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Welcome to the Onrecord Podcast.
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This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio in innovative ways to support their organization's objectives.
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My name is Mike Anselone, and my co-host is Carmen Hawk.
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And today I'm really excited because we got a couple guests from Northern Alberta Institute of Technology.
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Today we have Lisa George, and Lisa is the associate chair of Simulation and Interprofessional Education, and Tom Waring.
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Tom is the lead simulation technologist.
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Welcome both of you to the OnRecord podcast.
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Thanks so much for having us.
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And so to typically, before we kind of really um dive into the conversation, we'd like to get a little bit, um, learn a little bit about yourself, your background, and how you actually got to Northern Alberta Institute of Technology.
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So my background is a combined laboratory and X-ray technologist.
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And I came to NATE's as an instructor within that program and you know, worked in that program for about 13 years, instructing and then leading it as chair.
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Um, but how I got into interprofessional education and simulation is um actually when they introduced a course within the School of Health and Life Sciences.
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They did some onboarding training, which I was fortunate to be a part of and be one of many of the instructors as a part of that course early on, I think in about 2014.
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Um, and then in 2019, um, they were looking for a new instructor to lead um IPE for the School of Health and Life Sciences.
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And I had really enjoyed my experience as an instructor in that course and thought it was a great opportunity as a stepping stone.
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So put forward an expression of interest and was successful in being able to lead that.
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So now for two years, I've been full-time dedicated to leading IPE.
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We have 14 programs within our school that participate to have it embedded in their curriculum.
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And fortunate to be situated within the Center for Advanced Medical Simulation, where I'm one of many supporting SIM as well within our department.
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How about you, Tom?
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Yeah, so I like to say I don't really have a background in anything.
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My background is in simulation.
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I've been in healthcare simulation since I was 20.
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Um, so I've been here for over a decade now.
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I started as a clinical technologist apprenticeship at King's College Hospital in London, in England.
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Uh, was in that course for about eight months, rotating through like surgical theatres, ER, radiation protection, loads of different departments.
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And then, as most SIMTEX happened, uh a SIMTech job opened up at the hospital, fell into it and never really looked back.
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Uh worked there for three or four years, moved to Canada in 2018, kind of thought that may be it for simulation, sold jeans for six months, and then as it happens, happened to fall into a simulation position here with Nate, and have been here ever since then.
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What do you like best about being in simulation?
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I'm just a massive nerd at heart, so I get to use my skills, I kind of say, for the good of humanity rather than messing around in my bedroom.
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So I yeah, just a massive nerd.
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I love video games, board games, um I taking the personal fitness trainer diploma here at May, and I love using all of those skill sets to help students learn and be better healthcare professionals.
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I know both Carmen and I have a ton of questions because uh doing some research on the types of things that you've been able to accomplish at your institution have been just phenomenal.
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So maybe um if we can start about because I know uh Lisa, when you're talking about like the pulling together interprofessional education-oriented simulation, there's a lot of different moving parts.
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There's a lot of again, just from the title of it, you're bringing together teams that may not necessarily work together very often.
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What are can you tell us a little a little bit about some of the the challenges of putting together a scenario like that?
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And not only the challenges, but the types of outcomes that you're looking to gain from that kind of scenario.
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Yeah, I think, you know, first of all, it's really important to make sure that you have representation from each discipline that's going to be participating in the simulation because, you know, my background in lab and x-ray, you know, is great in terms of making sure that um the accuracies around the simulation scenario um represent what is you know happening in practice, but it's self-shore there.
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I'm not, you know, as knowledgeable in respiratory, paramedicine, etc., for the different programs that we have here at NATE.
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So we need to make sure that we have those people there to ensure it's accurate and it's appropriate for the learning uh of where the students are in their journey.
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Um, so coordinating, bringing people together and making sure that we have a solid understanding of how these roles will be interacting in these types of scenarios is key.
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And um so really what that's what I love about IPE, sim, is that in able to make sure that it's an effective um learning opportunity, we also have to be practicing it and modeling it for the students ourselves from the facilitation team as well.
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So that is a big part of it, make making sure that we have people that are participating as well as can, you know, feel comfortable and open and honest to share their feedback.
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And we have that psychological safety within the facilitation team as well.
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Now, how would you go about preparing in a professional type of scenario?
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Yeah, so I think um, like I said, a big part of that is bringing the people together, starting with our needs analysis.
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And, you know, what are we trying to achieve?
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What are the gaps that we need to fill here?
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And working through those learning objectives.
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Uh, also like to work very closely with Tom and his team to make sure that the modalities that we're choosing for these scenarios are appropriate for the goals of the scenario, um, as well as, you know, making sure that they have what they need in order to bring this scenario to life.
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So, you know, whether it is a five-minute communication-based scenario or, you know, a large-scale mass cashly incident sandwich we run, I think having the right people at the team, you know, in a timely manner is very important.
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So we have some very specific timelines in place um within the center to make sure that there's appropriate resources, including hiring those standardized participants and the appropriate tools and information needed around that.
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So Tom and his team have done a great job of creating a simulation template, which facilitators will need to fill in so we have all of the background information.
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And I'm sure Tom can speak better to that than I can.
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It's a key tool to making sure that we have all the details we need in order to run this scenario.
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Totally.
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We're incredibly fortunate that Nate and CAMS has such a huge facility with so much technology at our disposal that we can pull off these crazy simulations like giant mass casualty simulations, but really we don't want our facilitators to get too excited and try and drag in so much technology that you kind of lose the heart of the simulation and why you're doing it in the first place.
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So that's why keeping the core of the learning objectives is so key.
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So, Tom, how do you like from a technology perspective, your your translation process from these are the educational outcomes um designed for this scenario?
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How do you then orchestrate and coordinate all the technology that's required in order to support those educational outcomes?
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Sure.
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We've got a really good quality management system that helps with a lot of that aspect.
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Um and within it's a lot of collaboration really with the lead instructor for that program.
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So we don't necessarily know what a combined laboratory technologist student needs to know on the certain skill sets, but we can help uh interpret their needs into a simulation that's going to be valuable for that learner.
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It's the the creative output and knowing what the technology can do and helping interpret those needs.
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Just bearing witness the first couple of questions that have been asked, you two are very humble.
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You have extensive experience and you bring tremendous value, obviously, to Nate.
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Um, and just judging by how you've outlined your preparation, how you mitigate challenges, um, bringing that experience to the table and really driving the value home.
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Um, video obviously is a huge part of technology that has to be figured out and brought into the plans to make sure that um you have the proper learning outcomes.
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Well, you helped me understand in your opinion.
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We can start with Lisa and then move to Tom.
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How do we use video at NATE?
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Or how are you using video at NATE to make sure that you're getting those learning outcomes um achieved?
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Yeah, I think it's a huge piece, first of all, in maintaining the realism of the simulation environment.
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So, first of all, before we had the wonderful center that we do, you know, we used to host simulation within our lab spaces and the programs.
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And that included all the learners and facilitators outlining the space, you know, huddled, leaning up against the wall.
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And with the learners engaging in these scenarios, that really takes it away from trying to, you know, buy into the experience that it is a real situation with a real patient.
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So that's a huge piece in and of itself, still having an opportunity for learners to um view a scenario that's taking place, observe it, and you know, be able to witness what's happening and be able to participate in the debrief without the people having them in the space.
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And then second to that would definitely be for any debrief opportunities.
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I think it's a huge contributing factor to um students being able to look back on their performance, see how it's being um received from the people that they're interacting with.
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Much, you know, it goes beyond the facilitator mentioning what they noticed and observed, and they get to see it for themselves, which I think is just a much more powerful tool to help build those conversations and those learning opportunities.
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That's excellent.
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Lisa, what about your opinion, Tom?
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Yeah, Lisa kind of hit the the two cores there, the self-reflection piece, and then that kind of expanding the blast radius, if you will, of the experience so that more people can actually participate and get something from that experience.
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But the time that students have in simulation is somewhat limited.
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So being able to observe someone else and then participate in the debrief just adds a completely different perspective and a different element to it.
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The other things that we do here at CAMS that are a little different, that kind of add on and we can utilize video for is the research side of things.
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We do a ton of research both on simulation best practice and pedagogy, as well as with industry partners.
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So if someone wants to come in and bring in a product to do some testing with end users in a realistic environment, we can do that testing here in CAMS and then provide them that video footage, which is massive for them to go back, iterate on products and get ready for a launch.
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You're really diversifying, I was gonna say, your usage of it.
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I please elaborate.
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That's just fascinating to use it for multiple.
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Yeah, so we have the space and it's something that the industry really needs.
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It's really difficult to test a product in a real hospital, whereas we have a full simulated hospital at our disposal, so why not come in and utilize that and then bring in the end users that are going to be utilizing that product and get them hands-on with with the product early so you can make iterations to have a product that's really valuable at the end?
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I know Nate Ancams has received tons of accolades about the mass casualty type of scenarios that you've been running.
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Can you kind of walk us through like the how that got started, the motivation for that, and and again, the maybe the lessons that you've learned as a process of running that kind of scenario that maybe our listeners who are thinking about something like that could learn from?
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May I just preface?
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Is this is this commu care 2024?
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This is what we're talking about specifically, obviously, other um examples, but also is that what you're referring to, Mike?
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This is like something that okay.
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Absolutely.
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So this started three years ago.
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I attended um a program orientation meeting with our advanced care paramedic students.
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And so um I really wanted to connect with them as they are one of the few programs within our school that we have learners coming in already having experience within their discipline and they're retooling and advancing their practice.
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So it did, you know, kind of set the those students apart from some of the other programs where most of the students were coming in with no or limited healthcare experience.
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And I really wanted to make sure that the learning opportunities we were providing were going to be relevant for them.
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And I just, you know, took the opportunity to put it out there and say if you have any ideas on interprofessional education opportunities you would like to see included, please reach out, please let me know.
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And I did have a couple of students take me up on that, and they suggested that we, you know, put together a mass casualty incident simulation.
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And um we I was happy to take it from there.
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I was able to connect with our disaster and emergency management program, and the students in that program actually started and built the first iteration of the simulation.
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So it was a great learning opportunity for them to get some real life hands-on experience building out these exercises, and then we were able to coordinate with other, you know, Tom and the Syntech team, as well as other facilitators in NATO to bring it to life.
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So it's grown um significantly since the first year, um, where the first year we only had students within Nate participating.
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And then this last year we had students from a total of five different institutes across Alberta participating, and we were able to invite nursing and medical students, which we don't have at NAT, you know, to collaborate with our respiratory therapy students, our both primary care and advanced care paramedic students.
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We had MRI, we had X-ray technologists, lab technologists, medical lab assisting, and then we also have the Combined Lab and X-ray technology program, which is fairly unique to Alberta and Canada.
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I will say it's based on a rural healthcare environment.
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Um, so we expanded this year for a number of different ways to include um our on-scene response, which we have in our immersive 360 theater, which we Tom and the team did an amazing job setting it up as the building collapse scene and on the walls projecting the you know the rubble and that kind of thing.
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Uh, we were able to collaborate with um some local firefighters that came in, as well as Medib.
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They brought two ambulances in, so the students got to actually experience riding in an ambulance and supporting patients for the first time for our primary care of paramedic students.
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Um in addition to the ambulance simulator that we have at NAT.
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So from there, they then transported their patients after triaging them on scene.
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Um, we had two hospital settings.
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We had the rural hospital setting, and then CAMS was set up as our entire tertiary hospital with MRI, CT, X-ray lab, respiratory.
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And so a very um immersive high fidelity simulation.
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It was about an hour long in total, and really emphasizing the focus of team collaboration and communication, you know, interdepartmental communication via phone, as well as you know, from the scene to dispatch to the hospitals and kind of coordinating the care and the delivery of patients.
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Yeah, you the way I kind of treat this, other than just the huge amount of learning that the learners got from it, as a department here, we kind of treat it almost like our Apollo moon missions.
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It's our it's our like big we have a year to get this done.
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This is the vision, and all of those huge challenges that we're able to overcome with collaborating with other industries, engaging partners like yourselves to support with video recording, uh, all the ambulance services, fire, and other companies to pull off this one huge event.
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It it builds a lot of the innovation side of things for us internally and pushes the barriers of what we can actually deliver as part of a simulation activity.
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Even after that, and something we're working on now to bring it kind of back to the video portion of it.
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So these simulations we recorded from 40 different camera angles.
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Wow.
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Each of these simulations which were on twice in one day, we ended up with about 90 minutes per camera per sim.
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Oh my gosh.
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So at the end of the day, we're uh about 120 to 140 hours of video content.
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So now we're at the stage where we go, okay, what do we do with this?
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We've got so much content, so now we're innovating and trying to figure out ways to digest that content using things like AI to get outcomes and to support us in developing next year's solution that's more to what learners actually need and do learning from that video footage.
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And not only that, but we're also doing research um as a part of this year's learning experience.
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So from the simulation itself as well as the debrief, this is going to be um, you know, a big summer project, I'll say, combing through all of these recordings and using it um as a part of a couple of research projects that we have underway.
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I'd kind of like to think what you just described to me sounds like a big movie set.
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I was just thinking production.
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I was thinking the same thing.
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Yeah, production.
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And Tom, you mentioned 40 different camera angles, which kind of blows my mind in and of itself.
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But because part of the scenario is to understand how these different resources and teams are working together, communication is so important.
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And communication therefore requires really good audio so you can hear how they're communicating.
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How do you tackle that?
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I mean, video is one thing because you can just have the cameras set around, but audio is a is another beast in and of itself.
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Totally.
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Uh honestly, with extreme difficulty.
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Keep it real.
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Yeah, when you've got microphones in the embedded in a ceiling and there are 27 people in a single room, good luck to you hearing anything from that.
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So it takes a lot of time and a lot of effort and pulling all of those individual feeds to get anything from it.
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A lot of post-analysis and putting it in Premiere Pro and adjusting the audio to try and get certain frequencies dialed in a little bit so you can hear things.
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So it takes a lot of time and effort.
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Wow.
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Were these scenarios run inside a facility, or were they did you do anything outside, like in a parking lot?
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Bit of everything.
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So we started the scene in what we call our theater nine, our extended reality theater, which is a thousand square foot simulation space with projectors that go uh project scene onto the walls.
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There's a full theater lighting rigging, there's fog smoke machine going.
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Audio, and then we crammed it full of 20 standardized patients, and then a ton of rubble uh to represent this building collection.
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Up scene.
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The uh standardized patients and mannequins were then transported either via a simulated ambulance or via a real ambulance outside of the doors of that theatre round to the front entrance of cams, where they were met in the one of the two triage areas, either the triage for the first hospital or taken into the rural secondary hospital.
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Then from the hospital, they'd go that from that triage uh entryway, they'd get taken to a bed bay somewhere within the embedded hospital, which was an eight-bay hospital that we crammed, I think about 15 people into somehow.
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And then they had individual secondary rooms for lab and x-ray and CT and MRI, all separate rooms as well.
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Wow.
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I just have to say it's a it's a it's a huge commitment to the realism, and we're obviously recognizing that based on your descriptions.
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And then what a great service to your students for the learners to be able to have this realism, the opportunities you presented them with, and very rewarding, I'm sure, for all the participants involved.
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And it's got to be a passion project.
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You're driven by the motivation to give this experience, and that's part of what's rewarding you too, it sounds like.
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Right now, with the technology and what what you've used, you've come, you've come to a place where you're innovating and leading.
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Do you see like a future state down the road?
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Like, what do you see?
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I mean, you've mentioned AI, Tom.
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Is there other things like future state you're picturing?
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And I don't want you to give away your secret sauce, but like, what are you imagining to be the next stage of this?
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Uh personally, the thing I'm working on the most with the AI side of things is to be able to produce screen-based and virtual simulations rapidly, specific to learner needs.
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So that can be as like a pre-scaffolding or as a post-simulation experience.
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So sim is an amazing tool to discover your weaknesses.
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Now, what do you do with those weaknesses or those learning gaps?
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You've got to take that away and do a lot of work on your own.
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Well, if we can provide you with some tools to support that self-learning, then why not?
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And that's where AI is coming in to be able to create that rapid simulation delivery.
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Yeah, and I think specific to the mass casualty incident, Sim, we're definitely looking at ways to prepare the learners so they feel more confident coming in.
00:24:25.200 --> 00:24:39.440
So, like I said, there were a number of students that are not from Nate, so they're not familiar with the space, and it's it's a lot to excuse me, orientate yourself in a rapid way, you know, as well as get to know the teams that you're going to be working with.
00:24:39.599 --> 00:24:45.599
So we want to provide them a little bit more time to get comfortable with the space.
00:24:45.680 --> 00:25:03.440
And we have a fantastic digital twin of our center that I think we're definitely looking to incorporate and give them a bit of a virtual reality orientation so they can take a look at the equipment that we'll have in the space, see where it'll be located.
00:25:03.680 --> 00:25:11.200
So when they come in on the day of, they're much more confident and prepared to just start rolling with the simulation.
00:25:11.599 --> 00:25:19.279
What has been your students' and learners' feedback, particularly from you know this kind of mass casualty scenario?
00:25:19.680 --> 00:25:23.839
Yeah, I think we've definitely learned from their feedback each year.
00:25:24.000 --> 00:25:27.359
Um, this year it's been overwhelmingly positive.
00:25:27.519 --> 00:25:41.200
They truly appreciate the opportunity to get a glimpse of what it will be like to work in a hospital setting and how to collaborate with the various disciplines that will, you know, likely they'll encounter.
00:25:41.440 --> 00:25:55.519
So they really appreciated the opportunity to practice their communication in a very realistic way and then be able to work through the you know the experience as a part of the debrief.
00:25:55.759 --> 00:26:04.880
Um, because it is such a widespread um simulation, not every learner will encounter each aspect.
00:26:05.039 --> 00:26:10.880
So, for example, the students placed in the hospital, they they don't ever make it to the scene, right?
00:26:11.039 --> 00:26:17.759
It wouldn't be realistic, but they want to hear about what the paramedic students encounter.
00:26:17.839 --> 00:26:26.319
And so we try to use video one year to get them to see it afterwards, um, but as well as as a part of the deep break there.
00:26:26.400 --> 00:26:33.119
So I think there's some gaps there that we're looking to close through video solutions.
00:26:33.440 --> 00:26:48.160
And um, previously we did receive feedback the prior year about wanting to have more time with the students that will be participating so they can get to know each other and better understand each other's roles.
00:26:48.400 --> 00:27:06.880
So we did incorporate that feedback in an icebreaker type of activity, giving them an opportunity to introduce themselves, practice, you know, their name, occupation duty, um, a little bit of closed-lip communication that we wanted to see them demonstrate as a part of the simulation experience as well.
00:27:07.279 --> 00:27:13.839
And uh we're looking, you know, we're just starting to uncover the feedback and the learnings from that experience this year.
00:27:14.160 --> 00:27:20.720
I would imagine with a group that large, what is the debrief process like?
00:27:21.519 --> 00:27:24.319
Do you break them into groups?
00:27:24.559 --> 00:27:28.480
Like how kind of walk us through that that process.
00:27:29.359 --> 00:27:35.920
Yeah, this is something that we look at each year to see if there's a better way to run it.
00:27:36.160 --> 00:27:59.440
Um this year, what we did, we were very intentional about the groups that we brought together, especially with the co-facilitators, making sure that we had one person that was a part of the on-scene response, and one person in the hospital setting so they can incorporate both um parts of the experience in the conversation.
00:27:59.920 --> 00:28:06.559
We did take um a mixed group, so we really wanted to make sure it was interdisciplinary.
00:28:06.799 --> 00:28:31.039
Some people were placed in the rural hospital, some people were placed in the tertiary hospital, so it wasn't necessarily everyone from one area in a debrief group, and we tried to make it about um six to eight learners per group to kind of facilitate uh, you know, lots of opportunity for everyone to be um participating in the discussion.
00:28:31.680 --> 00:28:57.599
I know um some of the feedback we've already received this year is having a mini debrief in the space that they're that they're in as soon as we stop the simulation, so they can kind of talk through some things that happened specific to that area, and then breaking them up in their interdisciplinary groups um to talk more broadly about the teamwork, the communication, the objectives of the SIM.
00:28:58.160 --> 00:29:12.400
It just seems like there's so many layers to the work that goes into this that I'm still like wrapping my head around it because it's different between, you know, one interprofessional um exercise when you engage what you have 10 to 14 programs you mentioned.
00:29:12.480 --> 00:29:20.319
Um, everyone needs to have some value taken away and some uh feedback personally that hits home and then they want to self-reflect.
00:29:20.480 --> 00:29:21.519
There's a lot to unpack.
00:29:21.599 --> 00:29:27.680
And I think that um it's tremendous that you keep growing year over year and you're getting the feedback from your students.
00:29:27.759 --> 00:29:30.480
That's critical to making improvements when needed.
00:29:30.799 --> 00:29:31.039
Yeah.
00:29:31.119 --> 00:29:34.319
Can you tell us a little bit about the simulation center itself?
00:29:34.799 --> 00:29:35.119
Sure.
00:29:35.279 --> 00:29:38.720
It's a 6,000 square foot simulation center.
00:29:38.880 --> 00:29:45.119
Uh, we've got that 1,000 square foot that's taken up by the extended reality theater.
00:29:45.200 --> 00:29:52.000
Uh, we have four large simulation theaters that are two-bed bay uh spaces.
00:29:52.400 --> 00:30:02.559
Those of dividing wall between each of those rooms as well, so that that wall can be raised into the ceiling and then expanded to a four-bed bay room, so it's a super flexible space.
00:30:02.799 --> 00:30:06.960
Uh, we've also got four smaller rooms that are more like clinic kind of rooms.
00:30:07.359 --> 00:30:19.599
Because we deal with such a wide variety of learners from like animal health or dental or paramedicine, as well as the more typical in-hospital specialties?
00:30:20.160 --> 00:30:23.440
We have to be incredibly flexible in how we utilize the space.
00:30:23.680 --> 00:30:35.359
So we have things like portable bathrooms, portable kitchens that we can put inside of these rooms and completely convert them into whatever type of environment is required for the simulations.
00:30:36.559 --> 00:30:44.880
From a technology perspective, what kinds of challenges have you come across specifically in in that type of environment?
00:30:45.519 --> 00:30:46.400
So many.
00:31:08.799 --> 00:31:12.480
The extended reality room makes almost anything possible.
00:31:12.799 --> 00:31:20.720
So even looking at potentially working with the military and bringing in like armored vehicles and things like that into the space is possible in these environments.
00:31:21.759 --> 00:31:31.680
I'd like to ask our guest about uh future developments where you see the sp the field of simulation going.
00:31:31.920 --> 00:31:43.279
And from our conversation so far, it seems like you are living in the future already, uh, based upon everything that you've done, which is is truly amazing.
00:31:43.440 --> 00:31:51.759
But as you're thinking down the road, um what trends do you see?
00:31:51.920 --> 00:31:54.319
How can you make this more realistic?
00:31:54.559 --> 00:32:06.640
How can you use technology perhaps in a different in a way to in a way to again support the educational component of what you're looking to do?
00:32:08.079 --> 00:32:11.279
I think we're pretty good with the realism side so far.
00:32:11.359 --> 00:32:22.240
I think enhancements in mannequins and enhancements in standardized patient adjuncts make it more difficult to decide exactly which path to take.
00:32:22.400 --> 00:32:26.640
Typically, it was if you're gonna talk to your patient, you pick a standardized patient.
00:32:26.880 --> 00:32:30.079
If you want to do something tactile, you pick a mannequin.
00:32:30.319 --> 00:32:34.160
So those lines are blending quite a lot recently.
00:32:34.799 --> 00:32:47.440
But I think the enhancements that we're gonna see in the future are more customized simulations and more just-in-time training specific to unique learners.
00:32:47.759 --> 00:32:51.920
Rather than just on week six of this course, you will do this simulation.
00:32:52.079 --> 00:32:55.920
I think we're gonna be able to build in way more flexibility to those experiences.
00:32:56.240 --> 00:33:15.039
Yeah, and I'm really excited about the more opportunities for scaffolding of learning with virtual simulations, giving students the opportunity to run through a scenario online multiple times, as many times as they want, and you know, incorporating the use of AI.
00:33:15.200 --> 00:33:35.759
I know a lot of people are very curious about that right now, and we've been using it as well with some virtual simulations, getting that personalized feedback for learners and just, you know, you know, as well as even a tool for debriefing, helping facilitators as they're observing.
00:33:35.839 --> 00:33:38.319
You know, we're humans and we miss things too.
00:33:38.559 --> 00:33:51.359
So it could be an opportunity to help kind of um condense or like summarize what may have happened and help contribute to planning out debrief discussions as well.
00:33:51.680 --> 00:34:03.279
So I know you've all you also mentioned using simulation from a research perspective, and one example that you gave was like product usability, product development.
00:34:03.519 --> 00:34:07.519
What other types of examples could you share with our listeners?
00:34:07.920 --> 00:34:14.320
Without naming names, uh we had a company come in with an auto-injector.
00:34:15.199 --> 00:34:21.360
Um that auto-injector was to be used for emergency situations where someone was bleeding out.
00:34:22.079 --> 00:34:37.519
So we in our extended reality theater, we brought in an actual car that we crashed, had a mannequin lying out the side of the car, um, partly extricated with uh below knee amputation.
00:34:38.400 --> 00:34:42.239
Uh, and then the participants came into the room that was very cold.
00:34:42.320 --> 00:34:48.880
We set the temperature to about eight or nine degrees, a little bit, a little bit of fog and a little bit of wind going, and the lights nice and dark.
00:34:48.960 --> 00:34:51.920
So it was a dark winter's evening here in Canada.
00:34:53.119 --> 00:34:56.159
And our storytelling is on point.
00:34:56.480 --> 00:34:57.360
Thank gosh.
00:35:01.039 --> 00:35:09.119
The um auto injector had a very, very small light on the top of it that indicated when the drug had been delivered.
00:35:09.440 --> 00:35:15.440
And the participants said that they couldn't hear the little beep or see the light in the environment.
00:35:15.679 --> 00:35:25.760
So they were able to go away and add a brighter light and a lot uh more volume sound to the auto injector.
00:35:25.840 --> 00:35:28.559
So it was more obvious when the drug had been delivered.
00:35:28.719 --> 00:35:33.840
Because when you're testing in a silent lab environment, you don't think of those things until you're actually out in the field.
00:35:34.159 --> 00:35:40.400
And then I would say from like a pedagogy perspective, we're looking at, you know, specific to the MCI.
00:35:40.639 --> 00:35:42.079
We haven't worked through it all yet.
00:35:42.320 --> 00:36:05.119
It's going to be a very large project this summer, but um, we had an opportunity to compare and contrast um morning simulation to the afternoon simulation and um the difference that an icebreaker activity made on the students' comfort and the willingness to communicate interprofessionally during the scenario.
00:36:05.440 --> 00:36:19.280
Um, we also are looking at um the debrief and kind of having a structured debrief format to encourage participation from all disciplines present in that group.
00:36:19.440 --> 00:36:47.199
Um, so we're again comparing and contrasting between two groups there and really excited to you know use our video and um audio capture from that to then actually count how many times things like closed lip communication occurred, you know, the handoffs between the providers and how they formatted that, you know, in some of the tools that we provided them in advance.
00:36:47.280 --> 00:36:55.920
So there's going to, I think there's going to be a lot of learnings and a lot of opportunities through the use of research in our simulation experiences.
00:36:56.320 --> 00:37:02.079
I have one last question on the topic that it might be just based on some of the language you sprinkled in there, Lisa.
00:37:02.239 --> 00:37:05.199
You mentioned a lot about like psychological safety of the students.
00:37:05.360 --> 00:37:11.519
You talk about the preparation, um, the confidence building, maybe having materials prior, the icebreaking.
00:37:11.679 --> 00:37:18.559
How else and what is like the most critical tool you you're using for uh promoting psychological safety?
00:37:18.639 --> 00:37:28.000
Is is there something principle-wise you you live by, or what is your, I guess, idea behind um promoting that in such a large volume of students?
00:37:28.320 --> 00:37:54.480
Yeah, I don't know if I have one specific principle, but I think it's the idea that if we are asking students to really buy in and engage like they will in practice, it's so crucial to make sure that we're attending to their needs as learners as well and creating the space where they're able to do that, especially when we're asking them to come together with people they're meeting for the first time that day.
00:37:54.719 --> 00:38:14.800
So uh we really stepped up our pre-package information that we send out to students in advance and really emphasize that we know that each of them are at different stages in their learning and just recognizing that they are still learning their technical um expertise, and that's okay.
00:38:15.039 --> 00:38:26.239
You know, really emphasizing what the goals of this scenario is and giving them the tools to feel ready and opportunities to ask questions before they even come.
00:38:26.400 --> 00:38:34.480
So I think being very intentional about those things and then also repeating it again when they come there for that day.
00:38:34.639 --> 00:38:49.360
Um, what I was starting to notice this year is doing quite a bit of IPE simulation is that sometimes when they show up, the NERVs are already present, they're already happening, and they're only going to hear a certain amount of information that you're giving them.
00:38:49.519 --> 00:39:04.639
So I really wanted to make sure that we had an opportunity to provide all of that information in advance so they're in their comfortable space and they have time to read through it and really absorb as much as they can and then hear it again when they come there.
00:39:04.880 --> 00:39:11.920
So I try to give them that opportunity to really feel comfortable.
00:39:12.159 --> 00:39:18.320
Um I think it it's just huge in terms of IPE simulation, especially.
00:39:20.159 --> 00:39:28.880
Well, it's obvious you both have been extremely instrumental in building out a world-class simulation center.
00:39:29.119 --> 00:39:44.079
Um, of all the guests that we've had on what you've explained, I believe has been the most complicated type of scenario that could be run and you're doing it like with perfection.
00:39:44.320 --> 00:39:46.719
So hats off to the both of you.
00:39:46.960 --> 00:39:56.079
Before we wrap up, if we've got listeners who are thinking along those lines of that kind of dreaming to aspire, yeah, to that level.
00:39:56.400 --> 00:39:58.800
Dreaming to aspire, what you've accomplished.
00:39:59.119 --> 00:40:06.960
Can you both provide our listeners with some advice um on how to go about putting a program like this together?
00:40:07.360 --> 00:40:08.960
Don't try and do it alone.
00:40:11.360 --> 00:40:12.960
Contact Tom at Tom Me.
00:40:13.440 --> 00:40:13.760
Yeah.
00:40:14.159 --> 00:40:22.800
You're gonna need hands, you're gonna need people that are genuinely passionate about the cause, and that will go a long, long way in getting you to your end goals.
00:40:23.920 --> 00:40:41.519
Yeah, and I think for myself, from a facilitator standpoint, you know, sometimes I've been a part of developing new scenarios where it's the facilitator, facilitator team coming together and crafting up all these ideas and then going to meet with the simtech team.
00:40:41.760 --> 00:40:53.840
And I can't emphasize enough how critical it was to have the sim team a part of the development work right from the get-go because they can tell you right away, like, that's going to be a problem.
00:40:54.000 --> 00:40:56.880
Maybe we can do it this way instead.
00:40:57.119 --> 00:41:02.320
Um, so just making sure that you're working closely together right from the get-go.
00:41:02.880 --> 00:41:06.639
And then, you know, yeah, dare to dream.
00:41:06.800 --> 00:41:13.599
I mean, this year we we had the um Leta Beat team come say, like, hey, we'd like to bring two of our ambulances.
00:41:13.840 --> 00:41:17.679
And immediately I was like, Oh, the insurance issues.
00:41:18.400 --> 00:41:21.199
I thought for sure it was gonna be a no.
00:41:21.440 --> 00:41:30.079
But, you know, we we reached out and asked, and we were pleasantly surprised to say, like, hey, we're doing this, you're coming to us early, which is great.
00:41:30.239 --> 00:41:34.239
And here are the considerations we'll need to make, and here's how we can support you.
00:41:34.480 --> 00:41:40.960
So, you know, don't don't be afraid to ask, and seeing, you know, you might be surprised what is possible.
00:41:41.760 --> 00:41:48.639
Which actually brings up a good question in terms of Nate's leadership.
00:41:48.800 --> 00:41:55.440
How did you get their buy-in to, you know, put something so grandiose together like this?
00:41:56.719 --> 00:42:02.800
I mean, I think we're very fortunate to have a very supportive leadership within our school.
00:42:02.960 --> 00:42:07.280
Um, they see the true value of simulation and IPE.
00:42:07.920 --> 00:42:19.199
And as long as we're communicating and checking in for all of those necessary safety considerations, um, I feel very supported, Tom.
00:42:19.360 --> 00:42:21.199
I don't know, from your standpoint.
00:42:21.599 --> 00:42:22.639
Completely agree with Lisa.
00:42:23.039 --> 00:42:38.880
I think they also see the by pushing the boundaries of these crazy large sims, how that impacts everything else that we do and the innovations that come from pulling off something like this, they trickle down into every single simulation, not just this one event.
00:42:39.119 --> 00:42:41.199
It has a much wider impact.
00:42:41.679 --> 00:42:51.119
My takeaway from listening to your team talk through um everything in today's conversation has been you really are putting the care and communicare.
00:42:51.199 --> 00:43:00.400
I just love the care you have for one another, for your students, for the realism, for the outcomes, for improving for um the entire experience.
00:43:00.480 --> 00:43:04.800
And I think that speaks a lot to what you said, being passionate about what you're doing.
00:43:04.880 --> 00:43:05.519
You have to care.
00:43:05.760 --> 00:43:08.880
Well, we thank you both for for joining the podcast.
00:43:09.119 --> 00:43:09.599
Thank you.
00:43:09.760 --> 00:43:10.639
Thanks so much.
00:43:12.639 --> 00:43:20.239
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzolone and Carmen Hawk, and produced by Kyle Shellstead.
00:43:20.400 --> 00:43:27.519
Find us online at ipivs.com slash on record and on social media at Intelligent Video Solutions.
00:00:01.600 --> 00:00:04.240
Welcome to the Onrecord Podcast.
00:00:04.480 --> 00:00:16.719
This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio in innovative ways to support their organization's objectives.
00:00:16.960 --> 00:00:20.239
My name is Mike Anselone, and my co-host is Carmen Hawk.
00:00:20.480 --> 00:00:26.719
And today I'm really excited because we got a couple guests from Northern Alberta Institute of Technology.
00:00:26.960 --> 00:00:36.640
Today we have Lisa George, and Lisa is the associate chair of Simulation and Interprofessional Education, and Tom Waring.
00:00:36.799 --> 00:00:39.520
Tom is the lead simulation technologist.
00:00:40.000 --> 00:00:42.880
Welcome both of you to the OnRecord podcast.
00:00:43.280 --> 00:00:45.119
Thanks so much for having us.
00:00:45.600 --> 00:01:00.799
And so to typically, before we kind of really um dive into the conversation, we'd like to get a little bit, um, learn a little bit about yourself, your background, and how you actually got to Northern Alberta Institute of Technology.
00:01:01.119 --> 00:01:05.760
So my background is a combined laboratory and X-ray technologist.
00:01:06.000 --> 00:01:16.640
And I came to NATE's as an instructor within that program and you know, worked in that program for about 13 years, instructing and then leading it as chair.
00:01:16.799 --> 00:01:27.680
Um, but how I got into interprofessional education and simulation is um actually when they introduced a course within the School of Health and Life Sciences.
00:01:27.840 --> 00:01:39.439
They did some onboarding training, which I was fortunate to be a part of and be one of many of the instructors as a part of that course early on, I think in about 2014.
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Um, and then in 2019, um, they were looking for a new instructor to lead um IPE for the School of Health and Life Sciences.
00:01:50.239 --> 00:01:58.719
And I had really enjoyed my experience as an instructor in that course and thought it was a great opportunity as a stepping stone.
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So put forward an expression of interest and was successful in being able to lead that.
00:02:05.040 --> 00:02:10.560
So now for two years, I've been full-time dedicated to leading IPE.
00:02:10.639 --> 00:02:16.159
We have 14 programs within our school that participate to have it embedded in their curriculum.
00:02:16.479 --> 00:02:27.599
And fortunate to be situated within the Center for Advanced Medical Simulation, where I'm one of many supporting SIM as well within our department.
00:02:27.919 --> 00:02:29.039
How about you, Tom?
00:02:29.599 --> 00:02:33.759
Yeah, so I like to say I don't really have a background in anything.
00:02:33.840 --> 00:02:35.439
My background is in simulation.
00:02:35.599 --> 00:02:39.120
I've been in healthcare simulation since I was 20.
00:02:39.280 --> 00:02:42.319
Um, so I've been here for over a decade now.
00:02:42.560 --> 00:02:49.039
I started as a clinical technologist apprenticeship at King's College Hospital in London, in England.
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Uh, was in that course for about eight months, rotating through like surgical theatres, ER, radiation protection, loads of different departments.
00:02:58.560 --> 00:03:07.199
And then, as most SIMTEX happened, uh a SIMTech job opened up at the hospital, fell into it and never really looked back.
00:03:07.439 --> 00:03:23.199
Uh worked there for three or four years, moved to Canada in 2018, kind of thought that may be it for simulation, sold jeans for six months, and then as it happens, happened to fall into a simulation position here with Nate, and have been here ever since then.
00:03:23.520 --> 00:03:26.719
What do you like best about being in simulation?
00:03:27.039 --> 00:03:36.159
I'm just a massive nerd at heart, so I get to use my skills, I kind of say, for the good of humanity rather than messing around in my bedroom.
00:03:36.319 --> 00:03:38.960
So I yeah, just a massive nerd.
00:03:39.039 --> 00:03:53.280
I love video games, board games, um I taking the personal fitness trainer diploma here at May, and I love using all of those skill sets to help students learn and be better healthcare professionals.
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I know both Carmen and I have a ton of questions because uh doing some research on the types of things that you've been able to accomplish at your institution have been just phenomenal.
00:04:05.840 --> 00:04:20.240
So maybe um if we can start about because I know uh Lisa, when you're talking about like the pulling together interprofessional education-oriented simulation, there's a lot of different moving parts.
00:04:20.399 --> 00:04:28.800
There's a lot of again, just from the title of it, you're bringing together teams that may not necessarily work together very often.
00:04:29.279 --> 00:04:37.600
What are can you tell us a little a little bit about some of the the challenges of putting together a scenario like that?
00:04:38.160 --> 00:04:45.600
And not only the challenges, but the types of outcomes that you're looking to gain from that kind of scenario.
00:04:46.959 --> 00:05:12.959
Yeah, I think, you know, first of all, it's really important to make sure that you have representation from each discipline that's going to be participating in the simulation because, you know, my background in lab and x-ray, you know, is great in terms of making sure that um the accuracies around the simulation scenario um represent what is you know happening in practice, but it's self-shore there.
00:05:13.040 --> 00:05:19.439
I'm not, you know, as knowledgeable in respiratory, paramedicine, etc., for the different programs that we have here at NATE.
00:05:19.600 --> 00:05:31.839
So we need to make sure that we have those people there to ensure it's accurate and it's appropriate for the learning uh of where the students are in their journey.
00:05:32.000 --> 00:05:44.160
Um, so coordinating, bringing people together and making sure that we have a solid understanding of how these roles will be interacting in these types of scenarios is key.
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And um so really what that's what I love about IPE, sim, is that in able to make sure that it's an effective um learning opportunity, we also have to be practicing it and modeling it for the students ourselves from the facilitation team as well.
00:06:03.759 --> 00:06:15.199
So that is a big part of it, make making sure that we have people that are participating as well as can, you know, feel comfortable and open and honest to share their feedback.
00:06:15.519 --> 00:06:20.639
And we have that psychological safety within the facilitation team as well.
00:06:21.839 --> 00:06:28.800
Now, how would you go about preparing in a professional type of scenario?
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Yeah, so I think um, like I said, a big part of that is bringing the people together, starting with our needs analysis.
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And, you know, what are we trying to achieve?
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What are the gaps that we need to fill here?
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And working through those learning objectives.
00:06:47.120 --> 00:07:07.519
Uh, also like to work very closely with Tom and his team to make sure that the modalities that we're choosing for these scenarios are appropriate for the goals of the scenario, um, as well as, you know, making sure that they have what they need in order to bring this scenario to life.
00:07:07.759 --> 00:07:23.839
So, you know, whether it is a five-minute communication-based scenario or, you know, a large-scale mass cashly incident sandwich we run, I think having the right people at the team, you know, in a timely manner is very important.
00:07:24.000 --> 00:07:40.240
So we have some very specific timelines in place um within the center to make sure that there's appropriate resources, including hiring those standardized participants and the appropriate tools and information needed around that.
00:07:40.319 --> 00:07:49.920
So Tom and his team have done a great job of creating a simulation template, which facilitators will need to fill in so we have all of the background information.
00:07:50.160 --> 00:07:54.480
And I'm sure Tom can speak better to that than I can.
00:07:54.879 --> 00:08:01.839
It's a key tool to making sure that we have all the details we need in order to run this scenario.
00:08:02.800 --> 00:08:03.279
Totally.
00:08:03.439 --> 00:08:26.079
We're incredibly fortunate that Nate and CAMS has such a huge facility with so much technology at our disposal that we can pull off these crazy simulations like giant mass casualty simulations, but really we don't want our facilitators to get too excited and try and drag in so much technology that you kind of lose the heart of the simulation and why you're doing it in the first place.
00:08:26.399 --> 00:08:30.639
So that's why keeping the core of the learning objectives is so key.
00:08:31.120 --> 00:08:43.360
So, Tom, how do you like from a technology perspective, your your translation process from these are the educational outcomes um designed for this scenario?
00:08:44.000 --> 00:08:53.200
How do you then orchestrate and coordinate all the technology that's required in order to support those educational outcomes?
00:08:53.679 --> 00:08:53.919
Sure.
00:08:54.080 --> 00:08:59.039
We've got a really good quality management system that helps with a lot of that aspect.
00:08:59.440 --> 00:09:06.879
Um and within it's a lot of collaboration really with the lead instructor for that program.
00:09:07.120 --> 00:09:21.919
So we don't necessarily know what a combined laboratory technologist student needs to know on the certain skill sets, but we can help uh interpret their needs into a simulation that's going to be valuable for that learner.
00:09:22.080 --> 00:09:29.039
It's the the creative output and knowing what the technology can do and helping interpret those needs.
00:09:29.759 --> 00:09:34.399
Just bearing witness the first couple of questions that have been asked, you two are very humble.
00:09:34.559 --> 00:09:38.480
You have extensive experience and you bring tremendous value, obviously, to Nate.
00:09:38.799 --> 00:09:47.679
Um, and just judging by how you've outlined your preparation, how you mitigate challenges, um, bringing that experience to the table and really driving the value home.
00:09:47.840 --> 00:09:57.840
Um, video obviously is a huge part of technology that has to be figured out and brought into the plans to make sure that um you have the proper learning outcomes.
00:09:57.919 --> 00:09:59.919
Well, you helped me understand in your opinion.
00:10:00.080 --> 00:10:02.000
We can start with Lisa and then move to Tom.
00:10:02.159 --> 00:10:04.320
How do we use video at NATE?
00:10:04.399 --> 00:10:09.919
Or how are you using video at NATE to make sure that you're getting those learning outcomes um achieved?
00:10:10.240 --> 00:10:17.039
Yeah, I think it's a huge piece, first of all, in maintaining the realism of the simulation environment.
00:10:17.200 --> 00:10:25.440
So, first of all, before we had the wonderful center that we do, you know, we used to host simulation within our lab spaces and the programs.
00:10:25.679 --> 00:10:34.639
And that included all the learners and facilitators outlining the space, you know, huddled, leaning up against the wall.
00:10:34.879 --> 00:10:47.519
And with the learners engaging in these scenarios, that really takes it away from trying to, you know, buy into the experience that it is a real situation with a real patient.
00:10:47.759 --> 00:11:07.360
So that's a huge piece in and of itself, still having an opportunity for learners to um view a scenario that's taking place, observe it, and you know, be able to witness what's happening and be able to participate in the debrief without the people having them in the space.
00:11:07.600 --> 00:11:12.159
And then second to that would definitely be for any debrief opportunities.
00:11:12.320 --> 00:11:27.279
I think it's a huge contributing factor to um students being able to look back on their performance, see how it's being um received from the people that they're interacting with.
00:11:27.519 --> 00:11:43.440
Much, you know, it goes beyond the facilitator mentioning what they noticed and observed, and they get to see it for themselves, which I think is just a much more powerful tool to help build those conversations and those learning opportunities.
00:11:43.759 --> 00:11:44.399
That's excellent.
00:11:44.480 --> 00:11:46.240
Lisa, what about your opinion, Tom?
00:11:47.039 --> 00:12:02.480
Yeah, Lisa kind of hit the the two cores there, the self-reflection piece, and then that kind of expanding the blast radius, if you will, of the experience so that more people can actually participate and get something from that experience.
00:12:02.720 --> 00:12:06.240
But the time that students have in simulation is somewhat limited.
00:12:06.480 --> 00:12:14.000
So being able to observe someone else and then participate in the debrief just adds a completely different perspective and a different element to it.
00:12:14.320 --> 00:12:22.240
The other things that we do here at CAMS that are a little different, that kind of add on and we can utilize video for is the research side of things.
00:12:22.480 --> 00:12:29.759
We do a ton of research both on simulation best practice and pedagogy, as well as with industry partners.
00:12:30.000 --> 00:12:44.799
So if someone wants to come in and bring in a product to do some testing with end users in a realistic environment, we can do that testing here in CAMS and then provide them that video footage, which is massive for them to go back, iterate on products and get ready for a launch.
00:12:45.039 --> 00:12:47.120
You're really diversifying, I was gonna say, your usage of it.
00:12:47.200 --> 00:12:48.000
I please elaborate.
00:12:48.080 --> 00:12:49.600
That's just fascinating to use it for multiple.
00:12:50.159 --> 00:12:55.360
Yeah, so we have the space and it's something that the industry really needs.
00:12:55.519 --> 00:13:15.440
It's really difficult to test a product in a real hospital, whereas we have a full simulated hospital at our disposal, so why not come in and utilize that and then bring in the end users that are going to be utilizing that product and get them hands-on with with the product early so you can make iterations to have a product that's really valuable at the end?
00:13:15.759 --> 00:13:27.840
I know Nate Ancams has received tons of accolades about the mass casualty type of scenarios that you've been running.
00:13:28.080 --> 00:13:48.720
Can you kind of walk us through like the how that got started, the motivation for that, and and again, the maybe the lessons that you've learned as a process of running that kind of scenario that maybe our listeners who are thinking about something like that could learn from?
00:13:49.039 --> 00:13:50.000
May I just preface?
00:13:50.080 --> 00:13:52.559
Is this is this commu care 2024?
00:13:52.639 --> 00:13:58.320
This is what we're talking about specifically, obviously, other um examples, but also is that what you're referring to, Mike?
00:13:58.559 --> 00:14:00.320
This is like something that okay.
00:14:00.879 --> 00:14:01.679
Absolutely.
00:14:02.000 --> 00:14:04.559
So this started three years ago.
00:14:04.799 --> 00:14:11.679
I attended um a program orientation meeting with our advanced care paramedic students.
00:14:11.919 --> 00:14:27.840
And so um I really wanted to connect with them as they are one of the few programs within our school that we have learners coming in already having experience within their discipline and they're retooling and advancing their practice.
00:14:28.080 --> 00:14:38.960
So it did, you know, kind of set the those students apart from some of the other programs where most of the students were coming in with no or limited healthcare experience.
00:14:39.200 --> 00:14:46.159
And I really wanted to make sure that the learning opportunities we were providing were going to be relevant for them.
00:14:46.799 --> 00:14:59.120
And I just, you know, took the opportunity to put it out there and say if you have any ideas on interprofessional education opportunities you would like to see included, please reach out, please let me know.
00:14:59.279 --> 00:15:08.320
And I did have a couple of students take me up on that, and they suggested that we, you know, put together a mass casualty incident simulation.
00:15:08.799 --> 00:15:12.879
And um we I was happy to take it from there.
00:15:13.039 --> 00:15:25.279
I was able to connect with our disaster and emergency management program, and the students in that program actually started and built the first iteration of the simulation.
00:15:25.600 --> 00:15:42.399
So it was a great learning opportunity for them to get some real life hands-on experience building out these exercises, and then we were able to coordinate with other, you know, Tom and the Syntech team, as well as other facilitators in NATO to bring it to life.
00:15:42.559 --> 00:15:51.279
So it's grown um significantly since the first year, um, where the first year we only had students within Nate participating.
00:15:51.360 --> 00:16:12.480
And then this last year we had students from a total of five different institutes across Alberta participating, and we were able to invite nursing and medical students, which we don't have at NAT, you know, to collaborate with our respiratory therapy students, our both primary care and advanced care paramedic students.
00:16:12.639 --> 00:16:26.799
We had MRI, we had X-ray technologists, lab technologists, medical lab assisting, and then we also have the Combined Lab and X-ray technology program, which is fairly unique to Alberta and Canada.
00:16:26.960 --> 00:16:30.960
I will say it's based on a rural healthcare environment.
00:16:31.120 --> 00:16:52.799
Um, so we expanded this year for a number of different ways to include um our on-scene response, which we have in our immersive 360 theater, which we Tom and the team did an amazing job setting it up as the building collapse scene and on the walls projecting the you know the rubble and that kind of thing.
00:16:52.960 --> 00:16:59.120
Uh, we were able to collaborate with um some local firefighters that came in, as well as Medib.
00:16:59.440 --> 00:17:11.440
They brought two ambulances in, so the students got to actually experience riding in an ambulance and supporting patients for the first time for our primary care of paramedic students.
00:17:11.759 --> 00:17:16.240
Um in addition to the ambulance simulator that we have at NAT.
00:17:16.640 --> 00:17:21.680
So from there, they then transported their patients after triaging them on scene.
00:17:21.839 --> 00:17:24.079
Um, we had two hospital settings.
00:17:24.240 --> 00:17:34.319
We had the rural hospital setting, and then CAMS was set up as our entire tertiary hospital with MRI, CT, X-ray lab, respiratory.
00:17:34.720 --> 00:17:40.160
And so a very um immersive high fidelity simulation.
00:17:40.319 --> 00:18:02.559
It was about an hour long in total, and really emphasizing the focus of team collaboration and communication, you know, interdepartmental communication via phone, as well as you know, from the scene to dispatch to the hospitals and kind of coordinating the care and the delivery of patients.
00:18:02.880 --> 00:18:15.759
Yeah, you the way I kind of treat this, other than just the huge amount of learning that the learners got from it, as a department here, we kind of treat it almost like our Apollo moon missions.
00:18:16.000 --> 00:18:20.079
It's our it's our like big we have a year to get this done.
00:18:20.240 --> 00:18:39.759
This is the vision, and all of those huge challenges that we're able to overcome with collaborating with other industries, engaging partners like yourselves to support with video recording, uh, all the ambulance services, fire, and other companies to pull off this one huge event.
00:18:40.160 --> 00:18:51.359
It it builds a lot of the innovation side of things for us internally and pushes the barriers of what we can actually deliver as part of a simulation activity.
00:18:52.079 --> 00:18:56.960
Even after that, and something we're working on now to bring it kind of back to the video portion of it.
00:18:57.039 --> 00:19:01.920
So these simulations we recorded from 40 different camera angles.
00:19:02.319 --> 00:19:02.640
Wow.
00:19:02.960 --> 00:19:10.079
Each of these simulations which were on twice in one day, we ended up with about 90 minutes per camera per sim.
00:19:10.480 --> 00:19:11.119
Oh my gosh.
00:19:11.279 --> 00:19:16.880
So at the end of the day, we're uh about 120 to 140 hours of video content.
00:19:17.039 --> 00:19:21.200
So now we're at the stage where we go, okay, what do we do with this?
00:19:21.440 --> 00:19:40.559
We've got so much content, so now we're innovating and trying to figure out ways to digest that content using things like AI to get outcomes and to support us in developing next year's solution that's more to what learners actually need and do learning from that video footage.
00:19:40.799 --> 00:19:48.400
And not only that, but we're also doing research um as a part of this year's learning experience.
00:19:48.640 --> 00:20:04.799
So from the simulation itself as well as the debrief, this is going to be um, you know, a big summer project, I'll say, combing through all of these recordings and using it um as a part of a couple of research projects that we have underway.
00:20:06.000 --> 00:20:11.039
I'd kind of like to think what you just described to me sounds like a big movie set.
00:20:11.279 --> 00:20:12.480
I was just thinking production.
00:20:12.559 --> 00:20:13.440
I was thinking the same thing.
00:20:13.759 --> 00:20:14.480
Yeah, production.
00:20:15.279 --> 00:20:20.559
And Tom, you mentioned 40 different camera angles, which kind of blows my mind in and of itself.
00:20:20.880 --> 00:20:32.960
But because part of the scenario is to understand how these different resources and teams are working together, communication is so important.
00:20:33.680 --> 00:20:40.240
And communication therefore requires really good audio so you can hear how they're communicating.
00:20:40.559 --> 00:20:42.480
How do you tackle that?
00:20:42.640 --> 00:20:50.960
I mean, video is one thing because you can just have the cameras set around, but audio is a is another beast in and of itself.
00:20:51.279 --> 00:20:51.839
Totally.
00:20:52.000 --> 00:20:54.400
Uh honestly, with extreme difficulty.
00:20:55.839 --> 00:20:56.640
Keep it real.
00:20:57.279 --> 00:21:07.279
Yeah, when you've got microphones in the embedded in a ceiling and there are 27 people in a single room, good luck to you hearing anything from that.
00:21:07.359 --> 00:21:14.319
So it takes a lot of time and a lot of effort and pulling all of those individual feeds to get anything from it.
00:21:14.559 --> 00:21:22.720
A lot of post-analysis and putting it in Premiere Pro and adjusting the audio to try and get certain frequencies dialed in a little bit so you can hear things.
00:21:22.799 --> 00:21:24.559
So it takes a lot of time and effort.
00:21:24.880 --> 00:21:25.279
Wow.
00:21:25.519 --> 00:21:32.880
Were these scenarios run inside a facility, or were they did you do anything outside, like in a parking lot?
00:21:33.039 --> 00:21:33.839
Bit of everything.
00:21:34.000 --> 00:21:46.480
So we started the scene in what we call our theater nine, our extended reality theater, which is a thousand square foot simulation space with projectors that go uh project scene onto the walls.
00:21:46.640 --> 00:21:51.359
There's a full theater lighting rigging, there's fog smoke machine going.
00:21:52.640 --> 00:21:59.759
Audio, and then we crammed it full of 20 standardized patients, and then a ton of rubble uh to represent this building collection.
00:22:00.160 --> 00:22:01.039
Up scene.
00:22:01.599 --> 00:22:22.880
The uh standardized patients and mannequins were then transported either via a simulated ambulance or via a real ambulance outside of the doors of that theatre round to the front entrance of cams, where they were met in the one of the two triage areas, either the triage for the first hospital or taken into the rural secondary hospital.
00:22:23.519 --> 00:22:37.279
Then from the hospital, they'd go that from that triage uh entryway, they'd get taken to a bed bay somewhere within the embedded hospital, which was an eight-bay hospital that we crammed, I think about 15 people into somehow.
00:22:38.079 --> 00:22:46.000
And then they had individual secondary rooms for lab and x-ray and CT and MRI, all separate rooms as well.
00:22:46.240 --> 00:22:46.720
Wow.
00:22:46.960 --> 00:22:53.119
I just have to say it's a it's a it's a huge commitment to the realism, and we're obviously recognizing that based on your descriptions.
00:22:53.200 --> 00:23:03.359
And then what a great service to your students for the learners to be able to have this realism, the opportunities you presented them with, and very rewarding, I'm sure, for all the participants involved.
00:23:03.519 --> 00:23:05.599
And it's got to be a passion project.
00:23:05.680 --> 00:23:11.279
You're driven by the motivation to give this experience, and that's part of what's rewarding you too, it sounds like.
00:23:12.000 --> 00:23:17.759
Right now, with the technology and what what you've used, you've come, you've come to a place where you're innovating and leading.
00:23:17.920 --> 00:23:20.480
Do you see like a future state down the road?
00:23:20.559 --> 00:23:21.119
Like, what do you see?
00:23:21.200 --> 00:23:22.640
I mean, you've mentioned AI, Tom.
00:23:22.799 --> 00:23:25.839
Is there other things like future state you're picturing?
00:23:26.000 --> 00:23:31.119
And I don't want you to give away your secret sauce, but like, what are you imagining to be the next stage of this?
00:23:32.960 --> 00:23:46.079
Uh personally, the thing I'm working on the most with the AI side of things is to be able to produce screen-based and virtual simulations rapidly, specific to learner needs.
00:23:46.799 --> 00:23:51.039
So that can be as like a pre-scaffolding or as a post-simulation experience.
00:23:51.119 --> 00:23:54.640
So sim is an amazing tool to discover your weaknesses.
00:23:54.880 --> 00:23:58.000
Now, what do you do with those weaknesses or those learning gaps?
00:23:58.160 --> 00:24:01.519
You've got to take that away and do a lot of work on your own.
00:24:01.680 --> 00:24:07.759
Well, if we can provide you with some tools to support that self-learning, then why not?
00:24:07.920 --> 00:24:12.799
And that's where AI is coming in to be able to create that rapid simulation delivery.
00:24:13.119 --> 00:24:25.039
Yeah, and I think specific to the mass casualty incident, Sim, we're definitely looking at ways to prepare the learners so they feel more confident coming in.
00:24:25.200 --> 00:24:39.440
So, like I said, there were a number of students that are not from Nate, so they're not familiar with the space, and it's it's a lot to excuse me, orientate yourself in a rapid way, you know, as well as get to know the teams that you're going to be working with.
00:24:39.599 --> 00:24:45.599
So we want to provide them a little bit more time to get comfortable with the space.
00:24:45.680 --> 00:25:03.440
And we have a fantastic digital twin of our center that I think we're definitely looking to incorporate and give them a bit of a virtual reality orientation so they can take a look at the equipment that we'll have in the space, see where it'll be located.
00:25:03.680 --> 00:25:11.200
So when they come in on the day of, they're much more confident and prepared to just start rolling with the simulation.
00:25:11.599 --> 00:25:19.279
What has been your students' and learners' feedback, particularly from you know this kind of mass casualty scenario?
00:25:19.680 --> 00:25:23.839
Yeah, I think we've definitely learned from their feedback each year.
00:25:24.000 --> 00:25:27.359
Um, this year it's been overwhelmingly positive.
00:25:27.519 --> 00:25:41.200
They truly appreciate the opportunity to get a glimpse of what it will be like to work in a hospital setting and how to collaborate with the various disciplines that will, you know, likely they'll encounter.
00:25:41.440 --> 00:25:55.519
So they really appreciated the opportunity to practice their communication in a very realistic way and then be able to work through the you know the experience as a part of the debrief.
00:25:55.759 --> 00:26:04.880
Um, because it is such a widespread um simulation, not every learner will encounter each aspect.
00:26:05.039 --> 00:26:10.880
So, for example, the students placed in the hospital, they they don't ever make it to the scene, right?
00:26:11.039 --> 00:26:17.759
It wouldn't be realistic, but they want to hear about what the paramedic students encounter.
00:26:17.839 --> 00:26:26.319
And so we try to use video one year to get them to see it afterwards, um, but as well as as a part of the deep break there.
00:26:26.400 --> 00:26:33.119
So I think there's some gaps there that we're looking to close through video solutions.
00:26:33.440 --> 00:26:48.160
And um, previously we did receive feedback the prior year about wanting to have more time with the students that will be participating so they can get to know each other and better understand each other's roles.
00:26:48.400 --> 00:27:06.880
So we did incorporate that feedback in an icebreaker type of activity, giving them an opportunity to introduce themselves, practice, you know, their name, occupation duty, um, a little bit of closed-lip communication that we wanted to see them demonstrate as a part of the simulation experience as well.
00:27:07.279 --> 00:27:13.839
And uh we're looking, you know, we're just starting to uncover the feedback and the learnings from that experience this year.
00:27:14.160 --> 00:27:20.720
I would imagine with a group that large, what is the debrief process like?
00:27:21.519 --> 00:27:24.319
Do you break them into groups?
00:27:24.559 --> 00:27:28.480
Like how kind of walk us through that that process.
00:27:29.359 --> 00:27:35.920
Yeah, this is something that we look at each year to see if there's a better way to run it.
00:27:36.160 --> 00:27:59.440
Um this year, what we did, we were very intentional about the groups that we brought together, especially with the co-facilitators, making sure that we had one person that was a part of the on-scene response, and one person in the hospital setting so they can incorporate both um parts of the experience in the conversation.
00:27:59.920 --> 00:28:06.559
We did take um a mixed group, so we really wanted to make sure it was interdisciplinary.
00:28:06.799 --> 00:28:31.039
Some people were placed in the rural hospital, some people were placed in the tertiary hospital, so it wasn't necessarily everyone from one area in a debrief group, and we tried to make it about um six to eight learners per group to kind of facilitate uh, you know, lots of opportunity for everyone to be um participating in the discussion.
00:28:31.680 --> 00:28:57.599
I know um some of the feedback we've already received this year is having a mini debrief in the space that they're that they're in as soon as we stop the simulation, so they can kind of talk through some things that happened specific to that area, and then breaking them up in their interdisciplinary groups um to talk more broadly about the teamwork, the communication, the objectives of the SIM.
00:28:58.160 --> 00:29:12.400
It just seems like there's so many layers to the work that goes into this that I'm still like wrapping my head around it because it's different between, you know, one interprofessional um exercise when you engage what you have 10 to 14 programs you mentioned.
00:29:12.480 --> 00:29:20.319
Um, everyone needs to have some value taken away and some uh feedback personally that hits home and then they want to self-reflect.
00:29:20.480 --> 00:29:21.519
There's a lot to unpack.
00:29:21.599 --> 00:29:27.680
And I think that um it's tremendous that you keep growing year over year and you're getting the feedback from your students.
00:29:27.759 --> 00:29:30.480
That's critical to making improvements when needed.
00:29:30.799 --> 00:29:31.039
Yeah.
00:29:31.119 --> 00:29:34.319
Can you tell us a little bit about the simulation center itself?
00:29:34.799 --> 00:29:35.119
Sure.
00:29:35.279 --> 00:29:38.720
It's a 6,000 square foot simulation center.
00:29:38.880 --> 00:29:45.119
Uh, we've got that 1,000 square foot that's taken up by the extended reality theater.
00:29:45.200 --> 00:29:52.000
Uh, we have four large simulation theaters that are two-bed bay uh spaces.
00:29:52.400 --> 00:30:02.559
Those of dividing wall between each of those rooms as well, so that that wall can be raised into the ceiling and then expanded to a four-bed bay room, so it's a super flexible space.
00:30:02.799 --> 00:30:06.960
Uh, we've also got four smaller rooms that are more like clinic kind of rooms.
00:30:07.359 --> 00:30:19.599
Because we deal with such a wide variety of learners from like animal health or dental or paramedicine, as well as the more typical in-hospital specialties?
00:30:20.160 --> 00:30:23.440
We have to be incredibly flexible in how we utilize the space.
00:30:23.680 --> 00:30:35.359
So we have things like portable bathrooms, portable kitchens that we can put inside of these rooms and completely convert them into whatever type of environment is required for the simulations.
00:30:36.559 --> 00:30:44.880
From a technology perspective, what kinds of challenges have you come across specifically in in that type of environment?
00:30:45.519 --> 00:30:46.400
So many.
00:31:08.799 --> 00:31:12.480
The extended reality room makes almost anything possible.
00:31:12.799 --> 00:31:20.720
So even looking at potentially working with the military and bringing in like armored vehicles and things like that into the space is possible in these environments.
00:31:21.759 --> 00:31:31.680
I'd like to ask our guest about uh future developments where you see the sp the field of simulation going.
00:31:31.920 --> 00:31:43.279
And from our conversation so far, it seems like you are living in the future already, uh, based upon everything that you've done, which is is truly amazing.
00:31:43.440 --> 00:31:51.759
But as you're thinking down the road, um what trends do you see?
00:31:51.920 --> 00:31:54.319
How can you make this more realistic?
00:31:54.559 --> 00:32:06.640
How can you use technology perhaps in a different in a way to in a way to again support the educational component of what you're looking to do?
00:32:08.079 --> 00:32:11.279
I think we're pretty good with the realism side so far.
00:32:11.359 --> 00:32:22.240
I think enhancements in mannequins and enhancements in standardized patient adjuncts make it more difficult to decide exactly which path to take.
00:32:22.400 --> 00:32:26.640
Typically, it was if you're gonna talk to your patient, you pick a standardized patient.
00:32:26.880 --> 00:32:30.079
If you want to do something tactile, you pick a mannequin.
00:32:30.319 --> 00:32:34.160
So those lines are blending quite a lot recently.
00:32:34.799 --> 00:32:47.440
But I think the enhancements that we're gonna see in the future are more customized simulations and more just-in-time training specific to unique learners.
00:32:47.759 --> 00:32:51.920
Rather than just on week six of this course, you will do this simulation.
00:32:52.079 --> 00:32:55.920
I think we're gonna be able to build in way more flexibility to those experiences.
00:32:56.240 --> 00:33:15.039
Yeah, and I'm really excited about the more opportunities for scaffolding of learning with virtual simulations, giving students the opportunity to run through a scenario online multiple times, as many times as they want, and you know, incorporating the use of AI.
00:33:15.200 --> 00:33:35.759
I know a lot of people are very curious about that right now, and we've been using it as well with some virtual simulations, getting that personalized feedback for learners and just, you know, you know, as well as even a tool for debriefing, helping facilitators as they're observing.
00:33:35.839 --> 00:33:38.319
You know, we're humans and we miss things too.
00:33:38.559 --> 00:33:51.359
So it could be an opportunity to help kind of um condense or like summarize what may have happened and help contribute to planning out debrief discussions as well.
00:33:51.680 --> 00:34:03.279
So I know you've all you also mentioned using simulation from a research perspective, and one example that you gave was like product usability, product development.
00:34:03.519 --> 00:34:07.519
What other types of examples could you share with our listeners?
00:34:07.920 --> 00:34:14.320
Without naming names, uh we had a company come in with an auto-injector.
00:34:15.199 --> 00:34:21.360
Um that auto-injector was to be used for emergency situations where someone was bleeding out.
00:34:22.079 --> 00:34:37.519
So we in our extended reality theater, we brought in an actual car that we crashed, had a mannequin lying out the side of the car, um, partly extricated with uh below knee amputation.
00:34:38.400 --> 00:34:42.239
Uh, and then the participants came into the room that was very cold.
00:34:42.320 --> 00:34:48.880
We set the temperature to about eight or nine degrees, a little bit, a little bit of fog and a little bit of wind going, and the lights nice and dark.
00:34:48.960 --> 00:34:51.920
So it was a dark winter's evening here in Canada.
00:34:53.119 --> 00:34:56.159
And our storytelling is on point.
00:34:56.480 --> 00:34:57.360
Thank gosh.
00:35:01.039 --> 00:35:09.119
The um auto injector had a very, very small light on the top of it that indicated when the drug had been delivered.
00:35:09.440 --> 00:35:15.440
And the participants said that they couldn't hear the little beep or see the light in the environment.
00:35:15.679 --> 00:35:25.760
So they were able to go away and add a brighter light and a lot uh more volume sound to the auto injector.
00:35:25.840 --> 00:35:28.559
So it was more obvious when the drug had been delivered.
00:35:28.719 --> 00:35:33.840
Because when you're testing in a silent lab environment, you don't think of those things until you're actually out in the field.
00:35:34.159 --> 00:35:40.400
And then I would say from like a pedagogy perspective, we're looking at, you know, specific to the MCI.
00:35:40.639 --> 00:35:42.079
We haven't worked through it all yet.
00:35:42.320 --> 00:36:05.119
It's going to be a very large project this summer, but um, we had an opportunity to compare and contrast um morning simulation to the afternoon simulation and um the difference that an icebreaker activity made on the students' comfort and the willingness to communicate interprofessionally during the scenario.
00:36:05.440 --> 00:36:19.280
Um, we also are looking at um the debrief and kind of having a structured debrief format to encourage participation from all disciplines present in that group.
00:36:19.440 --> 00:36:47.199
Um, so we're again comparing and contrasting between two groups there and really excited to you know use our video and um audio capture from that to then actually count how many times things like closed lip communication occurred, you know, the handoffs between the providers and how they formatted that, you know, in some of the tools that we provided them in advance.
00:36:47.280 --> 00:36:55.920
So there's going to, I think there's going to be a lot of learnings and a lot of opportunities through the use of research in our simulation experiences.
00:36:56.320 --> 00:37:02.079
I have one last question on the topic that it might be just based on some of the language you sprinkled in there, Lisa.
00:37:02.239 --> 00:37:05.199
You mentioned a lot about like psychological safety of the students.
00:37:05.360 --> 00:37:11.519
You talk about the preparation, um, the confidence building, maybe having materials prior, the icebreaking.
00:37:11.679 --> 00:37:18.559
How else and what is like the most critical tool you you're using for uh promoting psychological safety?
00:37:18.639 --> 00:37:28.000
Is is there something principle-wise you you live by, or what is your, I guess, idea behind um promoting that in such a large volume of students?
00:37:28.320 --> 00:37:54.480
Yeah, I don't know if I have one specific principle, but I think it's the idea that if we are asking students to really buy in and engage like they will in practice, it's so crucial to make sure that we're attending to their needs as learners as well and creating the space where they're able to do that, especially when we're asking them to come together with people they're meeting for the first time that day.
00:37:54.719 --> 00:38:14.800
So uh we really stepped up our pre-package information that we send out to students in advance and really emphasize that we know that each of them are at different stages in their learning and just recognizing that they are still learning their technical um expertise, and that's okay.
00:38:15.039 --> 00:38:26.239
You know, really emphasizing what the goals of this scenario is and giving them the tools to feel ready and opportunities to ask questions before they even come.
00:38:26.400 --> 00:38:34.480
So I think being very intentional about those things and then also repeating it again when they come there for that day.
00:38:34.639 --> 00:38:49.360
Um, what I was starting to notice this year is doing quite a bit of IPE simulation is that sometimes when they show up, the NERVs are already present, they're already happening, and they're only going to hear a certain amount of information that you're giving them.
00:38:49.519 --> 00:39:04.639
So I really wanted to make sure that we had an opportunity to provide all of that information in advance so they're in their comfortable space and they have time to read through it and really absorb as much as they can and then hear it again when they come there.
00:39:04.880 --> 00:39:11.920
So I try to give them that opportunity to really feel comfortable.
00:39:12.159 --> 00:39:18.320
Um I think it it's just huge in terms of IPE simulation, especially.
00:39:20.159 --> 00:39:28.880
Well, it's obvious you both have been extremely instrumental in building out a world-class simulation center.
00:39:29.119 --> 00:39:44.079
Um, of all the guests that we've had on what you've explained, I believe has been the most complicated type of scenario that could be run and you're doing it like with perfection.
00:39:44.320 --> 00:39:46.719
So hats off to the both of you.
00:39:46.960 --> 00:39:56.079
Before we wrap up, if we've got listeners who are thinking along those lines of that kind of dreaming to aspire, yeah, to that level.
00:39:56.400 --> 00:39:58.800
Dreaming to aspire, what you've accomplished.
00:39:59.119 --> 00:40:06.960
Can you both provide our listeners with some advice um on how to go about putting a program like this together?
00:40:07.360 --> 00:40:08.960
Don't try and do it alone.
00:40:11.360 --> 00:40:12.960
Contact Tom at Tom Me.
00:40:13.440 --> 00:40:13.760
Yeah.
00:40:14.159 --> 00:40:22.800
You're gonna need hands, you're gonna need people that are genuinely passionate about the cause, and that will go a long, long way in getting you to your end goals.
00:40:23.920 --> 00:40:41.519
Yeah, and I think for myself, from a facilitator standpoint, you know, sometimes I've been a part of developing new scenarios where it's the facilitator, facilitator team coming together and crafting up all these ideas and then going to meet with the simtech team.
00:40:41.760 --> 00:40:53.840
And I can't emphasize enough how critical it was to have the sim team a part of the development work right from the get-go because they can tell you right away, like, that's going to be a problem.
00:40:54.000 --> 00:40:56.880
Maybe we can do it this way instead.
00:40:57.119 --> 00:41:02.320
Um, so just making sure that you're working closely together right from the get-go.
00:41:02.880 --> 00:41:06.639
And then, you know, yeah, dare to dream.
00:41:06.800 --> 00:41:13.599
I mean, this year we we had the um Leta Beat team come say, like, hey, we'd like to bring two of our ambulances.
00:41:13.840 --> 00:41:17.679
And immediately I was like, Oh, the insurance issues.
00:41:18.400 --> 00:41:21.199
I thought for sure it was gonna be a no.
00:41:21.440 --> 00:41:30.079
But, you know, we we reached out and asked, and we were pleasantly surprised to say, like, hey, we're doing this, you're coming to us early, which is great.
00:41:30.239 --> 00:41:34.239
And here are the considerations we'll need to make, and here's how we can support you.
00:41:34.480 --> 00:41:40.960
So, you know, don't don't be afraid to ask, and seeing, you know, you might be surprised what is possible.
00:41:41.760 --> 00:41:48.639
Which actually brings up a good question in terms of Nate's leadership.
00:41:48.800 --> 00:41:55.440
How did you get their buy-in to, you know, put something so grandiose together like this?
00:41:56.719 --> 00:42:02.800
I mean, I think we're very fortunate to have a very supportive leadership within our school.
00:42:02.960 --> 00:42:07.280
Um, they see the true value of simulation and IPE.
00:42:07.920 --> 00:42:19.199
And as long as we're communicating and checking in for all of those necessary safety considerations, um, I feel very supported, Tom.
00:42:19.360 --> 00:42:21.199
I don't know, from your standpoint.
00:42:21.599 --> 00:42:22.639
Completely agree with Lisa.
00:42:23.039 --> 00:42:38.880
I think they also see the by pushing the boundaries of these crazy large sims, how that impacts everything else that we do and the innovations that come from pulling off something like this, they trickle down into every single simulation, not just this one event.
00:42:39.119 --> 00:42:41.199
It has a much wider impact.
00:42:41.679 --> 00:42:51.119
My takeaway from listening to your team talk through um everything in today's conversation has been you really are putting the care and communicare.
00:42:51.199 --> 00:43:00.400
I just love the care you have for one another, for your students, for the realism, for the outcomes, for improving for um the entire experience.
00:43:00.480 --> 00:43:04.800
And I think that speaks a lot to what you said, being passionate about what you're doing.
00:43:04.880 --> 00:43:05.519
You have to care.
00:43:05.760 --> 00:43:08.880
Well, we thank you both for for joining the podcast.
00:43:09.119 --> 00:43:09.599
Thank you.
00:43:09.760 --> 00:43:10.639
Thanks so much.
00:43:12.639 --> 00:43:20.239
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzolone and Carmen Hawk, and produced by Kyle Shellstead.
00:43:20.400 --> 00:43:27.519
Find us online at ipivs.com slash on record and on social media at Intelligent Video Solutions.
