The Sim Cafe~ Interview with Dr. Beth Fentress Hallmark

I completed my ADN (Samford '86) BSN (Belmont, ‘89) and MSN (Vanderbilt ‘94).  I have been married to Brian for 31 years, we have 2 children: Allison, 25 and Mack, 23. I have been a faculty member at Belmont since ‘96; teaching Child and Family Nursing. I have been involved in Simulation since 2007; I am currently the Director of Simulation COHS. In 2010, I completed my PhD in Educational Leadership where I examined the impact of faculty debriefing training on the cognitive outcomes of students. I led the formation of the Tennessee Simulation Alliance and remain active on the board.  I am an active member of INACSL, a member of the standards committee.  I led the publication of the Professional Development standard. In 2017, I led the SSH accreditation at Belmont, the first center in TN to be accredited.  I am a SSH accreditation visitor. In 2019, I was inducted into the NLN Academy of Nursing Education.  I currently enjoy spending time at the lake, painting and I am honored to care for my elderly parents. My personal philosophy of simulation education is a direct result of my experience: An excellent clinician does not make an excellent educator, but we must be intentional about professional development in order to provide our learners with excellent educational experiences. I am excited to see where simulation education is headed, the possibilities are endless, and we are charged with ensuring excellence in all areas of this amazing tool!
Beth Fentress Hallmark, PhD, RN, MSN, CHSE-A, ANEF
Director of Simulation
College of Health Sciences & Nursing
Belmont University
1900 Belmont Blvd
Nashville TN 37212
Phone: 615.460.6112 | Mobile: 615.506.3263 | Fax: 615.460.6125
Email: beth.hallmark@belmont.edu
LinkedIn: https://www.linkedin.com/in/bhallmark/

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Transcript

Intro: 0:05

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: 0:39

Hi, welcome to another episode of The Sim Cafe. Today. We're going to interview Dr. Beth Hallmark,.Dr. Hallmark comes with a wide variety of experiences and she will be sharing them with us. I think the favorite thing I enjoyed about reading her bio is she currently enjoys spending time at the lake painting and she's honored to care for her elderly parents. And I think that that speaks to the quality of a person in a simple sentence. Thank you, Beth, for your contributions. Why don't you tell our guests a little bit more about yourself and your journey in simulation.

Beth: 1:15

Thank you, Deb. Thanks for your vision and having so many simulationists to share their story, because I really feel like we all have a story to tell and I'm honored to be able to tell mine today. My story begins really early when I was born and I was born with a pretty rare birth defect and have a sister that has cerebral palsy. And so we spent a lot of time in hospitals. We, um, I was hospitalized a lot as a child and I watched my mother navigate that. Um, while I had a great dad, he was at work, but my mother really navigated that and she had to, um, figure out what to do what not to do. And of course being 57 and my sister's older than myself, there was a lot, it's a lot different now than it was then. And so she really had be our advocate. And so I grew up wanting to be a pediatric nurse. And so that's what I did. I became a pediatric nurse. I finished my associate's degree first at, um, Sanford university in Birmingham. And then I got my BSN from Belmont and I became a pediatric surgical nurse. Post-op taking care of patient in on the floor at Vanderbilt University medical center, or now it's called the Children's Hospital, but it was just all combined back then. And I realized that I wanted to give back to help those parents and those children, not just as a bedside nurse, but try to help them navigate the home life, what it was gonna be like going home, maybe with a child, with an ostomy or a G2 or a trach. And so I began to consider going back to get my master's and I completed my master's in child and family nursing and became a clinical nurse specialist in about 1995. I finished my masters in 94' and interesting enough, this still informs my practice today. I think about teaching skills to those family members and we can teach skills to students, but can we teach'em to think a lot of times we're teaching wrote things to family members and they don't have a lot of background the patho or the physiology behind it. And so I really work with that now in my simulation work, helping these students figure out how to think. So moving on through my story, I worked the hours of a surgeon when I became a clinical specialist and then I had my first child and realized that wasn't what I wanted to do. I didn't wanna work 7:00 AM to 7:00 PM. So I was told about a job at Belmont, where I had finished my bachelor's to teaching child and family nursing. And I thought, Hmm, how hard can that be? You know, I'm a good nurse. Matter of fact, I'm a great bedside nurse and I do great teaching families. They love me. So how hard can it be? Um, teaching? Well, I was in for a rude awakening and it took me a long time to figure out what teaching was about in 1996, started teaching to child and family nursing. I taught in the labs and I had an affinity for technology. So as our program grew and we moved out of the old Sunday school rooms and the double wide trailer that we had out back where we had our skills labs. I was asked when we were building a new building in 2005 to be on a committee, to hire lab coordinator or lab director. And so I was on the committee. They couldn't find anybody to hire and because of my affinity for technology, they thought, oh, Beth will be good at this. So we had a rep come in from a company and I went with much hesitation to learn about these mannequins. And I thought, eh, they're okay. I don't see why we need mannequins to teach, you know, we and do injections and oranges and blah, blah, blah. But I just didn't see the value in it until I began doing some research. And I did some research and I found what is now an axle? Um, back then it was a lab coordinator's group, or I can't remember the exact name. And then I began finding other sites and other information online and it really peaked my interest. So I agreed to take the job as a lab coordinator. And we moved into our new building in 2006 and we had two eight bed labs, a seven bed, acute care lab, and four peds obese spaces. And I knew nothing about simulation except for what I had read online. So little did I know that Debra Spunt had been a consultation on our space, cuz I really wasn't involved prior to us moving in and taking this job. And so my Dean said, why don't you call Debra Spunt and see if you can go see her? Well, I happen to have a wedding planned in Baltimore and I went to Baltimore to see her. And part of my story is embarrassing. I was in a rental car and the clock was on central time and she was on Eastern time. And so I get a call and she's like, um, I thought you were coming. And of course, I didn't know who Debra Spunt was. Really. I didn't know she was important at the time. Not that I would've been any more disrespectful of anybody, but I was still embarrassed that I was an hour late. And I said, I'm on my way. I'm almost there. So she was so gracious. I just can't tell you how kind she was to me. She toured me around. She spent a couple of hours with me and I, at that time was hooked. Um, that's all it. I was excited. I began to get involved in an axle. Then I invited Deb to come to Belmont. Um, I needed somebody to help me be a champion to really talk to people about simulation because really people didn't know back in 2006 and seven about simulation. And unfortunately she got really sick. You know, her cancer had come back and she couldn't come. She had to play already planned. I mean, we were, it was the day before she said she couldn't come and she died not long after that, but Terry Bey came and Terry was great. She helped excite my faculty and I just continued to do work on simulation and integrating into our curriculum. Also around that time, my Dean came to me and said, um, I will live for an RWJ grant and we are going to have a conference where we teach all the nursing faculty in the state of Tennessee, how to use simulation. And I was like, okay, I don't know anything about this, but I'll do it. I didn't even know what a grant was at that time really. I mean I did, but not really. And it turned out to be the biggest blessing. We, um, had our first in 2008 and it was called from out of the box and into the curriculum and what a perfect name, because at that time, most people had their mannequins in their boxes still. So we had a great turn. I think we had 120 people our first year that was in 2008. We've had a conference every year since, and we eventually formed into the Tennessee simulation Alliance, which I was the president and founder of for quite some time I would be remiss if I didn't thank Melinda Clark from UT Knoxville school of medicine and Therea Brit from CHIPS in Memphis, they really stood by me. We locked arms and the three of us made it successful. We're now an affiliate under the Tennessee Hospital Association and it's a full fledged Alliance and we are, have a great website. So we'd love for people to look at that. Also around 2008, we became a center of excellence and I got to bump elbows with people like Paul Fraus, John O'Donnell, Mary Cato, Jeff Miller, just some people that I had no idea who they were. And I think at the time they just learning too. So we all learned together and I began to get a community that I could rely on. Another funny story is I was trying to develop some policies and procedures for our simulation center and I posted it on a list, serve somewhere, you know, back then list serves were totally different than they are now. And this guy named Michael Seropian said, just call me, I can help you. And I still remember where I was standing. He was so kind to me. And right now he's our consultant for our new building. We're having opening a med school. So he's our consultant. So we've had a great relationship. He has been a great mentor to me. In 2012, I became a hit scholar where I was on the faculty development to integrate technology. And I worked with a pharmacy colleague of mine and that's where I met Maryanne Visalo and she has been my mentor forever. And just a dear, dear friend. I love her like a mother she's wonderful and Vanderbilt at that time continued our, um, RDBJ grant and kept our Alliance going. So I was really involved in that. I became much more involved in NACSILand an SSH. I'm an SSH accreditation visitor. Our center was the first accredited center in the state of Tennessee. So we're really proud of that. Yay. I know that's something and we're getting ready to go up for re accreditation. So that's something exciting. And at Belmont, some of the things that we do, we, we work a lot on interprofessional simulations. We have a new concept based curriculum where we are, um, integrating simulation. I have four sim specialists that are masters prepared, nursing faculty that help run our sim. They do all our debriefing and pre-briefing, and I'm really proud of that. I'm also worked with the NLN a lot where, um, I write for their blog, The Nursing Edge, and I'm on their board for that. So simulation has just been such a gift when I look back and think, you know, I didn't really wanna work when I was a brand new mom. I wanted to stay home, but that's not really the path that I felt like God had me on. And so it's been a real big gift to me to see how it's unfolded and how my career is unfolded. I've been really blessed to say the least we are working right now. The NLN on the ACEs plus simulations, which are, um, the, LGBTQ plus simulations. And those are be coming out soon. We're piloting those right now. I guess. That's all. I don't know. I've got, I could just talk and talk, but I've just been really blessed to have a great career. And I'm really excited about our new med school. I do work with PT/OT, social work, nursing, exercise, science and pharmacy. So we've got a lot at our center and it's just an exciting place to be right now.

Deb: 10:51

Wow. Exciting. Thanks for sharing. Now, do you want me to call you Dr. Hallmark or Beth? What would you prefer?

Beth: 10:58

No, Beth is fine. Absolutely.

Deb: 10:59

Thank you. Thank you. The next question is, tell me about a simulation story that had an impact on you. And after a few of the simulation stories I have heard, I'm not gonna start with tell me your favorite.

Beth: 11:15

Yeah. You know, I think I thought about the, this a lot. It's very hard for me. We do our simulations and then our students go and they work in, in the, um, healthcare environment. We sometimes get some feedback about somebody that, you know, just did a sim and they were able to do CPR or they ran a code successfully, but I've got two little examples that always stick back in my mind. One of'em is a interfa stem we were doing with pharmacy. The nursing students were, and while we were debriefing, the one of the pharmacy students actually said, I didn't know that nurses knew so much. And they were so smart. And I was like, yep, we do. And that's not a against the pharmacy students. It was just such a great example to me of what simulation interprofessional simulation can do. And we could see the benefits of teaching each other about each other's discipline. So that was one of our objectives. So that was really good. And then I told you, we do a concept based curriculum and one of our concepts is perfusion. And so you think perfusion, you know, gunshot wound, something like that. Well, we do a postpartum hemorrhage and we don't do it during OB. We do it their last semester in an acute care course. And my favorite thing about it is to see the students light bulbs. When they see that perfusion is perfusion. When you're bleeding, you can be vaginally bleeding, you can be bleeding from an artery. You can have a gunshot wound to trauma. If there's all types, you can have a tonsillectomy and bleed out. There's lots of ways to bleed, but the students making that connection and the debrief is my favorite thing that we're doing right now, because they're able to see, wow, all their blood pressure's dropping their heart rates going up and I've got to do something and they've got gushing of blood coming out from somewhere. So it's really, it's been kind of controversial actually with our faculty because some faculty think it doesn't go in there. But to me, it's a great example of figuring out the concept of perfusion and seeing the students like bulbs go off. It's probably one of my favorite things that we're doing right now.

Deb: 13:16

Awesome. Thanks, Beth. What do you think the future of simulation's gonna look like? Where do you see things going?

Beth: 13:25

Well, that is a loaded question. I feel like, of course, augmented reality VR, I, you know, all kinds of different virtual things are gonna be important, but I think what I'm seeing, and actually this goes back to my daughter who teaches kindergarten. She teaches kindergarten. She has a kindergarten class that has never been to school before. And she sees a lot of differences in their behavior because they've never been exposed to a setting where they've had to learn, to communicate, learn to cooperate all those things they've been at home. And so I feel like simulation is going to have to be used to help with communication decision making, things that we take for granted that simulation does, to be honest with you, it helps build confidence. And I know we've done that over and over, and we're tired of hearing about confidence, but really giving a student confidence to walk into the room and talk to somebody. Um, especially in this advent of COVID, I feel like that the future of simulation is to help students make decisions. Um, not skills. I mean, skills are important. Yeah. You've gotta know how to put a fellow in, but you've also gotta know when to walk in the room and have that situational awareness. And I feel like that's one thing that we can do virtually, but I also think it's important for them to get some more communication strategies. We're using a lot of actors as our patients now, and as our family members, we do a great end of life simulation. We're really, the objective is they know the patient's gonna die. They're talking to that family member. So I feel like that's really where it's going. I know that there all the virtual things are gonna have to come, but I don't wanna lose some of those things that I think we will if we're not careful.

Deb: 15:04

No, I totally agree. I think those crucial conversations are paramount to, to have in health care. I am, you know, I think nursing students and medical people all go into thinking, you know, we're gonna save lives and stamp out diseases, but at the end of the day, a lot of times we're just having that vulnerable conversation with somebody about, we can't fix this. We can't stop. Um, yeah. So I, I, I applaud you guys for that, that, um, Beth, what do you think about telehealth?

Beth: 15:35

Well, that's interesting that my experience with telehealth personally was, um, you talked about my parents in the beginning. You know, I have a 91 year old dad and an 87 year old mother, and I do a lot of telehealth appointments with them, do it during COVID. But I also, you used my parents to do telehealth with our students, which was really interesting. So I don't think we can, we'll ever go back. Telehealth is here to stay. Um, I think it has its place, but I think as educators, we have to train our students to use telehealth and we had so much fun. My daddy was a patient. My mother was a, and you know, you do what you gotta do when you're in the middle of COVID and they were, they loved it. They had a ball doing it. So I think that's important. This is not really telehealth, but it's something that we did that I actually got from a friend of mine at UT Arlington. They do virtual sim where they put like the iPhone on their head, and this is what we did. And we had our, our students at home and they were telling us what to do. So we were the hands and feet. So while that's not, telehealth is just another example of that using technology for simulation. And so I think we have to train our students to use telehealth, especially our graduate students that not well, just anybody. I think when I was a clinical specialist, you know, if I was having to talk to somebody about a G2 wound or something like that. So I think it's here to stay and I'm excited about it. I just want us to make sure we prepare our students for it.

Deb: 16:58

So, Beth, uh, excuse my question here. How do you put your iPhone on your head?

Beth: 17:04

Well, they make a little thing that it's, I know you can't, this people can't see me, but it's like a strap. You put it on your head or you put it on your chest. We bought both. And you know, they logged in into resume and they, they logged in and they would say, okay, go introduce yourself. And we would go introduce ourselves, wash your hands. And we would wash our hands. And so we were still able to evaluate them. It wasn't hands on, but they were having to talk and communicate. And so, uh, we felt like it was better than some of the virtual simulations that we were developing. So we really, really enjoyed it. It's a lot of manpower are a lot of work though.

Deb: 17:35

I'm sure there's a lot of listeners that are gonna be like, yeah, that's a cool idea. Yeah.

Beth: 17:39

Well you can call Jenny Rowe at UT Arlington in Texas, cuz she's the one that taught me. She's actually published on it. It's very, very interesting.

Deb: 17:46

No, can you get those straps on Amazon?

Beth: 17:49

Yeah. You sure can. You can get'em on Amazon, just a track with your phone on your head or your chest and that's what we did. All right. Cool. You've got some good pictures too. They're funny. Let me tell you, we took pictures of each other.

Deb: 17:58

Why don't you send me a couple of those and we can put them in the ad.

Beth: 18:01

Okay. Okay. I will.

Deb: 18:03

Is there anything else that you'd like to tell our guests? Anything else you'd like to share or anything you wanna ask me? Because I only ask answer easy questions after 12 o'clock though.

Beth: 18:13

I don't think so. I'm just so excited that you're doing this because, um, you know, simulation right now is just so important. Oh, one thing I forgot to mention is the standards, the new healthcare simulation standards. I was the, I wanna say lead author. I really wasn't. I helped her, the cats. We wrote the new professional development standard. And so there's a new professional development standard. NACSILand Healthy SIM are now doing some webinars on those. And they're really, really good. There's a new pre-briefing standard. And then a lot of them have been revised. I really challenge you to look at the debriefing standard. It's been changed quite a bit. I feel like, and I I'm doing education for my faculty right now on all the standards. So I hope that you'll check those out. Those are a great resource.

Deb: 18:57

Thanks. Thanks now, Beth. If our listeners wanna get ahold of you, if they have questions for you personally, where would they go to get to?

Beth: 19:05

Um, they can email me at Beth.Hallmark. It's HALLMARK@ Belmont, B as in boy, E L M O nt.edu. And Belmont only has one L everybody always wants to put two Hallmark has two. Belmont has one, so...

Deb: 19:22

Right. Those will be in the speaker notes. So if you're listening and you wanna find it, uh, easily, just go to the speaker notes and you'll see the connection for Beth. Are you on, uh, any social media, Twitter?

Beth: 19:33

Or, yeah, sure. I'm on Twitter. I think it's at Beth_Hallmark and I'm on Facebook. Um, I'm really actively involved in several of the Facebook simulation pages that are really good if you're not in those, I really recommend, especially for a novices, it gets some good things, simulation technician when it's really good and I am on LinkedIn also. So you're welcome to find me on LinkedIn, so.

Deb: 19:56

Okay. Well, thank you so much for this opportunity to interview you. I've really enjoyed it. Sure.

Beth: 20:02

Thank you again for allowing us all to tell our stories because it, again, I think story is very important.

Deb: 20:07

Yes, we need to share. Yeah. All right. Thank you so a lot.

Beth: 20:12

You're welcome.

Outro: 20:18

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.