November 12, 2025 • 23 mins
What does it take to build safer clinicians, not just better test takers? We sit down with pediatric critical care pioneer and simulation leader Tonya Schneidereith to trace a career defined by curiosity, courage, and a relentless focus on patient safety. From early days as one of the first PICU nurse practitioners in the country to associate director of simulation at Johns Hopkins, Tonya reveals how mentorship, research, and design thinking shaped her approach to teaching and assessment.
We dig into her medication safety work using Google Glass to capture the learner’s point of view, exposing why accurate math still leads to dangerous IV pump programming when context is missing. That insight led to national recommendations on verifying dosage calculation competence and a sharper focus on debriefing. Tanya shares a memorable morphine case where most learners turned up oxygen as ventilation failed, and how a single probing question in debrief uncovered the real driver behind a “correct” action. The lesson is clear: simulation must illuminate decision-making, not just outcomes.
Tonya also opens the doors to SIMPL Simulation, the consultancy she co-founded to elevate faculty development, program design, and simulation operations. She walks us through a bold project with BSA LifeStructures and Wake Tech Community College: a true simulation hospital spanning EMS arrival, diagnostics, acute care rooms, an operating room, and a live MRI. It’s a blueprint for interprofessional education that makes teamwork the default. We then explore responsible AI in healthcare simulation, drawing on a new white paper Tonya helped shape. Ethical integration, transparent limits, and scenario design that builds judgment are essential as AI becomes part of daily clinical work.
If you care about better debriefing, safer medication practices, AI in nursing education, and simulation spaces that teach as powerfully as people do, this conversation will sharpen your approach. Listen, share with your team, and tell us the one change you’ll make in your next sim. Subscribe for more expert stories and leave a review to help others find the show.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Disclaimer/ Beaker Health A (00:00):
The views and opinions expressed in
this program are those of thespeakers and do not necessarily
reflect the opinions orpositions of anyone at
Innovative Sim Solutions or oursponsors.
This week's podcast is broughtto you by Beaker Health.
Beaker Health is auser-generated and peer-reviewed
community educational platformdesigned for healthcare
(00:23):
organizations.
We let your community connectand engage with one another
freely and efficiently.
Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions.
Edited by Shelly Houser.
Join our host, Deb Tauber andco-host Jerrod Jeffries as they
(00:50):
sit down with subject matterexperts from across the globe to
reimagine clinical educationand the use of simulation.
So pour yourself a cup ofrelaxation, sit back, tune in
and learn something new from TheSim Cafe.
Deb (01:13):
Welcome to another episode of The Sim Cafe.
Today, Jerrod and I are herewith Tanya Schneiderreit.
And Tonya is going to tell us alittle bit about herself.
And thank you so much for beinga guest.
Why don't you tell ourlisteners a little bit about
yourself?
Tonya (01:30):
Thank you.
Thanks for inviting me to this.
This is really wonderful.
So my name is TonyaSchneidereith.
I am a pediatric critical carenurse practitioner by training.
And I am currently an associateprofessor at Johns Hopkins
University School of Nursing,where I teach child health for
our master's entry to nursingprogram.
(01:52):
And then I'm also the associatedirector of simulation for the
master's entry to nursingprogram as well.
Deb (01:59):
Thank you.
Why don't you go ahead andshare your journey into
simulation for our listeners?
Like what inspired you to leapinto simulation from practice?
Tonya (02:09):
So I've always been that person that just enjoyed
learning, and I've alwaysenjoyed learning new things.
So when I started out as apediatric intensive care unit
nurse practitioner, I workedwith one of my attending
physicians, and he noticed thatthere was a difference in the
way that patients with sicklecell disease metabolized
(02:31):
lidocaine when they compared tonormal post-op controls.
So that got me interested inpatients with
hemoglobinopathies.
And so I decided to go back toschool to get a PhD where my
doctoral work was looking atpharmacogenetic pathways, basic
science stuff involved in fetalhemoglobin production.
(02:52):
And around that same time, Istarted growing my family.
And so I stepped away from thebedside and I met a woman in the
infant toddler class in JimBurie.
And Jared, you may be able torelate with some young children.
But one of these ladieshappened to be a nurse
practitioner, and she wastelling me about her role in
(03:16):
higher education.
And so I started looking forsome positions, thinking, is
this something that I might beinterested in doing?
And that led me into highereducation.
So I joined the faculty at asmall university in northern
Baltimore County here inMaryland.
And I was selected as one ofthe first designees to attend
(03:41):
the Maryland Faculty Academy forSimulation and Teaching at
Johns Hopkins University.
And that was spearheaded bythis wonderful innovator named
Dr.
Pam Jeffries.
And that was my introductioninto simulation.
And I had no idea at the timethat she would become my fairy
(04:01):
godmother in terms of simulationeducation.
And so from there I was hooked.
I learned all that I couldabout simulation.
And we were a small, smalllittle institution where I first
started.
So I was an island.
I was everything.
I was sim ops, I wasfacilitator, and I was
(04:23):
everything in between.
And a few years later, I wasselected for the 2015 NLN SIM
Leader Program.
And that's still impacting mylife today.
Ten years later, I metcolleagues, lifelong friends
from all around the globe, andthey've helped me and guided me
through my simulation journey.
(04:45):
That fed into work with the NLNthrough working with Dr.
Marion Rizzolo and Sue Fernaresand Mary Fay.
That allowed me to author theThomas Sykes case for the ACE,
the Pediatric EvolvingSimulations.
I started revising andreviewing CHSE- A applications
(05:08):
for our advanced healthcaresimulation education
certification.
And now I'm on the SSH board ofdirectors.
So it has been a windingjourney.
It's been amazing, and that'swhat led me to today.
Deb (05:23):
Thank you.
Thank you for that introductionand for your story about how
you got into sim.
Jerrod (05:29):
You knocked it out of the park there, Tonya.
That's I mean, a lot of thingsto dig into.
But I think there was onelittle piece that I and you
mentioned the pediatric criticalcare.
Did I hear that you're one ofthe first pediatric critical
care nurse practitioners in thecountry?
Yes.
Yeah.
Tonya (05:47):
Yes, I think I maybe was number seven.
I know I was the fourth.
What I was the fourth inMaryland, and I think there were
three in Utah prior to mystarting.
Jerrod (05:58):
Wow.
I mean, so being a pioneer, Imean, because like I mean, now
it's also you went throughsimulation in some of the early
days too.
I mean, you're you're used to alot of differences or pushing
the boulder uphill, so to speak.
So what are some of the momentsyou remember most and and any
advice to maybe some that aretrying to do new movers and
(06:19):
shakers in new industries aswell?
Tonya (06:21):
Well, so it it feels like as being one of the first
people in that role, we weredefinitely building the plane as
we were flying it.
And that's so much likesimulation, right?
There's there's so many thingsthat you have to take on and
figure out as you're goingalong.
But I think it's reallyrewarding to think of having
(06:45):
originated this role, goodnessgracious, 25 plus years ago, and
know that there's over 500pediatric critical care nurse
practitioners now.
So that just warms my heartwhen I'm walking down the halls
and see people who are trainingfor that same thing.
Back in the day, there wasn'tan exam.
(07:05):
So we had to sit for thepediatric primary care exam.
And so you can tell the theoldies based on our
certification, where ourcertification originates from.
But it's it's also reallysimilar to what we were going
through with certification forsimulation, trying to develop
(07:27):
those educator certificationsand then advancing to the
advanced certification.
And then the same for ouroperations specialist and
helping them to move into anadvanced operations specialist
certification as well.
So there are a lot ofparallels.
It may seem like they'recompletely different fields, but
very, very similar to what I'mdoing now.
Deb (07:49):
Thank you.
Amazing work, amazing work.
Tell us a little about simple,your simulation company that you
have.
Tonya (07:58):
Yes.
So as I mentioned, I was in the2015 cohort of the NLN Sim
Leader program.
And um, out of the 20 amazingpeople that I met in that
journey, four were fromMaryland.
And one of those individualswas the amazing Dr.
Crystal Farina, who is atcurrently, she's currently at
(08:20):
George Washington University,drawn there by Dr.
Pam Jeffries when she was thereas the dean.
And Crystal, hands down, has tobe one of the smartest
simulationists that I've evermet.
And when we were in thesimulator program, in our
conversations, in our travels,and going to conferences, we
(08:40):
recognized very readily thatthere was a need for
professional development.
And so two years later, wefounded Simple Simulation and we
derived the name simple.
We took SIM from simulation,the P is for practices, and the
L is for learning.
So that's where that uh simplecomes from and the name.
(09:04):
And our job right now is to tryto help individuals with
anything that they need to helpdevelop their simulation
programs, be it professionaldevelopment, be it, well,
currently we are in a really funplace where we are working with
architectural firms to designand develop sim spaces.
(09:27):
And one of the things thatwe're doing now, which is uh
it's a project that just itmakes my heart swell.
I'm so incredibly proud, iswe're working with BSA Life
Structures to design asimulation hospital for Wake
Tech Community College down inRaleigh, North Carolina.
And it is literally going to bea simulation hospital.
(09:48):
So can you imagine three floorswhere you come into the
entrance as if you're coming offan ambulance, you get
diagnostics, screening, you moveto the third floor where you
would have acute care rooms.
There's also going to be an OR.
They have a live MRI machinethat's been donated that will be
(10:10):
there for them to help train.
They have a variety ofprograms: nursing, ultrasound
tech, radiography, MRI,mammography, respiratory
therapy, to just name a few ofthem.
So can you imagine everybody inthere to learn?
And when we think about whatwe're looking for for
interdisciplinary learning, thatthat's just that's gonna be the
(10:33):
mecca there.
So I'm really excited to be apart of that that project.
They are definitelytrailblazers.
Deb (10:39):
When do you think they'll be done?
Tonya (10:41):
So they just broke ground um this past summer.
Deb (10:45):
How exciting!
Tonya (10:46):
Yeah, so they have a couple of years of building, and
then it's it's it's gonna be apremier place to be.
Jerrod (10:53):
And that's out of Raleigh.
Tonya (10:54):
That's in Raleigh, yes.
Jerrod (10:55):
Yeah, that's cool.
That was the first I've heardof that.
Yeah, that's so cool.
Tonya (11:00):
Yeah, so that's that's sort of an area now that we are
we are focusing on, but stillour our passion and love is also
in professional development.
Jerrod (11:11):
You've spanned so many places.
So maybe even more with simple,but but even with your time at
Hopkins, you've seemed to haveexperimented with some pretty
cool stuff.
Uh so I think with what you'velearned and where you have been,
where would your thoughts be onhealthcare simulation with AI?
(11:33):
Do we need to keep it human?
Or should we, or should we not?
Does it matter?
Uh I want to tap more into someof the new technologies and
where you think that's headed.
Tonya (11:44):
Uh, that's a loaded question.
Um, my tech journey startedwith Google Glass.
So back in the mid-uh, early2000s, when Google Glass was
first launched, uh, I had agirlfriend of mine who was
telling me about this reallycool technology and where you
could you could watch movies,you could talk on the phone, you
(12:06):
could video record from thewearer's perspective.
And that's what perked my earsup.
What do you mean you can videorecord from the wearer's
perspective?
Because my research had been insafe medication administration
and looking at the behaviors ofstudents in simulation, um, and
just starting with the basicfive rights.
(12:27):
Like how how many times arethey running through all five
rights before giving uhmedication?
And then that sort of took medown this path of dosage
calculation and realizing thatour students they could do the
math, right?
If you said what's two timestwo, they would know readily
(12:50):
it's four.
What got in the way was theselong provider orders that had
all of this information inthere, and you didn't know what
to extract to put in these verycomplicated formulas to then try
to come up with the rightanswer to either administer a
medication or to program an IVpump or sort of anything in
(13:15):
between.
So I was able to secure somegrant funding and I got Google
Glass and was able to recordfrom the wearer's perspective.
And it just was a really,really fascinating peek into
what it was that they weredoing.
And it confirmed that yes, theythey knew how to do the math,
(13:35):
but they but they also didn'thave the context to critically
apply if the answer even madesense.
For example, if they are havingto program an IV pump for uh
15-minute infusion, and theycould only use an hourly setting
(13:58):
to program the pump.
Sometimes, if there was 10 milsthat needed to infuse, they
would set the pump at 0.1 milsper hour, which is going to take
many more hours than 15minutes, or they would set it at
some other rate that justdidn't make sense.
So then that took me into well,how are we teaching dosage
(14:22):
calculation?
And how are we verifying thatdosage calculation is actually
something that they know?
Or are they just learningenough to be able to take a test
and pass the test?
How many tests should they beallowed to take?
How many items should be onthat test?
So I did a national survey andI published that a couple of
(14:42):
years ago with somerecommendations on how we should
both test and verify thatstudents are competent in
medication administration.
So that's sort of that initialrole of tech.
But then with my work with SSH,the Society for Simulation and
Healthcare, I was on a committeethat wrote a white paper on how
(15:07):
to integrate artificialintelligence in simulation.
And we published that whitepaper.
It's on the SimulationHealthcare Collaborative
website, and that was inconjunction with SSH.
And what we've realized is thatwe have an enormous
responsibility, both in how howwe utilize AI, but also how
(15:30):
we're teaching AI.
And artificial intelligence,it's here.
I mean, we all know this.
This is not a surprise, right?
It's here, people are using it.
I use it just about every day.
I love using AI, but I thinkthat we need to teach
responsible usage because whenour students go into the
hospital, it's there.
(15:51):
It's there.
So I think we as educators, andwe know that a lot of our
educators are older generations.
And we have a responsibility tolearn about the technology, to
have an idea of how thetechnology works.
And then how might we integratethe technology in both our
(16:13):
classroom and our clinical andour simulation settings so that
we're preparing our students touse it ethically and
responsibly?
Deb (16:21):
Yes.
Well, yeah, well said.
Now, Tonya, we're gonna takethe show in a little bit of a
different direction.
Do you have a favoritesimulation story you'd like to
share with our listeners?
It's always my favoritequestion.
Tonya (16:35):
Yeah, it's like asking your favorite child, right?
Do you have a favorite storylike that?
Um, but I I think for me, oneof the things that really stands
out, it's a super simple, supersimple simulation.
There were uh simulations thatI I've run previously where we
(16:55):
would bring students, seniorstudents getting ready to
graduate.
We would would bring them intoan individual one-on-one
simulation.
And this scenario, there was afemale patient who was post-op
who needed to receive morphinefor pain.
And the students did a reallygreat job.
They administered her morphine,and her respiratory rate
(17:20):
started to drop, her oxygensaturation started to drop.
And she eventually got to arespiratory rate of four.
And every I would say 99% ofthe time, I would watch the
students and they'd go andthey'd turn up the oxygen flow
on her nasal cannula.
It's not a bad first thought,but then they would be perplexed
(17:43):
as to why that's not working,and they turn it up a little
more and they turn it up alittle more.
And it wasn't until the debriefwhere we would have a
conversation about ineffectiveventilation and how we might be
able to support that with thetools that we have in the room.
But there was one time astudent, she reached for the bag
(18:04):
valve mask and she startedbagging the patient.
And I thought, yay, it'shappened.
I have somebody who understandsthe difference between
oxygenation and ventilation.
And we got into our debriefingconversation, and I said, I
noticed that when she starteddropping her oxygen saturations
and she dropped her respiratoryrate, that you reached for the
(18:27):
bag valve mask and began toventilate her.
And I know that that was theright action because she wasn't
breathing effectively.
So walk me through yourthinking in that moment.
And how is it that that youcame to make those decisions?
And she said, Well, what Ireally wanted to do was turn up
the oxygen, but it was on theother side of the bed.
(18:49):
I couldn't reach it.
And this was the thing that wasclosest to me.
And so I grabbed the bag and Istarted bagging her.
And I thought, well, isn't thisa beautiful place for
debriefing?
Because had I not asked thequestion, she would have gone
into practice.
And if somebody would havedesaturated without effective
(19:09):
ventilation, she also would havereached to increase the oxygen
flow, which is not the rightthing, right?
So my favorite aspects ofsimulation is that debriefing
piece.
And I think in my journeys, Ihave seen so many places that
(19:30):
bring in instructors to teach ina simulated setting.
And it very much mimics whatthey would do in the clinical
setting, right?
They give feedback, theycorrect behaviors, right?
But but not being trained todig into those aspects of why
(19:51):
did they make that decision?
Was it because they didn't haveenough knowledge and can we
fill that knowledge gap?
Or was there some other reason?
What what was their frame?
And so I think that that also,you know, takes me back to our
consulting company, SimpleSimulation, where we need to
have people who are facilitatingour simulation debriefings that
(20:15):
are trained in the pedagogy,that understand it.
And ultimately, that's whatwe're all trying to do is to
create safe people, safeprofessionals.
And if we make the assumptionthat we know why they did
something and provide feedback,that unidirectional
conversation, then we're nevergoing to know whether they did
(20:37):
the right thing for the rightreason or the wrong thing for
the wrong reason, or anycombination in between.
So that's one of my favoritestories.
Deb (20:48):
That's a great story.
Jerrod (20:50):
Yeah, that's a good one.
Yeah, it just depends on theside of the bed that they're on.
Tonya (20:55):
Apparently.
Jerrod (20:56):
What can I reach?
Yeah.
Okay.
I I want to take us home,Tanya.
I want to hear final thoughts,but also what do you want
listeners to remember you by, orhow do you want to leave this?
Tonya (21:09):
Oh, it sounds like something that should be on my
tombstone.
How would you like to leavethis?
Well, so uh I think that I'veshared just sort of bits and
pieces about how my journey inacademia sort of came to be.
It was just a lot of it wasjust serendipitous, right?
Just sort of asking questionsand being in places.
But no matter what, I waswilling to try something and try
(21:33):
something new.
And so I I think what I wouldencourage all of your guests to
do is just be willing to trysomething new.
Be willing to be part of a teamthat's working to improve
patient safety.
Be willing to be flexible.
We all have to be flexible inwhat we're doing.
Nothing ever, ever goes toplan.
(21:54):
Be willing to look at asituation and ask, what can I do
to improve the process andremove barriers?
And be willing to embrace theride.
We're a unique and we're aspecial group of people, but
we're all here for one another.
And so I think everyone needsto find your tribe.
If you're an island like I wasin that first place where I
(22:16):
worked, reach out to me and I'llconnect you with other islands
so that you have a supportsystem.
I think that we are a mightygroup.
I think that we make a bigimpact.
And I'm just super proud to bea simulationist.
unknown (22:29):
Yeah.
Jerrod (22:30):
And with that, how can our listeners find you?
Tonya (22:33):
So you can find me at you can go to our website,
www.simplesimulation.com, andthat's simple without the e,
simulation.com, or you can reachme at the Johns Hopkins
University School of Nursing.
So either way, I'll respond.
Deb (22:48):
Thank you.
Thank you very much for beingon being a guest and just so
impressed by all of the thingsthat you've done.
It's very encouraging, andyou've certainly given a lot to
simulation.
Tonya (23:01):
Thank you.
It's been my pleasure.
Deb (23:03):
Thank you.
With that, happy simulating.
Disclaimer/ Beaker Healt (23:08):
Thanks to Beaker Health for sponsoring
this week's podcast.
Beaker Health, wheredissemination and measuring
impact comes easy.
We hope you enjoyed.
(23:29):
Visit us at www.innovativesimsolutions.com.
And be sure to hit that likeand subscribe button so you
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Innovative Sim Solutions isyour one stop shop for your
simulation needs.
A turnkey solution.
The views and opinions expressed in
this program are those of thespeakers and do not necessarily
reflect the opinions orpositions of anyone at
Innovative Sim Solutions or oursponsors.
This week's podcast is broughtto you by Beaker Health.
Beaker Health is auser-generated and peer-reviewed
community educational platformdesigned for healthcare
(00:23):
organizations.
We let your community connectand engage with one another
freely and efficiently.
Welcome to The Sim Cafe, apodcast produced by the team at
Innovative Sim Solutions.
Edited by Shelly Houser.
Join our host, Deb Tauber andco-host Jerrod Jeffries as they
(00:50):
sit down with subject matterexperts from across the globe to
reimagine clinical educationand the use of simulation.
So pour yourself a cup ofrelaxation, sit back, tune in
and learn something new from TheSim Cafe.
Deb (01:13):
Welcome to another episode of The Sim Cafe.
Today, Jerrod and I are herewith Tanya Schneiderreit.
And Tonya is going to tell us alittle bit about herself.
And thank you so much for beinga guest.
Why don't you tell ourlisteners a little bit about
yourself?
Tonya (01:30):
Thank you.
Thanks for inviting me to this.
This is really wonderful.
So my name is TonyaSchneidereith.
I am a pediatric critical carenurse practitioner by training.
And I am currently an associateprofessor at Johns Hopkins
University School of Nursing,where I teach child health for
our master's entry to nursingprogram.
(01:52):
And then I'm also the associatedirector of simulation for the
master's entry to nursingprogram as well.
Deb (01:59):
Thank you.
Why don't you go ahead andshare your journey into
simulation for our listeners?
Like what inspired you to leapinto simulation from practice?
Tonya (02:09):
So I've always been that person that just enjoyed
learning, and I've alwaysenjoyed learning new things.
So when I started out as apediatric intensive care unit
nurse practitioner, I workedwith one of my attending
physicians, and he noticed thatthere was a difference in the
way that patients with sicklecell disease metabolized
(02:31):
lidocaine when they compared tonormal post-op controls.
So that got me interested inpatients with
hemoglobinopathies.
And so I decided to go back toschool to get a PhD where my
doctoral work was looking atpharmacogenetic pathways, basic
science stuff involved in fetalhemoglobin production.
(02:52):
And around that same time, Istarted growing my family.
And so I stepped away from thebedside and I met a woman in the
infant toddler class in JimBurie.
And Jared, you may be able torelate with some young children.
But one of these ladieshappened to be a nurse
practitioner, and she wastelling me about her role in
(03:16):
higher education.
And so I started looking forsome positions, thinking, is
this something that I might beinterested in doing?
And that led me into highereducation.
So I joined the faculty at asmall university in northern
Baltimore County here inMaryland.
And I was selected as one ofthe first designees to attend
(03:41):
the Maryland Faculty Academy forSimulation and Teaching at
Johns Hopkins University.
And that was spearheaded bythis wonderful innovator named
Dr.
Pam Jeffries.
And that was my introductioninto simulation.
And I had no idea at the timethat she would become my fairy
(04:01):
godmother in terms of simulationeducation.
And so from there I was hooked.
I learned all that I couldabout simulation.
And we were a small, smalllittle institution where I first
started.
So I was an island.
I was everything.
I was sim ops, I wasfacilitator, and I was
(04:23):
everything in between.
And a few years later, I wasselected for the 2015 NLN SIM
Leader Program.
And that's still impacting mylife today.
Ten years later, I metcolleagues, lifelong friends
from all around the globe, andthey've helped me and guided me
through my simulation journey.
(04:45):
That fed into work with the NLNthrough working with Dr.
Marion Rizzolo and Sue Fernaresand Mary Fay.
That allowed me to author theThomas Sykes case for the ACE,
the Pediatric EvolvingSimulations.
I started revising andreviewing CHSE- A applications
(05:08):
for our advanced healthcaresimulation education
certification.
And now I'm on the SSH board ofdirectors.
So it has been a windingjourney.
It's been amazing, and that'swhat led me to today.
Deb (05:23):
Thank you.
Thank you for that introductionand for your story about how
you got into sim.
Jerrod (05:29):
You knocked it out of the park there, Tonya.
That's I mean, a lot of thingsto dig into.
But I think there was onelittle piece that I and you
mentioned the pediatric criticalcare.
Did I hear that you're one ofthe first pediatric critical
care nurse practitioners in thecountry?
Yes.
Yeah.
Tonya (05:47):
Yes, I think I maybe was number seven.
I know I was the fourth.
What I was the fourth inMaryland, and I think there were
three in Utah prior to mystarting.
Jerrod (05:58):
Wow.
I mean, so being a pioneer, Imean, because like I mean, now
it's also you went throughsimulation in some of the early
days too.
I mean, you're you're used to alot of differences or pushing
the boulder uphill, so to speak.
So what are some of the momentsyou remember most and and any
advice to maybe some that aretrying to do new movers and
(06:19):
shakers in new industries aswell?
Tonya (06:21):
Well, so it it feels like as being one of the first
people in that role, we weredefinitely building the plane as
we were flying it.
And that's so much likesimulation, right?
There's there's so many thingsthat you have to take on and
figure out as you're goingalong.
But I think it's reallyrewarding to think of having
(06:45):
originated this role, goodnessgracious, 25 plus years ago, and
know that there's over 500pediatric critical care nurse
practitioners now.
So that just warms my heartwhen I'm walking down the halls
and see people who are trainingfor that same thing.
Back in the day, there wasn'tan exam.
(07:05):
So we had to sit for thepediatric primary care exam.
And so you can tell the theoldies based on our
certification, where ourcertification originates from.
But it's it's also reallysimilar to what we were going
through with certification forsimulation, trying to develop
(07:27):
those educator certificationsand then advancing to the
advanced certification.
And then the same for ouroperations specialist and
helping them to move into anadvanced operations specialist
certification as well.
So there are a lot ofparallels.
It may seem like they'recompletely different fields, but
very, very similar to what I'mdoing now.
Deb (07:49):
Thank you.
Amazing work, amazing work.
Tell us a little about simple,your simulation company that you
have.
Tonya (07:58):
Yes.
So as I mentioned, I was in the2015 cohort of the NLN Sim
Leader program.
And um, out of the 20 amazingpeople that I met in that
journey, four were fromMaryland.
And one of those individualswas the amazing Dr.
Crystal Farina, who is atcurrently, she's currently at
(08:20):
George Washington University,drawn there by Dr.
Pam Jeffries when she was thereas the dean.
And Crystal, hands down, has tobe one of the smartest
simulationists that I've evermet.
And when we were in thesimulator program, in our
conversations, in our travels,and going to conferences, we
(08:40):
recognized very readily thatthere was a need for
professional development.
And so two years later, wefounded Simple Simulation and we
derived the name simple.
We took SIM from simulation,the P is for practices, and the
L is for learning.
So that's where that uh simplecomes from and the name.
(09:04):
And our job right now is to tryto help individuals with
anything that they need to helpdevelop their simulation
programs, be it professionaldevelopment, be it, well,
currently we are in a really funplace where we are working with
architectural firms to designand develop sim spaces.
(09:27):
And one of the things thatwe're doing now, which is uh
it's a project that just itmakes my heart swell.
I'm so incredibly proud, iswe're working with BSA Life
Structures to design asimulation hospital for Wake
Tech Community College down inRaleigh, North Carolina.
And it is literally going to bea simulation hospital.
(09:48):
So can you imagine three floorswhere you come into the
entrance as if you're coming offan ambulance, you get
diagnostics, screening, you moveto the third floor where you
would have acute care rooms.
There's also going to be an OR.
They have a live MRI machinethat's been donated that will be
(10:10):
there for them to help train.
They have a variety ofprograms: nursing, ultrasound
tech, radiography, MRI,mammography, respiratory
therapy, to just name a few ofthem.
So can you imagine everybody inthere to learn?
And when we think about whatwe're looking for for
interdisciplinary learning, thatthat's just that's gonna be the
(10:33):
mecca there.
So I'm really excited to be apart of that that project.
They are definitelytrailblazers.
Deb (10:39):
When do you think they'll be done?
Tonya (10:41):
So they just broke ground um this past summer.
Deb (10:45):
How exciting!
Tonya (10:46):
Yeah, so they have a couple of years of building, and
then it's it's it's gonna be apremier place to be.
Jerrod (10:53):
And that's out of Raleigh.
Tonya (10:54):
That's in Raleigh, yes.
Jerrod (10:55):
Yeah, that's cool.
That was the first I've heardof that.
Yeah, that's so cool.
Tonya (11:00):
Yeah, so that's that's sort of an area now that we are
we are focusing on, but stillour our passion and love is also
in professional development.
Jerrod (11:11):
You've spanned so many places.
So maybe even more with simple,but but even with your time at
Hopkins, you've seemed to haveexperimented with some pretty
cool stuff.
Uh so I think with what you'velearned and where you have been,
where would your thoughts be onhealthcare simulation with AI?
(11:33):
Do we need to keep it human?
Or should we, or should we not?
Does it matter?
Uh I want to tap more into someof the new technologies and
where you think that's headed.
Tonya (11:44):
Uh, that's a loaded question.
Um, my tech journey startedwith Google Glass.
So back in the mid-uh, early2000s, when Google Glass was
first launched, uh, I had agirlfriend of mine who was
telling me about this reallycool technology and where you
could you could watch movies,you could talk on the phone, you
(12:06):
could video record from thewearer's perspective.
And that's what perked my earsup.
What do you mean you can videorecord from the wearer's
perspective?
Because my research had been insafe medication administration
and looking at the behaviors ofstudents in simulation, um, and
just starting with the basicfive rights.
(12:27):
Like how how many times arethey running through all five
rights before giving uhmedication?
And then that sort of took medown this path of dosage
calculation and realizing thatour students they could do the
math, right?
If you said what's two timestwo, they would know readily
(12:50):
it's four.
What got in the way was theselong provider orders that had
all of this information inthere, and you didn't know what
to extract to put in these verycomplicated formulas to then try
to come up with the rightanswer to either administer a
medication or to program an IVpump or sort of anything in
(13:15):
between.
So I was able to secure somegrant funding and I got Google
Glass and was able to recordfrom the wearer's perspective.
And it just was a really,really fascinating peek into
what it was that they weredoing.
And it confirmed that yes, theythey knew how to do the math,
(13:35):
but they but they also didn'thave the context to critically
apply if the answer even madesense.
For example, if they are havingto program an IV pump for uh
15-minute infusion, and theycould only use an hourly setting
(13:58):
to program the pump.
Sometimes, if there was 10 milsthat needed to infuse, they
would set the pump at 0.1 milsper hour, which is going to take
many more hours than 15minutes, or they would set it at
some other rate that justdidn't make sense.
So then that took me into well,how are we teaching dosage
(14:22):
calculation?
And how are we verifying thatdosage calculation is actually
something that they know?
Or are they just learningenough to be able to take a test
and pass the test?
How many tests should they beallowed to take?
How many items should be onthat test?
So I did a national survey andI published that a couple of
(14:42):
years ago with somerecommendations on how we should
both test and verify thatstudents are competent in
medication administration.
So that's sort of that initialrole of tech.
But then with my work with SSH,the Society for Simulation and
Healthcare, I was on a committeethat wrote a white paper on how
(15:07):
to integrate artificialintelligence in simulation.
And we published that whitepaper.
It's on the SimulationHealthcare Collaborative
website, and that was inconjunction with SSH.
And what we've realized is thatwe have an enormous
responsibility, both in how howwe utilize AI, but also how
(15:30):
we're teaching AI.
And artificial intelligence,it's here.
I mean, we all know this.
This is not a surprise, right?
It's here, people are using it.
I use it just about every day.
I love using AI, but I thinkthat we need to teach
responsible usage because whenour students go into the
hospital, it's there.
(15:51):
It's there.
So I think we as educators, andwe know that a lot of our
educators are older generations.
And we have a responsibility tolearn about the technology, to
have an idea of how thetechnology works.
And then how might we integratethe technology in both our
(16:13):
classroom and our clinical andour simulation settings so that
we're preparing our students touse it ethically and
responsibly?
Deb (16:21):
Yes.
Well, yeah, well said.
Now, Tonya, we're gonna takethe show in a little bit of a
different direction.
Do you have a favoritesimulation story you'd like to
share with our listeners?
It's always my favoritequestion.
Tonya (16:35):
Yeah, it's like asking your favorite child, right?
Do you have a favorite storylike that?
Um, but I I think for me, oneof the things that really stands
out, it's a super simple, supersimple simulation.
There were uh simulations thatI I've run previously where we
(16:55):
would bring students, seniorstudents getting ready to
graduate.
We would would bring them intoan individual one-on-one
simulation.
And this scenario, there was afemale patient who was post-op
who needed to receive morphinefor pain.
And the students did a reallygreat job.
They administered her morphine,and her respiratory rate
(17:20):
started to drop, her oxygensaturation started to drop.
And she eventually got to arespiratory rate of four.
And every I would say 99% ofthe time, I would watch the
students and they'd go andthey'd turn up the oxygen flow
on her nasal cannula.
It's not a bad first thought,but then they would be perplexed
(17:43):
as to why that's not working,and they turn it up a little
more and they turn it up alittle more.
And it wasn't until the debriefwhere we would have a
conversation about ineffectiveventilation and how we might be
able to support that with thetools that we have in the room.
But there was one time astudent, she reached for the bag
(18:04):
valve mask and she startedbagging the patient.
And I thought, yay, it'shappened.
I have somebody who understandsthe difference between
oxygenation and ventilation.
And we got into our debriefingconversation, and I said, I
noticed that when she starteddropping her oxygen saturations
and she dropped her respiratoryrate, that you reached for the
(18:27):
bag valve mask and began toventilate her.
And I know that that was theright action because she wasn't
breathing effectively.
So walk me through yourthinking in that moment.
And how is it that that youcame to make those decisions?
And she said, Well, what Ireally wanted to do was turn up
the oxygen, but it was on theother side of the bed.
(18:49):
I couldn't reach it.
And this was the thing that wasclosest to me.
And so I grabbed the bag and Istarted bagging her.
And I thought, well, isn't thisa beautiful place for
debriefing?
Because had I not asked thequestion, she would have gone
into practice.
And if somebody would havedesaturated without effective
(19:09):
ventilation, she also would havereached to increase the oxygen
flow, which is not the rightthing, right?
So my favorite aspects ofsimulation is that debriefing
piece.
And I think in my journeys, Ihave seen so many places that
(19:30):
bring in instructors to teach ina simulated setting.
And it very much mimics whatthey would do in the clinical
setting, right?
They give feedback, theycorrect behaviors, right?
But but not being trained todig into those aspects of why
(19:51):
did they make that decision?
Was it because they didn't haveenough knowledge and can we
fill that knowledge gap?
Or was there some other reason?
What what was their frame?
And so I think that that also,you know, takes me back to our
consulting company, SimpleSimulation, where we need to
have people who are facilitatingour simulation debriefings that
(20:15):
are trained in the pedagogy,that understand it.
And ultimately, that's whatwe're all trying to do is to
create safe people, safeprofessionals.
And if we make the assumptionthat we know why they did
something and provide feedback,that unidirectional
conversation, then we're nevergoing to know whether they did
(20:37):
the right thing for the rightreason or the wrong thing for
the wrong reason, or anycombination in between.
So that's one of my favoritestories.
Deb (20:48):
That's a great story.
Jerrod (20:50):
Yeah, that's a good one.
Yeah, it just depends on theside of the bed that they're on.
Tonya (20:55):
Apparently.
Jerrod (20:56):
What can I reach?
Yeah.
Okay.
I I want to take us home,Tanya.
I want to hear final thoughts,but also what do you want
listeners to remember you by, orhow do you want to leave this?
Tonya (21:09):
Oh, it sounds like something that should be on my
tombstone.
How would you like to leavethis?
Well, so uh I think that I'veshared just sort of bits and
pieces about how my journey inacademia sort of came to be.
It was just a lot of it wasjust serendipitous, right?
Just sort of asking questionsand being in places.
But no matter what, I waswilling to try something and try
(21:33):
something new.
And so I I think what I wouldencourage all of your guests to
do is just be willing to trysomething new.
Be willing to be part of a teamthat's working to improve
patient safety.
Be willing to be flexible.
We all have to be flexible inwhat we're doing.
Nothing ever, ever goes toplan.
(21:54):
Be willing to look at asituation and ask, what can I do
to improve the process andremove barriers?
And be willing to embrace theride.
We're a unique and we're aspecial group of people, but
we're all here for one another.
And so I think everyone needsto find your tribe.
If you're an island like I wasin that first place where I
(22:16):
worked, reach out to me and I'llconnect you with other islands
so that you have a supportsystem.
I think that we are a mightygroup.
I think that we make a bigimpact.
And I'm just super proud to bea simulationist.
unknown (22:29):
Yeah.
Jerrod (22:30):
And with that, how can our listeners find you?
Tonya (22:33):
So you can find me at you can go to our website,
www.simplesimulation.com, andthat's simple without the e,
simulation.com, or you can reachme at the Johns Hopkins
University School of Nursing.
So either way, I'll respond.
Deb (22:48):
Thank you.
Thank you very much for beingon being a guest and just so
impressed by all of the thingsthat you've done.
It's very encouraging, andyou've certainly given a lot to
simulation.
Tonya (23:01):
Thank you.
It's been my pleasure.
Deb (23:03):
Thank you.
With that, happy simulating.
Disclaimer/ Beaker Healt (23:08):
Thanks to Beaker Health for sponsoring
this week's podcast.
Beaker Health, wheredissemination and measuring
impact comes easy.
We hope you enjoyed.
(23:29):
Visit us at www.innovativesimsolutions.com.
And be sure to hit that likeand subscribe button so you
never miss an episode.
Innovative Sim Solutions isyour one stop shop for your
simulation needs.
A turnkey solution.
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