Human Touch In Simulation with Jennifer McCarthy

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The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors.
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Welcome to the Sim Cafe, a podcast produced by the team at Innovative Sim Solutions.
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Edited by Shelly Houser.
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Join our host, Deb Tauber and co-host Jared Jeffries as they sit down with subject matter experts from across the globe to reimagine clinical education and the use of simulation.
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So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.
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Welcome to The Sim Cafe.
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And today we are here with Jennifer McCarthy, who is a new fellow from the Society for Simulation and Healthcare.
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So congratulations on that.
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Welcome, Jen.
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Why don't you tell our listeners a little bit about yourself?
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Jared's not here today because he's got no power.
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So we're going to talk about humanistic simulation.
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Thank you so much.
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And thank you for the shout out on my journey as a new fellow, uh inducted with a great class of fellow, fellow fellows, as we call ourselves.
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My background is uh clinically as a paramedic from New Jersey.
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I always point that out because we're hospital-based employees.
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And that really set me up in healthcare simulation to have a lot of colleagues and contacts in the healthcare realm.
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When I started teaching in community college for a paramedic program, I had the blessing of meeting and finding simulation through mannequin-based SIM and human-based.
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I didn't realize they were called standardized patients at the time.
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It was 2000.
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Fast forward, I'm now the director of clinical simulation at Seton Hall University, where I'm leading the development and delivery debriefing of simulation to graduate health science students, undergraduate students, and students in our Bucino Leadership Institute, where I serve as a faculty fellow.
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So very excited to be here and especially to talk about humanistic aspects of simulation.
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Thank you.
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Well, why don't you all tell our listeners a little bit about what humanistic simulation is?
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So for me, when I came here, I'm the founding director.
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We had this immense opportunity at Seton Hall to move to a new building with amazing space and assets and recording capability.
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And for me, reflecting on many decades as a healthcare clinician, the thing that I always fell back on wasn't being the smartest in the room, wasn't being the most educated, high, you know, highly certified, especially being a paramedic.
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And that's no disrespect to my EMS colleagues at all.
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It's just an acknowledgement of the hierarchy in healthcare.
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It was always my ability to speak with people, to actively listen and be in these really uncontrolled environments and yet get it right and get it right from their perspective.
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And that hit me in a way that allowed me to make great, really great and strong clinical decisions, obviously, because I was able to have the data to do so.
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So when I became the founding director here, I said, yes, of course, we want to do competency-based assessment.
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And I had done a lot of that in the paramedic realm for 22 years prior to coming to Seton Hall.
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But the thing that I really wanted to cultivate was compassionate communication and the ability to teach students how powerful human connection can be.
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And that's what our SIM is about here.
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It is about honoring another person.
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Yes, there's usually a clinical component tied to it, whether it is a clinical decision-making aspect or decision on mission or discharge planning, but there is also always a communication feedback component of how well, how empathetic, how was the interview and questions laid out by the student clinician so that they can grow in this area of really honoring the invitation that they get every time to sit and walk side by side with a patient and their family, but also to hone it over time, that it's building out a culture where we don't always get it right, but we have the opportunity to grow and make it better.
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And yeah, that's what humanistic sim is for me, is that we're we're carving out a place to really say this is important, and this is important because it's what makes the world go round, uh, human touch, human, human contact.
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Right.
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And you talked a little bit earlier about, you know, there's so many people that are so fearful of AI replacing us.
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What are your thoughts on that?
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So it's funny.
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Um, my close colleagues who will listen to the podcast and say, oh, how's she gonna get herself out of this one?
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I happen to be a sim purist, I label myself, and I watched us as a healthcare simulation community really allow our development of technology, drive where, you know, for over a decade plus drive our growth as a profession until leaders within the profession were like, hey, wait a second, to all of our industry colleagues, we started to have more collaborative discussions.
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And I feel like AR, VR came out, and you know, there were a lot of early adopters, and now it's AI AI.
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Listen, I think AI can really hone our time management, can help us cull through data in a way that we can't as individuals.
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But I want us all to be very clear about something.
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AI will never be the empathetic voice, the compassionate touch, or the thing that intangibly heals.
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And we know this from uh Stephen Traziak's work and Anthony Mazzarelli's work on compassionomics out of uh Cooper Medical Center in New Jersey.
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They have a book out about it.
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Uh, they have a second book called The Wonder Drug, which is about 40 seconds of compassion, helps people not only feel a connection, but patience to heal.
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And it's intangible that it's 40 seconds that makes this impact.
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But the thing for me that drives me to really talk out loud about it is it helps the clinician have resilience.
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It helps the clinician feel important in this technology AI-driven world that we find ourselves, that you matter as a human, and we need your humanistic skill because this is a human science that we're in called medicine, healthcare delivery.
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And then we have our subset professions in it.
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And that's powerful to step back and think about.
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So, yes, AI has a very important role.
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I want to say arm in arm with uh humanistic touch, communication, and uh compassion connection.
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Right.
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I appreciate that.
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No, I do.
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Thank you.
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I think it's easy to get lost in the tech.
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I think it's easy to get lost when you're in SI2 simulation in the care area.
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I think it's easy to get lost in a sim lab when you're designing and developing a sim, and the focus is for the learner to get the correct classification of the chest pain or the endocrinology diagnosis.
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That all comes from the humanistic connection.
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Patients tell us more accurate data when they trust us and believe that we're actively listening.
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And I think it's interesting to even think about cultivating mindfulness within simulation to enhance our ability as clinicians to be present and have enhanced listening.
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And all of that, the reason I'm so passionate about it is it goes back to resiliency and retention of clinicians.
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This is this work is not the lame heart, right?
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I mean, this work takes grit.
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It takes an acumen to do it correctly and for a long period of time, a truthfulness with self.
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And I think the gift we owe it to our future clinicians is teaching them that gift, that it's right in front of your eyes.
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It's not in a device, a technology that you hold in your hand or look up at a heart, a cardiac monitor or a Pulse Ox reading or an ABG result.
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Like it's not there.
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It's actually right in front of you with the people that you're interacting with, including your peers.
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And that's powerful to say that I help to plant that seed.
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Hopefully it grows some roots and really can become something that our students take out into clinical practice with them.
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Well, and and you think about humanistic care, and and you think about Alex Pretti, who's just, you know, got killed during being passionate about something, being out there, being a part of something that he sees as a problem.
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He wanted to be a part of a solution.
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And his humanistic care is promoted by social media.
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And you know, some of the interviews where he's saying final farewells to veterans, and yeah, his humanistic vulnerability is what made him special.
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Yeah.
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Um, for sure.
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And I appreciate you pointing out the vulnerability piece, not of how his life ended, but the walk that he did and the recordings that we now revere to get to know him better, right?
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And him saying a goodbye to a veteran.
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And if you haven't seen it, it's uh very, very moving.
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And probably my fellow veteran nurses are saying, Jen, you know, that's part of what we do.
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And yes, but that time out, um, it takes a patient with a diagnostic label and brings them to life and allows everybody on that team to know the impact that they made in another and that they're making a difference in our society.
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And I think we're at a time right now in society where we need to purposely remind ourselves how connected we are, because it's not intuitive when you go on your social media feed and the algorithm that is going to send you the stories that you're gonna read and your likes and dislikes, et cetera.
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I think that's the other piece that I've learned and been at Seton Hall for close to eight years.
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And it's a gift.
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And the gift is that I'm working side by side with students who are so thirsty to be the best that they can be.
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And I have the, I say to them all the time, I have the best seat in the house.
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I'm in the front row watching you transform.
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I am witnessing your transformation and you putting yourself out there in that vulnerability to grow.
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And transformation comes from discomfort.
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We never go to a cocktail party, have a few martinis, and get anything other than a hangover, right?
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It's that grit moment where we're paused to grow.
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And that takes vulnerability.
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And it takes vulnerability to really stand on a soapbox and say humanistic sim matters.
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And for me, just coming off of IMSH and listening to some of our plenary speakers talk about AI and the integration and then call out loud that AI will help us with data for sure.
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It will help us have smarter answers for sure, but it cannot replace who we are and the essence that we are.
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So our tone matters, our voice matters, our words matter, and practicing that in a safe environment to grow is priceless.
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I mean, if MasterCard wants to take that, they can, but please, they need to keep Dev and Jen with them.
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But it's it's priceless, the impact that it can have.
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Yeah.
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Absolutely.
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Now, what would you say as far as incorporating humanistic simulation?
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Can you describe a simulation where you mindfully put that in there?
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Sure.
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We do a couple of things, and I appreciate the opportunity to talk out loud.
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One is that we utilize a high number of our uh simulations, are utilizing standardized participants, either as patients themselves or family members with mannequins.
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So there's, I would like all my mannequin-based simulationists to think about, oh, I could then take this less clinically minded, and it's not less, it's equally clinically minded with the mannequin and add in the communication aspect with a family member, whether it's a parent because it's a minor, whether it's a spouse, whether it's an elderly uh spouse or sibling who can't care for.
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So now you have this layer of need from the patient's perspective.
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And these are real issues impacting our patients and their families, right?
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Uh care, caregiver fatigue is real, depression and anxiety impacts from long-term illnesses are real.
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So it's really learning about, and I'm serving uh six clinical programs.
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So it's really learning about the human aspect of this diagnosis, the diagnostic piece that they're pursuing, and really cultivating with those faculty members to say, how about if we worked in the aspect of caregiver fatigue in this case?
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So it provides an opportunity for our students to learn about it, identify, and then what we do is we build in SIM cues where that live person is offering some little nuggets of realism that it's not, hey, I want to introduce myself.
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I'm the family member, I have caregiver fatigue.
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It sounds real.
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How am I going to get them to PT three days a week and still have my job?
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I have my own children to care for.
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I guess we'll figure it out.
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It's real sentences that end up being the cues and the clues that we know clinicians need to be able to put the pieces together.
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We also use standardized data, and I'm proud of this integration where we have a standardized patient feedback form, and it's across all six of the programs, so that uh every student, regardless of their clinical background, are receiving the same feedback items.
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And this really allows us when we become interprofessionally and learning side by side, the expectations of feedback are already established because it's standardized across.
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But then lastly, the data that I'm really proud of is the students themselves do a personal inventory at the end of every sim where they reflect.
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We use gender-neutral names and they reflect on what stood out.
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So if I say the name Jerry Jones, I'm sure everybody listening has a picture of an image of a person, a specific gender, specific ethnicity.
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And this is a safe space where they can take a personal inventory and say, did the patient actually match the image that you had in your mind of who you were going to meet when you read their name?
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And then we travel into a safe space to have reflection on social influences in the case, whether that's divorce, religion, gender identification, and the list goes on.
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And all of that is under this umbrella of humanistic, right?
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Allowing students who the majority are 20 to 26, 27 years old in graduate health science programs to explore and learn about themselves so that they can be more grounded in healthcare delivery.
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And the work has been very rewarding seeing them transform from that front seat.
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Yeah, it's so much fun to watch learners digest the information, understand it, talk about it.
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Yeah.
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Yeah.
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I would say, you know, I used to think that simulation um is experiential.
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And it is, obviously.
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There's, you know, if you look at Kolb's model and we're having an event and then we're letting them self-reflect, and then they're going to make change based on the feedback and the self-reflection that they have, and then they'll come back and do it again.
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But for me, I know we've done it correctly when it's transformational, when it changes them, when that personal inventory opened a window or a door for them to learn something about themselves that they didn't even know was there.
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And sometimes it's not about implicit bias, it's just learning their own weakness.
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I found it hard to be vulnerable in, you know, and then fill in the blank.
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And that data about themselves allows them to be better prepared for clinical rotations and then ultimately clinical practice because now they can enter the clinical rotation better prepared for what would potentially hold them back.
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And this isn't easy work, right?
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You have to have an army of people ready to pick them up if the pieces get so heavy that it bogs them down.
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Um, blessed here, Seaton Hall, to have that with a really robust caps program, which most most universities have, and then faculty who who are supportive and small group faculty ratio that they have the supportive mechanism, and then an open door policy to the to myself or the sim team who they had this moment with, right?
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Because it is a moment.
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And that those moments remind me of of the past of the moment I had uh with patients and the impact with a patient.
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And um that's why I think I revere them, right?
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And revere helping somebody grow through a moment that feels overwhelming, but yet they come out so much stronger than they arrived in the program.
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Right.
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Now, is there anything you'd like to leave our listeners with today?
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I would like to leave everybody with an affirmation that no matter where you are, what struggle you're going through, uh, the challenge from your boss, the meeting you have on your schedule that you're just not looking forward to going to.
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Don't tell them, by the way, it's just between you and I.
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That you take a breath and you celebrate yourself.
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You celebrate the work that you're doing, and you take a moment to celebrate the wins and then high five yourself.
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Mel Robbins talks about that a lot, like looking in the mirror and high-fiving yourself.
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And I do a fist pump instead, you know, don't break the mirror because then it's seven years of bad luck.
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But um, a fist pump to be like, you got this.
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You you because if we don't stop and take our own inventory of what we achieved, it's easy to get lost in the journey forward to forget and to forget that we have impacted people.
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So my hat goes off to all the simulationists, health educators out there who are driving positive change and hopefully a humanistic element has uh now been brought forward for you to think about integrating and its importance as we grow as a field.
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Thank you.
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And I think, you know, we talked about earlier how we were so blessed to have the opportunity to be at IMSH, being among our tribe, right?
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Absolutely.
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We were among our time.
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And now you also we talked about this too.
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You are going to be a guest on one of the webinars for new assimilation.
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So look forward to that.
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And if our guests want to get a hold of you, where would they go?
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The best way to get a hold of me is through Seton Hall University.
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It's jennifer.edu.
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You can also just put Jennifer McCarthy S H U for Seton Hall University, and my faculty page comes up and you can email me straight from there.
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And I would love to hear humanistic stories that are happening in.
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Your own uh delivery or what you've observed as well.
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Because I think it's an important growth for all of us as simulationists.
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Thank you.
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Because you make a difference.
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Thank you.
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So do you.
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Thank you for the opportunity.
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Thank you.
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All right.
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Happy simulating.
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Thanks for joining us here at The Sim Cafe.
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We hope you enjoyed.
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