The Center for Medical Simulation

"Please Hold for Technical Difficulties": Accidental monitor arrhythmia, mannequin head on fire, powerpoint on the fritz... What do you do when a technical problem threatens to derail your simulation or your debriefing?

Has anyone other than Janice Palaganas ever attempted to take two Zoom meetings simultaneously? Zoom Exhaustion and other crises in multitasking this week on "SimFails."

What happens when you realize halfway through a debriefing when you realize you don't know enough about the topic you are trying to teach? Join Janice Palaganas, Kirsty Freeman, and Sacha Muller-Botti for more SimFails!

SimFails returns to fail again! Janice Palaganas, Kirsty Freeman, and Sacha Muller-Botti discuss this week: what happens when your sim is too real for your participants? How do you recover?

SimFails returns to fail again! What do you do when participants try to cheat their way through the simulation experience?

"Circle Up: Debriefing in the Clinical Environment," presented by Jenny Rudolph and Demian Szyld at Tower Health Grand Rounds.

We're back for Healthcare Simulation Week 2021 and with a spate of new episodes for the future! Join Janice Palaganas, Kirsty Freeman, and Sacha Muller-Botti as they share a new year's worth of simulation fails, so that you can learn from their mistakes.

New from the Center for Medical Simulation: A new study in "Obstetrics + Gynecology" finds a significant reduction in malpractice claims against physicians who participate in simulation-based communication and teamwork training, including a dose-response effect for each instance of training. Join Roxane Gardner, Senior Director of Clinical Programs at the Center for Medical Simulation and Senior Author on the paper, along with Komal Bajaj, Chief Quality Officer at NYC Health + Hospitals and Clinical Director for NYC Health + Hospital's Simulation Center, as they discuss the implications of this research for OB/GYN training and beyond! Facilitated by James Lipshaw, Education & Media Instructional Designer at CMS.

From IMSH 2021's Virtual Conference, featuring Demian Szyld, Stuart Rose, Jennifer Arnold, Esther Leon, Paul Mullan, Cristina Diaz-Navarro, Bram Welch-Horan, Pier Luigi Ingrassia, & Laura Rock.

Expertise of the debriefer is critical to ensure simulation participants achieve the best possible learning outcomes. Debriefers need a specific skills set in order to balance multiple priorities, including covering all learning objectives, facilitating reflection, incorporating teaching and feedback, managing student questions, maintaining psychological safety, and at the same time, allowing conversation to flow. As the use of simulation in healthcare continues to expand rapidly, especially during the global pandemic, large numbers of instructors find themselves to be novice debriefers in this teaching paradigm. While understanding the approaches used by novice debriefers is critical in informing faculty development needs in simulation, however, to date, very little empirical research has focused on debriefing approaches used by debriefers at any experience level, especially novices. Drawing from their extensive experiences in simulation faculty development, Grace Ng and Daniel Lugassy share key findings and insights from their qualitative study focused on exploring experiences of novice debriefers in this webinar. Join us to discuss common experiences and challenges of novice debriefers, and explore strategies to facilitate debriefer expertise development.

Following this webinar, participants will be able to: Describe the role conversation plays in driving organizational culture Contrast front-line workflow adaptation using briefing and debriefing versus traditional planning approaches in shaping culture Explain the role of discovery and curiosity in conversations to support staff well-being and reliability and avoid burnout and inconsistency

We take it for granted that effective teams apply crisis resource management skills during emergency care, but how often do those teams also rehearse teamwork from the start of each shift together, through centering, agreements, briefings, and practicing connectedness? Amelia Rudolph and Rebecca Minehart share how preparing teams means more than practicing drills, and that conceptualizing care delivered through a “score,” knowing each team member’s essential parts, can help us stay nimble during dynamically shifting crises. Drawing from their experiences in elite performance, clinical care, and simulation, Amelia and Rebecca provide insights into keeping teams resilient in even “dangerous” environments. Watch this conversation moderated by Jenny Rudolph, PhD on how to prepare for complex high-risk patient care situations and maintain resiliency.

Building on the discussion in Building on the discussion in Broaching Race and Racism in Debriefing and Team Simulations (Part 1), CMS presents a conversation with healthcare leaders who are directly addressing discrimination, burnout and health disparities through simulation education. They partnered with CMS to create and launch this successful program.

Meet the Author is an opportunity to hear from leaders in the fields of healthcare simulation, patient safety and education about the process and outcomes of their scholarship. You are invited to listen and comment as our team interviews contemporary authors in the field. This is a chance to hear about aspects of the projects that did not make it into the publication and learn about their craft and process. Add your questions when you register or at the beginning of the webinar to shape the content of the presentation. In this session, Jeffrey B. Cooper, PhD, will discuss his recent publication: “The Case of the Inadvertently Triggered Laser; An Historical Example of Simulation-Enhanced Adverse Event Investigation.”

Professionals are overcommitted both at home and at work. And feeling busy doesn’t help stress. When professionals try to take tasks off their plate, mentorship may be a first to go. Understandably, this relationship and commitment is mostly unpaid, uncompensated, and underrecognized work. In this discussion, we offer a reframe of the conversation on mentorship. We wish mentorship to gain the attention it deserves. We explore how to make mentorship more efficient while enhancing meaning and connection. Join this conversation moderated by Jenny Rudolph, PhD on how to sustain both the mentoring process and the mentors themselves. The presentation will be followed by an interactive Q&A where the audience can interact with the speakers.

Online learning doesn’t have to be a pale imitation of “real” in-person learning. It’s a whole new way of interacting with learners. What if instead of a boring, predictable series of discussion question posts and assignments, your online courses were a dynamic journey that surprises and engages learners?

Center for Medical Simulation (CMS) faculty are often asked to share their perspectives on a variety of topics. These informal discussions often take place during meal breaks during courses or in the hallways at conferences. These questions often lead to interesting discussions and sharing of resources. Questions and comments for this informal question and answer session were submitted prior to the webinar and live during the webinar.

During this presentation, Dr. Sarah Janssens will expand on how she became interested in the topic of leadership and why she decided to focus specifically on the subject of shared leadership. Together, Dr. Demian Szyld and Dr. Janssens will discuss the results of a systematic review which examined how leadership is shared within healthcare emergency teams, exploring the how and why of leadership sharing across ER, Trauma, and resuscitation teams. Dr. Janssens will also share the results of her empiric research on leadership sharing within simulated maternity emergencies and what it means for those teams responding to emergencies in the clinical environment. “Should we demolish traditional medical ‘lighthouse leadership’ to ensure our teams function more effectively?” Tune in to hear Dr. Demian Szyld speak with Dr. Sarah Janssens to get her thoughts on the subject and open up a conversation about leadership research. The presentation will be followed by an interactive Q&A where the audience can interact with the speaker.

Hospital environments and clinical care has become complex. Managing interfaces across different aspects of the health system is critical, for example, patient flow across departments in a hospital. There has been a call for addressing these and other human factors in healthcare, but it is not clear what interventions are supported by data. Dr. Saša Sopka, anesthesiologist and medical education researcher, and the Medical Director of AIXTRA – Aachen Interdisciplinary Competency Center for Training and Patient Safety has been working to systematically review this topic. During this presentation, Dr. Sopka will review major problems in healthcare and human factors, explore solutions implemented in aviation and other related fields, and describe the published experience in healthcare highlighting several unexpected outcomes and examples. Two focus areas will be the Safe Surgery Checklist and IPASS for handovers.

Center for Medical Simulation (CMS) faculty are often asked to share their perspectives on a variety of topics. These informal discussions often take place during meal breaks during courses or in the hallways at conferences. These questions often lead to interesting discussions and sharing of resources. Questions and comments for this informal question and answer session were submitted prior to the webinar and live during the webinar.

Center for Medical Simulation (CMS) faculty are often asked to share their perspectives on a variety of topics. These informal discussions often take place during meal breaks during courses or in the hallways at conferences. These questions often lead to interesting discussions and sharing of resources. Questions and comments for this informal session were submitted prior to the webinar and live during the webinar.

Design thinking, a human-centered design method, represents a potent framework to support the planning, testing, and evaluation of new processes or programs in healthcare. As opposed to traditional education needs assessment, design thinking takes the next step (beyond the impact on learning) to explore, diagnose, and test how new interventions will impact actual patient care and workflow. Andrew Petrosoniak, Chris Hicks, and Kari White from St. Michael’s Hospital in Toronto will discuss how their team used design thinking to open a new emergency department. They employed end-user engagement and feedback to brainstorm and implement effective solutions to problems encountered before opening. The iterative steps and targeted use of simulation resulted in better designed departmental processes and actual clinical space while mitigating safety threats and departmental deficiencies. Design thinking, coupled with simulation, can be applied to current healthcare system challenges such as COVID-19. This session builds on this team’s recent publication in Simulation in Healthcare to achieve the following objectives: Contrast traditional educational needs assessment with design thinking “customer empathy” Apply the steps of design thinking to create simulation interventions that best meet “end-user” needs Describe “use cases” of high impact design thinking-informed simulation education and quality and safety interventions

Most of us in the simulation community have a lot to learn about making a difference regarding racism, how to integrate anti-racism, implicit bias, healthcare disparities and the like, into our work.  In the wake of the police killings of George Floyd, Breanna Taylor, and many others, the simulation community needs to take action. What can we do? We are experts on practice, learning, and creating environments where real patients are not harmed if we make mistakes. However, the social risks of simulation for the participants are high when we try to tackle one of the ultimate undiscussables, racism. Colleagues of color may worry that if they bring race up, responses will be predictably or surprisingly upsetting and re-traumatizing. White colleagues may worry that if they bring up race they will say something racist or be perceived as racist and thereby harm relationships. This workshop takes some small steps to explore how simulationists can use our skills of reflection, learning design, and balancing high standards and high regard for each other to craft a way forward. High standards for caring and respect across racial differences and high regard and generous inferences when we inevitably make mistakes in this difficult terrain. In this session, we discussed practical applications with leading researchers on broaching racism in teamwork contexts and meet simulationists addressing these issues. Learn more at www.harvardmedsim.org.

As faculty have rapidly adopted online learning, many have found it challenging – the technology, managing the curriculum, and especially connecting with learners in a meaningful way. Join experienced online teachers as they discuss creating an online community of practice and facilitating meaningful experiential learning online. Learning Objectives Following this webinar, participants will be able to: Discuss practices for creating Social Presence online Describe methods to facilitate online experiential learning

Scholarship is an important element of an academic career. Most health professions faculty are expected to produce scholarly work. But what exactly is scholarship? Aside from publishing a research study, what does that mean? How does one become A Scholar? How does a busy clinician make that happen? Join experienced researchers Mary Fey, PhD, RN, Jenny Rudolph, PhD, and Suzie Kardong-Edgren, PhD, RN as they discuss various paths to meaningful scholarly work and how to turn doing the work you love into scholarship.

Simulation-based curriculum should fit into a clear learning progression and solve important developmental problems for the healthcare organization. This webinar introduces participants to the SimZones system of matching learners and learning objectives with optimized simulation-based learning curriculum and pathways. The “with good judgment” approach to SimZones offers a robust approach to curriculum development and faculty development for positive-minded and forward-thinking simulation programs of all sizes. Learning Objectives Following this webinar, participants will be able to: Describe how SimZones offer a system of matching learners to learning objectives and optimized simulation-based learning programs Categorize simulation activities using SimZones Organize simulation-based activities as part of a learning progression that leads to continuous readiness and mastery

Since the start of the modern simulation era, many in the healthcare simulation community have taken a “Field of Dreams” approach to our simulation efforts, believing, like the character Ray Kinsella in the movie of the same name, that “If we build it, they will come.” Often, however, “buy-in” to simulation programs is just as difficult as getting real people to come to a baseball diamond in the middle of an Iowa cornfield. Simulation increasingly competes with a variety of other healthcare education, quality, and safety efforts for resources. Rather than creating simulation programs hoping colleagues and trainees will “buy-in”, instead we need to solve real clinical problems, using goals co-created with the colleagues we aim to serve. In this session, we turned our attention to making an impact with your simulation program. The approach involves two major shifts: Focusing on other people’s “frames” regarding your simulation program rather than your own; and Finding ways to help them solve the problems, reach the goals, or do their jobs with your simulation efforts, rather than focusing on education alone. This approach blends two concepts: Translational simulation and customer-oriented innovation. Translational simulation focuses on identifying and addressing high yield problems at the “coal face” of clinical care. The focus is on simulation interventions that stretch outcomes beyond clinical and teamwork skills to improving such things as clinical benchmarks, clinical outcomes, organizational culture, and the patient journey. Customer-centered innovation concentrates on identifying, at a granular level, the problems and pain points, the jobs-to-be-done, and the gains or rewards of the people we aim to serve. This is a shift for many simulation educators and managers because the “customer” is not always the participants in the simulation; rather it is often the funder or leader or manager who makes the program possible. Identifying “what is in it for them” helps us design and position our simulation efforts in a way that attracts resources and buy-in. It also allows us to design our program for maximum impact because we discover and address the outcomes other people in our organization really care about.

What do you do when your emotions get out of control during a debriefing? Do you need to limit them, or can they actually help us make good decisions about care? Join us this week as a German, Australian, and American discuss very different perspectives on getting emotional at work.

Goals like "I'm going to communicate better" are far too broad for effective learning outcomes. How can we make our takeaways more precise? What mistakes do we make when we think we're being learner-centric in our conversations, when actually they need a little more from us as debriefers. Janice, Kirsty, and Marcus explore this week on SimFails!

How do you work with embedded participants and simulated patients when doing assessment in simulation? How do you make sure that any assessments you do are both valid and reliable, especially if you don't have a way to see what your participants are thinking? Join us this week to learn from our assessment failures!

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today.

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today.

Learn more and watch the video interview at http://www.harvardmedsim.org/resources/jeff-cooper-the-history-of-simulation/

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today. Learn more and view the video interview at http://www.harvardmedsim.org/resources/jeff-cooper-the-history-of-simulation/

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today. Check out the video interview at https://harvardmedsim.org/resources/jeff-cooper-the-history-of-simulation/ Sign up for Jeff's complimentary upcoming webinar: https://harvardmedsim.org/event/weekly-webinars-meet-jeff-cooper-sep-16-2020/

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today. Check out the video interview at http://www.harvardmedsim.org/resources/jeff-cooper-the-history-of-simulation/ Sign up for Jeff's complimentary upcoming webinar: https://harvardmedsim.org/event/weekly-webinars-meet-jeff-cooper-sep-16-2020/

Jeff Cooper, Executive Director Emeritus of the Center for Medical Simulation, joined us in 2017 to tell the story on camera of how an Operating Room fire sparked by an accidental use of a laser led to the development of healthcare simulation into the massive industry it is today. We’ll be releasing a new chapter of this history every week for the next seven weeks, so be sure to check back soon! Learn more and watch the video version at http://www.harvardmedsim.org/jeff-cooper-the-history-of-simulation/

This week, Janice brings up a traumatic episode from her experience: a team reveals in debriefing that their department regularly does something unsafe for patients. How do we keep patients safe while also maintaining confidentiality? Why is confidentiality important in debriefing? People need to feel safe taking risk and making mistakes in order to learn and improve. Simulation is not stand alone--it's part of your organization's culture. If there's an opportunity for learning, how do we take advantage of it? Share your thoughts with #SimFails, or learn more at www.harvardmedsim.org. --The SimFails team

SOAP BUBBLE EMOTIONS: In this week's SimFails, Marcus brings us a failure from the reactions phase of debriefing, and an argument that's existed about that phase. How do we go from scripted searches during that phase looking for a "feelings word" to genuine emotional inquiries from one person to another? How do we listen to the hidden emotions behind participant's words and in their non-verbals? Learn more at www.harvardmedsim.org.

Note: This podcast was recorded in September 2019. What are some strategies to implement when you have too many participants to safely or efficiently fit into your simulation space? Kirsty, Janice, and Marcus bring strategies for activating observers and creating effective learning for observers of simulations when there are too many attendees to all participate in the room. Enjoy another week of learning from our simulation failures! Learn more at http://www.harvardmedsim.org. --The SimFails Team

Welcome back to SimFails! We'll be releasing this limited series podcast over the next few months in the lead-up to Healthcare Simulation Week 2020. Join Janice Palaganas, Kirsty Freeman, and Marcus Rall as we learn from each other's mistakes and failures in this new series from the Center for Medical Simulation. In this episode, Marcus brings us the story of a failure to work with the frames of the participant in his debriefing. How do you get at the learner's mental model instead of explaining your own and trying to force them to copy it? What do you do in a debriefing when you are flabbergasted by the words coming out of your own mouth? How do you help the learner discover "why" they did something? All that and more on this week's SimFails. Find out more at www.harvardmedsim.org.

The COVID-19 pandemic has created a profound moment of disruption of hierarchy, silos, speed and type of communication in healthcare. At the same time, we face a profound moment of disruption of business as usual regarding baked-in institutional and structural aspects of racism.  Stir these up together and we are at a once-in-a lifetime moment to make changes in how healthcare is conceived, how it is structured, and who it serves.  Joining us today for this special roundtable are: ·Erica Foldy: Associate Professor of public and nonprofit management at Wagner School of Professional Studies at NYU and researcher of race and racism in organizations. ·Jody Hoffer Gittell: Professor of management at Brandeis University and Director of the Relational Coordination Research Collaborative. ·Kate Kellogg: Professor of Business Adminstration at MIT Sloan School of Business and ethnographer of work and change movements in healthcare. ·Victoria Parker: Associate Dean and Associate Professor at the University of New Hampshire Paul College of Business and Economics, and researcher of job design and organizations of front-line workers in long-term care. Learn more at http://www.harvardmedsim.org

This week on Brief Debriefings, we joined with Center for Medical Simulation Senior Fellow Suzie Kardong-Edgren to talk about how nursing programs are adapting to forced changes to their clinical learning in light of COVID-19, and what the future holds for nursing education. Learn more about how CMS is partnering with nursing education programs at www.harvardmedsim.org.

Not being able to give a goodbye hug to a trainee ending their fellowship; delivering children without their families present; managing deeply isolated COVID-19 patients: Our normal routines and "islands of mastery" have been disrupted by the strangeness of the landscape. Each action that would be routine now requires additional cognitive effort. How do we manage that fatigue as the crisis extends over additional months? Learn more at http://www.harvardmedsim.org.

This week on COVID Chronicles, Komal Bajaj, Chief Quality Officer at NYC Health + Hospitals/Jacobi, joins us to discuss how four fundamental principles from the world of quality and safety are informing their efforts as they change procedures during the COVID-19 surge in New York City. Komal Bajaj, MD, MS-HPEd is Chief Quality Officer at NYC Health + Hospitals/Jacobi, catalyzing quality improvement transformation through culture change and data-driven decisions. She is an Associate Professor of Obstetrics & Gynecology at Albert Einstein College of Medicine and serves as the Clinical Director of Simulation for NYC Health + Hospitals, the largest municipal health system in the United States.   Dr. Bajaj attended medical school at Northwestern University’s Feinberg School of Medicine and completed her training in Obstetrics & Gynecology at McGaw Medical Center of Northwestern University. Following residency, she completed a fellowship in Reproductive Genetics at Albert Einstein College of Medicine and continues to deliver cutting-edge reproductive genetics care in the Bronx. Sparked by desire to incorporate contemporary educational theory in her quality improvement work, she completed a Masters in Health Professional Education from the Massachusetts General Hospital Institute of Health Professions. Dr. Bajaj has is nationally and internationally speaker on the use of simulation to advance healthcare quality and safety. Her scholarly interests include defining innovative approaches to embed simulation within the clinical environment, developing sustainable programs to build agency in healthcare teams, and characterizing the emerging role of debriefing in healthcare quality/safety. She sits on the Advisory Board for the Foundation for Healthcare Simulation Safety and on the External Advisory Board for the Joan H. Marks Graduate Program in Human Genetics of Sarah Lawrence College. Learn more at http://www.harvardmedsim.org.

What are the resources we can bring with us into stressful or triggering situations, so that we can continue to be our best selves as people and professionals? David Richo is a psychotherapist, teacher, and author of over 20 books including "Triggers: How We Can Stop Reacting and Start Healing." Today he joins Jenny along with Rebecca Minehart, an anesthesiologist at Massachusetts General Hospital and the Director of CMS's Anesthesia Courses, to talk about how we can help equip providers to deal with the trauma they have been dealt during the COVID-19 pandemic. We'll learn how to see something that causes an unbalanced emotional reaction, a trigger, can be used as a sort of trail head into exploring things in our lives that haven't been fully resolved. We'll also learn how can clinicians get past their anger and fear when the actions of others directly endanger them, and how the support of a team can help us to safely release our emotions at the appropriate time. To learn about more resources for wellness and psychological safety for providers, join us for the next round of our Circle Up online webinar, available at www.harvardmedsim.org.

Marjorie Lee White and Andres Viles, an Emergency Physician and Emergency Nurse from the University of Alabama-Birmingham join us to discuss how their organization has worked to integrate simulation into the health system at every level and in every program. The story begins when the simulation program was put in charge of the response to the 2017 Ebola outbreak. Now people say “we need to simulate first” when new issues emerge. We discuss how the simulated run-through of complex plans can show the flaws in systems before they can potentially harm patients. We also talk about how preparing for Ebola management through simulation gave expertise in donning and doffing and other PPE measures, including the technique of creating a remote doffing expert who helps tired providers stay safe at the end of procedures. Andres Viles is a Simulation Coordinator, Senior and Director of Immersive Simulation in the Office of Inter-professional Simulation for Innovative Clinical Practice at UAB in Birmingham. He also holds the title of Training Coordinator for the UAB Serious Infectious Disease (SID) Team. Marjorie Lee White MD, MPPM, MA serves as Vice President for Clinical Simulation UAB Health System, the Director of the Office of Interprofessional Simulation for Innovative Clinical Practice within the Center for Interprofessional Education and Simulation at University of Alabama at Birmingham (UAB), and Assistant Dean for Clinical Simulation for UAB School of Medicine. She is professor in Pediatric Emergency Medicine, Medical Education in the School of Medicine and the Department of Health Services Administration in the School of Health Professions and practices clinically in the emergency department at Children’s of Alabama. Learn more at www.harvardmedsim.org.

This week on COVID Chronicles we're joined by Jody Hoffer Gittell, a professor of management at Brandeis University and expert on relational coordination. We discuss how to transform our relationships with others, achieve high performance, and increase mutual respect through a shared knowledge of each other's goals as well as each other's tasks. How can a lack of systems thinking negatively effect our outcomes during this pandemic? We'll also talk about how knowing what your role is, how you fit into a larger whole, and how your actions affect others is critical to organizational success, and look at whether we've achieved that in our national response to COVID-19. Learn more at www.harvardmedsim.org.

Amelia Rudolph is the founding Creative Director of Bandaloop, a vertical dance company founded in 1991. Bandaloop performs aerial dances which shift the plane of the dance floor vertically and create a sense of awe and wonder, everywhere from the edge of cliffs in the Sierra Nevada to the heights of New York skyscrapers. Today she joins Jenny to talk about managing fear in moments where we’re operating at the edge of or beyond our comfort zones, and how to maintain a sense of connection with others in this work. What’s required systematically from leaders and team members to ensure safety in situations that would be dangerous without effective protocols and procedures? How do we put anchors and checks in place to allow our teams to do their work without harm? We’ll examine these questions, as well as learn how naming your discomfort out loud can connect you with your team members and with the people you’re caring for, and how to stay in the moment and tuned to our colleagues even through layers of PPE. Learn more at www.harvardmedsim.org. --Jenny Rudolph, James Lipshaw, and the Center for Medical Simulation team

DOFFING GRIEF: Joining us this week is Liz Crowe, a pediatric social worker, self-described “naughty Australian,” cohost of the Coda Change podcast, and author of The Little Book of Loss and Grief You Can Read While You Cry. Liz joins us today to discuss many topics including finding small moments of humor and release while mucking through unprecedented levels of difficult work, mindsets for post-traumatic growth, and framing your challenges in a way that makes them survivable. We also dive in depth into how to don your armor and doff your grief by building microtransitions and boundaries including briefing and debriefing, mental rehearsal, and finding space from COVID related noise when it threatens to break through the barriers between our work and home life. We hope this podcast will help you to create a small oasis in your day. Learn more at www.harvardmedsim.org.

Clément Buléon is an attending anesthesiologist from Normandy, France, and a founding member for the French Society for Simulation in Healthcare. His hospital has designed an alternate strategy for COVID response: Creating an airway "SWAT" team. This novel approach focuses on creating one expert team through extensive training rather than risking many staff members with minimal training being exposed to aerosolizing procedures. Building highly collaborative pairs of anesthesiologists and nurse anesthetists and creating a new algorithm with practice and development through simulation has led to the development of a new, high performing team. Learn more at www.harvardmedsim.org.

Stefanie Heiter is the CEO of Bridging Distance, a remote-work consulting company based in Massachusetts. She joined us this week to talk about the way our work will change as staff for many companies have moved to work from home during the pandemic.  How does the "distance lens" change how we work together remotely? What does digital etiquette look like for folks who have never worked remotely? How does our body language speak for us online?  One major component for many leaders will be addressing the digital loneliness of our workers who are used to a bustling social environment. When do we reach out, and how do we make informality formal online? What should leaders do to make sure their workers feel supported in this time, and what new opportunities does it create for making our teams even better? All these questions and more answered this week on COVID Chronicles. Learn more at www.harvardmedsim.org

Lon Setnik (twitter.com/lonsetnik) is an emergency physician and medical director of the Forrest D. McKerley Simulation and Education Center at Concord Hospital. He joined Jenny Rudolph to discuss his work creating the COVID-19 Suspected or Confirmed Airway Management Checklist, which in combination with extensive simulation practice has been keeping providers safe at his hospital. Intubation during the COVID-19 outbreak is one of the more dangerous procedures for our teams. We worked across the organization to create an approach that would keep our patients and providers as safe as possible during this pandemic. The COVID-19 Suspected or Confirmed Airway Management Checklist is designed for the team to use outside the room as they set up for managing the airway, and inside the room to remind them how their job should be performed in this new process. Learn more at http://www.harvardmedsim.org.

Welcome to COVID Chronicles with Jenny Rudolph, a just-in-time podcast checking in with friends and colleagues from the front lines of healthcare, the home front, and other unique perspectives on learning and connecting in the time of coronavirus. Ignacio del Moral (twitter.com/leading4you) is the Executive Director of the Hospital virtual Valdecilla in Santander, Spain. In a major regional hospital in Cantabria, nearly 1/3 of all patients in the hospital are COVID-19 positive. In this context, leaders must manage staff, space, and critical resources including ventilators. As an MD with a PhD in Microbiology, Nacho is well positioned to understand the crisis, but what he says clinicians need more than anything in this moment, is empathy. "We have to listen to them, instead of telling them what they have to do." Listen along to learn how in a just-in-time fashion in their simulation center, Nacho has created a space for safe, informal debriefing once the clinical day is over, to protect the psychological wellness and well-being of clinicians in his community.

Welcome to COVID Chronicles with Jenny Rudolph, a just-in-time podcast checking in with friends and colleagues from the front lines of healthcare, the home front, and other unique perspectives on learning and connecting in the time of coronavirus. Albert Chan (twitter.com/gaseousXchange) is an anesthesiologist at Prince of Wales Hospital in Hong Kong, where they've been applying lessons learned during the SARS outbreak of 2003 to help prepare for COVID-19. Albert's infographic on safe airway management in patients with confirmed/suspected coronavirus has gone worldwide, helping clinicians on the internet to build better infection control processes and keep themselves safe. The success of this just in time learning, first published on the Life in the Fast Lane blog, has now been written up in Anaesthesia. Listen along as we learn how to use simulation as a tool to make providers feel safe when they have to take care of COVID-19 postive patients, building collective competence and confidence among the staff.

JJ Simulationistas: The big day has come! Dan joins us one last time for the big handoff, as Janice Palaganas and Jenny Rudolph take over the team to move the podcast forward as JJ Simulationistas. Learn how we're going to talk more simulation than ever, but bridge it into real life situations. Enjoy!

SAYING GOODBYE TO DAN: In a bittersweet finale to the DJ Simulationistas podcast, Janice leads Dan through the final simulation experience of his career. But wait! Dan will return next week as we bring you the next version of the Center for Medical Simulation flagship podcast. Enjoy!

DJ SIM SPECIAL: Brad Morrison joins Janice as guest host, along with Christian Balmer, Catherine Chang, Derek Monette, and Benjamin Schultze to discuss how ad hoc teams can form smoothly in real time. What's the special sauce of how four people who don't know each other can become a team? Enjoy!

I'D READ ABOUT IT: Dr. Paul Quigley, Emergency Medicine specialist from Wellington, New Zealand joins Mary Fey from the Center for Medical Simulation to discuss turning knowledge from articles into clinical praxis, identifying with learner's state of mind, and being aware of the mindset you bring into the debriefing room. Enjoy!

DAN IS RETIRING! This is the penultimate episode of DJ Simulationistas as you know it. Janice, considering how her retiree parents seem to worry over everything, asks Dan to come up with a list of his worries for simulation in the future. Sim Worry 1: Will the expense of simulation cause it to decline? Sim Worry 2: Somehow, simulation will hurt patients or providers. Sim Worry 3: The quality of simulation instruction will go down as the number of instructors goes up. Sim Worry 4: Sim becomes monopolized by one profession or one way of doing things. Sim Worry 5: People won't appreciate what good sim looks like and the effort it takes to achieve it. Sim Worry 6: Letting down people who expected to learn more. Listen to learn how you can keep each of these dark futures for simulation from happening to your learners and your institution!

THE 50% SIM STUDY: Apologies for the poor audio quality in this episode, which was recorded on the road at a CMS traveling course. Brad Morrison joins Janice Palaganas as a guest host to interview Suzie Kardong-Edgren, a new member of the Center for Medical Simulation faculty, about her experience as an editor at a major nursing journal, about the massive study which found that 50% of nursing school patient care experience can be done as simulation, and about life as an expert on research. Enjoy!

100% of OR Teams using a checklist and conducting debriefs. Mortality rates dropped by 35%. An economic return of 80,000 hours annually due to a reduction of time spent on each surgical case, equaling $4,000,000 saved. Another $3,000,000 earned per year via increased through-put. But perhaps most importantly, an estimated additional 500 lives saved per year across the state. Today we're talking with Dr. Michael Rose of McLeod Health in Florence, South Carolina, and Kate Hilton, the lead faculty for the Institute for Healthcare Improvement (IHI)'s Leadership and Organizing for Change virtual program, about how these changes were made possible. Enjoy!

SimFails … and Other Conversations from the Sim Sofa: Janice Palaganas, Kirsty Freeman, and Marcus Rall are an experienced, interprofessional, global healthcare simulation team, and they’re here to talk about all the ways they’ve “stuffed it up” over the past 20 years so that you can learn from their failures! Join them in the coming months for SimFails … and other conversations from the sim sofa. About Us Dr. med. Marcus Rall is founder and CEO of InPASS, Institute for Patient Safety & Team Training in Reutlingen, Germany with a focus on human factors, teamwork and simulation team training, as well as train-the-trainer concepts. He worked 17 years as a physician in anesthesiology and prehospital emergency medicine. He studied medicine in Germany, at Harvard, and at the University of Michigan and has worked as a fire-fighter and paramedic. He is founding president of the German Society for Simulation in Healthcare (DGSiM) and was Co-Chair of the IMSH World Congress of Simulation 2008. He is associate editor of the international journal Simulation in Healthcare. Over the last 15+ years Kirsty Freeman has been in simulation-based education and research within both the clinical and academic settings. The most recent of her positions is with The University of Western Australia, Faculty of Health and Medical Sciences, where she is part of the academic faculty in the Division of Health Professions Education. With a Masters in Health Professions Education (Research), Kirsty is currently a PhD Candidate researching the incidence of impostor phenomenon in healthcare simulation faculty, and the impact of professional identity. Co-Chair for IMSH 2020 and Chair of the Media and Communications Committee for the Society for Simulation in Healthcare, Kirsty is soon to be inducted as a Fellow in the SSH Academy Class of 2020. Dr. Janice Palaganas is currently the Director of Educational Innovation and Development for the Center for Medical Simulation (CMS) in Boston, Massachusetts and a Lecturer for Harvard Medical School, Department of Anesthesia and Critical Pain Management. Janice has developed a passion in teamwork from her background as an emergency nurse, trauma nurse practitioner, director of emergency and critical care services, and faculty for schools of medicine, nursing, allied health, management, physician assistant program, and emergency medicine. As a behavioral scientist, her passion is in using healthcare simulation as a platform for interprofessional education (IPE) and has served as a committee member of the National Academy of Medicine’s (formerly the Institute of Medicine [IOM]) report on measuring the impact of IPE on practice.

Design Thinking at ResusTO: Jenny Rudolph and Rebecca Minehart are at ResusTO in Toronto, Ontario, and are podcasting their post-session debriefs! Join us for this session as Jenny and Rebecca discuss how they learned to put the design in "design thinking," trying to determine: what are the real problems people have in simulation for resuscitation,  and how can we as an organization help and innovate? What do clinicians need from us to make their work better? Here we learned to 1) Focus on the user, 2) Keep it broad, and 3) Make it manageable.

Resus Linguistics: Jenny Rudolph and Rebecca Minehart are at ResusTO in Toronto, Ontario, and are podcasting their post-session debriefs! Join us for this session as Rebecca and Jenny discuss Keri White and Vic Brazil's workshop. There's a declining tone from the pulse oximeter as your patient becomes increasingly hypoxic... How explicit do you need to be with your team when moving toward a particular intervention? We discover a vulnerability in the diversity of ways in which tools and strategies are asked for. How do you optimize care with a novice team differently from an expert team?

SIMULATE TO COMMUNICATE: CMS faculty Walter Eppich and Janice Palaganas sit down at the end of an intensive weeklong course to discuss how simulation can help develop your team's communication skills with three participants: Suchismitta Datta, Alexis Graham-Stephenson, and Michael Morgan. Enjoy!

Today we present a few examples of personal and clinical moments where advocacy inquiry allowed one of our coworkers at CMS to stay curious and get to the root of someone else's thinking when presented with a surprising or upsetting situation. Watch the animated version at https://harvardmedsim.org/?p=222865

Today we present a few examples of personal and clinical moments where advocacy inquiry allowed one of our coworkers at CMS to stay curious and get to the root of someone else's thinking when presented with a surprising or upsetting situation. Learn more at www.harvardmedsim.org !

in 2018, Jenny Rudolph presented "Helping without Harming" at SMACC, where she led the audience in moving from "WTF?!" to "What's their frame?"  (https://www.youtube.com/watch?v=eS2aC_yyORM) Today we present a few examples of personal and clinical moments where advocacy inquiry allowed one of our coworkers at CMS to stay curious and get to the root of someone else's thinking when presented with a surprising or upsetting situation. Enjoy!

FRAMES ACTIONS RESULTS: The Learning Pathways Grid (or "LPG") is a tool we use at the Center for Medical Simulation to discover how we often get in the way of our best intentions, reframe our thinking to empower speaking up, and find techniques that are doable to enable us to speak up in the future. In this episode of Brief Debriefings, Kate Morse leads Melanie Barlow of Mater Education in Brisbane, Australia through the Learning Pathways Grid with regards to a difficult conversation regarding the well-being of a family member.

FINDING PATHWAYS TO SPEAK UP: The Learning Pathways Grid (or "LPG") is a tool we use at the Center for Medical Simulation to discover how we often get in the way of our best intentions, reframe our thinking to empower speaking up, and find techniques that are doable to enable us to speak up in the future. In this episode of Brief Debriefings, Jenny Rudolph leads Donna Bonney, Chief Executive of Mater Education in Brisbane, Australia  through the Learning Pathways Grid with regards to a case of interpersonal behavior from one of her staff members which ran counter to their institutional values.

FINDING PATHWAYS TO SPEAK UP: The Learning Pathways Grid (or "LPG") is a tool we use at the Center for Medical Simulation to discover how we often get in the way of our best intentions, reframe our thinking to empower speaking up, and find techniques that are doable to enable us to speak up in the future. In this episode of Brief Debriefings, Jenny Rudolph leads Janice Palaganas through the Learning Pathways Grid to discover how this expert on speaking up could find herself in a situation where she failed to speak up about a public health concern. Watch the animated video and see Janice's speaking up encounter at http://www.harvardmedsim.org/blog/brief-debriefings-learning-pathways-with-jenny-rudolph-janice-palaganas

Guess What I’m Thinking! In this week’s episode of Brief Debriefings, Jenny Rudolph joins Shaun Grant, a pediatrician from New Zealand, and Kelly Roszcszynialski, a physician in emergency medicine and simulation fellow at the University of Alabama at Birmingham, to discuss the challenge and peril of “Guess What I’m Thinking” questions. Shaun and Kelly re-enact a spicy debriefing event to show how playing guessing games with your learners in debriefing can lead to frustration and confusion for both learners and debriefers, and perform their own mini-debrief of the debrief to try to understand what went wrong in the debriefing, and how to get better results for your learners. About Our Guests Kelly Roszcszynialski, MD Simulation Fellow University of Alabama Office of Interprofessional Simulation for Innovative Clinical Practice Shaun Grant, MBChB, FRACP, General Pediatrician and Head of Department Gisborne Hospital, New Zealand Kelly and Shaun participated in the Comprehensive Instructor Course at the Center for Medical Simulation (CMS). The five-day immersion in healthcare simulation is led by experienced simulation educators and covers all high-level elements and concepts involved in running a simulation program. To learn more about the Comprehensive Instructor Course, please go to https://harvardmedsim.org/course/comprehensive-instructor-workshop/

"Distress is in the Eye of the Beholder": Michael DeVita, former president of the Society for Simulation in Healthcare and Chief Medical Officer of EarlySense, joins Dan & Janice to talk about his development of the "rapid response" team with the goal of preventing cardiac arrest rather than just responding to it, as well as surprising results from virtual gaming that can improve code response performance. Enjoy!

FRAME SHIFT: “I found out that telling the truth doesn’t make you the bad guy. Telling the truth is actually your job and it’s going to be beneficial for the learners and for yourself.” In this episode of Brief Debriefings, we talk with Frédérique Gauthier, Audrey Larone Juneau, and Lon Setnik, three participants from the May 2019 Advanced Instructor Course at the Center for Medical Simulation (CMS) in Boston, MA. Frédérique Gauthier, a physical therapist & educator at Sainte-Justine Hospital in Montreal, enrolled in the course to refine her debriefing and faculty development skills. Joining Frédérique from Sainte-Justine is Audrey Larone Juneau, a nurse educator working on in-situ simulations in the neonatal intensive care unit. She helps faculty from other departments develop simulation training programs, and she wants to learn coaching techniques to help her peers “level up” their skills. Lon Setnik, an emergency medicine physician and medical director of the simulation center at Concord Hospital, hopes to create a pathway for hospital faculty to participate in simulation. The group discusses the Learning Pathways Grid, the power of vulnerability, and the realization that honesty is the best policy, especially in debriefings.

GRADE LEVELS: Dan & Janice discuss how accidentally joining an expert biking tour of Portugal lent surprising insight into the experience of simulation learners. Also: the best ways to shepherd new learners through difficult tasks, and making challenge levels more learner-driven. Enjoy!

ROCKET DAN: Dan & Janice return, addled by time zone and weather changes, to talk about how to keep your sanity when juggling or transitioning roles in a healthcare organization. Also: forgetting your coworkers names, holding on to humility, and fighting against presenteeism when your work requires travel. Enjoy!

WHISPERED RULES: Join Suzie Kardong-Edgren, Jenny Rudolph, Janice Palaganas, & more from the CMS Book Club as we discuss Laura Liswood's "The Loudest Duck: Moving Beyond Diversity While Embracing Differences". Enjoy!

BRIEF DEBRIEFINGS: “A lot of what we did this week was centered around effective communication…and often times that skill is just as important as the care that we deliver and the manner in which we deliver it.”- Lisa Osborne, DNP, CRNA. In this episode of Brief Debriefings, we talk with Tonya Schneidereith, Greg Louck, and Lisa Osborne about their experience participating in the Comprehensive Instructor Workshop at the Center for Medical Simulation (CMS) in Boston, MA. Tonya Schneidereith, a nurse practitioner and associate professor, came to the course wanting to develop an interprofessional education program using experiential learning at the University of Maryland School of Nursing. Lisa Osborne, a nurse anesthetist and Director of Nurse Anesthesia Program, and Greg Louck, a nurse anesthetist and assistant professor, are working to incorporate debriefing strategies for their Anesthesia Crisis Resource Management (ACRM) course at the University of St. Francis. The group discusses what it’s like to jump back into simulation as a learner rather than an instructor, working as a team-player, and the importance of effective communications in clinical and non-clinical environments.

CRITICAL CONVERSATIONS WITH MARY FEY: Many educators struggle with how to help their learners achieve high standards of practice while also maintaining a caring relationship with them. The new book by Sue Gross Forneris and Mary Fey, "Critical Conversations: The NLN Guide for Teaching Thinking" teaches how to grapple with this problem in three arenas: clinical teaching, simulation teaching, and classroom teaching. In this four part series, Jenny Rudolph and Mary Fey sit down to discuss how to have critical conversations with your learners in the clinic, in simulation, and in the classroom. In part 4 of 4, Mary and Jenny discuss bringing critical conversations to the classroom and some takeaways for all of our listeners. Enjoy!

CRITICAL CONVERSATIONS WITH MARY FEY: Many educators struggle with how to help their learners achieve high standards of practice while also maintaining a caring relationship with them. The new book by Sue Gross Forneris and Mary Fey, "Critical Conversations: The NLN Guide for Teaching Thinking" teaches how to grapple with this problem in three arenas: clinical teaching, simulation teaching, and classroom teaching. In this four part series, Jenny Rudolph and Mary Fey sit down to discuss how to have critical conversations with your learners in the clinic, in simulation, and in the classroom. This week, in part 3, Jenny and Mary explore how to use critical conversations in clinical teaching.

CRITICAL CONVERSATIONS WITH MARY FEY: Many educators struggle with how to help their learners achieve high standards of practice while also maintaining a caring relationship with them. The new book by Sue Gross Forneris and Mary Fey, "Critical Conversations: The NLN Guide for Teaching Thinking" teaches how to grapple with this problem in three arenas: clinical teaching, simulation teaching, and classroom teaching. In this four part series, Jenny Rudolph and Mary Fey sit down to discuss how to have critical conversations with your learners in the clinic, in simulation, and in the classroom. This week, in part 2, Jenny and Mary explore how to use critical conversations in simulation teaching. Enjoy!

CRITICAL CONVERSATIONS WITH MARY FEY: Many educators struggle with how to help their learners achieve high standards of practice while also maintaining a caring relationship with them. The new book by Sue Gross Forneris and Mary Fey, "Critical Conversations: The NLN Guide for Teaching Thinking" teaches how to grapple with this problem in three arenas: clinical teaching, simulation teaching, and classroom teaching. In this four part series, Jenny Rudolph and Mary Fey sit down to discuss how to have critical conversations with your learners in the clinic, in simulation, and in the classroom. This week, in part 1, Jenny and Mary give an introduction to what a critical conversation is, and how we can use it to improve our learner outcomes. Enjoy!

PERSONAL PREVIEW: This week, Dan & Janice explore the two types of preview, the value of disclaimers, and bringing the preview to social settings. Enjoy!

NAME DROPPING: This week, Dan & Janice explore how to credit the creators of the ideas you use in your teaching. Also: When is naming scholars helpful to learners, and is publishing research even valuable? Enjoy!

LEARN THROUGH TALK: Walter Eppich, Demian Szyld, and Mary Fey join Dan & Janice to discuss Walter's PhD research on conversational learning, simulation as a means to better care for patients, productive tension, disguised feedback, & more. Enjoy!

CRITICAL CONVERSATIONS: Mary Fey joins Janice and guest hosts Walter Eppich and Demian Szyld to discuss her & Sue Forneris' monograph "Critical Conversations: The NLN Guide for Teaching Thinking," and the history of nursing simulation, as well as the effects on the teaching world of the study showing that 50% of clinical nursing hours could be simulation with similar outcomes. Enjoy!

PSYCH SAFETY: Join Roxane Gardner, Kate Morse, Laura Rock, Ignacio del Moral, & Janice Palaganas as they discuss Amy Edmondson's book "The Fearless Organization: Creating Psychological Safety in the Workplace for Innovation, Learning, and Growth."

PSYCH SAFETY: This week, Dan & Janice want to revolutionize how we establish psychological safety, with lessons learned from a piano teacher. Also: the role of modeling, getting buy-in for high stakes practice, the crisis menu, and more. Enjoy!

LOCALIZATION: Dan & Janice are joined at IMSH 2019 by Paul Phrampus, Dan's fellow former President of the Society for Simulation in Healthcare, to talk about his experience consulting on simulation and debriefing programs around the world. Enjoy!

HINDSIGHT BIAS: Dan & Janice investigate whether video or writing is more effective for post-event reflection. Also: Staying down the ladder of inference, skimming the surface of frames, and more. Enjoy!

PROJECT MANAGEMENT: This week, Dan & Janice take on the fundamental battles of order vs. chaos, and sprawling creativity vs. rigid organization. Also: Dan's manager jealousy, being philosophically ambidextrous, and the stunning complexity of interpersonal interactions. Enjoy!

SIMULATION RASHOMON: Dan & Janice explore what special techniques to bring to your debriefing when you didn't observe the event yourself, particularly when you are hearing conflicting reports about what happened. Enjoy!

"NO MARGIN, NO MISSION": Jenny Rudolph joins Dan & Janice to talk the logistics of keeping a sim center running, adjusting to the changing field of healthcare, & moving your agenda forward no matter the context of your center.

FINDING BALANCE: Roxane Gardner joins Dan & Janice to tell the story of how a tension pneumothorax changed her life and her perspective on medicine. Also: obstetrical simulation through history from 18th century France to virtual reality. Enjoy!

SIM PARTNERSHIPS: "We don't want to compete with people. We want to help people." Robert Simon joins Dan & Janice to talk sim affiliations, the qualities of a good partnership, and moving team agendas forward. Enjoy!

TOO MUCH FUN? Dan & Janice examine the question of whether simulations are allowed to be "fun." Also: abandoning prebriefing scripts, normalizing anxiety, and breaking preconceived notions about simulation. Enjoy!

SPEAK UP SCIENCE: Melanie Barlow joins Dan & Janice to discuss her PhD research on the science of speaking up. Also: new naming conventions in healthcare, how to "receive" speaking up, the difference between speaking up & feedback conversations, and moving beyond mandates to give concrete steps. Enjoy!

FUTURE OF THE MANNEQUIN: Bas Oei, a surgeon from the Netherlands and a CMS visiting scholar, joins Dan & Janice to discuss his PhD work combining virtual avatars with mannequins to increase the fidelity of simulation. Enjoy!

FAKING IT: Dan & Janice explore learning how to empathize, and how to show genuine respect for the learner. Also: skills vs. job requirements, consequences for unkind practitioners, and the preservation and destruction of trust. Enjoy!

NEW ALGORITHM: Talking drug research & the new ACLS guidelines with Dan Raemer & Janice Palaganas. Also this week: the half life of facts, and balancing speed with thoughtfulness in critical care decision-making. Enjoy!

WORKSHOPS: Dan & Janice prep for conference season by discussing cutting extraneous workshops, shocking the audience, creating practice forums, and what to do when someone hates the workshop you gave. Enjoy!

MISCOMMUNICATION: Dan returns from vacation to join Janice in a household human factors error root cause analysis. Also: Janice plays counselor, getting over being cryptic, and the safety of formed teams versus fixed teams. Enjoy!

FEEDBACK ACROSS CULTURES: Tim Brake joins Janice to discuss initial encounters in bringing debriefing to a global audience. Plus: antagonistic speaking up, breaking the safe container, & "global dexterity" in working with an international team. Enjoy!

SIMULATION GAMES: Dr. Vinay Nadkarni joins Janice in our second guest week to discuss simwars and simulation games, having just returned from judging the Italian Pediatric Simulation Games, a weeklong national simulation competition. They discuss fostering inter-hospital competition, positive results from ad-hoc teams, and much more. Enjoy!

HEALTHCARE SILOS: Angela Aristidou joins a solo Janice Palaganas (Dan is on vacation) to discuss her research around healthcare silos, organizational behavior, and more!

MODEL TEACHERS: This week on DJ Simulationistas, Dan & Janice explore the elements that make a model teacher, including mental models & frames, personalities, and more. Also: what is the best teaching you've ever gotten from a non-teacher, and how can you synthesize it into your own teaching? Enjoy!

FEEDBACK LOOPS: This week, Dan & Janice explore "feedback peace of mind" and how to achieve it. Also: making difficult conversations work online, transformative teaching on feedback, and overcoming discomfort to help your students grow. Enjoy!

DAN-CENTENNIAL: Birthday boy Dan Raemer shares lessons from the last year of simulation, where he has continued to learn new things. Also: how history comes to be, bringing your life experience to simulation, and putting a pelvis in backwards. Enjoy!

ONE YEAR OF DJ SIMULATIONISTAS: It's the DJ Sim 1 year, 50 Episode special! Join Dr. Dan Raemer, Dr. Janice Palaganas, & DJ Simulationistas producer / CMS Instructional Designer James Lipshaw as they model feedback conversations, share simulation anecdotes, analyze what we've been getting wrong and right, and set course for the next 50 episodes. Enjoy!

SIM STORIES: While we prepare for our one-year-anniversary, special episode #50 spectacular next week, enjoy two new hilarious simulation stories from Dan & Janice about simulations gone wrong. Have fun, and make sure to stop in next week for episode #50!

This podcast is a joint venture between CMS and Simulcast. Listen to more from Simulcast at http://www.simulationpodcast.com. Victoria Brazil: Translational Simulation Since the start of the modern simulation era, many in the healthcare simulation community have taken a “Field of Dreams” approach to our simulation efforts, believing, like the character Ray Kinsella in the movie of the same name, that we “If we build it, they will come.” Often however, “buy-in” to simulation programs is just as difficult as getting real people to come to a baseball diamond in the middle of an Iowa cornfield. Simulation increasingly competes with a variety of other healthcare education, quality, and safety efforts for resources. In this podcast, Jenny Rudolph talks with Victoria Brazil talk about Victoria’s alternate approach to positioning simulation in healthcare. Rather than creating simulation programs and then hoping people will come, instead, she argues, we need to solve real clinical problems, using goals co-created with the colleagues we aim to serve. This work focuses on clinical impact and culture change via what she calls “translational simulation. Translational simulation focuses our attention on identifying and addressing high yield problems at the “coal face” of clinical care. The focus is on simulation interventions that stretch outcomes beyond clinical and teamwork skills to improving clinical benchmarks, clinical outcomes and the patient journey. Is this the same age-old exhortation to focus on patient quality and safety or something different? Join the Center for Medical Simulation and Simulcast as we explore Victoria’s most recent publication on translational simulation and links to work by Bill McGaghie, and other exemplary work in the field. Victoria Brazil is an emergency physician and host of Simulcast, director of the Gold Coast Simulation Service in Queensland Australia, and Professor at Bond University Medical School. Jenny Rudolph is an organizational behavior scholar, executive director of the Center for Medical Simulation in Boston, and an Assistant Professor of Anaesthesia at Harvard Medical School and Massachusetts General Hospital.

THE SCIENCE OF TEAMS: Join the CMS crew as we discuss 5 articles from American Psychologist which can improve how your teams function! Research questions include: is an ad hoc team or an established one more safe for speaking up? Do western assumptions about how teams should function transfer to other cultures? What are the institutional influences on teamwork? Does face-to-face conferencing matter for developing collaboration? And much more! Featuring CMS staff and fellows including Jenny Rudolph, Janice Palaganas, Kate Morse, Jeff Cooper, Grace Ng, QJ Tong, Mabel Gomez, Clement Buleon, & Melanie Barlow.

TELEMEDICINE: Special guest Dr. Clement Buleon, as well as a secret surprise guest, joins Dan and Janice to discuss new innovations in telemedicine, and how to use simulation to train providers to use it. Auscultation, EKGs, and even some invasive procedures can now be performed remotely... so who is training healthcare providers to use these systems? Enjoy!

CRYSTAL BALL: Dan & Janice look ahead to the future of simulation, while examining Dan's failed predictions from history. Also: pulse oximeters, duck boats, the merger of clinical care with simulation, and the next big breakthrough in sim. Enjoy!

PROCRASTINATION: Dan & Janice investigate-- how does work get done? How to balance teams who want to negotiate every detail with those who want to get it done and move on. Also: moving forward with overripe projects, the importance of knowing work styles, and meeting your people's needs. Enjoy!

RESEARCH BIAS: Dan & Janice return to talk about speaking up research, and how to overcome research bias. Also: scientific conduct and what makes a great researcher, the impact of guidelines and oversight, and when to make your study even more rigorous. Enjoy!

TEAMWORK & JAZZ: Dan & Janice return from Montreal with new insights on teamwork in simulation, including: working together versus working well alone, the benefits of occasionally being a learner in the case, scenarios where trust is harmful, & nonverbals that can ease communication. Enjoy!

ROGUE PARTICIPANTS: Dan + Janice field a question from Facebook about what participants who want to "act" in simulations. Also: Accidentally pushing stereotypes, simulation as theater, how not to go over the top, and reigning in rogue faculty. Enjoy!

BEDSIDE CONFLICT: This week, Dr. Laura Rock joins Dan & Janice to talk conflict: how to negotiate with jerks, distinguishing positions from interests, setting the stage for productive bedside arguments, traditional versus integrative bargaining techniques, and more. Enjoy!

DEBRIEFING WITH WINE: Dr. Alexandre "Sascha" Ghuysen joins Dan & Janice for meditations on the nature of communication and its relationship with sim, and draws parallels between debriefing and the tasting of wine. Also: making a case for the possibility of common understanding, natural talents vs. acquirable skills, and the story of the world's greatest milk smeller. Enjoy!

Jenny Rudolph leads this month's CMS Book Club on "Rest: Why You Get More Done When You Work Less" by Alex Soojung-Kim Pang. How do you make rest and work partners in a setting of normalized overwork? What are your obstacles to unplugging? How can you regenerate through "deep play", and sustain creativity in your work? Listen to the first five minutes for a recap of the book, and after that for the group discussion with Jenny Rudolph, Robert Simon, Roxane Gardner, and Janice Palaganas. Enjoy!

KNOW YOUR SIMULATIONISTA II: This week on DJ Simulationistas, Dan & Janice put their new improvisation training to the test in a completely education-free fifteen minutes of … fun? Get to know the unscripted souls of Dr. D & Dr. J, in two short comic (hopefully?) scenes practice what they learned in class and apply it to potential simulation settings. Enjoy!

IMPROV FOR DEBRIEFING: This week on DJ Simulationistas, Dan & Janice return from an improvisation training workshop and examine whether the training they received could help with general debriefing skills. Also: eliminating "blocks" from your simulation, establishing identity and role clarity, expressing your "inner monologue" in a crisis, and more!

MAKING TIME: This week on DJ Simulationistas, Dan & Janice explore how to make time even when you're swamped. Also: mentorship, letting people fight their own battles, multi-tasking vs. task switching, and being "all in" when you teach. Enjoy!

BURNOUT: This week on DJ Simulationistas, Dan & Janice explore the 3 types of burnout and how to overcome them. Also: Dan's colleagues who never finished their PhDs, creating a mantra, and how to self-monitor and goal set to overcome fatigue. Enjoy!

"HOW TO" FOR JOURNAL REVIEW: This week on DJ Simulationistas, Jenny Rudolph joins Dan & Janice to discuss best practices for journal review, how to get yourself in a constructive mindset, and how to phrase advice so that it's easier for peers to accept. Also: getting criticized by your heroes, and should you sign your reviews? Enjoy!

In this month's CMS Book Club, Dr. Roxane Gardner leads the CMS team in a discussion of Edgar Schein's "Humble Inquiry: The Gentle Art of Asking Instead of Telling." Enjoy!

CLASH OF PERSONALITIES: This week on DJ Simulationistas, Dan & Janice explore how individual personalities can alter identical scenarios and debriefings. Also: team quality as a function of tolerance, creating healthy teams, and getting your staff personality tested. Enjoy!

CLINICAL EVENT DEBRIEFING: Dr. Jen Arnold joins Dan & Janice for a second week to discuss getting comfortable with conversations around death, getting peer-to-peer support in stressful clinical situations, and how to get around barriers to debriefing real clinical events. Join us as we investigate how to establish psychological safety for clinical events debriefing. Enjoy!

FAMILY SIMULATIONS: This week, Dan & Janice are joined by Dr. Jennifer Arnold, CMS Board of Trustees member, neonatologist, simulation director at Johns Hopkins All Children's Hospital, and star of TLC's "The Little Couple." Jenn, Dan, & Janice discuss creating simulations for non-professional caregivers, families, and EMTs, and the research results that have come from this work. Also: Getting mistaken for Steve Martin, getting excited about new realms of realism, and comparing contemporary children's hospitals to how they were in the past. Enjoy!

EMBRACE HYPOCRISY: Today on DJ Simulationistas, Janice debriefs her latest keynote with Jenny Rudolph, "Walking Our Talk: Finding and Embracing the Hypocrisy." Also this week: Prethink charts to reset yourself emotionally before difficult conversations, immunity to change, strengths and weaknesses in boundary setting, and Janice psychoanalyzes Dan. Enjoy!

STICKING WITH SIMULATION: In this week's DJ Simulationistas, Dan & Janice examine resilience and how it applies to simulation. Also: Janice complains about kids these days, Dan on when not to hire an Olympic athlete, and how to create patient-centered practitioners. Enjoy!

“CHANGE IN ONE DAY?”: On this week’s DJ Simulationistas, Dan & Janice are joined by Dr. Susan Farrell to discuss the MGH IHP Leading Across Professions conference, and whether it’s possible for a one-day event to generate real change for its participants. Also: empowering leadership qualities, uncovering assumptions about organizations, and fighting about sports. Enjoy!

VULNERABILITY IN DIFFICULT DEBRIEFINGS: Janice returns from a difficult conversations workshop with a new tool for assessing your contributions to negative emotions in the debriefing room. Also: teaching previewing with vulnerability, vulnerability vs. credibility, and how to apply vulnerability in algorithmic and IPE debriefings. Enjoy!

THE MAGIC OF NEW TOYS: On this week's DJ Simulationistas, Dan & Janice investigate whether fancy new toys make your simulations better. Also: PhD student "nesting", getting psyched for sim, the power of habit, and Roger Federer's beard. Enjoy!

LOW RESOURCE SIMULATION: In this week's DJ Simulationistas, Janice returns from leading sim-based classes in Guatemala with advice on running simulations without all the technology. Also: the effect of sim vendors on creativity, adjusting your scenarios to more locally common medical events, and a game of debriefing "Would You Rather?" Enjoy!

LOW-HANGING RESEARCH FRUIT: In this week's DJ Simulationistas, Dan & Janice take the true measure of what it means to do research. Also: How to maintain your study's sanctity, reflective medical ethics, getting your project off the ground, and getting the right help from the statistics wonks. Enjoy!

In this week's DJ Simulationistas, Dan & Janice take on tribalism and backstabbing behavior in clinical care after experiencing it from the patient side. Also: Dan makes a med student cry, barriers to speaking up for patients, and taking comfort from the complaints of hospital workers. Enjoy!

This week on DJ Simulationistas: Janice informs Dan of the "Dan Raemer rule" at CMS, Dan gets imposter syndrome, and both DJs discover a revealing truth about their public speaking practice. Also: how to use experiential learning to get your listeners involved; the talk topics that people get the most from; and attempting to live out childhood dreams as an adult. Enjoy!

This week on DJ Simulationistas: what is the value of teamwork and staff cohesion? When will you see returns on time you invest in building a team? Also: setting records for incompetence at CMS, the most chaotic scenario ever, and turning around a negative relationship through coaching. Enjoy!

In this week's episode of DJ Simulationistas: Dan & Janice debrief the IMSH conference and explore what inspires and energizes them to work harder in the coming year. Also: how to pick up your energy when your learners are flat, attention-seeking behaviors in debriefing, and the value of pure positive reinforcement for your learners. Enjoy!

This week on DJ Simulationistas: A split-second decision needs to get made in the ER. Two people have different ideas. How do you make a decision? An incident with Janice's daughter forced Dan & Janice to consider the problem of "certainty." Enjoy!

Greetings from flu-ridden Boston! We managed to roll out of our sick-beds to bring you this miniature episode. "Name It to Tame It" is a strategy for soothing upset emotions, solving team friction, and otherwise defusing a debriefing in danger of going off the rails. In this episode, Dan & Janice interview Stephanie Barwick of Mater Education in Brisbane, Australia, a sim educator who has some expert insight into how to use "Name It to Tame It" in your own practice. Enjoy!

In this week's episode of DJ Simulationistas, Janice & Dan return to their discussion from two weeks ago about debriefer self-rescue to ask one more question-- how do you save your debriefing when something you did sets off a participant? The team offers simple and effective solutions for managing an upset learner and making sure your learning outcomes still get reached. Enjoy!

In this week's episode of DJ Simulationistas, Dan & Janice examine some of the pervasive myths that they have encountered in their time in the world of simulation, and try to figure out which ones have some truth and which ones are complete nonsense. If you're at IMSH 2018 in Los Angeles this week, visit Dan and Janice at the Center for Medical Simulation booth, and watch Dan's interview of plenary speaker Jamie Hyneman from "Mythbusters" on Sunday, January 14th, from 3:00-4:30 PM at the LA Convention Center!

In this week's episode of DJ Simulationistas, Dan & Janice explore how to "chillax" in a stressful debriefing, Dan admits his fatal flaw, and the team explores how to deal with "resident hubris." Also: the importance of naming your demons, debriefing self-rescue, notes on triple-loop learning, and how having a good partner can get you through the toughest debriefing. Enjoy!

In this month's very bite-sized version of the CMS Book Club, Dr. Rebecca Minehart leads the team in a discussion of Dale Carnegie & Associate's book "Listen! The Art of Effective Communication." Joining us this week are CMS faculty and friends including Ignacio del Moral, Kate Morse, Janice Palaganas, Roxane Gardner, Stephanie Barwick, Robert Simon, and Laura Rock. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Dan reflects on the hidden costs of a life devoted to continual learning. Janice explores what motivates your adult learners to grow and change, and proposes a hiring method to find only people who want to get better at their jobs. Also: what do you do when you’re trying to remember an old skill and all you find is cobwebs? And when is prior experience harmful to learning? Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Dan teaches us about the one thing that frustrates him most watching teaching in simulation, and special guests Roxane Gardner and James Lipshaw join Janice to discuss the biggest bloopers and pratfalls in establishing an online learning environment that works for your students. Also: Janice explains the difference between entrepreneurship and intrapreneurship, and the team gives their best advice for writing educational grants. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Janice and Dan bring you the #1 skill that you can take back to patient care from simulation. Also this week: how to interrupt a doctor so that allied health workers can speak their minds, what interprofessional education actually is (versus what you’re doing), and the lightbulb moment for operating room teams. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Janice makes Dan reveal the secret to building successful models and sim technology. Also: how to engage surgeons in your simulation, the trick to modeling just a little chunk of a brain, and a research-based debate over the effectiveness of burning meat in the operating room. For tutorial videos on how to make some of our models, visit www.youtube.com/medicalsimulation !

The Center for Medical Simulation Book Club is a monthly session where the CMS team reads and discusses a relevant writing to the world of simulation. The Book Club is a light-hearted and enjoyable “play date,” where CMS faculty and guests have the opportunity to flex their mental muscles. In this episode, the team discusses the book "Radical Candor" by Kim Scott. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Dan and Janice tackle the question that CMS investigates every day: how do you best educate educators? We propose a number of solutions. Also this week: Dan’s surprise grandchild, the importance of experiential learning, Janice’s ideas for a new kind of primary practice, and a quick indoctrination into the cult of crossfit. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Dan & Janice tell us what they learned about simulation and society on their trip to give a keynote at the Korean Society for Simulation in Healthcare. Also this week: the danger of open-ended questions, the trouble with idioms, and how to project humor across the language barrier. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, we bring you an exclusive preview of IMSH 2018 from three members of the IMSH 2018 planning committee: Roxane Gardner, Jordan Halasz, and Jill Sanko. IMSH 2018 will take place in Los Angeles, California from January 13 to January 18, 2018, and will feature some special surprises which you can hear about in this episode! Dan Raemer, founding President of the Society for Simulation in Healthcare, also gives us a never before heard history of its founding, the story of how Dan nearly lost his house to pay for the first ever IMSH conference, and the episode ends with a special invitation from the planning committee to our listeners. Enjoy!

In this week’s episode of DJ Simulationistas … ‘Sup?, Dan and Janice run their own private book club for Daring Greatly by Brene Brown, because, well, Dan forgot about the actual CMS Book Club. From there, we discuss what exactly shame is, screaming while taking a tennis ball directly to the face, and gremlins on the wings of the plane.

The Center for Medical Simulation Book Club is a monthly session where the CMS team reads and discusses a relevant writing to the world of simulation. The Book Club is a light-hearted and enjoyable “play date,” where CMS faculty and guests have the opportunity to flex their mental muscles. In this episode of the CMS Book Club, the team discusses the book Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Brené Brown.

In this week’s miniature episode of DJ Simulationistas … Sup?, Dan and Janice explore educational models for spaced learning in healthcare education. Also: Dan discusses his past life studying the kinetics of anesthesia drug infusion, we run into issues with the Heisenberg uncertainty principle, and a conversation about memory and retention that (former middle school teacher) James the tech guy probably should have contributed to.

In this week's episode of DJ Simulationistas, Dan takes us through his new project to make sure that real patients are never hurt by simulation, including a deep dive into the history of sim, including real patient deaths that have been caused by simulation. For more information on Dan and Ann Mullen's project, visit www.healthcaresimulationsafety.org.

In this week’s episode of DJ Simulationistas … Sup?, Dan and Janice check in on our emotions before moving on to cognition… or do they? We explore strategies and alternative models for the Reactions Phase of debriefing. Also: Getting people to trust you in debriefing, keeping grounded in reality, and [insert Lisa Simpson “Grade Me!” gif here].

In this week’s episode of DJ Simulationistas … 'Sup?, Janice experiments on her children with facial recording software, and finds some unexpected results. Also: how to recognize a Super Recognizer, Dan takes us on a journey to Scotland Yard, people who never forget a place setting, and more!

The Center for Medical Simulation Book Club is a monthly session where the CMS team reads and discusses a relevant writing to the world of simulation. The Book Club is a light-hearted and enjoyable “play date,” where CMS faculty and guests have the opportunity to flex their mental muscles. In this episode of the CMS Book Club, the team discusses the book Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy by Amy Edmonson.

In this week’s episode of DJ Simulationistas … Sup?, Dan and Janice discuss words they find frustrating in simulation, and riff on an old George Carlin routine. Also: the origins of the Voice of God, to hyphenate or not to hyphenate, how to help with the simulation comedown, and more!

In this week's episode of DJ Simulationistas … 'Sup?, Janice returns from Saudi Arabia with new love and a permanent addition to her fashion collection. Janice and Dan discuss differences in Advocacy Inquiry around the world, Dan proposes a radical controlled study. Also: the team argues about the mathematics of poker, visibility versus legibility, a fresh new take on imagining the audience naked, and more!

In this week's episode of DJ Simulationistas … 'Sup?, Janice and Dan discuss finding the people who will give you feedback that actually helps you grow. Also: Janice freaks out at her children, Dan reaches a flow state, James the tech guy’s personal identity is threatened, and more!

In our initial episode of DJ Simulationistas … Sup?, Dan recounts the most scarring deception he ever experienced, and how it broke the “safe container.” Would he do it again? In a heartbeat. Also: why you should never boil a stinky tennis shirt, summer school for dorks, invaders from Mars, and more!

The Center for Medical Simulation Book Club is a monthly session where the CMS team reads and discusses a relevant writing to the world of simulation. The Book Club is a light-hearted and enjoyable “play date,” where CMS faculty and guests have the opportunity to flex their mental muscles. In this episode of the CMS Book Club, the team discusses the book Essentialism: The Disciplined Pursuit of Less by Greg McKeown. We argue over throwing out whole wardrobes, tricks to telling people "no" when they ask for favors, and how to avoid doing work tasks you just don't enjoy.

In this slightly oddball episode of DJ Simulationistas, James the tech guy introduces you to Dr. Dan Raemer and Dr. Janice Palaganas, two big names in simulation who will be leading you on both a roundabout tour of and a deep dive into the field. We’ll interview Dan and Janice on their simulation horror stories, and play a little game to get to know each other that is in no way based off of properties copyrighted by the Columbia Pictures Corporation [cough]. Also: Being cryptic, some recency bias re: Dan’s spirit animal, and an exploration of high-fidelity mannequin "parts"!