.jpg)
The Sim Cafe~
Discussions on innovative ideas for simulation and reimagining the use of simulation in clinical education. We discuss current trends in simulation with amazing guests from across the globe. Sit back, grab your favorite beverage and tune in to The Sim Cafe~
The Sim Cafe~
Beyond the Mannequin: Dr. Kristen Brown's Journey in Simulation
Finding your dream job isn't always a straight path – just ask Dr. Kristen Brown. What began as volunteering to be an "embedded actor" in simulation scenarios designed for medical residents transformed into a career-defining passion that now shapes healthcare education at Johns Hopkins and beyond.
Dr. Brown takes us behind the scenes as Associate Dean for Simulation and Immersive Learning at Johns Hopkins School of Nursing, where she's pioneered simulation education across all advanced practice nursing programs. Her innovative approach has expanded simulation capacity through virtual reality, adding thousands of additional training hours while maintaining the pedagogical integrity that makes simulation effective. From standardizing simulation curricula to leveraging cutting-edge technology, Dr. Brown reveals how simulation has evolved from a supplementary teaching tool to an essential component of clinical preparation.
The power of simulation comes to life through Dr. Brown's personal experience responding to a roadside emergency. Drawing on skills practiced countless times in simulation scenarios, she instinctively managed a critical airway situation despite being outside her specialty area. This real-world application perfectly illustrates why simulation matters – it creates lasting behavioral changes that translate directly to improved patient outcomes. As Dr. Brown emphasizes, regardless of technological advancements, effective simulation must drive behavior change through meaningful engagement and evidence-based practices.
Dr. Brown's work extends beyond Hopkins through her leadership roles with the Society for Simulation in Healthcare, where she serves on the Board of Directors and multiple committees. Her recent policy initiative brought together presidents of major simulation organizations, healthcare education leaders, and policy experts to develop a consensus statement that will shape simulation's role in addressing workforce development challenges. Join us for this fascinating conversation about how simulation is revolutionizing healthcare education and why staying true to its foundational principles ensures it remains transformative for learners and patients alike.
Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
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. 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. This week's podcast is brought to you by Beaker Health. Beaker Health is a user-generated and peer-reviewed community educational platform designed for healthcare organizations. We let your community connect and engage with one another freely and efficiently. Beaker Health where dissemination and measuring impact comes easily.
Deb Tauber:Welcome to another episode of The Sim Cafe. Welcome, and today, unfortunately, Jerrod's not with us, but we are so fortunate to have Dr Kristen Brown. Dr Brown is the Associate Dean for Simulation and Immersive Learning and Associate Professor at the John Hopkins School of Nursing, where she leads the Center for Simulation and Immersive Learning. Brown was the first nurse to be named the Zamorowski Simulation Fellow and completed a two-year simulation fellowship at the John Hopkins Medicine Simulation Center. Her passion for simulation education stems from her years in clinical practice as a pediatric critical care nurse practitioner. So thank you so much, and would you like to elaborate a little bit about that and maybe tell us about your current role?
Dr. Kristen Brown:Yeah, no, thank you, and thank you for having me. Yeah, so my current role it's actually my dream job. You know, when people ask you what do you want to be when you grow up and you don't know, I finally know and it's this job and I think, because it really blends all of my passions and things I love. I love immersive learning. I love working with students and seeing that light bulb go off but making the connections. And so right now I lead the Center for Immersive Learning and Simulation.
Dr. Kristen Brown:Immersive Learning and you know we incorporate some in all of our programs at Johns Hopkins School of Nursing, whether it is our pre-licensure programs and then all of our advanced practice programs. And initially, when I started there, I was brought in to incorporate SIM in all the advanced practice programs. So, like most schools, pre-licensure nursing, SIM has always been really well established and there's buy-in and advanced practice was a little bit. You know people would do it, they would do it in pockets, and so my role was to really standardize it and every one of our programs really make sure that there was a full curriculum. So, whether it was the pediatric primary care or our psych, mental health, MP program, really making sure that they had simulation in line with their curriculum.
Dr. Kristen Brown:And then, most recently, we've done a lot of trying to expand the amount of time we do in simulation by leveraging technology. So we've done a lot with virtual reality. We've added close to 4,000 to 5,000 additional hours of sim using virtual reality and that's not in place that we still do our in-person. That allows us to do it more often, and so we're always looking at ways to partner with engineering, partner across the school and think about ways we can deliver sim more often. So for me it's a really exciting role. That again my dream job, if you know, if you love sim and understand I'm in a good place right now that I can try different things.
Deb Tauber:That's wonderful and I'm really happy for you. I'm happy that you found your dream. It's that's what I love to do, what I do. So why don't you tell us how you actually got into simulation?
Dr. Kristen Brown:No one just falls into it. I mean you. Actually you do fall into it. No one says I'm going to, I'm going to pick this for my whole life.
Dr. Kristen Brown:I was a new nurse practitioner at Johns Hopkins Pediatric ICU and was a good PICU nurse, and being a new nurse practitioner was very scary new role and I was very fortunate enough to work with Dr Betsy Hunt, who was in the PICU but also our director of our Sim Center, and I noticed that there was a lot of Sim going on for fellows and residents and nurses, but not really for nurse practitioners. There was this kind of new role in the ICU. I didn't really know where I fit in and so I would volunteer to be an embedded actor because I wanted to learn and I was like, let me be on the inside, I'm kind of nervous, I want to learn. And so it was really kind of selfish at the beginning. I'm like I want to hear what's going on, I don't want to be put on the spot, and Betsy being Betsy and anybody that's a high level ICU physician sim lover was like you're volunteering, of course I'll take you for whatever you know. And so I just kept doing it more and more and more, and the more I did it, the more I loved it and the more I felt comfortable.
Dr. Kristen Brown:And one of the things I noticed is that there wasn't anything for nurse practitioners. There wasn't training for us and it wasn't just at Hopkins, it was really universal and part of my DMP work was to simulation boot camp for nurse practitioners. Very, you know, we've had them for fellows, we have them for residents and I'm like what if we did this? And it was an amazing response and it was obviously pediatric critical care. But I had centers I had 13 centers from across the country send people and it was the first time where people were like, wow, there's something for us. So that's kind of how I fell into it and then I never left it.
Deb Tauber:That is fantastic. I love that story and it's so true that once you fall into it, it's really hard to. It's hard to see anything else, because you see how successful you can be in helping people learn safe practices.
Dr. Kristen Brown:Yeah, and they feel comfortable and you start to feel comfortable doing it. And I think, too, for me it was saying okay, it's okay to fail and be safe and be in this environment and let's just be vulnerable and let's talk about it. And one of the big takeaways from the bootcamp the fact that it was all people playing embedded nurses and respiratory therapists, but the learners all being nurse practitioners they had the safe space to have a dialogue that they usually don't have and we had a really good opportunity to talk about. If you're working at academic center, how do you partner with your fellows and your residents and work together, where it's not us and them, but having that narrative where, if you're in the room and you're managing the patient, how do you talk and work together? And I thought that was like a really unique thing and it was really nice just to hear everybody talk and share information and kind of manage the patient together. So it was a really, for me, an amazing thing to see.
Deb Tauber:Yeah, it's a lot of fun. Now, recently, the John Hopkins Shaping the Policy Nexus Award was awarded to your group. Why don't you share with our listeners a little bit about that, about how that all happened and about the people that you included and involved, because it was a really worthwhile and exciting project?
Dr. Kristen Brown:So thank you. Yeah, no, it was really exciting. Johns Hopkins was very fortunate to have a lot of funding from Bloomberg and they built a policy center down in DC, so a building that's right near the Capitol in 555 Pennsylvania. I mean, it's right there in the background and and really I think, recognizing that everybody at the university, or any school, really should have some say or some place that you can move the needle with policy or advocacy for whatever you do, whether you're an engineer, whether you're in nursing, whatever it is like we need to have a place, we need to have a voice, and so a new building has recently opened and all the schools have a stake in it and there's different policy programs.
Dr. Kristen Brown:And recently I joined the advocacy committee for the Society for Simulation Healthcare and it's a newer committee and we're thinking about how do you have the narrative and what are the things that we want to say as a collective group that really gets people excited about something? We're excited and we talk to other same people that are excited and they know what we do. But how do we talk to our CEO or a congressman and what does this narrative look like and what is our story? So they have these awards, essentially a grant that you can put in and you can convene people and you can be in them in a way that you really want to for what your specialty is. So I put in to convene experts to look at how we can shape the US workforce from nursing and medicine and this was a collaboration with Jeff Miller from School of Medicine, myself at the School of Nursing and what are the implications and what are the things that we can do for having our shared narrative about simulation?
Dr. Kristen Brown:And I wanted to include the advocacy committee members, who are a great group of leaders from SSH and people that have different backgrounds. We have someone that works with the DOD. We have someone that kind of the DOD, we have someone that kind of newer to SIM, but they do a lot of advocacy work and they oversee a lot of the things and big issues within a hospital system. So it's a very unique group and it's run by Bob Armstrong and Haru Okudo, and so when I put this in, I just kind of was like let me just shoot for the stars. I'm going to say I'm going to have leadership from all the major organizations that impact US workforce and I'm going to bring organizations that affect health care, education and really across the continuum. Like we always want to think about fixing the pipeline, like let's get more nurses out there, let's get more physicians, but what about what next? The pipeline we can fix, but we want to keep people there and we know we can use SIM to keep people there. And I want to invite the organizations like ACGME, american Academy of Nursing, ncsbn, nln, and have a shared dialogue and come up with a consensus statement of where we're going and how do we shape the next 20 years or so of healthcare education with simulation.
Dr. Kristen Brown:So that just took place last week and I was very fortunate to have on the steering committee Haru and Bob and KT Waxman, who is also on the advocacy committee, and Barry Eisenberg, who at the time was the president for SSH, and we invited all the advocacy committee members and then a few other sim experts that are actively involved in policy or have done some sort of advocacy work, because I wouldn't invite everybody. I mean this is like oh, but you want to be really mindful about the group we brought together and then we invited our colleagues from the organizations and they came together and we had a great two days like two and a half days of a shared narrative and we were going to put out a consensus statement about next steps. What are the things that we really want to look at and how do we advocate for simulation-based education? Really exciting things to come.
Dr. Kristen Brown:I think it was just the beginning. Having the president and president-elect from ASPE, anaxal, ssh and GNSH was a huge part. Like to bring all these people together in the same room and have a shared narrative. To me was one of the highlights. Like I could just sit back and watch these giants talk and I'm like this is absolutely amazing. So it was very exciting.
Deb Tauber:That is very exciting. You were very deliberate and you had a lot of brilliant minds together. Yeah, yeah, yeah, thank you. Yeah, no, it was.
Dr. Kristen Brown:I am still recovering, but it was good.
Deb Tauber:Yeah, you mentioned it was a little overwhelming.
Dr. Kristen Brown:It was a lot. It's a lot. You plan for you know a year or so and you bring it together everybody. But it was. It was great and the the backdrop of having the break there at the Capitol and being present and we actually had some staffers that came by at our reception and just to start the narrative of looking at how we can get more funding, how do we advocate more for simulation? And we don't want to keep saying the same thing. We know it's important, we know there's good patient outcomes. So what are the new things we can say? How do we leverage technology and make it make sense? So I think a lot of good things will come.
Deb Tauber:Thank you. Thank you for your efforts. Now do a little bit on more of a personal level. Do you have a favorite simulation story you'd like to share with our listeners?
Dr. Kristen Brown:Wow, do I? There's so many. I think for me this is actually very personal, because you do so much, sim, and you teach and you do the things. And Hopkins, we do a lot of rapid cycle of different practice and how do you move to the next step? And you do a needs assessment and if your students aren't successfully doing the basic things, you don't move to the next thing. And so I was fortunate enough to do a simulation fellowship for two years at the School of Medicine and so I learned kind of that technique very well, and then I got to go to all the mock codes and do all the insight cues with the residents and we had this scenario we would do all the time.
Dr. Kristen Brown:It's like the first five minutes. It's you open up the gown and you open the airway and you bag, and then two-person bagging all the things, and did this you know I could do it in my sleep and it was early in COVID and we, my husband and I, happened on a car accident and there was and I'm peed, but a woman was pulled out of the car and we were kind of pretty close to the first responder. So I said, pull over and I go over, and it was like my scenario her airway is not open. I opened the airway and then there's people at the scene and I'm like, can you feel public? Keep your finger there. And then a police officer came and they had a bag and I'm like, okay, I can't bag this, is there's blood I'm holding. So I'm doing the two person bag and then I then the bag had an oral airway. I did so, I went through and did all my things and you're just kind of doing the motions. This is my. This is the scenario. Like she did fine, we were able to have the oral airway. She started to wake up, she pulled it out, Non-rebreather, took away and she did fine.
Dr. Kristen Brown:Long story short, it was. I just thought of Betsy Hunt in my head. I'm like this was you embedded this in me. I'm like this was like a no brainer. This is what I do. But my kids and my husband are in the car and the funny thing, I came back to the car and they're like their jaws are like what was that? I'm like, yeah, this mommy does this?
Dr. Kristen Brown:stuff, and so it was funny to see that reaction and just kind of spring into. But again, this is what's so great about sim. Even if I don't take care of adults, I did that so many times. I was so prepared and conditioned and felt comfortable that I'm like this is my scenario, so a little personal. But again that's like such a kind of putting all the sim pieces together in that perfect storm yes, yeah, that's a great story.
Deb Tauber:I love that one. Now can you share with our listeners the biggest thing you'd like them to share, like when you learned it, it changed the way you practice. Maybe a personal aha moment.
Dr. Kristen Brown:Yeah, I think for me. I thought I was pretty good with them. I'm like I know Sam, but I was doing all Pete's critical care scenarios. So I was really good at Pete's critical care scenarios. I was the content expert and I was learning them.
Dr. Kristen Brown:And when I did the fellowship and I had really great sim, educators say to me like no, no, you're going to be consulting and helping someone from anesthesia or someone from adult whatever. And I'm like whoa. And they're like no, no, this is what you do in sim. This is, this is now understanding the pedagogy and understanding how you help with learning objectives and how you match the modality to the sim. And it was like that aha, like oh, okay, this is starting to come together. And it was such a great exposure for me because not only did I do, I spent time with the educators and did that part and learned to take myself out of. I don't have to be the content expert, nor do I want to be. That's okay, I'm here in a different role. And it really prepared me for my future work because I wasn't going to just do PEDS, critical care, sim in my education role the rest of my life.
Dr. Kristen Brown:There were all kinds of specialties. So that was like a big aha moment. And again, it helps me too when I'm trying to talk to people that are really interested in sim and they want to do more and they do it a lot in their specialty and they want to kind of branch out. I said, well, you're going to have to be out of your comfort zone a little bit, but once you get comfortable and know similarly well, you're going to feel the same way that you feel doing that work in your specialty. And so for me I think that was like a big aha moment.
Dr. Kristen Brown:And that fellowship and that time that I was able to put in and I spent time with SimOps and when I was with SimOps, I was just with SimOps. I learned how to run everything. I'm doing things in boot camps and you got to see every side of it. And then I spent some time with the administrative side and what does it look like to run a SimCenter? And so I think all those pieces coming together for me made me really understand it fully of what the simulation educator or administrator, what does that role look like. So that, to me, was my biggest aha.
Deb Tauber:Thank you for sharing that. You do a lot of work for the Society for Simulation in Healthcare. Why don't you share some of the hats that you wear there with our listeners too, and what you got involved with the society?
Dr. Kristen Brown:Yeah, it's interesting too, because I think all of us have our specialties and you can be pulled in a million directions and I think for me I was trying to find where do I live, where do I sit, how do I navigate this? And early on as a new nurse practitioner faculty I did a lot of work for the National Organization of Nurse Practitioner Faculties, nos, and at the time they didn't have a simulation committee and they had a new committee and they really needed people to have a voice for sim and so for me I spent a lot of time. We did a white paper kind of talking about best practice for nurse practitioner education and again, this is jumping off the Naxal standards. It's no different, it's literally the same kind of you're going to do the same thing. But we wanted to put that out there and so for me I did a lot work there and then I realized SSH was really my organization, because I felt very welcome there. I love the fact that you had people from all backgrounds you name it, it was everybody coming together. No one made you say like, well, I'm a physician, you're a nurse, it didn't matter.
Dr. Kristen Brown:And for me I started to do more and more and I realized, if I could pick one organization, this is where I'm going to focus and I happened to be on the F&A committee. That was my first committee and that's the finance and audit committee and you learn about the inner workings of a society being on that and I'm on my second term and I'll be done. But I learned so much about the society and so for me, any opportunity that I could be involved I was part of the distance sim collaborative and worked with that, that group, and most recently on the board of directors. So I'm going to my second year and currently I am the board liaison for the Accreditation Council and I have to say that is the hardest working group in all of the organizations Sorry to my board of directors and finance. That group for accreditation is really the next level. And being a board liaison liaison I'm kind of there and I'm conveying information back and forth from the board but I'm really just taking it and I'm learning. And I'm not only learning the things that they do for predation here, but also making this really big impact internationally.
Dr. Kristen Brown:And how do we? I think this is very good. I'm part of the, the society, thinking about this. Obviously this is not just a US thing. This is really an international thing. And how do we get simulation centers to have the same standard and criteria that we really want here? And so for me, I'm in all of that group and I know you're part of that team of amazing group of people that it's volunteer and the effort that they put in to make sure that we get centers accredited has been absolutely amazing. And then most recently, like I said, I'm on the advocacy committee and for me, I think that's a very big passion, and advocacy and policy doesn't mean just being in front of Congress, it's anywhere you are advocating, and whether it's my school with our advisory board, or talking to leadership at the hospital, so, yeah, I'm really connected with the organization and I do love the work that I think every one of these groups is doing and everybody's volunteer and it's amazing.
Deb Tauber:Thank you. Thanks for everything that you're doing. It's overwhelming the amount of stuff that you're involved with, but keep up the good work, because you're making differences.
Dr. Kristen Brown:Thank you.
Deb Tauber:I agree, the council does some really good work right. If you have a job, give it to a busy person and they'll get it done right. That's exactly right.
Dr. Kristen Brown:And I think too, you know, one of some of the dialogue that came out of this convening is a lot of these organizations, when you're going to get buy in for simulation, they want to see that you have some standards and that you can make the case if I'm an accredited center or I have certified people within the center, and I think that really just moves the needle for us as a collective group and simulation to have that there's more to it than I'm just going to go and role play or do whatever. What people you know there's people that's still not really sure what you're doing and are you just in the basement with a mannequin or like this is like this is a real thing, and so that really was something we talked a great deal about and how that that accreditation and certifications really I think as a collective group, moved the needle a lot for us in simulation.
Deb Tauber:Yeah, I completely agree. It's really provided some guardrails for what you're doing. And there's so many more. There's so much more acknowledgement and appreciation when you achieve, you know, one of the certifications or if you become accredited by the society. It says a lot about the quality of your program.
Dr. Kristen Brown:Yeah, and you have to maintain it and you have to keep it going and it gets you doing the things that you normally. Maybe you have some policies and procedures floating around, but you have to get those together and you have to keep them organized and they have to be based on evidence, and, to me, without that evidence and data, we don't have a lot to really push for the things we want, and so that, to me, I think one of the best things that can come up. Yeah, it's a lot of work, but once you put the work in, I think it sets your center up for future success and whatever you end up doing.
Deb Tauber:Absolutely. Now, Dr Brown, are there any final words? You would like our listeners to remember this conversation by.
Dr. Kristen Brown:I really appreciate you having me. I know you do so much work and I love that you even have this platform to bring other people in and even talking a day. Just hearing all the things that you do and have done, I really appreciate it. I think one of my biggest takeaways where we're thinking with technology and how we're moving the needle and we, I think, as a collective group, you don't want to just check the sexy box and, oh, I'm going to do this thing and scale it One of my biggest things is verse of learning should change behavior and whatever we do, we still want to make sure we have behavior change and I know I'm preaching the choir, but I think for us as a collective group, making sure, no matter whatever technology we're doing, whatever we're doing, we just kind of hold true to the things that we know we do well, and that's engagement with our learners, having the debriefing, making sure we're was there really a change in behavior and is this going to really impact patient outcomes?
Dr. Kristen Brown:So for me, I think, as we're thinking about the future and how we can use technology, I think if we stay true to those kind of core values of what, why we fell in love with SIM to begin with. I think, if we stay true to those kind of core values of why we fell, in love with SIM to begin with.
Deb Tauber:I think we're going to be in good shape. Thank you, those are very encouraging words. I appreciate you and I appreciate your time.
Dr. Kristen Brown:Thank you, thanks again for having me.
Disclaimer/ Beaker Health ad/ Intro:Thank you and happy simulating. Thank you, thanks to Beaker Health for sponsoring this week's podcast. Beaker Health, where dissemination and measuring impact comes easy. We hope you enjoyed. Visit us at wwwinnovativesimsolutionscom and be sure to hit that like and subscribe button so you never miss an episode. Innovative Sim Solutions is your one-stop shop for your simulation needs. A turnkey solution, keys solution.
