May 20, 2025 • 24 mins
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.
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Disclaimer/ Beaker Health a (00:00):
The views and opinions expressed in
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Innovative Sim Solutions or oursponsors.
Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions, editedby Shelly Houser.
(00:27):
Join our host, Deb Tauber, andco-host, Jerrod Jeffries, as
they sit down with subjectmatter experts from across the
globe to reimagine clinicaleducation and the use of
simulation.
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and learn something new from TheSim Cafe.
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Deb Tauber (01:15):
Welcome to another episode of The Sim Cafe.
Welcome, and today,unfortunately, Jerrod's not with
us, but we are so fortunate tohave Dr Kristen Brown.
Dr Brown is the Associate Deanfor Simulation and Immersive
Learning and Associate Professorat the John Hopkins School of
Nursing, where she leads theCenter for Simulation and
(01:36):
Immersive Learning.
Brown was the first nurse to benamed the Zamorowski Simulation
Fellow and completed a two-yearsimulation fellowship at the
John Hopkins Medicine SimulationCenter.
Her passion for simulationeducation stems from her years
in clinical practice as apediatric critical care nurse
(01:57):
practitioner.
So thank you so much, and wouldyou like to elaborate a little
bit about that and maybe tell usabout your current role?
Dr. Kristen Brown (02:04):
Yeah, no, thank you, and thank you for
having me.
Yeah, so my current role it'sactually my dream job.
You know, when people ask youwhat do you want to be when you
grow up and you don't know, Ifinally know and it's this job
and I think, because it reallyblends all of my passions and
things I love.
I love immersive learning.
I love working with studentsand seeing that light bulb go
(02:26):
off but making the connections.
And so right now I lead theCenter for Immersive Learning
and Simulation.
Immersive Learning and you knowwe incorporate some in all of
our programs at Johns HopkinsSchool of Nursing, whether it is
our pre-licensure programs andthen all of our advanced
practice programs.
And initially, when I startedthere, I was brought in to
(02:47):
incorporate SIM in all theadvanced practice programs.
So, like most schools,pre-licensure nursing, SIM has
always been really wellestablished and there's buy-in
and advanced practice was alittle bit.
You know people would do it,they would do it in pockets, and
so my role was to reallystandardize it and every one of
our programs really make surethat there was a full curriculum
.
So, whether it was thepediatric primary care or our
(03:12):
psych, mental health, MP program, really making sure that they
had simulation in line withtheir curriculum.
And then, most recently, we'vedone a lot of trying to expand
the amount of time we do insimulation by leveraging
technology.
So we've done a lot withvirtual reality.
We've added close to 4,000 to5,000 additional hours of sim
using virtual reality and that'snot in place that we still do
(03:33):
our in-person.
That allows us to do it moreoften, and so we're always
looking at ways to partner withengineering, partner across the
school and think about ways wecan deliver sim more often.
So for me it's a reallyexciting role.
That again my dream job, if youknow, if you love sim and
understand I'm in a good placeright now that I can try
(03:54):
different things.
Deb Tauber (03:56):
That's wonderful and I'm really happy for you.
I'm happy that you found yourdream.
It's that's what I love to do,what I do.
So why don't you tell us howyou actually got into simulation
?
Dr. Kristen Brown (04:10):
No one just falls into it.
I mean you.
Actually you do fall into it.
No one says I'm going to, I'mgoing to pick this for my whole
life.
I was a new nurse practitionerat Johns Hopkins Pediatric ICU
and was a good PICU nurse, andbeing a new nurse practitioner
was very scary new role and Iwas very fortunate enough to
work with Dr Betsy Hunt, who wasin the PICU but also our
(04:33):
director of our Sim Center, andI noticed that there was a lot
of Sim going on for fellows andresidents and nurses, but not
really for nurse practitioners.
There was this kind of new rolein the ICU.
I didn't really know where Ifit in and so I would volunteer
to be an embedded actor becauseI wanted to learn and I was like
(04:53):
, let me be on the inside, I'mkind of nervous, I want to learn
.
And so it was really kind ofselfish at the beginning.
I'm like I want to hear what'sgoing on, I don't want to be put
on the spot, and Betsy beingBetsy and anybody that's a high
level ICU physician sim loverwas like you're volunteering, of
course I'll take you forwhatever you know.
And so I just kept doing itmore and more and more, and the
(05:15):
more I did it, the more I lovedit and the more I felt
comfortable.
And one of the things I noticedis that there wasn't anything
for nurse practitioners.
There wasn't training for usand it wasn't just at Hopkins,
it was really universal and partof my DMP work was to
simulation boot camp for nursepractitioners.
Very, you know, we've had themfor fellows, we have them for
(05:35):
residents and I'm like what ifwe did this?
And it was an amazing responseand it was obviously pediatric
critical care.
But I had centers I had 13centers from across the country
send people and it was the firsttime where people were like,
wow, there's something for us.
So that's kind of how I fellinto it and then I never left it
.
Deb Tauber (05:53):
That is fantastic.
I love that story and it's sotrue 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 peoplelearn safe practices.
Dr. Kristen Brown (06:10):
Yeah, and they feel comfortable and you
start to feel comfortable doingit.
And I think, too, for me it wassaying okay, it's okay to fail
and be safe and be in thisenvironment and let's just be
vulnerable and let's talk aboutit.
And one of the big takeawaysfrom the bootcamp the fact that
it was all people playingembedded nurses and respiratory
therapists, but the learners allbeing nurse practitioners they
(06:31):
had the safe space to have adialogue that they usually don't
have and we had a really goodopportunity to talk about.
If you're working at academiccenter, how do you partner with
your fellows and your residentsand work together, where it's
not us and them, but having thatnarrative where, if you're in
the room and you're managing thepatient, how do you talk and
(06:51):
work together?
And I thought that was like areally unique thing and it was
really nice just to heareverybody talk and share
information and kind of managethe patient together.
So it was a really, for me, anamazing thing to see.
Deb Tauber (07:03):
Yeah, it's a lot of fun.
Now, recently, the John HopkinsShaping the Policy Nexus Award
was awarded to your group.
Why don't you share with ourlisteners a little bit about
that, about how that allhappened and about the people
that you included and involved,because it was a really
worthwhile and exciting project?
Dr. Kristen Brown (07:24):
So thank you.
Yeah, no, it was reallyexciting.
Johns Hopkins was veryfortunate to have a lot of
funding from Bloomberg and theybuilt a policy center down in DC
, so a building that's rightnear the Capitol in 555
Pennsylvania.
I mean, it's right there in thebackground and and really I
think, recognizing thateverybody at the university, or
(07:47):
any school, really should havesome say or some place that you
can move the needle with policyor advocacy for whatever you do,
whether you're an engineer,whether you're in nursing,
whatever it is like we need tohave a place, we need to have a
voice, and so a new building hasrecently opened and all the
schools have a stake in it andthere's different policy
(08:08):
programs.
And recently I joined theadvocacy committee for the
Society for SimulationHealthcare and it's a newer
committee and we're thinkingabout how do you have the
narrative and what are thethings that we want to say as a
collective group that reallygets people excited about
something?
We're excited and we talk toother same people that are
excited and they know what we do.
But how do we talk to our CEOor a congressman and what does
(08:32):
this narrative look like andwhat is our story?
So they have these awards,essentially a grant that you can
put in and you can convenepeople and you can be in them in
a way that you really want tofor what your specialty is.
So I put in to convene expertsto look at how we can shape the
US workforce from nursing andmedicine and this was a
collaboration with Jeff Millerfrom School of Medicine, myself
(08:54):
at the School of Nursing andwhat are the implications and
what are the things that we cando for having our shared
narrative about simulation?
And I wanted to include theadvocacy committee members, who
are a great group of leadersfrom SSH and people that have
different backgrounds.
We have someone that works withthe DOD.
(09:14):
We have someone that kind ofthe DOD, we have someone that
kind of newer to SIM, but theydo a lot of advocacy work and
they oversee a lot of the thingsand big issues within a
hospital system.
So it's a very unique group andit's run by Bob Armstrong and
Haru Okudo, and so when I putthis in, I just kind of was like
let me just shoot for the stars.
I'm going to say I'm going tohave leadership from all the
(09:36):
major organizations that impactUS workforce and I'm going to
bring organizations that affecthealth care, education and
really across the continuum.
Like we always want to thinkabout 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 wewant to keep people there and
(09:58):
we know we can use SIM to keeppeople there.
And I want to invite theorganizations like ACGME,
american Academy of Nursing,ncsbn, nln, and have a shared
dialogue and come up with aconsensus statement of where
we're going and how do we shapethe next 20 years or so of
healthcare education withsimulation.
So that just took place lastweek and I was very fortunate to
(10:21):
have on the steering committeeHaru and Bob and KT Waxman, who
is also on the advocacycommittee, and Barry Eisenberg,
who at the time was thepresident for SSH, and we
invited all the advocacycommittee members and then a few
other sim experts that areactively involved in policy or
have done some sort of advocacywork, because I wouldn't invite
(10:42):
everybody.
I mean this is like oh, but youwant to be really mindful about
the group we brought togetherand then we invited our
colleagues from theorganizations and they came
together and we had a great twodays like two and a half days of
a shared narrative and we weregoing to put out a consensus
statement about next steps.
What are the things that wereally want to look at and how
do we advocate forsimulation-based education?
(11:04):
Really exciting things to come.
I think it was just thebeginning.
Having the president andpresident-elect from ASPE,
anaxal, ssh and GNSH was a hugepart.
Like to bring all these peopletogether in the same room and
have a shared narrative.
To me was one of the highlights.
Like I could just sit back andwatch these giants talk and I'm
like this is absolutely amazing.
(11:26):
So it was very exciting.
Deb Tauber (11:28):
That is very exciting.
You were very deliberate andyou had a lot of brilliant minds
together.
Yeah, yeah, yeah, thank you.
Yeah, no, it was.
Dr. Kristen Brown (11:39):
I am still recovering, but it was good.
Deb Tauber (11:42):
Yeah, you mentioned it was a little overwhelming.
Dr. Kristen Brown (11:48):
It was a lot.
It's a lot.
You plan for you know a year orso and you bring it together
everybody.
But it was.
It was great and the thebackdrop of having the break
there at the Capitol and beingpresent and we actually had some
staffers that came by at ourreception and just to start the
narrative of looking at how wecan get more funding, how do we
advocate more for simulation?
And we don't want to keepsaying the same thing.
(12:09):
We know it's important, we knowthere's good patient outcomes.
So what are the new things wecan say?
How do we leverage technologyand make it make sense?
So I think a lot of good thingswill come.
Deb Tauber (12:18):
Thank you.
Thank you for your efforts.
Now do a little bit on more ofa personal level.
Do you have a favoritesimulation story you'd like to
share with our listeners?
Dr. Kristen Brown (12:28):
Wow, do I?
There's so many.
I think for me this is actuallyvery personal, because you do
so much, sim, and you teach andyou do the things.
And Hopkins, we do a lot ofrapid cycle of different
practice and how do you move tothe next step?
And you do a needs assessmentand if your students aren't
successfully doing the basicthings, you don't move to the
next thing.
And so I was fortunate enoughto do a simulation fellowship
(12:51):
for two years at the School ofMedicine and so I learned kind
of that technique very well, andthen I got to go to all the
mock codes and do all theinsight cues with the residents
and we had this scenario wewould do all the time.
It's like the first five minutes.
It's you open up the gown andyou open the airway and you bag,
and then two-person bagging allthe things, and did this you
(13:12):
know I could do it in my sleepand it was early in COVID and we
, my husband and I, happened ona car accident and there was and
I'm peed, but a woman waspulled out of the car and we
were kind of pretty close to thefirst responder.
So I said, pull over and I goover, and it was like my
scenario her airway is not open.
I opened the airway and thenthere's people at the scene and
(13:32):
I'm like, can you feel public?
Keep your finger there.
And then a police officer cameand they had a bag and I'm like,
okay, I can't bag this, isthere's blood I'm holding.
So I'm doing the two person bagand then I then the bag had an
oral airway.
I did so, I went through anddid 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 ableto have the oral airway.
(13:54):
She started to wake up, shepulled it out, Non-rebreather,
took away and she did fine.
Long story short, it was.
I just thought of Betsy Hunt inmy head.
I'm like this was you embeddedthis in me.
I'm like this was like a nobrainer.
This is what I do.
But my kids and my husband arein the car and the funny thing,
I came back to the car andthey're like their jaws are like
what was that?
I'm like, yeah, this mommy doesthis?
stuff, and so it was funny tosee that reaction and just kind
(14:17):
of spring into.
But again, this is what's sogreat about sim.
Even if I don't take care ofadults, I did that so many times
.
I was so prepared andconditioned and felt comfortable
that I'm like this is myscenario, so a little personal.
But again that's like such akind of putting all the sim
pieces together in that perfectstorm yes, yeah, that's a great
(14:37):
story.
Deb Tauber (14:38):
I love that one.
Now can you share with ourlisteners the biggest thing
you'd like them to share, likewhen you learned it, it changed
the way you practice.
Maybe a personal aha moment.
Dr. Kristen Brown (14:48):
Yeah, I think for me.
I thought I was pretty goodwith them.
I'm like I know Sam, but I wasdoing all Pete's critical care
scenarios.
So I was really good at Pete'scritical care scenarios.
I was the content expert and Iwas learning them.
And when I did the fellowshipand I had really great sim,
educators say to me like no, no,you're going to be consulting
(15:10):
and helping someone fromanesthesia or someone from adult
whatever.
And I'm like whoa.
And they're like no, no, thisis what you do in sim.
This is, this is nowunderstanding the pedagogy and
understanding how you help withlearning objectives and how you
match the modality to the sim.
And it was like that aha, likeoh, okay, this is starting to
come together.
And it was such a greatexposure for me because not only
(15:32):
did I do, I spent time with theeducators and did that part and
learned to take myself out of.
I don't have to be the contentexpert, nor do I want to be.
That's okay, I'm here in adifferent role.
And it really prepared me formy future work because I wasn't
going to just do PEDS, criticalcare, sim in my education role
the rest of my life.
There were all kinds ofspecialties.
(15:53):
So that was like a big ahamoment.
And again, it helps me too whenI'm trying to talk to people
that are really interested insim and they want to do more and
they do it a lot in theirspecialty and they want to kind
of branch out.
I said, well, you're going tohave to be out of your comfort
zone a little bit, but once youget comfortable and know
similarly well, you're going tofeel the same way that you feel
doing that work in yourspecialty.
(16:14):
And so for me I think that waslike a big aha moment.
And that fellowship and thattime that I was able to put in
and I spent time with SimOps andwhen I was with SimOps, I was
just with SimOps.
I learned how to run everything.
I'm doing things in boot campsand you got to see every side of
it.
And then I spent some time withthe administrative side and
what does it look like to run aSimCenter?
And so I think all those piecescoming together for me made me
(16:36):
really understand it fully ofwhat the simulation educator or
administrator, what does thatrole look like.
So that, to me, was my biggestaha.
Deb Tauber (16:46):
Thank you for sharing that.
You do a lot of work for theSociety for Simulation in
Healthcare.
Why don't you share some of thehats that you wear there with
our listeners too, and what yougot involved with the society?
Dr. Kristen Brown (16:59):
Yeah, it's interesting too, because I think
all of us have our specialtiesand you can be pulled in a
million directions and I thinkfor 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 nursepractitioner faculty I did a lot
of work for the NationalOrganization of Nurse
Practitioner Faculties, nos, andat the time they didn't have a
(17:19):
simulation committee and theyhad a new committee and they
really needed people to have avoice for sim and so for me I
spent a lot of time.
We did a white paper kind oftalking about best practice for
nurse practitioner education andagain, this is jumping off the
Naxal standards.
It's no different, it'sliterally the same kind of
you're going to do the samething.
But we wanted to put that outthere and so for me I did a lot
(17:41):
work there and then I realizedSSH was really my organization,
because I felt very welcomethere.
I love the fact that you hadpeople from all backgrounds you
name it, it was everybody comingtogether.
No one made you say like, well,I'm a physician, you're a nurse
, it didn't matter.
And for me I started to do moreand 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&Acommittee.
(18:04):
That was my first committee andthat's the finance and audit
committee and you learn aboutthe inner workings of a society
being on that and I'm on mysecond term and I'll be done.
But I learned so much about thesociety and so for me, any
opportunity that I could beinvolved I was part of the
distance sim collaborative andworked with that, that group,
and most recently on the boardof directors.
So I'm going to my second yearand currently I am the board
(18:27):
liaison for the AccreditationCouncil and I have to say that
is the hardest working group inall of the organizations Sorry
to my board of directors andfinance.
That group for accreditation isreally the next level.
And being a board liaisonliaison I'm kind of there and
I'm conveying information backand forth from the board but I'm
really just taking it and I'mlearning.
(18:48):
And I'm not only learning thethings that they do for
predation here, but also makingthis really big impact
internationally.
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 USthing.
This is really an internationalthing.
And how do we get simulationcenters to have the same
(19:10):
standard and criteria that wereally want here?
And so for me, I'm in all ofthat group and I know you're
part of that team of amazinggroup of people that it's
volunteer and the effort thatthey put in to make sure that we
get centers accredited has beenabsolutely amazing.
And then most recently, like Isaid, I'm on the advocacy
(19:30):
committee and for me, I thinkthat's a very big passion, and
advocacy and policy doesn't meanjust being in front of Congress
, it's anywhere you areadvocating, and whether it's my
school with our advisory board,or talking to leadership at the
hospital, so, yeah, I'm reallyconnected with the organization
and I do love the work that Ithink every one of these groups
(19:52):
is doing and everybody'svolunteer and it's amazing.
Deb Tauber (19:55):
Thank you.
Thanks for everything thatyou're doing.
It's overwhelming the amount ofstuff that you're involved with
, but keep up the good work,because you're making
differences.
Dr. Kristen Brown (20:04):
Thank you.
Deb Tauber (20:04):
I agree, the council does some really good work
right.
If you have a job, give it to abusy person and they'll get it
done right.
That's exactly right.
Dr. Kristen Brown (20:16):
And I think too, you know, one of some of
the dialogue that came out ofthis convening is a lot of these
organizations, when you'regoing to get buy in for
simulation, they want to seethat you have some standards and
that you can make the case ifI'm an accredited center or I
have certified people within thecenter, and I think that really
just moves the needle for us asa collective group and
simulation to have that there'smore to it than I'm just going
(20:40):
to go and role play or dowhatever.
What people you know there'speople that's still not really
sure what you're doing and areyou just in the basement with a
mannequin or like this is likethis is a real thing, and so
that really was something wetalked a great deal about and
how that that accreditation andcertifications really I think as
a collective group, moved theneedle a lot for us in
simulation.
Deb Tauber (21:01):
Yeah, I completely agree.
It's really provided someguardrails for what you're doing
.
And there's so many more.
There's so much moreacknowledgement and appreciation
when you achieve, you know, oneof the certifications or if you
become accredited by thesociety.
It says a lot about the qualityof your program.
Dr. Kristen Brown (21:20):
Yeah, and you have to maintain it and you
have to keep it going and itgets you doing the things that
you normally.
Maybe you have some policiesand procedures floating around,
but you have to get thosetogether and you have to keep
them organized and they have tobe 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, andso that, to me, I think one of
(21:42):
the best things that can come up.
Yeah, it's a lot of work, butonce you put the work in, I
think it sets your center up forfuture success and whatever you
end up doing.
Deb Tauber (21:52):
Absolutely.
Now, Dr Brown, are there anyfinal words?
You would like our listeners toremember this conversation by.
Dr. Kristen Brown (21:59):
I really appreciate you having me.
I know you do so much work andI love that you even have this
platform to bring other peoplein and even talking a day.
Just hearing all the thingsthat you do and have done, I
really appreciate it.
I think one of my biggesttakeaways where we're thinking
with technology and how we'removing the needle and we, I
(22:20):
think, as a collective group,you don't want to just check the
sexy box and, oh, I'm going todo this thing and scale it One
of my biggest things is verse oflearning should change behavior
and whatever we do, we stillwant to make sure we have
behavior change and I know I'mpreaching the choir, but I think
for us as a collective group,making sure, no matter whatever
technology we're doing, whateverwe're doing, we just kind of
hold true to the things that weknow we do well, and that's
(22:42):
engagement with our learners,having the debriefing, making
sure we're was there really achange in behavior and is this
going to really impact patientoutcomes?
So for me, I think, as we'rethinking about the future and
how we can use technology, Ithink if we stay true to those
kind of core values of what, whywe fell in love with SIM to
begin with.
I think, if we stay true tothose kind of core values of why
we fell, in love with SIM tobegin with.
Deb Tauber (23:02):
I think we're going to be in good shape.
Thank you, those are veryencouraging words.
I appreciate you and Iappreciate your time.
Dr. Kristen Brown (23:07):
Thank you, thanks again for having me.
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Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions, editedby Shelly Houser.
(00:27):
Join our host, Deb Tauber, andco-host, Jerrod Jeffries, as
they sit down with subjectmatter experts from across the
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simulation.
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Beaker Health wheredissemination and measuring
impact comes easily.
Deb Tauber (01:15):
Welcome to another episode of The Sim Cafe.
Welcome, and today,unfortunately, Jerrod's not with
us, but we are so fortunate tohave Dr Kristen Brown.
Dr Brown is the Associate Deanfor Simulation and Immersive
Learning and Associate Professorat the John Hopkins School of
Nursing, where she leads theCenter for Simulation and
(01:36):
Immersive Learning.
Brown was the first nurse to benamed the Zamorowski Simulation
Fellow and completed a two-yearsimulation fellowship at the
John Hopkins Medicine SimulationCenter.
Her passion for simulationeducation stems from her years
in clinical practice as apediatric critical care nurse
(01:57):
practitioner.
So thank you so much, and wouldyou like to elaborate a little
bit about that and maybe tell usabout your current role?
Dr. Kristen Brown (02:04):
Yeah, no, thank you, and thank you for
having me.
Yeah, so my current role it'sactually my dream job.
You know, when people ask youwhat do you want to be when you
grow up and you don't know, Ifinally know and it's this job
and I think, because it reallyblends all of my passions and
things I love.
I love immersive learning.
I love working with studentsand seeing that light bulb go
(02:26):
off but making the connections.
And so right now I lead theCenter for Immersive Learning
and Simulation.
Immersive Learning and you knowwe incorporate some in all of
our programs at Johns HopkinsSchool of Nursing, whether it is
our pre-licensure programs andthen all of our advanced
practice programs.
And initially, when I startedthere, I was brought in to
(02:47):
incorporate SIM in all theadvanced practice programs.
So, like most schools,pre-licensure nursing, SIM has
always been really wellestablished and there's buy-in
and advanced practice was alittle bit.
You know people would do it,they would do it in pockets, and
so my role was to reallystandardize it and every one of
our programs really make surethat there was a full curriculum
.
So, whether it was thepediatric primary care or our
(03:12):
psych, mental health, MP program, really making sure that they
had simulation in line withtheir curriculum.
And then, most recently, we'vedone a lot of trying to expand
the amount of time we do insimulation by leveraging
technology.
So we've done a lot withvirtual reality.
We've added close to 4,000 to5,000 additional hours of sim
using virtual reality and that'snot in place that we still do
(03:33):
our in-person.
That allows us to do it moreoften, and so we're always
looking at ways to partner withengineering, partner across the
school and think about ways wecan deliver sim more often.
So for me it's a reallyexciting role.
That again my dream job, if youknow, if you love sim and
understand I'm in a good placeright now that I can try
(03:54):
different things.
Deb Tauber (03:56):
That's wonderful and I'm really happy for you.
I'm happy that you found yourdream.
It's that's what I love to do,what I do.
So why don't you tell us howyou actually got into simulation
?
Dr. Kristen Brown (04:10):
No one just falls into it.
I mean you.
Actually you do fall into it.
No one says I'm going to, I'mgoing to pick this for my whole
life.
I was a new nurse practitionerat Johns Hopkins Pediatric ICU
and was a good PICU nurse, andbeing a new nurse practitioner
was very scary new role and Iwas very fortunate enough to
work with Dr Betsy Hunt, who wasin the PICU but also our
(04:33):
director of our Sim Center, andI noticed that there was a lot
of Sim going on for fellows andresidents and nurses, but not
really for nurse practitioners.
There was this kind of new rolein the ICU.
I didn't really know where Ifit in and so I would volunteer
to be an embedded actor becauseI wanted to learn and I was like
(04:53):
, let me be on the inside, I'mkind of nervous, I want to learn
.
And so it was really kind ofselfish at the beginning.
I'm like I want to hear what'sgoing on, I don't want to be put
on the spot, and Betsy beingBetsy and anybody that's a high
level ICU physician sim loverwas like you're volunteering, of
course I'll take you forwhatever you know.
And so I just kept doing itmore and more and more, and the
(05:15):
more I did it, the more I lovedit and the more I felt
comfortable.
And one of the things I noticedis that there wasn't anything
for nurse practitioners.
There wasn't training for usand it wasn't just at Hopkins,
it was really universal and partof my DMP work was to
simulation boot camp for nursepractitioners.
Very, you know, we've had themfor fellows, we have them for
(05:35):
residents and I'm like what ifwe did this?
And it was an amazing responseand it was obviously pediatric
critical care.
But I had centers I had 13centers from across the country
send people and it was the firsttime where people were like,
wow, there's something for us.
So that's kind of how I fellinto it and then I never left it
.
Deb Tauber (05:53):
That is fantastic.
I love that story and it's sotrue 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 peoplelearn safe practices.
Dr. Kristen Brown (06:10):
Yeah, and they feel comfortable and you
start to feel comfortable doingit.
And I think, too, for me it wassaying okay, it's okay to fail
and be safe and be in thisenvironment and let's just be
vulnerable and let's talk aboutit.
And one of the big takeawaysfrom the bootcamp the fact that
it was all people playingembedded nurses and respiratory
therapists, but the learners allbeing nurse practitioners they
(06:31):
had the safe space to have adialogue that they usually don't
have and we had a really goodopportunity to talk about.
If you're working at academiccenter, how do you partner with
your fellows and your residentsand work together, where it's
not us and them, but having thatnarrative where, if you're in
the room and you're managing thepatient, how do you talk and
(06:51):
work together?
And I thought that was like areally unique thing and it was
really nice just to heareverybody talk and share
information and kind of managethe patient together.
So it was a really, for me, anamazing thing to see.
Deb Tauber (07:03):
Yeah, it's a lot of fun.
Now, recently, the John HopkinsShaping the Policy Nexus Award
was awarded to your group.
Why don't you share with ourlisteners a little bit about
that, about how that allhappened and about the people
that you included and involved,because it was a really
worthwhile and exciting project?
Dr. Kristen Brown (07:24):
So thank you.
Yeah, no, it was reallyexciting.
Johns Hopkins was veryfortunate to have a lot of
funding from Bloomberg and theybuilt a policy center down in DC
, so a building that's rightnear the Capitol in 555
Pennsylvania.
I mean, it's right there in thebackground and and really I
think, recognizing thateverybody at the university, or
(07:47):
any school, really should havesome say or some place that you
can move the needle with policyor advocacy for whatever you do,
whether you're an engineer,whether you're in nursing,
whatever it is like we need tohave a place, we need to have a
voice, and so a new building hasrecently opened and all the
schools have a stake in it andthere's different policy
(08:08):
programs.
And recently I joined theadvocacy committee for the
Society for SimulationHealthcare and it's a newer
committee and we're thinkingabout how do you have the
narrative and what are thethings that we want to say as a
collective group that reallygets people excited about
something?
We're excited and we talk toother same people that are
excited and they know what we do.
But how do we talk to our CEOor a congressman and what does
(08:32):
this narrative look like andwhat is our story?
So they have these awards,essentially a grant that you can
put in and you can convenepeople and you can be in them in
a way that you really want tofor what your specialty is.
So I put in to convene expertsto look at how we can shape the
US workforce from nursing andmedicine and this was a
collaboration with Jeff Millerfrom School of Medicine, myself
(08:54):
at the School of Nursing andwhat are the implications and
what are the things that we cando for having our shared
narrative about simulation?
And I wanted to include theadvocacy committee members, who
are a great group of leadersfrom SSH and people that have
different backgrounds.
We have someone that works withthe DOD.
(09:14):
We have someone that kind ofthe DOD, we have someone that
kind of newer to SIM, but theydo a lot of advocacy work and
they oversee a lot of the thingsand big issues within a
hospital system.
So it's a very unique group andit's run by Bob Armstrong and
Haru Okudo, and so when I putthis in, I just kind of was like
let me just shoot for the stars.
I'm going to say I'm going tohave leadership from all the
(09:36):
major organizations that impactUS workforce and I'm going to
bring organizations that affecthealth care, education and
really across the continuum.
Like we always want to thinkabout 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 wewant to keep people there and
(09:58):
we know we can use SIM to keeppeople there.
And I want to invite theorganizations like ACGME,
american Academy of Nursing,ncsbn, nln, and have a shared
dialogue and come up with aconsensus statement of where
we're going and how do we shapethe next 20 years or so of
healthcare education withsimulation.
So that just took place lastweek and I was very fortunate to
(10:21):
have on the steering committeeHaru and Bob and KT Waxman, who
is also on the advocacycommittee, and Barry Eisenberg,
who at the time was thepresident for SSH, and we
invited all the advocacycommittee members and then a few
other sim experts that areactively involved in policy or
have done some sort of advocacywork, because I wouldn't invite
(10:42):
everybody.
I mean this is like oh, but youwant to be really mindful about
the group we brought togetherand then we invited our
colleagues from theorganizations and they came
together and we had a great twodays like two and a half days of
a shared narrative and we weregoing to put out a consensus
statement about next steps.
What are the things that wereally want to look at and how
do we advocate forsimulation-based education?
(11:04):
Really exciting things to come.
I think it was just thebeginning.
Having the president andpresident-elect from ASPE,
anaxal, ssh and GNSH was a hugepart.
Like to bring all these peopletogether in the same room and
have a shared narrative.
To me was one of the highlights.
Like I could just sit back andwatch these giants talk and I'm
like this is absolutely amazing.
(11:26):
So it was very exciting.
Deb Tauber (11:28):
That is very exciting.
You were very deliberate andyou had a lot of brilliant minds
together.
Yeah, yeah, yeah, thank you.
Yeah, no, it was.
Dr. Kristen Brown (11:39):
I am still recovering, but it was good.
Deb Tauber (11:42):
Yeah, you mentioned it was a little overwhelming.
Dr. Kristen Brown (11:48):
It was a lot.
It's a lot.
You plan for you know a year orso and you bring it together
everybody.
But it was.
It was great and the thebackdrop of having the break
there at the Capitol and beingpresent and we actually had some
staffers that came by at ourreception and just to start the
narrative of looking at how wecan get more funding, how do we
advocate more for simulation?
And we don't want to keepsaying the same thing.
(12:09):
We know it's important, we knowthere's good patient outcomes.
So what are the new things wecan say?
How do we leverage technologyand make it make sense?
So I think a lot of good thingswill come.
Deb Tauber (12:18):
Thank you.
Thank you for your efforts.
Now do a little bit on more ofa personal level.
Do you have a favoritesimulation story you'd like to
share with our listeners?
Dr. Kristen Brown (12:28):
Wow, do I?
There's so many.
I think for me this is actuallyvery personal, because you do
so much, sim, and you teach andyou do the things.
And Hopkins, we do a lot ofrapid cycle of different
practice and how do you move tothe next step?
And you do a needs assessmentand if your students aren't
successfully doing the basicthings, you don't move to the
next thing.
And so I was fortunate enoughto do a simulation fellowship
(12:51):
for two years at the School ofMedicine and so I learned kind
of that technique very well, andthen I got to go to all the
mock codes and do all theinsight cues with the residents
and we had this scenario wewould do all the time.
It's like the first five minutes.
It's you open up the gown andyou open the airway and you bag,
and then two-person bagging allthe things, and did this you
(13:12):
know I could do it in my sleepand it was early in COVID and we
, my husband and I, happened ona car accident and there was and
I'm peed, but a woman waspulled out of the car and we
were kind of pretty close to thefirst responder.
So I said, pull over and I goover, and it was like my
scenario her airway is not open.
I opened the airway and thenthere's people at the scene and
(13:32):
I'm like, can you feel public?
Keep your finger there.
And then a police officer cameand they had a bag and I'm like,
okay, I can't bag this, isthere's blood I'm holding.
So I'm doing the two person bagand then I then the bag had an
oral airway.
I did so, I went through anddid 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 ableto have the oral airway.
(13:54):
She started to wake up, shepulled it out, Non-rebreather,
took away and she did fine.
Long story short, it was.
I just thought of Betsy Hunt inmy head.
I'm like this was you embeddedthis in me.
I'm like this was like a nobrainer.
This is what I do.
But my kids and my husband arein the car and the funny thing,
I came back to the car andthey're like their jaws are like
what was that?
I'm like, yeah, this mommy doesthis?
stuff, and so it was funny tosee that reaction and just kind
(14:17):
of spring into.
But again, this is what's sogreat about sim.
Even if I don't take care ofadults, I did that so many times
.
I was so prepared andconditioned and felt comfortable
that I'm like this is myscenario, so a little personal.
But again that's like such akind of putting all the sim
pieces together in that perfectstorm yes, yeah, that's a great
(14:37):
story.
Deb Tauber (14:38):
I love that one.
Now can you share with ourlisteners the biggest thing
you'd like them to share, likewhen you learned it, it changed
the way you practice.
Maybe a personal aha moment.
Dr. Kristen Brown (14:48):
Yeah, I think for me.
I thought I was pretty goodwith them.
I'm like I know Sam, but I wasdoing all Pete's critical care
scenarios.
So I was really good at Pete'scritical care scenarios.
I was the content expert and Iwas learning them.
And when I did the fellowshipand I had really great sim,
educators say to me like no, no,you're going to be consulting
(15:10):
and helping someone fromanesthesia or someone from adult
whatever.
And I'm like whoa.
And they're like no, no, thisis what you do in sim.
This is, this is nowunderstanding the pedagogy and
understanding how you help withlearning objectives and how you
match the modality to the sim.
And it was like that aha, likeoh, okay, this is starting to
come together.
And it was such a greatexposure for me because not only
(15:32):
did I do, I spent time with theeducators and did that part and
learned to take myself out of.
I don't have to be the contentexpert, nor do I want to be.
That's okay, I'm here in adifferent role.
And it really prepared me formy future work because I wasn't
going to just do PEDS, criticalcare, sim in my education role
the rest of my life.
There were all kinds ofspecialties.
(15:53):
So that was like a big ahamoment.
And again, it helps me too whenI'm trying to talk to people
that are really interested insim and they want to do more and
they do it a lot in theirspecialty and they want to kind
of branch out.
I said, well, you're going tohave to be out of your comfort
zone a little bit, but once youget comfortable and know
similarly well, you're going tofeel the same way that you feel
doing that work in yourspecialty.
(16:14):
And so for me I think that waslike a big aha moment.
And that fellowship and thattime that I was able to put in
and I spent time with SimOps andwhen I was with SimOps, I was
just with SimOps.
I learned how to run everything.
I'm doing things in boot campsand you got to see every side of
it.
And then I spent some time withthe administrative side and
what does it look like to run aSimCenter?
And so I think all those piecescoming together for me made me
(16:36):
really understand it fully ofwhat the simulation educator or
administrator, what does thatrole look like.
So that, to me, was my biggestaha.
Deb Tauber (16:46):
Thank you for sharing that.
You do a lot of work for theSociety for Simulation in
Healthcare.
Why don't you share some of thehats that you wear there with
our listeners too, and what yougot involved with the society?
Dr. Kristen Brown (16:59):
Yeah, it's interesting too, because I think
all of us have our specialtiesand you can be pulled in a
million directions and I thinkfor 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 nursepractitioner faculty I did a lot
of work for the NationalOrganization of Nurse
Practitioner Faculties, nos, andat the time they didn't have a
(17:19):
simulation committee and theyhad a new committee and they
really needed people to have avoice for sim and so for me I
spent a lot of time.
We did a white paper kind oftalking about best practice for
nurse practitioner education andagain, this is jumping off the
Naxal standards.
It's no different, it'sliterally the same kind of
you're going to do the samething.
But we wanted to put that outthere and so for me I did a lot
(17:41):
work there and then I realizedSSH was really my organization,
because I felt very welcomethere.
I love the fact that you hadpeople from all backgrounds you
name it, it was everybody comingtogether.
No one made you say like, well,I'm a physician, you're a nurse
, it didn't matter.
And for me I started to do moreand 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&Acommittee.
(18:04):
That was my first committee andthat's the finance and audit
committee and you learn aboutthe inner workings of a society
being on that and I'm on mysecond term and I'll be done.
But I learned so much about thesociety and so for me, any
opportunity that I could beinvolved I was part of the
distance sim collaborative andworked with that, that group,
and most recently on the boardof directors.
So I'm going to my second yearand currently I am the board
(18:27):
liaison for the AccreditationCouncil and I have to say that
is the hardest working group inall of the organizations Sorry
to my board of directors andfinance.
That group for accreditation isreally the next level.
And being a board liaisonliaison I'm kind of there and
I'm conveying information backand forth from the board but I'm
really just taking it and I'mlearning.
(18:48):
And I'm not only learning thethings that they do for
predation here, but also makingthis really big impact
internationally.
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 USthing.
This is really an internationalthing.
And how do we get simulationcenters to have the same
(19:10):
standard and criteria that wereally want here?
And so for me, I'm in all ofthat group and I know you're
part of that team of amazinggroup of people that it's
volunteer and the effort thatthey put in to make sure that we
get centers accredited has beenabsolutely amazing.
And then most recently, like Isaid, I'm on the advocacy
(19:30):
committee and for me, I thinkthat's a very big passion, and
advocacy and policy doesn't meanjust being in front of Congress
, it's anywhere you areadvocating, and whether it's my
school with our advisory board,or talking to leadership at the
hospital, so, yeah, I'm reallyconnected with the organization
and I do love the work that Ithink every one of these groups
(19:52):
is doing and everybody'svolunteer and it's amazing.
Deb Tauber (19:55):
Thank you.
Thanks for everything thatyou're doing.
It's overwhelming the amount ofstuff that you're involved with
, but keep up the good work,because you're making
differences.
Dr. Kristen Brown (20:04):
Thank you.
Deb Tauber (20:04):
I agree, the council does some really good work
right.
If you have a job, give it to abusy person and they'll get it
done right.
That's exactly right.
Dr. Kristen Brown (20:16):
And I think too, you know, one of some of
the dialogue that came out ofthis convening is a lot of these
organizations, when you'regoing to get buy in for
simulation, they want to seethat you have some standards and
that you can make the case ifI'm an accredited center or I
have certified people within thecenter, and I think that really
just moves the needle for us asa collective group and
simulation to have that there'smore to it than I'm just going
(20:40):
to go and role play or dowhatever.
What people you know there'speople that's still not really
sure what you're doing and areyou just in the basement with a
mannequin or like this is likethis is a real thing, and so
that really was something wetalked a great deal about and
how that that accreditation andcertifications really I think as
a collective group, moved theneedle a lot for us in
simulation.
Deb Tauber (21:01):
Yeah, I completely agree.
It's really provided someguardrails for what you're doing
.
And there's so many more.
There's so much moreacknowledgement and appreciation
when you achieve, you know, oneof the certifications or if you
become accredited by thesociety.
It says a lot about the qualityof your program.
Dr. Kristen Brown (21:20):
Yeah, and you have to maintain it and you
have to keep it going and itgets you doing the things that
you normally.
Maybe you have some policiesand procedures floating around,
but you have to get thosetogether and you have to keep
them organized and they have tobe 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, andso that, to me, I think one of
(21:42):
the best things that can come up.
Yeah, it's a lot of work, butonce you put the work in, I
think it sets your center up forfuture success and whatever you
end up doing.
Deb Tauber (21:52):
Absolutely.
Now, Dr Brown, are there anyfinal words?
You would like our listeners toremember this conversation by.
Dr. Kristen Brown (21:59):
I really appreciate you having me.
I know you do so much work andI love that you even have this
platform to bring other peoplein and even talking a day.
Just hearing all the thingsthat you do and have done, I
really appreciate it.
I think one of my biggesttakeaways where we're thinking
with technology and how we'removing the needle and we, I
(22:20):
think, as a collective group,you don't want to just check the
sexy box and, oh, I'm going todo this thing and scale it One
of my biggest things is verse oflearning should change behavior
and whatever we do, we stillwant to make sure we have
behavior change and I know I'mpreaching the choir, but I think
for us as a collective group,making sure, no matter whatever
technology we're doing, whateverwe're doing, we just kind of
hold true to the things that weknow we do well, and that's
(22:42):
engagement with our learners,having the debriefing, making
sure we're was there really achange in behavior and is this
going to really impact patientoutcomes?
So for me, I think, as we'rethinking about the future and
how we can use technology, Ithink if we stay true to those
kind of core values of what, whywe fell in love with SIM to
begin with.
I think, if we stay true tothose kind of core values of why
we fell, in love with SIM tobegin with.
Deb Tauber (23:02):
I think we're going to be in good shape.
Thank you, those are veryencouraging words.
I appreciate you and Iappreciate your time.
Dr. Kristen Brown (23:07):
Thank you, thanks again for having me.
Disclaimer/ Beaker Health (23:11):
Thank you and happy simulating.
Thank you, thanks to BeakerHealth for sponsoring this
week's podcast.
Beaker Health, wheredissemination and measuring
impact comes easy.
We hope you enjoyed.
(23:32):
Visit us atwwwinnovativesimsolutionscom and
be sure to hit that like andsubscribe button so you never
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(23:52):
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