The Sim Cafe~ An Interview with Lance Baily

In this episode Lance shares his journey from Hollywood to  Healthcare and his epiphany moment when he first saw SimMan Classic. Deb shares her appreciation for Lance and the  support he has provided over the years as the two entrepeneur's discuss simulation. Lean in, listen, learn, and enjoy...

Lance Baily, BA, EMT-B, is the Founder & CEO of HealthySimulation.com, which he started while serving as the Director of the Nevada System of Higher Education’s Clinical Simulation Center of Las Vegas back in 2010. Lance is also the Founder and acting Advisor to the Board of SimGHOSTS.org, the world’s only non-profit organization dedicated to supporting professionals operating healthcare simulation technologies. His new co-edited Book: “Comprehensive Healthcare Simulation: Operations, Technology, and Innovative Practice” is available now. Lance’s background also includes serving as a Simulation Technology Specialist for the LA Community College District, EMS fire fighting, Hollywood movie production, rescue diving, and global travel. He lives with his wife Dr. Abigail Baily in Las Vegas, Nevada with their newborn daughter and two crazy dachshunds.

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Transcript

Intro: 0:12

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions. Join our host Deb Tauber as she sits down with subject matter experts from across the globe to redefine 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: 0:48

Hi, welcome to the Innovative Sim Solution's, Sim Cafe today. Our guest is Lance Bailey and Lance and I go back a ways. U m, I met him at IMSH a nd INASCL and was really kind of, u h, fascinated by his story. U m, and we became kind of close friends, I would say. And when I decided to open Innovative Sim Solutions, I remember it like it was yesterday. I sent him an email and said, can you call me when? So I was walking around the Lighthouse Mall in Michigan city, Indiana, and I get a call and it's Lance Bailey. And I sit down and Lance tells me all about entrepreneurialship and starting a business. And I couldn't even believe that he had made that time for me, but I've been grateful ever since. U m, since then Lance and I have become pretty close. In fact, one time he and his mother and my son, and I went out to dinner because he's done some work for his mother, some just, you know, he had set up the simulation center. Um, i n fact, Lance, I don't know if you know this about him, but on his answering machine, on his phone, H anks says his voicemail leaves hi s v oicemail. So I said to Lance, I said, Lance, it's mother's day, can I call your phone? Don't answer it. So my kids can see this is legit. And that's exactly what they said. They said, wow, my p i t's l egit. So without further ado, Lance, why don't you tell them a little bit about yourself and your history and his and a healthy simulation?

Lance: 2:38

Sure. Well, thanks so much Deb, and really glad to be here at the Innovative Sim Solutions on the podcast and connecting with you and your audience, really excited to share more about, a little bit about, more about me and what we're doing at HealthySimulation.com to support those that are utilizing clinical simulation to improve education training and patient safety initiatives. I kind of got my started like most of us, not specifically in simulation, as we've all mostly sidestepped into this from some various aspect, whether that's healthcare, it audio, visual, military business, whatever it was that kind of brought us in first, uh, kind of knocked on the door of simulation from some of their experience, right? And so my background was actually audio video technology. So I went to film school and then worked in Hollywood for a bunch of years. That's where the Tom Hanks story comes into play. I did work for Mr. Hanks and his production company play tone for a bunch of years, have a lot of fun, you know, red carpet moments. Um, you know, there was a time where I was sitting in the video village with Mike Nichols, Tom Hanks, Julia Roberts, Phillip Seymour Hoffman, and Amy Adams, I think was there as well at the time. So it was just, just a gnarly scene, lots of fun, crazy things happen, but, you know, I didn't feel like I was really helping people beyond, you know, getting them coffee. I wanted to feel like I was really making an impact and helping people in their lives in a really meaningful way. So my family was really kind of, my parents had a background in healthcare. And so that was always kind of something there, but I wasn't really fully, you know, invested specifically in the clinical aspect, but also just the emergency aspect. So I went to school, went back to school, became an EMT B and as well, I became a firefighter in California. And so went through a two year process to kind of undergo that training. And that's where I first learned about simulated environments. You know, obviously in fire academy, we had the burn building, we've worked together as teams to coordinate attacks on fire drills. And so it really taught me, you know, the power of working in a team to kind of have those specific types of outcomes. Obviously with my EMT experiences, we did a lot of that kind of basic simulation work, but way much, much, much lower than I probably would have hoped or anticipated. You know, I went through my entire 10 week intensive EMT course without, without doing anything on OB or, uh, birthing simulations or, or experiences, right. Having seen those things. And so I just thought, you know, there was a lot of gaps there with some of my education and training in the space, but then while it was going through, I was trying to become a firefighter. I learned more about simulation technology. And so, um, my mom actually, as you suggested, is it clinical, you know, was a clinical nurse educator. She's retired now, but she was the director of the program for El Camino College where I was, I was taking my fire academy in a completely different department, but she said, why don't you come over to our SIM lab and check out this new mannequin that we got? And I walked into the room and there lo and behold was a SIM man classic. And it was like an aura, you know, around this mannequin. It was like, huh, like, this is what you're supposed to do with your life. So that audio, video technology, emergency medicine, experiential learning, you know, a lot of digital based technologies as well. And so I had the mannequin up and running and within minutes and I just found an immediate passion for it. Right. And so I became a Syntech for the LA Community College district, uh, worked at a lot of different campuses, helping them with their simulation-based technology operations and then was hired at the clinical simulation center of Las Vegas back in 2009 where it wasn't until 2012 at, which is for the Nevada system of higher education, their medical school. Uh, and there are two nursing schools, including UNLB S uh, uh, school of nursing and their advanced degree programs. They're all came together with a new kind of space and funds dedicated, uh, for all the states programs, the universities of the state to come together. And so I ran that program for a couple of years. And while I was there, I just saw the opportunity to help, to try to create ways that individuals within the community could come together and share those backgrounds and those experiences that they had from their previous lives before they came into simulation. And of course the things that they have learned in their simulation professional career developments. And so that's why you see, like, I created things like SIM Goes, the nonprofit organization that's put on over 20 events around the world and simulation technology operations, and then also HealthySimulation.com. So, um, I think probably about 30 people came to the website that first month that I put it up. I think half of those were on my mom. She was trying to support me with regards to buy new entrepreneurial project. There were a couple other projects that I've worked on over the past 10 years, but, you know, I've, since in a sense left Simcoe says as a staff person and as a board member, I'm more of an advisor now to the organization. They've got their own team of leadership there, but really focusing on HealthySimulation.com. And so since those humble beginnings of 30 people, we've now hit upwards of 45,000 unique visitors to the website this, uh, each month, this year, as well as 21,000 email newsletter subscribers and over 30,000 social media followers. So certainly, you know, I think we're making a, an impact with regards to the space and helping now to try to drive the industry forward in a lot, a lot of new and innovative ways. We've had a chance and an opportunity over the past year to really focus on increasing content through our new learn platform, Learn.HealthySimulation.com. So we've got, uh, webinars there, CE webinars, CE courses. Deb, you've got two courses on there as well as intro to nursing simulation. And so nursing is simulation instructor instructing. And so we've expanded our resources there. We've added to the number of writers on our team over the past two years, a massive increase in readership over the last two years, you know, all the major international conferences were shut down and people were frantically trying to figure out how to use simulation for just-in-time training, with regards to anything of, you know, donning and doffing PPE to how to do intubations and age of COVID. And how do we do resuscitation or any, or any education and training where you can't even come into the SIM lab anymore, you can't come into the building. And so, in a sense, you know, a lot of groups trying to figure out how are they going to kind of integrate these new technologies to overcome these challenges. We've just, you know, massive interest in the industry and the space because of that, both from internal kind of users to kind of COVID related issues, uh, non simulation users, or groups of stakeholders and leadership that have seen the power of simulation programs to deal with chaotic events and use to overcome those challenges. So for example, a vaccination site preparation and simulation before population gets there or testing COVID testing sites and those kinds of things. So, you know, that on top of the major investments that we're seeing in the space, so just a really exciting time. And so for me, I've been really focusing on HealthySimulation.com since about 20, 20 17 was when I really kind of went full time on the project. All the other things that I was working on at the time, kind of put those down and really focused on the website. And that's where it's seen considerable growth and success in terms of really helping and supporting the community. So, you know, we do have the majority of our traffic from the United States, but we do see that almost every country around the world has read HealthySimulation.com over the past decade. And so, you know, it's so exciting to get an email from somebody. Literally, I got one from a gentleman in Mongolia who said that one of our articles was extremely helpful to them in their process for creating their new SIM lab program. So really love hearing that kind of support from the resources that we've been creating there.

Deb: 9:58

Thanks, Lance, you have certainly made a difference in healthcare simulation on many fronts. I, um, you know, I just love hearing your stories and I love the work you've done. And thank you so much, and I'm honored to have you today. Now my next question is going to be, tell me about your favorite simulation experience. I think is simulation simulation is we all have like a favorite story that just wound we won't ever forget.

Lance: 10:24

Sure, sure. So I've got two that really stick out to me and I wouldn't say necessarily they were my favorite, but there are some of my favorite to share because I think there's so much to learn and deconstruct from them. The first of which is that I was at a very prominent institution. You have certainly heard of this institution of to keep the innocent, innocent I won't name names here, but I was there about a decade ago when the, the deans of my clinical simulation center program asked me to go and visit some of the other, other SIM centers that were utilizing some of the technologies that we're investing in to see how they were really kind of taking advantage of them and maximizing their output. And while I was there, um, I noticed that there was a resident who was outside the SIM lab room and she was crying. She was definitely very upset. And I asked, you know, what happened here? What's going on with this individual. I was just concerned for them and you know, how they were doing in that moment. And one of the other individuals who was kind of giving me a tour of the space, oh, you know, some of our instructors like to give simulation experiences that the resident is not ready for is not trained for just to show them that they can have days where they're not going to know what to do. And I thought much like what kind of Kobayashi Maru, you know, from Star Trek where it's the impossible simulation experience that captain Kirk and no one else is supposed to get through, he finds a way, but obviously, you know, why give this task where like we're showing people that they don't know something like what a waste of time, in my opinion, let's utilize this technology in this methodology in a way that's going to provide for an opportunity to expand or demonstrate our experiences and test those things in a way that gives us the opportunity to showcase them and try them on and engage with them, using a tool like simulation, just to prove to someone that they don't know everything. I mean, you could do that with a mathematical formula to just put something crazy on a piece of paper and say, you have to solve this in 30 seconds. Oh, he can't do it well, guess what? You don't know everything. I mean, we, you know, why, why punish the learner in such a bizarre and hurtful way that doesn't have any learning outcome potential to it in terms of their career other than to make them upset? Right. So I think really that kind of demonstrated to me that there was, uh, a major gap in understanding of what the potential for simulation was and is. And that's part of the conversation that we try to have, you know, on HealthySimulation.com. But I don't think a lot of the nonprofit organizations do. And, you know, it's always interesting to me because sometimes I talk with some vendors and they say, oh, you know, we're so tired of explaining very basics to people. And I'm like, please, you better get ready because we've got another 20 to 30 years of that where, you know, our, as our industry continues to grow and expand, there's going to be a lot of people who have just never engaged the, with the technology. I've estimated with some C-suite executives that we've had maybe 10% market penetration. And that's really only in developed countries and only to varying degrees of certain institutions. So maybe we're even lower than that. Maybe only 5%. That means that 90 to 95% of clinical programs out there have no effective, consistent standardized simulation program. And so that's going to be a lot of education that I think we need to help provide in terms of understanding the potential, the pitfalls and the opportunities of simulation as a whole. And then just my other second simulation scenario. This one is one of my favorites, but also kind of points out some lessons learned back when I was a SIM tech for LA Harbor College. And we only have very small SIM program. They're a one room SIM lab, kind of a med surge type environment, and then a small control room behind it. And this was kind of my new experimentation into simulation. So for me, it was, you know, just trying to think of well things coming from my audio visual background. And so what was going on in the, that space was that we had a nursing student, they were asked by the physician's orders to provide for some kind of medication and that the patient was allergic to. And so the patient was allergic and the arm armband had the patient had an armband allergic to this medication, what the doctor's orders did not make that connection. And so what I did was I put one camera on the student drawing up the vile and another camera angle on the arm band, right. Just to kind of show the learners in the other room like, oh, here's this conflict of items that's about to happen. And that's actually from my film school experiences, we learned about a film director, 1930s, kind of Soviet era named Serge Eisenstein. And he had this theory of film editing where he would basically take two competing images and cut between back and forth between them to provide for a contextual conflict that would then have a third meeting. And so I kind of like, I think brought that in. And I had one with regards to the medication and one with regards to the allergy band and literally halfway through the simulation experience learner students in the other room, banged on the wall and yell don't do it. So they were fully aware, you know, the camera angles had really built this tension up for them. So I kind of brought my Hollywood experiences into the environment. Uh, fortunately the student did end up pushing the medication and that ended up being their last day as a nursing student. They were so distraught by the experience that they had and ended up being something that they decided, you know what, this isn't for me, it's too much information and it's too risky and I'm just not comfortable with where I'm at when the program and everything else is as a whole. And so in a sense, it kind of was effective in a way in that. Not that we're creating barriers for people, but giving them that opportunity now to experience what it's like to be a nurse or a healthcare provider before they get into those actual rotations. And I think that's one of the crazy things about, you know, being in healthcare is that some people, you know, like any job, haven't an idea of what that's like, but then when they get into the job, it's kind of different, you know, in healthcare, certainly, you know, nurses eat their young and lots of stuff there that one would have to be ready and prepare for. But I think that giving people an opportunity to try on these roles and kind of experience them in some way earlier on in the process and to give them better outcomes and a better understanding of what it takes to be successful, but also what does it like a third of all new nursing students wants to get into it and quit nursing within a year? What are we doing wrong, where people are making such life-changing commitments two to four years, at least with pre-recs and all the rest of it, that's got to happen in order to be successful. And, you know, just as a nurse, for example, and we're not preparing them to be successful in the actual clinical space as per what the, what the reality of the job isn't. So I think simulation has just a massive role to play. So those are two of my favorite kind of stories, even though they weren't necessarily, you know, favorite moments of how simulation was being used, but certainly like had an impact on my understanding of, of the opportunities there.

Deb: 17:23

No, those are great stories. And I completely agree with the career thing. I mean, you know, you're, you're in debt. Oh, my daughter's a nurse and she's in debt so far.

Lance: 17:32

Yeah. So now you really have to make those kinds of commitments and if it's not something that's good for you or right for you then becomes extremely challenging. Right. And so, you know, I just think that, you know, one of the things that we've done recently on the learn platform with our webinars, which is the new platform that we built, the kind of in response to COVID learned on HealthySimulation.com was one of, with regards to using simulation for professional role identification. And so basically what this team had done was they had used simulation as a way to, you know, assess how people felt about themselves in terms of becoming the role that they were learning and training to do in terms of their education and found that it had a huge impact, some learners responding. This was the first time I actually felt like a doctor was going through simulation. Wow. What an opportunity to give these learners to feel like they are in the driver's seat of their own healthcare career that they're about to enter into in terms of experiencing what that's like. So, you know, very much think that this, that we're still learning about the benefits of simulation and what the outcomes could be. You know, just one note there I attended, um, one of the, uh, prominent simulation conferences, six or seven years ago, this one was in Canada and they had some very, uh, acclaimed PhD researcher come in and say that new simulation technologies don't necessarily translate to better outcomes. And I thought, you know, that's just kind of shortsighted on a historical perspective. And as a futurist, let's look at what the aviation industry has done with simulation. Let's look at the way that it is now mandated and regulated to the degree that simulators in aviation are regulated because they're so realistic, they translate to real world outcomes, right? So they've got the MTSB, they've got FAA 200 force, they've got black box technologies and CRM. And, and think about the technologies for just airplane simulation over the last 50 years, digital screen animation, hydraulic systems, control systems, all those things that have made for simulators to become much, much more realistic, so much so that I believe that there are some countries in the world where you can learn how to fly and become a pilot without actually ever stepping into a plane because simulators are so good. And so, you know, in our space, you do have to have a little bit of an excuse for some of the levels of realism within the technology, because I really think that we're probably only in the last 15 years since the original SIM man classic came out, did we have any kind of democratized access in terms of pricing that could go beyond the high level medical schools or hospitals that could afford them, you know, one of the higher fidelity simulators. And so, in a sense, you know, we're still in early days with all these technologies, but then if you contrast that with what's happening just in the last five years in XR, VR AR augmented reality, virtual reality, mixed reality, massive improvements in the quality of the digital hardware tools supported by groups like Facebook, owning Oculus or Microsoft and owning HoloLens, which is then going to be backed up and supported by more companies coming into the space to create these types of products and services. So, you know, in a way we're really going to be moving into the future of more and more advanced technologies, which I think is going to further force the naysayers to say, oh, well actually there aren't opportunities through technology COVID is certainly, you know, in a sense forced the laggards to reconsider, uh, or prevented them from having any reason to give us a reason to excuse why we should not do this right now and think about it some other time we had to, we had no other alternative, right. And so really, you know, I think that, you know, as a firefighter who went through simulated training and burn buildings, this high-level research you're telling me like, oh, more advanced technology does not lead to better outcomes. Well, I can guarantee in fire-fighting fighting fire is more realistic than just talking about fighting fire and yeah. Having the technology to have a burn building. So we could do that. Absolutely did provide for better outcomes. And I'm sure any pilot who flies on a 737 would much rather have a contemporary simulator than a simulator from 1950s. Right. So I think there's a lot of ego and tradition that we have to overcome in this space. And I'm hoping that our resources are enabling people, not only to develop themselves in terms of being able to understand how they can use simulation, but how can they sell simulation to those naysayers who are not going to jump on board? They're going to wait until everybody else is doing it.

Deb: 22:10

Yup. Yup. I agree, Lance. And I'm going to be taking a little bit of a turn. I'm an opinion to some, um, tele-health education. Like that's a big opportunity. Uh, what do you think, what do you thinking about tele-health and simulation? Do you have any thoughts on that?

Lance: 22:27

Yeah, so, you know, I think from everywhere, I'm seeing tele-health in telemedicine, telehealth in the past was well, something that was happening, but COVID acted as a catalyst to that process and it's become massive. So many C-suite Executives now see the power of enabling patients to stay at home, not come into a brick and mortar and to engage with clinical care, as best as possible from remote locations. One, we reduce the costs of running a business in a physical space. And if Amazon and its stock price are any indicator of what the future of brick and mortar is going to be, then certainly I think we need to be thinking about that in healthcare and also reduces the number of opportunities for infection and so helps with infection control. So we've got an entire business based off of people being sick. Well, if we're going to put all those people in the same, you know, that's just a liability for not only the patients, but also the care providers. And so the more distance we put in between people with regards to just basic communication, especially if we're not doing assessments where we need to physically assess the patient in any particular way, we're going to see, I think, a 10 X of that space in the next five to 10 years, not just in preparation for the next pandemic, as I'm every hospital executive and Dean of healthcare education or degree program is now considering I'm worried about, but more so because wow, we ripped off this bandaid. We saved a lot of money. We actually had better outcomes. And so, you know, in a sense, I think that's going to have a real dramatic impact on us, especially because of this new term I had never heard of before, uh, this past year Tele stimulation. So there's been a couple of Tele simulation conferences put together by our friends, Dr. Timothy Clapper, uh, on the East coast. And so they've done some amazing work there. And so I think people are starting to realize that not only is tele-health going to be a prominent figure in a sense of the space, but also tele simulation to train for those things. If we can use tele simulation to do our Oskies or to do our medical patients, standardized patient kind of interactions and engagements, why do we have to physically be in the same space to do that? And so enabling for an opportunity for students to learn how they're going to engage and work in telehealth through tele simulation is just going to be another key area that I think is a, is a new kind of consideration. It's been there floating around, but like now it's being taken seriously in a major way by every institution. We just wrapped up a webinar with Dr. Laura Gonzalez. Who's now on the team with, um, Sentinel U and she had presented us with an amazing statistic. And I want to absolutely make sure that I get it right here. It is. So Yungso Park et all, June, 2021 Distance Simulation survey, healthcare distance simulation collaboration, u m, h asn't been published as y et and was 618, 82% lo ng-term p lans to continue distance simulation slash hybrid simulation after the pandemic. So guess what? It worked in a major, major way. And so the things we've been harping on telling people like, ah, works, it works, it works well, you know, sorry that it took a global pandemic fa r. Some people in th is s pace to, you know, have no other alternative, but ge ez, okay. I guess we'll check out some of these technologies I'll come to find out ga p t h ey're j ust easier and more cost effective over time. Right. So with better outcomes. So, you know, I think the, I think we're Pandora's box is open. We're never going back to t he way th at t hings were, you know, and that's part of simulation as a whole too. It's like once we convince somebody wants or e xplain it to them in a way that they get it, I should say is a better than, than convincing them, but rather in lightening them to the process they're converts for life. Right? And so each and every day, ou r, our army, if it wi ll, is getting bigger and th is i s n ot going back, there's no way people, once they understand the power of c o mmunity t o be like, you know what, let's just go back to practicing on each other or practicing on oranges. That'll be, that was good enough. You know what I mean? Nobody's going to go back to that. So anyone who is n't o nboard now is basically dragging their feet, as far as I'm concerned and wi ll n ot have a say more and more into the future, especially with regards to digital natives, you know, the generation that's becoming a clinical educator, a clinical professional now grew up with iPads in their hands or iPhones or some level of digital technology that even not even, not even I was privy to or had access to in my youth. And so I think that students are go ing t o s tart to evaluate, especially in a post COVID world. What about remote an d d istance learning opportunities in case something happens. And I can't go to campus anymore because I've heard the horror stories about those nu rsing s tudents and medical students over the past two years. And I don't want that to happen to me. Oh, you guys don't invest in any, you don't have any virtual patients? Nothing I can do at home by myself? Okay. Well, let's think about some other schools or institutions and see if there's not others that ar e d oing that. It's just like the SIM lab is b e come t his kind of marketing showcase point of interest. So, we ll, the digital and learning tools that ba ck u p a nd support through that department lo ng-term f or learners overall.

Deb: 27:44

Right. Great, great answer. So you kind of hit on my next question, but I know you don't have a crystal ball, but where do you see simulation kind of going in the future?

Lance: 27:56

Yeah, so, you know, I think one of the things that I kind of alluded to, um, but I want to back up when support with some, some key numbers here is the investment that's going to come into this space, not even from internally within our own group that we're talking to ourselves a lot or even new healthcare institutions that have started to pick us up. But, uh, venture capital firms that see the writing on the wall with regards to what other spaces of high stakes environments look like and what our space looks like and what COVID did in terms of forcing institutions to reevaluate and to make new investments a number like 82% going to continue to do something that they didn't do two years ago is absolutely going to bring the attention of major investment partners in the groups that means more money and more people are going to come into their space than has ever been before recently, just for example, two weeks ago, Labster, which is a virtual like lab simulation company, life sciences, you know, more in the kind of like slightly chemistry, but also labs are a chemical labs. They medical labs, they two months ago received a$60 million series C investment from Andreessen Horowitz, which is one of the name brand venture capital firms in Silicon valley. You know, if you know anything about investment opportunities, Andreesen Horowitz is one of the top players in the space globally. And so their investment in Labster is I think a really important note for our industry as a whole major money's coming into these labs are just acquired. UbiSim, one of the leading nursing VR simulator platforms about two weeks ago. And so we may mention a both of that. And so us army invested$22 billion into hollow lens, Microsoft HoloLens technologies over the next decade, Bernie just took a$10 million around applied VR, took a$29 million round a few years back like a year or two health scholars took a$17 million round. So what does this going to do to our space on top of internal growth, it's going to start to bring external funds. That's going to bring external leadership, and it's going to bring external perspective to this space, all of that mixed with, I think, what will take place in the next five to 10 years at some point, the shoe's going to drop and we're going to have the public become more aware of not only the reasons why simulation is really important to prevent the next pandemic, but also just how important simulation is to prevent medical errors. Right? And so I think as that conversation becomes more in the public domain and the public becomes more aware that they are 10 times more likely to die in the hospital than they are in the car on the way to the hospital and a hundred times more likely to die in the hospital than in an airplane. I start to wonder, does their fear, you know, switch from one that is kind of quite frankly, a much more of a hypothetical than an actuality. You're so safe flying in an airplane right now because the industry has really worked hard to make those improvements over time. When you have 33,000 international flights a day 0.000001 improvements make a difference. And that's where that industry is at right now, fine tuning, right? Whereas we haven't even picked up the big brush stroke, broad stroke yet, yet with regards to like, you know, really looking at the problem and how we're going to solve it over time. So, you know, I think overall the, um, as I said, Pandora's box is over. We're never going to go back to the way things are. And now it's just a matter of how long will it take us to get where aviation is. That's the only question at this point. So certainly you're gonna see more adoption, more utilization, better outcomes. And so those outliers that you might meet at like groups like MedStar that are promoted by the patient safety movement foundation for their transparency, for their willingness to recognize their medical errors and take ownership of them, those outliers are going to become seen as basically the leaders in the space and all other healthcare institutions that want to remain in business at some point or another are going to start to make this shift to the ounce of prevention that is simulation versus the pound of cure, which is just call the lawyers. And nobody talk about anything until the lawyers have agreed upon whatever it is. That mentality is a 20th century, 20, you know, 21st century and beyond is about ownership of participation and what we need to do at a systemic level in order to make outcomes safer over time. And that doesn't just have an impact for patients. It's also about quality of life for providers. And I think that's a really important part of the discussion. We always talk about all education and training, but also just for those people in their own lives. Like if the system blames the individual, as opposed to the system, it's never going to lead to better outcomes for the system. That's just going to turn off or turn away an individual from making a mistake, as opposed to having a system that allows that mistake to be taught or learned or continued in any capacity and reinforced a lot of the time. Right. And so we just need more of that kind of work. And I think that that's where you're going to see happening more and more so in the near future.

Deb: 33:16

Wow. Thanks. Thanks. I agree. The other thing that I was thinking, and I think this would be a great idea for an industry. I'm going to spill it here cause way too well to ever be able to do something like this. I think you've probably seen like the, I fly. It's like a simulated experience. You are a skydiving.

Lance: 33:36

Oh yeah. What? Yeah, I think I've been on one of those, like a Disney world where you're kind of flying over something or in a seat. So what's making me so sick you, but yeah, I do know of those.

Deb: 33:47

So if you were to have us, you know, like a, a free standing and we talk about you and I was talking about Starbucks, so it's kind of a Starbucks, but you could go there and pick a simulation. So just a regular person could go in and they could go, yeah, I want to deliver a baby today. I want to be this. I want to be that. And then the staff could do it. And then you could say, you know what, just like you said, in nursing school, Gee that is not something that I would ever want to do. But I think you could have a menu of opportunities. And I think it would be kind of a great, uh, thing for somebody to get into business on.

Lance: 34:21

Yeah, well, you know, I think this is part of what, and I don't fully understand the metaverse yet, which is Facebook's new thing, but I think this is their long-term goal is to utilize things like the Oculus to create an environment where almost anything is possible training or entertainment and building a bridge for those things can be shared and experienced together. But what about as a prereq requirement for nursing school is that not only did you have to do a 12 hour shifts and nursing facility, but you also had to do 12 hours of simulated virtual reality experiences at a particular location or on your own, as long as you could demonstrate that you, you participated to show you what it's like to be a doctor, a nurse, a RT a EMT, whatever, giving you an opportunity to be a part of that space.And not that you've got to, you know, somehow test her knowledge, but rather just like they're gonna spoon feed some of those things to you and help you along the way. But is this something you actually want to do watch this video, you know, in 360 of the actual surgical environment, and you can fast forward it to 24 hour surgery. So just to make sure you're, you understand right. That surgeries are not just like, oh, 45 minute thing, like your wisdom teeth out. No, we can have a 48 hour surgery where you're not leaving until we're done. So, you know, just making sure that people actually know what an opportunity I think to do more of that kind of work, um, ahead of time, how much would that cost in terms of time and energy compared to the thousands and thousands and thousands of dollars of tuition, of books, of training of school, and then of orientation for those hospitals to hire those groups, that's tons of cash saved and better spent on individuals that go through those experiences in real, yes. More of this please. Like where can I do more? Because, you know, I think it's so important to, to just convey some of those realities so that the people that are continuing on this pathway know that now, before they get too far along with it. And that's just one example of how simulation can be used in orientation to improve incomes and reduce costs over time.

Deb: 36:27

Wow. I appreciate your time. Lance, thank you so much. I am going to ask you one more question. I'm super curious. What's your favorite movie for so long? I thought, you know, he's probably a s a favorite movie and I might need to need to c ut t hat out.

Lance: 36:44

This is a silly one, but I wrote my, um, senior thesis. It was called The Lingering Effects of Post- Colonial Control on Perry Handles the Harder They Come. And this is kind of an obscure film, but it was the first film, the Harder they Come that introduced a reggae to the Western kind of America basically, or north American, in sense, out of Jamaica where the rest of the world, it was the first film that really highlighted it. And so it's an amazing kind of representation of that country during the 1960s and seventies as a transitioned away. So, but, you know, really unique and kind of interesting film, but then in terms of big budget Hollywood, you know, I'm just such a fan of films like 2001 and Kubrick, and the way that that all came together in terms of the cinematography and the style, but also apocalypse. Now, do you learn about the production and what it took to actually get that film made, you know, years over budget and just huge amounts of struggles. And so to me, like for a film to be amazing at that level of quality, it's not just about the picture that we're seeing, but also the production behind it, just as that's my background and my experience. So those are a couple, uh, but I mean, there are so many, that's one of the crazy things about film school is that there were days when I would go to school literally at 8:00 AM at university, and then I would come back and I'd be home by about 11:00 PM. And all I had done all day on campus at different courses was just watch. So I'd probably see, I've probably seen 20,000 films at this point. Um, and so there are some, some golden jewels in there, Joan of Arc and 1930s film, just a really remarkable piece of work. And so plenty of, you know, unique little pictures along the way. So anyone who's interested in more of my movie picks can certainly email me, you know, on top of if anyone has any questions or needs that you can't find on HealthySimulation.com and feel free to reach out Lance@healthysimulation.com. Always happy to help.

Deb: 38:44

Thanks, Lance, thank you so much. Um, and, uh, next week, or actually later in the week, I'm going to interview all Laura Gonzales.

Lance: 38:53

Oh, okay. So great. So Dr. Gonzalez, awesome. Well, I can't wait to listen to that one too, because we just had a webinar with her and it was, and some panel members and really great topic of discussion. So I'm sure she'll have some, some more interesting things to say and to, and to see and to share.

Deb: 39:09

Okay. Well thank you so much and we will be in touch soon.

Lance: 39:13

Thank You, Deb.

Outro: 39:15

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Music: 39:44

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