How I Went from Bedside RT to Clinical Simulation Educator

Julie Peretta
Julie Perretta demonstrates a clinical technique to a colleague at Johns Hopkins.

The introduction of sophisticated human patient simulators has made it possible for RT students and seasoned practitioners alike to practice new skills in a safe setting. Organizing these learning sessions requires a good knowledge of the subject matter at hand as well as the technical expertise to get the most out of the simulation equipment.

Respiratory therapists who have the right combination of skills are perfect for the job, and Julianne Perretta, MSEd, RRT-NPS, is living proof. In the following interview, she explains how she was introduced to the area and what her job as simulation educator at the Johns Hopkins Medicine Simulation Center in Baltimore, MD, entails.

When did you become an RT and what drew you to the profession?

I completed my BSRT in 2001 at Indiana University of Pennsylvania/West Penn Hospital. My grandfather had emphysema while I was in high school. He spent several months in a Vencor hospital in Phoenix, and I got to see how respiratory therapists interacted with him and participated in his post-ICU rehabilitation. That’s when I really fell in love with the profession.

Where did you work when you first started out in the field and what did you like about that job?

I started my career in respiratory care in the neonatal intensive care unit at the Johns Hopkins Hospital in Baltimore, MD. I loved the autonomy I had there, and what a critical role the therapists played on the interdisciplinary team.

When and where did you first encounter clinical simulation and what piqued your interest in the area?

My first time using simulation was as an RT educator. We were trying to design a more authentic and engaging way to complete our staff therapist annual reviews. We wanted to get beyond just “checking off” whether they could set up equipment. Instead, we wanted to replicate the critical thinking, patient assessment, and decision-making that’s so essential for advanced clinicians. Human simulators seemed to be the perfect way to do that.

How did you prepare to work in this role and how did you land the job as simulation educator at the Johns Hopkins Medicine Simulation Center?

Prior to taking a role as a simulation educator, I had worked in hospital education and departmental quality improvement. This, paired with my clinical experience, helped me understand the complex systems at play during patient critical events, and how to assess where simulation can be best used to improve patient safety. I also completed a master’s in education, with focuses in adult learning and educational technology.

What does the job entail and what do you most like about it?

My role allows me to bring simulation and educational expertise to subject matter experts who have clinical problems that simulation can help solve. I get to work with every unit in our hospital to develop simulation curricula best suited to their individual needs. I love being able to help clinicians investigate problems, come up with solutions, and be part of the “aha!” moment when participants are able to improve their understanding and performance.

How is your background in bedside RT helping you in the job?

There are few roles in health care that could have better prepared me with the technical and clinical expertise necessary to work with simulation technology. I am familiar with many of the clinical problems we’re simulating, but I’m also very comfortable with the mechanics of ventilators and user interfaces, which helps me work with our simulators. Pulmonary simulations are some of the most complex things we do, and my respiratory knowledge is invaluable to bridge the gap between real human physiology and manikin capabilities.

What advice do you have for other respiratory therapists who would like to play a larger role in clinical simulation in their facilities?

My advice is to start by volunteering, and ask lots of questions. Every critical care scenario we perform is more valuable by having a respiratory therapist participating, even if they’re not the primary learner. I am always looking for RTs to show their expertise and role in critical patient simulations. The best way to learn what is going on in your own institution is to show your interest. I am excited to bring new people on board if they’re eager and interested to learn more.