We'll find ways to simulate it. Yeah ,

Jerrod: 24:43

<laugh>. Yeah , exactly.

Deb: 24:46

Alright , well thank you and happy simulating

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Outro: 25:12

Thanks for joining us here at The Sim Cafe . We hope you enjoyed. Visit us at www .nnovativesimsolutions.com and be sure to hit that like and subscribe button so you never miss an episode. Innovative Sim Solutions is your one stop shop for your simulation. Needs a turnkey solution.