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Episode Description
In this episode of On Record, hosts Mike Anzalone and Carmen Haak speak with Lisa George, Associate Chair of Simulation and Interprofessional Education, and Tom Waring, Lead Simulation Technologist, from the Northern Alberta Institute of Technology (NAIT) Center for Advanced Medical Simulation (CAMS).
Lisa and Tom walk through how NAIT designs and runs interprofessional education (IPE) simulations that bring together students from 14 health programs — and, most recently, five institutions across Alberta. They discuss what it takes to build scenarios that work for multiple disciplines at once, from the needs analysis and learning objectives all the way through to debrief, and why getting the facilitation and technology teams involved from the start is so important.
The conversation takes a close look at NAIT's mass casualty incident (MCI) simulation, now in its third year. What started as a student suggestion has grown into a full-scale exercise involving real ambulances, local firefighters, a 1,000 square foot extended reality theater, and a simulated multi-hospital system running simultaneously. The team captured this year's event from 40 camera angles across two runs — generating over 120 hours of footage now being used to support ongoing research and shape future programming.
Lisa and Tom also discuss the specific role video plays at CAMS: supporting student self-reflection during debriefs, enabling observers to participate without crowding the simulation space, testing products with industry partners in realistic conditions, and measuring outcomes like closed-loop communication and patient handoffs. They share where they see simulation heading next, including the use of AI to generate personalized feedback, build virtual pre-simulation experiences, and assist facilitators during debrief.
"Don’t be afraid to ask—you might be surprised what is possible. — Lisa George"
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00:00:01:20 - 00:00:27:03
Unknown
Welcome to the On Record podcast. This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio and innovative ways to support their organizations objectives. My name is Mike Anzalone and my co-host is Carmen Haak. And today I'm really excited because we got a couple guests from Northern Alberta Institute of Technology.
00:00:27:09 - 00:01:02:03
Unknown
Today we have Lisa George, and Lisa is the associate chair of Simulation and Interprofessional Education. And Tom Waring. Tom is the lead simulation technologist. Welcome both of you to the On Record podcast. Thanks so much for having us. And so typically before we kind of really dive into the conversation, we like to get a little bit, learn a little bit about yourself, your background and how you actually got to Northern Alberta Institute of Technology.
00:01:02:04 - 00:01:29:11
Unknown
So my background is a combined laboratory and X-ray technologist, and I came to NAIT as an instructor within that program and, you know, worked in that program for about 13 years instructing and then leading it as chair. But how I got into interprofessional education and simulation is actually when they introduced a course within the School of Health and Life Sciences.
00:01:29:12 - 00:02:01:00
Unknown
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 and then in 2019, they were looking for a new instructor to lead IPE for the School of Health and Life Sciences. And I had really enjoyed my experience as an instructor in that course and thought it is a great opportunity as a stepping stone.
00:02:01:00 - 00:02:30:11
Unknown
So put forward an expression of interest and was successful in being able to lead that. So now for two years I've been full time dedicated to leading IPE. We have 14 programs within our school that participate to have it embedded in their curriculum, 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.
00:02:30:16 - 00:03:01:09
Unknown
How about you, Tom? Yeah. So I, I like to say I don't really have a background in anything. My background is in simulation. I've been in healthcare simulation since I was 20, so I've been here for over a decade now. I started as a clinical technologist apprenticeship at King's College Hospital in London in England, was in that course for about eight months, rotating through like surgical theaters, E.R., radiation protection, loads of different departments.
00:03:01:09 - 00:03:27:01
Unknown
And then, as most sim techs happen, a sim tech job opened up at the hospital, fell into it and never really looked back. Worked there for 3 or 4 years. Moved to Canada in 2018. Kind of thought that maybe it full simulation. Sold jeans for six months and then, as it happens, happened to fall into a simulation position here with NAIT and have been here ever since then.
00:03:27:06 - 00:03:57:12
Unknown
What do you like best about being in simulation? 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. So I. Yeah, just a massive nerd. I love video games, board games. I'm taking the Personal Fitness trainer diploma here at NAIT and I love using all of those skill sets to help students learn and be better health care professionals.
00:03:57:17 - 00:04:25:00
Unknown
I know both Carman and I have a ton of questions, because doing some research on the types of things that you've been able to accomplish at your institution have been just phenomenal. So maybe if we can start about because I know, Lisa, when you're talking about like pulling together interprofessional education oriented simulation, there's a lot of different moving parts.
00:04:25:00 - 00:04:52:01
Unknown
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. What are can you tell us a little bit about some of the the challenges of putting together a scenario like that, and not only the challenges, but the types of outcomes that you're looking to gain from that kind of scenario?
00:04:52:03 - 00:05:16:07
Unknown
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 and lab and x ray, you know, is great in terms of making sure that the accuracies around the simulation scenario represent what is happening in practice.
00:05:16:07 - 00:05:50:05
Unknown
But it's so short there. I'm not, you know, as knowledgeable in respiratory paramedicine for the different programs that we have here at NAIT. So we need to make sure that we have those people there to ensure it's accurate, and it's appropriate for the learning of where the students are in their journey. 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.
00:05:50:07 - 00:06:21:15
Unknown
And so really I that's what I love about IPE Sim is that enable to make sure that it's an effective learning opportunity. We also have to be practicing it and modeling it for the students ourselves from the facilitation team as well. So that is a big part of it, 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.
00:06:21:15 - 00:06:49:13
Unknown
And we have that psychological safety within the facilitation team as well. Now, how would you go about preparing in a professional type of scenario? Yeah, so I think like I said, a big part of that is bringing the people together, starting with our needs analysis. And you know, what are we trying to achieve? What are the gaps that we need to fill up here?
00:06:49:13 - 00:07:31:19
Unknown
And working through those learning objectives? 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 as well as, you know, making sure that they have what they need in order to bring this scenario to life. So, you know, whether it is a five minute communication based scenario or, you know, a large scale mass casualty incident sandwich we run, I think having the right people of a team, you know, in a timely manner, it's very important.
00:07:31:19 - 00:08:03:05
Unknown
So we have some very specific timelines in place within the center to make sure that there's appropriate resources, including hiring a standardized participants and the appropriate tools and information needed around that. So, Thomas, I've done a great job of creating a simulation template which facilitators will need to fill in. So we have all of the background information and I can that to that than I can.
00:08:03:07 - 00:08:30:00
Unknown
It's a key tool to making sure that we have all the details we need in order to run this scenario. Totally. We're incredibly fortunate thatNAIT and Cam's 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.
00:08:30:00 - 00:09:03:01
Unknown
So much technology kind of lose the heart of the simulation and why you're doing it in the first place. So that's why keeping the core of the learning objectives is so key. So, Tom, how do you like, from a technology perspective, your your translation process from the user, the educational outcomes designed for this scenario? How do you then orchestrate and coordinate all the technology that's required in order to support those educational outcomes?
00:09:03:03 - 00:09:39:21
Unknown
Sure. We've got a really good quality management system that helps with a lot of that aspect. And within there's a lot of collaboration really with the lead instructor for that program. So we don't necessarily know what a combined laboratory acknowledges. Student needs to know when the skill sets, but we can help interpret their needs into a simulation that's going to be valuable for that learner, the creative and knowing what the technology can do and helping interpret those needs.
00:09:40:00 - 00:10:08:13
Unknown
Just bearing witness. The first couple of questions that have been asked. You two are very humble. You have extensive experience, and you bring tremendous value, obviously, toNAIT. And just judging by how you've outlined your preparation, how you mitigate challenges, bringing that experience to the table and really, really driving the value. Home video obviously is a huge part of technology that has to be figured out and brought into the plans to make sure that you have the proper learning outcomes.
00:10:08:18 - 00:10:50:00
Unknown
You help me understand in your opinion. We can start with Lisa and then move to Tom. How do we use video atNAIT, or how are you using video atNAIT to make sure that you're getting those learning outcomes achieved? Yeah, I think it's a huge piece. First of all, in maintaining the realism of the simulation environment. So first of all, before we had the wonderful center that we do, you know, we used to host simulation within our lab spaces in the programs, and that included all the learners and facilitators outlining the space, you know, huddled, leaning up against the wall and with the learners engaging in these scenarios.
00:10:50:02 - 00:11:19:09
Unknown
That really takes it away from trying to, you know, buy into the experience that it is a real situation with a real patient. So that's a huge piece in it of ourselves still having an opportunity for learners to 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.
00:11:19:09 - 00:11:56:07
Unknown
And then second to that would definitely be for any debrief opportunities. I think it's a huge contributing factor to students being able to look back on their performance, see how it's being received from the people that they're interacting with 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.
00:11:56:09 - 00:12:27:09
Unknown
That's excellent. So what about your opinion, Tom? Yeah, Lisa kind of hit the the two cause that the self-reflection piece and then 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 at the time that students have in simulation is somewhat limited. So being able to observe someone else and then participate in the debrief just adds a completely different two on a different element to it.
00:12:27:11 - 00:12:59:16
Unknown
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. We do a ton of research both on simulation, best practice and pedagogy, as well as with industry partners. 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 providing that video footage, which is massive, for them to go back, iterate on products and get ready for a launch, you're really diversifying.
00:12:59:16 - 00:13:29:16
Unknown
I was going to say your usage of it. Please elaborate. That's just fascinating to use it for. Multiple. Yeah. So we have the space and it's something that the industry really needs is really difficult to test a product in a real hospital. Whereas we have a full simulated hospital 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.
00:13:30:00 - 00:14:03:18
Unknown
I knowNAIT and Cam's has received tons of accolades about the mass casualty type of scenarios that you've been running. 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 running that kind of scenario that maybe our listeners who are thinking about something like that could learn from.
00:14:03:19 - 00:14:43:06
Unknown
May I just preface is this is this 2024? This is what we're talking about specifically, obviously other examples. But also, is that what you're referring to? Mike, this is like something that okay. Yeah, absolutely. So this started three years ago. I attended a program orientation meeting with our advanced care paramedic students. And so 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 their retooling and advancing their practice.
00:14:43:06 - 00:15:14:04
Unknown
So it did, you know, kind of set those students apart from some of the other programs where most of the students were coming in with no or limited health care experience. And I really wanted to make sure that the learning opportunities we are providing were going to be relevant for them. 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.
00:15:14:05 - 00:15:41:18
Unknown
Please let me know. 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. And we I was happy to to take it from there. 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.
00:15:42:01 - 00:16:08:02
Unknown
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 syntax team, as well as other facilitators in need to to bring it to life. So it's grown significantly since the first year, where the first year we only had students with innate participating.
00:16:08:02 - 00:16:44:08
Unknown
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 atNAIT, you know, to collaborate with. Our respiratory therapy students are both primary care and advanced care paramedic students. 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 in Canada.
00:16:44:09 - 00:17:11:03
Unknown
I will say it's based on a rural health care environment. So we expanded this year for a number of different ways to include our on scene response, which we have in our immersive 368 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.
00:17:11:05 - 00:17:40:10
Unknown
We were able to collaborate with some local firefighters that came in as well, as they brought two ambulances into. The students got to actually experience riding in an ambulance and supporting patients for the first time for our primary care paramedic students, in addition to the ambulance simulator that we have at night. So from there, they then transported their patients after triaging them on scene.
00:17:40:12 - 00:18:22:00
Unknown
We had two hospital settings. We had the rural hospital setting, and then Camhs was set up as our entire tertiary hospital with MRI, CT and X-ray lab respiratory. And so a very immersive high fidelity simulation. It was about an hour long in total and really emphasizing the focus of teen collaboration and communication, you know, inter-departmental communication via phone as well as, you know, from the scene to dispatch to the hospitals and kind of coordinating the care and the the delivery of patients.
00:18:22:03 - 00:19:00:00
Unknown
Yeah. 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 come to treat it almost like our Apollo moon missions. It's our it's our like big. We have a year to get this done. This is the vision and all of those huge challenges that we're able to overcome with collaborating with other industries, engaging partners like yourself to support with video recording, all the ambulance services, fire and other companies to call off this one huge event.
00:19:00:02 - 00:19:23:11
Unknown
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. Even after that, and something we're working on now to bring it kind of back to the video portion of it. So these simulations we recorded from 40 different camera angles. Wow.
00:19:23:13 - 00:19:56:16
Unknown
These simulations, which were around twice in one day, we ended up with about 90 minutes per camera per SIM. So at the end of the day, we're about 120 to 140 hours of video content. So now we're at the stage where we go, okay, what do we do with this? I've got so much confidence. 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.
00:19:56:18 - 00:20:27:11
Unknown
It's more to what learners actually need and do. Learning from that video footage, and not only that, also doing research as a part of this year's learning experience. So from the simulation itself as well as the debrief, this is going to be, you know, a big summer project, I'll say, combing through all of these recordings and using it as a part of a couple of research projects that we have underway.
00:20:27:13 - 00:20:55:07
Unknown
I kind of like to think what you've just described to me sounds like a big movie set. I was just thinking production. I was thinking the same thing. Production. And Tom, you mentioned 40 different camera angles, which kind of blows my mind in and of itself. But because part of the scenario is to understand how these different resources and teams are working together, communication is so important.
00:20:55:07 - 00:21:29:20
Unknown
And communication therefore requires really good audio. So you can hear how they're communicating. How do you tackle that? 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. Totally, honestly, with extreme difficulty. So. Give it real. Yeah. When you got microphones embedded in a ceiling and there are 27 people in a single room, good luck to you from that.
00:21:29:20 - 00:21:47:12
Unknown
So it takes a lot of time, a lot of effort and pulling all of those individual feeds to get anything from it. 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. So it takes a lot of time and effort.
00:21:47:14 - 00:22:16:15
Unknown
Wow. Where these scenarios run inside a facility or were they did you do anything outside like in a part of everything? So we started seeing in what we call our our extended reality theater, which is 1000 square foot simulation space with projectors that go projector scene onto the walls. There's a full theater lighting, rigging, the fog smoke machine going right audio.
00:22:16:15 - 00:22:47:11
Unknown
And then we crammed it full of 20 standardized patients and then a ton of rubble to represent this building collapse scene. The standardized patients and mannequins will then transported either via a simulated ambulance or via a real ambulance, outside of the doors of that theater, around to the front entrance of Cams, where they were met in the one of the two triage areas, either the trials for the first hospital or taken into the rural secondary hospital.
00:22:47:13 - 00:23:14:20
Unknown
Then from the hospital, they'd go back from that triage entryway. They'd get taken to a bed base somewhere within the embedded hospital, which was our eight bay hospital that we crammed, I think about 15 people into somehow. And then they had individual secondary rooms for lab and X-ray and CT and MRI, all separate rooms as well. Wow. I just have to say, it's a it's a huge commitment to the realism.
00:23:14:21 - 00:23:35:01
Unknown
And we're obviously recognizing that based on your descriptions. 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. And it's got to be a passion project. You're driven by the motivation to give this experience, and that's part of what's rewarding you too.
00:23:35:01 - 00:23:58:14
Unknown
It sounds like right now, with the technology and what you view is you've you've come to a place where you're innovating and leading. Do you see like a future state down the road? Like what do you see? You mentioned AI Tom. Is there other things like Future State you're picturing? 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?
00:23:58:16 - 00:24:23:14
Unknown
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 London needs. So that can be is like a pre scaffolding or as a post simulation experience. So SIM is an amazing tool to discover your weaknesses. Now what do you do with those weaknesses or those learning gaps?
00:24:23:14 - 00:24:51:04
Unknown
You've got to take that away and do a lot of work on your own. Well, if we can provide you with some tools to support that self-learning, then why not? And that's where AI is coming in to be able to create that rapid simulation delivery. 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.
00:24:51:04 - 00:25:11:20
Unknown
So like I said, there were a number of students that are not fromNAIT. 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. So we want to provide them a little bit more time to get comfortable with the space.
00:25:11:20 - 00:25:38:08
Unknown
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 will have in the space, see where it'll be located. So when they come in on the day of, they're much more confident and prepared to just start rolling with the simulation.
00:25:38:10 - 00:26:08:13
Unknown
What has been your students and learners feedback, particularly from, you know, this kind of mass casualty scenario? Yeah, I think we've definitely learned from their feedback each year. This year it's been overwhelmingly positive. 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 likely they'll encounter.
00:26:08:13 - 00:26:38:20
Unknown
So they really appreciate it. 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, because it is such a widespread simulation, not every learner will encounter each aspect. So for example, the students place in the hospital, they they don't ever make it to the scene, right.
00:26:39:02 - 00:27:16:15
Unknown
Would it be realistic? But they want to hear about what the paramedic students encounter. And so we tried to use video one year to get them to see it afterwards, but as well as as a part of the debrief there. So I think there's some gaps there that we're looking to close through video solutions. And 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.
00:27:16:15 - 00:27:43:01
Unknown
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, a little bit of closed loop communication that we wanted to see them demonstrate as a part of the simulation experience as well. And we're, you know, we're just starting to uncover the feedback and the learnings from that experience this year.
00:27:43:03 - 00:28:29:13
Unknown
I would imagine with a group that large, what is the debrief process like? Do you break them into groups like how kind of walk us through that, that process? Yeah, this is something that we look at each year to see if there's a better way to to run it 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, you know, both parts of the experience in the conversation.
00:28:29:15 - 00:29:02:00
Unknown
We did take a mixed group, so we really wanted to make sure it was interdisciplinary. 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 deep, brief group. And we tried to make it about 6 to 8 learners per group to kind of facilitate a, you know, lots of opportunity for everyone to be participating in the discussion.
00:29:02:02 - 00:29:28:18
Unknown
I know 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 happen specific to that area and then breaking them up in their interdisciplinary groups to talk more broadly about the teamwork, the communication, the objectives of the SIM.
00:29:29:00 - 00:29:51:15
Unknown
It just seems like there's so many layers to the work that goes into this. I'm still like them head around it because it's different between, you know, one interprofessional exercise, when you engage what you have 10 to 14 programs you mentioned, everyone needs to have some value taken away and some feedback personally that hits home and then they want to self-reflect.
00:29:51:17 - 00:30:17:02
Unknown
There's a lot to unpack, and I think that it's tremendous that you keep growing year over year, and you're getting the feedback from your your students. That's critical to making improvements when needed. Yeah. Can you tell us a little bit about the simulation center itself? Sure. It's 6000 square foot simulation center. We've got about 1000 square foot that's taken up by the extended reality theater.
00:30:17:04 - 00:30:52:07
Unknown
We have four large simulation theaters that are too bad. They spaces those dividing wall between each of those rooms as well, so that wall can be raised into the ceiling and then expanded to a four bedroom. So it's a super flexible space. We've also got four smaller rooms that are more like clinic kind of rooms, because we deal with such a wide variety of learners from like animal health or dental or paramedic, as well as the more typical in hospital specialties.
00:30:52:09 - 00:31:18:00
Unknown
We have to be incredibly flexible and how we utilize the space. So we have things like portal 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. From a technology perspective, what kinds of challenges have you come across specifically in that type of environment?
00:31:18:00 - 00:31:22:07
Unknown
So many because.
00:31:22:09 - 00:31:54:18
Unknown
It's really down to the imagination of the instructors and the technologist team to come up with what we can actually pull off. So far, we've had a hard time saying no to basically anything. So we've created things like swimming pool, locker rooms inside of what would typically look like a hospital room. The extended reality room makes almost anything possible, 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.
00:31:54:20 - 00:32:23:15
Unknown
We like to ask our guests about future developments, where you see the the field of simulation going. And from our conversation so far, it seems like you are living in the future already based upon everything that you've done, which is truly amazing. But as you're thinking down the road.
00:32:23:17 - 00:32:56:18
Unknown
What trends do you see? How can you make this more realistic? How can you use technology, perhaps in a different innovative in a native way, to again support the educational component of what you're looking to do? I think we're pretty good with the realism side so far. I think enhancements in mannequins and enhancements in standardized patient adjuncts make it more difficult to decide exactly which path to take.
00:32:56:19 - 00:33:27:01
Unknown
Typically it was if you're going to talk. You're a patient, you pick a standardized patient. If you want to do something tactile, you pick a mannequin. So those lines are blending quite a lot recently, but I think the enhancements that we're going to see in the future are more customized simulations and more just in time training specific to unique learners rather than just on week six of this course, you will do this simulation.
00:33:27:01 - 00:34:01:15
Unknown
I think we're going to be able to build in way more flexibility to those experiences. 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. 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.
00:34:01:15 - 00:34:34:01
Unknown
And just, you know, you know, as well as even a tool for debriefing, helping facilitators as they're observing, you know, we're humans and we miss things to. So it could be an opportunity to help kind of condense or like summarize what may have happened and help contribute to planning out debrief discussions as well. So I know you've you also mentioned using simulation from a research perspective.
00:34:34:01 - 00:35:19:07
Unknown
And one example that you gave was like product usability, product development, whether are types of examples. Could you share with our listeners without naming names? We had a company come in with an auto injector, and that auto injector was to be used for emergency situations where someone was bleeding out. 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, partly extricated with below knee amputation, and then the participants came into the room that was very cold.
00:35:19:07 - 00:35:36:06
Unknown
We set the temperature to about 8 or 9 degrees a little bit, a little bit of fault and a little bit of wind going and the lights nice and dark. So it was a dark winter's evening. Here in Canada, storytelling is on point.
00:35:36:08 - 00:36:03:11
Unknown
Audio. The auto injector had a very, very small light on the top of it that indicated when the drug had been delivered, and the participant said that they couldn't hear the little beep or see the light in the environment. So they were able to go away and add a brighter light and a lot more volume of sound to the auto injector.
00:36:03:11 - 00:36:22:14
Unknown
So it was more obvious when the drug had been delivered, 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. And then I would say from like a pedagogy perspective, we're looking at, you know, specific to the MCI. We haven't worked through it all yet. So it's going to be a very large project this summer.
00:36:22:14 - 00:36:58:09
Unknown
But we had an opportunity to compare and contrast a morning simulation to the afternoon simulation. And the difference that an icebreaker activity made on the students comfort and willingness to communicate into professionally. During the scenario. We also are looking at the debrief and kind of having a structured debrief format to encourage participation from all disciplines present in that group.
00:36:58:11 - 00:37:35:13
Unknown
So we're again comparing and contrasting between two groups there and really excited to use our video and audio capture from that to then actually count how many times things like closed loop 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. 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.
00:37:35:14 - 00:38:08:05
Unknown
I have one last question on the topic, that it might be just based on some of the language you sprinkled in there. Elisa, you mentioned a lot about like psychological safety of the students. You talk about the preparation, the confidence building, maybe having materials prior icebreaking, how else, and what is like the most critical tool you're using for promoting psychological safety is is there something principle wise you you live by or what is your, I guess, idea behind promoting that and such a large volume of students?
00:38:08:07 - 00:38:34:18
Unknown
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 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.
00:38:34:18 - 00:39:07:04
Unknown
So we really stepped up our prepackaged 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 expertise. And that's okay. 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.
00:39:07:04 - 00:39:30:14
Unknown
So I think being very intentional about those things and then also repeating it again when they come there for that day. What I was starting to notice this year is doing quite a bit of IP simulation is that sometimes when they show up, the nerves are already present, they're already happening, and they're only going to hear a certain amount of information that you're giving them.
00:39:30:14 - 00:39:54:20
Unknown
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. So I try to give them that opportunity to really feel comfortable.
00:39:55:00 - 00:40:02:01
Unknown
I think it's just huge in terms of IP simulation especially.
00:40:02:03 - 00:40:30:18
Unknown
Well, it's obvious you both have been extremely instrumental in building out a world class simulation center. 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. So hats off to the both of you before we wrap up.
00:40:30:19 - 00:41:01:09
Unknown
If we've got listener to our thinking along those lines of that kind of dreaming to aspire. Yeah, to that level. Dreaming to aspire what you've accomplished, can you both provide our listeners with some advice on how to go about putting a program like this together? Don't try and do it alone. Yeah, sure. Contact. Tom. Tom. Yeah. In these hands, you're going to need people that are genuinely passionate about the cause.
00:41:01:12 - 00:41:37:11
Unknown
And that will go a long, long way in getting you to your uncle's. Yeah. And I think for myself, from a facilitator standpoint, you know, sometimes I've been a part of developing new scenarios where the facilitator, facilitator team coming together and crafting up all these ideas and then going to meet with the tech team. And I can't emphasize enough how critical it was to have the same team 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.
00:41:37:12 - 00:42:05:06
Unknown
Maybe we can do it this way instead. So just making sure that you're working closely together right from the get go and then, you know, yeah, dare to dream. I mean this year we had the that'd be team come say like, hey, we'd like to bring two of our ambulances. And immediately I was like, oh, well, the insurance issue for sure, it was going to be a no.
00:42:05:06 - 00:42:26:01
Unknown
But, you know, we we reached out and asked and we were surprised to see, like, hey, we are doing this. You're coming to us early, which is great. And here are the considerations will need to make. And here's how we can support you. So, you know, don't don't be afraid to ask and see. You know, you might be surprised what is possible.
00:42:26:03 - 00:43:03:20
Unknown
Which actually brings up a good question in terms ofNAIT's leadership. How did you get there by in to, you know, put something so grandiose together like this? I mean, I think we're very fortunate to have a very supportive leadership within our school. They see the true value of simulation and IP. And as long as we're communicating and checking in for all of those necessary safety considerations, I feel very supported.
00:43:03:21 - 00:43:27:03
Unknown
Tom, I don't know, for your standpoint, completely agree with Lisa. 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. It has a much wider impact.
00:43:27:05 - 00:43:51:13
Unknown
My takeaway from listening to your team talk through everything in today's conversation has been you really are putting the care and communicator. I just love the care you have for one another, for your students, for the realism, for the outcomes, for improving, for the entire experience. And I think that speaks a lot to what you said. Being passionate about what you're doing, you have to care.
00:43:51:14 - 00:43:58:17
Unknown
When we thank you both for for joining the podcast. Thank you. Thanks so much.
00:43:58:19 - 00:44:13:08
Unknown
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzalone and Carmen Haak and produced by Kyle Shelstad. Find us online at IPIVS.com/onrecord and on social media at Intelligent Video Solutions.
Unknown
Welcome to the On Record podcast. This is a podcast where we talk with professionals and subject matter experts from diverse markets that are using video and audio and innovative ways to support their organizations objectives. My name is Mike Anzalone and my co-host is Carmen Haak. And today I'm really excited because we got a couple guests from Northern Alberta Institute of Technology.
00:00:27:09 - 00:01:02:03
Unknown
Today we have Lisa George, and Lisa is the associate chair of Simulation and Interprofessional Education. And Tom Waring. Tom is the lead simulation technologist. Welcome both of you to the On Record podcast. Thanks so much for having us. And so typically before we kind of really dive into the conversation, we like to get a little bit, learn a little bit about yourself, your background and how you actually got to Northern Alberta Institute of Technology.
00:01:02:04 - 00:01:29:11
Unknown
So my background is a combined laboratory and X-ray technologist, and I came to NAIT as an instructor within that program and, you know, worked in that program for about 13 years instructing and then leading it as chair. But how I got into interprofessional education and simulation is actually when they introduced a course within the School of Health and Life Sciences.
00:01:29:12 - 00:02:01:00
Unknown
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 and then in 2019, they were looking for a new instructor to lead IPE for the School of Health and Life Sciences. And I had really enjoyed my experience as an instructor in that course and thought it is a great opportunity as a stepping stone.
00:02:01:00 - 00:02:30:11
Unknown
So put forward an expression of interest and was successful in being able to lead that. So now for two years I've been full time dedicated to leading IPE. We have 14 programs within our school that participate to have it embedded in their curriculum, 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.
00:02:30:16 - 00:03:01:09
Unknown
How about you, Tom? Yeah. So I, I like to say I don't really have a background in anything. My background is in simulation. I've been in healthcare simulation since I was 20, so I've been here for over a decade now. I started as a clinical technologist apprenticeship at King's College Hospital in London in England, was in that course for about eight months, rotating through like surgical theaters, E.R., radiation protection, loads of different departments.
00:03:01:09 - 00:03:27:01
Unknown
And then, as most sim techs happen, a sim tech job opened up at the hospital, fell into it and never really looked back. Worked there for 3 or 4 years. Moved to Canada in 2018. Kind of thought that maybe it full simulation. Sold jeans for six months and then, as it happens, happened to fall into a simulation position here with NAIT and have been here ever since then.
00:03:27:06 - 00:03:57:12
Unknown
What do you like best about being in simulation? 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. So I. Yeah, just a massive nerd. I love video games, board games. I'm taking the Personal Fitness trainer diploma here at NAIT and I love using all of those skill sets to help students learn and be better health care professionals.
00:03:57:17 - 00:04:25:00
Unknown
I know both Carman and I have a ton of questions, because doing some research on the types of things that you've been able to accomplish at your institution have been just phenomenal. So maybe if we can start about because I know, Lisa, when you're talking about like pulling together interprofessional education oriented simulation, there's a lot of different moving parts.
00:04:25:00 - 00:04:52:01
Unknown
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. What are can you tell us a little bit about some of the the challenges of putting together a scenario like that, and not only the challenges, but the types of outcomes that you're looking to gain from that kind of scenario?
00:04:52:03 - 00:05:16:07
Unknown
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 and lab and x ray, you know, is great in terms of making sure that the accuracies around the simulation scenario represent what is happening in practice.
00:05:16:07 - 00:05:50:05
Unknown
But it's so short there. I'm not, you know, as knowledgeable in respiratory paramedicine for the different programs that we have here at NAIT. So we need to make sure that we have those people there to ensure it's accurate, and it's appropriate for the learning of where the students are in their journey. 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.
00:05:50:07 - 00:06:21:15
Unknown
And so really I that's what I love about IPE Sim is that enable to make sure that it's an effective learning opportunity. We also have to be practicing it and modeling it for the students ourselves from the facilitation team as well. So that is a big part of it, 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.
00:06:21:15 - 00:06:49:13
Unknown
And we have that psychological safety within the facilitation team as well. Now, how would you go about preparing in a professional type of scenario? Yeah, so I think like I said, a big part of that is bringing the people together, starting with our needs analysis. And you know, what are we trying to achieve? What are the gaps that we need to fill up here?
00:06:49:13 - 00:07:31:19
Unknown
And working through those learning objectives? 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 as well as, you know, making sure that they have what they need in order to bring this scenario to life. So, you know, whether it is a five minute communication based scenario or, you know, a large scale mass casualty incident sandwich we run, I think having the right people of a team, you know, in a timely manner, it's very important.
00:07:31:19 - 00:08:03:05
Unknown
So we have some very specific timelines in place within the center to make sure that there's appropriate resources, including hiring a standardized participants and the appropriate tools and information needed around that. So, Thomas, I've done a great job of creating a simulation template which facilitators will need to fill in. So we have all of the background information and I can that to that than I can.
00:08:03:07 - 00:08:30:00
Unknown
It's a key tool to making sure that we have all the details we need in order to run this scenario. Totally. We're incredibly fortunate thatNAIT and Cam's 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.
00:08:30:00 - 00:09:03:01
Unknown
So much technology kind of lose the heart of the simulation and why you're doing it in the first place. So that's why keeping the core of the learning objectives is so key. So, Tom, how do you like, from a technology perspective, your your translation process from the user, the educational outcomes designed for this scenario? How do you then orchestrate and coordinate all the technology that's required in order to support those educational outcomes?
00:09:03:03 - 00:09:39:21
Unknown
Sure. We've got a really good quality management system that helps with a lot of that aspect. And within there's a lot of collaboration really with the lead instructor for that program. So we don't necessarily know what a combined laboratory acknowledges. Student needs to know when the skill sets, but we can help interpret their needs into a simulation that's going to be valuable for that learner, the creative and knowing what the technology can do and helping interpret those needs.
00:09:40:00 - 00:10:08:13
Unknown
Just bearing witness. The first couple of questions that have been asked. You two are very humble. You have extensive experience, and you bring tremendous value, obviously, toNAIT. And just judging by how you've outlined your preparation, how you mitigate challenges, bringing that experience to the table and really, really driving the value. Home video obviously is a huge part of technology that has to be figured out and brought into the plans to make sure that you have the proper learning outcomes.
00:10:08:18 - 00:10:50:00
Unknown
You help me understand in your opinion. We can start with Lisa and then move to Tom. How do we use video atNAIT, or how are you using video atNAIT to make sure that you're getting those learning outcomes achieved? Yeah, I think it's a huge piece. First of all, in maintaining the realism of the simulation environment. So first of all, before we had the wonderful center that we do, you know, we used to host simulation within our lab spaces in the programs, and that included all the learners and facilitators outlining the space, you know, huddled, leaning up against the wall and with the learners engaging in these scenarios.
00:10:50:02 - 00:11:19:09
Unknown
That really takes it away from trying to, you know, buy into the experience that it is a real situation with a real patient. So that's a huge piece in it of ourselves still having an opportunity for learners to 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.
00:11:19:09 - 00:11:56:07
Unknown
And then second to that would definitely be for any debrief opportunities. I think it's a huge contributing factor to students being able to look back on their performance, see how it's being received from the people that they're interacting with 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.
00:11:56:09 - 00:12:27:09
Unknown
That's excellent. So what about your opinion, Tom? Yeah, Lisa kind of hit the the two cause that the self-reflection piece and then 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 at the time that students have in simulation is somewhat limited. So being able to observe someone else and then participate in the debrief just adds a completely different two on a different element to it.
00:12:27:11 - 00:12:59:16
Unknown
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. We do a ton of research both on simulation, best practice and pedagogy, as well as with industry partners. 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 providing that video footage, which is massive, for them to go back, iterate on products and get ready for a launch, you're really diversifying.
00:12:59:16 - 00:13:29:16
Unknown
I was going to say your usage of it. Please elaborate. That's just fascinating to use it for. Multiple. Yeah. So we have the space and it's something that the industry really needs is really difficult to test a product in a real hospital. Whereas we have a full simulated hospital 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.
00:13:30:00 - 00:14:03:18
Unknown
I knowNAIT and Cam's has received tons of accolades about the mass casualty type of scenarios that you've been running. 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 running that kind of scenario that maybe our listeners who are thinking about something like that could learn from.
00:14:03:19 - 00:14:43:06
Unknown
May I just preface is this is this 2024? This is what we're talking about specifically, obviously other examples. But also, is that what you're referring to? Mike, this is like something that okay. Yeah, absolutely. So this started three years ago. I attended a program orientation meeting with our advanced care paramedic students. And so 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 their retooling and advancing their practice.
00:14:43:06 - 00:15:14:04
Unknown
So it did, you know, kind of set those students apart from some of the other programs where most of the students were coming in with no or limited health care experience. And I really wanted to make sure that the learning opportunities we are providing were going to be relevant for them. 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.
00:15:14:05 - 00:15:41:18
Unknown
Please let me know. 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. And we I was happy to to take it from there. 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.
00:15:42:01 - 00:16:08:02
Unknown
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 syntax team, as well as other facilitators in need to to bring it to life. So it's grown significantly since the first year, where the first year we only had students with innate participating.
00:16:08:02 - 00:16:44:08
Unknown
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 atNAIT, you know, to collaborate with. Our respiratory therapy students are both primary care and advanced care paramedic students. 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 in Canada.
00:16:44:09 - 00:17:11:03
Unknown
I will say it's based on a rural health care environment. So we expanded this year for a number of different ways to include our on scene response, which we have in our immersive 368 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.
00:17:11:05 - 00:17:40:10
Unknown
We were able to collaborate with some local firefighters that came in as well, as they brought two ambulances into. The students got to actually experience riding in an ambulance and supporting patients for the first time for our primary care paramedic students, in addition to the ambulance simulator that we have at night. So from there, they then transported their patients after triaging them on scene.
00:17:40:12 - 00:18:22:00
Unknown
We had two hospital settings. We had the rural hospital setting, and then Camhs was set up as our entire tertiary hospital with MRI, CT and X-ray lab respiratory. And so a very immersive high fidelity simulation. It was about an hour long in total and really emphasizing the focus of teen collaboration and communication, you know, inter-departmental communication via phone as well as, you know, from the scene to dispatch to the hospitals and kind of coordinating the care and the the delivery of patients.
00:18:22:03 - 00:19:00:00
Unknown
Yeah. 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 come to treat it almost like our Apollo moon missions. It's our it's our like big. We have a year to get this done. This is the vision and all of those huge challenges that we're able to overcome with collaborating with other industries, engaging partners like yourself to support with video recording, all the ambulance services, fire and other companies to call off this one huge event.
00:19:00:02 - 00:19:23:11
Unknown
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. Even after that, and something we're working on now to bring it kind of back to the video portion of it. So these simulations we recorded from 40 different camera angles. Wow.
00:19:23:13 - 00:19:56:16
Unknown
These simulations, which were around twice in one day, we ended up with about 90 minutes per camera per SIM. So at the end of the day, we're about 120 to 140 hours of video content. So now we're at the stage where we go, okay, what do we do with this? I've got so much confidence. 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.
00:19:56:18 - 00:20:27:11
Unknown
It's more to what learners actually need and do. Learning from that video footage, and not only that, also doing research as a part of this year's learning experience. So from the simulation itself as well as the debrief, this is going to be, you know, a big summer project, I'll say, combing through all of these recordings and using it as a part of a couple of research projects that we have underway.
00:20:27:13 - 00:20:55:07
Unknown
I kind of like to think what you've just described to me sounds like a big movie set. I was just thinking production. I was thinking the same thing. Production. And Tom, you mentioned 40 different camera angles, which kind of blows my mind in and of itself. But because part of the scenario is to understand how these different resources and teams are working together, communication is so important.
00:20:55:07 - 00:21:29:20
Unknown
And communication therefore requires really good audio. So you can hear how they're communicating. How do you tackle that? 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. Totally, honestly, with extreme difficulty. So. Give it real. Yeah. When you got microphones embedded in a ceiling and there are 27 people in a single room, good luck to you from that.
00:21:29:20 - 00:21:47:12
Unknown
So it takes a lot of time, a lot of effort and pulling all of those individual feeds to get anything from it. 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. So it takes a lot of time and effort.
00:21:47:14 - 00:22:16:15
Unknown
Wow. Where these scenarios run inside a facility or were they did you do anything outside like in a part of everything? So we started seeing in what we call our our extended reality theater, which is 1000 square foot simulation space with projectors that go projector scene onto the walls. There's a full theater lighting, rigging, the fog smoke machine going right audio.
00:22:16:15 - 00:22:47:11
Unknown
And then we crammed it full of 20 standardized patients and then a ton of rubble to represent this building collapse scene. The standardized patients and mannequins will then transported either via a simulated ambulance or via a real ambulance, outside of the doors of that theater, around to the front entrance of Cams, where they were met in the one of the two triage areas, either the trials for the first hospital or taken into the rural secondary hospital.
00:22:47:13 - 00:23:14:20
Unknown
Then from the hospital, they'd go back from that triage entryway. They'd get taken to a bed base somewhere within the embedded hospital, which was our eight bay hospital that we crammed, I think about 15 people into somehow. And then they had individual secondary rooms for lab and X-ray and CT and MRI, all separate rooms as well. Wow. I just have to say, it's a it's a huge commitment to the realism.
00:23:14:21 - 00:23:35:01
Unknown
And we're obviously recognizing that based on your descriptions. 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. And it's got to be a passion project. You're driven by the motivation to give this experience, and that's part of what's rewarding you too.
00:23:35:01 - 00:23:58:14
Unknown
It sounds like right now, with the technology and what you view is you've you've come to a place where you're innovating and leading. Do you see like a future state down the road? Like what do you see? You mentioned AI Tom. Is there other things like Future State you're picturing? 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?
00:23:58:16 - 00:24:23:14
Unknown
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 London needs. So that can be is like a pre scaffolding or as a post simulation experience. So SIM is an amazing tool to discover your weaknesses. Now what do you do with those weaknesses or those learning gaps?
00:24:23:14 - 00:24:51:04
Unknown
You've got to take that away and do a lot of work on your own. Well, if we can provide you with some tools to support that self-learning, then why not? And that's where AI is coming in to be able to create that rapid simulation delivery. 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.
00:24:51:04 - 00:25:11:20
Unknown
So like I said, there were a number of students that are not fromNAIT. 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. So we want to provide them a little bit more time to get comfortable with the space.
00:25:11:20 - 00:25:38:08
Unknown
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 will have in the space, see where it'll be located. So when they come in on the day of, they're much more confident and prepared to just start rolling with the simulation.
00:25:38:10 - 00:26:08:13
Unknown
What has been your students and learners feedback, particularly from, you know, this kind of mass casualty scenario? Yeah, I think we've definitely learned from their feedback each year. This year it's been overwhelmingly positive. 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 likely they'll encounter.
00:26:08:13 - 00:26:38:20
Unknown
So they really appreciate it. 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, because it is such a widespread simulation, not every learner will encounter each aspect. So for example, the students place in the hospital, they they don't ever make it to the scene, right.
00:26:39:02 - 00:27:16:15
Unknown
Would it be realistic? But they want to hear about what the paramedic students encounter. And so we tried to use video one year to get them to see it afterwards, but as well as as a part of the debrief there. So I think there's some gaps there that we're looking to close through video solutions. And 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.
00:27:16:15 - 00:27:43:01
Unknown
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, a little bit of closed loop communication that we wanted to see them demonstrate as a part of the simulation experience as well. And we're, you know, we're just starting to uncover the feedback and the learnings from that experience this year.
00:27:43:03 - 00:28:29:13
Unknown
I would imagine with a group that large, what is the debrief process like? Do you break them into groups like how kind of walk us through that, that process? Yeah, this is something that we look at each year to see if there's a better way to to run it 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, you know, both parts of the experience in the conversation.
00:28:29:15 - 00:29:02:00
Unknown
We did take a mixed group, so we really wanted to make sure it was interdisciplinary. 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 deep, brief group. And we tried to make it about 6 to 8 learners per group to kind of facilitate a, you know, lots of opportunity for everyone to be participating in the discussion.
00:29:02:02 - 00:29:28:18
Unknown
I know 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 happen specific to that area and then breaking them up in their interdisciplinary groups to talk more broadly about the teamwork, the communication, the objectives of the SIM.
00:29:29:00 - 00:29:51:15
Unknown
It just seems like there's so many layers to the work that goes into this. I'm still like them head around it because it's different between, you know, one interprofessional exercise, when you engage what you have 10 to 14 programs you mentioned, everyone needs to have some value taken away and some feedback personally that hits home and then they want to self-reflect.
00:29:51:17 - 00:30:17:02
Unknown
There's a lot to unpack, and I think that it's tremendous that you keep growing year over year, and you're getting the feedback from your your students. That's critical to making improvements when needed. Yeah. Can you tell us a little bit about the simulation center itself? Sure. It's 6000 square foot simulation center. We've got about 1000 square foot that's taken up by the extended reality theater.
00:30:17:04 - 00:30:52:07
Unknown
We have four large simulation theaters that are too bad. They spaces those dividing wall between each of those rooms as well, so that wall can be raised into the ceiling and then expanded to a four bedroom. So it's a super flexible space. We've also got four smaller rooms that are more like clinic kind of rooms, because we deal with such a wide variety of learners from like animal health or dental or paramedic, as well as the more typical in hospital specialties.
00:30:52:09 - 00:31:18:00
Unknown
We have to be incredibly flexible and how we utilize the space. So we have things like portal 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. From a technology perspective, what kinds of challenges have you come across specifically in that type of environment?
00:31:18:00 - 00:31:22:07
Unknown
So many because.
00:31:22:09 - 00:31:54:18
Unknown
It's really down to the imagination of the instructors and the technologist team to come up with what we can actually pull off. So far, we've had a hard time saying no to basically anything. So we've created things like swimming pool, locker rooms inside of what would typically look like a hospital room. The extended reality room makes almost anything possible, 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.
00:31:54:20 - 00:32:23:15
Unknown
We like to ask our guests about future developments, where you see the the field of simulation going. And from our conversation so far, it seems like you are living in the future already based upon everything that you've done, which is truly amazing. But as you're thinking down the road.
00:32:23:17 - 00:32:56:18
Unknown
What trends do you see? How can you make this more realistic? How can you use technology, perhaps in a different innovative in a native way, to again support the educational component of what you're looking to do? I think we're pretty good with the realism side so far. I think enhancements in mannequins and enhancements in standardized patient adjuncts make it more difficult to decide exactly which path to take.
00:32:56:19 - 00:33:27:01
Unknown
Typically it was if you're going to talk. You're a patient, you pick a standardized patient. If you want to do something tactile, you pick a mannequin. So those lines are blending quite a lot recently, but I think the enhancements that we're going to see in the future are more customized simulations and more just in time training specific to unique learners rather than just on week six of this course, you will do this simulation.
00:33:27:01 - 00:34:01:15
Unknown
I think we're going to be able to build in way more flexibility to those experiences. 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. 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.
00:34:01:15 - 00:34:34:01
Unknown
And just, you know, you know, as well as even a tool for debriefing, helping facilitators as they're observing, you know, we're humans and we miss things to. So it could be an opportunity to help kind of condense or like summarize what may have happened and help contribute to planning out debrief discussions as well. So I know you've you also mentioned using simulation from a research perspective.
00:34:34:01 - 00:35:19:07
Unknown
And one example that you gave was like product usability, product development, whether are types of examples. Could you share with our listeners without naming names? We had a company come in with an auto injector, and that auto injector was to be used for emergency situations where someone was bleeding out. 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, partly extricated with below knee amputation, and then the participants came into the room that was very cold.
00:35:19:07 - 00:35:36:06
Unknown
We set the temperature to about 8 or 9 degrees a little bit, a little bit of fault and a little bit of wind going and the lights nice and dark. So it was a dark winter's evening. Here in Canada, storytelling is on point.
00:35:36:08 - 00:36:03:11
Unknown
Audio. The auto injector had a very, very small light on the top of it that indicated when the drug had been delivered, and the participant said that they couldn't hear the little beep or see the light in the environment. So they were able to go away and add a brighter light and a lot more volume of sound to the auto injector.
00:36:03:11 - 00:36:22:14
Unknown
So it was more obvious when the drug had been delivered, 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. And then I would say from like a pedagogy perspective, we're looking at, you know, specific to the MCI. We haven't worked through it all yet. So it's going to be a very large project this summer.
00:36:22:14 - 00:36:58:09
Unknown
But we had an opportunity to compare and contrast a morning simulation to the afternoon simulation. And the difference that an icebreaker activity made on the students comfort and willingness to communicate into professionally. During the scenario. We also are looking at the debrief and kind of having a structured debrief format to encourage participation from all disciplines present in that group.
00:36:58:11 - 00:37:35:13
Unknown
So we're again comparing and contrasting between two groups there and really excited to use our video and audio capture from that to then actually count how many times things like closed loop 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. 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.
00:37:35:14 - 00:38:08:05
Unknown
I have one last question on the topic, that it might be just based on some of the language you sprinkled in there. Elisa, you mentioned a lot about like psychological safety of the students. You talk about the preparation, the confidence building, maybe having materials prior icebreaking, how else, and what is like the most critical tool you're using for promoting psychological safety is is there something principle wise you you live by or what is your, I guess, idea behind promoting that and such a large volume of students?
00:38:08:07 - 00:38:34:18
Unknown
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 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.
00:38:34:18 - 00:39:07:04
Unknown
So we really stepped up our prepackaged 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 expertise. And that's okay. 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.
00:39:07:04 - 00:39:30:14
Unknown
So I think being very intentional about those things and then also repeating it again when they come there for that day. What I was starting to notice this year is doing quite a bit of IP simulation is that sometimes when they show up, the nerves are already present, they're already happening, and they're only going to hear a certain amount of information that you're giving them.
00:39:30:14 - 00:39:54:20
Unknown
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. So I try to give them that opportunity to really feel comfortable.
00:39:55:00 - 00:40:02:01
Unknown
I think it's just huge in terms of IP simulation especially.
00:40:02:03 - 00:40:30:18
Unknown
Well, it's obvious you both have been extremely instrumental in building out a world class simulation center. 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. So hats off to the both of you before we wrap up.
00:40:30:19 - 00:41:01:09
Unknown
If we've got listener to our thinking along those lines of that kind of dreaming to aspire. Yeah, to that level. Dreaming to aspire what you've accomplished, can you both provide our listeners with some advice on how to go about putting a program like this together? Don't try and do it alone. Yeah, sure. Contact. Tom. Tom. Yeah. In these hands, you're going to need people that are genuinely passionate about the cause.
00:41:01:12 - 00:41:37:11
Unknown
And that will go a long, long way in getting you to your uncle's. Yeah. And I think for myself, from a facilitator standpoint, you know, sometimes I've been a part of developing new scenarios where the facilitator, facilitator team coming together and crafting up all these ideas and then going to meet with the tech team. And I can't emphasize enough how critical it was to have the same team 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.
00:41:37:12 - 00:42:05:06
Unknown
Maybe we can do it this way instead. So just making sure that you're working closely together right from the get go and then, you know, yeah, dare to dream. I mean this year we had the that'd be team come say like, hey, we'd like to bring two of our ambulances. And immediately I was like, oh, well, the insurance issue for sure, it was going to be a no.
00:42:05:06 - 00:42:26:01
Unknown
But, you know, we we reached out and asked and we were surprised to see, like, hey, we are doing this. You're coming to us early, which is great. And here are the considerations will need to make. And here's how we can support you. So, you know, don't don't be afraid to ask and see. You know, you might be surprised what is possible.
00:42:26:03 - 00:43:03:20
Unknown
Which actually brings up a good question in terms ofNAIT's leadership. How did you get there by in to, you know, put something so grandiose together like this? I mean, I think we're very fortunate to have a very supportive leadership within our school. They see the true value of simulation and IP. And as long as we're communicating and checking in for all of those necessary safety considerations, I feel very supported.
00:43:03:21 - 00:43:27:03
Unknown
Tom, I don't know, for your standpoint, completely agree with Lisa. 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. It has a much wider impact.
00:43:27:05 - 00:43:51:13
Unknown
My takeaway from listening to your team talk through everything in today's conversation has been you really are putting the care and communicator. I just love the care you have for one another, for your students, for the realism, for the outcomes, for improving, for the entire experience. And I think that speaks a lot to what you said. Being passionate about what you're doing, you have to care.
00:43:51:14 - 00:43:58:17
Unknown
When we thank you both for for joining the podcast. Thank you. Thanks so much.
00:43:58:19 - 00:44:13:08
Unknown
On Record is a podcast presented by Intelligent Video Solutions, hosted by Mike Anzalone and Carmen Haak and produced by Kyle Shelstad. Find us online at IPIVS.com/onrecord and on social media at Intelligent Video Solutions.