The Sim Cafe~ An interview with Dr. Dan Weberg

Dan Weberg, Vice President, Transformation Services, Ascension

Dr. Dan Weberg is an expert in nursing, healthcare innovation and human-centered patient design with extensive clinical experience in emergency departments, acute in-patient hospital settings, and academia. He currently serves as the Vice President for Transformation Services at Ascension, supporting 60,000 nurses and 140+ facilities in modernizing nursing technology, developing new care models, and measuring innovation outcomes.  

Previously he was Head of Clinical Innovation for Trusted Health, the staffing platform for the healthcare industry, where he helped drive product strategy and works to change the conversation around innovation in the healthcare workforce.

Prior to joining Ascension, Dan spent seven years at Kaiser Permanente, where he held executive roles in nursing innovation, research, and technology strategy across eight regions, 38 hospitals, and 60,000 nurses. He was also part of the founding faculty for the new Kaiser Permanente School of Medicine.

Dan is on the faculty at The Ohio State University College of Nursing and has multiple innovation fellowship programs. He previously taught nursing innovation and leadership at Arizona State University. He is on the editorial board for Nursing Administration Quarterly and has authored two dozen peer-reviewed articles and two textbooks, including Evidence-Based Innovation Leadership for Health Professions and Leadership in Nursing Practice.

Dan earned his bachelor in Nursing and was in the first cohort to graduate from the Masters in Healthcare Innovation program at ASU, as well as the first-ever graduate of the Ph.D. in Healthcare Innovation Leadership program at ASU. Dan serves on several advisory boards, including the American Nurses Association Innovation Advisory Board. His clinical background is in Emergency and Trauma nursing at level 1 trauma centers in California and Arizona.

Website:
https://drnursedan.com/
LinkedIn: 

https://www.linkedin.com/in/dr-dan-weberg-phd-mhi-rn-6195894/?trk=public_profile_browsemap

UCLA Health: 

https://www.uclahealth.org/nursing/workfiles/EBP/EBP%202017/Weberg%20Biography%20-%20Web.pdf

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Transcript

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Intro: 0:29

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Simsolutions, edited by Shelly Houser. Join our host Deb Tauber, as she sits down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.

Deb: 1:02

Welcome to another episode of The Sim Cafe. Today, we are truly blessed to have Dr. Daniel Weberg and Dr. Weberg is a subject matter expert in many things. Dr. Weberg would you like me to call you Dr. Weberg or Dan?

Dan: 1:19

No, please. Dan.

Deb: 1:20

Okay. Thank you. So, Dan, why don't you tell our listeners a little bit about yourself and about your new appointment too?

Dan: 1:29

Yeah, so I'm an ER nurse at heart, and I jumped into simulation as a nursing student. SimMan was in a closet and, uh, I taught myself how to program him from there that sort of catalyzed me into realizing that we can do things differently in healthcare and nursing. Um, simulation was a way to differently train our students, including myself, and I've just got this bug for innovation. So I sort of built my career on innovation and have done everything but pure operations. That's sort of,<laugh>, that's sort of in the theme of my career is, you know, done simulation and innovation and research and education and professional practice. And I never had a desire to go up through sort of the operational leadership ranks, but have held roles at some of the top health systems in the country, Kaiser Permanente, uh, Ascension healthcare, Arizona state university, Ohio state, the Ohio state university, and just really built my career on trying to push the entire nursing into, into the future.

Deb: 2:26

Excellent. Now, why don't you share your journey into simulation? Exactly. How did you get into it?

Dan: 2:33

Yeah, so I was a senior nursing student and I was sitting in one of our classes, one of our nursing theory classes, and I said, for your senior year, you have to do a project. And, um, I was like, okay, what does that mean? And one of our faculty came up and her name was Bunny Casamom. And she said, we have these simulators. We bought, we're trying to rethink nursing education. We need somebody who's sort of tech savvy to come in. We're gonna do, you know, one or two students to, to, to sort of craft this senior project. And I signed up and I, I think I was the only one that signed up and I basically locked myself in the room with SimMan for about two weeks, just pushing buttons and seeing what he could do and ultimately learned how to program automated scenarios with him. So the first one we made was coder Johnson, which was code scenario. And, um, I think it was a VTAC code, CS code, and I demonstrated it for the faculty I showed how, like, when you start chest compressions, you could trigger a next thing to happen and really automate the use of the simulator in some capacity. And it just took off and we started running coder Johnson with the senior students. And then when I graduated, they were like, Dan, we have no one who knows how to use simulation. Can you come back and say, actually hired me as a consultant right after I graduated to come back and teach the faculty how to run simulation. And from there, you know, really just sort of build, help them build out their, their sim center. I went off to be an ER nurse for a little bit, uh, for a year at UCLA, California, and then they were continuing ASU was continuing to expand their sim center and there's an opportunity to come back. So I ended up coming back to Arizona, working full-time nights in the ER part-time days in the sim center as the simulation technology nurse. And I got to do everything from programming to moulage, to running scenarios, to being the voice, to even teaching some of the courses and really sort of, and this was before simulation was sort of ubiquitous. So we were trying to, you know, learning as we went. And so we, we were trying to figure out, you know, how to do debriefings and, and really just sort of building how SIM is now taught from the ground up, which is, which is really fun. And then from there just sort of consulted a little bit on, uh, with different nursing schools and programs on simulation. And that was sort of my entree into the larger innovation technology space within healthcare simulation was really, really my start. And then sort of wrapping that up is when I ended up doing my PhD in innovation, I used simulation the adoption of simulation in a nursing school as a proxy for how change in innovation occurs in an organization. So I did a case study on a nursing school that was adopting simulation for the first time and looking at all the leadership characteristics translated that sort of case study into innovation behaviors that would allow for successful adoption of innovation really in any organization. So SIM's really been my core.

Deb: 5:13

Excellent. Excellent. Dan, what year was that, that, that you were at Arizona state when you opened, you know, started With that?

Dan: 5:19

Yeah, when I pulled sim man out of the closet, that was 2004 five. So, um, so it was 2004, 2005. When we pulled out, when I did my dissertation, it was, I think we started the data collection in 2010 and yeah, so that is really that, that kind of five year period between 2005, 2010. And I think that's really when simulation was really starting to take off within nursing school. So that was sort of the growth years and now it's just expected across the country.

Deb: 5:48

Excellent. Excellent story. Now, can you share your favorite or most impactful simulation story with our listeners?

Dan: 5:56

Ooh,<laugh>, there's so many, I mean, I'm, you're bringing back memories of like students crying over SimMan<laugh>, you're bringing back memories of like these aha moments that happened. You know, I think one that was cool from a mage standpoint is I figured out how we could make SimMan urinate into a Foley that was kind of fun to figure out, like, how do you set up this pump offsite to push when they gave LASIK to check the urine sort of thing. There's another one and really, you know, cuz I was the ER, so I love doing like the critical care sort of arrhythmia stuff. And so, you know, I'd bring in rhythm strips from work and show them and have them sort of walk through an entire progression of a code before they went into SimMan. They could see the changes in rhythms and stuff and you could just see the light bulbs going off. And so I just, I'm such a fan of SIM and its ability to evoke emotion and solidify these concepts that students just never see in the clinical environment. And so, I mean, there's probably too many to list<laugh>

Deb: 6:59

Yeah. Now Dan, you've got a lot of experience at a lot of different places with your consulting. Do you foresee some of the future of nursing of using simulation for interviews?

Dan: 7:13

Yeah, I honestly do. I mean, I think sim has is completely underutilized. So I think simulation used for interviews, I think simulation for competency assessment. And that was a grant I was involved in, in Arizona state. We built a simulation that the board was gonna use in order to assess nurses, decision making after having their license suspended or on C because of some error. And so using simto assess competency, using sim to assess interview pieces, their, their practice, I think we could use sim in order to, uh, educate patients. I don't think we do enough of bringing patients into the SIM center to teach them how to care for their loved ones or what's gonna happen during a surgery and that kind of stuff. And then even when I helped build the Kaiser Permanente medical school, as one of the founding faculty and in there they have a huge SIM center. I hired the team and helped design that SIM center and it's a cadaverous anatomy lab. So using virtual reality, augmented reality to teach things like anatomy and then taking them into the sim center to do it on a mannequin. I mean, there's just so many things that simulation can do to give us a better picture of the clinical decision making and competency of, of our nursing workforce or, or clinical workforce. I think sim is just completely underutilized.

Deb: 8:24

Yeah, I would totally agree. Where do you see the future of simulation going?

Dan: 8:29

Yeah, well, I don't know. I guess if you ask Zuckerberg, he's gonna say the metaverse, but you know, I think it's gonna be this mix of sort of physical mannequin and the augmented reality on top of that. And so, and I know the big simulation manufacturers have come out with some things related to that, some goggles and things that can place either moulage or data on top in, in sort of this augmented reality piece. I think that that's gonna be huge. I also think that because we need to train more clinicians more effectively to produce more because we have such a shortage across almost every profession that simulation's gonna be adopted more for nursing school in general. And maybe we see a decline in the number or the way we've done pure clinical hours with patients and move those dis simulation to prepare. And so I think we have to think about things differently, cuz the limiters in nursing education right now are clinical assignments and faculty, but with simulation and virtual reality, you can actually expand the reach of that content massively. And so I think we have to double down on things like SIM in order to train more people more effectively to provide the care because there's, there's not enough.

Deb: 9:36

I totally agree. Can you share with our listeners some of the things that you learned and did during that pandemic? Where, where were you? What's your story?

Dan: 9:47

Yeah, so I was in a interesting position. I had just left Kaiser Permanente and joined a startup company called trusted health, which is a staffing marketplace for travel nurses. And so I had started at the late 20, 19 and quickly after<laugh> we started getting the COVID spikes and things. And so in the first wave in New York, we, our company sent over 200 nurses to New York on a plane within a couple days. And then throughout the pandemic of the heavy part of the two years of the pandemic, I was basically a chief clinical officer for trusted health. And so I was doing everything from, you know, supporting nurses and standing up mental health support systems for them to maintaining quality of nursing practice and, you know, issues happened having to deal with that or report to the board of nursing and those type of things going through a J O staffing assessment. And so really got to see across 5,000 hospitals and several thousand nurses who were out working across the country. And it gave me a great insight to what's broken in healthcare. And one of the biggest things is how we assess competency<laugh> and how we train and do onboarding of nurses. And I think, you know, there's a huge opportunity for sim to play a part there instead of these online modules that you can Google the answers to and click next, next, next to finish up. I think there's an opportunity for us really to assess clinical work better using some sort of simulation.

Deb: 11:09

Excellent. Now, can you share with our listeners the biggest thing you'd like them to know like something that you learned and it changed the way that you practice almost a personal aha moment.

Dan: 11:24

Yeah. I mean, for me it's really, it was a leadership thing. And so I was working in the ER and I was working nights and we had our pre-shift huddle that we had every, every night where the manager would come in and kind of talk about, you know, how the unit looked that day and that kind of stuff. And this time the director of the ER came in and I remember like, why, why are they here? What's going on? And she got up in front of the room and you know, we're all just trying to finish our dinners before we get out on the, on the floor. And she said, we're over budget this month. We really need to sort of clamp down on that. And so one of the things that I've decided we're gonna do is you guys need to stop using so much gauze.<laugh> like, that was her answer. And I was like, we're in ER,<laugh> like where like use less gauze? Like what, what kind of solution is this? Like where do people, like you sat in your office and you thought about all the ways we could reduce the budget and it was stop using gauze in the emergency department. And I was just, I was just so frustrated and the whole, I looked around the room and just everyone's like, what, what are you even talking about? Like what an irrelevant sort of thing. And so that shift, we used as much gauze as we possibly could, which probably wasn't the right thing to do. But it was just, we were just so baffled by this just lack of understanding of what actually happens out on the floors. And I think that was a moment that I realized, you know, we have these people in leadership positions, they're not always prepared or know what they're doing. And so I was just fascinated by like, how do you lead? What is the science behind leading? Are there special tricks and things you can do to actually be a good leader? And that sort of catalyzed me into my master's program and my PhD program. And then, you know, all the, the writing and teaching and stuff that I do is just like, we there's a way to do it. And that wasn't it<laugh>. And so like how do you prepare leaders across all parts of healthcare to actually understand the science of change, the science of innovation and adoption of new things and, and problem solving. And so that, that moment though, I just, it's something I write about and talk about all the time it's it's um, that really just made me realize just cuz you have a leadership title, doesn't make you a leader and there's ways to do it and throwing stuff at a wall and seeing what sticks is in it.

Deb: 13:31

No, I totally agree. I remember I was a clinical educator in level one trauma center and for some reason everyone was to wear white and they were to wear white underwear and I remember one nurse just didn't wanna do it. And so she would she'd wear like crabby pants, underwear, and you know, to just get leadership riled up. I mean, it's just like you guys with the gauze, like how much gauze can we use and I'm sure it was all over on the, on the Pixus and

Dan: 13:59

Yep. Yeah, yeah. And part of me, and now that I know, I understand sort of how systems change and that kind of stuff, those provocation moments like wearing the<laugh> crabby pants, underwear and stuff. There's something to that because why people don't change, they get in routines. And so you get in this routine and you never break the routine. And so you just get used to it. You never question why you do these things over and over and over and over again. And we saw it in SIM too, like you'd come in and the faculty just start lecturing<laugh> at their students that using the power of simulation in the SIM center to actually show them. And so we had to break that routine of not about content delivery. It's it's not about always following there was about questioning them and bringing evidence to show that maybe this isn't the best way or, you know, maybe it's not as culturally sensitive or whatever it is. And to break that routine by wearing different underwear or using more gauze, this doesn't work, it's sort of that positive deviance sort of stuff that I think ultimately helps people question the routines that may not be as relevant as we thought.

Deb: 14:56

Yeah. I could see people, oh, Hey, let's pad the side rails with gauze for<laugh>.

Dan: 15:01

Let's go, let's go TP the office....laugh.....

Deb: 15:05

No, yeah, I get it. I get it. Is there anything else that you'd like to share with our listeners? You wanna talk a little bit about your new appointment and what that's gonna mean and how you're gonna effectively use that?

Dan: 15:16

Yeah, so I'm excited recently got selected as a fellow for the American Academy of Nursing, which is amazing honor. I think it's 0.1% of the profession has that fellowship. It, it demonstrates sort of an international impact and significant contribution to the profession, which is an awesome honor and wanna thank my two mentors, Tim Port or gradient Cathy Mallick as sponsoring me and, and helping me go through that. But I think when, what I wrote in my LinkedIn post about it was for me, you know, people question, yeah, why are you gonna be a fellow? It seems like something you do at the end of your career sort of thing. And for me, it was validation that the work I've done is recognized, which was really cool. But for me also, you know, I've built my career on sort of honoring the traditions of nursing and healthcare and then pushing it<laugh> past where it is and trying to push it into the future and sort of fellowship is a recognition of that. So it, it validates that you meet the criteria that's been set up for a long time. Uh it's, it's a, it's a long held sort of recognition and then use that platform to help say, Hey, look, this is legitimate stuff that I'm not just throwing stuff at the wall, but I've met your criteria now let's continue to push forward on it. So I'm excited to, to use that and really have another cohort of some of the top people within the profession to be colleagues with and help them shift into the future and hopefully push them, you know, using things like simulation as the backbone for care and education. I think there's just huge opportunities that nursing needs to jump on.

Deb: 16:41

Excellent. Excellent. Is there any specific research projects you're gonna do?

Dan: 16:45

So with this fellowship, it's not necessarily research focus, but there are different sort of committees within the academy that you can jump on. And one of them is a future of nursing sort of technology bend. And so, um, my plan is to be a part of that community to do assessments and to push the kind of thought leadership of nursing into the technology space. So that's where I'll focus. And then, you know, I'm still faculty at Ohio state. They're doing a ton of stuff in VR at the moment. So Mike Ackerman, who runs the master's in innovation program in the center for innovation there, uh, just got a big grant from American nurses foundation to fund and build out a, an extended reality lab. And so hoping I can be involved with that with my work at Ohio state. And so I think there's lots of different pieces here that gonna come together as the future unfolds.

Deb: 17:32

Excellent. Now, is there anything else that you'd like to ask me

Dan: 17:35

You're much closer to the sim stuff than me? So I would say, you know, where, where do you think the biggest gap in sim is? You know, for me, I used to tell people the moment you can start educating patients with simulation. The other one was can, can you prove that doing simulation based training directly enhances care delivery, those were sort of the two unknown questions when I was very focused on sim, but I would love to hear what your future is. And where do you think the biggest gap is?

Deb: 18:02

I think the hybrid is in the futures, uh, augmented reality, virtual reality simulation, all of them together. One of the things I feel really passionately about what I love to see is teaching done for patients maybe on their iPhone or device so that when they leave, they can see what they're supposed to do. What's expected of them. I feel like patients are anxious when they leave, you know, the hospital, the nurse physician's office, whatever, and they don't understand what they're supposed to do. So they, you know, like for example, take care of a, you know, how to take care of your wound or the things that you're supposed to do. So if, if you were to go ahead and do them on a video, then they would have access to that to make sure that they're doing things that's right.

Dan: 18:50

Yeah, no, I love that. And I'm working with a grant at university of Calgary with a local nursing home on something like that. They're gonna try and train their residents on some daily care pieces using simulations. I think that's a huge opportunity and I love the virtual extended reality piece too. The reason we did the SIM lab and the cadaverous lab at the med school was there was some research at a case Western saying, students could learn anatomy in three hours instead of nine hours per body system using virtual reality than they could with cadavers. And so we're like, well, if you could get six hours back per body system, that's massive.<laugh>, you know, that's like, I don't know, 24 hours back in your curriculum for that year. That's where you can teach leadership, but you can teach skills that they don't have, or you can do all these things that we sort of skip over, cuz we have to focus and, and take so long in these lectures and things like if, if you can teach more efficiently, both to patients and to students, I think there's a huge opportunity for us to do that. Cuz we need to speed up nursing tool, what we need to make it more effective so that we can get more people into the professions.

Deb: 19:50

Yeah, I totally agree. Is there anything else you'd like to leave our listeners with,

Dan: 19:54

You know, continue to push the walls? I mean, there's a,<laugh>, there's a lot of people still resistant to SIM, I would say, you know, continue to push and show and do the research on it. I'm a huge fan of it. I think we need to flip the paradigm to say nursing school's core is simulation and clinical experiences are an augmentation. And so that's sort of a provocative thing, but I think if we can start flipping that script, then we can actually provide a more consistent educational experience. And you know, for me, just I'm all about positive deviant. So if people are telling you no and you believe in your heart that this is the right way to go, I say, try it out and ask forgiveness later. So that's what I'll leave the, leave the listeners with.

Deb: 20:32

Oh, I love that. I love that. Thanks. Now, if our listeners wanna get ahold of you, is there anywhere special that they can get ahold of

Dan: 20:38

You? Yeah. So you can go to doctor, nurse dan.com, Dr.Nursedan.com and find me there. I'm on LinkedIn a lot. And so LinkedIn's one of the best places to find me. And I share a lot of content on innovation technology and, and everything that's going on in my world. So I would say those are the two places.

Deb: 20:58

Excellent. Really appreciate your time today. Thank you so much.

Dan: 21:01

Yeah. All

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Outro: 21:21

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