Dr. Jared Kutzin, Professor of Emergency Medicine and Medical Education at the Icahn School of Medicine at Mount Sinai and President of the Society for Simulation in Healthcare

In this episode, Dr. Jared Kutzin, Professor of Emergency Medicine and Medical Education at the Icahn School of Medicine at Mount Sinai and President of the Society for Simulation in Healthcare, discusses how simulation-based education is evolving with advanced technologies like VR and AI. He also shares insights into building scalable programs, fostering global collaboration, and preparing the healthcare workforce of tomorrow.

Episode Transcript

(00:00):
This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Jared Cutson, professor of emergency medicine and
medical education and senior director of simulation at
Icahn School of Medicine at Mount Sinai and
president of the Society for Simulation in Health
Care. Doctor Kudson, it's a pleasure to have
you on the podcast today. Thank you so
much for having me today. It's, really exciting

(00:22):
to be here with you. Absolutely. Well, I'm
looking forward to our conversation because I know
there are so many cool things that you're
you're doing,
at Mount Sinai, and, certainly, just a lot
happening in the health care space today. But
before we dive into that, can you introduce
yourself and tell us a little bit more
about the school of medicine?
Sure. So,
as you said, I'm a professor of emergency

(00:43):
medicine and medical education at the Icahn School
of Medicine and senior director for the simulation
teaching and research center at the Mount Sinai
Hospital, and the Mount Sinai Health System. So
we are a large integrated health system in
New York City. We have seven different campuses,
comprising everything from, academic medical center, quaternary care
hospitals to community hospitals,

(01:04):
trauma centers,
and freestanding emergency departments. So,
urgent care centers, behavioral health centers,
so it's a really large integrated system. We
have residencies
at multiple institutions,
and we have our medical school, the Icahn
School of Medicine at Mount Sinai, as well
as our graduate,
school of biomedical sciences
and our school of nursing.

(01:25):
So our Phillips School of Nursing, which is
a excellent program for, the health system as
well to ensure that we have a properly
trained and ready workforce across
specialties, for the health system, so both medicine
and nursing well represented.
I happen to be a nurse by background,
and I get to spend my day really
looking at and thinking about and and implementing,

(01:47):
immersive,
and technology forward educational opportunities for,
the learners in the health system. So everything
from undergraduate medical education through graduate medical education
and continuing professional development.
And so that's a little bit about what
I do during the day and a little
bit about the health system.
Absolutely. Well, it's fascinating. You know, what a
great background to have and bring into your

(02:09):
current role, really expertise across the board, on
the medical side as well as in simulation
and and continuing that professional development. So that's
great. From your perspective, what are some of
the trends that you're watching currently?
So in my space in particular,
we see a couple different things happening. One
is more integration of simulation based education throughout

(02:31):
the learning cycle.
Traditionally, when we think of simulation based learning,
a common notion is out of a standardized
patient or a standardized participant, that being a
person that a medical student is interacting with
to learn interpersonal communication skills, to learn how
to talk to patients or engage with them
or their family members.
But we're starting to see and and and

(02:52):
more along the continuum
of not just learning but also assessment. So
medical students have used simulation based learning for
quite some time as well as as our
nursing students,
clinical skills, IV catheterizations,
Foley catheterizations,
different heart lung sound exams.
But today, we're starting to see more use
of virtual reality, augmented reality,

(03:13):
artificial intelligence with, large language models and natural
language processing being incorporated into these,
immersive learning opportunities.
And then we're starting to see our,
governing bodies and our certifying bodies
requiring simulation based
assessments
for our learners as well. So emergency medicine

(03:34):
coming up this year for the first time,
has replaced their oral board exams, which traditionally
took place in a hotel like setting where
a faculty member would sit across from a
newly graduated resident and ask them questions about
how they would handle a certain situation,
to a more immersive format where all graduating
emergency medicine residents are gonna have to go
to a centralized location

(03:55):
and participate in not just standardized patient exams,
but also clinical skills assessments as well. And
so we're starting to see simulation based education
become more technology focused, more integrated,
but also
starting to use it for more high stakes
assessment or, summative assessment,
not just the formative assessment as it used
to be used for. And so those are

(04:16):
some of the really exciting things that we're
starting to see,
especially as technology advances and we're using more,
standalone headsets like the Oculus,
Quest headset,
which provides opportunities for our learners to engage
with content from multiple different areas, distance learning
simulations as well. We're starting to see that
technology become more prevalent, in our learning and

(04:38):
educational
portfolio
throughout the, educational life cycle of all of
our health system learners.
That's amazing to hear. You know, and really
cool to have that type of technology,
integrated into the learning process,
getting those students ready, then for for what
comes next and and beginning to jump in
with real patients.

(04:59):
From your perspective, what does it take to
set up a program like this? How do
you, make sure you have the right resources
in place and then the the team that
could, jump in and optimize the technology in
the right way?
Oh, it takes a couple different things, and
one is the institutional buy in. And so
we've talked a lot about how submission can
be used for our learners, our undergraduate and
graduate learners, and our continued professional development.

(05:20):
The one piece that we didn't mention was
the integration with our patient safety curriculum and
our patient safety focus quality improvement.
So preparing
our newly built environments for patients, testing out
those environments, focusing on reducing infections.
And so what I see is that it
takes really this broad,
dynamic group of people to come together and

(05:42):
say this isn't a technology that we're willing
to invest in. But more so than the
technology is the knowledgeable
and
able staff
to dynamically manage all of these different environments.
And so it takes educators. It takes process
improvement specialists. It takes simulation operation specialists.

(06:02):
It takes,
administrative
mindset to sort of meld all these together
because simulation is really where education,
patient safety, quality improvement,
the process improvement,
technology,
all of these things come together in the
simulation environment. You need to have a
workforce that's prepared to do that. And we
see that through a couple different ways. One

(06:23):
is finding the right clinical background of individuals
to be able to lead these programs, but
also integrate this with our clinical faculty across
the board. So being able to work with
our physicians, our respiratory therapists, our advanced practice
providers, PAs and MPs, and our nursing staff,
our ancillary staff, even all the way down
to our security staff who are taking basic
CPR and first aid and then integrating this

(06:45):
technology
into it. And so there's,
IT infrastructure and educational infrastructure that's required as
well.
The Society for Simulation and Health Care, which
I'm president of, offers certifications for both educators
and operation specialists. So that's a one sort
of marker of somebody's ability and knowledge base
to enter into this into this field and

(07:07):
into this career. And then we also offer
accreditation programs for simulation centers to demonstrate their
meeting of the standards that are set forth.
And so I think that when you are
working towards building a program like this, it's
both the technology and infrastructure that's necessary, but
also the personnel
and making sure that you're adhering to the
best practices that are in place.

(07:27):
And the field is changing so quickly and
so dynamically
that you have to have people who are
doing the research and keeping up on these
new technologies, emerging technology, and emerging uses as
well. And so all of those pieces really
come together,
and you have to have that leadership buy
in and support to be able to engage
with a multitude of different people across a
health system and an institution,

(07:49):
because we touch so many different areas and
impact so many different areas. We're able to
look at and utilize simulation for reducing central
line infections, which has a direct correlation to
the bottom line of an institution in terms
of the hospital acquired infections,
but we can also develop programs for patient
safety or staff safety,
which again may not have that direct correlation

(08:10):
to the bottom line but has that tangential
relationship to staff satisfaction and staff wellness. And
so really being able to get the leaders
in all of these different areas to understand
the value that immersive learning and technologically advanced
learning and,
new cutting edge learning can have in an
institution
takes some political capital and oftentimes,

(08:30):
a lot of negotiation.
But I think once organizations
realize it, they really do see the benefits
of having well established and well thought through
simulation based education programs as part of their
portfolio.
Got it. That makes a lot of sense.
You know, it's really helpful to dig dig
a little bit deeper, and peel back the
onion on some of those things because I
know, you know, there's so many organizations that

(08:52):
are trying to figure this piece out or
understand, you know, what they can do on
the virtual side and how it can, as
you mentioned, not only dovetail into some of
the great aspects of the training, but also
looking at the quality,
in other areas where it really makes a
big difference for continuing education for folks as
well.
I'm curious. If you look into the future,
what are you most focused on and excited

(09:13):
about?
I think there's a couple of things that
are really exciting. One, I think, is this
continued use of simulation for both formative and
summative assessment,
making sure that our clinicians who are working
in the clinical environment are prepared to enter
the clinical environment and then also recredentialed
and still have the best skills to care
for our patients.

(09:33):
I think the continued use of technology,
and there are other versions of what we
call, extended reality environments,
whether they're headset worn and augmented or virtual
reality. And augmented reality to me is, just
an amazing opportunity for learning and understanding different
concepts, but also environments where we recreate,

(09:54):
patient care environments or,
stressful situations by the use of something called,
a wave or a cave, which is a
wide,
area virtual environment or confined area virtual environment.
Think of this as a movie projected onto
a wall that immerses you in a realistic
environment
and then adding on to the realism.
So I was fortunate enough to go to

(10:16):
Lyon, France, where the World Health Organization,
has opened up their new simulation training facility.
And in this facility, they have this wide
area of virtual environment that can replicate a
disaster zone, heat emergencies, cold emergencies,
and then they've built the environment to actually
replicate the temperature and the humidity as well.
So with a push of a button, you
can go from a 35 degree environment

(10:38):
to a 95 or a hundred degree environment
with different humidity levels so that they can
prepare their workforce
for emerging,
diseases and emerging threats in in developing nations.
And so I think the use of simulation
is going to start continue to be ingrained
and start to be ingrained in multitude different
areas.
And we have a lot of opportunities to

(10:59):
partner and really build collaborative relationships. And that's
one of the other things that simulation is
so key for is to build interprofessional
collaborative relationships. And so EMS,
hospital based providers, disaster response work,
all these areas can come together within our
health system to really make sure that we're
providing the the quintessential best care, highest quality,

(11:21):
safest care for whoever enters into the health
system,
that our providers may be practicing in. And
so that to me is the exciting part
of this is those continued,
building of relationships,
the emerging use of those different technologies, and
then the continued use of formative and summative
assessments,
to ensure a prepared workforce going forward.
Got it. That's helpful to know. It's certainly

(11:43):
just fascinating to see some of those use
cases in other industries and and what that
could really mean for,
health care and and technology moving forward. It
seems like almost the sky's the limit here,
which is really, really cool.
It is,
but it's not cheap.
It's not cost prohibitive either, but it takes
that dedicated leader, that

(12:05):
boundary spanning idea
thinker to say, you know, this is something
that that the institution is going to value
and really invest in to move this
forward, both the space,
the equipment, the personnel.
It's it's not a again, not a cheap
investment,
but it's also not cost prohibitive when we're

(12:25):
talking about, you know, the grand total of,
what health care costs.
But the real returns, I think, you can
see from simulation based education and assessment and
integration into a health system,
are really demonstrable,
and I think that more and more health
systems are coming around to this.
Got it. That's really helpful to know.

(12:46):
Thank you so much. Is there anything else
from the last six to eighteen months or
so that you're really proud of that you
want to share with us?
A society for simulation and health care perspective,
I think what we're really excited about is,
the global expansion that we see in simulation
based education and the partnerships that we're starting
to form and,

(13:07):
foster,
and continually
integrate with across across the globe. So, the
Society for Simulation and Healthcare is a the
global leader in simulation based education.
Our annual conference draws over 5,000 people to
our meeting
from across the globe,
And so we are
continually seeing projects,

(13:28):
that are crossing the oceans and crossing the
land masses. And so,
there are projects in developing nations. We are
involved with a project in Nepal right now
to bring simulation based education and best practices
to,
hospital and university in Nepal.
Recent journal articles demonstrated the success of simulation
based education
in Sub Saharan Africa,

(13:50):
and there's tons of opportunities
for cross integration between, as you said, with
the other industries, the military and aviation,
the railroad industry, those high reliability organizations,
and health care. So I see the most
exciting part about this is the continued collaboration,
networking,
globalization
of,
this technology and this technique and partnering with

(14:12):
these other organizations worldwide.
We have a had a discussion yesterday with
a group in Germany who was developing a
virtual reality
neurological based simulation scenario that we're looking to
do some research with,
and on that technology to see how that
translates from the designers to our use here
in The United States because we think that
there's a gap in the education for some

(14:33):
of our neurology residents,
about a very specific skill. And so we're
excited to see if what they've built, will
be able to be utilized by our residents
and others going forward. So I think the
technology is certainly making the world smaller and,
pushing us forward, and I think those continued
collaborations and opportunities
to work together is what's really, really exciting.

(14:54):
That's great to hear, and and what a
great example of, again, another way collaboration and
and just, like, looking, you know, across industries,
is really meaningful. Now before we wrap up
here, what advice would you give to evolving
leaders today?
I think it's really about
thinking about your own world and how you
can expand it and being a boundary spanner.

(15:14):
So no matter where you are at, I
think it is important to make connections
with people,
across the system.
We started out, a couple of years ago
talking about virtual reality when it was still
sort of evolving, and we were doing programs
with our,
maintenance staff and our housekeeping staff.
And I think that, you know, when we're

(15:35):
talking about engaging our learners across the health
system, it really is
from our frontline nonclinical
staff, our security officers,
all the way up through the c suite
who come down and take part in ACLS
or our PAL certification
programs that uses some form of simulation technology.
Or it's with our in situ simulation programs

(15:57):
and actually bringing the learning opportunities out of
the sim center and into the clinical environment
by doing mock codes or simulated scenarios or
practicing in an environment where that is yet
to be open. And so I think it
really is about
expanding your boundaries and making those connections
because there are so many different
opportunities for simulation education

(16:19):
to get engaged with. As a new leader,
as a developing leader, it's about making those
connections, building your network, and ensuring that the
true value of whatever you're doing, it doesn't
have to just be in simulation, but so
the true value of what you're involved with,
is understood
by the people who, can help make those
decisions. So I think, you know, continuing to

(16:39):
network and making those connections is really, really
important.
Well, that's fantastic to hear. Doctor Cuttson, thank
you so much for joining us on the
podcast today. This has been really a fascinating
discussion, and I look forward to connecting with
you again soon. Thanks so much for having
me.