This CMS Grand Rounds features Susan Eller, Komal Bajaj, and Jenny Rudolph, moderated by James Lipshaw. The speakers discuss the article "Leading change in practice: how "longitudinal prebriefing" nurtures and sustains in situ simulation programs," written by authors Stephanie Barwick, Sarah Janssens, and today's three speakers.

Article Link: https://pubmed.ncbi.nlm.nih.gov/36681827/
More from CMS: https://harvardmedsim.org/resources/

Center for Medical Simulation Grand Rounds

Grand Rounds | Longitudinal Prebriefing for In-Situ Simulation

What to do when your debriefing gets dragged off-track by someone who was supposed to be on your side? Join us this week for more SimFails... and Other Conversations from the Sim Sofa.

SimFails... and Other Conversations from the Sim Sofa

SimFails #016: Not So Co-Debriefing

A nurse preceptor has just watched a trainee commit a serious error despite hours of lecture, reading, and hands on training. In spite of herself, she starts to heat up, much like the more severe clinical educators who trained her years ago. "Why can't you just get this right?"

In this moment, how do we reset ourself to a place of care, curiosity, and compassion? How do we model a better culture of learning? How do we have our judgment, instead of our judgment having us?

In "Curious Now with Jenny Rudolph," a social scientist takes on the hidden structures that shape our behavior, culture, communication, and learning in healthcare.

In this interactive podcast, Jenny Rudolph will help listeners approach the thoughts, feelings, and judgments underlying their reactions in a psychologically safer manner, helping us to better connect with curiosity and compassion to the people around us, especially when we feel that they've done something "wrong."

Jenny Rudolph has made a career exploring what makes clinicians, healthcare organizations, and health professions training programs tick. Underneath the surface of intelligent, capable people who care about doing their best are hidden patterns that interfere with how they perform. Hierarchy, ego, communication glitches, resilience, power, professional learning, and how learning happens all flow downstream into creating actions that work and actions that don’t. 

Jenny found out the hard way that being too certain can get you in trouble. Demoted from third to second grade for poor academic performance when she arrived in Jaipur, India as an eight-year-old, she realized she had better get curious about how her new school and culture ran, and that curiosity has remained with her ever since.

Jenny now works with clinicians around the world to help them develop their own love of that little dopamine drip of rewarding surprise when you find out something new about your colleagues and how they think. Whether trying to figure out a diagnosis, discovering what a learner is thinking, or upping your own clinical mastery, getting Curious Now is the solution.

Curious Now on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP?si=890ed4b02bfe4838
Curious Now on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Curious Now #1: Foundations of Good Judgment

Every "judgment" or "complaint" we have about others reveals a hidden standard that we hold about how people should behave, both in our general lives and in the workplace. By becoming aware of our own hidden standards, we can defuse the heat of arguments when we think someone else is doing something "wrong."

Learn more from Jenny Rudolph at www.harvardmedsim.org

Curious Now on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP?si=890ed4b02bfe4838

Curious Now on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Courses from CMS

Curious Now #2: Hidden Standards Behind Your Judgment

Welcome to our second chapter of Curious Now! We’re joined by a new set of simulation educators as they work through our weekly workouts together. For the next five episodes, we’ll have an Australian focus as we’re joined by B.J. So, an anesthetist and simulation educator based in the Sydney area, and Mel Barlow, a registered nurse and academic lead for faculty support at Australian Catholic University. They’ll share their experiences on both ends of the breach, from the perspective of a teacher who thought they and their student were on the same page, and a worker who thought their boss was promising something totally different from what they got.

Get coaching from Jenny Rudolph at www.harvardmedsim.org

Curious Now on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Curious Now on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Curious Now Listeners #6: "I set my learner up to fail..."

Little Acts of Genius: In this week’s Curious Now, we’re introducing the idea of ‘Frames, Actions, Results’, an action science framework that CMS has used for many years to help advanced clinical and debriefing practitioners overcome the internal obstacles that are keeping them from being able to reach their goals. Here, we want to apply the framework to other people’s actions—what could the person’s frame have been that, when we view their action through that frame, the totally strange or confounding thing they did is, in fact, a little act of genius?

•	Get coaching from Jenny Rudolph at www.harvardmedsim.org

•	Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

•	Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Curious Now #10: Little Acts of Genius

BJ So and Mel Barlow join us for the final time to discuss last week’s exercise of trying to come up with a frame to understand an action we saw that didn’t make sense in the moment. BJ shares the story of a near miss in a complex case, and how he tried to understand his junior doctor’s actions.

•	Get coaching from Jenny Rudolph at www.harvardmedsim.org

•	Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

•	Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Curious Now Listeners #10: "I could have asked for the frame."

In decades of faculty and clinician training at the Center for Medical Simulation, we’ve identified one element of our approach to Good Judgment learning conversations that people have the most difficulty with. This obstacle can take what should be an insightful, curious inquiry and leave it with a defensive or confused learner. Similar effects happen in negotiations at point of care and feedback conversations. The greatest obstacle is this: clearly and transparently sharing what you think about the situation. There are many reasons why we struggle with this, from thinking that if we share what we believe, it will be too harsh or too threatening for the other person, to believing that sharing our point of view will be used against us and that it would be safer to try to unilaterally steer the discussion without it. In this week’s workout, you’ll be challenged to try sharing your underlying point of view in a situation where that feels vulnerable to you.

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Curious Now #12: The Greatest Obstacle to Effective Learning Conversations

On this week’s Curious Now Listeners, Jenny, Laura Rock, and Janice Palaganas each share a recent time that they’ve struggled to be transparent with their own thinking as they rejoin us to discuss their experience with last week’s workout of sharing one vulnerable point of view in a conversation to try to work towards a collaborative inquiry rather than mystery and defensiveness.

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822



Curious Now Listeners #12: "You have to do a scene assessment."

This week on Curious Now, bring home the heart of this summer's work on internal resets, thought bystanding, communication, and teamwork. Our workout of the week is a simple one: go from mental rehearsal to actual practice. 

In previous weeks we asked ourselves, and this week ask the group:
•       “Who sees this differently?”
•       “What am I not noticing?”

Learn more and get coaching from Jenny Rudolph at at www.harvardmedsim.org.

Curious Now #13: How We Talk Shapes the Way We Work

Janice Palaganas and Laura Rock rejoin us to talk about their experiences of moving from mental rehearsal to actually asking the group, “What am I missing?” We explore what are the things we do or struggle with in terms of point of care conversations?

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Curious Now Listeners #13: "Culture is something we can change."

Today we’re talking about transforming toxic culture, whether on your floor, in your unit, or in your department. How do we change unit culture via point of care conversations? You can teach people all the speaking skills in the world, but if they don’t care about the other people in the room or don’t think there’s a possibility they aren’t perfectly right, it won’t take. This topic was featured in a keynote of the same name by our colleague Laura Rock at SESAM2025 this summer.

Workout of the week: Share your point of view, and follow it with a genuine, open inquiry into the other person’s perspective.

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Coaching from Jenny

Curious Now #14: Transforming Toxic Culture One Conversation at a Time

Laura Rock, Janice Palaganas and Jenny explore where they are currently struggling in their practice of sharing their point of view clearly and then really inviting the other person’s perspective. How does this go when your identity is more provisional, and you feel like to have to establish yourself and insert your point of view to be ‘strong’?

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Curious Now Listeners #14: "The curiosity is not there and everyone can feel it."

Dare to Be Ready with Dr. Chris Roussin, founder of CMS-ALPS, the Center for Medical Simulation’s team and organization readiness consulting service. In this podcast, available on Spotify, Apple Podcasts, and in video form on Youtube, Chris will meet with a series of guests with specific readiness challenges in their healthcare teams. Each week we will approach the challenge of how to get teams ready for the difficult work they face every day, and work through how we can get our people and teams ready to face that challenge. Join us monthly and Dare to Be Ready!

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Episode 1: Ready to Help “Safe” Patients with Diabetes in the ER

Dr. Marie McDonnell is an Endocrinologist and Director of Diabetes at the Brigham and Women’s Hospital, joins us to discuss her team’s readiness challenges around training with the Emergency Room to connect triaged emergency care with diabetes specialty care. 

Readiness Challenges: The care teams in the Emergency Room are ready and skilled in treating patients with diabetes who come in very sick and need to be admitted to the hospital. However, the Emergency Room also experiences a very high volume of diabetes recidivism, patients with diabetes who are stabilized and able to be discharged but then return later with the same issue presenting again. This is compounded by the fact that 50% of diabetes patients in the ER arrive between 5 PM and 9 AM because they could not contact their normal endocrinology care teams.

Today we work on a readiness plan to help ER teams better connect into the big system of diabetes care within the hospital so that patients who are “safe” get connected with specialists who can solve the underlying diabetes self-care issues that brought them to the ER, so that they don’t end up back in the ER later that day.

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Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/)

Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/)

Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety

Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822



Readiness w/ CMS-ALPS

DTBR #1: Ready to Help "Safe" Patients with Diabetes in the ER

This week on Curious Now we’re introducing a tool to help us bring the approach of understanding why people did what they did and helping them change the underlying analysis that got them into trouble, called the FAR or Frames, Actions, Results tool. 

Where has your team gotten stuck or glitchy, and what were the underlying frames that got your team intro trouble or got the job done great?

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/

More on the LPG: https://www.aliem.com/improving-debriefing-skills-pathways-grid/

Curious Now #15: Scaling Good Judgment to Your Team

This week Laura Rock and Janice Palaganas return to crack the code of team culture, map the blueprint underneath what we’re thinking. In the final episode of this chapter, we ask our guests what they’ve discovered about themselves with a Frames, Actions, Results test.

Janice has a glitch with a student where their understandings didn’t match, and Laura shares how being honest about her own critical care strengths and weaknesses with a group of trainees helped them focus on learning the most from her and other members of the team.

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Curious Now Listeners #15: "There's a little sigh of relief."

We have an incredibly special guest this week on Curious Now! Amy Edmondson, Professor at Harvard Business School, and author of numerous books including Right Kind of Wrong: The Science of Failing Well, Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy and The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth joins us to discuss her concept of psychological safety, how a failed study led to its invention, and how leaders can create organizations that learn.

An initial study with a well-validated tool found a correlation between having better teams and having HIGHER error rates. Reluctant to bring this result to her thesis advisor, she came to an idea: Maybe better teams don’t make more mistakes, but rather better teams are more willing to talk about mistakes.

Bringing psychological safety to the present day, Amy and Jenny discuss how the best examples of crisis leadership involve what Amy calls “situational humility,” the ability to say, “we’ve never been here before,” and then framing the problem as an opportunity to find solutions and seeking and inviting input, along with a continual refreshment of common purpose.

How can individuals create a “learning frame” to grow in a crisis rather than an “execution frame” where you’re just getting work done; being open to hearing feedback both from your colleagues and your work itself as you do it. 

While “learning work” can seem in the short term to take more energy or more bandwidth, in the broader view it creates vastly easier work through an increase in skill and understanding. Dr. Edmondson says, “If you’re not an organization that has found ways to hardwire learning and feedback loops into everything that it does, you will get caught unawares in a fast-changing, complex world.”

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Amy Edmondson: Creating Psychological Safety | Curious Now #16 Special Event

In this special episode, Jenny Rudolph and James Lipshaw, producer of Curious Now, debrief our performance so far with the podcast, what we had in our original vision that we haven’t achieved yet, and where we’d like to go next. How can we rachet up the interactivity of the podcast, how do we make the experience of trying to do this work right more relatable and less of a lecture, and how do we tune the difficulty of the workouts to the experience levels of our guests better?

Do you have feedback for Jenny on the first three chapters of Curious Now? Now is a great time to comment—let us know below this post what you’d like to see in the future, and how the workouts are going for you!

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Curious Now on Video: https://youtube.com/medicalsimulation

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/

Debriefing Jenny's Performance | Curious Now #17

Christian Balmer, an anesthesiologist and critical care doctor from Switzerland, joins us to look at the readiness of surgical teams in his organization to recognize and deal with cases that have gone beyond the capacity of the peripheral center to handle. 

Far from being a readiness plan around technical skills, the team discovers that it is the gray areas between intersecting teams and intersection institutions where the process of caring for the patient breaks down. Do the ICU teams at both hospitals agree about when is the right time to transfer the patient? Do the surgeons have training on stepping back and declaring that there is a crisis that needs to be managed via transport? Are there communication plans in place to make sure that the ICU has available beds, and to help the main hospital trust that when the peripheral group sends a patient, that patient has a real need for the ICU bed?

Finally, we discuss aligning training programs from healthcare schools all the way to the hospital—if health systems are looking for teams that can talk to one another, work with patients, and provide care in a particular way, how can we make sure that the schools that are training future healthcare workers are in communication and prioritizing the skills and ability to learn that they will need to be ready for the job?

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Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/)

Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/)

Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety

Readiness Planning in Advances in Simulation: https://advancesinsimulation.biomedcentral.com/articles/10.1186/s41077-024-00317-z

Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


DTBR#2: Ready to Declare a Case Has Gone Wrong

This week, Jenny and James explore recent conversations that didn’t go as well as they could have, because of different types of failures in the words we chose to use or the things we chose to reveal. Building on the work of recent guest Amy Edmondson, we look at the way that people in fearless organizations can talk—using the conversations that you have to frame the work, emphasize shared purpose to create joy even in everyday work, and demonstrate that you don’t think you have all the answers. 

Workout of the week: Observe for conversations where you feel unclear—what was the point of this meeting, why are we having this conversation, what are our goals of care for this patient?

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


A Deep Dive into Psychologically Safe Conversations | Curious Now #18

Too often, meetings and announcements, especially around policy changes and new ways of working, are a list of topics that fail to address the fundamental questions that matters to team members—why are we talking about this? Whose decision was it? And is that decision final?

Leaders and team members need to understand how power is being wielded, especially when it comes down the line in seemingly inhumane ways. By simply saying a few key words, we can make our teams feel like they had a voice, like power is not being used unfairly, and safe to say when they don’t understand and when they want input.

Workout of the week: Use the subject line of your emails to practice more clearly telling what the purpose of the conversation is.

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


What They Aren't Saying | Curious Now #19

When we lead a conversation where we only bring our conclusions and inferences to the table, rather than the concrete data that helped lead us there, we are influencing (sometimes unjustly) what is even discussable among our teams. By going back down to discussing the data that helped us shape those conclusions, we can make conversations and meetings more fair, more equal, and more productive.

Workout of the week: Note when you have gone up the ladder of inference to a conclusion about a person and perhaps lost track of the data that led you there. Then, go back down and incorporate the data into an observation. Example: “She was defensive” is an inference or conclusion. Go back down the ladder to the data and turn it into an observation: “I observed that she crossed her arms and said, ‘I don’t know,’ twice.” 

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/



Making Leadership More Fair | Curious Now #20

Why is it so hard for healthcare educators to share what they actually think in a debriefing or feedback situation? Jenny shares the story of a participant in an anesthesia clinical simulation who helped guide her to be more transparent: “I’m often talking to providers on the worst day of their career, after a medical error has occurred. If I’m going to ask them to be honest with me about what they were thinking, the least I can do is be honest about what I’m thinking.”

Over the years training faculty in feedback conversations, we’ve run into many who ask, how is it helpful to tell my learner that I think they’re an idiot? But telling the person what you think honestly should not be your feelings or attributions about their character. It should be the impact of their actions, which exist at the level of concrete data.

Workout of the Week: Practice saying to people, “When you did x, it led to y.” One great feature about this workout is that you can use it for positive things! “When you stayed late to help me with that report, it lowered my stress level.”

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Impact, Not Feelings | Curious Now #21

Just in time for the Thanksgiving Holiday— the CMS Book Club reviews “How to Avoid Awkward Silences” by Patrick King!

“You set the tone for how people react to this… when you act awkward and diffident, people feel awkward and diffident.” 

Join us as eight learning conversation experts debate the value of silence, and how we can get the conversation back to flowing when we feel like we’ve lost touch with what’s happening in the debriefing room, classroom, or around the family dinner table.

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822


Awkward Silences and How to Prevent Them | CMS Book Club #16

Dr. Catherine Allan, Director of the Cardiac Care Unit and Inpatient Cardiology at the Cleveland Clinic joins us to talk about readiness for teams to perform pediatric ECMO, a high-risk, high-complexity therapy that staff might only see a third as often as they see patients on ventilators. ECMO can also be called for during CPR, which greatly increases the time pressure and complexity of the procedure.
During ECPR, there is not only the ICU resuscitation microteam but also the surgical team and the perfusion team, leading to potentially having up to 20 people working in the room when running an ECPR case.

We discuss how leaders can help connect seemingly imposed efforts like checklists and huddles to what it is that frontline workers are trying to achieve and are meaningful to them, and how simulation program designers must do the same in order to make sure that training is not a top-down checklist but rather a mutually owned process that gets teams where they believe they need to go.

Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/)

Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/)

Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety

Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822



DTBR#3: Ready for Pediatric ECMO + ECPR

Debriefings are often delayed and diminished by questions the asker already knows the answer to. “Wouldn’t it have been better to give epinephrine faster?” “Did it occur to you to have a family meeting?” And when asked why they don’t just share what they clearly think is the answer, the debriefer will often say something like, “It’s better for them to come to the answer themselves.” But we aren’t really asking the learner to come to an answer with these kinds of questions—we’re asking them to read our mind, and then to agree with us once they do. There’s no opportunity for them to understand their own thinking better.

Today’s episode will try to get you ready to live with the discomfort of not knowing the answer you’re going to get for long enough to ask a genuinely curious question in debriefing.

Workout of the week: Every day, ask one truly open-ended, curious question—one you don’t already know the answer to.

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/

#healthcaresimulation #medicine #nursing #debriefing #podcast 

Why Real Questions Feel Risky in Debriefing | Curious Now #22

This week on Curious Now, we’re joined by an expert in the exploration phase of debriefing to help us better understand the “listen and explore” region of PAAIL. Bridget Van Gotten is a Learning and Design Strategist for the Zamierowski Institute for Experiential Learning at Kansas University Medical Center, and a 2015 alum of the CMS Healthcare Simulation Essentials: Design & Debriefing course.

The KUMC team designed a new approach to exploration when they found that in simulation, learners were simply agreeing with the debriefer’s point of view rather than trying to contrast it with their own thoughts, especially when they were doing the right thing (i.e. “I did the correct thing because that’s the correct thing to do.”) A second major discovery was that learners at all experience levels were describing the same barriers to success, rather than having different needs at different levels. For example, both med students and attendings might describe the busyness of the code space as making it difficult to claim a leadership role during the case, often using the exact same words.

Bridget coaches Jenny on how to conduct better explorations of learner thinking, in this case in a faculty development conversation about classroom management and maintaining the attention of learners.

#healthcaresimulation #nursing #medicine #debriefing

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Debriefing Universal Clinical Struggles (with Bridget Van Gotten) | Curious Now #23

We're taking this week off, but we'll have a new podcast on January 2nd, and the CMS media team will be in San Antonio from January 11-14 for IMSH 2026! We hope to see you there.

Happy Holidays, and See You at IMSH 2026!


This week, Jenny and James discuss how organizations, not just individuals, can have hidden or implicit standards that are not spoken aloud. We look at how a tool like the new Advocacy Inquiry Rubric, or AIR, can help make excellent performance visible, learnable, and repeatable, and how explicit standards help us target what actually matters in performance and what we want to move toward as a shared goal.

Workout of the Week: When you detect an implicit standard, say it out loud and make it explicit (but be sure to own that this is your perspective!). For example, “I believe that our standard in this unit is that if we need blood drawn from a patient, we start a new draw rather than using an existing IV.”

#healthcaresimulation #nursing #medicine #debriefing

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/


Making the Standard Explicit | Curious Now #24

Marjorie Lee White and Andres Viles, an Emergency Physician and Emergency Nurse from the University of Alabama-Birmingham join us to discuss how their organization has worked to integrate simulation into the health system at every level and in every program.

The story begins when the simulation program was put in charge of the response to the 2017 Ebola outbreak. Now people say “we need to simulate first” when new issues emerge. We discuss how the simulated run-through of complex plans can show the flaws in systems before they can potentially harm patients.

We also talk about how preparing for Ebola management through simulation gave expertise in donning and doffing and other PPE measures, including the technique of creating a remote doffing expert who helps tired providers stay safe at the end of procedures.

Andres Viles is a Simulation Coordinator, Senior and Director of Immersive Simulation in the Office of Inter-professional Simulation for Innovative Clinical Practice at UAB in Birmingham. He also holds the title of Training Coordinator for the UAB Serious Infectious Disease (SID) Team. 

Marjorie Lee White MD, MPPM, MA serves as Vice President for Clinical Simulation UAB Health System, the Director of the Office of Interprofessional Simulation for Innovative Clinical Practice within the Center for Interprofessional Education and Simulation at University of Alabama at Birmingham (UAB), and Assistant Dean for Clinical Simulation for UAB School of Medicine. She is professor in Pediatric Emergency Medicine, Medical Education in the School of Medicine and the Department of Health Services Administration in the School of Health Professions and practices clinically in the emergency department at Children’s of Alabama. 

Learn more at www.harvardmedsim.org.

COVID Chronicles with Jenny Rudolph

COVID Chronicles #009 | Marjorie Lee White & Andres Viles: PPE Practice to Build Safe Systems

A nurse preceptor has just watched a trainee commit a serious error despite hours of lecture, reading, and hands on training. In spite of herself, she starts to heat up, much like the more severe clinical educators who trained her years ago. “Why can’t you just get this right?”

An ICU attending asks her resident to call her if a patient’s hematocrit drops under a certain value. Despite this agreement, and despite the patient deteriorating, the resident never calls. “Are you an idiot? Why didn’t you call me?”

In these moments, how do we reset ourself to a place of care, curiosity, and compassion? How do we model a better culture of learning? How do we have our judgment, instead of our judgment having us?

In “Curious Now with Jenny Rudolph,” a social scientist takes on the hidden structures that shape our behavior, culture, communication, and learning in healthcare.

In this interactive podcast, Jenny Rudolph, PhD, FSSH, will help listeners approach the thoughts, feelings, and judgments underlying their reactions in a psychologically safer manner, helping us to better connect with curiosity and compassion to the people around us, especially when we feel that they’ve done something “wrong.” This podcast will include weekly challenges to examine your own thinking, including follow-up with listeners and experts about their experience on the journey to Good Judgment.

Jenny Rudolph has made a career exploring what makes clinicians, healthcare organizations, and health professions training programs tick. Underneath the surface of intelligent, capable people who care about doing their best are hidden patterns that interfere with how they perform. Hierarchy, ego, communication glitches, resilience, power, professional learning, and how learning happens all flow downstream into creating actions that work and actions that don’t.

Jenny found out the hard way that being too certain can get you in trouble. Demoted from third to second grade for poor academic performance when she arrived in Jaipur, India as an eight-year-old, she realized she had better get curious about how her new school and culture ran, and that curiosity has remained with her ever since.

Jenny now works with clinicians around the world to help them develop their own love of that little dopamine drip of rewarding surprise when you find out something new about your colleagues and how they think. Whether trying to figure out a diagnosis, discovering what a learner is thinking, or upping your own clinical mastery, getting Curious Now is the solution.

Curious Now on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP?si=890ed4b02bfe4838

Curious Now on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

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Founded in 1993, the Center for Medical Simulation was one of the world's first healthcare simulation centers and continues to be a global leader in the field. Simulation training at CMS gives healthcare providers a new and enlightening perspective on how to handle real medical situations. Through high-fidelity scenarios that simulate genuine crisis management situations, the CMS experience can open new chapters in the level of healthcare quality that participants provide. Find out more and apply for CMS simulation workshops at www.harvardmedsim.org.

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