NLN Nursing EDge Unscripted

Surface - BASE Camp: Acclimating Interprofessional Teams to Overcome the Impossible - Part 2

January 26, 2023 Kevin Ching and Kathryn Muccino Season 3 Episode 2
NLN Nursing EDge Unscripted
Surface - BASE Camp: Acclimating Interprofessional Teams to Overcome the Impossible - Part 2
Show Notes Transcript

This episode of the NLN Nursing EDge Unscripted Surface track is part 2 of 2 featuring guests Kevin Ching and Kathryn Muccino. 

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[Music] Welcome back. Last episode we talked with Dr. Kevin Chang and Kathryn Muccino to learn  about the immersive and interprofessional simulation experience is called BASE Camp  that help to prepare pediatric emergency medicine teams tackle some of the most  challenging clinical situations and how we can learn from this and apply  it to our own environments and our own organizations. Thank you for joining us.  I just want to say how impressed I am with the amount of psychological safety you all have been  able to create for this experience. I wasn't even a part of it. I've only heard Michelle's lens of  her experience and what you're sharing here and for such a transformative, emotionally activating  intense weekend and for people to be able to lean into that especially from different professions  and be able to create these communities really it sounds like communities of practice that follow  them and go with them beyond these two days speaks to just the art and science of your ability to  create a psychologically safe space for them and so I just want to commend you both and your team  because that's impressive and you know it's one thing to create psychological safety within a  group of people who are used to working with one another. You start from a different starting place,  but when you pull people together from different professions, different lived experiences who don't  know one another, that's a...you're upping the ante there and trying to be able to create a  psychologically safe space. I don't know if you're in a place where you could speak to the  deliberate intentional things you do to make that happen or if you have any insight that you  could share with others that might be helpful and how do you create create that safe space  especially when it's strangers from different professions and different lived experiences? Every year we bring together probably somewhere in the vicinity of 100 plus multi-professional  and multi-disciplinary faculty to come teach at BASE Ccamp. It includes people from  

all different fields:

nursing, child life, trauma, obviously emergency medicine, pediatric emergency  medicine, critical care, anesthesiology even sometimes things like ENT. But they all bring  something different to the table which is to say they bring their own expertise and experiences.  These expertises are of course content and subject matter expert sort of related but  it's also education. Michelle had said something that resonated with me, which was she's a  educational expert, she's a clinical expert, but her field isn't pediatric emergency medicine. Yet  her role at BASE Camp was so critical because what we what we look for are people  who bring educational expertise to elevate the way that we practice and so when it  comes to celebrating the many multi-professional and multi-disciplinary faculty who come we want  to set them up for success. Before all faculty come to BASE Camp  we have two opportunities to sort of get people on board and have that shared  mental model. One is of course we have a faculty handbook. This faculty handbook is designed to  cover all the details and expectations for faculty before coming to teach.  We also do a pre-conference, a sort of a meeting for new faculty so those who are new faculty  have an opportunity to sort of ask questions and explore sort of like what's  involved and have a better anticipation of what's going to happen.   Then each day of BASE Camp it started with a a sort of pre-brief. We huddle together as a  multi-professional team of faculty in the morning. I mean it's God awful early in the morning. It's  

like 5:

45 AM or something or six AM. O dark thirty. Yeah. And then  Kathryn, Hillary and then our other co-directors which include Alice Ruscica, Maria Lame and  Justin Jeffers, the group of us. We do a briefing. we just want to  make sure that everyone is set up for success. That success is not just about  the sort of instructional delivery, but it's also for, you know, you had talked  about how important the psychological safety of our learners were but it's also just  as intense for all these faculty who are there volunteering their time for again the marathon  of two days. That mutual support is something that those sort of huddles allow us to sort of get everyone to sort of feel like, hey, we're  all here to work together. We have a shared mission. Our mission is to level  the playing field of all these different providers who come from pretty  much all over the country but let's work together to do that and support one another.  There are multiple layers and levels of how we try to set our faculty up to be successful,  not only in their instruction but in how they debrief  and just having been there, Kevin and Kathryn, I just want you to know that it was felt, it was  perceived that I felt very supported as a faculty being there for the first time. I felt  like there was a community of faculty that was comfortable with BASE Camp that had been there  and they welcomed me with open arms and I could ask them where am I supposed to be next?  How many times did I ask you, Kathryn, where am I supposed to be? That's no reflection,  first of all, the logistics of this operation of 100 plus students 100 plus faculty, multiple  many simulations happening at the same time. The spreadsheets were the most impressive spreadsheets  I've ever seen. The logistics around this... I just wanna commend you for the organization.  But there were times where I would feel a little disoriented and I would say, Kathryn, where am I  supposed to be? You always welcomed me and said right here let me pull out my sheet and  show you where you need to be. I just felt very comfortable, very psychologically safe. I  felt like I could ask questions and I just love Kevin that you're saying that that is a very big  focus for the faculty to create that space as well as for the learners. I think that magic  connection is what I think can really help to hold that bigger space that meta-  psychologically safe space that is required to do to run such an emotionally, a deeply  emotionally activating experience such as the mass casualty in a pediatric emergency medicine  space. I mean that is tremendous. When we say psychological fidelity, Rachel,  the New York Marathon was actually happening one block away.  It felt real because it felt like you're in New York City, you've got the marathon  down the street, a couple hundred thousand people down the street. This could happen  at any moment, at any time, so it's not even just the immediate space that required that  psychological safety, but kind of that bigger space as well. It was done  so beautifully, so thank you. That was how it was perceived for me personally. Thank you. When I hear this, it makes me think that mentoring must be a really big and important component of this work and I'm so  curious to hear from you more about your approach to mentoring and how it's built  into this experience both in terms of the faculty and for the learners. So we're in our 13th year and as Kathryn had shared we're very, very fortunate,  very privileged to have a community of faculty who enjoy the program like we do and come back  for seconds, thirds, fourths, every year and that has created a network of experienced  faculty both in education and as content experts who are able to help shape and advance the  professional development of younger faculty. I think it's because of that network that we were inspired I think it's seven years ago at this point, six or seven years ago,  to develop a BASE Camp junior faculty instructor mentorship program. That's probably  about seven years ago and the idea was that we were trying to...well  first off as we saw like, wow so many new faculty come to BASE Camp and leave feeling exhilarated,  invigorated, and loving the prospect of becoming future educators and using simulation  as a tool and it occurred to us, why not create a structured opportunity to really  sort of make that happen for people who are thinking about a career in education? And so  that's the BASE Camp junior faculty instructor mentorship program. We invite pediatric  emergency medicine fellows who are in the third year of training, those who have already taken or  participated in BASE Camp when they were first year fellows and they participate in  the structured mentorship, which is that they get paired with a a simulation educator, someone who is  everyone comes with like a different sort of set of skills and so our mentors are come  from all different walks of life and they get paired and then they spend the entire weekend  working together and sort of climbing that hill if you will together. They're  trying to advance their knowledge, skills, and aptitude in becoming expert debriefers  and the mentors are there to help sort of shape and support them. It's a sort  of like it's a guided mentorship that has a stepwise sort of weekend approach because  there are so many opportunities to do it that from the beginning  these mentors get to sort of model best practices and the the junior faculty instructors  get to sort of dip a toe in and feel just how safe they are with sort of experimenting  and then as the weekend goes gets all  sort of moves forward. The mentor  sort of like lets go of the reigns and take a step back and lets the junior  faculty fly. This is again - it's intended as a multi-professional sort of debrief and the fact that it's interprofessional, interdisciplinary gives these  junior faculty an appreciation for how important that kind of co-debriefing is  to being successful in really connecting with your learners.  I'll turn it over to Kathryn to sort of share some of her thoughts about our future  development, our future directions in this. Sure. I think those are all really good points and  you're asking well what kind of the mentorship and how we deliberately  keep that safe space and the growth? Kevin and I have talked a couple of times  now about developing a similar program for nursing. I think one of the  things again having been a nurse and now a nurse practitioner a little bit more on the provider  side that when you look at pediatric emergency medicine and exactly what you're  speaking to Michelle, these scenarios where the safety, the psychological safety is so important.  It's the same in the real trauma situations, right? Like you want people to feel that they can  trust the environment, that they can speak up, they can feel safe in their practice. That's  what we're trying to create here at BASE Camp. I just think that the way that we work with our  our faculty to help them mentor the participants is really critical and a lot of these  nurses especially. I'm going to speak to that side right now, nurses come in a little bit timid not knowing  what to expect. It's not anyone that they've worked with before, usually maybe one person,  and so they're a little bit timid and often I feel like sometimes nursing in  that situation, not always, one of the fellows or the the attending is taking  the reins on running a code or a trauma resuscitation in the ER and so the nurses  are hugely critical thinkers but they their voices can get lost and what I love about BASE Camp weekend is there are many opportunities for the nurses to be leaders also and to really find  their voice and to really work collaboratively with the physician staffs, the fellows, and child life and to realize that their voice is equally important and everybody brings a really unique  role and the way that safety happens really like as we have said with deliberate practice over  and over again really allows them to take that and move forward with it and I think that  even in how we do brief I feel like much like lectures, you lose the  emotional piece when you're sitting in front of a screen but when you're sitting in stimulation  after simulation and you continue to feel just how safe you feel when the right environment is  cultivated that is just something that's so easy to replicate moving forward. I'm grateful that  we have faculty like Kevin has said that continues to come back year after year because they love  how awesome it is. It's a lot of fun and so in that I think we've created a space where people  really trust and have developed a professional practice where it's inherent to them and then  again with the nurses, I do have the nursing faculty that come back most of them have  participated in BASE Camp and they love it and so they've come back now as faculty and they  still remember what it was like to be a participant. It's very easy to make that safe  space and so what we're thinking about doing now is finding either nurses that have been  to BASE Camp that maybe are a charge nurse at their institution or an educator or someone that can be  much like we have a junior faculty the same thing like a junior faculty mentor for nursing  or other nurse practitioner. There's many unique roles which is awesome that's what I love  about nursing. There's so many opportunities like a clinical specialist, a nurse educator that can come  and take on that role and learn the debriefing process because it's so critical. Being  able to talk to patients, families, colleagues is equally important is the clinical care that  we're providing. Kevin has really, in collaboration with Justin, created this  really amazing mentorship model that I think is so equally important in nursing because in nursing there's a lot of room to switch the field that you're in and move and  wiggle and and float. I think cultivating a nursing environment where they love the role  that they're in and they get that autonomy and they feel supported and they can see their own  personal growth through mentors that have been through it themselves is so critical because you  look back at nursing school and a lot of the faculty that you had shape your future.   We have the opportunity to do that here with the faculty that we bring in. Kevin and I  have talked about it a lot and we're excited to continue to do that because we are really proud  of a lot of the faculty that we have and they love being there and it's such a great family and so we  want to continue to use that network to create more learners and more educators and  more professionals that equally love it and can go on to educate in that sense and so that's coming  down the path pipeline. We're thrilled about it and would love to have any of your  insight. It's really been fantastic to watch the mentorship program grow for the  fellows and I'm thrilled to be able to institute it in nursing as well because I love being a nurse  and I love watching the field grow and I love all the different disciplines that you can  be and I'm excited to continue what I love. I love being at the bedside but I also really, really love supporting nursing professionals and staff and watching them grow through their  careers. It's really just so great to have the opportunity to do both of those at BASE Camp.  That's awesome Kathryn. What I heard from both you and Kevin that I  really appreciate is that we can advance practice clinical practice with evidence  using good teaching strategies and combine that with good educational mentorship. We can combine  advancing practice and advancing education at the same time and do it very well and I think your  the experience of BASE Camp marries those two things together so beautifully and effectively.  I just think it's a model that other people can learn from so I just want to thank you so  much for coming on here, into this conversation to share your insights  and share the successes of this program for 13 years. Like, that's amazing. It's amazing  and hopefully inspire somebody to either create some kind of program that can  combine again this advancement in practice and advancement in education at the same  time interprofessionally. It's the Triple Crown right here. It's amazing so thank  you so much for coming and we before you go we do have some questions, some rapid fire fun questions  that we'd like to ask you if that's okay just to get to to know you even better. All right. All right. So if you were to write a memoir what would you title the book? I don't know. I guess, I always part of me has always thought, I've kind of fallen into, I've been lucky in the  opportunities that I've fallen into like I've always thought like I can't explain it but I'm  like oh this like I started my first nursing job ever was in burns and I loved it loved it  and then I was at Cornell it was a wonderful place and I happened to I wasn't necessarily looking to  work in an ER I didn't know but it was one of the openings at Cornell and I applied for it  and I got it and I just happened to fall into this role and I met awesome people there and I  realized how much I love procedural skills and I love being a practitioner and I met Kev and then he was so wonderful and asked me to join the BASE Camp team and I realized I really love educating  and I really love doing all these things and so part of me feels like well yes I did a lot  of preparation for my life like the title of the book would somehow be how I've like fallen into  what my life is like and all these opportunities and really not realize that I did put the work in,  but like all these opportunities and maybe I'm just that person that I've been lucky enough to  love everything that my life has taken me. There are people that  know exactly what they want and they go for it and I have fallen into kind of what I feel like  by happenstance opportunities that I've ended up truly loving and finding my passion through  and it's been people largely like Kevin that have saw something in me that have  really inspired me to take the next step like Kev was the one that brought me onto BASE Camp and I  love BASE Camp. I love education and I've gone on to use that and another fellow friend of ours  Tim Brennan told me to go to business school at Yale and I did that and I ended up working in  leadership and I really loved it because it's it's allowed me to find my voice in nursing  and to educate further and it's been great. So something along those lines - I don't have  the exact title - but like something like that. I love it when I heard you say Kathryn was  like falling into my life and I think that's perfect. I was reflecting too when I was  listening to you, I was like, I think that's what I've done too. You just kind of fall into these  opportunities and that's how you know they're right when they feel good. So awesome. The  next question is what is on top of your reading list right now for fun? This one's Kevin's. Oh man. My book you can read my memoir when I write it. Wait, are  you writing your memoir? I'm kidding. They were just I mean you're so young! What do I have at home? Oh I just got Trevor Noah's book  but I haven't opened it yet so I haven't started. I mean that's probably next up. It's it's sitting right next to my bed. I have like a pile of them and I just put my tea on top  of them sometimes I don't even open them up they're just holding things but that's okay.  If you could have dinner with one person dead or alive who would it be? Michelle Obama. I think I'm so psyched to hear you say that I love her, her impact. I mean  I would move to DC for this. When she was the first lady she would go to Children's  National every holiday and read a book to all of the children in patient and so the nursing staff  had to be present with the children and they got to meet her I would move to DC to meet her but  she just, her genuine impact and warmth and care and it's just so pervasive and I love everything,  all that she stands for, her mission, everything she embodies everything in  females and empowerment and just and keeping soft and genuine and inherent to who you are  and balancing family and professionalism in a way that I think is so I'm in awe of.  That's awesome. What about you Kevin? I mean this is very clearly why Kathryn and I are such good  friends because I without a doubt would say Barack Obama. It's awesome. I mean Barack Obama is perhaps one of the most thought-provoking, stimulating,  energetic, passionate people that really gets why his role as a leader is one of  accountability, responsibility for people and in a heartbeat I would I would drop  everything to even have like a 15-minute run or a two-minute elevator ride with Barack Obama.  That's fantastic and they both, in my perspective, have this presence  about them, this very centered presence and that's what they  lead with and I think that's why they they're just so effective in reaching  people like I think they've reached you so and myself included them. Thank you. All right, well thank you for joining us it's been a wonderful conversation. I've learned a lot  and again, I appreciate the opportunity to be a part of what you've created so thank you. Thank  you so much. This has been really, really great and I can't we can't wait to see you both at BASE Camp. I just want to thank you both and your team for the amazing impact that you're having to not  only as Michelle has said grow educators but also prepare health care professionals for the skills  and the knowledge and the aptitude to successfully care for patients in in our community on what  could be the worst day of their lives so I just want to thank you so much for the impact you're  having and your dedication to advancing health care and the quality of care we give so thank you. Thank you Michelle. Thank you Rachel. Thank you both for inviting us. Thank you for joining us on this episode of NLN Nursing EDge  Unscripted Surface. We hope you join us next time. Until then, remember, whether  your water is calm or choppy, stay connected, get vulnerable, and dare to go beneath the surface.[Music]