Billie Paschal - From Stay-at-Home Mom to Healthcare Simulation Manager: Exploring the Many Roles of a Sim Tech

Dive into the dynamic world of healthcare simulation with our guest, Billy Pichelle, who made the remarkable journey from stay-at-home mom to simulation education program manager at the University of North Texas Health Science Center. What if you could find a career where your mom skills are useful, and your passion for learning and innovation are constantly satiated? Billy's story is just that - a testament to the exciting opportunities that simulation in healthcare education presents. We probe into her most impactful simulation story that marries the world of academia with the practicalities of a hospital setting.

We then switch gears to discuss something that's often overlooked – the role of a sim tech. Ever wondered what goes into being a sim tech beyond just pushing buttons and voicing mannequins? Billy breaks down these misconceptions with her intriguing hashtag #simtechmorethanbuttons, giving us a glimpse into the many hats a sim tech wears. Billy doesn't stop there; she opens up about her experiences with networking and mentoring in the industry, underscoring the importance of tribal knowledge. Prepare for a stimulating dialog that sheds light on the unique blend of mom skills, technical know-how and passion that creates success in healthcare simulation.

Twitter: @ TXSIMTCH
LinkedIn: https://www.linkedin.com/in/billie-paschal/
Sim GHOSTS email: Billie@simghostorg.

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Transcript

Disclaimer/ Innovative Sim Solutions Ad/ Show Intro: 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. We are a team of simulation subject matter experts and consultants with over 50 years of experience designing simulation centers and programs. We are here to help you save time and money. Innovative Sim Solutions is your one-stop shop for all your simulation needs. Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelley 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 Tauber: 1:15

Welcome to another episode of The Sim Cafe. Today, Jerrod Jeffries and myself are here with Billie Paschal. Billie is a simulation education program manager at the University of North Texas Health Science Center in Fort Worth, texas. She previously worked in nursing education in the community, college and university setting. Billy has experience in the hospital setting, working as a simulation coordinator at Cook Children's Hospital and was part of the team that received SSA accreditation as the first standalone pediatric hospital to achieve all standards. Billie served on the board of directors at SimGhosts and founded the organization's international mentorship program. And welcome, Billie. Thank you so much for joining us today, and why don't you just say hello to our guests?

Billie Paschal: 2:10

Thanks, Deb and Jerrod for having me. I'm glad to be here.

Deb Tauber: 2:14

Thank you.

Jerrod Jeffries: 2:15

We're excited. We had such a great time at an Omaha, Nebraska, at the SimGhosts conference. Your fingers and a lot of pies and a lot of experience to be doing, with what you have been doing and what you're currently doing and what the future brings. So excited for what's to come here in the next 20, 30 minutes.

Billie Paschal: 2:32

Yeah.

Deb Tauber: 2:33

Thanks me too, all right. So, billy, why don't you share with us your journey into simulation? How did you end up in this crazy field?

Billie Paschal: 2:41

Well, like most of my peers, it was not a direct choice. It just kind of fell in my lap. I was a stay-at-home mom for 16 years and from there I transitioned to being a preschool teacher while my children were at school, and then I realized, hey, I think I might want to do something else. So when I was trying to figure out what that something else was, my very good friend was a professor at the local community college. She was telling me about this grant that she had just gotten. And she's like I have this mannequin and I have all this stuff and they've given me a room and I've got all this money to spend. But they didn't give me any time and they didn't give me any help. And she's like would you do me a favor and come and help me? So it's like sure, because apparently the Board of Regents were coming in the next week to visit her little one room that she was being given to set up simulations.

Billie Paschal: 3:38

So I put my mom's skills to work, I straightened things up and made them look nice and I pulled the mannequin out of a box and I was like what is this? It was a Laredol Simman 3G. He was huge, he was in pieces and yeah. So I just took him out of the box, set him on the stretcher and waited for the Laredol Field Rep to come and put him together. And after getting to observe the field engineer, I was hooked. I was like I don't know exactly what this is or how I'm going to fit in here, but I've got to stay. I always laugh and think there's some things you can't unsee, and a simulation is one of those. So here I am, from my own children to preschoolers to adult education Fantastic.

Jerrod Jeffries: 4:29

Well, that is a first I think we've heard of that. It is always interesting how everybody has their own unique story, but I love the mom skills put to work. That is the perfect one.

Billie Paschal: 4:39

And that was actually had written my resume when they created a position for me. I listed myself as CFO of the of my family and just talked about how I was able to maintain a budget and get people on time and meet objectives and all those years that I thought I was behind the curve and didn't know what to do to rejoin the workforce, but apparently I was just waiting for simulation.

Jerrod Jeffries: 5:07

And never underestimate the mom skills. I mean. Praise be to anything there.

Deb Tauber: 5:12

Yeah, true, learning how to use, how to set up toys right.

Jerrod Jeffries: 5:17

Time efficiency. I mean, it just goes into so many different areas. It does, it does.

Billie Paschal: 5:22

And the only difference between. I made some faculty laugh the other day when I had told them they used to be a preschool teacher. So the only difference between my preschool students and those in higher education is that you don't have to tie the shoes to the older ones, but you still have to tell them where the bathroom is, and they need to be quiet and they need to not be where they are.

Jerrod Jeffries: 5:47

So a lot of certain negotiation skills.

Deb Tauber: 5:51

This goes on.

Jerrod Jeffries: 5:52

But going into that though, Billie, is do you have a favorite or most impactful simulation for it?

Billie Paschal: 5:57

Actually I do, but mine is a little bit different than everyone else's Having like goes the best having listened to the podcast.

Billie Paschal: 6:07

There are so many different things that I, like everyone else, have the stories of the students like oh my gosh, we just had that happened last week or I can't believe this happened, just like it didn't. Simulation but one of my preferred impactful simulation story is more from an operation side. In 2018, I was working for a university and I was. I was working as their sim tech and I was setting up a simulation. The way that center worked is the. The sim tech had a checklist right of equipment needed in room in the lodge. You know patient identifiers, things like that. So I was just doing my thing, getting ready for the day, and I realized, as I'm reading through the requirements for the case, I was like this seems really familiar. Now, on a side note, I am a non clinical person that functions in simulation, so I always say that what clinical knowledge I have has been absorbed through through observing simulation and running them and then just osmosis. So I'm setting up for the simulation and I'm like seems really familiar. And I've got to. I've got to create some swelling in the legs and I need to make some redness and we've got pain.

Billie Paschal: 7:21

And reading through the case and it it hits me, this case is deep vein thrombosis that will turn into a pulmonary embolism.

Billie Paschal: 7:31

That is exactly how my father passed away in 2017.

Billie Paschal: 7:36

So it was the first time that simulation in my real life cross paths and I will admit I had not worked there very long and when they came in looking for me in all transparency, I was literally in the corner crying. I was it kind of just all hit me right. So was from that point forward that, after the new girl got herself together, I had a conversation with the director and talked about how that, in line of that situation, we needed to change the checklist, because where I was working at that time had multiple locations across the United States as far as locations and I said I can't be the only person that functions in this role that something else is going to happen like this. So now we changed it where the differential or the diagnosis of the case is listed at the front of that checklist, so that way, if there is someone that has obviously a trigger of this, of a certain situation, they're able to you know, to speak up, pass it on to somebody else. So that's my impactful simulation story, but extremely powerful.

Jerrod Jeffries: 8:46

I mean one again back to kind of a mom's skill of harnessing and taking the emotion and then also communicating it out. But but it's also with how wide the spectrum of simulation stories goes. Right, you are correct, that is something very different, but just as powerful as some of the other ones that we've heard, where you know it can go from so many different degrees. But thank you for sharing that.

Deb Tauber: 9:12

Yeah, thank you, it does, it tugs, it can go really deeply on the heartstrings and gets into the whole situation about psychological safety For not just our learners but as well as our instructors and faculty. And sim tax, right, right, it does, it does make a difference.

Billie Paschal: 9:34

There's those little, those little nuances, but you're very correct psychological safety for everybody.

Deb Tauber: 9:38

Yeah, all right, thank you. Now. Where do you see, Billie, the future of simulation? I love to ask this question.

Billie Paschal: 9:48

There are so many different answers. I feel that, like everyone else, I listened to Tom LaMastre's response to this question and I agree with him. We are going to be moving to a more virtual reality mixed reality component, simply because facilities and time are huge barriers for healthcare education. I don't see. I think what will happen is simulation as we know it. I do not think it will go away. It's going to change. When I started simulation 13 years ago, it did not even look like it does today. I look back and sometimes grimace it. Some of the things that faculty did to students, simply because we were still trying to figure it all out and standards what were those? And not a lot of people knew what they were. I feel that you're never going to take the human aspect out of simulation, be that touching a high-fidelity mannequin or interacting with a standardized patient. That part is not going to go away. But the utilization of newer technologies is going to change and it's going to be different for every facility.

Deb Tauber: 11:10

Right, right. We're going to have to learn how to use and implement the tools. As far as virtual reality, augmented reality, how do they fit in with our program? It's going to be a puzzle.

Billie Paschal: 11:22

Exactly. There's going to be a lot of parents that have gamers that are children are going to be excited to know that there will be somewhere that they can go to work every day. It's not in their room.

Jerrod Jeffries: 11:37

Well, and to your point of how it's going to be changed for every facility or center it's going to be personalized. The most notorious thing goes if you've seen one center, you've seen one center and everybody has different needs and it just goes into all these different aspects of where it can go. What leads into the next is do you have any particular goals or what you want to accomplish for your own center in the next one, three or five years?

Billie Paschal: 12:05

Well, interestingly enough, our university is in the process of adding a College of Nursing program. That is a new challenge in of itself. We just celebrated the first birthday of our current simulation center, which is full and at capacity, with a team of six and 15,000 feet.

Jerrod Jeffries: 12:27

Wow.

Billie Paschal: 12:27

Congratulations, thank you Then. Oh, by the way, we're going to add another program to the mix, trying to figure out how to accommodate everyone. Deal that justification of the importance of simulation. I have met the senior associate dean of the College of Nursing that's been hired and she's a huge simulation advocate. She actually has a lot of VR experience at her previous university, so it's going to allow us to tap into some things that we've talked about in our simulation team meetings, but it's going to give us a driving force and someone to work with that sees the same vision. Any good simulation center. Our goal is to become SSH accredited. There's a lot of ducks that you have to get in a row first before you can start that process.

Deb Tauber: 13:22

Excellent Love to hear that you guys are looking at thinking about considering accreditation and having that you've come from an accredited center, you'll be able to really support that goal and initiative.

Billie Paschal: 13:35

Yes, I think that's going to be an acquired skill that will be beneficial as well.

Deb Tauber: 13:42

Yeah, no, I'm curious also about the, not just a sim tech. How did you start that and what? Because I think you're the one who kind of yeah.

Billie Paschal: 13:53

So thank you for asking me about my hashtag. So in 20 and 2019, I had been to IMSH and I had had a conversation with David Shablak and he has always just said I'm just a sim tech. And then I just finally told him. I said, do you know how many years I have spent telling people that I work with, that I'm not just a sim tech, that I do more than just you know, push some buttons and voice for a mannequin? So then I so I got very reflective about of all the things that we do.

Billie Paschal: 14:33

There are so many things that that a sim tech or some specialist, we have 1000 different name title choices, but we, we all do the same thing. Our goal is to make sure that the learners get the best experience and we handle that logistics and technology component so that the faculty can focus on the learning objectives and the learners time making it beneficial in this in the simulation center. But there's a lot of things that we have to know to be able to support that. Let's be honest, there are a lot of universities and community colleges and even hospital settings that struggle with with turnover on on both sides on the operation side and on the education side for faculty and things such as that. So you need as many people at your center to have a true understanding of adult learning theory, standards of best practice, what is psychological safety and how to ensure that for people, how to advocate at times I've had to advocate for learners. You know those are some very difficult conversations to have, but I have seen faculty in certain situations acting appropriately and asked me to do things with the simulation different because of a learner in the sim being able to stand up and justify and say I'm sorry I can't do that for a whole list of reasons, right, but to be able to speak to the fact that there are standards and there there is a code of ethics and things like that. So it's just important for the sim tech to know and do and support those things.

Billie Paschal: 16:16

In my role as a sim tech, there were many times that I would come to my director with a here's a new equipment or this is what they're doing at this university. Or hey, I heard that they're getting ready to change the standards with this accrediting body. Just different things that we pick up and see and interact is proof that we're not just a sim tech. So that's kind of where that. It's kind of where my hashtag came up from Twitter, and I use it occasionally on LinkedIn whenever I feel worthy. But that Twitter well, I refuse to call it by its new name, but that Twitter hashtag has just been very, very helpful in the things that I do post and share, which are all clearly my own opinion, to be able to show that I'm not just here to do one thing, I'm here to help the greater good.

Deb Tauber: 17:08

Right, and you also mentioned earlier your passion for mentoring.

Billie Paschal: 17:13

Yes, like I said earlier, I have a non clinical background and when I found my pathway to simulation so I have had to rely on finding my own resources right to kind of help me find my own way. But back when I started in simulation in the mid-2010s, there wasn't a lot of printed materials, right, there was some websites and there was some ghosts, but it was a baby conference and Heaven forbid you give the new mom that's only part-time access to a conference, right. So I had to find my way and find people. So I worked. One of the educators that I worked with, amy Wise, was also passionate about simulation operations and she was fortunate enough to go to the very first SimGhost in Las Vegas and she had met some people. So whenever I was constantly coming to her with questions is when she says okay, I'm gonna send you a list of emails from people that you can ask so that you don't have to keep asking me. So before you know it, I had mentors all over the United States, you know, sending a quick email and then turn into text messages, and I'm sure there are definitely a handful of mentors that are thinking why did I give her my phone number? But being able to gain that tribal knowledge and that someone has achieved, and just because it applies to their tribe may not necessarily fit in mine, but at least it helps me not have to start from zero, right? Why?

Billie Paschal: 18:57

Recreate the will is one of my favorite sayings.

Billie Paschal: 19:01

I mean, and to this day, people that were my mentors I don't know my colleagues and my friends Will Infinger, David Shablak, Phil Wortham, roy Ridgway, lance Bailey, I mean these are all big names in the Sim operations world and I got them in my phone, right.

Billie Paschal: 19:19

So if I need something, I know I just gotta shoot a message or start a chat somewhere. So it's having that support. You know, even if you go home at the end of the day and you talk to your significant other about your job which, as crazy as our jobs are no one is going to understand that for the seventh time in a row, the urinary catheter China broke in the middle of 240 students needing to get checked off for foley catheter insertion. God, love your significant other. They are not gonna have a clue other than, oh, sorry, right, but you could call up someone that's also in Zoom and say, oh my gosh, this task trainer is making me crazy. Do you have any suggestions on what I can do to make it better, or so having someone that can listen to you vent, that can empathize with you, is also definitely a good-.

Jerrod Jeffries: 20:20

And that ability to relate. And Billy, there's a couple things I mean. One I love the tribal knowledge. I haven't heard that before, but tribal knowledge I really, really like and just like the mentoring program. There needs to be a home and there needs to be a way for people to connect with each other. Obviously, you probably got some digits early on and those people are like lose my number.

Jerrod Jeffries: 20:45

Who is this, lose it. But over time they're like, okay, she's not that crazy, she's pretty cool. I've met her, she's a good person. But it is crazy where sometimes and this goes back to your earlier point before the mentoring was, when it comes to us discussing different areas of, okay, we need to learn new standards or we need to learn new functionality, technology, whatever it may be, and we just expect adults sometimes to be like, okay, you were hired to do this, so it's gonna stay the same way for 10, 20 years. And we all know that it is not true. What needs to happen is it needs to be this community of people sharing knowledge. I mean what all these professional organizations do that we've talked about. Of course, some ghosts here and SSH there and all the others that are doing incredible jobs, but make that more convenient and accessible. And I think that there's you really resonate with that tribal knowledge piece of know your tribe, but there's also different situational pieces always.

Billie Paschal: 21:49

Right. There's a different feel for that right and I always tell people, especially when we work with the SimGhost mentorship program, we match up a mentee and a mentor together, but we always encourage the mentors of those pairs. First of all, there's not one SimOps person that has all the answers to everything, and if they are, I haven't met them yet and if you're out there, you need to hit me up because I'd like to meet you, but-.

Jerrod Jeffries: 22:19

Yeah, you want their phone number. Exactly, I want your phone number.

Billie Paschal: 22:23

We all have different strengths and one of the things as a mentor is to be able to help your mentee find that person. It's like you know what. That's a great question. I don't know the answer to that. Let's find out together. So there's a lot of that that goes. It's a way to extend, enlarge their community as well their support system. So I always say that when you first start in simulation, the first two years is like trying to take a drink from a fire hose and it's just coming at you nonstop and sometimes it's just so overwhelming. But being able to throw out a lifeline right Every now and then and to help make things better, it's been really a game changer professionally for many people. Thanks, billy.

Deb Tauber: 23:12

Now I'm curious do we have anything that you wanna add, any aha moments for our listeners and anything you'd like to leave the show with?

Billie Paschal: 23:22

Ooh, this is always like this, like deep question right here. This is the one thing that I would like to. I would like people to leave with, because I know that different people within the organizational chart right, that is simulation different people from different aspects of simulations listen to this program. The one thing that I want you to understand is that everyone brings a unique skill set and life experience to your program and that one person that you're locking them in a specific role and you're making them quote stay in their lane could actually be a disadvantage for your program. It could be that person that you're making stay within a certain boundary could actually offer something and fill a gap that you're looking for. So we need to make sure that we, as a team, when you're in simulation, that you know what everybody can do, what all their strengths are and what their passions are. Their passions personally could bring something to your program as well.

Deb Tauber: 24:33

Thank you. Thank you very much. Is there any any questions yet for Jared and I?

Billie Paschal: 24:40

actually asked them before it started, but I will ask this one. I want to ask your mom and I'm sure that there's like a thousand people in simulation that ask you that I just I always wonder if people like your mom have to justify the the need for simulation with their students, and I always, always chuckle if maybe she just says here you should read this and just slides the study across the table.

Jerrod Jeffries: 25:10

Yeah, just the elegant couple fingers, but actually, billy, I have one last question for you regarding the mentorship program. How do people get involved in that if they want to find a mentor or want to be be involved more?

Billie Paschal: 25:24

Oh sure. So the mentorship program is one of the components that is available to SimGhost members. It is a members only aspect, but membership is very cost effective, even on a SimTech salary. We go through and we, nick Brower and I we are the coordinators of that program, we the SimGhost website has an application and you can fill that out either as a mentee or a mentor, and then I jokingly say that we are the matchmakers of health care simulation. So then we, we use our algorithm, our real people AI, to create and match up mentees and mentors together.

Billie Paschal: 26:12

Now, in all transparencies, not all of our matches are successful. There are times that once a couple of people get to know each other, they realize there's a little bit of a not quite the same type of personality. So those issues have always, fortunately, been addressed to be a little exchange of partners. Unfortunately, over the past, the past several years, we've actually had some people that were mentees that actually just left simulation altogether. So I'm always curious to know if they left because it was like drinking from a water hose, or if they had, or if they had, some other life situation that they needed to leave their job possibly. So, but for the most part, we've been very, very successful. We've had numerous new people in simulation achieve their CHSOS, their certification for the operation specialist. We do have an arrangement with SSH because it is mentoring those mentors that do have their CHSOS. They are able to earn units towards their requirements to maintain their certification. So there's definitely benefits to that.

Billie Paschal: 27:22

So I will share my email for you to put in the show notes. You can find me everywhere. I'm on LinkedIn, I'm on Twitter. My Twitter handle is Texas SimTech, but that's TXSIMTCH, and then I'm at Twitter and LinkedIn. You can also email me my role as the mentor ship coordinator. I have a SimGhost email, so that's Billy, billy with an IE at ghostorg. So I'm very available and if you don't have my number, just ask, look around and find a mentor.

Jerrod Jeffries: 28:05

We certainly appreciate the time today. Billie. This is, this has been wonderful and and love your experience from CFO slash King, queen of the mountain family, and then in the sim world and and going into using those different skill sets in so many different places. So thank you so much for your time. Thanks for having me.

Billie Paschal: 28:24

Thanks for the invite. I appreciate it very much.

Deb Tauber: 28:27

We appreciate you and all you do. It was wonderful to get to see you at SimGhost and you did that amazing presentation on research and yeah good strong work.

Billie Paschal: 28:37

Thank you very much, it's been a pleasure.

Deb Tauber: 28:41

All right with that. Thank you and happy simulating.

Disclaimer/ Innovative Sim Solutions Ad/ Show Intro: 28:50

Thanks to Innovative Sim Solutions for sponsoring this week's episode. Thanks for joining us here at The Sim Cafe. We hope you enjoyed. Visit us at www. innovativesimsolutions. 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.