Will Bundy, MMSc, CHSE is Director of Simulation for the Master of Medical Science program in Anesthesiology at Emory University School of Medicine. In this episode, Will talks about his journey from a learner to his current roles as an educator and leader in the same program he graduated from. His passion for simulation has led to developing a joint sim or an interprofessional simulation where learners get to practice communication and teamwork in their future roles. Will's words of wisdom include "learn from everybody. Learn from the people that are obviously your teachers. I learn from my students all the time. Learn from your clinical preceptors. Learn from your coworkers. Everybody's got something that they can teach you, and rarely is a day going to go by where you can say you haven't learned anything new. Just being open and receptive to that puts you in the position where this is something that you can pursue."

Resources

• WHEA Fellowship in Educational Scholarship
• Society for Simulation in Healthcare

Hello, listeners. Welcome to Educational Landscapes, Lessons From Leaders. On today's episode, we are going to learn from Will Bundy. Welcome to the show, Will.

Hey Ulemu, thanks for having me.

Most welcome. To get us going, what is your educational leadership title or titles?

It's always a mouthful, isn't it? I'm an instructor of anesthesiology and I'm director of simulation for the master medical science program in anesthesiology at Emory University School of Medicine, if that all fits in your mouth.

Yes, that was a lot there. That was a lot. What do you do in your role?

I'm in charge of designing and implementing the simulation curriculum for our learners, and that spans the course of basically an entire year, over four semesters. And that supplements and goes in tandem with the didactic learning that they're getting in the classroom. They get to implement through active learning and small teacher student ratio. That's the majority of that. And then I also teach a didactic course on the anesthesia machine. And then I also have clinical responsibilities over at the hospital. I wear lots of hats.

Indeed, indeed, you do. To help our listeners, how many anesthesiology assistant learners do you have per cohort and at what point and how long is the program?

It's a 27 month program and it runs continuously through the summer. Each cohort ranges between 36 and 40 students. At any given time, we'll have at least two cohorts. And then in the fall, we have three cohorts. As one graduates in December, and then the new one starts in August.

Ah, fun times. When during those 27 months do they get to do the simulation?

Simulation is an integral part of the initial portion of the onboarding of bringing someone in off the street without an in-depth knowledge of medicine or anesthesia and getting them up to speed in order to, by the end of the first semester, be able to do an uncomplicated anesthetic from start to finish. Our simulation curriculum builds them from how do we draw up medications and how do we start an IV, all the way to let's manage an anesthetic.

Wonderful. As somebody who's had to be put under, I appreciate y'all.

It's always better to practice on a dummy first.

Exactly.

The curriculum continues from there. We do more advanced scenarios, more critical event management, and that carries on all the way up until when they graduate really. But it's really intensive for that first year.

Okay, thank you. Thank you for that clarification. Given that you've got multiple hats, what skills do you use in your roles?

All of them. What skills do I not use? For example, today I was teaching students how to place spinals and epidurals, and so there's the physical portion and the tactile sense of how to actually physically do it. There's the conceptual use of, okay, what are the indications, contraindications, and all the theory that needs to go behind it in the anatomy.

Yesterday, we were simulating critical events of anaphylaxis and malignant hyperthermia. It's a different set of being able to work under pressure and do a differential diagnosis. I really get to use the full span of the skills that I've learned over a career and really implement that.

Wonderful. Talking about the span of your career, what was your journey that led to these current roles?

I started off as a student of the program I teach at, graduated from Emory back 2011, came to work for Emory University Hospital. Did that for a number of years, and that kind of started it. Because being at an academic hospital, we're very much involved in training of AA students, and so you get your first exposure as a preceptor and through working at that hospital, I was invited to join the faculty in 2016.

And then from there, it was working by mentorship, had some great teachers along the way, people that taught me as I was coming through, and then working alongside them and getting to really learn how they taught. We all stand on the shoulders of giants at some point, and I definitely had mine along the way. From there, it was learning what my teachers hadn't learned and how education has evolved since the 30, 40 years that they started doing this.

That was on my own seeking out additional resources in order to make myself a better teacher, coming from a completely clinical side and then learning how to teach as I'm doing it.

I love that, the whole, what is that saying, building the plane as you're flying it.

Yeah, yeah, yeah, there's definitely a lot of that, but that's anesthesia as a whole sometimes too.

Good to know. Good to know. I would love, as you're reflecting on that, what do you wish you knew before stepping into your current roles?

Thankfully, again, having good teachers along the way, my eyes have been fairly open, so I don't have a lot of regrets. In the current role of director, I find what I've been avoiding up until now, of the non-teaching work is that goes into supporting course and curriculum and making sure that a large staff of simulation faculty is all on the same page.

I spend more time not teaching when all of us get into it for the passion that we have for actually doing the work. Even that, my wife's a high school teacher, so I know a lot of what goes into the background of teaching and how much gets done at home.

Yes, indeed. Isn't it always interesting the level of administrative and logistical things that need to be put in place so that you can enjoy the front-end and the teaching?

Yeah, absolutely.

Given the scope of things that you do, as you said, being an educator, being a healthcare practitioner, what continuing professional development do you do to keep up with the needs of your roles?

I guess I was alluding to it before. I had to go out and learn how to teach. One avenue at least through what I was involved in in simulation was the Society for Simulation in Healthcare offers a certification for certified healthcare simulation educator. I pursued that and have been maintaining that accreditation for six years now.

And then now I'm expanding on my role as far as in the academic sphere with the Woodruff Health Educators Academy Fellowship in Educational Scholarship and getting a little more involved in research. That's had direct carry over to our students who are getting to participate in a lot of this cutting edge technology we're trying out.

That is awesome. That is awesome. As you think about the journey that you took, and I think it's wonderful that you got to have folks as your educators and then your mentors, what advice would you give someone interested in doing the same type of leadership roles that you have?

The same advice I give my students is learn from everybody. Learn from the people that are obviously your teachers. I learn from my students all the time. Learn from your clinical preceptors. Learn from your coworkers. Everybody's got something that they can teach you, and rarely is a day going to go by where you can say you haven't learned anything new. Just being open and receptive to that puts you in the position where this is something that you can pursue.

Wonderful. I love that because I often tell people that any interaction has the potential of being a teaching and learning interaction. As you think about the work that you've done, how do you support or expand education in your profession or through your roles?

Definitely in the clinical sphere, you carry that forward. When you're heavily involved in the education of the students and the other clinicians are interacting with students, they see you as a point of contact and you get to act as a little bit of a liaison between the academic portion of these students' lives and the clinical portion. And in that way, the preceptors are looking for feedback. We give them survey results, but it's very easy for them to come to me, "Hey, what do we think about this student? How can I best help them?"

And that improves them as preceptors and as educators. Honestly, those are the people that we draw from when we're looking at bringing people into the faculty. Who are the ones that are performing well as preceptors, really take an interest in the students' learning, have a good manner about them? We expand our faculty through that indirect development. I think it's the best I can answer that.

No, that's wonderful, because I think we often hear... It's almost sometimes it feels very separated in healthcare professions programs where it's like there's the didactic, there's the clinical. During the didactic, they've got their faculty. During clinical, they've got their preceptors. And sometimes the two groups don't get to talk as much. I think that's wonderful that there's this engagement with them. Talking about those preceptors, are your preceptors mainly inside Emory Healthcare, or are they in a range of...

We have I think 60 different clinical sites spread all over the country. It could be any number of practitioners at those different sites. Of course, they will weight heavily towards the Emory System, St. Joe's, Grady, the Atlanta Hospitals, but Northside, Piedmont, Gwinnett, Kennestone, everybody. And then out into the Greater Georgia area, up in Athens, down in Florida, Vermont. They go all over the place. Coordinating those clinical sites and coordinating with the preceptors and setting reasonable expectations of where students should be at a certain point in their training, that's a full-time job for somebody else luckily.

I love how that was said, like a thank goodness, not me.

We all have our strengths. Keeping up with that many people maybe not one of mine.

Fair, fair. I understand that. As you think about the stuff that you have done, what has been one of your greatest successes thus far?

I think one of the things that I started when I came on back 2016-2017 was a idea of moving towards interprofessional simulation. We work in a profession where mid-levels and MDs work side by side day in and day out as part of a anesthesia care team model. And up until that point, there really hadn't been any time for these groups of learners, the anesthesia residents and our AA students, to really come together. We developed a joint sim or an interprofessional simulation where they got to practice communication and teamwork in their future roles.

That's something that we've been able to carry through year to year ever since that point, COVID excepting. It's been something that's been super beneficial and well received by residents, by the AA students and has repercussions that I notice to this day. People come back five, six years later, oh, I remember when we did that simulation. I really took some of those lessons to heart. I hold that one up pretty high.

That is wonderful. Can you tell our listeners a bit more about what is entailed in trying to logistically put that kind of thing together?

It's coordinating a lot of people, first and foremost. It's making sure that we have the staff in order to run the simulation. Appropriate faculty both from our end and from the MD side as observers in order to give good expert feedback on the simulation that's run. We take up most of the office suite between running the simulation, having a conference room for debriefing. There's the logistical schedule of getting 16, 17 anesthesia residents and that many anesthesia students paired up together. Each simulation for a pair of learners runs for close to an hour.

You can see it's done over multiple days, and then take some time commitments from a lot of people in order to make it work. And then making all that work while these people have full clinical obligations, both the faculty observers and the learners. There's a lot of strings to pull. We've managed to do it once a year and that's about the bandwidth that most of us can support. Everybody says they want more, but logistically putting it together is a lot of work.

Indeed, indeed. As you said, that once a year though, people still remember it, so it's a powerful once a year. As you talked about the staff, who all is involved? Do you have standardized patients, people who have to run? I've always been like there's a black box when it comes to simulation.

We adapt to the scenario or the objective that we're trying to do. For the specific joint sim scenario, there's a MD with an interest in simulation who's helping direct our lab manager who's running the mannequin. She's giving him the medical input of how the mannequin should react in order of the therapies that the learners are then producing themselves. We can't really predict what actions they're going to take.

If it falls outside of the knowledge of this person who maintains the machine very well, that's where we need medical direction on that side. We have usually one of our faculty playing the role of the surgeon. We have the full high fidelity suite. And then at least one member of our faculty and as many community docs as we can have, usually two or three, in order to facilitate debriefing and me running around facilitating the whole thing.

Wonderful, wonderful. I see what you mean about the logistics, but it must be amazing once everything comes together.

Yeah, it's a lot of fun. Everybody enjoys it.

Great, great. Thank you for sharing. As you think about the journey you've had, I always think of us as lifelong learners, as educators, so what are your biggest growth opportunities currently?

I think I look forward to having unlimited funds and unlimited space. I have big ideas and learning to manage those and work within the confines and limitations is something that I'm working on. In anesthesia, we're used to instant feedback based on our interventions. I give a medication I expect, I know the onset time, I know when I expect to see a result. Education works on a different timeframe. Just implementing and getting things accomplished is where we all have opportunities for growth.

Indeed. Working within the bounds when we have big dreams that are way bigger than those bounds. I understand that. As you think about what you've done thus far, what do you love most about your work and what you do?

The fact that I do and see something different every day, every week, every month, I find that I've got a great balance between the academic life and the clinical life, and so that I feel good going into clinical and not burnt out and really wanting to perform my best there. At the same time, I get to bring and relate that into the academic side and provide real life scenarios.

Every patient's different. Every student's different. Even if the material's the same, there's always a little bit. There's always something to learn every day. It really gives me the opportunity to do that and work along people that are equally capable. It's, yep, dream job.

Love it. Love it. Oh, and can you explain... You've talked about you get to do your clinical practice and then there's the academic side. How is that scheduled? Is it per week you do this much percentage of this and that percentage of that?

Yeah. I'm 60% academic and 40% clinical. Out of a 40-hour work week, do the math from there. 24 hours.

Okay, thank you. Thank you. That helps. I was trying to wrap my head around that. Overall, reflecting on your experiences to date, what would you say are your passions around education?

This has definitely been learned since I started teaching. Things are vastly different from when I went through school. The concept of it's okay to make mistakes, we learn better through our mistakes, when those mistakes are encouraged as opposed to penalized. Not so much encouraging the mistakes as that, but encouraging people to be bold and to make mistakes by trying new things.

When I came through in medical education as a whole, it was very much if you do things a certain way, if you don't do them exactly this way, we're going to get onto you and make you feel pretty bad about the mistake you made. That has definitely changed since I've been teaching and that hasn't been that long as far as trying to take an approach to this new generation of learners that is accessible to them and has been shown out to be more effective.

That's been a passion of getting my colleagues and people who grew up around me from that same kind of environment to acknowledge, hey, we don't raise our kids that way. We've learned better and we don't do the things that our parents did to us. Why would we expect that education to stand still? That's been a passion of mine.

Now it also makes sense why simulation is such a close element because people always talk about simulation as the perfect place to try things out and fail in a safe environment and learn. Awesome. Awesome. Recognizing you are more than what you do at work, what are some things you do outside of work to help you maintain joy in life and practice?

Having done so recently, travel. I love to get out and see the world. I take my camera with me. I like to do photography just on my amateur level. Very much related to simulation, I like to play a lot of games.

Video, TV, what type of games are we talking here?

Mostly tabletop. I'll do what you would consider very long form games, either elaborate board games or I'll do tabletop miniature war gaming and things like that. Very much akin to simulation. Let's set up a scenario and see how things play out.

There's a running theme here, even in your fun.

Hey, if you love what you do, you'll never work a day, right?

There we go. There we go. As a fellow lover of travel, what are I won't say your top one, but your top three destinations so far?

My wife's from Spain. We've gone there every year for 20 years visiting her family and have traveled all over the country. It's an amazing place to be. If I had to pick a place outside of that, I love going to Costa Rica. That was really nice. But we do vacations a little bit different than maybe most do. Neither of us is one to really sit still and be passive and chill at the resort. We're all, okay, where's the next mountain that we're going to climb, or let's do ziplining in between the rainforest. Very good at catering to the people who can't sit still.

Love it, love it. I appreciate those of you who can do that. I'm a very, okay, let me just sit still and watch them go by.

We all start to get antsy and be like, okay, we've been sitting here for 30 minutes. What's next?

Right. We have to have a balance in the world, right? Somebody's got to do the ziplining and I appreciate that it's you. Those were my core questions for you. Before I let you go, any last words of wisdom for aspiring educators or education leaders?

I feel like I've used all the good ones up until now, so I'll just repeat it and just say, never stop learning and your students are going to teach you a whole bunch.

I love that. I think that's such a wonderful way for us to end this episode. Thank you, again, Will.

All right, thank you so much.