Get the Lowdown on Simulation and Teamwork from TLC's "The Little Couple" Star

Jennifer Arnold, M.D., neonatologist at Texas Children’s Hospital and medical director of the simulation center at Baylor College of Medicine in Houston, was the keynote speaker at this year’s QEP Symposium.

In a one-on-one interview, “The Little Couple” star gives us the lowdown on interprofessonal education, simulation for teamwork training and how she juggles her career and her star status.

Q:Why is interprofessional teamwork so important in health care?

A: “Interprofessional teamwork is so important in health care because there’s no other field where it takes such a dedicated, well-coordinated team to work together in a crisis, I think, than health care.

“It’s very similar, however, to aviation and other high-risk industries where people who have various levels of expertise, training and roles who are well-trained to be able to do their job every day they’re challenged with the ability to work together in a crisis, so really what it all comes down to is that whether you’re a nurse, a physician, a respiratory therapist, a pharmacist, or whoever, in a high-risk situation in patient care, you have to work together as a team.

“And unfortunately, we all train in our own respective schools and somewhat in silos, and so what we’re learning now is that there’s the need to start out at the student level training all these different specialties and disciplines to work together effectively and to continue that effective good work and coordination of care as they become professionals in the hospital environment.

“And it’s a challenge because whenever you are done with your training, you know your skills, you know how to take care of patients, but then you’re in a high-risk situation you may have not really practiced how to work together with the other team members, and believe it or not, even though everyone is well trained, there can be problems in communication and teamwork, that then lead to mistakes and those mistakes lead to medical errors and then bad patient outcomes.”

“Really, the goal of simulation training for me, and team training and interprofessional training is to improve how people work together in a crisis so that they can ultimately improve the care that they give to patients.”

Watch Dr. Arnold discuss the future of simulation.

http://www.youtube.com/watch?v=CQ8N4ltpuI0

Q: How has simulation changed health care education? How do you think it will continue to evolve in the future?

A: “I think simulation is really revolutionizing how education happens today in health care from everything from the undergraduate to the graduate to the post-graduate, and then sort of the professional level. Because simulation provides an opportunity to practice in a realistic environment for providers, it’s safe, so we have mannequins that are realistic, they’re really high-tech, they have pulses, they turn blue, they have all of these great features, but it’s really not the features of the mannequin that make simulation so cool. It’s just the opportunity for a team now to practice in real life under time pressure, under stress like they would in a real situation, and to learn from it.

“And what’s so great about simulation is that it’s not only a learning opportunity to practice skills, but you can also make mistakes, and you can experiment a little bit. And it’s completely safe. And the goal of what we do in our simulation program is we try and actually push clinicians until they make that mistake, because by making that mistake in the simulated environment, they're going to learn from it, and they’re going to prevent that mistake from being made in the real world.

“Whether you’re a student or whether you’re a professional, we all are well-intended, we all want to do a great job, and we’re well-trained, but mistakes happen, we’re human. Hospital systems are complex, and you’re in a stressful situation in a crisis and maybe even a certain situation that maybe you haven't experienced before. The great thing about simulation is I can create that unusual high-stress situation, a team can work together, refine their skills, they can make mistakes, they can watch the video recording, and they can be led in a debriefing to really improve their performance based on what they did.

“It’s similar to sports players, baseball players or track and field folks, whatever skill and sport you’re doing or maybe theatre, you watch yourselves, you go over your performance very carefully, and simulation is really the only opportunity where a health care provider can watch themselves sort of in real life, in the performance they give, the care that they give, how they act, talk, work and the things that they do and really learn from it and improve. We all need to constantly improve, and the great thing about simulation is you can continue to improve the good care that you provide.

Q: Have you heard of The F. Marie Hall SimLife Center at TTUHSC? How do you think it compares to other simulation centers in the country?

A: “Before I came here, yes, I had heard about the simulation program here. Of course, your leader of your simulation program, Dr. Decker, is a pioneer and a leader in the field of simulation, so, very familiar with her and her work and so I had heard about the program here and was excited to see it.

“What I’ve learned so far about the program here that I think makes it so unique is that it’s not only a beautiful facility with lots of technology to allow simulation to occur for all of the students here, but there’s an emphasis right from the beginning at all different professional levels to train together and so including interprofessional education from the beginning I think is incredible and wonderful. It’s not something that I benefitted from as a student, and I think as more and more schools follow the lead of Texas Tech to do that at the student level, we’re going to see health care changing because now when these students become clinicians, they’re going to be in the hospital and they’re going to expect to have the same type of training.

“They’re not only going to be better prepared for practice, and they’re going to be better at working as a coordinated team taking care of patients, but they’re going to expect to continue that type of training in simulation or outside of simulation when they’re actual professionals, which is something that in my daily life, I’m challenged with trying to implement.”

Q: What is the transitional period for teaching interprofessional teamwork in simulation and health care education? How long do you think it will take to get everyone on the same page?

A: “Simulation has just grown leaps and bounds in the last three to five years. Five years ago, there was maybe 60 simulation centers in the country all together ... mostly in schools ... so very small. And today there’s got to be in the hundreds of number of simulation programs in the country and in the world.

“My wish and hope ... maybe in the next five years, we’ll see that every medical institution, health care institution, whether they’re a school, a hospital, a clinic, that they will have the opportunity to have simulation training embedded into their daily life. That’s my goal in my program, and that’s a hard thing to do, but until we do it we’re not going to be able to decrease those medical errors that we know are so common.”

Q: When you’re at work, do you think it is difficult for your co-workers and patients to look past your star status after being on “The Little Couple”?

A: “It doesn’t feel like it’s difficult for them to forget about the fact that I have a television show, so you know, having been on “The Little Couple,” it’s been a great opportunity, it’s nothing that I ever expected to be doing, and when I started working at Texas Children’s, it was just a possibility that I might be doing that, and so when it actually came to fruition and we started filming the show, I think at first it was just a challenge because I wasn’t sure how to navigate with cameras while at work and never mind in my own personal life, so that took some time to figure out how we were going to make it work and to make it safe for the providers and the patients.

“Most people actually enjoy it because they’ve seen how it comes out and that it really does highlight health care in a good way and people have been pretty happy with it. Some folks that I work with, they kind of shy away from the camera, no problem, they don’t have to be on camera. And all of our patients, I always ask them, ‘I have the camera crew with me today if you’d like to be on, great, if not no problem,’ and we always just ask them straight up and many parents actually are very excited to have an opportunity to have their child their newborn on camera.

“I would say overall it has been a positive experience. I think because people knew me before I had the cameras that I work with for the most part, they forget all about it, and in fact, as I mentioned, sometimes they’re like ‘Oh, no, does Jen have a camera crew today?’ I try to warn people so they can put their lipstick on before we come around, otherwise I get in trouble later, but in all sincerity and seriousness, it’s been a great opportunity and for the most part, people, I think, forget about it just like I do.”

Q: What has been the most rewarding thing about being on a TV show?

A: “There’s been a lot of great things that have come out of being on television, but the most rewarding has been the people that I’ve met or been contacted from who say it’s helped them in some way.

“My husband and I have always been really passionate about raising awareness about for various things, but particularly for people with disabilities or obviously skeletal dysplasias like us.

“Being a little person, you stand out from a crowd, and you often are picked on most of your life, and many people have preconceived notions about what your capabilities are, and so one of the great things has been the opportunity to have a platform to raise awareness.

“But what has come from that that was a little unexpected was just how many different people have come up to us and they’ve said, ‘Oh my goodness, watching your show I realized I could do this, or I could do that.’ To me, I never would have expected that, but I’m thrilled to hear it.

“We had, for example, one of the nurses that I work with come up to me and write me this beautiful letter and meet me in the hospital that she’d been in horrific car accident and had been very, very sick and unable to work for a really long time, and she, poor thing, while she was recovering watched reruns of “The Little Couple,” and I thought, ‘Oh, I’m so sorry, I hope you weren’t tortured by that,’ and she just laughed and said, ‘No, it made me realize that I need to get back out there and I need to enjoy my life, and life is short, no pun intended,’ and she said it helped her feel like she could – that she could go through [physical therapy] and now she’s back working at the hospital today. It’s amazing.

“Those are the things, when people say to me that somehow the show has touched their lives in a positive way, that really all makes it worth while.”

Q: Has being on a reality show had any impact on your career? If so, how?

A: “When I first started the show, I was actually worried about the negative aspects of being on television as a physician. As an academic physician it’s so much about research and publication – media, not so much, and so I was a little afraid at how I’d maintain that balance.

“It’s definitely a struggle at times, mostly time management wise, but, it’s worked out in the end, and to be quite honest, I’m sure there’s been a lot of opportunities that have come my way to be able to go talk about what I’m passionate about simulation and things like that because people do know me and they’ve seen that I do simulation where I work, and so there’s definitely been those positive opportunities from being on television that I probably wouldn’t otherwise have had.

“I would say as much as it’s a time management issue for me to balance everything, it’s been overall rewarding and provided a lot of opportunities that I wouldn’t have otherwise had.”

Q: Is there anything else you’d like to add?

A: “I just think what you guys are doing here is really amazing when it comes to interprofessional teamwork training and education, and I’m so thrilled to be here and honored, and most importantly, I hope that everybody else learns that this is so important and other institutions like Texas Tech, like Texas Children’s, really puts the resources into providing this type of training for their providers. It’s crucial.”