December 3, 2024 • 31 mins
Discover the fascinating intersection of theater arts and healthcare simulation with our special guest, Dr. Lou Clark. Transitioning from the vibrant world of acting and playwriting to becoming a leading educator in healthcare simulation, Dr. Clark shares her unique journey and insights into the evolving field. Her story unfolds with her move to the University of New Mexico, where her theater background became an invaluable asset in training simulated participants (SPs). Now at the helm of the Association of SP Educators (ASPE), she discusses the critical, yet often overlooked, role of SP educators and the transformative power of performance in healthcare education.
Explore the intricate responsibilities of SP educators, from recruiting standardized patients to crafting scenarios that resonate with authenticity and inclusivity. This episode shines a spotlight on an innovative collaboration with pharmacy faculty to develop a transgender care scenario, highlighting the significance of consulting the trans community for genuine case development. Learn about ASPE's groundbreaking accreditation program, set to debut at the 2025 conference in Montreal, underscoring the organization's dedication to maintaining high standards and inclusivity in SP programs worldwide. Join us for an engaging conversation that celebrates the blend of disciplines like psychology, education, and theater in the realm of SP education.
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Episode Transcript
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Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions, editedby Shelly Houser.
Join our host, Deb Tauber, andco-host, Jerrod Jeffries as they
(00:49):
sit down with subject matterexperts from across the globe to
reimagine clinical educationand the use of simulation.
So pour yourself a cup ofrelaxation, sit back, tune in
and learn something new from TheSim Cafe.
Deb Tauber (01:16):
Welcome to The Sim Cafe.
Thank you for joining us today.
Today we have Jerrod as co-hostand we have Dr Lou Clark, so
welcome, Dr Clark, and thank youso much for agreeing to being a
guest with us today.
Dr. Lou Clark (01:31):
Thanks for having me, Deb and Jerrod, and just
kind of moving forward.
Please feel free to call me Lou, I'm very informal.
Jerrod Jeffries (01:38):
Thank you.
Dr. Lou Clark (01:38):
Thank you.
Jerrod Jeffries (01:39):
Thanks for being here, Lou.
Absolutely.
I think there's a lot to getinto, but maybe we want to level
set with all our listeners andfirst, starting off, could you
give us a little bit about yourbackground, where you come from,
what you're doing now?
Dr. Lou Clark (01:53):
Yeah, absolutely.
I didn't start out to be aneducator or in simulation.
I think, like a lot ofsimulationists of my generation,
like a lot of simulationists ofmy generation, I started off
life in the theater.
I'm a trained actor and singerand did the freelancing and all
those kinds of things in a fewdifferent cities and got my
(02:14):
master's of fine arts indramatic writing.
So I'm also a playwright, andthat was at the University of
New Mexico.
And as I was getting out ofschool and this was back in 2007
, I wanted to stick around and afriend of mine said you know,
there's this amazing job.
You should go down to themedical school because you would
be, you'd be really good atthis.
(02:34):
They need someone to coach theactors.
And that was how I got involved.
That was my first position wasas an SP educator at the
University of New Mexico inAlbuquerque.
It's a wonderful program andfrom there I really discovered
that this job that I sort oftook on as a day job was really
meaningful.
It was rewarding to use theskills that I have as an artist,
(02:58):
as a theater artist, in serviceof healthcare, training and
education.
And so I went on from there,got very interested in
communication, because that'ssuch a part of performing arts,
and got a doctorate in healthcommunication and organizational
communication from ArizonaState University.
So I've been in SIM since 2007.
And what keeps me excited towork with SPs is just that
(03:24):
connection that I've watchedthem make on a routine basis and
how that really transformslearners.
Jerrod Jeffries (03:31):
And just to clarify SPs, for some of our
listeners might be yeah.
Dr. Lou Clark (03:35):
So that's a really interesting clarification
, Jared, because there are somany different ways to name who
are SPs.
And I will say today you know,late in 2024, we are really
adopting simulated participantas a term widely and this is
because the methodology, the SPmethodology, while very widely
(03:59):
used in healthcare simulation,is also used in other kinds of
disciplines.
Our ASPE members have trainedschool principals, We've trained
chaplains in the military,lawyers, law students, police.
So we really look at simulatedparticipant as a term that is
(04:20):
being more increasingly adoptedworldwide.
Jerrod Jeffries (04:23):
Okay, and then you mentioned ASPE.
I know that you are leadingASPE.
Could you give us what theacronym stands for and then give
us a little bit more about thatorganization as well?
Dr. Lou Clark (04:33):
Sure ASPE stands for, and it's great because it
relates to this idea of what dowe call SPs.
Aspe was founded over 20 yearsago as the Association of
Standardized Patient Educationand a few years ago our
membership voted to change thename to the Association of SP
Educators because it's moreinclusive, and so that's the
(04:58):
official name now theAssociation of SP Educators.
We have just under 1,000 membersworldwide from 44 different
countries, and our members tendto be concentrated in North
America.
But again, we're really oneverywhere in terms of the globe
and the primary folks who areASPE members tend to be people
(05:23):
like the kind of job I hadstarting out in New Mexico
people who routinely coach SPsas part of their work day to day
.
And there's so much that goeswith that work which I can speak
to now or later, but I wouldsay that, as ASPE president, a
big part of my sort of callingto do this is to raise up and
(05:45):
amplify the hidden work of SPeducators, because a lot of it
takes place behind the scenes,especially because the SPs are
the ones front facing withlearners and faculty.
So all that kind of preparatorywork that happens before and
even behind the scenes during asimulation and after tends to go
unnoticed.
(06:06):
Not for any sort of bad reason.
It's just that so much of it ishappening behind the scenes
that people don't often noticeit, and so I've really been
trying to amplify that.
Jerrod Jeffries (06:17):
But it also goes ties in pretty well to your
acting and theater background,where there's so much prep for
an actor.
I assume right, correct me ifI'm wrong but reading lines,
memorizing those, trying to getin the right flow, and then when
it comes to that 15 minutes offame on the screen or whatever
it may be on the stage, thenyou're like, oh, that must be
really easy.
But you don't really see the,and so there's a little bit of a
(06:38):
crossover.
Dr. Lou Clark (06:40):
I definitely think that.
I think that very much, Jerrod.
That's really astute is thatprobably 95% of the work that we
do with SPs is happening wherelearners and faculty, who aren't
in a center day to day can'tsee it.
And it is that behind thescenes, that offstage work.
And so most recently I'vecollaborated with nine other SP
(07:01):
educators who are alsoresearchers from around the
world, with nine other SPeducators who are also
researchers from around theworld, and we will soon have
published in the journalSimulation Healthcare Journal an
editorial, a peer-reviewed,invited editorial, called Call
to Action Honoring SPs andCollaborating with SP Educators.
And what we've sought to do inthis publication is to really
(07:23):
call out the contributions ofthe SPs, who I see as
educational change agents theyreally are and then the work
that we do as SP educatorsbehind the scenes, that often
hidden work that supports themin making these contributions.
Deb Tauber (07:40):
To follow up on that .
How do you see simulatedparticipants contribute to
health professions education?
Dr. Lou Clark (07:48):
Such a great question.
I see it every day.
I see it in small ways, in bigways.
You walk through anybody whohas one of our programs, any of
our ASPE members.
You go to their center and yousee, say, a medical student, a
nursing student, an alliedhealth profession student role
playing with an SP in aformative setting.
You know there could be asituation where I think
(08:11):
constructive verbal and writtenfeedback is the gold here.
I really do.
I think it's great you can workwith SPs to assess your learners
, but where I see a lot of thereal learning happening is
through that feedback processwhere the SPs can provide the
feedback directly to the learnerfrom the patient perspective.
Because we know the power ofthis methodology is that actual
(08:37):
patients don't often give youthat feedback right.
It's really rare to have apatient give a clinician
feedback in the clinical setting, whether that's an outpatient
clinic, the hospital, and so thewhole point, one of the whole
points of SP methodology, isthat patient perspective in the
scope of learning.
And how does that influence andsupport and guide the learner?
(09:01):
Of course we know there areclinical milestones in every
sort of health professionsprogram.
The SPs add thepatient-centered component.
Deb Tauber (09:09):
Yes, it certainly is a great outlet for feedback for
the learner because, you'reright, they don't get that
opportunity to get feedback onhow they're doing as a clinician
and how that directed thefeelings of the actual,
standardized simulatedparticipants.
Dr. Lou Clark (09:32):
I think, also to add to that in a way that we
strive, through our professionalASPE standards of best
practices, to do this in arigorous way.
There is an ASPE methodologyand there are five domains of
our best practices.
This is a publication thatanybody can find.
(09:52):
It's freely downloadable.
It was published in 2017 inAdvances in Simulation and it's
currently being revised.
I'm very excited there's goingto be a new version of the
standards out within the nextyear or so.
But these standards number onedomain is safety and so, just
like any other sort ofsimulation modality because we
know safety is paramountthroughout simulations why we do
(10:14):
it in part.
This is a little bit interestingbecause there are nuances when
you are working with humanbeings that are the vehicle or
that they're allowing themselvesto be the teaching tool, right.
So SPs are partners.
They're our allies in teaching.
One of the tenets in this newpublication I mentioned is we're
(10:36):
really trying to get a culturalshift and a linguistic shift
going among the simulationcommunity so that we stop saying
that we're using SPs becausethat using people carries a
negative connotation.
We don't want to use people inour daily lives right In our
lives, in work and just personaldaily living.
(10:57):
Well, we shouldn't use SPsright.
The SPs are our partners,they're our allies, they're the
people who are with us.
You know teaching and so I thinkpart of that shift, that
cultural and linguistic shift,is about safety, not only in the
space for learners but in thespace for SPs who are helping us
(11:18):
carry out the learning.
So we need to regard SPs asadult learners themselves.
So we need to regard SPs asadult learners themselves.
SP educators, coach SPs andthen SPs themselves are the
instrument of the education, thehuman living instrument, and so
this is why safety in SPeducation and SP methodology is
(11:40):
a very nuanced topic, becauseyou really have to pay attention
to psychosocial safety andwhere we're seeing this so
importantly especially, I thinkthere's been such a shift in
call since the pandemic tofurther diversify SP programs
and pools.
Every you know I hear this alot from our members, I
(12:01):
experienced it myself.
My home institution is theUniversity of Minnesota in
Minneapolis, and we have a lotof faculty coming to us saying
can we get a sim that helpsstudents learn about how to care
for transgender patients?
Can we get a sim where we'rereally making sure that we have
BIPOC or Black Indigenous Peopleof Color as the SPs, or Black
(12:21):
Indigenous people of color asthe SPs.
And it's great to want todiversify health professions
education and we need to bemindful to support the
individuals who are stepping upand saying I will be your SP
from a BIPOC community, I willbe your SP as a transgender
(12:42):
person.
We have to support them as theydo the work, prepare them to do
it and we call it de-roll themafter they do the work, because
the last thing we would want todo is further marginalize or
hurt a person coming from acommunity that is historically
(13:03):
underserved health professionsand healthcare.
So this is the kind of safetythat SP educators promote,
advocate for and navigate on aroutine basis with our SPs.
Jerrod Jeffries (13:17):
That's wonderful and I want to dig into
actually one piece you talkedin there and that was about the
SP educators.
So what is their role or whatdoes it entail?
And maybe even morespecifically, how do they coach
or support?
Because I think we also touchedupon the before, during and
after, because I also wanted tohammer in a little on the after
(13:38):
piece.
But yeah, SP, educators andkind of the process throughout.
Dr. Lou Clark (13:43):
I really appreciate that question.
And again, it's hidden workoften.
So SP educators do everythingfrom recruiting SPs.
So when a faculty member comesand says we really want to do
this, I'll give you an example.
In my own institution, a reallycollaborative group of pharmacy
faculty came and said we wantto do inclusive cases and we
(14:06):
want to do them with SPs.
One in particular we want to doinvolves transgender care
trying to explain medication toa transgender patient who opts
to start going on hormones.
And so as we began to thinkabout OK, well, how do we
approach this, to think aboutokay, well, how do we approach
(14:27):
this?
The work of myself and anothermember of our SP education team
included collaboratively writingthe case or the scenario.
So we collaborate on creatingthe SP case, the curriculum the
students will experience.
Often I'm coaching faculty whodon't have as much experience in
sim on things like writinglearning objectives to make the
(14:49):
sim effective.
That's very standard for our SPeducators.
To help create that, we giveadvice on performance assessment
tools that have to do withcommunication skills.
That's a very standard for us.
We have knowledge of that.
Anybody who's been in SPmethodology for a while you kind
of get that knowledge of how doI write, how do I help that
(15:10):
faculty member write the case sothat it really works
effectively when it's brought tolife?
So you can imagine that was oneof the first things I really
grabbed onto as a playwright,because and a lot of, I should
mention this a strength of ASPEis the interdisciplinary nature
of the members.
So ASPE members come from alldifferent backgrounds, most
(15:32):
predominantly education,psychology, theater and the
performing arts, communication.
We do have healthcare folks inthere as well, but it's a real
mix and it really leans towardsarts, social sciences, education
.
So we really bring that pieceto the work as SP educators and
again, it's often hidden work,you know.
(15:54):
So we help create the scenariosI mentioned about the safety.
Not only are we helping tocreate the scenarios from a
curricular standpoint, we'realso offering guidance on
logistics as to how to bring theSIM to life.
And that's not just aboutmoving people around, it's about
, well, how many encountersshould that trans SP do before
(16:15):
they get a break?
What kind of content in thecase would be appropriate for
them to portray?
And have we involved a transperson in the writing of the
case?
And so in our standards and inthe work that we promote.
We're really promotinginclusive case writing.
So to involve, as they arewilling and want to be involved,
(16:39):
some of the SPs or communitymembers in and around our SP
programs who could help adviseus from their own lived
experience right?
So in the example I'm sharing,that is not my way.
I identify as transgender.
I identify as cisgender, withshe, her pronouns, so I needed
to go and see was there anexpert I could go to?
(17:02):
A trans person?
And there was a wonderfulperson within our SP pool who
worked with me to write thiscase with the pharmacy faculty
and the case was better for it.
This person opted not toportray the case, which we
always respect.
So there are different ways youcan involve SPs and be mindful
of their comfort, you know, andsafety be mindful of their
(17:29):
comfort, you know, and safety.
Jerrod Jeffries (17:30):
So is all this, these benefits, because of the
membership into ASPE, or how doyou tap into these resources in
this, in this community?
Dr. Lou Clark (18:27):
Well, I would say a really great resource are the
ASPE highlighting for andadvocating transgender non sort
of initiatives within ourorganization?
So I think to your question,Jerrod, it really depends on
what the initiative is or theidea is and, that being said, we
pride ourselves on being veryinclusive and open organization.
Jerrod Jeffries (18:51):
Wonderful.
Deb Tauber (18:52):
What new initiatives are on the horizon for ASPE?
Dr. Lou Clark (18:56):
We have a very exciting initiative, which is a
new accreditation program forASPE.
It's long due because of someof the very nuanced sort of
things I've been sharing abouthow we work with ASPEs and ASPE
really is the foremostinternational organization that
has this expertise among ourmembers, and so immediate past
(19:19):
president, Sean Gilleen I reallywant to call him out has done a
wonderful job with a group ofpast presidents of ASPE and
others in launching thisinitiative.
So right now we are in theinaugural year of an
accreditation program for SPprograms from ASPE, and so we're
(19:39):
very excited, and ourconference will be in June 2025
in Montreal in Canada, Quebec,Canada, and the programs that
are accepted for this inauguralyear will be recognized at that
conference.
So we're very excited.
We're less than a year awayfrom the first SP programs
(20:01):
around the world beingrecognized with the official
ASPE SP program accreditation.
Jerrod Jeffries (20:07):
And I love it.
I absolutely love it, lou.
One what are the steps to learnmore?
Two what's that process looklike and how long does it take?
Dr. Lou Clark (20:15):
Yeah, so we have.
Anybody can find out more aboutit on our website and we just
closed last week the letter ofintent to apply for the
accreditation.
So there is an LOI process andif listeners are familiar to the
NACSIL endorsement program, youwould probably be familiar with
the type of process this is.
(20:37):
We designed it to be asstreamlined as possible and the
accreditation program isdesigned around our five domains
of our standards of bestpractices.
So I had mentioned I think I'dmentioned just two of them
because I sort of went off on atangent, but that is, five
domains are safety casedevelopment, so I mentioned that
(20:59):
one.
We really promote collaborativework from subject matter experts
, sp educators, sps, communitymembers, anybody relevant.
It always makes it better.
Domain three is the coaching orthe training of the SPs, where
we really want to see our SPeducators adopting adult
learning theory, best practicesin coaching adults, unless, of
(21:23):
course, your SP is pediatric oradolescent.
You know, then there are otherkinds of training you might
employ, but really, when itcomes to working with SPs, most
of us are working with adults,not all.
So we really want to see thosebest practices of how do you
coach adults, because adultsbring lived experience to any
training situation and you wantto honor it and you want to.
(21:46):
I think the nuance of trainingSPs, at least for me, has always
been to honor the livedexperience of the SPs in the
room, keep us on track, to stickto what do we need to get to to
cover the material, to bestserve the learning objectives
and be prepared to work with thelearners.
And then to be thinking aboutthings like affect, you know,
(22:08):
because nonverbal communicationis 75 to 80 percent of all
communication.
So we think about things likethat.
And then if you're doing anysort of assessment, you know
that and feedback I've alreadymentioned.
So those are really thingsencapsulated in the training.
And then domain four is themanagement of SP programs.
That's a lot, even more of thathidden work Jared with that
(22:30):
recruitment, onboarding of SPs,making sure the SPs are paid If
you have paid SPs as opposed tovolunteer or student SPs really
just keeping them on track,scheduling them all that hidden
work.
And then making sure that yourprogram adheres to institutional
policies and then we hope isguided by these ASPE standards
(22:53):
and best practices.
And then addition to all ofthat, domain five is
professional development, and wereally think about professional
development for SP educatorsand SPs, and so one resource
ASPE has is an annual researchaward that is administered
through our grants and researchcommittee of ASPE.
(23:14):
We know that SIM programs tendto run really lean.
While we get a lot of requeststo do innovative work, we aren't
always the ones who get todrive it.
We aren't often the ones whoget to drive it.
Oftentimes we're reacting toprojects that are presented to
us and we're collaborating onthose projects.
Something I love about the ASPEgrant is that SP educators can
(23:37):
apply and we use it to help fundinnovative work, and past
grants have included justprojects around how to promote
new curricula, and often withinthe last few years it's been
leaning towards initiativesaround equity, diversity,
inclusion and social justice,which again probably tells you a
little bit about ASPE as anorganization.
Deb Tauber (23:59):
Right, those are all very exciting things.
How many programs have set outto achieve this designation in
June?
Dr. Lou Clark (24:13):
We've had several and because we're right in the
thick of the application process, I will not provide an exact
number, but I will say what isvery exciting is the response
has exceeded our expectations.
So we've had a wonderfulresponse and more to come on the
numbers of this, but I think Ifeel very confident that Sean
and the team who are working onthis are ready, and it's a
(24:35):
wonderful problem to have whenyou're in the midst of bulking
up the reviewer pool, if youwill, because you had such a
great response.
So that's really literally whatwe were talking about last week
.
So it's a really nice situationand I wanted to share, just to
kind of like wrap up, why did Igo through all the standards?
(24:56):
Because that accreditationprogram is guided by the
standards.
Programs that will beparticipating will need to
demonstrate competency in allthe areas I spoke to.
Jerrod Jeffries (25:09):
Safety case development, coaching and
training, management of SPprograms and professional
development.
Dr. Lou Clark (25:14):
Yeah, excellent, you nailed it.
Jerrod Jeffries (25:15):
Yep.
Dr. Lou Clark (25:17):
Yep.
And then another initiative Ijust want to mention because I'm
very excited about it is inMontreal.
Our conference will bepre-conferences start May 31st
2025, and the conference willrun through June 4th in Montreal
, Quebec, canada 2025.
And we are going to be holdingthe first ever Human Simulation
Research Forum.
(25:37):
We are going to be havingspecial programming in terms of
different types of workshops tosupport ASPE members and
attendees on research skills toutilize with SPs, really going
to that mindset of not using SPsbut working with SPs, and how
(25:58):
do you take on practices ofresearch when you're doing
research with human simulation.
And I'm very excited becausecoming out of this will be an
ASPE driven research agenda forhuman simulation.
Jerrod Jeffries (26:15):
It's very exciting.
Has that been done before?
Dr. Lou Clark (26:17):
To my knowledge, no, not by ASPE.
And so Sean's passion, which isresulting in this incredible
project and gift to ASPE, as Imentioned, is this accreditation
and my real passion as a artist, as someone who's trained as a
qualitative researcher andreally I started my doctorate at
(26:38):
age 40.
I came to this to beinginvolved in research through the
membership I received as a partof the ASPE Grants and Research
Committee.
It was the senior members ofthat committee who mentored me
from the moment I kind of walkedin the door as someone very
interested in training and whatdoes it mean to train SPs and
(27:01):
how can we talk about the skillsthat only uniquely ASPE members
bring?
A unique interdisciplinary skillset and I have seen over time
how special that is and theunique contributions that our
members as SP educators makebehind the scenes in the
development of SP education.
(27:21):
And I want to see our memberscelebrated and recognized and
it's critical that we documentin the research, in the
literature, our own practicesand the hidden labor of what we
do.
So that's what I feel I cancontribute as someone who really
started off as an artist SPeducator coaching SPs, went on
(27:46):
to engage in research because Iwas mentored.
So my real passion is mentoringmembers and making sure that
all the great work our membersare doing is documented, really,
and we're advancing simulationas a profession through our
innovations and that needs to becalled out and it needs to be
(28:09):
recognized.
And for us to have that happen,we have to take responsibility
and make it happen.
So that's why we're doing this.
Deb Tauber (28:16):
For sure.
It's very obvious that you'reextremely passionate about
standardized patients andsimulated participants, as the
new language would have it, andwe're thankful to you for all
that you're doing.
Do you have anything that youwant to leave our listeners with
?
Dr. Lou Clark (28:35):
I think I would say this, and it may be
surprising I think a lot abouttechnology as well.
I think about AI.
It's the new thing, right, andso I think for years, what's
been really interesting becausethis is almost 20 years for me
working with SPs is that a newsort of technology comes along
(28:55):
and a friend, a good-naturedfriend, who errs more towards
technical sim, will say, well,there won't be SPs a few years
from now, and they give me kindof like a nod or a wink or
whatever.
So I'll say I don't think so.
I think, as long as healthcareprofessionals are treating and
caring for us as human beings,the role and the contribution of
(29:18):
the SP is singular, it's unique, and I also think it's critical
for us who identify more on thehuman simulation side of the
profession, we must engage andcollaborate with people who have
technical expertise, and so Ithink it's really critical that
(29:40):
we approach this in acollaborative way, and so I just
want to leave listeners withthat.
There is room for everyone tobe a part of SP methodology, and
I think we need to collaboratewith our colleagues who have the
experience and the expertise inAI and virtual reality and
augmented reality, because webring what is uniquely human and
(30:03):
that will inform theirtechnology, and together we can
really innovate and push thisprofession forward.
Deb Tauber (30:11):
Thank you.
Yeah, thank you for yourcontributions.
We appreciate.
Will you be at IMSH this year?
Dr. Lou Clark (30:18):
I will.
I'm really looking forward toit and I hope I see you there.
Yeah, yeah, all right, this isfantastic.
Jerrod Jeffries (30:26):
Thank you so much for the time yeah.
Dr. Lou Clark (30:28):
Thank you for having me.
Thank you so much for having meand for highlighting ASPE.
We appreciate it.
Deb Tauber (30:35):
You're very welcome.
It's been a pleasure and honor.
Thank you and happy simulating.
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(00:23):
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Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions, editedby Shelly Houser.
Join our host, Deb Tauber, andco-host, Jerrod Jeffries as they
(00:49):
sit down with subject matterexperts from across the globe to
reimagine clinical educationand the use of simulation.
So pour yourself a cup ofrelaxation, sit back, tune in
and learn something new from TheSim Cafe.
Deb Tauber (01:16):
Welcome to The Sim Cafe.
Thank you for joining us today.
Today we have Jerrod as co-hostand we have Dr Lou Clark, so
welcome, Dr Clark, and thank youso much for agreeing to being a
guest with us today.
Dr. Lou Clark (01:31):
Thanks for having me, Deb and Jerrod, and just
kind of moving forward.
Please feel free to call me Lou, I'm very informal.
Jerrod Jeffries (01:38):
Thank you.
Dr. Lou Clark (01:38):
Thank you.
Jerrod Jeffries (01:39):
Thanks for being here, Lou.
Absolutely.
I think there's a lot to getinto, but maybe we want to level
set with all our listeners andfirst, starting off, could you
give us a little bit about yourbackground, where you come from,
what you're doing now?
Dr. Lou Clark (01:53):
Yeah, absolutely.
I didn't start out to be aneducator or in simulation.
I think, like a lot ofsimulationists of my generation,
like a lot of simulationists ofmy generation, I started off
life in the theater.
I'm a trained actor and singerand did the freelancing and all
those kinds of things in a fewdifferent cities and got my
(02:14):
master's of fine arts indramatic writing.
So I'm also a playwright, andthat was at the University of
New Mexico.
And as I was getting out ofschool and this was back in 2007
, I wanted to stick around and afriend of mine said you know,
there's this amazing job.
You should go down to themedical school because you would
be, you'd be really good atthis.
(02:34):
They need someone to coach theactors.
And that was how I got involved.
That was my first position wasas an SP educator at the
University of New Mexico inAlbuquerque.
It's a wonderful program andfrom there I really discovered
that this job that I sort oftook on as a day job was really
meaningful.
It was rewarding to use theskills that I have as an artist,
(02:58):
as a theater artist, in serviceof healthcare, training and
education.
And so I went on from there,got very interested in
communication, because that'ssuch a part of performing arts,
and got a doctorate in healthcommunication and organizational
communication from ArizonaState University.
So I've been in SIM since 2007.
And what keeps me excited towork with SPs is just that
(03:24):
connection that I've watchedthem make on a routine basis and
how that really transformslearners.
Jerrod Jeffries (03:31):
And just to clarify SPs, for some of our
listeners might be yeah.
Dr. Lou Clark (03:35):
So that's a really interesting clarification
, Jared, because there are somany different ways to name who
are SPs.
And I will say today you know,late in 2024, we are really
adopting simulated participantas a term widely and this is
because the methodology, the SPmethodology, while very widely
(03:59):
used in healthcare simulation,is also used in other kinds of
disciplines.
Our ASPE members have trainedschool principals, We've trained
chaplains in the military,lawyers, law students, police.
So we really look at simulatedparticipant as a term that is
(04:20):
being more increasingly adoptedworldwide.
Jerrod Jeffries (04:23):
Okay, and then you mentioned ASPE.
I know that you are leadingASPE.
Could you give us what theacronym stands for and then give
us a little bit more about thatorganization as well?
Dr. Lou Clark (04:33):
Sure ASPE stands for, and it's great because it
relates to this idea of what dowe call SPs.
Aspe was founded over 20 yearsago as the Association of
Standardized Patient Educationand a few years ago our
membership voted to change thename to the Association of SP
Educators because it's moreinclusive, and so that's the
(04:58):
official name now theAssociation of SP Educators.
We have just under 1,000 membersworldwide from 44 different
countries, and our members tendto be concentrated in North
America.
But again, we're really oneverywhere in terms of the globe
and the primary folks who areASPE members tend to be people
(05:23):
like the kind of job I hadstarting out in New Mexico
people who routinely coach SPsas part of their work day to day
.
And there's so much that goeswith that work which I can speak
to now or later, but I wouldsay that, as ASPE president, a
big part of my sort of callingto do this is to raise up and
(05:45):
amplify the hidden work of SPeducators, because a lot of it
takes place behind the scenes,especially because the SPs are
the ones front facing withlearners and faculty.
So all that kind of preparatorywork that happens before and
even behind the scenes during asimulation and after tends to go
unnoticed.
(06:06):
Not for any sort of bad reason.
It's just that so much of it ishappening behind the scenes
that people don't often noticeit, and so I've really been
trying to amplify that.
Jerrod Jeffries (06:17):
But it also goes ties in pretty well to your
acting and theater background,where there's so much prep for
an actor.
I assume right, correct me ifI'm wrong but reading lines,
memorizing those, trying to getin the right flow, and then when
it comes to that 15 minutes offame on the screen or whatever
it may be on the stage, thenyou're like, oh, that must be
really easy.
But you don't really see the,and so there's a little bit of a
(06:38):
crossover.
Dr. Lou Clark (06:40):
I definitely think that.
I think that very much, Jerrod.
That's really astute is thatprobably 95% of the work that we
do with SPs is happening wherelearners and faculty, who aren't
in a center day to day can'tsee it.
And it is that behind thescenes, that offstage work.
And so most recently I'vecollaborated with nine other SP
(07:01):
educators who are alsoresearchers from around the
world, with nine other SPeducators who are also
researchers from around theworld, and we will soon have
published in the journalSimulation Healthcare Journal an
editorial, a peer-reviewed,invited editorial, called Call
to Action Honoring SPs andCollaborating with SP Educators.
And what we've sought to do inthis publication is to really
(07:23):
call out the contributions ofthe SPs, who I see as
educational change agents theyreally are and then the work
that we do as SP educatorsbehind the scenes, that often
hidden work that supports themin making these contributions.
Deb Tauber (07:40):
To follow up on that .
How do you see simulatedparticipants contribute to
health professions education?
Dr. Lou Clark (07:48):
Such a great question.
I see it every day.
I see it in small ways, in bigways.
You walk through anybody whohas one of our programs, any of
our ASPE members.
You go to their center and yousee, say, a medical student, a
nursing student, an alliedhealth profession student role
playing with an SP in aformative setting.
You know there could be asituation where I think
(08:11):
constructive verbal and writtenfeedback is the gold here.
I really do.
I think it's great you can workwith SPs to assess your learners
, but where I see a lot of thereal learning happening is
through that feedback processwhere the SPs can provide the
feedback directly to the learnerfrom the patient perspective.
Because we know the power ofthis methodology is that actual
(08:37):
patients don't often give youthat feedback right.
It's really rare to have apatient give a clinician
feedback in the clinical setting, whether that's an outpatient
clinic, the hospital, and so thewhole point, one of the whole
points of SP methodology, isthat patient perspective in the
scope of learning.
And how does that influence andsupport and guide the learner?
(09:01):
Of course we know there areclinical milestones in every
sort of health professionsprogram.
The SPs add thepatient-centered component.
Deb Tauber (09:09):
Yes, it certainly is a great outlet for feedback for
the learner because, you'reright, they don't get that
opportunity to get feedback onhow they're doing as a clinician
and how that directed thefeelings of the actual,
standardized simulatedparticipants.
Dr. Lou Clark (09:32):
I think, also to add to that in a way that we
strive, through our professionalASPE standards of best
practices, to do this in arigorous way.
There is an ASPE methodologyand there are five domains of
our best practices.
This is a publication thatanybody can find.
(09:52):
It's freely downloadable.
It was published in 2017 inAdvances in Simulation and it's
currently being revised.
I'm very excited there's goingto be a new version of the
standards out within the nextyear or so.
But these standards number onedomain is safety and so, just
like any other sort ofsimulation modality because we
know safety is paramountthroughout simulations why we do
(10:14):
it in part.
This is a little bit interestingbecause there are nuances when
you are working with humanbeings that are the vehicle or
that they're allowing themselvesto be the teaching tool, right.
So SPs are partners.
They're our allies in teaching.
One of the tenets in this newpublication I mentioned is we're
(10:36):
really trying to get a culturalshift and a linguistic shift
going among the simulationcommunity so that we stop saying
that we're using SPs becausethat using people carries a
negative connotation.
We don't want to use people inour daily lives right In our
lives, in work and just personaldaily living.
(10:57):
Well, we shouldn't use SPsright.
The SPs are our partners,they're our allies, they're the
people who are with us.
You know teaching and so I thinkpart of that shift, that
cultural and linguistic shift,is about safety, not only in the
space for learners but in thespace for SPs who are helping us
(11:18):
carry out the learning.
So we need to regard SPs asadult learners themselves.
So we need to regard SPs asadult learners themselves.
SP educators, coach SPs andthen SPs themselves are the
instrument of the education, thehuman living instrument, and so
this is why safety in SPeducation and SP methodology is
(11:40):
a very nuanced topic, becauseyou really have to pay attention
to psychosocial safety andwhere we're seeing this so
importantly especially, I thinkthere's been such a shift in
call since the pandemic tofurther diversify SP programs
and pools.
Every you know I hear this alot from our members, I
(12:01):
experienced it myself.
My home institution is theUniversity of Minnesota in
Minneapolis, and we have a lotof faculty coming to us saying
can we get a sim that helpsstudents learn about how to care
for transgender patients?
Can we get a sim where we'rereally making sure that we have
BIPOC or Black Indigenous Peopleof Color as the SPs, or Black
(12:21):
Indigenous people of color asthe SPs.
And it's great to want todiversify health professions
education and we need to bemindful to support the
individuals who are stepping upand saying I will be your SP
from a BIPOC community, I willbe your SP as a transgender
(12:42):
person.
We have to support them as theydo the work, prepare them to do
it and we call it de-roll themafter they do the work, because
the last thing we would want todo is further marginalize or
hurt a person coming from acommunity that is historically
(13:03):
underserved health professionsand healthcare.
So this is the kind of safetythat SP educators promote,
advocate for and navigate on aroutine basis with our SPs.
Jerrod Jeffries (13:17):
That's wonderful and I want to dig into
actually one piece you talkedin there and that was about the
SP educators.
So what is their role or whatdoes it entail?
And maybe even morespecifically, how do they coach
or support?
Because I think we also touchedupon the before, during and
after, because I also wanted tohammer in a little on the after
(13:38):
piece.
But yeah, SP, educators andkind of the process throughout.
Dr. Lou Clark (13:43):
I really appreciate that question.
And again, it's hidden workoften.
So SP educators do everythingfrom recruiting SPs.
So when a faculty member comesand says we really want to do
this, I'll give you an example.
In my own institution, a reallycollaborative group of pharmacy
faculty came and said we wantto do inclusive cases and we
(14:06):
want to do them with SPs.
One in particular we want to doinvolves transgender care
trying to explain medication toa transgender patient who opts
to start going on hormones.
And so as we began to thinkabout OK, well, how do we
approach this, to think aboutokay, well, how do we approach
(14:27):
this?
The work of myself and anothermember of our SP education team
included collaboratively writingthe case or the scenario.
So we collaborate on creatingthe SP case, the curriculum the
students will experience.
Often I'm coaching faculty whodon't have as much experience in
sim on things like writinglearning objectives to make the
(14:49):
sim effective.
That's very standard for our SPeducators.
To help create that, we giveadvice on performance assessment
tools that have to do withcommunication skills.
That's a very standard for us.
We have knowledge of that.
Anybody who's been in SPmethodology for a while you kind
of get that knowledge of how doI write, how do I help that
(15:10):
faculty member write the case sothat it really works
effectively when it's brought tolife?
So you can imagine that was oneof the first things I really
grabbed onto as a playwright,because and a lot of, I should
mention this a strength of ASPEis the interdisciplinary nature
of the members.
So ASPE members come from alldifferent backgrounds, most
(15:32):
predominantly education,psychology, theater and the
performing arts, communication.
We do have healthcare folks inthere as well, but it's a real
mix and it really leans towardsarts, social sciences, education
.
So we really bring that pieceto the work as SP educators and
again, it's often hidden work,you know.
(15:54):
So we help create the scenariosI mentioned about the safety.
Not only are we helping tocreate the scenarios from a
curricular standpoint, we'realso offering guidance on
logistics as to how to bring theSIM to life.
And that's not just aboutmoving people around, it's about
, well, how many encountersshould that trans SP do before
(16:15):
they get a break?
What kind of content in thecase would be appropriate for
them to portray?
And have we involved a transperson in the writing of the
case?
And so in our standards and inthe work that we promote.
We're really promotinginclusive case writing.
So to involve, as they arewilling and want to be involved,
(16:39):
some of the SPs or communitymembers in and around our SP
programs who could help adviseus from their own lived
experience right?
So in the example I'm sharing,that is not my way.
I identify as transgender.
I identify as cisgender, withshe, her pronouns, so I needed
to go and see was there anexpert I could go to?
(17:02):
A trans person?
And there was a wonderfulperson within our SP pool who
worked with me to write thiscase with the pharmacy faculty
and the case was better for it.
This person opted not toportray the case, which we
always respect.
So there are different ways youcan involve SPs and be mindful
of their comfort, you know, andsafety be mindful of their
(17:29):
comfort, you know, and safety.
Jerrod Jeffries (17:30):
So is all this, these benefits, because of the
membership into ASPE, or how doyou tap into these resources in
this, in this community?
Dr. Lou Clark (18:27):
Well, I would say a really great resource are the
ASPE highlighting for andadvocating transgender non sort
of initiatives within ourorganization?
So I think to your question,Jerrod, it really depends on
what the initiative is or theidea is and, that being said, we
pride ourselves on being veryinclusive and open organization.
Jerrod Jeffries (18:51):
Wonderful.
Deb Tauber (18:52):
What new initiatives are on the horizon for ASPE?
Dr. Lou Clark (18:56):
We have a very exciting initiative, which is a
new accreditation program forASPE.
It's long due because of someof the very nuanced sort of
things I've been sharing abouthow we work with ASPEs and ASPE
really is the foremostinternational organization that
has this expertise among ourmembers, and so immediate past
(19:19):
president, Sean Gilleen I reallywant to call him out has done a
wonderful job with a group ofpast presidents of ASPE and
others in launching thisinitiative.
So right now we are in theinaugural year of an
accreditation program for SPprograms from ASPE, and so we're
(19:39):
very excited, and ourconference will be in June 2025
in Montreal in Canada, Quebec,Canada, and the programs that
are accepted for this inauguralyear will be recognized at that
conference.
So we're very excited.
We're less than a year awayfrom the first SP programs
(20:01):
around the world beingrecognized with the official
ASPE SP program accreditation.
Jerrod Jeffries (20:07):
And I love it.
I absolutely love it, lou.
One what are the steps to learnmore?
Two what's that process looklike and how long does it take?
Dr. Lou Clark (20:15):
Yeah, so we have.
Anybody can find out more aboutit on our website and we just
closed last week the letter ofintent to apply for the
accreditation.
So there is an LOI process andif listeners are familiar to the
NACSIL endorsement program, youwould probably be familiar with
the type of process this is.
(20:37):
We designed it to be asstreamlined as possible and the
accreditation program isdesigned around our five domains
of our standards of bestpractices.
So I had mentioned I think I'dmentioned just two of them
because I sort of went off on atangent, but that is, five
domains are safety casedevelopment, so I mentioned that
(20:59):
one.
We really promote collaborativework from subject matter experts
, sp educators, sps, communitymembers, anybody relevant.
It always makes it better.
Domain three is the coaching orthe training of the SPs, where
we really want to see our SPeducators adopting adult
learning theory, best practicesin coaching adults, unless, of
(21:23):
course, your SP is pediatric oradolescent.
You know, then there are otherkinds of training you might
employ, but really, when itcomes to working with SPs, most
of us are working with adults,not all.
So we really want to see thosebest practices of how do you
coach adults, because adultsbring lived experience to any
training situation and you wantto honor it and you want to.
(21:46):
I think the nuance of trainingSPs, at least for me, has always
been to honor the livedexperience of the SPs in the
room, keep us on track, to stickto what do we need to get to to
cover the material, to bestserve the learning objectives
and be prepared to work with thelearners.
And then to be thinking aboutthings like affect, you know,
(22:08):
because nonverbal communicationis 75 to 80 percent of all
communication.
So we think about things likethat.
And then if you're doing anysort of assessment, you know
that and feedback I've alreadymentioned.
So those are really thingsencapsulated in the training.
And then domain four is themanagement of SP programs.
That's a lot, even more of thathidden work Jared with that
(22:30):
recruitment, onboarding of SPs,making sure the SPs are paid If
you have paid SPs as opposed tovolunteer or student SPs really
just keeping them on track,scheduling them all that hidden
work.
And then making sure that yourprogram adheres to institutional
policies and then we hope isguided by these ASPE standards
(22:53):
and best practices.
And then addition to all ofthat, domain five is
professional development, and wereally think about professional
development for SP educatorsand SPs, and so one resource
ASPE has is an annual researchaward that is administered
through our grants and researchcommittee of ASPE.
(23:14):
We know that SIM programs tendto run really lean.
While we get a lot of requeststo do innovative work, we aren't
always the ones who get todrive it.
We aren't often the ones whoget to drive it.
Oftentimes we're reacting toprojects that are presented to
us and we're collaborating onthose projects.
Something I love about the ASPEgrant is that SP educators can
(23:37):
apply and we use it to help fundinnovative work, and past
grants have included justprojects around how to promote
new curricula, and often withinthe last few years it's been
leaning towards initiativesaround equity, diversity,
inclusion and social justice,which again probably tells you a
little bit about ASPE as anorganization.
Deb Tauber (23:59):
Right, those are all very exciting things.
How many programs have set outto achieve this designation in
June?
Dr. Lou Clark (24:13):
We've had several and because we're right in the
thick of the application process, I will not provide an exact
number, but I will say what isvery exciting is the response
has exceeded our expectations.
So we've had a wonderfulresponse and more to come on the
numbers of this, but I think Ifeel very confident that Sean
and the team who are working onthis are ready, and it's a
(24:35):
wonderful problem to have whenyou're in the midst of bulking
up the reviewer pool, if youwill, because you had such a
great response.
So that's really literally whatwe were talking about last week
.
So it's a really nice situationand I wanted to share, just to
kind of like wrap up, why did Igo through all the standards?
(24:56):
Because that accreditationprogram is guided by the
standards.
Programs that will beparticipating will need to
demonstrate competency in allthe areas I spoke to.
Jerrod Jeffries (25:09):
Safety case development, coaching and
training, management of SPprograms and professional
development.
Dr. Lou Clark (25:14):
Yeah, excellent, you nailed it.
Jerrod Jeffries (25:15):
Yep.
Dr. Lou Clark (25:17):
Yep.
And then another initiative Ijust want to mention because I'm
very excited about it is inMontreal.
Our conference will bepre-conferences start May 31st
2025, and the conference willrun through June 4th in Montreal
, Quebec, canada 2025.
And we are going to be holdingthe first ever Human Simulation
Research Forum.
(25:37):
We are going to be havingspecial programming in terms of
different types of workshops tosupport ASPE members and
attendees on research skills toutilize with SPs, really going
to that mindset of not using SPsbut working with SPs, and how
(25:58):
do you take on practices ofresearch when you're doing
research with human simulation.
And I'm very excited becausecoming out of this will be an
ASPE driven research agenda forhuman simulation.
Jerrod Jeffries (26:15):
It's very exciting.
Has that been done before?
Dr. Lou Clark (26:17):
To my knowledge, no, not by ASPE.
And so Sean's passion, which isresulting in this incredible
project and gift to ASPE, as Imentioned, is this accreditation
and my real passion as a artist, as someone who's trained as a
qualitative researcher andreally I started my doctorate at
(26:38):
age 40.
I came to this to beinginvolved in research through the
membership I received as a partof the ASPE Grants and Research
Committee.
It was the senior members ofthat committee who mentored me
from the moment I kind of walkedin the door as someone very
interested in training and whatdoes it mean to train SPs and
(27:01):
how can we talk about the skillsthat only uniquely ASPE members
bring?
A unique interdisciplinary skillset and I have seen over time
how special that is and theunique contributions that our
members as SP educators makebehind the scenes in the
development of SP education.
(27:21):
And I want to see our memberscelebrated and recognized and
it's critical that we documentin the research, in the
literature, our own practicesand the hidden labor of what we
do.
So that's what I feel I cancontribute as someone who really
started off as an artist SPeducator coaching SPs, went on
(27:46):
to engage in research because Iwas mentored.
So my real passion is mentoringmembers and making sure that
all the great work our membersare doing is documented, really,
and we're advancing simulationas a profession through our
innovations and that needs to becalled out and it needs to be
(28:09):
recognized.
And for us to have that happen,we have to take responsibility
and make it happen.
So that's why we're doing this.
Deb Tauber (28:16):
For sure.
It's very obvious that you'reextremely passionate about
standardized patients andsimulated participants, as the
new language would have it, andwe're thankful to you for all
that you're doing.
Do you have anything that youwant to leave our listeners with
?
Dr. Lou Clark (28:35):
I think I would say this, and it may be
surprising I think a lot abouttechnology as well.
I think about AI.
It's the new thing, right, andso I think for years, what's
been really interesting becausethis is almost 20 years for me
working with SPs is that a newsort of technology comes along
(28:55):
and a friend, a good-naturedfriend, who errs more towards
technical sim, will say, well,there won't be SPs a few years
from now, and they give me kindof like a nod or a wink or
whatever.
So I'll say I don't think so.
I think, as long as healthcareprofessionals are treating and
caring for us as human beings,the role and the contribution of
(29:18):
the SP is singular, it's unique, and I also think it's critical
for us who identify more on thehuman simulation side of the
profession, we must engage andcollaborate with people who have
technical expertise, and so Ithink it's really critical that
(29:40):
we approach this in acollaborative way, and so I just
want to leave listeners withthat.
There is room for everyone tobe a part of SP methodology, and
I think we need to collaboratewith our colleagues who have the
experience and the expertise inAI and virtual reality and
augmented reality, because webring what is uniquely human and
(30:03):
that will inform theirtechnology, and together we can
really innovate and push thisprofession forward.
Deb Tauber (30:11):
Thank you.
Yeah, thank you for yourcontributions.
We appreciate.
Will you be at IMSH this year?
Dr. Lou Clark (30:18):
I will.
I'm really looking forward toit and I hope I see you there.
Yeah, yeah, all right, this isfantastic.
Jerrod Jeffries (30:26):
Thank you so much for the time yeah.
Dr. Lou Clark (30:28):
Thank you for having me.
Thank you so much for having meand for highlighting ASPE.
We appreciate it.
Deb Tauber (30:35):
You're very welcome.
It's been a pleasure and honor.
Thank you and happy simulating.
Disclaimer/Beaker Health (30:40):
Thanks to Beaker Health for sponsoring
this week's podcast.
Beaker Health, wheredissemination and measuring
impact comes easy.
Thanks for joining us here atThe Sim Cafe.
We hope you enjoyed.
(31:01):
Visit us at www.
innovativesimsolutions.
com and be sure to hit that likeand subscribe button so you
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