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to Sim VS for sponsoring this week's

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to The Sim Cafe , a

0:49

podcast produced by the team at

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Innovative Sim Solutions , Edited

0:54

by Shelly Houser . Join

0:57

our host , Deb Tauber , as

0:59

she sits down with subject matter experts

1:01

from across the globe to reimagine

1:04

clinical education and the use

1:06

of simulation . So

1:08

pour yourself a cup of relaxation

1:10

, sit back , tune

1:12

in and learn something new from

1:15

The Sim Cafe .

1:21

Welcome to another episode of The Sim Cafe . Thank

1:24

you very much for joining us and welcome

1:26

Jerrod . And today

1:29

our guest is Billy

1:31

Martin . Billy is a

1:34

fascinating person , Billy

1:37

. Why don't you tell our listeners a little bit about yourself

1:39

?

1:40

Sure Deb . I'm just thrilled

1:42

for the opportunity , Thank you , thanks for being

1:44

here . So I've got kind of a mixed

1:47

bag of a background , but I did simultaneous

1:49

careers in medicine and in

1:52

the electric utility business so

1:55

it's kind of hard to explain . But I started

1:57

as a in the electric utility you know , janitor

1:59

, all that kind of stuff up to 20 years as a lineman

2:01

. And while I was a lineman I became a ski patrol

2:03

and then realized that

2:06

I didn't get enough experience . So I became an EMT and

2:08

then a paramedic and then

2:10

as a lineman I actually rolled onto a double

2:12

log truck , tip over onto two cars

2:14

that was the first one to seen . So I

2:16

ended up managing the scene and called

2:19

in three helicopters and

2:21

then when I contacted the helicopter company they

2:23

sent me an application . So I started flying

2:25

and then I had a flying 23 years on a helicopter

2:27

while I was in the electric utility business . So

2:30

my interest in medicine and now the outdoors

2:33

also led me to a diploma in mountain medicine

2:35

. I'm a ski patrol instructor , trainer

2:37

, and it just keeps going on from there . So

2:39

somehow I have these simultaneous things

2:41

going on , which has evolved

2:44

into a different way of thinking because I'm

2:46

involved in a lot of high intensity

2:48

adventures you know like . For

2:50

example , I'm climbing Mount Kenya in Africa February

2:53

5th . It's a thousand foot rock

2:55

climb to 17,000 feet will be my third time

2:57

, wow , but my first

2:59

time at 67 years old .

3:03

It's just all in the mentality and there's already

3:05

in that sentence , Billy , which is just so much

3:07

personal curiosity Where's your favorite place to

3:09

?

3:10

So I'm a ski patrol at Whitefix Mountain . My

3:12

favorite favorite place to ski is in the woods in

3:15

the back country . I do a lot I

3:18

do . I'm ice climber and also a back country adventurer

3:20

and I really had a really good

3:23

time . I've skied back country in Idaho . Just

3:25

right when , just before COVID hit , I was stayed

3:27

at the Opus hut between your

3:29

Colorado and Silverton . It's situated

3:32

11 , 6 . You skin in three

3:34

miles to get there and you climb . You

3:36

ski , skin the peaks around and ski

3:38

. That was unbelievable . I think I would like to

3:40

do that again .

3:41

Yeah Well , your third time

3:44

doing elevation that most people have not

3:46

ever experienced as well , you know , outside

3:48

an airplane . But we are going to take

3:50

this podcast in a little different direction

3:52

and make it a little more laissez-faire . So

3:55

I'd love to just unpack a lot , because

3:57

we both find you , as well as many of

3:59

our listeners , so fascinating , and actually

4:01

I want to lead off with a question of what are

4:03

you reading , if anything , and what would you recommend

4:05

to read ?

4:06

That's a really good question . I got hooked on Audible

4:09

a number of years ago , so I don't even know

4:11

if I know how to read anymore , Jerrod , I

4:14

just listen . But what I've been reading

4:16

is a lot of neuroscience , the

4:18

interesting thing . So I'm in the utility business and

4:20

I do a lot of speaking on safety and I've also been

4:22

in medicine . I just I spoke in San Diego

4:25

just in November in the Citizen

4:27

CPR Challenge Status Co-Conference

4:29

and I also spoke in San Diego for the

4:31

Incident Prevention Conference . So I also write for and

4:33

do podcasts for , and was really

4:36

there were two weeks apart in the same hotel , which was kind of

4:38

interesting . But I like to tell people that

4:40

you know , if I want to spin the news , I can spin Fox News

4:42

or CNN , or if I want to spin safety , there's

4:44

a lot of really good safety gurus out there . But

4:47

if you start learning about how our human works

4:49

, that's not spin . That's

4:51

based on studies . So , for example , andy

4:53

Clark wrote the book the Experience Machine how Our

4:55

Mines Predict and Shape Reality in May

4:57

2023 . So this is pretty current study

5:00

he's talking about and he refers a lot to Lisa Feldman

5:02

Barrett who wrote seven and a half

5:05

lessons of the brain 2020 . And

5:08

both of them talk about how our brain is a prediction machine

5:10

. He calls it the experience machine

5:12

. And then Andy

5:15

M Paul wrote the Extended

5:17

Mind the Power of Thinking Outside the Brain . That

5:19

was 2021 . Interestingly

5:21

, Andy Clark also wrote a paper in 1997

5:25

, where Does the Mind Stop and the World Begin

5:27

, which is really kind of an interesting

5:30

paper , because back then they

5:32

were thinking you know where is the mind and the brain encompassed

5:34

in the same space ? And they started

5:36

doing studies where , like

5:38

elementary kids , if they're doing math , if they

5:40

sit on their hands , they can't do math because as they move their

5:42

hands and fingers around , their mind is now in

5:45

their hands and fingers to calculate

5:47

math . And in 2007

5:49

, they kind of proved that your mind goes wherever

5:51

your focus is when

5:53

the iPhone came into market

5:55

. Because now that everyone has an iPhone

5:57

, if you lose your iPhone Jared , you lose your mind .

6:00

Yeah , very true

6:02

.

6:02

Very true . But just to summarize

6:05

that , though most of what you're reading is around

6:08

neuropsychology or

6:10

some form of mind

6:12

matter , environment , society

6:15

Is that fair to say ?

6:17

Yes , yes , so it's a cross between

6:19

behavioral neuroscience , neuroscience and cognitive

6:21

psychology . Daniel Kahneman of course

6:23

, the thinking fastest flow from 2011

6:26

was groundbreaking work and he got a Nobel

6:28

Prize in economics actually

6:30

for that . But where

6:32

he refers to the brain as a metaphor of system

6:35

one or system two thinking and system one's really fast

6:37

and system two's more accurate

6:39

, but you have to slow down . Tan

6:41

Lee wrote the book Neurogeneration in 2020

6:43

. She did studies on high

6:45

school kids with EEG headsets and she found high

6:49

school kids don't like to make eye contact , but when they do

6:51

, their brain waves synchronized . And

6:53

when you're engaged , like we're engaged right now , our

6:55

brain waves start to synchronize , which

6:58

now we're talking about things like neurosynchrony

7:00

and social enhanced cognition or

7:03

collective intelligence , which

7:06

means we have to connect . I

7:08

like to say that every generation has a higher IQ

7:10

than the one before it . But the IQ doesn't

7:12

matter , because one neuron in your head screaming

7:14

alone in a football field doesn't really do much . But

7:17

when these really brilliant neurons connect

7:19

with other people and we create that connection

7:21

, we operate it in higher ground . Oh

7:24

, I love that . I love that Tan

7:26

Lee Sherrod wrote the Optimism Bias which we'll be talking

7:28

about today , a tour of the irrationally

7:31

positive brain . He also wrote the Influential

7:33

Mind , which is what our brain

7:36

reveals about our power to change others . I'm

7:38

involved with a study right now with John Barge and Gary

7:40

Latham . John Barge is out of Yale . He's

7:43

retiring this month . Actually , he wrote

7:45

, before you Know it , the Unconscious Reasons we Do what we

7:47

Do , and there's more , but I don't want to do

7:50

the whole thing on books . But honestly , these

7:52

books are all interconnect

7:54

at some point where they

7:56

all are , how we actually

7:58

run our human . So , Jerrod , I don't

8:01

know if I've talked to you about this . Before

8:03

we get into what this model is that I've been working

8:05

on , I kind of have to diffuse something

8:08

. Is that all right ?

8:09

Yeah , please . And also I think we should

8:11

list the books that you just mentioned so we can include in the show notes too .

8:13

But yeah , yeah , so I've

8:15

got a slide with 12 books . I'll send it to you

8:17

, Please do so . I'm a

8:19

baby boomer and I speak a lot

8:21

now and almost everybody's younger than me , so

8:24

I often start by apologizing for being a baby

8:26

boomer and I also apologize to the baby boomers in the room

8:28

first . You see , look , I

8:30

don't want you to , you know , please don't , you know

8:32

, be judgmental of this . I'm not trying to call anybody out

8:34

, but my generation , which was

8:36

command and control , is really good at modeling

8:39

defensiveness , divisiveness and dismissiveness

8:41

. And when we do that

8:44

, we hold the people we're operating with

8:46

to a lower cognitive level . Because as soon as

8:48

I make put you into defense , you're

8:50

now moving into justification and rationalization

8:53

and that's a ripple into

8:55

the past . Right , but

8:57

what we want to be ? Because you guys

8:59

are brilliant and , like I said , every generation has a higher IQ

9:01

than one before , it's on the dumbest guy in the room , right

9:04

, you don't have to defend anything , you just have to be

9:06

curious and interested . You know why someone

9:08

might have a different idea . That's

9:10

a better model , because that unlocks reason , logic

9:12

and intuition . But you can't be justifying

9:15

and rationalizing and move forward at

9:17

the same time , right . And

9:19

then , if you've read any Eckhart Tolle or Tolle Harvey

9:21

von Braunz's last name , the power

9:23

of now , really the only chance

9:26

we have to change the future is right now . Whoops , that's

9:28

gone . I mean right now , right

9:32

. So when we're pushed into the past and

9:35

we only have a certain amount of cognitive load available

9:38

, it stunts our ability to

9:40

operate at higher levels . So what I'm going to

9:42

ask is I'm going to introduce some new things

9:44

today and it's going to make some people feel uncomfortable

9:46

because either haven't heard it or it's going to twist

9:48

their brain a little bit . I'm just going to ask that you

9:51

know if you've watched the Matrix take the red pill just for this

9:53

podcast . Perfect there

9:55

you go .

9:57

So I don't know where you want to go from here . I

9:59

love that you want to make people feel uncomfortable , because

10:01

I think you grow when you're out of your comfort

10:03

zone and I think that we most

10:06

, by default , homo sapiens , will always

10:08

default back to that comfort zone of this

10:10

is safe , it's secure and we don't ever

10:12

want to get out of that circle or out of

10:14

that comfort zone . So I think conversations

10:16

like this are what push society

10:19

forward . And then when you get there and you're

10:21

creating the synchronicity

10:23

among humans or community and

10:26

pushing those industries forward , pushing

10:28

those boundaries forward , I think is

10:30

beautiful , so we're so happy to have you there's

10:32

a video if you want to .

10:34

It's apples . It was 1997

10:36

, called the crazy ones , IBM

10:39

ThinkPad . It just hit the market and it was

10:41

controlling the market for computers . So

10:43

Bill Gates comes on with this Apple commercial

10:46

that doesn't show any computers . It shows Einstein

10:49

and Amelia , Earhart and

10:51

the Muppets . I mean all these things . And

10:53

then the catchphrase at the end is the people who are

10:56

crazy enough to think they can change the world are

10:58

the ones that do .

10:59

I remember that commercial yeah

11:01

.

11:02

And it's just proof that the most

11:04

successful people in businesses don't

11:06

tell you how smart they are and what they're going to tell you

11:08

. They tell you what they believe .

11:09

So yeah .

11:11

I'm sorry , so

11:13

go ahead . Dave , you're just going to say something .

11:16

No , I'm just interested in

11:18

the things that you're doing now . What are

11:20

your new ? You have some forward thoughts

11:22

.

11:23

So I mean , you guys are in simulation and

11:25

I started this journey doing

11:27

mental rehearsals and mental simulations

11:30

with Lyon to prepare for the worst case

11:32

scenarios , and it's evolved

11:34

, based on this research

11:36

, to a formula . And actually

11:38

I'm speaking in incident prevention

11:41

in Orlando in May and it's going to be

11:43

a pre-conference workshop . I

11:45

spoke on it in San Diego a little bit and most of the comments

11:47

I got were we need more time , can

11:50

you talk longer about this ? So now I'm going to do a

11:52

pre-conference workshop and

11:55

, oddly enough , I'm also partnered with a company

11:57

up here now that is modeling this theory

12:00

and rolling it out to their workforce

12:02

, and the CEO and this lead safety

12:04

person is going to come and speak . I'm going

12:06

to reveal the formula which I'm going to do here

12:08

as an early reveal , and

12:11

they're going to talk about the model . So anybody want to know

12:13

how to deploy it . They're going to talk about how

12:15

they're deploying it . So

12:17

I think it's a logical progression

12:19

. So when I'm about to tell you so

12:21

I did five years with Greg Greg

12:24

from CVS just did the

12:26

pump simulations , fusion pumps

12:29

, and

12:31

that infusion pumps is a chance to experience

12:33

using pumps before

12:35

you use them . It's okay to fail safely

12:37

in a simulation , which is why simulations are

12:39

so good because it is a simulation

12:41

. Well , the same thing occurs with the

12:43

way your mind works . So

12:46

there has been studies where , if

12:48

you sit quietly and envision something like a

12:50

golf swing , your golf swing improves

12:52

almost as much as it is . You swing it 15

12:55

minutes in the morning and an afternoon is one group's swung

12:57

or clubs , and another group sat in a chair 15

12:59

minutes in the morning and afternoon . When they

13:01

finally did the evaluation , the

13:03

people who swung the clubs were 23% better

13:05

. People who sat there and envisioned it were 21%

13:08

better . So when we create an experience

13:10

for our mind , our mind

13:12

you've heard neurons that fire together , wire together

13:14

. Have you heard that before ? Right

13:17

, so our mind creates a

13:19

circuit . So , for example , when you first

13:21

touched a hot pan as a kid and you

13:23

burned your finger , you had never had

13:25

the experience . So let's say you were

13:27

experientially blind to

13:29

that possibility . So your brain's prediction

13:31

wasn't that you would burn yourself . It had

13:34

a predictive processing error and you burned your

13:36

finger . And as soon as you do , it

13:38

creates a circuit that to prevent you from ever doing that

13:40

again . Well , it turns out you don't need to burn your finger

13:42

to make that circuit . That's what the model's about

13:44

. It's a tally share with the book Optimism

13:47

Bias , and optimism is a really

13:49

good thing . Optimists do much better than

13:51

pessimists , but we all have this optimism

13:53

bias where we don't think it's ever going to happen to us

13:55

. If we don't believe a thing will happen

13:57

, then our brain doesn't create an experience

14:00

for it , for us to predict the

14:02

right outcome . So what

14:04

you guys have been doing , in simulation is

14:06

actually creating an experience for

14:09

the brain to see what's

14:11

going to happen , but I think we're not using it to the

14:13

level of the availability . So

14:16

when I went around with Greg with high fidelity mannequins , that

14:18

was really cool because the mannequin was really cool and

14:20

we could have all kinds of cool scenarios . But

14:22

the relationship between the people that are doing the

14:24

simulation and the experience is

14:27

just as important as the high fidelity . And

14:30

I don't know if we weigh that . What do you think ? No-transcript

14:34

. Yeah , so let me ask you this what if we

14:36

did a simulation of a nurse

14:38

making a medical error ? The

14:40

whole simulation wasn't , it isn't just if an error

14:42

happened . The whole simulation is based on all

14:45

right you're giving , you have one of a

14:47

simulated pump and you just set it to the wrong

14:49

setting and now you're overdosing whatever drug

14:51

you can choose right To your patient

14:53

and you notice it's the beta blockers

14:55

, say , and their eyes are rolling back in their head and

14:58

they're going unconscious . Go

15:00

. And now what you need to do is you need

15:02

to process . What do I need to do medically

15:04

to help this patient ? What kind

15:06

of reporting system do I have that I ? Who do I report

15:09

to ? What kind of remediation does our

15:11

system have ? I don't know . If you guys are in medicine

15:13

, you can almost feel the pressure . Do you feel that ?

15:15

Yeah . Yeah you just feel the pressure that

15:17

creates that circuit .

15:19

So once you create a subconscious circuit

15:21

, you won't know if that changes

15:24

your behavior , because it's subconscious . So

15:26

I'm an optimistic nurse . I'm never gonna make a

15:28

medical error . So I'm just , I'm multitasking

15:30

. The bells are going off . All these things are going on . I have

15:32

all this distraction . I set the pump .

15:34

But now that I've done this simulation .

15:36

I've actually made a medical error in simulation

15:39

, so my brain knows that's possible

15:41

. So I'm no longer optimism biased , I'm no longer

15:43

experientially blind , so my subconscious

15:46

can create a different prediction into

15:48

the outcome . Our whole we seem

15:50

to be focused on preventing the error and controlling

15:52

the risk of medicine , not

15:55

in predicting a different on

15:58

different predictions .

15:59

And also , if you're not prepared , then you don't believe

16:01

it'll happen . And so the flat tire analogy

16:04

is that if you don't think the plane's gonna take

16:06

off or the drive is gonna happen , then

16:09

you're never gonna fully be able to fully

16:11

execute as well as

16:13

you would . So if you don't have your suitcase

16:16

because you don't think you're actually gonna go well

16:18

, then you're not gonna be prepared for the trip on hand . You

16:21

know the same thing to be practiced in healthcare , where

16:23

if you're not prepared via

16:25

simulation , then you're not really

16:27

gonna actually execute as well within

16:30

the actual patient .

16:31

So that's . I appreciate that that was excellent . And

16:33

what you're talking about , the way you're speaking about

16:35

this , is conscious , but what you're

16:37

really doing is priming your subconscious , because in

16:40

the prediction machine and in Lisa Feldman-Beret

16:42

also has a TED Talk , a really

16:44

good TED Talk about emotions . We

16:47

don't have a circuit for emotions , they're

16:49

created by our brain , right ? So ? And

16:51

she talks about experiential blindness . If

16:54

you haven't experienced something , you're blind . Like when

16:56

you look at those pictures that are two variations

16:58

of the same picture . Your eyes see

17:00

the same thing , but all of a sudden you see both

17:02

pictures , like the old lady , the young lady

17:05

, right those ? Have you seen those pictures

17:07

? There's

17:09

a bunch of those . So your eyes are seeing the same

17:11

thing , but your brain changes the prediction

17:13

. So because your brain ? So this is kind of the

17:16

thing is your brain . You know you guys aren't seeing me

17:18

right You're only seeing as reflection of light , that's

17:20

on cones and rods in the back of your eyes . Your

17:23

brain is interpreting those lights

17:25

through electrical and chemical images

17:29

. And then you're also not hearing me . I'm

17:31

vibrating the air to my speaker , which is

17:33

sending a signal a wavelength which is

17:35

vibrating the air in your eardrum , which

17:38

is now being interpreted by your brain

17:40

. So your brain is an interpreter

17:42

, it's an experience and interpretation machine

17:44

. It doesn't see anything , so it

17:46

bases everything based on experience and

17:49

there's turns out , there's four times the circuitry

17:51

to get you moving forward . Then there

17:53

is coming in for the stimulus

17:55

that you're experiencing and the

17:57

stimulus is really to fine tune what your brain has already

18:00

decided . You know that the old

18:02

tape was that they would dissect

18:04

brains and determine routes . You know where they

18:06

go and where the signal goes . But the

18:08

new scientists say dead brains don't talk , they're

18:10

using FMRI and EEG . So

18:13

this is pretty new . Well , it's a little

18:15

uncomfortable . There's

18:18

another piece to it that I haven't gotten to and I know I'm talking

18:20

a lot . I hope I'm , you know no , but I love this

18:22

One .

18:22

it is heavy , but I love that . It is

18:24

because it makes you a little uncomfortable , and this

18:26

is what I so you did preface it . I'm

18:29

just really enjoying listening to you .

18:31

So Victor Frankel , who ?

18:33

Man searcher meaning yeah .

18:34

And he lived through four Holocaust camps . Right

18:36

, and he said this is his quote

18:38

he said there's this space between

18:40

stimulus and response and in

18:42

that space is our power to respond and in that response

18:45

is our growth and our freedom . So

18:47

Victor Frankel had to separate himself from

18:50

his emotion in order to survive four Holocaust

18:52

camps . In doing that we

18:54

now realize there really isn't a space between symbols

18:56

and response . We have to create the space or

18:58

, better yet , we have to be aware that there is a space , and

19:00

so I'll ask you this Jerrod

19:03

, are you aware of the voice in your head ? I

19:05

am yes , so you are aware

19:07

of the voices . So are you aware that that voice in your

19:09

head is not you ? I'm not no

19:11

. Right now you are hearing

19:13

, we're interacting and you're aware that you're

19:15

interacting . Correct , Now , when

19:17

you're speaking in your head , you're the only one that's interacting

19:20

with your head , right ?

19:21

Aside from my imaginary friends .

19:23

But yeah , so , so , yes , you

19:25

are actually the person or

19:27

the observer that's aware of the voice

19:29

in your head . You're

19:32

not the voice in your head , you're not your mind , you're not your brain

19:34

. You are aware of the

19:36

voice in your head . So that creates

19:38

a space between you and your emotion

19:40

and we seem to have an entire population . As

19:42

soon as you make a mistake , you're embarrassing it , but

19:44

that's not even us . That's a biological

19:47

reaction and make the law , hijack if you

19:49

will . But if we start to realize

19:51

that we are not the voice in our head , we're not

19:53

even our emotion , we are the person that's aware

19:55

of it . We can create a space

19:57

and then be curious and interested why

20:00

I'm having that emotion . And the psychologist

20:02

say if we call the emotion out and I'm feeling intimidated

20:04

or I'm feeling anxious , our subconscious

20:07

goes to work to bypass it . But if

20:09

we are our emotion , we will react , and you guys

20:11

have . I've done it and I still am not great at it . But

20:13

as soon as you react , and then you feel a little bit bad about

20:15

what you said because it wasn't you , it was a reaction

20:18

, right . Well , when

20:20

we start realizing that we are

20:22

optimistic and we might be experientially

20:24

blind to this and the prediction , the

20:27

error we made was just a predictive processing error

20:29

and what I need to do is get my brain to experience

20:31

that thing so it can prepare

20:33

me to not to make that error

20:35

again . We start looking at

20:38

simulation like , well , what experiences

20:40

do we need to prepare for ? And it turns out because

20:42

of optimism bias , we don't prepare

20:45

for worst case scenarios . I'll give you an example

20:47

. I asked this recently and

20:50

there's a bunch of people that I was at a CPR

20:52

event and I was going to write this citizen CPR

20:54

and I was explaining optimism bias

20:56

and I said anybody here a CPR instructor ? They said well , yeah

20:58

, sure . I said well , can I trigger you a little

21:00

bit emotionally ? And I said it's gonna make you uncomfortable and

21:03

I have to prepare the audience for this because

21:05

if I just jump in on them , they may they're

21:07

defensive , yeah and beat me up

21:09

or something .

21:12

What no , I was gonna say . Why don't you

21:14

tell our listeners about the 3Ds

21:16

? I think that's

21:18

really important to remember

21:21

when you're having conversations

21:23

, especially when something could trigger

21:26

someone .

21:27

So you know , our tap room investigations are about

21:29

the five whys . I

21:31

just wrote an article it's still in draft

21:33

right now on pattern

21:35

disruption . Don't ask why , because

21:38

as soon as I ask you why , that puts you in

21:40

defense right , your

21:43

next move is defense . If I say why you're

21:45

gonna defend your position Really the words

21:48

how and what , or

21:50

clean language , that's something you can look

21:52

up . It's a way to ask unbiased

21:54

questions like what's that for

21:57

or what would you like to have happen ? Those

21:59

are not why . So when

22:01

I talk about the 3Ds , my

22:04

generation is modeling defensiveness , divisiveness

22:06

and dismissiveness right . And as soon as

22:08

we do that , it puts you in

22:10

defense . Because if you're accusatory

22:12

or I dismiss you now

22:14

, you need to defend your position . But because

22:16

we don't ever need to defend our position , we believe

22:19

what we believe . We're welcome to believe whatever

22:21

we want to believe in this country , which is so far anyway

22:23

, which is pretty awesome .

22:25

But I like to say a .

22:26

Muslim , a Jew , a Buddhist , an atheist

22:28

and a Catholic can build a house together with

22:30

the same tools , Because the house

22:33

and the tools live in physical reality and

22:35

they don't care what we believe or what we think Right

22:38

. So when we start to realize that our

22:41

brain is a structure , and

22:43

as we change that structure to be

22:45

more curious and interested , we

22:47

will learn more things . It

22:50

doesn't matter what we believe . We can believe anything we want . It

22:52

doesn't affect any of that . That

22:54

changes physical reality of our conversation

22:57

. I don't know if that makes any sense . This

22:59

is pretty heavy , too dear , but I

23:01

often hand out a corn seed .

23:02

Well , it does make sense and I think I would

23:05

interpret it as based

23:07

off where you're born , is the beliefs , customs

23:09

, norms that you acquire , and

23:11

based off that environment

23:14

from society

23:16

, community , family , etc

23:18

. I mean religious practices

23:20

probably be one of the most prominent . Is

23:23

then that leaves you to believe X over

23:25

time and your , your

23:27

heuristics and mnemonics and other

23:29

types of ways of looking at

23:32

life , very well studied and researched

23:34

, I think really applies

23:36

to a lot of areas , obviously

23:39

in the physical , mental , spiritual world

23:41

, but also resonates

23:45

deeply within healthcare too , because

23:47

you're able to say you know , I

23:49

love the analogy of all the different religious

23:51

practices building a house is you

23:54

have interprofessional education of . Even though

23:56

you have different backgrounds and you have different

23:58

mental frequencies or

24:00

you know substances internally

24:03

, you can still practice towards the

24:05

common goal and create this shared outcome

24:07

.

24:08

Yeah , so that's the world I want to live in , right ? So

24:11

what we do is we hold on to ritual , right

24:13

? That's kind of what you're talking about debates

24:16

on whatever heuristics where we are

24:18

, so we develop this . So the

24:20

taproot is a ritual , the five Y's

24:22

and then the hierarchy of controls

24:24

was a ritual started around 1950,

24:26

. Right , we need to control hazards

24:28

. This model is based more on prediction

24:31

than control , because if

24:33

we change our prediction , the

24:35

thing never happens . And

24:37

there are I mean you can link to this as a short story

24:39

where there are no parades for things that don't happen . So

24:42

, for example , I can give you an example . I just spoke

24:44

in Long Island and I was

24:46

moving from Island Park to some

24:49

other part of the island , to another fossil fuel plant

24:51

for the next day , and the directors

24:53

just oh , by the way , when you come in , if you come in from the North , there's

24:55

a really steep hill with a lot of traffic and there's

24:57

a 90 degree driveway at the bottom . You got to turn in

24:59

and it's horrendous . So if you can come in

25:01

from the South , that would be better . I've never been there

25:03

. I have no idea what he's talking about . So I get

25:06

up in the morning and I punch up my deep grass and there's a 35

25:08

minute route and a 45 minute route and

25:10

normally I just pick the shortest route right

25:12

. But I know that all of a sudden it plugged into my

25:14

head when he said that shortest route comes

25:16

down and then there's a left turn . So

25:19

I said well , that must be what he's talking about . I'll take the other route

25:21

. So I changed the

25:23

prediction of my trip to that thing based

25:25

on his input , because he raised a concern

25:28

. So this is the other thing I'm doing

25:30

with this is that round this should happen

25:32

in medicine . When we're doing a

25:34

nurse's shuttle , whatever , or they're

25:36

doing it already , a tool of Guwani's checklist

25:38

manifesto , they're doing it in operating rooms , right . If

25:41

they get in a circle , they say what's your role , what

25:43

concern do you have ? You realize , somebody

25:45

expressing a concern is not somebody writing

25:48

down a concern . They're calling it up , and

25:51

when I call up a concern , it triggers you . If I say

25:53

finger licking , you might see that we're good at

25:55

a chicken , right ?

25:57

Right .

25:57

I don't say finger licking , you see nothing . So

26:00

he raised his concern , and a concern

26:02

is a prediction of an outcome you don't

26:04

want . So if we could

26:06

practice every day in a hospital setting

26:08

, okay , everybody gets to speak up . That's

26:10

practicing speaking up . The likelihood

26:12

of somebody speaking up at the moment they need to

26:14

is slim . But if you practice the violin , you

26:16

get pretty good at it . And if you don't , you don't

26:18

. But if you practice speaking up in this little huddle , what's

26:20

your role ? What concern do you have ? I'm doing

26:22

it with the electric utility and they love it . Even

26:24

after they do their job brief , they

26:26

get in a circle and they're all type A's , they're competitive

26:29

and they're like oh man , I got to have

26:31

the best concern . Today they're all looking around for

26:33

the best concern before they get to that part of the job brief

26:35

now , and that raises

26:37

a number of predictions . And

26:39

then , once you play out , well , what's going to happen if that happens

26:41

? It changes your experience in your brain

26:43

, which changes the outcome . That

26:46

director changed the outcome for me going that

26:48

day because he gave me a prediction of that hill

26:50

and the funny

26:52

thing was when I got there I said this is exactly what I'm talking

26:54

about .

26:54

He said yeah , you know that's the shortest route for me . I'm

26:56

beginning to wonder if I should be going that way and

26:59

I laughed .

27:00

I said did you hear yourself ? I said you

27:03

already answered your question , right ? Right

27:05

, you had enough concern to tell

27:07

me and you're still driving that way . That's a higher

27:10

level thought . And we get caught up in those rituals

27:12

, right ? The Swiss

27:15

cheese model , James Reason , I don't feel familiar

27:17

with that . That was around

27:19

2000 . And I love James Reason's

27:21

work and I've read it . But the Swiss , the

27:23

model itself , the depiction of a bunch of slices

27:26

of cheese and the holes lining up , is

27:28

not a good model because it's a model of

27:30

an anomaly . And when

27:32

that all if nothing happens linearly and

27:34

if everything , all the holes line up , that's a pretty rare

27:36

event . And then what we do is we try to

27:38

add layers and layers of control to prevent that thing

27:40

from ever happening again . But

27:42

really all we needed to do is do a small compass correction

27:44

in the front . That thing would have never happened . But

27:47

we're not aware that it didn't happen . Because we made the

27:49

change . I think we are capable

27:51

of improving our predictions and

27:54

removing experiential blindness and that's why this

27:56

model is starting to gain ground

27:58

. I think because it's . I did its test on

28:00

LinkedIn . I wanted to see if the

28:03

hierarchy controls was actually a religion and

28:06

I knew , if I posted something about

28:08

it , that you know where are the hierarchy

28:10

controls , because it talked about a hierarchy of predictions

28:13

. And I immediately got

28:15

a repost with a whole negative post on it

28:17

and people just beating the crap out of me , which

28:19

I love . I guess it's a social experiment

28:21

for me , like , and I don't get emotional about it , it's

28:23

just fun , right ? So one guy

28:25

said our controls is perfect , we don't need

28:27

to put a strawberry on top , and I loved

28:29

that because it might

28:31

be perfect , but that

28:33

pretty much just confirmed You're so

28:36

sold on it . Now you're defending it , and

28:38

I didn't say the post to defend it . I was curious about

28:40

how much are we working on predictions , but

28:43

what range of defense , and that's I take

28:45

some responsibility for that . My generation has

28:47

modeled that really well , you know yeah

28:50

. I even did a tiktok recently , just

28:52

as it is . I do that I'm on tiktok because

28:54

the younger generations are there and I want to see what

28:56

they're learning . So I did one . I was

28:59

riding the chairlift at whiteface and I just did a brief

29:01

one on . I said I'm a baby woman

29:03

, I'm sorry . And then I went through the whole defensive device of dismissive

29:05

thing . It's a short tiktok and

29:08

the guy got out there and he said with a comment he

29:10

said hey , I'm a baby boomer . My millennial

29:12

and gen X started to watch your video . But when

29:14

they saw that you were on your ski vacation , they

29:16

tuned up and

29:18

I said and I said , geez , I love this . Thank

29:21

you for confirming this . I said what

29:23

I'm hearing is they immediately judged

29:25

and dismissed me because I'm on

29:27

a ski vacation . I said but what's

29:29

interesting ? I'm not . For 30 years I've been a volunteer

29:32

ski patrol and and I started

29:34

ski patrolling because I couldn't afford to ski . So

29:36

you dismissed me based on a belief .

29:38

That's not true .

29:39

Hmm , I said , which means your children

29:41

learned well . Wow

29:45

, that's something . Yep , I

29:47

mean , you see it . On Facebook and all these

29:49

other social media , people go rate to defense

29:51

. If somebody challenges their belief , they

29:53

go read to defense , and I think the world we want to live in is

29:56

we don't need to defend . We have we're pretty

29:58

cognitively high level on this planet . We

30:01

just need to be curious why somebody else has a different

30:03

belief .

30:04

Yeah , to that point , which I completely agree

30:06

with . They always try to shift

30:08

the blame too , and I

30:10

love what you're doing , billy is trying to learn

30:12

and interact with younger generations , where

30:15

most people try to blame younger generations or

30:17

older . Oh yeah , I see a lot

30:19

on on X . It's like we can't

30:21

afford a house now because the boomers did

30:23

this , and it's like what what that

30:25

doesn't do with them , you know , and so there's

30:27

always a shift in blame . And to this

30:29

one , it's like , to your point . There's always

30:31

a shift in like okay , I have this

30:34

preconceived notion of what I believe

30:36

and there's not room for

30:38

growth lack of better word Because

30:40

they're not trying to learn and they're not trying to understand

30:43

more of different situations , unique

30:45

situations . Back to your Swiss cheese model

30:47

. Is these anomalies like wait

30:49

, now , you know , on 2023 , December

30:52

, skeen in the United

30:54

States is expensive . You found

30:56

a way ? Hey , I want to volunteer , I'm gonna

30:58

make sure this happens . Or Outside

31:01

the US , right , if you get there somehow on

31:03

a cheap airfare , or whatever . Most

31:05

Europe or or even South America , is way cheaper

31:08

because it's not almost a Monopoly or

31:10

a small conglomerate that owns all the mount

31:12

ranges , and so there's all

31:14

these different ways , but it's it's easier to always say

31:16

, oh , billy's scheme

31:18

, I can't listen to him and it's just

31:20

yeah . It's just so unique that

31:22

where you're coming from is a much

31:25

more open , optimistic Learn

31:27

. I will even go out of my comfort zone joining tick-tock

31:29

I'm not even on tick-tock , so I love that but

31:32

joining tick-tock to try to learn and

31:34

be with , be with the youth and try to understand

31:36

them more .

31:38

So I started a path and I don't want to go too long

31:40

here for you , but the CPR thing and the CPR

31:42

instructor thing I started as I got . I got a ping-pong

31:45

and missed it . But so

31:47

I asked the the , the CPR instructor

31:49

. I said I'm gonna trigger you . I remember I started talking about

31:51

that .

31:52

I said is it okay ? I said yeah , so .

31:54

So I'm gonna explain optimism bias . So are you

31:56

gonna CPR ? Yeah , are

31:58

you married . Yeah , all right , let's

32:00

just say You're washing dishes

32:02

. I said it was a male . I said , which I know is

32:04

not true and and your wife walks in and you look

32:06

and all of a sudden you drop , did Go

32:09

. What will she do ? And she said well

32:11

and Well , and it's a lot of them

32:13

will look probably . I said well , probably . You

32:15

know , those are those red flag words Probably

32:17

, maybe , should be , might be means we don't know . But

32:19

going , keep going . And you know , with simulation , I can't

32:22

tell you what to do . I can only keep asking questions . So

32:24

, she's well , so he'll call 911 . Okay , does she know CPR

32:26

? Well , yeah , okay , what she

32:28

gonna do ? Well , she's gonna start CPR and then what well

32:31

, 911 is gonna tell you . It's 12 minutes . I

32:33

said so what's she thinking about ? And

32:36

at the end we redo .

32:38

I said when's the last time

32:39

you visited that sequence in your mind Never

32:42

? When's the last time a nurse

32:44

, dead , has sequence going home

32:46

doing CPR on their own husband ? Right

32:49

? It's not something you want to , it's not a

32:51

norm , right ? So because because we're out , because

32:53

we don't think it will happen , although it happens , thousand

32:55

out of hospital cardiac arrest a day , 700

32:58

are in the home . You know 70% are in the home

33:00

but we don't think it was gonna happen . So

33:02

we practice for the skill of CPR

33:04

but not for that stress response

33:06

. And I gotta tell you as a paramedic , if you call me

33:08

Jared and you have a broken leg

33:10

, you're kind of hoping I have some experience in that thing . But

33:13

we actually don't practice

33:15

for worst-case scenarios and when we do , we're

33:17

experientially blind to them . I

33:19

work with the utility industry . Heat

33:22

stroke those guys don't know the difference between exhaustion

33:24

and heat stroke . You don't realize they're gonna be

33:26

soaking wet because they're they're working outside

33:28

and they're sweating already a lot

33:30

of these to be hot and dry . For heat stroke it's not

33:32

, unless you're in a nursing home , right

33:34

, or electrocution . You know there

33:37

I investigated a number of the fatalities last

33:39

year the utility industry and every

33:41

time it appeared they were out at first . They're out of . The

33:43

crew was out of sync and that response

33:46

was so stressful for them that

33:48

now they're PTSD Because

33:50

we don't practice for that thing even in our mind

33:52

. So I think Simulation

33:55

needs to start doing some exercise

33:57

for the brain , and by doing that we

33:59

need to remove experiential blindness

34:01

To things like nursing

34:03

errors or . You know , you're not just

34:05

. You run a quote in ACLS . The

34:08

coach should actually follow some natural

34:10

sequence . No person has chest pain

34:13

and then all of a sudden , and now they're grabbing their chest

34:15

and now they're in v5 . You know , now they're

34:17

in v-tac . You know , now they're . Now

34:19

we're shocking them and they're , they have a weak pulse and

34:22

well , now they just lost the pulse again and that type of

34:24

thing .

34:25

Right , because you , those are the ones , real ones you've been on , yeah oh

34:27

, yeah , yeah , compared to a CLS

34:29

, when they're just putting different rhythms

34:32

up and you have to randomness

34:34

.

34:34

Right . Yeah this didn't sound

34:37

as scary to talk to you about as I thought it was going to

34:39

you guys , but it's . We

34:41

all have optimism bias . It creates experiential

34:43

blindness because we don't our

34:45

brain doesn't have the experience that we don't think it'll

34:48

ever happen , which causes

34:50

a predictive processing error so we

34:52

can get better at predictions . Which

34:54

removes the event all together . I think an example

34:56

9 11 Shouldn't

34:59

have never happened and the odds of

35:01

it happening before and after are the same , except

35:03

now I have to be got my belt in my shoes To

35:06

go fly right . We created all these layers

35:08

to control the thing from ever happening again

35:10

. But the thing with an anomaly there's so many

35:12

combinations and permutations

35:15

as to how things , outcomes

35:17

, can occur . We can't control them

35:19

all . But if we get in the front and start

35:21

actually focusing on predictions , being

35:23

prepared for that worst-case scenario and

35:26

making it happen , so it actually does stress us a little bit

35:28

I think it changes outcomes .

35:30

And that's no . I think you're right . I think

35:32

when I hear about your , what you're doing with the linemen

35:35

and having them think differently before

35:37

they start their work Right

35:40

, and they're all challenged to come up

35:42

with you know , one up each other and

35:44

I think that that's a cultural shift . Well

35:47

, that's the other part is we don't have to like each other

35:49

.

35:50

We just have to be curious and interested why somebody

35:53

as bright as you guys might think something

35:55

different than me , and that's . I think I mentioned

35:57

the hamburger thing last

35:59

time . I'm not sure , in case

36:01

I didn't . So I asked people if they like

36:03

hamburgers or not . They say you do eat hamburgers

36:05

here , I do you ever have a really good

36:08

hamburger ? I have , and

36:10

How'd you know it was good ? I enjoy

36:12

the taste of it , right , and that's what we think

36:14

the reality is . The only reason you

36:16

knew was good is because you've had a bad one , and as

36:19

soon as you bite into it without cognitive load , you

36:21

know this is really good . Not as good as Joe's , but ten times

36:23

better than those other ones . And I remember I did this

36:25

with dead last time . She likes McDonald's , right ?

36:28

So that's your hamburger bandwidth .

36:30

You don't base your good hamburgers only on the good ones , it's

36:33

on all the hamburgers . It's the same with

36:35

ideas . You don't base a good idea just

36:38

on the ones you like . Your bandwidth

36:40

is based on all of the ideas . So you wouldn't have to

36:42

even like my idea or who I am or any of that . But

36:44

you need to be interested why this idea

36:47

might be something different and you should really add

36:49

it to your bandwidth . You know I think

36:51

it was Margaret Mead said Never

36:54

underestimate the power of a small , dedicated group

36:56

of individuals to change the world . It's

36:58

the only thing that ever has . True

37:01

, so I appreciate to

37:03

Si m V S setting this up . I wrote three

37:05

one-page blurbs on optimism

37:07

, bias , experiential blindness and predictive processing

37:09

and Greg said he's going to put those up on his

37:12

SimVS website . So if anybody wants

37:14

to read a little bit more about it , I

37:16

can give you the word my book list . The

37:19

reality is , you guys are that population

37:22

that Margaret Mead was talking about . This

37:24

podcast has the potential to change the world

37:26

. I changed the route I traveled

37:28

because one guy told me something

37:30

and I don't know what would

37:32

have happened coming down that hill . Maybe nothing , but

37:35

I can tell you , I can guarantee you , if I got hit in the rear end

37:37

making that left turn .

37:38

I would have been mad that I didn't listen to him so

37:41

it's the same thing with my pool mitigation

37:43

, the risk mitigation plan that we work through

37:45

. We have the slide . We went

37:47

ahead and created a sign . I

37:50

put new things on the stairs

37:52

, creating that awareness to

37:55

a potential safety threat .

37:58

Absolutely and the easy way to start . So I'm going

38:00

to add just the physical reality , and

38:02

I mentioned this earlier . I handed

38:04

out a corn seed . The only thing I handed out in Sim Prevention

38:07

for the utility was a corn seed , and

38:09

I had everybody hold in their hand and I said this

38:12

corn seed , what is the potential ? And

38:14

they were like that can become a corn plant . I said right , and

38:17

what is its potential ? If you set it on your desk tomorrow

38:19

and come back in , Will it be a plant ? They said no

38:21

, and I said what does it need ? Well , it needs good

38:23

soil , sunlight and water . And your plant

38:25

doesn't care what you think or believe . If you

38:27

do the right thing with that seed , you can leave and it grows

38:30

a plant . That's exactly

38:32

how your subconscious works . You

38:34

can plant an idea and I said

38:36

so what on our planet starts

38:38

with that genetic code ? And

38:40

they're like thinking I said well , let me change that . What on

38:42

our planet doesn't start with that genetic code

38:44

? Everything starts just as genetically

38:47

coded , like the seed , including us , right ? I

38:49

mean your seed , Jerrod , started

38:51

a week before your mother was born . All

38:54

of the ingredients to form your eggs of her million were

38:57

there , right , and then you are

38:59

whatever number of siblings you have in a million , not

39:01

counting the odds of what that particular

39:04

sperm fertilizing that egg . And

39:06

then at some point you came into some

39:08

level of consciousness , you came from a biological

39:11

journey to a spiritual or conscious journey

39:13

and to me that's a space

39:15

, that's a room in space , and

39:17

the door opened , you entered the room and

39:20

you guys are in the room and we create whatever havoc

39:22

we can create in this life and eventually we

39:24

exit Because we wake up , having

39:27

never been asleep , and we go to sleep never

39:29

to wake up . But I firmly

39:31

believe , and especially being in medicine

39:33

, I've seen that space in that room be very small . A

39:35

baby born , is born and dies , sometimes in

39:37

a matter of minutes . But that

39:39

space we come from , the space we go to , I

39:41

have to believe , is the same space , regardless

39:44

of our religion , right ? And what we

39:46

do , what we accomplish in that space . I

39:49

read the book also 4,000 weeks , but

39:51

4,000 weeks is a lifespan If

39:54

you start looking at how many weeks you have left . Why

39:57

do we want to spend any more of our weeks being defensive

39:59

?

40:00

Right . There's only a certain number left Right

40:03

.

40:04

While we're in that space , before we hit that exit door , let's

40:06

raise our consciousness to

40:08

a higher level for the whole society and start

40:10

realizing that the bomb that lands in Palestine

40:13

or the bomb that lands in Israel is in physical

40:15

reality . It doesn't care . Its job

40:17

is to blow things up . The only difference between

40:19

those two bombs is their justification for being there

40:21

.

40:22

And that's a social construct .

40:23

Right , right , but

40:25

I talked to a lot , I know , and I bounced around

40:27

a lot of things . I hope I didn't blow your mind too much

40:30

, Jerrod .

40:31

No , this was excellent and my biggest

40:33

takeaway is , if you optimize , your

40:36

optimizing bias leads helping to remove

40:38

that experiential

40:40

blindness which then causes the predictive

40:42

processing errors . And I

40:44

think that there's a lot that you've if

40:47

I'm unpacking so

40:49

much of I'm grasping here from

40:51

all different areas , but

40:53

one is it's your own perspective in

40:55

a much larger world , where

40:58

being more predictive or taking

41:00

in outside variables

41:02

to try to learn obviously learning

41:04

is more powerful than anything but

41:07

then using that to be more

41:09

cautious I don't want to say cautious , but predictive

41:12

in what you're pushing forward in

41:14

your future .

41:15

So what we need are triggers . So the

41:18

optimism bias actually causes experiential

41:20

blindness , because if we don't think it's going to happen

41:22

. We don't predict and experience where

41:25

it happens . So if you don't think you're going to fall

41:27

off the bridge today , you're not going to be worried

41:29

walking across it , yeah , or wearing a light

41:31

jacket , exactly . So

41:34

the optimism bias that's Tali Sherrick's

41:36

book she wrote causes experiential blindness

41:38

, which is in the YouTube video by Lisa

41:41

Feldman-Barrick which is the easiest way to see

41:43

that explanation . So it changes our

41:45

predictions . We need triggers . So

41:47

, for example , when that thought comes to your mind

41:49

without your permission , we go to do a defense

41:51

off suddenly like , oh , I don't need to worry

41:53

about that or that's not going to happen . But

41:55

really , if there's a high consequence to

41:58

that thought that enters your brilliant

42:00

mind without your permission , you

42:02

need to just take a moment and switch to that system

42:04

. Two condiment , more accurate thinking

42:06

. Just weigh it . We can move

42:08

ahead with a maybe , but not without

42:10

switching out of your system one mind to your system two

42:13

to really consider the consequence

42:15

for that action which is what I did when

42:17

I changed my route on

42:19

Long Island last week . And

42:23

then you learn not to blow other people's ideas Because

42:25

it didn't show up in your head doesn't mean it's

42:27

wrong if it shows up in somebody else's head

42:29

. It takes practice . I'm

42:31

not great at it yet , but I'm working on it . I

42:34

still have time .

42:36

Great outlook .

42:38

Well , listen , I appreciate this and I

42:40

think I probably talked too long . It's been almost an hour

42:42

, no , but thank you .

42:44

Yeah , thank you . We enjoyed listening

42:46

to your unique perspectives

42:48

and the

42:51

things that you're trying to do . Thank you .

42:53

Well , thank you , guys . You're providing a platform to

42:56

change the world , right ? You are exactly

42:59

what Margaret B talked about Small

43:01

group of dedicated individuals with

43:04

a desire to change the world . So thank you .

43:05

Certainly try the only the crazy ones do . That's

43:08

right , all right , thanks guys .

43:11

Thank you , happy simulating

43:13

.

43:14

Thanks again to

43:16

SimVS for sponsoring this week's episode . Check

43:21

out simvs . com to

43:24

learn more about their new four-pump

43:26

simulator . Thanks

43:33

for joining us here at The Sim Cafe . We hope you

43:35

enjoyed . Visit

43:40

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43:42

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