Nurses Immerse in Simulated Training

Inside a patient room at the Johns Hopkins School of Nursing Center for Simulation and Immersive Learning, monitors beep, IV fluids flow, and nursing students dressed in scrubs place a breathing tube in a mannequin patient. The flurry of activity is intended to inspire the same tension a nurse would experience in an actual hospital room, according to Kristen Brown, Nurs ’17 (DNP).

“We want students to feel like they’re really taking care of patients and making decisions because the more times they practice, whether they’re under high stress or doing repetitive tasks in that environment, the more successful they’re going to be in a clinical setting,” Brown says.

An associate dean at the School of Nursing, Brown oversees the Center for Simulation and Immersive Learning where students are able to experience clinical scenarios in a safe, simulated space. To ensure the best educational experience, Brown researches novel immersive technologies and determines which will be most worthwhile for students.

“Technology is changing rapidly, and one of the things I feel very strongly about is not just checking a box because something seems cool or new and exciting,” Brown says. “Immersive learning should result in a change of behavior in the learner, and if it doesn’t, then it’s not effective.”

Today, the center is home to labs for practicing skills like administering medications, wound care, and other procedures, as well as patient rooms outfitted with hospital equipment for simulated situations, where students can practice communication skills and interprofessional collaborations across disciplines. There are also outpatient rooms that replicate real-life environments and an extended reality (XR) lab for students to participate in simulations through virtual reality, allowing for more training without the burden of more space.

However, an expansion is also underway which will feature high-fidelity spaces that can be adapted to meet the needs of multiple learners. This addition will include critical care spaces, a fully equipped OR setting, and multiple rooms that can be converted from an outpatient environment to a home-health setting, to illustrate situations across the spectrum of health care.

Before her current role, Brown spent nearly two decades in nursing, first as a pediatric critical care nurse and then as a nurse practitioner in the Johns Hopkins Pediatric Intensive Care Unit. This transition in roles led her to simulation learning.

“As a new nurse practitioner, I was very nervous and wanted to have some more education, and I stumbled upon simulation,” Brown says. “I quickly fell in love with it and decided that I wanted to take my nursing career in a direction where I could use simulation to educate.”

This revelation led Brown to pursue her doctor of nursing practice degree with her research centering on simulation learning. During her doctoral work, she was named a Zamierowski Simulation Fellow, a two-year fellowship at the Johns Hopkins Medicine Simulation Center, focusing on all aspects of simulation, from research and education to operations and administration. The fellowship was funded by a gift from alumnus and retired surgeon, David Zamierowski, Med ’68 (MD).

“The fellowship was a game changer for me and my career. I was able to get my doctoral degree and research simulation-based education as a direct result of that funding,” Brown says. “I like to think everything I do now has snowballed from that generosity.”

Zamierowski’s philanthropic support for simulation education has also continued, with gifts enabling the School of Nursing to expand and explore other innovative technologies, such as extended reality experiences using a new artificial intelligence platform which will guide students through their nursing journeys by learning how they best master material and suggesting resources to help fill in any knowledge gaps.

“So, let’s say a student is struggling with one area and needs additional support, or a student learns better through auditory, visual, or other means. The goal is to have the AI platform offer resources based on this need, whether that’s additional reading or doing some asynchronous virtual reality simulations,” Brown says. “This allows the suggestions to be more learner-centered and tailored to the student.”

Brown stresses that her foremost priority is that the nurses who train at the center leave ready for anything they might encounter during their nursing careers.

“One of the studies I did recently after a specific simulation training asked if the students used what they learned in their clinical setting, and if they found it helpful,” Brown says. “It was really amazing to see the students write, ‘Oh my goodness, I took care of a patient with the very thing that we trained for, and I felt prepared,’ or, ‘I was able to speak up in a situation that I didn’t feel empowered to do in the past.’ So, for me, the greatest reward is when students tell me the training was effective in that transition to the practice phase.”