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How VR And Simulation Build Confident Nurses with Dr. Stephanie Justice

• Deb Tauber • Season 3 • Episode 117

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We explore how simulation and VR turn abstract lessons into action, helping students build clinical judgment through safe mistakes, clear feedback, and repeatable practice. Dr. Stephanie Justice shares practical setup tips, leadership lessons, and a realistic roadmap for immersive learning.

• simulation as a safe space to learn and fail
• debriefing to build clinical judgment and confidence
• VR for repetition, scale, and AI-driven feedback
• hygiene, battery life, and hardware management
• staffing models with asynchronous labs and student workers
• breakthrough student moments in high fidelity and VR
• leadership growth through NLN’s program
• the future with mixed reality and better analytics
• practical advice for starting and iterating
• wellness uses of headsets beyond patient care

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Disclaimer/ XRenages Ad/ intro:

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. This episode of Innovative Sim Solutions is proudly sponsored by X Renegades, your trusted partner in immersive training and simulation. At X Renegades, we support hospitals, universities, and training institutions to build the right XR ecosystem from the ground up. We're your one-stop shop for selecting the best hardware, software, and applications to power a seamless, efficient, and future-ready SimLab. Whether you're launching a brand new XR program or expanding your existing lab, our teams guide you through every step from evaluation and procurement to setup, training, and ongoing support. Our mission is simple. Make immersive simulation easy, scalable, and impactful. And don't forget to check out our brand new show, the XR-RX Podcast, where we break down the latest in extended reality, simulation technology, and what's shaping the future of healthcare and education. To learn more or to connect with our team, visit us at XRenegades.com or reach out directly on LinkedIn. Welcome to the Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelley Hauser. 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:

Welcome to another episode of The Sim Cafe. Today I'm here with Dr. Stephanie Justice from Intellect. Prior to this, she was at Ohio State University College of Nursing. She's a simulation and virtual reality education expert who's all about making nursing learning more real, more hands-on, and more meaningful. Welcome, Dr. Justice, and thank you for being a guest. Now, before we dive into simulation and innovation, why don't you tell us a little bit more about yourself? Sure.

Dr. Stephanie Justice:

So I have been a nurse now, wow, 27 years, which boy, it went by fast. And my background is in I started as a floor nurse on pulmonary renal diabetic. We were like a step-down unit. I did clinical drug trials at Ohio State in Nephrology and benign hematology. I also worked on a vascular surgery step-down unit, but I switched over to education back in 2009. And I absolutely love it. More fun. I have uh been married for 28 years. I have one son and two dogs that love to bark when I'm being recorded.

Deb Tauber:

Hopefully they'll join in a little bit. Maybe not. They're loud. What inspired you to go into nursing and then eventually into nursing education?

Dr. Stephanie Justice:

Well, it's actually kind of a funny story, you know, because I talked to people who are like, I wanted to be a nurse since I was little. And I really didn't know when I graduated from high school. So I kind of floundered around a little bit. And then I went to Columbus State to one of our community colleges, and I decided I was going to be an EMT. I was going to go be a paramedic. And I took my first EMT course and I loved it. And we went into the hospital at the end of it. And we were in the ER. And I was like, oh, I like this better than like pushing people up embankments and things, you know? And so I decided to go into nursing. And I haven't looked back since. I mean, it's been a really good choice. The education part is even funnier because when I was in nursing school, I worked as a like a work study student in the Sim Lab, which I guess back then it was really called the Skills Lab at Otterbein, used to be college. And uh I worked there and I met my husband when I was in college and I told him, I said, one day I want Trudy's job. I did eventually get it. I was the manager of that lab for four years, but it's kind of funny because I was like, oh my gosh, this is like so cool.

Deb Tauber:

Yeah, it is so cool. Now, on your personal pathway, you've become well known in the simulation space. What originally drew you into simulation as a teaching approach? And what keeps you passionate about it?

Dr. Stephanie Justice:

So I am one of those people who I can sit in a lecture, I can read a book, and it does not click like it does when I get my hands on something and I see and I do it. I remember in nursing school seeing the pictures and learning about peritoneal dialysis and see that very flat image of the two bags. And then when I got my first job after I passed the NCLEX and I saw the PD setup the first time and actually got my hands on it, I swear you could have seen that light bulb in Cleveland. And I live in Columbus. So, you know, like it just clicked. I just got it. And I just remember those were the things I got the best was when I got to do it or see it or touch it or experience. And so for me, that's where the simulation part comes in, because the more experience, the more chances we give our students and our nurses even, just how much better they are and how much easier it is for people like me to retain what we're learning.

Deb Tauber:

And it's very obvious that you're passionate, very, very passionate about this. Now, for simulation and practice, for people who might not be as familiar with how simulation works, how would you describe the role simulation plays in preparing nursing students for real clinical experiences?

Dr. Stephanie Justice:

So, my favorite part about simulation for nursing students is it's the one place I can let them be the nurse before they're ready to be the nurse, where they can learn and make mistakes, or they can have a great day and actually do things right. But you can't put them in the hospital and be like, I hope it goes well and you don't hurt anybody. But in sim, they can go in and it's a great place to figure out, hey what what do you know? What did I actually know exactly that I was doing? What do I need to work on? Like, what was I confused? Or what mistake did I make? Because we learn more when we make mistakes. I mean, if everything goes 100% perfect, did you learn anything new? Well, no. But you can't remember how to give the medication, or you're not sure what that sound is, once you, you know, actually get to go through and have that debriefing and learn what you should have done, it really helps with kind of cementing that knowledge. And then especially if you can repeat it, repeat the same.

Deb Tauber:

And I would challenge that in just the way that a lot of times these learners don't even know what they're doing right. And unless you point out what they are doing right, they might not do it again.

Dr. Stephanie Justice:

Absolutely. Yeah. And it's so hard. I mean, in the hospital, obviously, I'm not going to, I've been a clinical instructor. I'm not going to let them go in and just be like, good luck. You have to be sure they're doing it right. You know, I mean, patients' lives are at stake. In simulation, we have reset buttons. That's what I always say. We have a reset button, and I know they'll come back. Unless you pour water on a computer, you know, it'll come back.

Deb Tauber:

I think I'd come back if you were my teacher as well. You you create a very psychologically safe environment. As it should be, right?

Dr. Stephanie Justice:

The safe to make a mistake.

Deb Tauber:

Yes, yes. Now, VR and immersive tech. You've been involved in bringing virtual reality and extended reality into the curriculum, which is exciting and very, very forward thinking. What challenges in nursing education does a VR help solve? And what surprised you most along the way?

Dr. Stephanie Justice:

So one of the things it really, I think it really can help solve. And it sort of depends on how you put it into your curriculum and how your staffing is. I mean, there's a lot of factors that go into it, but it really lets you do more repetition. For example, the company I work for, we're going to have multiplayer coming out, but right now it's individual person. And you can repeat the sim as many times as you want, and it's not facilitated. So it's AI-driven, AI-graded, AI conversation, and you can do it over and over and over without needing the full sim lab. Because that's one of the big drawbacks I always saw with High Fidelity SIM. I've never been to a school that had enough space, staffing, simulators, and time. I mean, the time is probably one of the biggest ones to just repeat sims as students want to. Whereas in the VR space, I have three headsets sitting out like right here. And I can get into those anytime I want and redo a sim.

Deb Tauber:

Yeah. Now I was able to watch your presentation for the AACN and you talked about some of the challenges as far as keeping the headsets clean. Why don't you share some of those things with our listeners today? I thought that was a very enlightening uh conversation that you shared.

Dr. Stephanie Justice:

Yeah. So that is one of the challenges because, you know, obviously they're going to be shared between different people, and you want to make sure that you're not passing anything, you know, back and forth. One of the drawbacks with the MetaQuest headsets, which I mean, which is what I have here, what I use all the time, is as they are purchased, they have kind of like a foam around your face that touches your skin. Well, that soaks up makeup and sweat. So I always replace them with the ones that have silicone because you can wipe the silicone, you can scrub the silicone. When I was at Ohio State, we always use Lysol wipes or Clorox wipes, you know, nice cleaning wipe on the headset, especially on that silicone, and clean the lenses with like a regular lens wipe. There are the blue light boxes, the UV light, but you do have to watch where any straps lay across. Cause if the head strap is across part of that silicone, it doesn't clean under it. So we would always kind of double clean and make sure everything was wiped down, dried in between. Because I know I take mine off and it's, I think it's classic ivory, I think is my color that it will be when I take it off. And I wouldn't want to stick that on someone else's face.

Deb Tauber:

Good what other tips do you have? That's a good tip for people.

Dr. Stephanie Justice:

That's a that's that's one of my big ones. Another one is to always make sure you're keeping them charged and have extra batteries because they make these cheap little ones that just pop right on the side and will give you a couple extra hours because there's nothing worse than a headset dying in the middle of someone's simulation.

Deb Tauber:

Yeah.

Dr. Stephanie Justice:

I always say that's a good way to make a student mad, right? Yes, they're halfway through. We're almost done, and it just stops.

Deb Tauber:

Yes, and to challenge their confidence a little bit. Yeah.

Dr. Stephanie Justice:

The other thing I think is really a really good tip is one of the challenges in a VR lab is staffing and how you're going to run it. And Ohio State did an asynchronous lab. So students signed up for time that they would come in. There was a lab manager, and we used a lot of student workers to help get people in and out. And that made it a lot more cost effective because the simulation programs that we used ran on their own. They weren't facilitated. So we didn't have to have a full faculty member in there constantly.

Deb Tauber:

Yeah, I enjoyed using student workers when I oh, they're wonderful. Yeah. They well, the other part of it is that they sometimes are more effective with their peers because they're less intimidating than a quote unquote professor or doctor. Absolutely.

Dr. Stephanie Justice:

We used to joke that if someone gave them too much trouble, they would have Dr. Justice come talk to them just because they never knew if they'd have me in a class. So I had carried a different weight. But I also didn't want to, I don't want to intimidate them because this is a safe space where you can make mistakes and you should learn. Like I'm not judging you if you're not sure what to do. Right.

Deb Tauber:

Right.

Dr. Stephanie Justice:

Yes.

Deb Tauber:

Now let's tell um, we know about some of the things that you're doing. Let's hear about the human side of your work. Can you share a moment when you saw students' confidence or understanding shift during a simulation or immersive experience?

Dr. Stephanie Justice:

Yeah, there's there's two that come to mind. And the first one was in a high fidelity sim. It was back when I worked at Otterbine. And we used to do this sim, and it was just kind of a mess. It was a critical patient and nothing was like set up right. You know, we didn't connect the chest tube, we didn't connect the oxygen, and we wrote the orders very jumbled, you know, just to kind of stress them out. And I had a student who was not strong at all, barely passing courses, you know, very low C. And he was my primary nurse. Oh my gosh, he blew me away. He turned to his team and he's like, I don't care about their foley. They're not breathing right. I mean, he just totally took over. And I just remember being so excited. And I talked with him later about how impressed I was. And he's like, I'm just a terrible test taker. And I'm like, you are gonna be an awesome nurse. And I wouldn't have seen that just looking at his C. But I can tell you that I would like for him to be my nurse by watching his performance. And that one just like blew me away. He went and called his mom that night and told her how good he did in Sim. And I just remember being like, yeah, this is why we do this, right? Because that was exciting.

Deb Tauber:

Yeah.

Dr. Stephanie Justice:

And then I have another one that's really funny because it's it's with VR. And it was the first year we started the program. And we had a student who was not excited to do VR and came in with just kind of this, you know, very irritated attitude. You know what I'm talking about. And put them in the in the headset, and it was a febrile seizure simulation. And no matter what you did, about two minutes in, the patient went into a seizure. And as soon as the patient started seizing, he didn't know what to do. Like he was not sure what actions to take next. And like just the whole body posture changed. You have to excuse my language. He goes, Holy shit, she's seizing three times because he didn't know what to do. And we also had to have a conversation about appropriate language in front of you know families and children. But it was so funny because it went from being this is stupid to oh my gosh, it felt so real because of the immersion of the VR. That he was just so he he was didn't know. It was like, I don't know what I'm supposed to do. And I'm like, Well, this is when you finish the sim, you read your feedback, you go through and you try it again and did it three times. And the attitude change was so much fun to watch. Yeah, yeah. Talk about learning, right? Right. Because nobody jumped in to help him. Like we wouldn't clinical. I'm not gonna let him flounder there.

Deb Tauber:

No, that's a great point. And that's a great point about how virtual reality can be different than an actual simulation. Absolutely.

Dr. Stephanie Justice:

Yeah.

Deb Tauber:

You were selected for the National League for Nursing's National Leadership Development Program for Simulation Educators. Tell us a little bit about that and what did that experience change the way you lead, teach, or think about innovation? How did that impact you?

Dr. Stephanie Justice:

You know, the funny thing is, is when I saw the call to apply, I had just finished or was just finishing my doctorate. And I'm one of those people, there's a lot of imposter syndrome that goes on. Damn I good enough. Do I when are they gonna come take my degree away?

Deb Tauber:

You know, that's you and able sister. Yeah.

Dr. Stephanie Justice:

I think everybody struggles with that. And it was so interesting being in the with the NLN because first off, it's a competitive thing. So you actually get selected. That was pretty neat. But they really worked a lot on that confidence. Like we did one of my favorite things, and I wasn't sure if I was gonna love it, to be honest, when we first started. But we met with a mentor who helped coach us through. For me, being called Dr. Justice felt really weird, especially at that time. And I was like, no, no, just call me Steph. And she was like, No, you earned that degree. And I was like, I did earn that degree. I worked really hard to get these degrees. But just having that kind of reinforcement and the group, I mean, I still talk to people I went through the program with. And so that's just kind of amazing because you get this very small core group that you kind of just clicked with. And so you get this support, and they're also looking for better ways to do everything. So that just leads to innovation. And I think that just makes it so much fun. Yeah. Very cool. I highly recommend it. What year did you do that? Um, I finished it in 22.

Deb Tauber:

Okay. Looking into the future, where do you see simulation and immersive learning headed in the next five years? And what advice would you give educators who want to start innovating?

Dr. Stephanie Justice:

So I think simulation, I I think, I mean, I love virtual reality. I think that's gonna continue to grow. But I think in the next five years, I think we're gonna see a lot more mixed reality where we can maybe put a headset and actually make our mannequins have an expression so that you could see it. Of course, headsets are gonna have to get a little bit more comfortable, lighter, that type of thing to actually have that happen. But I think it's just going to continue to grow. And AI is going to do a lot because of the type of feedback and analytics that we can actually give to the students, like on their performance and their communication. As far as advice for faculty or for nurse leaders, you know, educators in the hospital, is don't be afraid to try it because you're gonna make some mistakes. Because boy, I sure did when we first started. I thought tech natives, they're 20. They'll pick up the headsets. They're not gamers. My son's a gamer, man. He was just like two seconds later throwing like ninja stars and dodging beer bottles. Our nursing students, like, I don't understand how to hold this. And so I'm always reminded it's the I'm gonna totally mess the quote up, but I think it was Thomas Edison who said, I haven't failed, I just found 10,000 ways that didn't work. Yep. And I love that quote because that goes with the innovation, right? Stuff that we did that first semester, boy, did we learn really fast that that wasn't the way to do it. And if everything goes perfect, I think you learn more from your failures and your successes, right? Because if if you struggled, you really have to work through it. You have to find a new way to make it work. And I think as this simulation space is continuing to grow, I think you're gonna have students expecting to have that combination of the high fidelity hands-on and the virtual reality, which I think is phenomenal for clinical judgment, critical thinking. And I see that being almost becoming an expectation.

Deb Tauber:

Yeah, I would agree. Do you have any final words that you want to leave our listeners with or any questions for me?

Dr. Stephanie Justice:

I guess my last thing that I would give to them would be if you haven't tried VR yet, you should. Just see what it's all about. You don't have to do patient care. And don't forget that those headsets are also good for other things like stress relief meditation. We can actually work on some of that mental health in addition to the SIMS with the same hardware. You just need different software on it.

Deb Tauber:

Yeah. And if our listeners want to get a hold of you, where can they get a hold of you, Stephanie?

Dr. Stephanie Justice:

So, well, they can always reach out to me on LinkedIn or my email at work is is actually super easy because it's justices at intellect.com and that's I-n-t-u-l-e-c-t.

Deb Tauber:

All right. Well, thank you so much. Yeah, thank you.

Dr. Stephanie Justice:

Thanks for having me.

Deb Tauber:

Thank you.

Disclaimer/ XRenages Ad/ intro:

Happy simulating. Thanks to X Renegades for sponsoring this week's program. Be sure to check them out at XRenegades.com or on LinkedIn. Thanks for joining us here at The Sim Cafe. We hope you enjoyed. Visit us at www.innovative simsolutions.com. 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.

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