The Sim Cafe~ An episode with Bryan Dang - Discussion on solutions for the nursing shortage

Bio for Bryan K. Dang

Bryan is a nurse who merges his background in pediatrics, education, and human factors research to create impactful solutions to challenges faced by our nurse training pipeline. Together with his team at Syminar, Inc., Bryan is on a mission to help schools end the nursing shortage by 2029.  

As a co-founder and Head of Product, Bryan has been leading Syminar’s charge in overcoming the shortage of nursing faculty and facilities for simulations and clinical rotations for nursing programs.

 Most recently, Bryan and his team showed up at IMSH to launch a paid pilot for Syminar’s VR360 Live Streaming Station. This innovative system aims to help sim centers build business cases for funding and demonstrate the positive impact of psychologically immersive technologies on nursing students’ learning and performance outcomes.

 Bryan's passion for healthcare education and desire to improve access to resources led him to develop this VR360 Live Streaming system while in graduate study for Product Design and Engineering. The results of his and his collaborators’ research have been published across various nursing education journals since 2018, showcasing the positive impact of VR360 videos on student engagement in simulation and lecture hall environments.

 He’s excited to share his journey, Syminar’s current impact, and how he hopes to shape the future world of nursing education with our podcast audience.

Website:    www.Syminar.com

Email: bdang@Syminar.com

Innov2Learn website:    https://Innov2learn.ca 

Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.

Transcript

Disclaimer: 0:00

The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors.

Innov2Learn Ad: 0:14

This podcast featuring Bryan Dang, is sponsored by Innov2Learn the creator of user-friendliest, simulated medical devices. Advance your simulations w ith Innov2Learn's latest release, the Bluetooth controlled,simulated forehead thermometer using a mobile app. Use the promo code, THESIMCAFE(in all caps) to get a$100 early bird discount Offer expires March 12th. Don't miss out!

Intro: 0:42

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host, Deb Tauber and co-host Jarrod Jeffries as they sit 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: 1:22

Welcome to another episode of the Sim Cafe, and I'm your host, Deb Tauber, and our co-host, Jarrod Jeffries, is here along with us.

Jarrod: 1:33

Hello. Hello. And now we are truly blessed to have the discussion over Mr. Bryan. Dang. We're excited to lead into this.

Deb: 1:42

Thank you, Bryan for being here today. I'm gonna give you a little bit of a background. Bryan is a nurse who merges his background in pediatrics education and human factors research to create impactful solutions to challenges faced by our nurse training pipeline. Together with his team at Syminar Inc., Bryan is on a mission to help schools end the nursing shortage by 2029. So we applaud this mission and really wanna know how we can help and serve you and help you reach this goal. Thank you. We wanna tell our listeners a little bit about yourself.

Bryan: 2:19

Sure. I spent some time as a pediatric nurse and clinical skills educator. I was a nursing and human factors major in undergrad. And my journey into clinical simulation actually came about through exploring human factors research, which I think is such a fascinating area to dive into. Eventually, I created some products for nursing programs through the support of some really fantastic friends as well as my graduate program in product design and engineering. I co-founded a startup called Seminar. We believe it's an incredibly important goal for schools to tackle the nursing shortage by 2030. So we ship products and services to that end.

Jarrod: 2:57

Great. And we were put in touch by some of nursing simulations greats with, with Kim and Suzie, and they were also at IMSH as you were. So what did you think of IMSH as a whole this year and how many years have you been?

Bryan: 3:10

So I think I met, I met Suzie Kardong- Edgren back in 2016, and I'd gone maybe between now and that time. I think I'd gone to maybe three. What did I think of my message overall? Uh, it's a lot bigger this year than I remember from previous years. I think my first year was also in Orlando and it was in a different center. It was in a different hall and it was much smaller then. But the energy was something my teammates and I, we all super appreciated. Everybody just seemed so eager to kind of sit and, and contribute their time. We were in the nonprofits booth, so you know, like kind of a little bit in the back. But fortunately we were positioned next to cms, so we got to benefit a lot from their foot traffic. And we thought that a lot of people would be tired and unwilling to interface with us, you know, because we were all the way in the back and people would probably be burnt out talking to vendors all all day. But no, everyone was just super cool and came back home and the energy carried on. So I don't know, I was just astounded by a community that came together. Different people, right? Doctors, nurses, um, human computer interactions, folks, just crazy, crazy, uh, diversity of backgrounds.

Jarrod: 4:17

It truly is a professional education, really at its finest. I always find with what s SSH does. And then, you know, more specifically the conference of IMSH. There's always to, I mean, to your point, diversity, but there's all these collections of disciplines or healthcare disciplines that you really don't find in many other healthcare conferences. So it's, it's always a special time. From your background as a pediatric nurse, then you transitioned into more of a a product role. Can you tell us what this product role is? Where are you working? How do you spend your time now?

Bryan: 4:50

So Syminar is a tool for live streaming and recording VR 360 video. Think of it as a Zoom, but with VR 360 video. So what is that like? Imagine students attending a Zoom class wearing virtual reality headsets wherein they can turn their heads and follow the subject of the Zoom or say a clinical simulation across a 360 degree view in the student's minds. This creates a sense of presence that makes it easy for them to lose themselves inside the scenario to become engaged and untractable because to them it feels like they're standing inside at the video of a simulation. So there are no tempting side conversations from their peers or phone notifications that exist to distract them.

Jarrod: 5:33

What's the benefit of a 360 video versus just the what we're kind of used to today?

Bryan: 5:38

Oh, I think the practical benefits are many. I can think of four. Firstly, teachers can record sessions with 360 degree views without needing a camera person controlling the pan tilt or zoom. Because VR 360 recordings capture 360 degrees worth of angles. Teachers can view and review the video from any angle they like. This feature is particularly useful for recorded skills competency evals, because the subject, usually a student can't go off camera to read notes and any post editing of the video is easily detectable through software. Secondly, VR 360 is inclusive of students who have historically experienced motion sickness when using vr. This technology can be used on existing hardware that students and schools already have. Students can interact with VR 360 content on their existing devices by simply using their computer's cursor or their finger to touch and, and, and pan around. Educators who are worried about students who are offsite often ask us, what are the bandwidth and device limitations? Are there any, and we normally reply, if you can play YouTube videos on the device, you could use it for VR 360. Thirdly, VR 360 is a simple and easy to understand VR medium. It's basically a video where viewers can look around. So if teachers can wrap their minds around this, they can quickly turn this into a tool that is a low cost means of immersing students and recapturing their attention whether they're onsite or they're intellis sim. Lastly, it's a learning modality that has engagement measures that are similar to that of simulation participation, but without the performance anxiety. This entire project started as a university funded grant and we brought this learning modality and the results to sim inventors where we met Suzie Kardong-Edgren a lot of encouragement from her and from the community led us to gather a team to make this psychologically immersive learning condition readily available to sim centers as a paid pilot.

Jarrod: 7:40

So I love the live stream and I love the differences, you know, probably from some of the other providers. Is there the case where this is recorded? If it's not recorded, how do you access it after? Do you guys integrate with other platforms or programs? Tell me a little bit more about that.

Bryan: 7:56

There's recording capability, I think with all live streaming. Live streaming is useful, but like live streaming plus recording is the best on the platform. There is a record option. We don't set recording as a default one because it takes a lot of space up. And two, a lot of programs have concerns about student privacy. Even though our tool is c ompliant, every type of c redit cloud service, data security checkoff that's needed, we have, we s et it as an option for educators to actually, uh, hit the record button themselves. And to Jared's question about what is my daily life like, most of my choices are made through a single lens alone. And that is, how does this action or project support schools in ending the nursing shortage? At a tiny s tartup, that usually means I'm playing the role of mortar between the bricks. Some days I'm engineering through a human-centered design model. And so I usually find myself working on that concept, presenting it to a stakeholder, usually a customer, and then I'll usually put it in front of a consumer and I'll run an analysis on how that affects the greater community overall. And then, uh, if it really hits and it checks off all those hurdles, then I'll hand it off to my developer team to further f lush it out. And that means I'm working on a piece of hardware, I'm chatting that or, uh, other days I'm working on a piece of software. Lately I've been designing a service to help schools u ncap t he number of available clinical sites. So we're trying to find a way to get schools an unlimited number of clinical sites anywhere around the nation. On other days, I will be working on designing research studies. I might be running, uh, literature review and compiling that. Then I'll hand it off to a sim c enter collaborator to submit to h is o r h er or their their. U h, more recently I'm working on a way to influence public policy. A new tool has k ind o f come out i s Chat GPT. It's a generative pre-trained language model. And this has been really t hrown educators for a loop, right? What do you do when your students can reach i n t heir, their phone or their iPad and ask a really smart AI assistant for answers to a test or to write them an essay that would misrepresent them as being ready to take on a, a role where lives are involved a nd patient safety i s a t s take when in fact they're actually underqualified. So I'm working on writing a piece i n op-ed to some journal of nursing regulation, perhaps the Journal o f Nursing Regulation, i f they'll a ccept m e. The piece is basically a call to regulatory agencies to rally behind two parties, uh, nursing educators who are working on new ways to do nursing student evaluations and clinical simulation and skills educators who are willing to lead from the front suggesting new methods of evaluation that might, uh, create like a Chat GPT free testing environment that would result in new grads that are more closely aligned with what we want good clinicians rather than good test takers. So working on public policy to defend us against AI misuse that piece. I've recently handed off to one of my mentors who's a senatorial staffer with experience in writing policy memos and congressional testimonies. So this is a broad set of activities I do in the day-to-day. S ome are research, s ome are development, and s ome are to bring seminar o ut of a niche and into the broader sphere of public awareness. But all of these are in service of the core mission to end t he nursing shortage by 2030.

Jarrod: 11:09

So addressing this nursing shortage, I'm curious about a couple things, but I'll, I'll start with this one. What does the future look like for syminar and what does success look like as well?

Bryan: 11:17

Well, my answer to both questions is to help schools end the nursing shortage by solving two of the three Fs that are cited by the AACN each year as reasons why schools can't admit more student nurses. Those three reasons being a lack of faculty, a lack of funding and a lack of facilities, facilities being broken down into two things. A place for clinical practice and a place for pre-transition to practice like sim and skills labs. This VR 360 live streaming station that we brought to IMSH addresses the facilities pre-transition to practice piece. It does so by lowering the barriers to simulation through making, you know, uh, really great AV capture, really usable, high quality and low cost. And it also helps teachers engage students more easily on any devices they have and also like seamlessly transition over to VR headsets if they so choose to try that out on their campus. And finally, it increases the usefulness of past livestream recordings to at the very least, help students approach test training with greater confidence. I really think educators will start turning towards VR 360 video for much more than simulation education, especially in the age of Chat GPT, for instance, in clinical skills evaluations, using it over computer-based quizzes or essay evaluations. My thoughts regarding simulationist in the age of Chat GPT, what with OSS and evaluation methods performed in the skills and simulation space? I think this is a right time for simulation is to stand up as problem solvers and champions against generative AI exploits. And to say things like, you know, hey, we know ways other than computer-based multiple choice questions and essays where we can extract and evaluate student knowledge through performance-based and think aloud protocols. And I think the evaluation backgrounds of simulation is make them the ideal candidates to spearhead the creation of new evaluative methods in these times.

Jarrod: 13:18

Okay. And so the success of Syminar is it that of safeguarding the from generative AI to show true student and educator behavior and performance, and then creating a space where you can have better evaluation methods,

Bryan: 13:38

Syminar's, VR 360 video product line will be successful to us if we're able to increase the amount of simulation that schools are doing. If we're able to lower the barrier of entry for these schools. And if teachers start feeling more comfortable using video recordings and video debriefings and, you know, can be more reliant on those, that to us you will be successful for the, for the VR 360 1.

Deb: 14:02

Bryan, I know you were at Google for a while. Do, do you wanna share how that might have impacted the way that you think and see things in nursing?

Bryan: 14:12

Yeah, I think Google gave me a long hard look at the human factors in a system, specifically how humans interact with their computers and smart devices. So this really got me thinking that a deliberate application of human computer interactions, research or, you know, optimizations could really impact the way that we as nurses give and receive care. And also got me thinking about how we could heal our workforce someday by making the way that we learn and practice feel more natural.

Deb: 14:44

Thank you. Yeah,

Jarrod: 14:45

And I, I do wanna piggyback on that cuz I appreciate the question, Deb, because then I know kind of going, going back into the nursing, you had a capstone one board and that was trying to address more of the nursing shortage, kind of identifying that, that pipeline bottleneck problem. Tell us a little bit about this if you may.

Bryan: 15:04

Yeah, I actually think this is the perfect audience to plant this idea in front of. So thank you for bringing this up Jared and audience, I would really welcome your thoughts here. So please reach out. So let's rewind for just a second. There's no mystery to anybody listening to this podcast that there's a shortage of nurses, but the problem is a bottleneck in the training pipeline of nurses, schools can't admit enough students so that they can output enough new grad nurses in time to replenish the workforce. That's where the shortage is coming from. And where is this shortage coming from? Well, it's those three Fs that we talked about earlier. A lack of faculty, lack of funding, and a lack of facilities. Funding is now being supplied. But you know, like you can't over, if you can't overcome the faculty and the facilities piece, you're kind of in trouble. So talking about facilities, as we said earlier, we can split the facilities piece into two things, clinical sites and pre-transition to, to care places like sim labs and skills labs. So let, let me hone in on the clinical sites for a moment. As it turns out, I, I realize the secret over the summertime there are no shortage of clinical training sites, let's call them internship sites, you know, for lack of a better term. And just to make it easier for, you know, non-healthcare folks to follow. There's no shortage of clinical internship sites. However, hospitals are not offering these spots, at least in most locales in the US. And if you think about it as a hospital executive, why would I want to train 100 students on my workforce's time that is giving interns to nurses so they can work with them and train. Why would I want to train 100 of these students if on my time and on my dime, if I know that 60 of them will go and work elsewhere and only 40 will stay? It's not a very good business decision. Schools can't admit more students because they don't have internship spots. Assured hospitals don't have an incentive to offer these spots. So it seems like these behaviors of BSN students wanting to enter nursing for the freedom to provide care and to have the benefit of a balanced life and mobility and not stay in the same spot, it doesn't lend itself to hospital's human resource problem. It's rather than, you know, admitting student nurses in hoping they stay and become your next workforce, it's easier just to go get a travel RN who's already experienced. You pay'em a lot more though. So the problem is misalignment of incentives, you see. So our next product line focuses on this lack of clinical placements or internships. Seminar is helping solve this problem gradually. First on a community level, then at a state level, then at a national level. And we're scrambling to make it in time to help the nursing workforce see enough feet on the ground for 2030 spike in baby boomer inpatients. Again, I would love to hear your listener's thoughts on this one.

Jarrod: 18:00

I appreciate that. The faculty v ersus facility. C uz my next question was gonna be o f all the projects to tackle, why was that around video recording? A nd I think that you probably just answered it, but I'll I'll still leave the question open. Why video recording, Bryan?

Bryan: 18:14

Why video recording? I think video recording will help with the facilities piece insofar as simulation facilities, you know, the lack of simulation facilities for sure, simulation facilities are going to be more widely in demand and widely used because it's the safe place for students to practice and show readiness before stepping out there and working with live patients. So that's the facilities piece that the VR 360 kind of, uh, product line can help solve the lack of facilities. However, the lack of clinical training, internships, let's call them, right? I think that is something that needs a little bit more fleshing out. But I think that if we can help, if seminar can help schools ensure that they will have, if they admit, you know, two x three x four x more students, that they will have four x more clinical placement sites wherever these students want and wherever these students will promise to work for the next two years after licensure, I think we may have something going here.

Jarrod: 19:21

Yeah. And Bryan, this is has been fascinating. I wanna really go into that faculty piece of, of what you discovered too, but I I'll also, yeah, hand hand it over to Deb here now to close us down.

Deb: 19:32

So when you say faculty, you talk about the three F's, which I'd never really heard that faculty funding and facility, we are short of faculty. Everyone is always saying, yes, we need funding. And yes, we need facilities and facilities as where do you do your training, right? How does those hospital wanna place that risk of taking a new student into that transitional practice? Right? So I think what I'm hearing, the 360 training helps the hospitals understand that the nurses are prepared.

Bryan: 20:02

That's right. Deb 360 video capture is a way for schools and subsequently hospitals to evaluate. Students have in fact learned in a Chat GPT free environment and the live streams are for students to feel more immersed in simulation trainings for a greater likelihood that they'll engage in the simulation and the rest of the debriefing process. Together, these aspects of syminars and VR 360 live streaming system helps schools solve the lack of facilities piece proceeding, transition to practice.

Deb: 20:35

Great. I also see that you are part of the visioning group for the society. Why don't you tell me just a little bit about what that means? And I can see, cuz if our listeners are listening, there's actually energy going on in this, in this podcast when we're talking, you can see the thinking happening, which is really fun.

Bryan: 20:55

So the society's always casting its eyes forward on, you know, like what's around the corner? How can we best serve those needs? And so I think what I lend to the table at the, in the visiting committee is, and I'm just like our Silicon Valley kid, I guess<laugh>. Um, and I'm very, very kind of interested and very close. I work closely with all the new kind of developments that happen here in the valley. So when it comes to pulling out the abstractions and thinking to ourselves, you know, like what's possible in the next two or three years, what kind of innovative projects do we wanna invite to speak at our conference? What kinds of content do we wanna see and encourage more of? Uh, where do we wanna kind of steer our attention to? Whether it's, you know, ai, vr, you know, or diversity equity inclusion, right? Sim center entrepreneurship, right? These things are all really, really important to consider. And so those are the lenses that I try my best to kinda bring to the table there.

Deb: 21:54

Thank you. Thank you. And I'm gonna ask you one of my favorite questions. Do you have a favorite simulation story that you wanna share with our listeners?

Bryan: 22:02

Yes. Okay. So this one I always go to. The syminar thing has been scary and really hard, right? Starting any startup. And I'm sitting here with two entrepreneurs,<laugh>, you know, like, so I know you two understand, like just getting the product out there in front of people. That's one thing, right? Getting yeses, especially from a really supportive community, that's one thing, but getting yeses and then getting people to actually pay for the thing is another thing, right? And right now, seminar, at any given point in time, we have a development force of eight to 12 developers that's men and women that I am responsible for, right? And I need to make sure that they're, you know, provided for. And so when we think of like marketing campaigns where it's like$5,000 to get you started on the hardware, the software, and all the support you can possibly consume, that does cause me to, you know, kinda second guess myself and think to myself, you know, like, am I being a good steward of my, you know, of my team here, right? Am I taking good care of them? Am I taking, taking good care of my co-founder? Am I taking good care of myself? Right? So I will say that a really gratifying moment, that kind of sort, it is one of those moments that kind of made it all worth it. There was a period of time when I was kinda doing seminar full-time and also I, I happened to be in the sim lab at my alma mater at San Jose State, and there was some inner city, you know, kind of kids, you know, on a field trip, I mean, right? So like fourth, fifth graders, right? And they came in and they, there's a very purposeful, you know, kind of reason for that field trip. It's expose these kids whose parents might not have graduated college to a college environment, right? And to bring them into something as innovative as a, you know, as, as as forward facing, as as a sim lab that just had all of them<inaudible>. And so when they came and, and, and they sat in the lab, PI of the lab kind of came out and she said to me, Hey, why don't you fire up seminar and show'em, you know, like what you're working on. Exactly. And so like all the self second guessing and the, you know, the times when a third of our annual budget fell through and like all these kind of traumatic kind of tales of entrepreneurship almost were made worth it. When I was able to put those kids in these little, you know, VR headsets and like, they were able to kind of see themselves being placed in a remote location elsewhere by a clinical bedside. They were able to turn their heads and see the mannequin. They were able to turn their heads the other way and they were able to see, you know, the monitors and the clinician practicing behind them and the squealing and just the, just the energy that I could feel and just the hope that I have planted a seed in the NextGen's mind that to me kind of made it all worth it.

Jarrod: 24:30

What a tremendous amount( inaudible)

Deb: 24:31

What a great story. Yeah. That is choking me up a little bit. Thank you.

Bryan: 24:36

Oh good. Thank you.

Deb: 24:38

Uh, do you have anything you wanna ask Jared or I?

Bryan: 24:41

Oh, how on earth did two entrepreneurs find the time to, to, to sit and on-ramp another entrepreneur to share all their stuff? Like I just, it's astounding to me the generosity of this particular community, right? Like hugely talented folks, all of you traverse some kind of weird confluence between healthcare, education, technology, and all of you are probably highly sought after in your locales, yet you find the time to sit here extracting these little insights from the community, like this must be to me like a, a work of passion,

Deb: 25:14

Total labor of love.

Bryan: 25:14

W hat keeps y ou t wo going?

Deb: 25:15

Yeah. Total labor of love, right? We're waiting for it. Yeah. To make a difference.

Jarrod: 25:20

And to add to it, it's, again, I, I preach on health and relationships a lot, but in any relationship you just want to, you know, iron sharpens iron, but you want to be around people that want you to succeed and you want to support. And that's what we want to do for other, not only entrepreneurs, but within the industry of healthcare simulation, healthcare education, it's so important that people have their voice and have an opportunity to, to kind of have that heard one. But two, the ones that are, as we talked about just before the, our conversation, the man in the arena, but really trying to put themselves out there to make a difference that's brings light and helping save lives into the world is so big. So that's exactly what we see you, Bryan, and, and seminar trying to encapsulate.

Bryan: 26:02

Yeah, I t's a huge pleasure to be, y ou know, to like spend some time amongst kindred spirits. It's< laugh>. This is t he, this is the stuff that makes the tapestry of life so colorful.

Deb: 26:09

Right? Now. If our listeners w anna get ahold of you, if they w anna know more about you, y our company, where would they go?

Bryan: 26:16

Yeah, no problem. Um, Syminar.com is a good place to start. There's, you know, there are videos there kind of indicating what we it is that we do. Messaging me at bdang@ Syminar.com is a, you know, another really good place to go.

Jarrod: 26:31

Bryan, it's, it's really been a pleasure, man. It's, it's been such a delight chatting with you and seeing the vision and what you hope to accomplish and how we can all contribute to not only the nursing shortage, but supporting nurses in general.

Deb: 26:43

Yep. All right. With that, thank you so much and happy stimulating!

Innov2Learn Tag: 26:50

Thanks to Innov2Learn for sponsoring this week's podcast. To learn more about their new simulated forehead, thermometer and other simulation devices, visit Innov2learn.ca details in the show notes.

Outro: 27:11

Thanks for joining us here at The Sim Cafe. We hope you enjoyed, connect with us at www.innovativesimsolutions.com and be sure to hit that like and subscribe button so you never miss an episode of The Sim Cafe.