Dr. Marie Gilbert A Leap of Faith Into Healthcare Simulation

We talk with Dr. Marie Gilbert about the leaps, pivots, and partnerships that turned a pediatric ICU nurse educator into a healthcare simulation leader. We also dig into mentorship, the SSH Ascend program, and why competency-based education needs simulation that measures more than technical skill. 
• moving from England to Fresno and finding an unexpected long-term home 
• seeing early sedation simulations and realizing why safety and realism matter 
• building simulation programs without perfect funding through creative collaboration 
• growing through SSH leadership and shaping the Ascend mentorship model 
• designing Ascend to be accessible with no fee and global participation 
• connecting competency-based education to technical, cognitive, and human performance 
• planning the IMSH 2027 consensus forum to define simulation as foundational in CBE 
Visit us at www.innovative simsolutions.com. And be sure to hit that like and subscribe button so you never miss an episode.

Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.

Transcript

Copy Transcript Copied

Disclaimer And Show Welcome

Disclaimer/ 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. Welcome back 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 Jefferies 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 and tune in and learn something new from the Sim Cafe.

Meeting Dr. Marie Gilbert

Deb Tauber 1:31

Welcome to another episode of The Sim Cafe. And today we are here with Dr. Marie Gilbert. And many of you know her. She's a colour luminary in Simulation. And I want to thank you so much for joining us. And why don't you tell our listeners a little bit about yourself and um how you got into this journey and how you even got to the United States?

Marie Gilbert 1:55

Thanks, Deb. It's it's wonderful to be here and thank you for the time to have a conversation with you. So my my journey to the United States, you may be able to tell, and if you haven't met me, I am not from the US. I'm actually from England. I did my nurse training in England in a very traditional hospital-based school. And I worked for about 10 years in the health service, and then my husband and I felt that it was a good time for us to travel, and we had great ideas. We were going to travel to the US, we were going to travel around the US, and then we were going to go on to Australia and New Zealand. So I was looking out at travel companies to see how that all works and very excited. The first workshop I went to was a company that was bringing experienced RNs to the US because of the nursing shortage. So we started that journey. We were assigned Fresno, California. Neither my husband nor I had heard of Fresno, California. But we were, they had a great children's hospital. My background's pediatrics, pediatric intensive care, and in particular, congenital hearts. So this children's hospital had General PEEDS ICU and also congenital hearts. So although we didn't know about Fresno, we were like, this is a great facility, let's go for it. So we came out initially on an 18-month travel nurse contract with, as I said, the plan to travel around the US. And uh we have been in Fresno now for 26 years. I was talking to Deb earlier, you never really know what's planned out for you, and there were many reasons for us to stay. So that's how we ended up in the US. Uh maybe we'll travel when we retire, but uh, we've made Fresno our home.

Deb Tauber 3:53

That's that's wonderful, and I I really appreciate all the work that you've done for the society and in for simulation all over. How

First Simulation Spark In Pediatrics

Deb Tauber 4:03

how about sharing with us how you're you got into healthcare simulation from pediatrics and critical care?

Marie Gilbert 4:11

Yes. So I'd always been interested in um education. I really enjoyed precepting. I always had the dream job of being a clinical educator, a PICU clinical educator. And at the end, okay, this is why you never know where your journey is going to take you. At the end of my 18 months travel nurse contract, um, a clinical educator for the PQ came up. So I was all over that. So we're like, yeah, we'll stay a little bit longer in Fresno. And it was during that time, so I was doing a lot of professional development for nurses and involved with clinical education at the children's hospital. And this is going back about 20 years, this was about 2006. Uh, the hospital was looking at ways to validate hospitalists' competencies for giving sedation outside of the OR. It was back at a time where the conscious sedation kind of hit the hospital world, and everyone was trying to work out how do we make sure that our physicians who are not used to giving sedation in an OR can do that safely outside. So the hospital had uh contacted actually an East Coast facility that was using the simulation, and they came to our organization, and the hospitalists and residents were very gracious and let a few of us, uh educators, into the room to see what was happening. So I can just remember being in there and watching this simulation play out. Obviously, not understanding everything that goes into running a simulation, but immediately to me it was like, where has this been? Why are we not doing this? Why isn't this mandatory? This was just by watching what was going on, how the residents and the hospitalists were really comfortable, the facilitators were really great, and they actually the scenario an act of dose stacking. So it wasn't just wow, isn't this great? It was the recognition that this is something that could have happened on a child. And these were very competent providers, but they were doing something they've never done before. And immediately I was like, I want to know more about this. So at that hospital, I from the moment I saw that, probably four years, it was 2010, I actually left the organization, but I spent about four years working out how we can do more of this. And we did some creative initiatives, uh, as we know in simulation, especially in the early days, trying to find funding was was very difficult. And we did a um co-parenting of a baby simulator with our university, one of our universities. They had they'd had some grant funding, so they had a baby simulator and they had nowhere for it to live. I think if you remember back in those days, a lot of nursing programs were buying mannequins, but they had nowhere to put them. So I was like, well, we'll co-parent with you. So all the time the students were in the facilities, they had priority, and when they didn't, we had priority. So that's kind of where where I learned. And then about 2010, it was actually after my first IMSH, which I think was the first was in Phoenix, I came back absolutely convinced that I need to know more. It was one of those things, the more you learn, the more you want to learn. So I actually, at the time, the organization I worked with, they could see the value, but it was it was really it was a really hard sell. It was a lot of competing priority. So I took a leap of faith and quit my job to learn more about simulation. And of note, I have to say, that organization I I left. I, although I wasn't there to see it through, I feel I sowed seeds and seeds, and they now have a really fabulous accredited simulation center. So I feel I've spent quite a lot of my career sowing seeds so that people can kind of get interested and then eventually they come around to it. So so anyway, I took a leap of faith. I went to as many workshops, I read, I did the at the time it was the California Simulation Alliance, I did their level one and level two training where it began to begin merged into the simulation community. And the rest is history, as they say. It was just that it was probably about nine months I wasn't working. Um my husband and I like to call that an unpaid sabbatical. Um, and towards the end of that year, the Fresno State was actually looking for a simulation coordinator, and again, I was like, oh, this is meant to be. So um I jumped into that and continued to develop my skills.

Deb Tauber 9:06

Yes, yes, you have developed your skills. So you went from I think watch one, do one, teach one wasn't working for you.

Marie Gilbert 9:15

Yes, no, not at all. It was, and I think anyone that sees a really well-run simulation, um, I mean, I've had, you know, I've had many conversations with executives who said, well, it's a no-brainer, we should be doing this. And then you usually get the competing priorities. And so, you know, I I've learned a lot since those early days, and you know, how those conversations would happen differently now. But it was it it was just something that was something I just knew I had to go and learn more about. And the more I learned, the more convinced I was that this should be mandated in every health professional education program and in every organization.

Deb Tauber 9:59

Yes,

Building Leadership Through SSH Ascend

Deb Tauber 10:00

I agree. I agree. It absolutely should be. Now, you've been deeply involved with the Society for Simulation and Healthcare. Why don't you tell our listeners a little bit about your involvement with the society and then stepping up and serving the Ascend program for you know listeners who might not be familiar with it?

Marie Gilbert 10:21

Okay. So again, as I was on, I think I'd my voyage of discovery that year, I was actually in the simulation role, and I and as I said, I'd been to IMSH, so I knew about SSH. I joined SSH. I joined the, it was actually a SIG, the nursing section SIG, as it was transitioning to a nursing section. And at that time, Krista Anderson, who was the nursing section chair, reached out to me and said, Hey, why don't you get involved with the with the section and be our secretary? And very hesitant. Well, I'm so I'm new, I don't know. She's no, no, no, no. Um, come come on board. She'd also encouraged me to lead a work group around scenario validation tools, so she really encouraging. So I I got active with the nursing section, and that really did uh allow me just to dive even further into the simulation community. So I was with the uh nursing section for a for as a secretary, and then I transitioned into the vice chair, and then I transitioned into the chair, and I just I really enjoyed it, I really enjoyed the community, and then as my chair uh time was coming to an end, I'd been involved with the Internal Relations Committee, which is around membership, and uh there was a call for um interested people for the board. So I think I I don't know, it's sometimes you feel a little bit apprehensive about things and go, oh, I don't know, and could remember Krista, just you know, with the nurses section, yeah, you could do this. So I submitted an interest to be on the board of directors and was elected onto the board, and I'm now actually in my second term, my first year of my second term on the board of directors. So that really kind of leads me into the Ascend program. So the ASCEN program is a board initiative, and it's essentially a early leadership simulation career development program. That's a mouthful, and it stands for advancing simulation careers and empowering next generation development. So that's a long title, which is why we lovingly refer to it as the Ascend program. And as I said, it's for early career leadership development through mentorship. And we had our first cohort in 25, so last year. We wanted to coincide with the 25 years at IMSH. So we had the idea, we had the concept, we had a rough plan. I think I was sharing this with you earlier, and we dove into it. And it's just in the 18 months it's been running, we've done a lot of rapid cycle performance improvement, so to speak. So very early on, we realized we needed a lot more structure, and we did that on the fly. Our first cohort of mentors were fellows and so gracious and patient with their time and everything that happened during that first year. So we learned a lot of lessons, and we are now in our second cohort and high-level overview, some of the things that have remained consistent. We have um every mentee is has a mentor. In year one, it was a mentor group. In year two, they they have uh a couple of mentors assigned to them. Um, we have monthly education sessions, and then we have actually started in year one. One of the mentor groups had fireside chats, which is a time for the mentors to come together. So we've we've continued that in year two, where we have all of the mentors come together, mentees come together, sorry, and um have some discussions. So, yeah, there's no fee for becoming uh for applying or joining the Ascend as a mentee, and that's intentional. We know sometimes when there's a fee structure, it can actually prohibit people getting involved, so there isn't a fee. And you also don't have to be a member of SSH. Again, that's intentional because this program is about growing the future leaders for healthcare simulation. And as we are, you know, the many of us that are in leadership roles now are kind of looking towards the retirement. We want to make sure that we're growing and developing the future leaders of healthcare simulation, and and one of the things that this aligns with beautifully is the global approach that we're seeing with many initiatives in simulation, you know, with the global consensus statement that came out. We have the international ILCOS, the the research, international research. So there is a lot of initiatives going on about connecting simulation world globally, and I'm happy to say the ESN program, we have over the two years had mentees from 11 different countries. So that has been really, really great for us.

Deb Tauber 15:48

So yes, that is great, it's wonderful, and it's been it's an honor to be a mentor in the program. I have just, you know, I get so much out of my meeting with my mentee and having the opportunity to have um uh Dave Bafar is one of my partners with the two of us and and Philip Wortham. So it's it's also a joy to you know bounce ideas off of them as well. And really, you know, it's a very, very meaningful opportunity to be selected. And I and I thank you for the opportunity in that you've created for mentees and mentors.

Marie Gilbert 16:31

And you bring up a really good point, Deb, in that I um, you know, when we're talking to our mentors, they they really do identify that, that it's a two-way process. It's not just oh, it's all time consuming, and that it's energizing. And you know, I I am mentoring with two phenomenal uh simulationists, Beth Mancini. Oh I know Beth Mancini and I are mentoring um one of our international mentees from the Czech Republic, and I'm learning so much from Beth. And then Joe Davis, I am a mentoring Welsh pharmacist who is doing phenomenal work. So, again, what I I sometimes feel that you know it's almost selfish because I'm learning so much from both the mentees because they're fresh sets of eyes, they're coming in with um different ideas and initiatives. So I'm learning so much from them, and then I'm learning so much from the mentors as well. So it it really is energizing and a great professional growth opportunity, whether you're just starting out or you're established in your mentoring.

Deb Tauber 17:51

Well, it's kind of timely that right now the applications are still open, correct?

Marie Gilbert 17:56

They actually close on the 24th.

Deb Tauber 17:58

So after the so someone would have to be looking into getting into the 28th cohort.

Marie Gilbert 18:06

Right, right. All right.

Deb Tauber 18:09

Well, thank you for that. Now,

Competency-Based Education Meets Simulation

Deb Tauber 18:12

looking beyond mentorship, you've also been leading conversations about competency-based education. Why is this such an important topic? Why do you feel it's an important topic? It is a very hot topic.

Marie Gilbert 18:24

It it really, it really is. I think from a nursing world, I think when the AACN came out with the essentials and the competency framework and the you know encouragement to shift towards competency-based education, I think it mirrors where a lot of health professional education programs are going or have gone or are in the midst of. And it really aligns with so much of what we're seeing in healthcare now. Healthcare is rapidly changing. I think it always has been a dynamic area and competency-based education, even back when I trained. I mean, I trained in a very apprenticeship model. So I could do technical things when I graduated, but I wouldn't say I was competent because I didn't necessarily have that cognitive ability to shift in different circumstances. So I think even back then it it was something that would have been meaningful. There's increasing evidence and literature that that shows that, particularly in nursing, but I think this is probably something that for all health professions, while they may cognitively be able to know what to do, being able to apply that knowledge in an environment that's rapidly changing is becoming increasingly difficult. So I think this is something that's been been seen across all professions. And in regards to simulation in this world, I I had I was at SimOps last week, and it was my first SimOps conference, and it was absolutely brilliant. It was just, it was such a good conference. And the keynote, Remy Rowe, he wasn't talking necessarily about competency-based education. He was just, he was talking about simulation, and he said something that I thought was so aligned with what we're trying to do. And he talked about simulation and three fires. He talked about a technical fire, which is something I think we can relate to. These are the technical skills that a lot of people outside of the simulation world still think of simulation very procedurally, that this is just about the technical skill. He also talked about the cognitive fire, and he the term fire is the theme of the conference was ignite. So this is where the fire comes from. So the cognitive fire, and this was around making decisions in uncertainty and how simulation can prepare you for that. Um, and then the final fire he mentioned was the human fire, and this is again how simulation can help you manage your fear, fatigue, and feeling unsafe. And we all know when we're doing anything new in anything, even in simulation, we can feel unsafe. That is a feeling that we are gonna have pretty much every clinical day that we work. Throughout our work, there's always gonna be something new that you're gonna feel a little bit uncomfortable. And I think simulation, hopefully, when facilitated well, high quality simulation kind of gives you the ability to lean into that discomfort. Not that it's great, but you what's the thing? You you're you're comfortable feeling uncomfortable. And I think that when we're thinking about competency based education, when Renee talked about these three fires, I'm like, oh, there you go, that's more reasonable. Why you know simulation and CBE fit so well. It's not just about do you know it? Can you do the skill on a certain day? This is really about all of those components.

Deb Tauber 22:11

Right, right. I I've heard a lot about how wonderful that conference was and how Rami's uh information was so inspirational to so many people.

Marie Gilbert 22:23

Right. It was, it was, it really was great. And I was looking forward to that. His um his keynote, he recently published an article um about code switching and how cognitive load and how our brain works. And I don't know the title off the top of my head, but if you code switch in and put in Rome's name, find it. It again, it really helps us think about many things. When I read that article, um I've been doing some work on metacognition, I've been doing some work on implicit bias and competency, and that just kind of having another dive into the way our brains work in any situation is just again really, it was a really aha paper. I really enjoyed it.

Deb Tauber 23:11

I'll have to read that. Thank you. Thank you. Now we're just going to jump ahead a little bit.

IMSH 2027 Forum Vision And Framework

Deb Tauber 23:17

I know that you're co-leading the IMSH 2027 Forum, the CBE Overture Consensus Forum and Simulation in CBE. What's the vision behind that?

Marie Gilbert 23:28

So, again, this is something I'm really excited about. And I'm I'm leading the planning team with Curtis Nickel, who's an anesthesiologist from Canada who has extensive experience in a CBE, and someone I think many people know, Kristen Brown, who is on the board with me. We we work on a lot of projects together. She's a a colleague and friend. And from the nursing world, we were both, we were both kind of like, well, how does simulation fit in? We were hearing uh around with our colleagues that they were when uh CBE came out, there was kind of a mindset that, oh, well, if it's observing rather than if it's observing application, then we just do more sim. And we were like, whoa, let's just stop that there. So we, with the approval of the board, we put together a small simulation-grounded CBE task force. So that there was just six of us, so uh Curtis, Kristen, myself, and then Brian Mann, who is uh dean at of a of uh health, various health professionals who has significant experience of operationalizing CBE, Vivian Obesso, who has done who did some work with entrustable professional activities when medical education moved to CBE, and then Madeline Keener, who is is just a hidden expert amongst our midst, who is a cognitive scientist who has a lot of experience in learning and assessment. So the six of us met, and the task force really was charged with some key components. The first thing that we did was set up the simulation grounded CBE Affinity Group, and that was so that members and non-members, so as you know, affinity groups are open to SSH members and non-members. So that pretty quickly after the task force was uh formed at IMSH 25, we kicked off the affinity group, and that's really a platform for people to come with their questions about uh simulation in CBE. The task force also started an umbrella scope and review, and I do have to give, as I say, a big shout out to Kristen Brown because I don't know if anyone's done umbrella reviews or scope and reviews. We had so many articles to review, and there was a lot of us because of that. And I think sometimes I felt like that she was just trying to herd cats because there was so much going on. Um, so we have finished that scope and review, and it is under review for publication. Really important, important work. And then at IMSH this year, the task force ran two complementary workshops on CBE. One was really for the people that are delivering it, so facilitators, SIMOps folks, around the kind of the delivery of a scenario as it relates to CBE. And then the afternoon was more for deans, directors around operationalizing it. The vision always was to have a forum for a simulation-grounded competency-based education. And and and for people, just to a recap what a forum is, the forum isn't where you come and you have lectures or you know sessions on how to do it. The forum brings together the simulation community to explore emerging issues and shape the future of healthcare simulation. So this year's was technology, there was a technology forum, and I believe it was last year was really the vision of simulation in 2050. So it's the forums are broken up into there'll be it's immediately before IMSH, so it's the Friday afternoon and the Saturday morning prior to um IMSH kickoff. And we're in the planning stage, and again, our planning team, and I'm if I can just kind of do a shout out to our planning team, it's obviously all of the task force, and then we have um uh a representation from Aspie. So Amelia Wallace, who is the current president of Aspie, she's on our planning team, and and I have to say, the the lens of um ASPI methodology has just been great. I've had many conversations with Amelia, and one of the things, again, it was another one of those mic drop moments, she said um, she said, she asked, she said, well, where's the human voice in competency-based education? And and I and I was like, Oh, it was such a it was such a moment where I just thought, you know, you're right. And and with simulation methodology, when you work with standardized patients, they are bringing the voice of the patient. So she's bringing a great perspective to the planning team. And then from Inaxel, Nikki Petsus blog blogged it. She's representation from um in Axel, and we had conversations with Penny Watts, who was the president when we we started the planning committee, and she recommended Nikki, and Nikki's bringing some great, great views, and then just two other stars we have, and I share this because I want people to kind of get the sense that there's a lot of minds coming here, there's a lot of different lenses here. We have Andrew Hall, who is an anesthesiologist from Canada, who has so much experience, so much publications in the realm of uh competency-based health professional education. He brings such a great lens to the conversation. And then Hugh Stottard, and if there's anyone who's listening who's been on any of the affinity groups, will know Hugh really well. And he describes himself, I believe the way he isn't his job title, but I think it should be, is a philosophy of curriculum. So he brings a very thoughtful lens and challenges us as we're planning this. So anyway, the shout out to the planning team. So we will have it set up so that there'll be kind of an opening session, which really is getting every all participants with a shared mental model, and then we'll have breakout groups where we'll have discussions um around certain components of simulation and uh competency-based education. And our ultimate goal is that we will we will be able to get some consensus around how to how simulation is foundational in competency-based education rather than an add-on. So we we've from this scoping review uh we have created a framework which is a living document, and that will be the foundation for the forum, so that we can kind of look at what we've created and really pull it apart and add more perspective to it. So I I'm looking forward to it. I I think just the conversations I have with the planning team are amazing. So I I think when we open it up to the rest of the simulation community, the the it's just gonna be some rich dialogue um that comes out of it.

Deb Tauber 31:02

Yes, it's gonna be great. When you get to IMSH, there's just so much going on, it's hard to soak everything in.

Marie Gilbert 31:10

Right.

Deb Tauber 31:10

And I think that was one of the things that's a little bit different than from the smaller conference at SimOps, where it's just much more intimate group and yeah, yeah. Um, you know, in closing, and you've really inspired me in many ways, and I want to thank you so much.

Get Involved Find Mentors Stay Curious

Deb Tauber 31:29

For someone listening today who's inspired by this conversation, what's one action you'd encourage them to take?

Marie Gilbert 31:35

So I think I said right at the beginning, get involved, get involved with the simulation community. I was fortunate. I had someone who reached out and said, Hey, come, come on. And and again, I think that that is one of my passions about the Astend program, is that I've had had several mentors. So when I started my leap of faith and I was doing the CSA, uh, the first facilitator of the level one training, uh Marjorie Miller, completely took me under our wing. She absolutely and just was amazing. And then Krista pulling me into a lot of the nursing section stuff. Know that just reach out to people. And I've I've had people reach out to me about Ascend who um maybe at this point are not quite ready for Ascend, but being able to say, hey, just get involved with a six section affinity group. Any I'm obviously kind of talking about SSH, but in Axel and Aspie, they have these special interest groups. Get involved. The simulation community truly is welcoming. And I think sometimes when people are new to simulation, they hear that, but they maybe don't believe it because it's not true for every other professional organization, maybe that that we're involved with. Truly reach out and get involved, find a mentor, be a mentor. If you've been in the if one of the things we're we're beginning to to know is there's from the ascend, we really need some initiative before you kind of ready for your leadership development. So we're looking at things like that, but then at seven, eight years, then what? You know, being a mentor is a way of professional development. There is so much you have to offer, and we both shared in our in our menti-mentor relationship. We we continue to grow. I think, and this really does align with the Ascend program, don't wait for perfect conditions to innovate. If you have an idea and you're not sure, there will be a home for it. You know, reach out to anyone in the simulation community, reach out. If it's a section, um, sections and can have work groups that can work on it, but we definitely didn't have perfect conditions for ascend. I don't think transparent, we had everything thought out. I actually think that was a good thing because the program's organically grown, and I think that's some of the reason it's successful. We didn't lay out everything, we had the flexibility to kind of pivot and change. And then really, this this is something that we all do in simulation, but stay curious, just stay curious, keep learning. If you see something and you're like, I wonder if absolutely, I mean, it's it's our bread and butter in the in the community, which is why I think healthcare simulation has evolved so rapidly in the last 20 years with having standards, codes of ethics, the dictionary, accreditation, you know, very short space of time, the profession has exploded. And I think that's because we're always curious and we're always looking to. I wonder if there's another way, or I wonder if. So, yeah, get involved. And through the Ascend and through other mentoring, truly, there are so many brilliant people out there that just don't realize that they're just sitting on a goal mine. They have so much to offer the community, and the community really wants it. So don't be afraid. And know that if your idea maybe isn't quite as brilliant as you think, there will be components of it, and you'll get feedback, and no one is gonna is gonna put you down for for reaching out and um saying, Hey, I've got an idea. Those conversations are oh, that's great, and how about? So yeah, get involved.

Deb Tauber 35:35

Find your people, right? Yes, find your tribe.

Marie Gilbert 35:39

Find your people, and and that's I just I think every year I'm involved with simulation, there is just more, it kind of doesn't fade, you know. When you first start out, that honeymoon period of everyone's so nice, this is so great, everyone's so helpful. It hasn't really faded, you know. As I've grown, even going onto the board, I I don't want to embarrass Barry Eisenberg, but I my first term, my my first year, I was sat next to Barry Eisenberg, who was the president-elect coming in. I I was weaned on Barry's papers, and and I I really sat there and I was like, I don't know if I can talk. And he has been so he he was been instrumental in helping Kristen and I set up the task force. He's really helped us with the umbrella review. Um, it's just been it's just been amazing. And and I think I can say that for pretty much every person whose article I've read and I've gone up to going, just Beth Mancini, say she's brilliant. And she is just so know that when we say that we truly mean it.

Deb Tauber 36:52

Yes, yes, I couldn't agree more. And I want to thank you so much for everything that you've done and for your time today.

Marie Gilbert 37:00

Oh, thanks. Thanks for this opportunity. I as you can tell, I'm still passionate. Like 20 years on, I'm still passionate about simulation in the community.

Deb Tauber 37:09

We love simulation.

Marie Gilbert 37:11

We do indeed.

Deb Tauber 37:13

All right, thank you so much and happy simulating.

Marie Gilbert 37:17

Thanks, Deb.

Disclaimer/ intro 37:25

Thanks

Closing And How To Follow

Disclaimer/ intro 37:26

for joining us here at The Sim Cafe. We hope you enjoyed. Visit us at www.innovative simsolutions.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.