Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Interview with Prof Adam Montagu, Director, Adelaide Health Simulation at Adelaide University.
30 Plays1 month ago
Jane had the opportunity to sit down and have a chat with Prof Adam Montagu, Director, of the Adelaide Health Simulation at Adelaide University.
Recommended
Transcript
Intro
Introduction of Professor Adam Montague
00:00:14
Speaker
Hi everyone, it's Jane Frost and this is Simulation Happy Hour and today i am at Adelaide Simulation Centre with Professor Adam Montague. Now Adam, it was remiss of me, I didn't get a bio so I'm going to ask you to introduce yourself to us. Jane, it's lovely to be with you and you're listeners of Simulation Happy Hour. My name is Adam Montague and I'm the Director of Adelaide Health Simulation here at Adelaide University.
00:00:41
Speaker
Fantastic.
Adam's Journey to Simulation Education
00:00:42
Speaker
Can you tell me about how you got into sim and your journey with simulation? I can. It was a bit of a right place, right time type of story. So it was about over a decade ago now, and about 2015, and fifteen I was working as an emergency nurse at the old Royal Adelaide Hospital and I'd had an interest in education for some time and I was actually reflecting on this this morning.
00:01:07
Speaker
I'd inherited a video camera from my grandfather after he passed away and I was making education videos in our emergency department and also i made an orientation video. So I always had an interest in education.
00:01:21
Speaker
and I was an acting nurse educator for about a year and I didn't get the job when I went for it formally. Somebody else got the job. And I think they felt a little bit sorry for me and they came to me and they said, look, the university, the medical school specifically, is looking for a nurse to be what I know now to be called an embedded participant in a deteriorating patient course they were running. So the University of Adelaide at the time had just established four bed simulation centre in the basement of one of their buildings.
00:01:54
Speaker
So it was a very small centre, just a few staff and I was going there every Thursday as a casual nurse to help them teach medical students how to manage undifferentiated deteriorating patients.
00:02:08
Speaker
and that was run by a couple of doctors who were working out of the acute medical unit who had an interest in simulation and and that's where i first was exposed to the modality and I just couldn't believe how much the students learnt from the morning to the afternoon and how how impactful it was and I just kind of fell in love with it at that point.
00:02:33
Speaker
And so that was the beginning, that was the the moment And then fast forwarding, I guess, the the very short answer is i then shifted away from clinical nursing more into education and the university offered me a full-time position in simulation. And I took that in about 2016 towards and seventeen And this is where the right place, right time comes. The hospital was closing.
00:03:01
Speaker
They were building a brand new hospital here in Adelaide. And this building was created. And it was the largest single investment in capital infrastructure the university had ever made.
Expansion and Visionaries Behind the Simulation Center
00:03:12
Speaker
It's a $300 million 12-storey building and two floors of that happened to be simulation and they were looking for, well, there was a vacancy for a simulation director and I applied and and got the job and that's now the last 10 years have gone very quickly. but So that's my story.
00:03:29
Speaker
Fantastic. what What a whirlwind of of a journey. So how did this, you've touched on this, but how did the and Adelaide Simulation Centre come to be? How did it morph from that four bed yes in in a basement to being two floors of this building?
00:03:47
Speaker
I don't think that... That is not a me situation and I really want to give credit to a few people who had a vision, i imagine, well before 2015 create what was created here.
00:04:03
Speaker
And I think there was two people, Dr. Simon Patton, who was working in Australia at the time, who was the director of the small former centre that I told you about, and also Emeritus Professor Alastair Burt, was the Faculty Executive Dean at the time of the Faculty of Health and Medical Sciences.
00:04:23
Speaker
And when this building was being established, I think the motivation for creating Adelaide Health Simulation with 24 single rooms was the fact that they had the vision to bring all OSCE assessment for medicine and nursing into one place.
Role and Impact of the Simulation Center in Education
00:04:40
Speaker
But there was more than just infrastructure. They also wanted to create a team of people who worked in that centre full-time, who became expert at that function. So it wasn't just about building a building, it was building a team of people around it to make it happen. So the motivation...
00:04:57
Speaker
On reflection, now that I look at it, given the design, was assessment, clinical assessment using OSCEs. And secondary to that, my team and I have been able to build it into, I think, quite an exceptional simulation facility as well.
00:05:12
Speaker
Fantastic. So i've I've been to your centre. It's fantastic. But could you tell our listeners a little bit about the different things that you have so that they get a sense of the size and the scale and everything that you do in Sim here? Sure. So for the last decade, our team have been primarily responsible for simulation-based education for undergraduate and postgraduate nursing.
00:05:42
Speaker
and an undergraduate medical program which is a six-year program. So that really is our bread and butter and the percentages there loosely is it was about 60% medicine, 40% nursing teaching.
00:05:54
Speaker
And to give you an idea of scale, in our last couple of annual reports we we run several thousand learn individual learning sessions a year. We have a simulated patient program that delivers about or we offer around 12,000 hours of simulated patient work a year.
00:06:13
Speaker
Simulations embedded from year one into medicine from the first week. Medical students meet with simulated patients every week in their journey. But I think this is a really important... I guess my business mind, if you like, looks at the investment that was made in the people and the infrastructure here, and our simulation environment is used in semesters for undergraduate teaching, so we have two semesters.
00:06:41
Speaker
And let's imagine they run for about 12 weeks each semester, that's 24 weeks plus you've got assessment time. That still leaves several weeks in an academic year that the centre's not utilised.
00:06:53
Speaker
So what we've done is we've established a core business function that is undergraduate teaching, but also looking for external opportunities to get return of investment on the infrastructure and the people, but to contribute to education more
Standardization and Importance of Simulation in Education
00:07:06
Speaker
broadly. So that means that we have worked with specialty colleges, we've worked with places like ARPRA, Defence Force and other universities.
00:07:16
Speaker
other stakeholders to provide clinical assessment or education using simulation and generate income. And then that income is used to then, you know, reinvest into what we do to give opportunities for our students and to build our staffing profile and buy equipment and those sort of things.
00:07:34
Speaker
Great. So why is a SIM centre important? That's a good question. So I think my mind first goes to patient safety, particularly in an undergraduate program. I think that In this day and age, with the overwhelming evidence that we have,
00:07:55
Speaker
it's almost it's you could almost make an argument that health professions education requires an element of simulation, both for learning but also assessment of competence, and I think that simulation can do both of those things well.
00:08:12
Speaker
A simulation centre as a home is important, I think, for equipment and to build skills in people. But it's not only about equipment. Like I said earlier, the investment in people is equally important. So if you can have an area where there's an environment where people are learning and becoming expert in simulation, then that sort of bleeds out, if you like, into other areas of the curriculum and informs that.
00:08:35
Speaker
I think looking forward to the future, modern technology, Modern education, particularly post-COVID, and the shortage of health profession staff that we have around Australia and the ageing population, and there's lots of compounding factors.
00:08:51
Speaker
It's my view, and it's also informed by evidence from a recent literature review I was involved in, is that clinical placements are becoming hard to attain for for students at scale and also our colleagues in the hospital environment or or pre-hospital environment or primary care are really busy and I think universities probably have a little bit of a responsibility to consider could we be replacing some of our placement hours with a simulated clinical placement at very high quality which gives a standardised, high quality experience to students.
00:09:28
Speaker
So that's a brief answer, there's more to it, but simulation centres are important. Remembering, of course, though, that the physical location isn't everything. We can also go out to other areas and do in situ simulation, translational simulation, but I think that...
00:09:45
Speaker
I'm excited. We get a lot of visitors here from different institutions who are building simulation facilities or looking to build them. And it's it's good to see that there is there is a real momentum at the moment in Australia and through the Asia Pacific to invest in simulation infrastructure.
00:10:02
Speaker
So I wanted to just pick up on a couple of things sure that you've just mentioned. One, the replacement of clinical hours. I know that there has been a study in the US which has suggested that you can replace up to 50% of clinical hours.
00:10:17
Speaker
That's not happening in Australia. Do you think that... that is going to be something that's going to happen or do you think that could happen? So for your listeners, we've just done, like I said, a very comprehensive literature review looking at this and i'd I'd encourage your listeners to have a look at that. It's going to be on our LinkedIn at Adelaide Health Simulation imminently, I imagine by the time this podcast is published.
00:10:42
Speaker
And it looked at from memory, it's over 130 studies from around the world It showed that nursing is leading the way in this. They have published the most on simulated clinical placements. But what it showed is there is an evidence gap and the paper illuminates where that area is. And the gap is in defining what a simulated clinical placement is.
00:11:06
Speaker
i think we know the motivations for why people are having it. What worries me in Australia, and this is a personal opinion, this is not an evidence-based opinion, is that even simulation between institutions is delivered at a different quality.
00:11:22
Speaker
So I think that the regulatory bodies... would be really wise to say, yes, we could replace clinical placement with simulation. I think that's a smart move, but it must be done to a standard.
00:11:35
Speaker
And I think that's where accreditation comes in. Because if it's done poorly, it's it's it's perhaps not safe for the community. But at the same time, simulated Genuine clinical placements give a variety a variable meet variable learning outcomes.
Challenges and Staffing Innovations in Simulation
00:11:52
Speaker
And I think universities can provide a very safe environment with very targeted learning outcomes if the clinical placement is simulated. i don't like the word replaced I think it's augmented and and it's it's a shared partnership between didactic teaching and theoretical teaching practical and experiential learning and simulation and then genuine work integrated learning in clinical environments and I think that sort of triangle is the sweet spot because we only have 800 hours so replacing that
00:12:26
Speaker
may be controversial, but i like I like the fact that you're saying that it could augment the placements because personally I think that we should be better preparing our students so when they do go out for those 800 hours because...
00:12:40
Speaker
in the UK it's over 2,000 hours of placement that they have, that they're better prepared and they're safe so they they get the most out of out of those hours. That's right. I don't think I'm expert enough on this particular topic to give to give a definitive answer, but what I would say is I believe that that when when a student goes to a clinical placement, you really don't know the quality of supervision they're going to get, what patient mix they're going to have, what opportunities they're going to have to apply their knowledge.
00:13:15
Speaker
And I think it's critically important that they have that experience and build their professional identity. But I do think simulation offers something quite remarkable if it's done to a high quality, and that is we can allow students to perhaps work to the to the very end of their scope of practice, experience new things that they may not be able to see in the hospital environment,
00:13:38
Speaker
I suspect it's also probably less expensive in some areas to be able to do that at scale. And there are a lot of modalities we can use to to do this. So it's it's an interest please, if you're listening, go and have a read of that literature review. it it It raises more questions than answers, but I think that's important. But I think this is going to be a hot topic over the next decade for all of us. Absolutely. We'll put a link in greatlet on the Simulation Happy Hour website. Thank you very much.
00:14:05
Speaker
The other thing that I wanted to pick up on was the training of staff. So if we're going to have these high quality simulation, and you also alluded to the fact that having a SimCenter enabled you to really train staff, how do you go about that? And what do you how do you do your training of staff?
00:14:27
Speaker
So professional development for simulation staff is, it's it's quite ad hoc really, isn't it? There are formal pathways, but it is it is an ad hoc pathway. So I had a meeting yesterday actually with one of our new simulation fellows. We employed two simulation fellows every year to do a fellowship.
00:14:48
Speaker
And she's currently pre-fellowship with the College of Emergency Medicine. And there is such a defined, structured pathway to to competence and then to fellowship.
00:15:01
Speaker
And we reflected on the fact that for a simulation educator, there are, of course, there are courses that you can do, postgraduate courses, debriefing courses and other things. but it's much harder to to be able to say, i am a qualified expert simulation educator.
00:15:16
Speaker
This is another space that I think in Australia particularly we need to focus on and again I think will be another hot topic for for listeners to keep an eye on over the next decade.
00:15:27
Speaker
So when I took over as Director of Adelaide Health Simulation a decade ago, I really didn't know what the standards were that we were aiming for. So one of the places I looked to was the learning and education standards for accreditation with the Society for Simulation in Healthcare.
00:15:44
Speaker
And it wasn't necessarily that we were looking to be accredited at that time, but it was just it was a it was a guiding document to say when we're embedding governance and infrastructure, this is some standards that we can move towards.
00:16:00
Speaker
move towards Now, I think the Asia Pacific, Australia and our neighbours have a different approach to education and a different approach to medicine. And I would love to see standards and bodies that help us provide standards and and guidelines and certification for educators in Australia. So I know that was a long way around that. The professional development we do here is in-house. We have a visiting scholars program, so every year we bring people in.
00:16:34
Speaker
We've, in 2002, established a research program, and that means that we're doing weekly journal clubs, we're looking at the evidence, we're generating evidence.
00:16:45
Speaker
We're currently writing a debriefing course for our casual staff and people that come in externally to teach because it's not always simulation educators. We need a lot of subject matter experts.
00:16:59
Speaker
But I'll be honest with you, and again, I reflect on the conversation I had with our fellow just recently, She'd taken a deep dive into debriefing methodology and pre-briefing and debriefing, and she felt a little bit lost as to what how what she was going to apply.
00:17:19
Speaker
And I said, look, I think the place to start as an educator in simulation is be genuinely curious about your learners, make sure they're feeling comfortable, know that you are you have clinical expertise that they want to learn from you, and trust the team around you, that is our simulation technicians and simulator patients, to take some of the load of the delivery and you just enjoy the conversation and helping them learn. And I think if you start with that and then then look to the evidence a little bit later,
00:17:50
Speaker
you don't become overwhelmed with what should I be saying, what questions should I be asking, what format should I use. think I think we set people up for failure sometimes. So I think it's about relaxing and just, you know, it's not as complicated as it looks. And I don't know if I'm oversimplifying that, perhaps I am, but I think it's that relationship with the learner that's the most important part.
00:18:13
Speaker
Yeah, I agree. I think that it's great that your fellow has a team that they can rely on to run the sim, but out in, I'll say the real world, where we don't have a sim centre or we don't have dedicated staff, how would you suggest we develop staff to do sim when it's only part of their role or only something that they're able to do when they're in a and in a classroom and they don't have that yes huge lot of people to back them up? Yes.
00:18:48
Speaker
I know that we're incredibly privileged here at Adelaide Health Simulation, but that has been also a lot of hard work to get to that point. When we first started, we made decisions and sometimes we had luck by accident. So I'll give you an example.
00:19:06
Speaker
Michael Gilmore, who is now our senior simulation technician, and he's now a certified healthcare simulation operations specialist, and he's incredibly talented with IT, et cetera.
00:19:19
Speaker
His first role with us at 19 years old, now also a decade ago, was as a simulator patient. Now we couldn't afford to have a simulator patient and a full-time technician, so we offered him a hybrid role where half the time he was working as a sim tech and half the time he was working as a simulator patient.
00:19:37
Speaker
And that's actually continued on through our... journey so we've got a team of six simulation technicians four of them are professional actors as well so there's a dual purpose to the or there's a dual role to what they can offer so in the morning there might be a patient in the afternoon they're they're doing a sim tech role so that that that has helped by diversifying the workforce and then for example the fellowship is great because it means that we can bring a doctor in from you know they're often at the top of their game and they've got incredible clinical knowledge so it's bringing people onto the team that can help i think you can work in a resource poor environment but people make bad decisions on return of investment and i'll give you an example
00:20:24
Speaker
I often visit nursing schools particularly and they i say that they're using their resources I think in a misaligned way and i often see the most senior educator, often a nurse, sitting behind the mannequin control at the computer being the voice for the mannequin and running the scenario.
00:20:44
Speaker
When what I prefer to see is them either as an embedded participant or look or with the learners. that It's a misalignment of their skill set to have them running a mannequin. And then to make make it even worse, the the scenario that they're running probably doesn't need a mannequin. It could probably run quite well with a simulated patient.
00:21:03
Speaker
So I think we're sometimes a little bit stuck in the modality. We're a little bit addicted to the mannequin. We're using people in that we're not using people, sorry, we're deploying people probably for the wrong skill set. And I think if we real if we shook everything up and thought really, who is in the room? What is their purpose? What is their role?
00:21:19
Speaker
and stripped it back a little bit you could probably work with a simulator patient and an educator just the two of you and deliver a richer learning environment meeting your learning outcomes more than if you had technicians unloading mannequins and nurses running simulators and I don't know if that helps but yeah Yeah, thanks. So you've mentioned a few times that it's been 10 years that this same the centre has been running. What's changed in those 10 years? I imagine quite a lot.
00:21:50
Speaker
A lot has changed. A lot has changed. think I think fundamentally, the first two years of our operation was an absolute nightmare.
00:22:04
Speaker
And it was a nightmare because we were afforded all of this technology. We had a huge... installation of what was Beeline then is now SimCapture we had new mannequins coming in new technologies and a bespoke AV system and our team just wasn't ready for that rapid change in growth and and change of processes and to be honest with your audience we were failing regularly so we weren't delivering what we were designed to deliver
00:22:37
Speaker
Because there was a mix of, there was a huge skills gap between operating that equipment and there was an assumption by the university that the IT department would be managing all of this.
00:22:48
Speaker
But if you're in the middle of a high-stakes exam and you ring the level one help desk and they say, I'm sorry, what what what what service? We should be able to have that fixed next week. if They don't understand that you've got 36 examiners and 100 students that day to get through.
00:23:03
Speaker
But I reflect on that and it was because of those failures that our team had to take a really deep dive into what the problems were and fix them. that they we got a culture of sort of examining problems, working together to solve them, having the the reward of success when we when when we could get overcome problems. And it sort of set up a culture of, we you know, we can do anything if we do it well together and we communicate and we bring in the right people for advice.
00:23:35
Speaker
We're assertive as well. If you said you were gonna deliver this product that works, then we need you to come back and help partner with us until it does and design processes. And that slowly built trust with our nursing school and our medical school.
00:23:50
Speaker
And then the biggest growth over the tent last 10 years is we now have about 200 people that report through to Adelaide Health Simulation. So we've got our core team, of course, but then we had 35 nursing educators, which we casual nursing educators, which we spent a lot of time providing professional development for. We've got casual medical educators.
00:24:15
Speaker
We've got a team of about 80 simulated patients. We've got our administrative staff. So it's just it's just this big group of people. So
Research and Relationship Building in Simulation Programs
00:24:22
Speaker
that's been one change. I think the most significant shift in our in our in our place in the academic world of simulation was in 2022 when we recruited Associate Professor Ellen Davies to open our research program.
00:24:42
Speaker
And I think that shifted us from a learning and teaching focused approach organisation to one that values scholarly output and research and we now have a very active HDR programme. We've got about five PhD candidates here researching topics specific to simulation-based education and that's changed I think our external engagement with other audiences around the Asia-Pacific particularly and it's something that I'm really excited about and very proud of.
00:25:17
Speaker
So how how were you able to bring on someone but in a research sort of focused role? So again, i turned to the SSH accreditation standards and realised that we were coming up for our four yearly review of that.
00:25:35
Speaker
And I benchmarked us against what I believe to be some of the leading simulation centres in the world. And our mission and vision statement says that we want to be equal to any of the, and I know that's aspirational, but you then you have to look at, well, what are the gaps?
00:25:54
Speaker
And earlier on in the conversation, Jane, I talked about the fact that we've got our core business, but then we've got revenue generating business outside of that. So I made the decision to the director of where are we going to reinvest those funds to have the greatest impact?
00:26:09
Speaker
And it wasn't your question was, how do we bring on a and and a researcher? We did bring on Ellie as the research program lead, but the return and investment in that has been enormous because now we have...
00:26:28
Speaker
we have you know we're We're contributing to the to the evidence base for simulation. We're promoting it. we're We're looking at where we can improve and attracting HDR candidates to the university and high quality. We've got some incredible people now in our program.
00:26:47
Speaker
And so all of those things start to give you return and investment and also generates opportunities. resources to be able to be to better grow that opportunity.
00:26:58
Speaker
So it was just a decision. let's get Let's do this. right So I think you've already shared a few of the lessons that you've learned, which was my next question. Anything else that you'd like to share about things that you'd do differently maybe if you were starting again?
00:27:20
Speaker
Or for any any of us who were hoping to get a simulation centre. Look, I think I'll frame that as what advice would I give yeah perhaps. Yes, yeah. And I think that the first one would be relationships before infrastructure.
00:27:38
Speaker
So even before you started building a centre, you need buy-in from senior leaders and others.
00:27:47
Speaker
Attracting the right people to your team and when you find them, doing everything you can to keep them challenged and engaged and ensure that they're respected and valued. And I do a lot of, i'm really passionate about that.
00:28:02
Speaker
I think for leaders like yourself, you would agree with this, I would imagine, is don't underestimate the administrative and political load of being a leader in simulation at this level. Stakeholder management is really important. It's as important as education and it takes a lot of time.
00:28:22
Speaker
And the final one, I think, is to advocate that simulation really isn't becoming a nice-to-have. It's becoming essential, both in the regulatory frameworks, in the ethical standards that we have, in learner expectations.
00:28:37
Speaker
So i think that we have a role to advocate for that a little bit more aggressively than than we have in the past. I think we always go with our hat in our hand begging, and I'm just a little bit tired of that approach, a hearing that from people other people and I think it's time that we I don't know how to make it happen but I think if we keep pushing and showing success and publishing why it is what what we do and what and what impact is having it will become easier for people after us to establish centers like this one so my next question is about what do you think and you have touched on this a little bit I think but what's your most valuable simulation item or modality
00:29:21
Speaker
What's your guess? What do you think I'm going to say? thought you were going to say simulated patients. Yeah, 100%. I don't think there's any secret. That is my favourite modality. My dream, and and I'm kind of working in this in the background, but if any of the listeners either want to do it with us or or have one already, my dream is to have just a simple A4 page or a little app on the phone that helps simulation educators understand choose what might be the best modality for a simulation. And I think that'd be great because I believe probably most scenarios, particularly in nursing, physiotherapy, allied health, most scenarios could probably be designed and optimized for a simulated patient.
00:30:05
Speaker
And our students are going to be dealing with human beings. so why not have a human being in the room as a starting point? And if they happen to have a cardiac arrest or they happen to need intubation or they happen to need whatever it is mannequin can provide, sure, use a mannequin.
00:30:21
Speaker
But if you look at the average price of a mannequin in Australia these days, let's pick $100,000,
00:30:28
Speaker
If you divide $100,000 let's say, $40 an hour or $50 an hour for a simulated patient, that's that's a fairly cracking simulation SP program you could have for for the cost of a mannequin.
00:30:41
Speaker
And I think that the scenarios just lift. So yes, my favorite modality, I don't want to talk to them like they're an object, but the the people that we engage as simulated patients is my favorite modality.
Integrating New Tools and Techniques in Simulation
00:30:55
Speaker
But I've got two other ones to add on to the back of that. At the moment, I'm really enjoying learning about and teaching others about VEMS, that's Visually Enhanced Mental Simulation. and I know we touched on that the other day.
00:31:07
Speaker
and I've bought a few kits from Simulation Simplified, who and Dr. Eve Purdy is is a great resource for us in learning about that. And the reason I love that is I've used it, for example, in the Philippines and other resource-poor areas with great success, and I think it just lowers the tone of simulation and it makes it very accessible. So that's number two. And number three, my favourite product at the moment is an Academic EMR. We're using SimEPR from Medequip, but we made a decision to try and make a paperless experience for our students. That's what they're seeing in their clinical environment in South Australia anyway. So that's my current favourite product.
00:31:48
Speaker
Great. Thank you. No worries. So my final question is, what do you want people to know about simulation technology? Oh, that's a big one.
00:31:59
Speaker
Look, I think you and I had a discussion on this other day, and I hope I'll try and make this as quick as I can. i think before I talked about our fellow being a little bit confused about the literature and so on, the more that I'm engaging with simulation educators when I visit centres or they come to visit us, I'm realising that terminology like pre-brief, simulation, debrief,
00:32:26
Speaker
is being confused I think and applied sometimes incorrectly. And that's um's people are giving it a go, which I think is great, but I think we need to take a step back. And I'll give you the example I gave you the other day was if we were running up a school to teach pilots how to fly, on day one of their program, we wouldn't put them in a $300 million dollars flight simulator and ask them to land a jumbo jet into Hong Kong airport because they just couldn't do that.
Adam's Preferences and Light-hearted Closing
00:32:58
Speaker
What we need to do first, and particularly for undergraduate education, is we're using the tools of simulation, but really what we're doing is we're simply doing skills teaching.
00:33:10
Speaker
And skills teaching has a very different set of educational tools where we're providing we're providing education and we're providing probably immediate feedback for the purpose of use of teaching a skill. But what I'm seeing a lot is that Terms like pre-brief and scenario and debrief are being overlaid to that basic clinical skills teaching and I think it's probably confusing learners and educators.
00:33:38
Speaker
So I would just encourage people to separate the two. We need to teach the pilot how to use the joystick, how to read the instruments, how to put the wheels up. Teach them all those things individually first and give them feedback and opportunities to learn that.
00:33:51
Speaker
And then as they mature a little bit of learners, then start providing immersive simulation scenarios where we are doing the pre-brief and they're having to draw on lots of skills at once, synthesize information, build relationships with team members and have interprofessional opportunities and then have a formal structured debrief learning conversation at the end. They're two different things. That's probably one of my bugbears at the moment that I'd like to share on your forum.
00:34:19
Speaker
Thank you. Okay, so we always finish our podcast with this question. So if you could be anywhere in the world, where would you be and what would you be drinking?
00:34:32
Speaker
Okay, well, I think I'd like to be with you, Jane, because I always enjoy having a drink when you're in Adelaide. It's only 8.30 in the morning here, listeners, so we're sitting here with coffee, not a wine. But I thought about this. I think I'm going to see Sandler's year in Lyon in June, and I'd like to be there right now with a nice glass of French wine or champagne and reconnecting with our simulation colleagues from around the world, and I'm very much looking forward to that.
00:35:00
Speaker
Sounds perfect. Thank you so much. Thank you for having me. Thanks. Bye.