The Sim Cafe~

The Sim Cafe~ An Interview with Dr. Nicole Szalla

May 04, 2022 Season 2 Episode 19
The Sim Cafe~
The Sim Cafe~ An Interview with Dr. Nicole Szalla
Show Notes Transcript

 Dr. Szalla is a Pittsburgh native and United States Navy Veteran. She began her Nursing career in 2006 after completing her enlistment obligations where she served as an undesignated seaman and dental assistant within the United States and abroad from 1997-2003. After a short hiatus and receiving her Nursing degree, Dr. Szalla rejoined the US Navy in 2010 as a Naval Officer in the Nurse Corps, and in totality has served our country honorably and meritoriously for 11 years. Dr. Szalla has developed clinical expertise in medical surgical nursing (CMSRN), and health care simulation (CHSE) attaining certification in both of these areas. Dr. Szalla’s clinical practice centers on adult populations, women’s health, breastfeeding promotion, and home health care. Her scholarly interests are related to working interdisciplinary with colleagues, focused on serving vulnerable populations, students, and the Nursing profession. Dr. Szalla is passionate about coaching Nurses through difficulties with interprofessional relationships and her Doctoral work at Duquesne University centered around mitigating acts of incivility and bullying in the workplace. Currently Dr. Szalla leads a simulation team at Robert Morris University as the Director of the RISE Center in the School of Nursing, Education and Human Studies. Prior to taking this role she worked with undergraduate students at Duquesne University as a Clinical Assistant Professor in the School of Nursing. Expertise: Multidimensional interdisciplinary health care simulation, Workplace incivility and bullying mitigation using cognitive rehearsal, Medical surgical nursing, Maternal health nursing, Leadership, Quality and safety and Professional Development. 

Contact: Dr. Nicole Szalla

Szalla@rmu.edu 

www.linkedin.com/in/nicole-szalla-dnp-rn-chse-cmsrn-1436aa59 

Innovative SimSolutions.
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Intro:

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Simsolutions, edited by Shelly Houser. Join our host Deb Tauber, as she sits 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:

Welcome to another episode of The Sim Cafe. Today we are truly blessed to have Dr. Nicole Szalla. She's a Pittsburgh native and United States Navy veteran. She began her nursing career in 2006 after completing her enlistment obligations where she served as an undesignated seamen and dental assistant within the United States in a broad between 1997 and 2003, she then received her nursing degree and rejoined the US Navy in 2010 as a Naval officer in the nurse court. Thank you for serving our country and Dr. Szalla, would you like me to call you Dr. Szalla or Nicole?

Nicole:

Ah Nicole's fine.

Deb:

Okay. Why don't you tell us a little bit about how you went from the Navy into civilian simulation, and I'd also like to know what you guys did with simulation in the Navy.

Nicole:

Sure. So in the Navy, you know, I sing the song.( signing) So in the Navy, you know, I can remember vague, almost traumatizing. We did some simulation in bootcamp. We did have a simulated ship environment and it was, you know, the ship was sinking and we had to respond with the training that we had received in bootcamp to that unfortunate situation. So it it's real water it's, it looks like a real ship, like, um, aircraft carrier, and you're in there and you have to like dog zebra, the doors, and, you know, and you have to go through that piece. We also do the overboard training when you're jumping off the ship and going to the life raft. And, and so, you know, that is that's similar, definitely leaves an imprint for you. And you know, when you're dealing with something like lifesaving, like jumping off of a ship and they even teach you that your uniform in the Navy is a lifesaving device. So you take off your dunes at the time, you know, is going way back, cuz they don't wear dungaree anymore. But all of the uniforms in the Navy are specifically designed to become lifesaving devices. So like you take off your pants and you have to pump them up with air and tie them. And so you can wrap it around yourself. So definitely something to reflect on about simulation that I did way back when I knew nothing, didn't even know what the word meant or anything,

Deb:

But probably this would be my guess that probably because you had those natural experiences, when you got into simulation and learned about what it was, it was a natural fit. You understood how it could have an impact in education.

Nicole:

Absolutely. You know, you know, the time that I started working was simulation was just very serendipitous. Wasn't something, you know, I don't think a lot of us were seeking out, but it, we kind know stumbled upon it. You know, I've heard the stories and my story is similar. I started working with simulation and in my graduate education and my master's in nursing education program and I was introduced to, it was tasked with designing a simulation for an assignment and then was also working to do clinical makeups cuz I was teaching clinical and I didn't really know a lot about simulation, but I was using a mannequin and trying to give students a really good experience for a makeup clinical, even though I didn't know really what I was doing until I had the curriculum and started learn more about it. So that was really like all of us, like the shock treatment introduction to simulation. It's like, you know that this is useful, you know, that you want to give them a deliberately, specifically designed scenario that is going to, uh, potentiate their thinking and when their, their clinical judgment, how they approach this scenario. So I learned that early on was immediately drawn to it, loved that I could do that for a student because we know in clinical we can't give them all the experiences that are really important.

Deb:

Right. And then you had worked for Suzie. So you had, you know, one of the greatest teachers

Nicole:

I did, I, I didn't know who Suzie was. And so I'll tell that little story I had that experience with undergraduate designing simulation, kind of implementing some simulation, not really knowing what I was doing. And then I was looking for more work as most graduate students do, who don't work full time. And I Googled simulation jobs in Pittsburgh, or I did something like that and Robert Morris university popped up. And so I applied, you know, I was like, oh, I, I wanna do this. This is wonderful. There's a job for this somewhere. And I didn't hear anything for a little while. So, and then I Googled again the phone number<laugh> to the simulation center at Robert Morris. And I called and Suzie answered the phone and I don't remember exactly, but it was something, you know, I just said, you know, Hey, I applied for the position and I was curious, there was any word on, has it been filled? I see it still posted. And so we just kind of went from there and she just started interviewing me on the phone and I was not prepared. I remember her to me about, you know, like talking about methodologies and methodology, do you use for debriefing? And I was, oh my goodness. You know, I was overwhelmed. And she, I remember her saying, you know, you can do simulation with a cantaloupe, but it's, it's really about your skill and your ability and the objectives, the learning, and to, to do a skill debriefing that is methodical. Right? And so we must have had a decent enough conversation. She invited me in for an interview. So I came here and was interviewed and did something well, left an impression and was offered the job. So worked here part-time for about a year or so, and then finished my degrees, my doctoral work, and then was offered a full-time position in another university, worked there and then low and behold, this position became available as a director for the rise center where I really was introduced to that quality of simulation, the theory, all of the standards and the good stuff about how wonderful simulation can be. And more importantly, we're not doing it well, if we're not using the standards, it, you know, it can be detrimental to the learner, right? That psychological safety and maintaining that and cultivating that psychological safety in your environment when you're teaching simulation or designing simulation. So here I am here I am. I took the, the position was offered the position. And of course, you know, I think that's attributed to U which she just inspired and cultivated in, in me and the others that, that are here, who love simulation.

Deb:

Are you guys accredited?

Nicole:

We are, we are accredited for The Society and Simulation Healthcare and Teaching and Education.

Deb:

Excellent. Excellent. Yeah, that's a feather in your cat for sure. I'm gonna ask you my next question, which is, can you share with us your most impactful simulation story please?

Nicole:

Sure. The most impactful simulation for me is when we facilitate our first medical surgical simulation for our undergraduate nursing juniors. So they're starting their clinical rotations in the hospital and for the simulation, we use a standardized patient and I love how students really get a sense for what it's like to step into that student nurse role and have a patient encounter. It's so significant for me because it makes me remember what it was like during those first times when I walked into the hospital with a patient in the bed and I was supposed to assess them, you and the instructor's like, just go ahead, just do your thing. We didn't have simulation when I was in nursing school. So we practice assessment on one another, but not the part where you introduce yourself, where you have to ask for permission to ask, take the lungs. You know, I'm gonna listen to your lungs now. So it is really about that part for me, that is so important. We didn't practice assessing the data and interpreting it in the moment. So what action are you gonna take now that you've osculated these adventitious long sounds. What pieces of your assessment concern you and how will you express your concerns to the, to the provider? How immenennt is the situation? Did you feel a sense of urgency? You know, for me, it's most significant that I now get to be part of cultivating their professional identity and giving them a safe place to discover their style and explore how their actions or their inactions will make a difference for the patient.

Deb:

Thank you. Thank you. Now, Nicole, where do you see the future of simulation going? Where do you, where do you envision things to be?

Nicole:

I see it expanding. Um, I feel confident in that simulation is the future of not just nursing education, but in any profession or area for leaders, leadership, training, schools of psychology, non-nursing educators, people who work in primary education who have to learn those soft skills, those non-technical skills to navigate like a parent teacher conference or for a child that's being difficult. Or how do you conduct group therapy, right? Like how does that go? Especially with SP's. And we do that here. So I see that expanding. Um, I'm really excited about the thought of that and the prospects for other professions. Um, we come from the airline industry with simulation into healthcare and, and it's also in my opinion, the precursor to patient safety and quality, you know, simulation. So let's do more of that.

Deb:

Yeah, I totally agree. And we talked before, I know that you're really interested in doing some incivility training using simulation that you've done. Some of your,

Nicole:

mm-hmm<affirmative>.

Deb:

your doctoral work has been around that I was able to interview, uh, Renee Thompson and she's got a lot of stuff on instability on at her website though. So why don't you tell me about what you are going to deliberately be putting into simulation? What your, what your dream is?

Nicole:

Yes. So I am work on designing a course, you know, some simulation for undergraduate nursing students, because as we know, they are a vulnerable population, right. And we know the term, you know, we eat our young, I mean, the culture is shifting, so that's great. Well, I can see a little shift and Renee Thompson's work is so important. So I'm, I'm a big fan of hers. So what I did in my doctoral work was I did hour long training sessions for nurses. And, you know, you don't have a lot of time in the hospital environment to do training with nurses cuz you're taking them away from the floor. So I was able to get it down to an hour because that's what I was allowed to do.<affirmative> and we did some role playing and, and worked off of Martha Griffin Sentinel work when she talked about teaching cognitive rehearsal as a shield for lateral violence. And so for example, during that session, we'd talk about the history. And then we would talk about how to respond, right? Because the literature talks about it really is a grassroot efforts. Like you cannot rely on policy. You cannot rely on a manager coming to save you when there's instability or bullying going on in the moment. So it really is about training ourselves to respond. So let's respond let's practice. So one of the most common forms of incivility is rolling our eyes, right? We're rolling our eyes. And so Martha Griffin developed a phrase and she was like, in response to that, say something like it's okay to speak to me directly. I can tell from your body language, there might be something you wanna say. And so during that training session, I was teaching that and we practiced that, but I wanna take that steps further right. In simulation. So I see a lot of opportunity here to work with our standardized patients and really deliberately cultivate and design scenarios that give these students opportunities to work with peers, you know, might be uncivil rolling their eyes. Um, providers,

Deb:

Can you repeat that? Can you repeat that? What you said? Cause I'd never heard that one and I, I love it. I wanna use it

Nicole:

The phrase?

Deb:

Yep.

Nicole:

So when yeah, it's okay to speak to me directly so I can sense or see from your facial expressions, there might be something you wanna say, so it's okay to speak to me directly. So there's a short version and like a long version of this. And so sometimes it's, I would just tell them, you know, just say, it's okay to speak to me directly if you can't remember the whole phrase, but you have to practice and that's why it's called cognitive rehearsal. Right? So she, she had these students in her Sentinel work in 2004 practice. They weren't students actually, they were new graduate nurses and she worked with them and she taught them these phrases and they practiced and rehearsed and rehearsed. And then they were able to actually use them in practice when they were experiencing that. And there's more out there about cognitive rehearsal in the clinical setting and how it's being used. And there are people designing programs to sustain this type of training for nurses, right. Because it impacts patient safety. So when, when you are at work and you're not comfortable with your work environment or your colleagues or your peers, it causes a lot of problems.

Deb:

Yeah. When you're afraid to speak up, I, I totally agree when you're afraid to have your voice. Excellent. Excellent. Now, if our learners, listeners wanna get a hold of you, where would they get a hold of you? Maybe they are interested in this work also.

Nicole:

Right? So I I'm on LinkedIn with Robert Morris University. You can go on their website and just search the rise center. Um, that's our simulation center, but LinkedIn, you know, my name is pretty unique, so I'm not hard to find.

Deb:

Thank you. Thank you. Do you have any, anything that you'd like to leave the listeners with before we, we conclude?

Nicole:

Um, no. I just wanna say thank you for having me and following your intuition to do something like this and offer another modality for sharing information and stories and talking, you know, we need to, oh my goodness. So I, I just love being able to listen to this in the car and just, it grounds me and makes me feel connected to others. So thank you.

Deb:

Thank you so much. Thank you so much. All right. With that happy simulating.

Outro:

Thanks for joining us here at The Sim Cafe, we hope you enjoyed connect with us at www.innovativesimsolutions.com and be sure to hit that like and subscribe button. So you never miss an episode of The Sim Cafe.