Fostering a Symphony of Voices in Healthcare Simulation Leadership featuring Shannon DiMarco, sponsored by Interact Solution.

Discover the unexpected perks of diversity in healthcare education with Shannon DiMarco, administrative director at the University of Wisconsin in Madison, who graces the Sim Cafe with her profound insights. From her non-traditional path into clinical simulation to her pivotal role in fostering teams with varied strengths, Shannon's experiences reveal the vibrancy that different perspectives bring to emergency education. This episode uncovers the subtleties of clinician approaches through a memorable breast exam simulation narrative and champions the notion that eclectic teams are the engine of innovation in healthcare advancement.

Embark on a behind-the-scenes tour of the rigorous Society for Simulation in Healthcare accreditation process, where we traverse from provisional status to the coveted full accreditation with strategic planning and relentless dedication. Leadership in simulation isn't just about decision-making; it's about bringing together a chorus of voices to sing in harmony—a theme we explore with real-world examples and lively discussion. We share the enriching experience of mentoring burgeoning simulation programs and look forward to the future of healthcare simulation, including the anticipated IMSH 2024. Join us for a conversation that's as thought-provoking as it is enlightening, perfect for anyone passionate about the evolving landscape of healthcare education.

Shannon DiMarco's email: Sdimarco@ u-w-healthorg

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Transcript

Disclaimer/ Ad/ 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. This episode of The Sim Cafe is brought to you by Interact Solutions. Interact Solutions is a revolutionary and cost-effective audio-visual simulation learning management system developed for instructors to record, organize, schedule, annotate and debrief student simulations, delivering timely, evidence-based feedback. 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 Tauber: 1:20

Welcome to another episode of The Sim Cafe. Today, Jerrod and I are here with Shannon DiMarco. Hi, so welcome, Shannon. Thank you for being here. Why don't you tell our listeners a little bit more about yourself so that we can dive into today's podcast?

Shannon DiMarco: 1:41

Perfect. Well, yes, like Deb said, I'm Shannon DiMarco. I'm the administrative Director of Clinical Simulation and Emergency Education at the University of Wisconsin in Madison, the University of Wisconsin-Madison simulation program, the joint venture between the School of Medicine and Public Health and UW Health, and I oversee the programs and the strategic planning of both of those organizations. Originally, I'm from the Midwest, so I've been in the Midwest my whole life and I've worked in simulation in a couple of different facets, working in a research lab for Carla Pugh for several years and then moving over to Children's Minnesota for a few years working in their Sim program and their research institute, before coming back to Madison in 2019.

Jerrod Jeffries: 2:27

So you had a stint within children's or pediatrics.

Shannon DiMarco: 2:29

I did, yeah. For about two and a half years I was at Children's Minnesota.

Jerrod Jeffries: 2:34

Oh nice. So Minnesota, Wisconsin, midwest, I love it. So you've been in simulation for about 10 years or so 10 years.

Shannon DiMarco: 2:44

Yeah, this is coming January. It'll be 10 years since I started in STEM, Correct.

Jerrod Jeffries: 2:47

Fantastic. I'm glad you took that red pill. That's good.

Shannon DiMarco: 2:50

Yeah, I agree.

Jerrod Jeffries: 2:52

Well, and then do you have any type of favorite simulation story within it?

Shannon DiMarco: 2:56

Yeah, I do. I don't have a clinical background. I actually don't have a background in healthcare at all until I started in STEM and I had been working in an office as a team trainer coordinator for a small office supply company in Madison for several years and I just kind of needed a change of pace. And so I got a job working as a research manager for Carla Pugh in her simulation medical education laboratory at the University of Wisconsin in Madison with the Department of Surgery, and I was feeling very much like I was in over my head when I started and I remember asking Dr Pugh several times you know, why would you pick me for this position? I don't have the clinical background that you're looking for. And she always would tell me you know, Shannon, you fit a piece of a puzzle that really is important that some of my clinicians can't fill and some of my researchers and some my engineers just can't fill, and so I've always kind of looked at my job or my career in simulation in that regard that I fit a piece of a puzzle that fits well within the groups that I work with, and so I think that kind of was what kept me in CEM in the beginning. But then my story is that what really interests me in simulation was I went to a conference with the Pew Lab back in March of 2014 and we were testing the clinical breast exam, and watching different clinicians palpate the breast on these simulated breast samples was fascinating to me. I recognized there, as a layman to healthcare, that everybody does procedures differently and I didn't have an understanding of that before I started in simulation. And so to see these clinicians palpate the breast and you know, look for different pathologies within the breast tissue the ways that they did it was like a snowflake. Everybody did something different and at that moment I was like this is where I need to be. I want to understand better about how clinicians learn and how educators teach clinicians on how to do different procedures. So that's really what fascinated me in the first couple of months of working in CEM. It's what kept me going since I started working in CEM.

Jerrod Jeffries: 4:59

Incredible. I love the snowflake that everybody does it differently. But then the other one you know when you were mentioning the piece of the puzzle, it is those diversity in teams that really, you know, help extrapolate that and push it to new boundaries, because you surround yourself by the same exact people. It's like you're going to get the same results or so you're going to miss something. But I love that you're that special addition within these teams to really really make that more holistic and fulfilled and pushing it forward.

Shannon DiMarco: 5:25

Thank you. When I look for new team members on my teams, that's kind of what I explained to them too, it's. I don't want to keep that to myself. That's a story. I want everybody to feel like they have a problem is that everybody's a piece of the puzzle and everybody has their own passions they bring to the team and I think the highest performing teams are the ones that are more diverse.

Jerrod Jeffries: 5:43

You have to be within some sort of spectrum, but you know, I'm sure there's some studies out there that are showing, okay, there is a way that you need to be able to have critical thinking skills or layman's or you know different types of interprofessional education that actually pushes that forward and that's also why you know, with SSH you know, of course, we're coming up on the conference here next month but why it's so important that you've seen all these perspectives and even with yourself of not having a clinical but also being involved within a decade. It's so special of the people that are getting involved and able to actually help contribute and push this but not only simulation, but all healthcare forward.

Deb Tauber: 6:16

And I hid the honor of meeting Shannon serendipitously. We we had applied to be in a group an affinity group application for new to simulation and so she agreed to be the chair and I agreed to be a co-chair with a group of some other people and they SSH announced that we would go be able to have to have the group, and so I met with Shannon and she just really just took the ball and ran with it and I was just so impressed and so excited. So we are really excited to share that we're going to be having our kickoff meeting at IMSH in 2024 in San Diego. So, Shannon, do you want to talk a little bit more about what we're doing with that?

Shannon DiMarco: 7:03

Yeah, I'd love to. So again, that group is really passionate for me because I felt like when I first started in Sim it would have been great to have some kind of outlet that I could have gone to and felt like I can ask any questions. I have a great network of people that can mentor me and now me being in the industry for about 10 years now, I can mentor other people. So I feel like I want to be able to give back where I felt like I maybe could have used some more resources back when I started 10 years ago. So again, along with Deb and our other partners, we really kind of came up with some goals for the group, which was to really integrate, you know, evidence based simulation across healthcare educational groups interprofessionally deliver resources for implementing best practices of SIM. I know we've got a lot of programs out there that might be smaller, might have less resources, so this would be a great opportunity for them to be able to bounce ideas off of us. So we're looking at like providing mentorship to those newer programs, that are, those newer individuals who are in simulation and looking for some guidance. So really looking at that, and you know we're planning on meeting. Our first meeting will be in IMS age 2024, like Deb mentioned. Pull up the date here.

Shannon DiMarco: 8:09

For us, I believe that we're going to be meeting on the 20, oh, I hear the 22nd, I believe. I think that sounds nope, I'm sorry. It's Sunday the 21st. At 7am We'll be meeting together and we'll just kind of a kickoff meeting, kind of talking about our goals and objectives. And in the next week we're going to be setting out a quick little survey and needs assessment survey to those members who have already joined to kind of say what do you want out of this group? Because we don't want to say what we think people want, we want to make sure that we're actually looking at what do people want out of this new affinity group. So that's kind of what we're going to talk about our first meeting. It's going to be very casual, just kind of come as you are, want to hear what you have to say. If you're interested to be a mentor mentee, we'd love to hear from you.

Jerrod Jeffries: 8:53

And that's 7am on the Pacific time zone, so it's not as early as everybody thinks. It's more, maybe you know. Nine for central and for Okay. Well, that's good and that's great and I love that. In our view, you've already started the affinity group with SSH, is that correct? Correct, yeah, but how many are in the group?

Shannon DiMarco: 9:10

Well, there was over 200 people who have signed up to get notifications from our group, so there is a good amount of people that have already signed up, but we'd love to have as many people as we could.

Jerrod Jeffries: 9:20

And that's incredible. I mean, it's the same thing as what I'm seeing here, and you know, I say conference season 2023, yet lack of better word but within 2023, you're seeing so many new faces and so many people wanting to be involved, because I think simulation is growing, of course, not only through policy or law, but there's a lot of new, inexperienced individuals that are joining and they don't know where to start, and I think that maybe this would be such a good stepping stone, initial stepping stone for it all.

Shannon DiMarco: 9:47

Yeah, I hope so. That's like. I think that's what Devonize goal has been this whole time, and we're going to bring this together.

Deb Tauber: 9:52

Yeah, we just, we just don't want people to go through what we went through when we first started.

Jerrod Jeffries: 9:58

And I think we should also follow up on this, because for those that aren't able to i or maybe have I don't want to say something else at 7am, but maybe they're still sleeping from the night or diamond ball, I think is the night before, but it is. But say they're not able to join there. We want to make sure that best practices get disseminated. Don't know how that would happen, but I think we can follow up on that after January as well.

Shannon DiMarco: 10:19

Yep.

Jerrod Jeffries: 10:20

Incredible initiative.

Shannon DiMarco: 10:21

Yeah, I think our goal is to have at least two meetings virtual meetings in the year, just so, like you said, if anybody's unavailable to come and meet with us at IMSH, they're so interested in what we have to offer, you know, really kind of having that resource for people that might not be able to get to us in person will have opportunities for them virtually throughout the year.

Deb Tauber: 10:40

Thanks, thanks. I think another thing that we talked about which is absolutely very interesting is that you are part of the 2025 planning committee IMSH 2025.

Shannon DiMarco: 10:55

I am. Yeah, that is very exciting moment for me to be able to be part IMSH at at a deeper level. I'm really excited for what's going to happen with that.

Deb Tauber: 11:04

I know that you can't really share much about what's going to be in 2025, but it would seem to me that having the year 2025, there'd be a lot of pressure on you guys.

Shannon DiMarco: 11:15

It is. We have been meeting for a couple of months already and bouncing some ideas around, excited to release some of those ideas at IMSH 2024. But just so you know, IMSH 2025 will be the 25th anniversary of IMSH, so it is going to be hopefully very special for everybody and we're very excited about what's to come.

Jerrod Jeffries: 11:35

Is the 25th. Is that silver or what?

Shannon DiMarco: 11:38

I believe so yeah.

Jerrod Jeffries: 11:39

Yeah, okay, so everybody will have to wear silver face paint or something.

Deb Tauber: 11:43

Oh yeah, Right, some good ideas being generated already.

Shannon DiMarco: 11:48

All right, I'll make sure we get to the committee, yeah.

Jerrod Jeffries: 11:50

You don't need to change that one, but very exciting, that's incredible. Yeah, oh, I mean because, of course, 2024 hasn't even happened. It's also to me very interesting that you've already started meeting and planning for something that's over your way when the event previous that hasn't even taken place. So this is how much work and collaboration goes into all these events.

Shannon DiMarco: 12:10

Yeah.

Deb Tauber: 12:10

And it's volunteers.

Shannon DiMarco: 12:12

Mm-hmm. Yeah, I'm very excited we meet weekly and it's been a real kick for me so far. I've just had the best time.

Deb Tauber: 12:19

Good. Something else exciting happened for you, Shannon, this year. Why don't you tell our listeners about it?

Shannon DiMarco: 12:27

I'm not sure what you're referring to.

Deb Tauber: 12:29

That you became accredited by the Society for Simulation and Healthcare.

Shannon DiMarco: 12:33

Oh, yes, so that actually has not been. We have not actually found out that for sure yet. Oh, we had our site visit about a month and a half ago and we are waiting to hear back, but we're very optimistic that we actually got accredited. So this week final, yes.

Deb Tauber: 12:50

And what was that process like? What was it like going through it as a team?

Shannon DiMarco: 12:54

Yeah, that's a great question to ask. We have been. We were provisionally accredited two years ago through SSH and got some really great feedback from them what we should be thinking about as far as you know, policies we need to make sure we had in place in order to get that full accreditation.

Shannon DiMarco: 13:09

Some of the things that we were lacking when we first went through a provisional accreditation was our code of ethics really wasn't very strong in our policies and procedure manual.

Shannon DiMarco: 13:18

So we really took some time to delve in and really create a great ethical policy within the center and spent a lot of time hashing it out and making sure that you know we took actually it was we took a lot of what SSH came out with in their code of ethics, kind of as our blueprint to what we wanted to do. So we were able to take that blueprint and put it in the context of our simulation center and we got a lot of great accolades for that from our reviewers when they were on site about how thorough we had been with that process. I would think my advice would be to anybody who's considering accreditation is to go for it, and really we knew at the beginning that we probably weren't ready for full accreditation. So that provisional accreditation really gave us a blueprint of what we really still need to focus on before we went for full accreditation. So it was a really great moment for us to have that opportunity.

Jerrod Jeffries: 14:07

So in walking me through this, let's walk some of our listeners who might not be fully aware about the accreditation piece for SSH and provisional versus full, etc. So I'm going to take a step back. You applied a couple of years ago and you submitted all this paperwork and I'm trying to keep it a little surface level, but I want you to fill in a lot more detail. You've sent in all this paperwork. They had some site visits and said, hey, we want to apply for accreditation. They came back and said you guys are good, but you know we can be a little better. So we're giving you a stamp of provisionally accredited. So what steps or what have you needed to do from being provisionally accredited to becoming potentially becoming fully accredited? What's that timeline? What's the steps you need to take? What's the communal effort that needs to happen? Can you walk me through a little more detail?

Shannon DiMarco: 14:58

Yeah, that's a great question. So the provisional accreditation from SSH lasts for two years and it is kind of their idea of we want to accredit you fully, but if you're not quite there yet we're going to give you a provisional accreditation. So we actually applied, for we knew we were applying for provisional accreditation and then the SSH tells you okay, you have two years to apply for full accreditation and at that time you can decide if you want to do okay.

Jerrod Jeffries: 15:24

So you're intentionally applying for provisional accreditation?

Shannon DiMarco: 15:26

Correct. You intentionally apply for provisional accreditation, receive that was given feedback of what we need to do, and then the SSH, the way they work. It is in two years you need to either apply for full accreditation or you can apply for one more time of provisional accreditation. They really are trying to push our centers into being fully accredited after that first provisional accreditation. But they do understand that sometimes things happen that you have to get a second provisional accreditation in order to kind of bridge that gap. So the difference between the two are is that the set of standards for provisional accreditation is maybe just a little bit less all-encompassing than a full accreditation. So what we had to do in the last two years was look at their feedback and say if you're going to go for full accreditation, these are the five, 10 things that you need to focus on.

Shannon DiMarco: 16:16

So in our strategic planning that we did, we do a strategic planning retreat every year in the center and when we did our first one after we got the provisional accreditation, we said great, we only have these eight things that we need to focus on. How are we going to get these accomplished? And then every month at our team meetings we go through a quick. Where are we at with getting these things from provisional to full accredited? How are we doing with those?

Shannon DiMarco: 16:38

So, for example, our Code of Ethics we hadn't even drafted it out. So my sim educators and myself sat down kind of fleshed through what we wanted to have in our Code of Ethics, bring it to our team, bring it to we have. I report to an executive board, the hospital, and so I brought it to them, had them approve it, and then we kind of felt like, okay, that's great. And that's kind of what we did for all those different points that we had to hit in order to get that full accreditation. Then, once we felt confident that we had kind of hit all those points, we put in our full accreditation application.

Jerrod Jeffries: 17:09

And so for those eight points, and we can continue back to some of the Code of Ethics, for concrete example. So they're saying, hey, these eight things need to be firmed up. Are they giving you a plethora of resources when you are given provisional? Or are they saying, look at this center, by this year, the best practices from XYZ institution. Is that happening?

Shannon DiMarco: 17:29

So sometimes they would give us those resources if we asked for them. For sure, some of the things we knew we could handle in-house, for another example was we need to have evaluation data from our learners, which we didn't have really great record keeping of that, but we knew how to execute that. We knew what we needed to do to do that. Now for the code of ethics. I actually reached out to somebody from the accreditation committee and said we are struggling to figure out what to do and they gave us those resources, so you never feel like you're alone in the SSH accreditation process. The SSH is really great about providing you whatever you need to help you be successful.

Deb Tauber: 18:01

Yes, we do. I sit on the council and I would wholeheartedly agree with that. We really want programs to be successful. I think the other difference between provisional and full accreditation is that data metrics. You have to have the numbers in order to receive full accreditation. So that was weak the first time around for provisional. It sounds like you did a good job of keeping track of the metrics for the second time and I really like how you went ahead and adopted the code of ethics for your center specifically. That's unique.

Shannon DiMarco: 18:35

Yeah, well, I have learned in my work that to work smarter, not harder. And so we really thought well, the SSH has really put a ton of work into their code of ethics. What can we use from theirs and then put into ours? So in our handbook it says we've adopted it from the SSH code of ethics policy that they have. So the credit is still there. But we were thinking to ourselves why would we try to recreate something that's already pretty much flashed out by an organization we are at both standard with?

Jerrod Jeffries: 19:02

100 percent. No need to completely reinvent the wheel. Yeah right, just modify it, right, that's needed.

Deb Tauber: 19:07

So do you have any things that you'd like to let our listeners know, things that you learned? You know personal aha moments on your simulation journey.

Shannon DiMarco: 19:16

I think it is sometimes overwhelming to feel like you need to know everything about everything, but I kind of go back to that. We all fit a piece of the puzzle. So, as the director of the program, I'm in charge of the finances, I'm in charge of strategic planning, I'm in charge of hiring and looking at reviews for our team members, but really I don't make a single decision on my own. I hardly ever make that decision without consulting every person in my group, because we all have different specialties in different backgrounds and different opinions, and so if I have an issue, I really try to collaborate across the board and if I need some guidance external to my team that I'm not quite getting what I need to from my team, I go to my simulation community, go and talk to people that I've become friends with, some colleagues with, and ask them for guidance and how would you do this? What would you do to make this better?

Shannon DiMarco: 20:09

I really never try to make a decision on my own without really looking at my team members for their advice and input and then looking also to my community. So I know that sometimes I don't make the decision that the team wants to see. It's hard decision sometimes to make in this level leadership but also I think my team respects the fact that I do really ask them for everything that they can give me, and so when they hear a decision I make, they know that I'm doing it with the best goodness and kindness in my heart and that I've done it by doing my due diligence and asking them for help.

Jerrod Jeffries: 20:41

Certainly that's really well said and I think that I don't want to say decision by committee, but there's so many different variables that go into each of the decisions that you have to make as a director of the program, and the guiding light is you want to make the program better. Sometimes, when people get their toes stepped on or something, it's like, it's not a personal attack. It's more that I want to create a long term vision and something more holistic for the program, and this is a short term kind of maybe a step back for you, but for overall it two steps forward, and I think that that's sometimes a little tough pill to swallow. But to your words of this is the decision to make in this form of leadership is just necessary.

Deb Tauber: 21:21

We appreciate everything that you're doing, shannon, thank you Very much. You're doing an outstanding job, and is there anything you want to ask here tonight?

Shannon DiMarco: 21:32

I think it would be to just kind of understand a little bit more about what do you feel like in the next five years of your careers and, sam, where would you see yourself going from here? What do you think is up and coming for you in the world of simulation?

Jerrod Jeffries: 21:44

For me, what I'm doing, or what I'm trying to help facilitate, is that sharing of best practices. I think that institutions should be able to connect more seamlessly, without sort of admin faculty, high cost structures, and able to really make that seamless and efficient and so right, even as with your institution, there's I'm making this number up but 20 others that are right where you were two years ago and, you know, in a couple years maybe it's hundreds. And to help facilitate that, not in a form base but more of a contextual base and feedback that allows this efficiency for institutions to find, sort and learn just in time. Education is, I think, paramount and I think that I would like to see more best practices being spent on so we could push for innovation instead of recreating the wheel.

Deb Tauber: 22:34

Yeah, and I would have to say I've been as far as what I've been doing is, you know, taking Jared on as co-host has been amazing to have him join with the podcast. I think we'd like to continue with the free podcast for the listeners as well, as I'm doing significant amount of consulting with new programs and, depending on where the program is, either helping them to build a SIM Center, helping them to advance their simulation center or, if they want to become accredited. Sometimes they'll reach out to me and it's just such a joy to me to help them work together and learn about simulation and the things that they need to do. Once again, just like you both stated, it's not about recreating that wheel. I think so many people get stuck with that thought that it needs to be. Oh, we need to get a brand new wheel. We need to work together with all the things that are already out there and, you know, sometimes I like to consider myself more of a simulation coach, not as a. I serve as a guide on the side.

Jerrod Jeffries: 23:40

Well, it's something that you both are spearheading right With the affinity group. It's the chair for new simulation and co-chair it's. More of people need to know where to start and then everybody's path is different. But your end goal is almost relatively on a very small spectrum is the same, and so you all want to get to granted. I don't want to say the end goal is accreditation. That's kind of the start and the standard approval. But you want to make sure that we're producing quality simulationists. We're producing quality simulations and I think that the steps. There's a huge bucket of anything that could happen and you just need to make sure that there's a way to do it.

Shannon DiMarco: 24:17

That's awesome.

Deb Tauber: 24:18

Yeah, exactly Thanks, Jared. All right, Well, this is going to. This episode will air. Probably will air before IMSH 2024. So hopefully some of our listeners will meet us at our first affinity group meeting.

Shannon DiMarco: 24:35

Yeah, yeah, we'd love to see you come on by and say hi, and if you don't get a chance to say hi and you're at IMSH, look for Deb an I. We'd love to chat with you and talk to you about anything you want to talk about with them.

Jerrod Jeffries: 24:46

Shannon, how can our listeners reach you?

Shannon DiMarco: 24:48

Yeah, they are. Feel free to email me. I can join us. Give the email address. Is that worth?

Jerrod Jeffries: 24:53

it. Yeah, you can give it. We can put in the show notes as well.

Shannon DiMarco: 24:55

Okay, it's sdemarco. It's D-I-M-A-R-C-O at u-w-healthorg. Yeah.

Deb Tauber: 25:04

Thank you so much and we'll see you at IMSH 2024 in San Diego.

Shannon DiMarco: 25:11

Very excited, thank you.

Deb Tauber: 25:13

Thank you.

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