Next up in our “How I Sim” series is Jenny W Rudolph.
You probably know of the Center for Medical Simulation founded 22 years ago where Jenny works; and to people in the world of sim she’ll need little introduction as we are well aware of the significant contributions she’s made to the way we think about debriefing.
I’m sure that I’m not the only one in the world of #FOAMsim and #FOAMed that sees “There’s no such thing as nonjudgmental debriefing” as one of the most important publications out there for anyone trying to become a skilled debriefer. She has recently taken on pre-briefing with “Establishing a safe container for learning in simulation”.
With a background in Organizational Behavior, Jenny has become a leading authority on how cognition, emotion and communication interact in high-stakes healthcare situations. Her expertise emerges from research on learning from accident and error in disasters and high-hazard industries and from her personal experience as a rock climber and world-class rower.
For me, every single publication from Jenny has had a huge impact on the way I’ve grown as an educator, doctor and person.
It’s therefore truly a great honor and a pleasure for us to share her views on sim with the rest of you.
If you haven’t already, connect with her on twitter at @GetCuriousNow.
Enjoy Jenny’s “How I Sim” story.
“How I Sim”
Executive Director, Center for Medical Simulation
One sentence to describe your sim recently
Planning the 6th Edition (12th year) of our Anesthesia Crisis Resource Management for faculty across the Harvard system. Using a blend of Rapid Cycle Deliberate Practice and traditional simulation + debriefing; also trying out allowing participants to “choose their own adventure.”
Favorite topics in sim
- Linking honesty and positive regard in debriefing
- Psychological safety challenges for learners in in situ and center-based simulation.
Current sim project(s)
- Sim in everyday life! E.g rehearsing and visualizing difficult conversations.
- Strengthening my and my colleague’s reflective practice muscles by leading a deliberately developmental organization.
- Supporting Janice Palaganas and Roxane Gardner in launching the health professions faculty development web-based third space, iCoP (interprofessional community of practice)
How I see simulation scenarios
- As portal to different individuals’ and professions’ world views, assumptions, and mental models
- As needing to flex to learning outcomes… full simulation plus reflective debriefing, pause and discuss, pause and coach, sim with close coaching can all be mixed and matched.
How I see debriefing
- This is where we can change culture by speaking “with good judgment”. “With good judgment” means each person using his or her own power and voice to share their best judgment (understanding) of what is happening, being fair to self and others; assuming we all are trying to do our best; assuming we can and should reach high standards.
- A mind-training workout for the debriefers—constantly resetting oneself to hold learners and other debriefers in high regard while holding them to high standards.
- A mind-training workout for the learners—it’s hard not to believe everything you think; it’s hard to question your own assumptions.
Simulation in the future
Once natural language processing is available, screen and virtual reality simulations of high stakes conversations—feedback, consent, breaking bad news, conversations with families of critically ill patients can all be practiced.
Collective, remote learning using VR will allow practitioners to come together to practice on-demand.
Your advice to any new sim’er
If people do not open up or are defensive in a debriefing, the first line treatment is to examine and change what I (the instructor) am doing or saying. Simulation and debriefing put participants’ core professional skills and identify under the spot-light—understanding identity threats and securing their psychological safety is our responsibility.
Expect to be “triggered” sometimes. It is natural to feel defensive or angry occasionally as an educator. So you need a self-rescue routine to calm yourself down. Mine is “React, reset, get curious!”
“React, reset, get curious!”
I would like to nominate these three great educators in #FOAMsim:
- Laura Rock @LauraKaneRock. Critical care pulmonologist and communication educator Laura Rock’s mantra, “Emotion before Cognition!” is influencing simulation education and difficult conversations
- Betsy Hunt. Betsy’s rockin’ “Rapid Cycle Deliberate Practice” tunes up team and individual skills with demonstrable benefit
- Jose Maestre (@HvValdecilla) – An anesthetist bringing the best of reflective practice and learning curve theory to simulation education across the Spanish-speaking world
As you may have noticed – Betsy Hunt is not on twitter. Not to worry, we have her email and have already passed the nomination on as we are sure you agree with Jenny and would love to hear her thoughts on sim and Rapid Cycle Deliberate Practice.