ON RECORD

00:00:02:01 - 00:00:28:19
Unknown
Welcome to the On Record podcast. This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio and innovative ways to support their organization's objectives. My name is Mike Anzalone and my co-host is Kyle Shelstad. And our guest today is Deb Tauber. Deb is the founder and CEO of Innovative Simulation Solutions.

00:00:28:21 - 00:00:53:06
Unknown
And she's also the host of Simulation Cafe podcast. Welcome, Deb. Thank you. Thank you. It's a great honor to be to be here today. We're excited to have you as well. And before we, you know, kind of hop into the conversation, I'm always fascinated how people get involved with simulation, because it seems to be like such a niche market in health care.

00:00:53:07 - 00:01:38:03
Unknown
Can you tell us a little bit about your journey, how you got involved with simulation, and what brought you to found your your company? Yeah. Great question. Thanks. So I'm a nurse by trade, and I worked primarily emergency medicine for the first 25 years of my career. I was involved in when trauma became level trauma. So it went from people would go to the closest hospital and then in the 80s, they came up with the idea of having hospitals take trauma patients, depending on their level of care, that they needed.

00:01:38:04 - 00:01:52:03
Unknown
And so, I was blessed to work in a level one trauma center and help, you know, organize it, which was really a great opportunity. And.

00:01:52:05 - 00:02:38:19
Unknown
at one point in my career, I started to be the clinical educator of the emergency department. And being the clinical educator, I was responsible for making sure that everyone knew what they were doing and. We were using simulation, but we weren't calling it that. We were just doing it. We were doing drills with patients. We were, you know, staff members and and so after I left the emergency department, I took a job at Chamberlain College in nursing, and they brought me into the simulation center and said, you know what?

00:02:38:21 - 00:03:19:00
Unknown
You're good with kids. We want you to set up this pediatric manikin. And I thought, yeah, I'm good with kids, but I'm good with real kids and sick kids. It's not a manikin, not a simulator. And so I was fortunate enough to to be introduced to simulation through Chamberlain. And he had the opportunity to set up the stuff for pedes and and the what I learned was that there was this whole different science to health care using simulation.

00:03:19:00 - 00:03:44:11
Unknown
And I thought to myself, if I could have used simulation when I was working in the E.R. and actually knew what we were doing, I would have used it for training decisions, because it's really hard to, you know, you look at you get five resumes and five people have great references. They train from amazing schools and their GPAs were top of their class.

00:03:44:13 - 00:04:22:15
Unknown
However, you put them into a situation and they might not be able to respond under the type of pressure that, you know, is there. And if you were able to use simulation to determine people who have the ability to prioritize, to delegate, to communicate effectively and not to panic would have been a lot easier in my career to make hiring decisions, because at the end of the day, no one wants to let someone go because they were too panicked in an ER when you were working.

00:04:22:18 - 00:04:57:02
Unknown
I mean, it's not good for the person, and it wasn't good for me either, because you just need you need people to be calm. So when you were setting up the pediatric simulators, what age did they go from? Like a little preemie baby all the way up to six, seven months. How we did that? Yeah, we had the, Gaumard pediatric and the Gaumard infant, so that Little HAL.

00:04:57:04 - 00:05:41:03
Unknown
And, that's the two that we had there at Chamberlain. They used, several different simulators, products from Laerdal from CAE, as well as from Gaumard. Laerdal which is still there now CAE which is now elevate and then Gaumard which is, which was Gaumard and still Gaumard. When you were training those students, particularly in pediatrics, one of the things that I've, I've come across in working with simulation professionals and educators was this idea of they would be studying like time to intervention, aspects of simulation.

00:05:41:04 - 00:06:04:07
Unknown
And it was interesting because some of the researchers would tell me in those studies, they would find that students would be nervous, more nervous with a pediatric scenario than they were with an adult scenario. How? And number one, was that is that your experience? And if that's your experience, like how were you able to overcome that, that reluctance?

00:06:04:07 - 00:06:36:16
Unknown
Gee, I'm working on a tiny little baby. And they're just maybe more of a more of a nervous factor. Oh, Mike, that's very, very, very true. And it's not in simulation. I mean, it's in real life. When I worked in the level one trauma center in the emergency department, there was a 100% sure that when a pediatric patient came in, compared to an adult in a trauma, in a full rest in anything, anxiety levels went up.

00:06:36:17 - 00:07:01:08
Unknown
It's just that helpless feeling. So one of the things that we did was we got something called a Broselow Tape. I don't know if you've ever heard of it. No, it's, a tape measure that you put on the gurney when the patient comes in, and then you measure the child and they fall into a different color.

00:07:01:10 - 00:07:30:11
Unknown
And whatever color they fall into, like it's orange or blue or pink, purple, red. There's a corresponding drawer with the correct size of equipment, because that would be one of the things that was so different from adults than children is their sizes are so different, and you need to make sure that you have the right equipment. So that was one of the things that really helped.

00:07:30:13 - 00:07:59:21
Unknown
And then I incorporated that into, using it in, in simulation so that the learners would learn right from the get go how to use this system for measuring. And it gives you a place to focus instead of just thinking about the fact that you're taking care of someone's most important person in their whole world. We've seen a variety of use cases for video in simulation.

00:08:00:01 - 00:08:31:10
Unknown
What are some of the more popular use cases that you've seen in that you've used in your career? So one of the things I love to use video for is for AIDET like introducing yourself, acknowledging the patient. And making sure that introductions are done. And I think that. Are you familiar with AIDET?

00:08:31:12 - 00:09:04:04
Unknown
I would probably mess up if I said yes. It sounds familiar. Is it something to do with disability? No. It's an acronym for How to introduce yourself to a patient. So you acknowledge them, then you introduce them. You introduce yourself. And I'd give them time, durations. E what to expect. And then thank them because especially now that we live in such a technological.

00:09:04:06 - 00:09:32:15
Unknown
Society, it's even more challenging for new people to learn how to communicate with patients like they would literally stand outside the door, like, do I have to go in there? Yeah, you do it. Yes. The clinical instructor. Yes you do. You do need to go in there. You do need to acknowledge them, introduce yourself, tell them how long it's going to take on which to expect what you know, explain, explain, explain.

00:09:32:15 - 00:10:01:11
Unknown
And then, you know, thank them for choosing your organization to put them at ease. So I love to use that for videotaping because it gives the learner a very, something that you have to do, right? Something very important, but a pretty easy task. And for them to watch themselves and how that simple communication goes can be very powerful.

00:10:01:13 - 00:10:48:13
Unknown
Now, I'm sure that you guys are aware of this, that there's, many times where learners can learn more than watching the video than they do actually doing it just because they're so anxious, depending on, you know, what the person's personality type is, that they're just watching with such intent. It's not like watching a movie where you, you know, like, oh gosh, or done it, but you're watching to think, how would I do this if I were in this situation you were talking earlier about, so kind of throughout your career and you mentioned like, communication or, working with nurses that are maybe nervous in a situation or in the ER.

00:10:48:15 - 00:11:20:02
Unknown
Have you seen video, you know, play a role in helping train that or make people feel more comfortable in their communication in a stressful setting? Well, I think to use that to use the video for teaching purposes afterward is where the learning would mostly occur. You would look at, you know, like, let's let's look right here when you didn't wash your hands, when you walked into the room and you didn't acknowledge the patient and you didn't introduce yourself, right.

00:11:20:04 - 00:11:57:04
Unknown
Or conversely, you know, you did a great job when you wash your hands, you acknowledged the patient. You introduced yourself. So you can learn on both sides of the spectrum. Because just because someone does something once, unless someone else lets them know that what they're doing is effective, they may or may not repeat what they did. Right. And so just as much emphasis needs to be placed on what learners do, right?

00:11:57:06 - 00:12:43:18
Unknown
As does what things don't go so well. So, you know, a lot of the clients that we work with, one of the common themes that they share with us is this idea of, student self-reflection. So they'll they'll watch themselves in a video and say, I can't believe I did that, or I can't believe I said that because they're maybe not as focused in that particular aspect during the scenario, but when they see themselves, then all of a sudden it's like, oh, I can't believe I now I, I there's like a really intense learning moment on their own, their own actions, their own behaviors.

00:12:43:19 - 00:13:11:13
Unknown
And I'm kind of curious, what if you've had similar experiences from the students and learners that you've worked with? Oh, absolutely. They watch themselves and they're so critical on how they, you know, how they look, how they handle things. They're not looking for the good things that they're doing. So I think that's where a really,

00:13:11:15 - 00:13:34:09
Unknown
A good instructor can go ahead and help them look through the positives as well as things if they didn't do so, because I think all of us well, I and I can say all of us, many people want to look at you might you might get, you know, 25 scores and some that you're teaching evaluations and yet five, five, you know, 1 to 5.

00:13:34:10 - 00:14:12:03
Unknown
Right. And so you get 25 learners and you get. 21 fives. But you focus on what about that four what happened with that? Four did they are there any comments in there? So I think focusing on what you do right is just so important, especially in simulation. You know what? I get started in simulations. Almost 15 years ago it was the idea was video at that time was it was a nice to have and today it seems like it's a must have.

00:14:12:05 - 00:14:41:14
Unknown
What how would you kind of explain that evolution of the the necessity to integrate video into those simulation scenarios, at least the high stakes scenarios. Right. Not every sim is is recorded, but it just seems it's becoming more and more an accepted practice that we need to record these sessions for a variety of reasons, whether it's to support student self-reflection.

00:14:41:14 - 00:15:18:04
Unknown
Like we like we mentioned, it's to support video assist, debrief or using it to support how we're going to assess and evaluate students. I'm just kind of curious from your perspective why video has become so integral a component to simulation? I think that there's so many things that you can use it for, and starting with. Obviously, you're high stakes when you're doing your, high stakes simulation, the summative right practices of summative experiences.

00:15:18:06 - 00:15:47:03
Unknown
And that's going to be either okay, you pass or you fail. And it's can be objective to look at it by the you know, the three of us, say the three of us. Did you did you see that? Did you? You know, we all saw the same thing, right? But even for your formative, it just like what we talked about earlier, as far as helping learners learn things that they're doing right and what things that they could improve upon.

00:15:47:04 - 00:16:14:15
Unknown
And the whole gambit, I think the other thing with the video systems now is that there's so much more that they're able to do than when they first came out. They're less complicated, just like the simulators are. There's, you know, so much more ease of use, promotes use. And so I think that the systems are becoming easier to use and more people are using that adaptability.

00:16:14:15 - 00:16:40:16
Unknown
I mean, if you think about the transition from the flip phone to, you know, the smartphones that we have now and that learning curve there, and you have to go from, oh my gosh, I have to put my flip phone down in one. But then it depending on what you learned with if you were, you know, an Android or an iPhone, that's generally what you're going to stick with in my opinion.

00:16:40:20 - 00:17:04:16
Unknown
A lot of people then start with whatever you start with, you just going to continue with it. You've had quite the career in nursing. And so I'm just curious, you started as a nurse. You kind of went into clinical education, into the education side of it, but now you've founded your own business. Is that correct? Yes. I'm curious to kind of that's a really cool journey.

00:17:04:16 - 00:17:48:04
Unknown
And you've also established yourself as a prominent voice in simulation. So curious, what your business is, how you made and why you made that pivot. Yeah. Tell us about it. Yeah, it was 2017, and I had been talking with my family about, you know, the possibility of maybe going in and, starting a business and just kind of doing this just because I thought it would be fun, maybe a fun way to to make sure that the people that I work with are like, I always say, I like to work with nice people who are smart.

00:17:48:05 - 00:18:11:03
Unknown
And so not to say that, you know that I won't work, but so it's that's not smart, but I want someone who's made like it. And so I mean, to me, I'm not going to work with them. It's just not just not going to work for me. It just what? This isn't working right? The world needs more kindness.

00:18:11:03 - 00:18:44:16
Unknown
That's all there is to it. So I start the company. And at first I didn't. I lacked a little bit of focus. I was very fortunate. DePaul has a women's entrepreneur group, and I was fortunate to get selected to be in one of those cohorts. So then I had to learn things about pitch decks and how to do an elevator speech, and how to sell yourself and all the things about business that a nurse doesn't want to do, like accounting and, you know, finance stuff and marketing and just.

00:18:44:18 - 00:19:15:20
Unknown
Yeah. So, I was fortunate to find some, some people that gave me some help with that. And I honed the business down to three things that we do. One is we have the free podcast, The Sim Cafe. And two, I do consulting. So if a programs learning, wanting to start out, they are looking for a recommendations I can help them with say I have I like to work closely with Ferooz Sekandarpoor from,

00:19:15:20 - 00:19:49:08
Unknown
He was the president of SimGHOSTS at one point, but I enjoy working with him. He's very, very nice and very smart and so we work well together. And then, I do the training sessions and I love doing the training. It is so much fun for me to, help people understand what simulation is and what it what it isn't, because I think when you first learn about it, it just seems like so overwhelming that then when you break it down, it's pretty, you know, it's pretty simple and pretty usable.

00:19:49:08 - 00:20:15:09
Unknown
And a lot of people are doing it, but they just don't realize that they're doing it. And then the final thing I do is help programs. If they want to get accredited by the Society for Simulation in Healthcare, I will help them get their documents together for accreditation. And that is one of my favorite things to do. I like to call myself the Accreditation Whisperer because I do.

00:20:15:11 - 00:20:31:16
Unknown
I like to tell them what things they might not be thinking about in trying to get them to be calm enough, because it once again, it's one of those things that, you know, they're going to be doing this and they're going to be looking at this and they're be looking at that. And I'm like, well, they're going to be.

00:20:31:16 - 00:21:01:10
Unknown
But but we really like to pride ourselves in is, are is the, accreditation in being a reviewer? A site reviewer is that we're not prescriptive. We're going to look at every program is their own program and help them to determine what things are going great and what things they might need help with. And so I do a lot, a lot of volunteer work for the society for Simulation and Health Care, and I really enjoy it.

00:21:01:11 - 00:21:32:05
Unknown
Deb, from I'm curious, from the accreditation perspective of your business, what are what are some of the accreditation standards that a center needs to go through to become accredited? So they need to have a structure. They need to have a mission and vision that has to do with simulation. They need to have adequate funding. They need to have adequate staffing.

00:21:32:07 - 00:22:01:06
Unknown
They need to have, policies and procedures. There are seven specific policies and procedures that we're going to look for. And one of them is, audio visual. What do you do with the the videos? You know, after the learner leaves the, the center, the program. So you have to do policies and procedures and then ethics, and what you're doing to expand the field.

00:22:01:08 - 00:22:32:11
Unknown
And there's different areas that you can do, that you can apply for, for accreditation. You need to absolutely apply for corps, which is though there's seven components to corps. And then you can select from teaching an education assessment, research. And then there's also a couple other areas that you can get accredited in. One is human simulation which is new, which is, you know, very exciting if you're accrediting for standardized patients.

00:22:32:11 - 00:23:08:18
Unknown
And the program that a program is developed, and then fellowship and systems integration, which means that the program is integrated within systems and that you can demonstrate that. I'm curious then all sounds really fascinating, but what's the benefit to a center center simulation center to become accredited demonstration of quality, you can demonstrate that you are providing best practices or good practices for simulation global recognition.

00:23:08:20 - 00:23:40:02
Unknown
There's less than there's probably between 250 and 300 centers worldwide that have been accredited so far. Then you know how many centers there are in the demand for this is just going up. Is people recognize the value that it can add to an organization. So it's real easy for a center to say we're doing everything great, and then one person doesn't want to do it.

00:23:40:03 - 00:24:16:01
Unknown
And so they can, you know, create a fuss. But once you've been accredited, it's much more difficult for those one off people who don't want to play nice, because you can say, you know what we have, we've been accredited, and now we need to make sure that we're following the things that we've demonstrated. Is that accreditation, through SSH, is it, is this mandated by state or federal governments, or is it more of a way for a program to distinguish itself, amongst others?

00:24:16:03 - 00:24:49:01
Unknown
Great question, Kyle. So it is a way to distinguish themselves, however, in the state of in the state of New York, they have the nursing boards have agreed that a third of the clinical that they're doing can be used. They can use simulation for those clinical hours, and they require that the program is in some way demonstrating quality.

00:24:49:03 - 00:25:23:19
Unknown
So they can either go with the SSH to accreditation or they can go by the INACSL endorsement. But they are requiring they have raised the standards and actually made, you know, it's in the in the laws, which is in with signature and specific to, to New York so far. Yeah, yeah. Just specific to New York at this point and going back with, I have one more question with the accreditation stuff is, so there is an audio and video piece to that SSH accreditation.

00:25:23:21 - 00:25:56:06
Unknown
And I guess my question is, is that just for the program to show simulations to the accrediting body for review, or is that like SSH just requiring some sort of sort of video for review or debrief with students? They don't really require that you have video what they requires that you have. If you do have video and audio, you know, video in that you have policies and procedures built around them.

00:25:56:08 - 00:26:41:21
Unknown
Yeah. I'd like to, just get back to the the consultative aspect of your business to learn a little bit more about what your consultative services do and who you work with. Okay. So I work with, any program that's looking for, you know, they're looking for help because what happens a lot of times and and I think it's, it's with great intention is people will want to go ahead and do all the work after they got the grant funding or, you know, whatever their they're going to do and they go into it, but they have some blind spots, like they might not think about all the things that go into all the cameras you

00:26:41:21 - 00:27:08:03
Unknown
need all the layers you need, all the all the special things, all the extra things that you need for the equipment, the simulators you might not think about. For example, when I was working at Chamberlain, we had a situation where they wanted the simulation center set up on the second floor and they there's the birthing bed that they use for simulation.

00:27:08:05 - 00:27:32:13
Unknown
It wouldn't fit in the elevator. So they actually need to take out a window and put the, the bed in that way. And I mean you don't think about all these things that people who have done this have the experience of saying, you know, you don't want to do that, right. Measure use that carpenters rule of measuring, measuring twice and cutting once.

00:27:32:15 - 00:28:02:11
Unknown
That's a really good example because is a very visual example I can see. But what other challenges do you do? You come across and how do you ideas that you have to overcome some of those challenges? So if our listeners are like are listening and saying, yeah, I'm thinking about putting together a SIM center or expanding my SIM center, renovating a new SIM center, what advice can you give them?

00:28:02:13 - 00:28:34:02
Unknown
Other than, you know, contact me, you know, consult you know, I usually do literally sit down with them and get to know what they want and what their vision and what their dreams are. And many centers, many organizations, they have some things that they are really they maybe they started using a particular simulator, or maybe they are more, you know, inclined to go with the specific AV solution.

00:28:34:02 - 00:29:09:15
Unknown
Right. So I think, one of the things that I'm able to do is be vendor neutral, essentially, if is a vendor in doing sales, I think that the vendors will frequently trying to sell all of their products, which might be not the best need for for a center. I mean, it's really and I know that any listeners out there who can relate to this, it's really sad to go to a center and just find all this equipment that they had money for, and they bought and just sitting there.

00:29:09:17 - 00:29:37:04
Unknown
Right. So it's all about what what's going to be what are you going to get and what are you going to use. And if it is a center that's just going to expand, let's reuse, repurpose, recycle what you have and then figure out what new things you want to get. Because I think right now there's a great, opportunity for, you know, using the headsets and picking you into into virtual reality.

00:29:37:04 - 00:30:12:08
Unknown
What do you do now? You're going to have a, an area set up for that to make sure that you include that in your space. What about telehealth? Have you, you know, are you using telehealth and different things that you need to be thinking of for the way that the industry is changing now? Have you noticed any specific trends in terms of centers that are adopting new technologies, new workflows, new ideas, things of that sort?

00:30:12:10 - 00:30:43:15
Unknown
Yeah. So I would say virtual reality is becoming a reality in the SIM centers. And I think that a lot I think about I want to see might have been 20, I don't know, 2018. And I remember being at the conference and there was just like, you know, a couple of, you know, the goggles and stuff, but now you go to the conference and there's 25 different vendors for a, you know, VR, virtual reality solutions and augmented reality.

00:30:43:15 - 00:31:10:01
Unknown
And, you know, so it's it's it's going to be interesting to watch how that space grows, I think until the, until the headsets get really comfortable like a set of glasses, I think they're going to always be a little bit, it's I think that's going to make it much easier when you can get just a set glasses that you put on from a nurse.

00:31:10:02 - 00:31:40:15
Unknown
If being a nursing student to now advising programs on their simulation centers, things like that, you've kind of seen the changes of technology over the years. Like you mentioned, VR is a huge part of the discussion today. Do you see our nurses as better trained now than maybe when you went through the program? Like, do you see an impact from all this technological change?

00:31:40:17 - 00:32:06:14
Unknown
Oh, absolutely. I just wish that we would have had simulation when I was in nursing school. The best thing that we had was you had to make a real bed. And there was the simulator was making real bed and injecting into oranges. And you know, those it injecting into each other, giving each other IMs and starting IVs and, you know, crazy to think about.

00:32:06:14 - 00:32:23:15
Unknown
But it was the old days of watch one, do one, teach one. I mean, it's scary. Yeah. Okay. Watch this now do it now. Teach it. So there, before we wrap up, anything else that you'd like to share with our listeners?

00:32:23:16 - 00:32:50:20
Unknown
No. Thank you for the opportunity. It's been an honor and a privilege, and I've enjoyed talking with you guys. And if listeners want to get Ahold of me, they can reach out, on LinkedIn, or to the company innovative SIM Solutions dot com. Well, Kyle and I can certainly, testify to the the training that you've provided.

00:32:50:20 - 00:33:22:01
Unknown
We both attended your simulation training session, walked away with tons of valuable information, how we can communicate with our clients, just to better understand their world. Right. How the challenges that they're experiencing, the things that they're looking for. So we want to thank you for delivering such valuable information not only to us, but I'm sure to our listeners and folks out there that really need, the level of training and education that you can provide.

00:33:22:01 - 00:33:32:20
Unknown
So thank you very much. You are so kind. Thank you so much. You have made my day. Yeah. And you well, you've made ours Deb. So we appreciate you joining us today.

00:33:33:00 - 00:33:44:19
Unknown
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzalone and Andy Simmons and produced by Kyle Shelstad. Find us online at ipivs.com/onrecord and on social media at Intelligent Video Solutions.