Transforming Healthcare Education with Virtual Simulation: A Conversation with Kyle Johnson at the SIM Cafe

Experience the journey of Kyle Johnson, from his early days in cardiac intensive care to shaping the future of healthcare through medical simulation education. As he sits down at the SIM Cafe, our esteemed guest and pioneer in simulation, the Executive Director of the TTUHSC simulation program, takes us on a riveting exploration of how virtual environments are revolutionizing healthcare training. Through his eyes, we witness the pedagogical evolution from a mere fascination with simulation tech to creating impactful educational experiences, with mentorship tales and his pursuit of a PhD adding depth to his narrative.

Step into the virtual resuscitation room with us, where ethical quandaries and critical decision-making collide, pushing the boundaries of professional collaboration. This episode vividly recounts an online simulation that affected all involved, emphasizing not just the technological prowess but the human touch behind these scenarios. The integral role of simulation operations teams in crafting such profound learning moments is brought to light, highlighting their artistry in merging narrative and education to forge truly immersive experiences.

Finally, peel back the curtain to reveal the meticulous planning that goes into orchestrating the International Meeting for Simulation in Healthcare (IMSH) 2025. Uncover the committee's responsibilities, from theme selection to the orchestration of unforgettable conference experiences, and consider the lasting impact of a culture rooted in feedback. By fostering this environment in training, we're cultivating a new generation of healthcare professionals who not only expect but demand high-quality communication in the service of patient care. Join us, absorb the wisdom, and be part of the continuous evolution of medical simulation education.

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Transcript

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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.

Deb Tauber: 0:14

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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 Jerrod 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 Tauber: 1:45

Welcome to another episode of The Sim Cafe. Welcome, Welcome Jerrod an Kyl Jerro. Today we have an esteemed guest, Kyle Johnson, and Kyle is the Executive Director of the TTUHSC simulation program, which is an SSH multi-site accredited simulation program in teaching, education and assessment, with seven locations extending from West Texas to DFW Metroplex, serving interprofessional learners. Kyle is also an associate professor in the School of Nursing and the Covenant Health Systems Endowed Chair in Simulation and Nursing Education at Texas Tech University Health Sciences Center. Welcome Kyle.

Kyle Johnson: 2:32

Thank you. Thank you for having me.

Jerrod Jeffries: 2:35

Thank you. Thank you, Kyle. I remember seeing you at IMSH. Of course, you're up on stage. I don't know receiving or giving awards, but you know all the same for me. So I want to ask initially, is what was your journey into simulation? Were you always in Texas? I know things are bigger down there, so I want to understand. Give me everything you got.

Kyle Johnson: 2:57

My story does all those centers in Lubbock Texas . I was a student. I received my bachelor's in nursing at Texas Tech University Health Sciences Center in 2010, went into cardiac intensive care. So that was my clinical background. And really my journey into simulation begins when I was in my master's program and I was taking some of my coursework on educational theory. And really this story that probably stands out to me is a moment that I was called in.

Kyle Johnson: 3:25

I really was passionate about the science around therapeutic hypothermia. We had just started types of protocols around inducing patients into therapeutic hypothermia and I remember being called in in the middle of the night because our team was slammed, so to speak, and they had a patient that was coming in that needed to have therapeutic hypothermia induction and they said you're the first person to answer the call and you've been through the class and the whole drive. I'm thinking, yes, I did, and that was an eight hour day of lecture and I can regurgitate some things, but now I'm going to be tasked with doing it. So I let that story somewhat influence my question that I was asking in some of my early work in educational theory and I just remember getting into a library system and saying what are some of the best learning methods for health care education. I would have been around 2012, 2013. And I began to find myself immersed in the simulation literature. I was fortunate enough to have been at Texas Tech University when Sharon Decker was leading the program into. I learned under her and then was fortunate enough to be mentored by her in my time at Texas Tech. But I had a chance to collaborate with her and I ran a small, a very small scale therapeutic hypothermia simulation versus some nurses in the cardiac intensive care unit. That's really when I began to think, wow, there's really something powerful about this.

Kyle Johnson: 4:49

I would say that I was initially fascinated with the technology, having it as a student and then seeing it in terms of education, and then really kind of what led me down the pathway of pursuing simulation as an area of research. I was studying for my certification in healthcare simulation education. I happened to find myself at a national league for nursing conference, walking around looking for doctoral programs, and I happened to meet Christina Dryfirst, who happened to have wrote chapters with Sharon Decker on simulation and debriefing. I didn't know who she was when she approached me and she said what are you interested in studying? And I said I think something around simulation and I put my application in Indiana University at the end of that conference and the rest is history.

Kyle Johnson: 5:37

That's how my story began, because I was found myself really fascinated at that point with the pedagogy of simulation and that initial excitement around the technology. And then what I began to really uncover and what the pedagogy does, I knew it was the thing. I knew it was my thing for the long haul. The power that it has to teach healthcare profession students. We atakes the Där breathe stripped up the thigh, devocast breath and mental health systems. A is not lecture onWSU.

Deb Tauber: 5:59

Yeah, he's not pretty passionate about it and it does make all the difference.

Jerrod Jeffries: 6:04

Yeah, I mean a good mentor is so much these days too, which I don't say it's. It's rare to find, but it's more difficult to find the right one for your passion and alignment, and there's a lot of variables have to go along there. So I want to keep digging in though. So you do your PhD at Indiana University, go Hoosiers and from there, so you're still involved pretty heavily with associations and organizations. Can you tell us about what? What you're doing now?

Kyle Johnson: 6:33

Yes, really, some of my earliest earliest involvement was actually with dual, a joint effort with the Society for Simulation and Healthcare and an axle international nursing association for clinical simulation and learning. They had started doing regional best practice workshops in rural areas and if you know anything about love, it's a pretty rural area Just kind of in the middle of nowhere in Texas, in the panhandle, and I believe it was the second workshop that Texas Tech University Health Sciences Center hosted. I was, I think, in maybe year one of my of my PhD work and I had an invitation to apply to do a speaking event that connected me to both an axle and SSH and then we had best practice workshops around the around the states in rural areas and then for the pandemic we brought ASPE. ASPE is now part of what's. It's not the regional workshop anymore, it's considered the best practices workshop when we go over all the standards and it's a three force effort for ASPE and axle and SSH team up to present now online content. So COVID kind of changed the outline but being online more than in person workshop, that was my initial involvement but it got my foot into more.

Kyle Johnson: 7:50

So SSH and an axle, and so I've been part of the education committee with an axle actually hosted let's talk Sim. I was the season two post for let's talk Sim and then with the Society for Simulation and Healthcare, I've been part of the research committee for the last two years. I've been part of the research committee and all the scientific content that you see at Funnels through our committee and make sure that it's got the best, the best presentations in terms of research posters, oral presentations, awards, researcher of the year, those kind of awards that we present in terms of the top abstracts submitted. So that's been most of my involvement. And then the newest would be that I'm on the IMSH 2025 planning committee that'll be in Orlando in in 2025.

Jerrod Jeffries: 8:36

And so from pioneering or helping pioneer the regional best practices for rural areas around what you was at, I would say that my first workshop would have been in 2000.

Kyle Johnson: 8:46

Maybe end of 2016 or early 2017.

Jerrod Jeffries: 8:51

From, from there now to planning. You know, I guess is the world's, world's largest healthcare simulation conference. So I love it, Kyle, yeah.

Kyle Johnson: 9:01

Yeah it's been really exciting to be able to present in small towns that were often community colleges not near a major university, and now then getting a chance to do something. Like I am SSH, the journey has been. It's been a lot of fun. I really do love every minute of it.

Deb Tauber: 9:18

Good, Good Now, Kyle, do you have a favorite simulation story for us besides your first one that you shared?

Kyle Johnson: 9:27

I do.

Kyle Johnson: 9:27

I would say that one of the ones that stands out to me that I find myself telling people in different disciplines is a simulation that I was actually invited to be part of an individual's doctoral dissertation research and we logged on and found ourselves in what is called the virtual recess room, the virtual resuscitation room. It's it's a Google. C, Google com Type of form. It's again, I would say, low technology, but the ability for collaboration in those types of platforms are are pretty fascinating. So we were brought in it was myself and my background of course, is in critical care nursing. There was a resident, a medical student or a resident to respiratory therapists, all connected in zoom and we found ourselves getting pre briefed in preparation for a code type situation and really the whole simulation was going to be around collaborating roles and responsibilities. So we all kind of knew what we were walking into.

Kyle Johnson: 10:30

But the technology of the virtual resuscitation room, you know, you find yourself clicking to kind of simulate CPR compressions, you find yourself dragging and dropping things from different Google forms into the environment and I guess one could say initially I was like, oh, this is kind of this is kind of odd, this is kind of clunky, what would that be? What is this all about? And in the middle of the scenario and I don't want to give it away because it's done quite a bit, I think, but in the middle of the scenario, every one of you are hit with an ethical dilemma that the team doesn't have. It has to has to do with an antidote that needs to be administered, but it's not an antidote that you typically find in like a advanced life support algorithm and status around a patient who is in a do not resuscitate situation and potentially a medical error that has happened, but there's so much uncertainty around what happened and how it happened that it raises the level of question as to how the team should respond. And in my clicking of this virtual resuscitation room simulating a CPR, I feel like there was this moment where you could hear a pin drop and the debriefing that occurred afterwards.

Kyle Johnson: 11:48

I think all of us were in that moment of we didn't know what to do, we didn't know how to handle it and the whole purpose was to help the team and, again, all interprofessional learners. How could we have navigated that better when there wasn't a clear solution and someone's life was at stake and we were questioning what? And so I say that because it's my favorite sim story, because I think it lends itself very well to what healthcare providers face when they're in practice with many of these optical dilemmas. It connected people from around the globe in ways that I would have never imagined. It transcended beyond the technology and really tapped into this pedagogy of team training, interprofessional collaboration and I think, in terms of helping people communicate, it's one of those things that you know.

Kyle Johnson: 12:41

When I think about my favorite sim story, it'd probably be easy to think about, you know. Oh, the first time I put on a hole, you know, or an oculus or some of those cool things, I find one of my favorite stories in an environment just like this, where I think many people would think oh really, especially post-pandemic Zoom, you were connected in Zoom, yes, I was, and it was one of the most powerful simulations I've ever been in, and I think it really opens the door to how, you know, acute care facilities, hospitals, people from any background in their practice, all centered in around a scenario that probably happens all too often.

Deb Tauber: 13:17

Wow, and I think you shared something pretty profound here as well, and that is what you just stated, that in a Zoom room. So any of those people who would argue that, no, you can really only get a good simulation in an actual simulation center environment, but you know, the virtual reality, the augmented reality, all of it has a place and we just once again I'd like to steal Jared's pie analogy we just have to grow that pie and not keep thinking that we have to slice smaller and smaller slices.

Jerrod Jeffries: 13:50

Yeah, and I mean, here you speak, Kyle. You have the feeling and the emotion, and it's the same thing as like, okay, I can listen to something. My favorite artist on iTunes. I mean that dates me Apple Music or Spotify or whatever. But you still want to go to the concert occasionally, or some people do, right.

Jerrod Jeffries: 14:07

And maybe you know and it doesn't matter if the simulation would have been the scenario would have been better in the simulation room, you got by with what you had, and that's virtually, and it's still just as powerful, Because what is the most important is that you're able to do it collaborate, connect, engage and I loved it. I think it's, and well-designed scenarios do that.

Kyle Johnson: 14:29

Well, and I would say that the level of technology that was happening behind I would imagine there was a fully prepared simulation operations team ready for any pathway. We chose the pre-briefing. From getting our buy-in to adopt this kind of technology as well as just how to navigate, you could tell that it was following every having presented on the standards of best practice. I was watching a doctoral student unfold the standards of best practice in a simulated environment that I myself had never experienced, and so I had a chance to meet that doctoral student at IMSH this year and had a chance to tell her how beautifully arched it was. The story was fascinatingly designed, and so it was fun to see it come to life. And all those standards of practice that many listeners of The Sim Cafe probably are like oh, I helped write those or I used those in my center Every one of them came to life.

Jerrod Jeffries: 15:25

Wow, I want to go back a bit to the planning committee now as well.

Jerrod Jeffries: 15:31

So especially hearing that, like with planning committee, I want to hear a little bit about the responsibilities One. Two, about the process of being selected. When does it start? When does obviously we, I assume I know where it ends. That's the 20-20-5. But or is there a way that you, as being on the planning committee, is able to take some of these unique or most powerful simulation stories and say, hey, I really want to have a session around this. So can you give me just an overview and then go into any detail you want?

Kyle Johnson: 16:02

Yeah, we started just to tell you about the process, I believe. The call comes in April or May from the Society for Simulation and Healthcare and you just plie, put in a brief overview and a CV, and then we found out I guess later in the summer, and learned that some of our first phone calls, first meetings, would occur in the beginning of October. So the team of the three of us set a date that we meet pretty much every week and we've met weekly since October beginning to think about the theme for IMSH 20-25. And I would say that there was definitely a platform for us to talk about. What should the next IMSH 20-25 be focused on?

Kyle Johnson: 16:47

And each of us on the planning team come from very different backgrounds in simulation education and so we all begin to kind of share our stories, I believe at some point or another, whether it was in person. I mentioned just the power of pedagogy that transcends the technology, and so that very much part of when we revealed the theme of looking back, reaching forward, which was revealed at IMSH 20-25 this year, there were elements that each of us talked about in our simulation story and in our experience with the society for simulation and healthcare that I feel like each of us would say, yeah, that's what influenced the theme. We get to have discussions around the theme. We also, I believe, we will be setting the call for content in collaboration with the team members from the society for simulation and healthcare. The rest, we met for the first time in January in San Diego and we know that we have a lot ahead.

Kyle Johnson: 17:45

I would say that getting a chance to work on the graphic design of what the theme would look like and how it would be presented, that's not an area I find myself in, and those meetings I think for all of us were pretty delightful in how they took our words and our ideas and our background in simulation, with the idea of what the theme would be, and brought a theme to it. I'm so thankful that people have an eye for that. I think all of us left many of those thinking, oh my gosh, I'm so glad that people are dedicated to doing this. But that's been a lot of fun and the synergy among the three of us is really exciting.

Deb Tauber: 18:22

Can you share who the committee is?

Kyle Johnson: 18:25

Yes, it's myself, Shannon DeMarco and Katie Max Kinsey.

Deb Tauber: 18:29

Thank you.

Jerrod Jeffries: 18:30

I would just find myself in that and I'll be like I don't, but I like Metallica. Can you put something really sharp, or whatever your favorite brand would be, and try to manipulate and twist some of that graphic design Because it is memorable? That is one of the things that's, of course, with the idea in this past year. So people do remember that and they remember the icon or the emblem of saying oh yeah.

Jerrod Jeffries: 18:55

I was in New Orleans, I was in San Diego. Maybe they couldn't have foreseen the future, but they could have had a flood coming in or a tsunami or something coming in. Yeah, no kidding.

Deb Tauber: 19:07

Yeah, hopefully you guys won't have any surprises like that in Orlando next year.

Kyle Johnson: 19:11

I hope not, I hope not. I will say one of the highlights, I would say and it seems like it's become, from what I can hear, a little bit of a tradition is after IMSH we had a chance to connect with the three. Of course we met them and saw them doing all their work during IMSH, but once the final session had ended there was a lot of time for us to connect with the three who planned 2024. That was special. It was really special to connect with them and hear all that they saw come to fruition in their own. So that was a lot of fun.

Jerrod Jeffries: 19:43

So is there like a handover book, or obviously there's a, I would say a debriefing for maybe them and then a free briefing for you.

Kyle Johnson: 19:51

But is there any lesson learned.

Jerrod Jeffries: 19:53

That's kind of handed over year after year after year to say, hey, watch out for XYZ or this is who.

Kyle Johnson: 20:00

It's something that I think we go over pretty in depth. I mean, you can just tell that IMSH, the planning begins. So I mean our first call has already happened post IMSH 2024, but those meetings begin in October of 2023 for January of 2025. And so there is what they call like the playbook of certain things that have to happen by certain dates. And you can just tell the team at the Society for Simulation and Healthcare is passionate about making it a very, very powerful conference, and that has kind of been laid on us is these these things have to be met at this time so that we're on time for the next phase. That's really probably all I know at this point. I have a lot at the end of February that I think I get to learn about.

Deb Tauber: 20:45

And I hope maybe with your experience from a nascar you'll have the puppies.

Kyle Johnson: 20:49

Yeah, you've heard about that right. So yeah, I mean I think that they tell us we can have any kinds of ideas. So you know, I'll keep that in mind.

Deb Tauber: 20:58

The adoptive path.

Jerrod Jeffries: 20:59

I'm voting for a hot air balloon, Kyle, if I can, Okay.

Deb Tauber: 21:02

I'll let them know, thank you, oh, brother, all right, kyle, what words of wisdom do you have for our listeners, like something because you've been in the field for a long time and you've, you know, done a lot. What kind of things can you share with our listeners that have helped you in the field?

Kyle Johnson: 21:20

I think what I would share is that early on I really embraced the idea that you know what we are doing in the Sim Lab or what we're doing in the Sim Center with this piece of equipment and this technology and this debrief, and they're going to learn so much from this one experience, and I think that what we found in the Sim community is that repeated doses of simulated content are needed. But there's also the thing that I would share that has probably been laid upon me the most in studying pedagogy is that as we begin to think about psychological safety and how we debrief as I just think that there are larger lessons that come from Sim that, if I mean, I think many of us can probably resonate with the idea that we've had a simulation around this really great patient, this great story. And then we come to Sim four weeks later and we ask our students, like do you remember four weeks ago when we were in here and we were talking about this patient? And they kind of stare at you like no, I don't. And you're like what? You don't wait, you don't remember we were just here four weeks ago, remember this patient? And you can kind of see that they're like oh yeah, and usually there's one or two that they're like, yes, and those are the ones that have paid attention to every single thing.

Kyle Johnson: 22:32

A lot of times you find yourself thinking, well, how did they, how did they not remember this?

Kyle Johnson: 22:37

But I think we as simulationists have an opportunity in the debriefing and the pedagogy of Sim that when they're repeatedly exposed to environments that are intentionally set up to be psychologically safe, and the questioning that comes in the debriefing, that is situated on the basic assumption that everybody's here doing their best, doing their best, desires to improve, wants to learn that you may not realize it, but what you're doing is teaching the future of healthcare to give, receive and expect good feedback.

Kyle Johnson: 23:14

I think that sometimes, when we get lost in those moments of oh, they didn't remember that great story, remember that from a larger scope, you're teaching them to hopefully give, receive and expect good feedback as they pursue practice.

Kyle Johnson: 23:27

And those are the types of healthcare professionals I want caring for me, caring for my loved ones, caring for the community, is people who intentionally think after an event in a hospital or intentionally try to change the culture in their institution to give, receive and expect good feedback, and I think that that's the larger lesson that comes from simulation is that when facilitators engage in these best practices over and over, you might find yourself disappointed that they don't remember the scenario that you wrote. But when exposed enough that's the larger lesson of SIM is is really good high quality feedback that we hope makes it into skilled nursing units and acute care facilities and community based settings that champions are leading teams where we know psychological safety and psychologically safe environments impact patient outcomes. We know that exists and I think that we as educators have a piece of that pie in our training when they're consistently exposed to it.

Jerrod Jeffries: 24:29

Well said. I love that and I love the tidbit of give, receive and expect good feedback. I think that if every faculty member or every you know teacher and I use that very loosely in terms of life right, not even, as you say, simulation teaches, but a teacher doesn't always have to be within the four walls of an academic institution. It could be across any sort of discipline or discipline or scenario and as long as you're trying to to use your words directly right give, receive and expect good feedback, that communication cycle just improves and its ongoing improvements, process improvement.

Jerrod Jeffries: 25:05

Yeah that's what it now, but that's that's what. That's what becomes.

Kyle Johnson: 25:09

Yeah, yeah, and that's what I love about it is I. I think that that's where we have the power to shape those, those students that are getting exposed to it over and over, that like, oh wow, I really was able to share a vulnerable situation. I really was able to share that. I felt like I made a huge mistake and the way that that was encountered, the way that that was met, I think that we're potentially shaping champions to do that in practice for for people who they've never met, to set up good spaces for feedback, and so that's that's what I love about the potential for sim and even, at a broader point, just for anybody outside the four walls of teaching, just good feedback, how we give, receive and expect good feedback.

Deb Tauber: 25:54

Absolutely Give, receive and expect good feedback. I love it. Anything else, anything else you want to leave our listeners worth as we conclude this episode. Kyle, we're really grateful that we had an opportunity to meet you and meet with you virtually.

Kyle Johnson: 26:11

Thank you. I think the one thing that I always try to tell people is, when you find yourself we talked quite a bit about conferences Don't be afraid to go and talk to somebody. That that wound up being a huge component for me is just the willingness to go talk to the people who are writing the standards, the articles that you're reading. I've never found somebody who hasn't returned an email or hasn't reached out. You know to say, oh yeah, you're interested in this. Those people are at these conferences, whether it be an Axel or ASP or SSH or SimGhosts or you name the conference. Those people are there that are passionate about this, and that has served me well and just reaching out. One of my favorite stories is I connected with a colleague by walking up to her and saying I think you and I might geek out about theory just a little bit too much, and it happened to be Mary Faye and she stepped back and she goes tell me more.

Kyle Johnson: 27:00

We've been true to briefing fashion, right, and so for about 45 minutes we sat there and chatted about simulation theory and best practices and pre-briefing and debriefing, which led to two articles published together. I mean, we just had a blast with it. But it all started with a hey, you might want to geek out with theory on theory with me just a little bit, and that's how the story began. But it was at a conference in person and I think that just kind of lends itself. If you're interested in the field, people who are passionate about the field are right around you, so just tap them on the shoulder and ask a question.

Jerrod Jeffries: 27:34

Very well said, kyle, and to that point it's more of. This is the one place that these geeks right are subject matters that actually able to be aired and explored and explained is such an nth degree where you're not going to go in the shopping mall or wherever people go. Now it's like you're not going to find those people, but at these conferences, that's exactly the place to geek out about it.

Kyle Johnson: 27:57

Even if it is theory. Yep, even if it is theory.

Deb Tauber: 28:00

Yep, thank you so much, and with that we will conclude this episode. Happy simulating.

Kyle Johnson: 28:07

Thank you.

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