This Innovation Changes Everything


The HESS Project: Better Nursing Education Tools - affordable by anyone, accessible to everyone

"This project story is about transforming nursing education through interprofessional collaborative innovation to develop and use a complement of technology-based portable simulation devices collectively known as the Healthcare Education Simulation Station.

This collection of inexpensive, simulated point-of-care instruments controlled wirelessly by an instructor or simulation operator were developed and field tested by an interdisciplinary team to enhance learning experiences in several configurations, including those using standardized patients and those using static and low-, mid-, and high-fidelity manikins.

The core feature of this project story is the collaboration of students and faculty from two unrelated disciplines, nursing and engineering. The story includes a description of the development, field testing, and initial deployment of a simulated pulse oximeter, capnograph, automated sphygmomanometer, cardiac monitor, thermometer, and fetal monitor. Underpinning this project story is Rogers' Diffusion of Innovation theory and how the characteristics of the innovation, the personnel, and the environment worked together to enable this project and the innovation's subsequent diffusion into nursing education. The aspiration to improve learning experiences for students in multiple disciplines was paramount.

The desire to acquire high-quality, dynamic educational tools for nursing educators, coupled with an environment that encourages collaboration, led to an innovation that can transform nursing preparation and ultimately improve patient care, while minimizing cost."

- Abstract from:  Transforming nursing education through interprofessional collaborative innovation: A project story. Haverkamp et al. CIN: Computers, Informatics, Nursing: April 2020 - Volume 38 - Issue 4 - p 176-182

The Challenge:
Utilizing technology-enabled Active Learning and Simulation approaches in healthcare education are now well accepted ways to enhance learning. According to Working Nurse "advanced technology is improving the quality and safety of patient care by allowing nurses to practice their skills and use critical thinking in a realistic but calm, non-intimidating environment before facing real-life experiences as a professional nurse." From learning basic assessment skills to practicing for rare or high-risk situations, Active Learning and Simulation are rapidly improving healthcare education.

But the high costs associated with technology-enabled Active Learning and Simulation are often out of reach for many healthcare educators. Freestanding simulation centers total an estimated $200,000 to $1.6 million for start-up costs (Tuoriniemi & Schott-Baer, 2008) and according to a National Council of State Boards of Nursing report, annual fixed costs were estimated at $361,425. Additionally, operating the simulation technology often requires specialized knowledge and skills that many healthcare educators do not possess.

The Innovation:
However, an innovative idea proposed by experienced simulation professional Stephanie Justice, MSN, RN, CHSE while she was managing the Simulation Lab at The Otterbein University Department of Nursing offered a new approach to the challenge. What if basic medical devices measuring vital signs could be simulated and controlled by an instructor to reflect whatever vital signs were needed? She reasoned that such “fake devices” would be much less costly than high-fidelity manikins, plus they would be more flexible and therefore more accessible and useful to learners. By using low cost Android tablets and new Internet of Things (IoT) technology, the idea was prototyped and then developed into a set of healthcare education tools call the HESS – the Healthcare Education Simulation Station.

The Result:
The HESS is proving itself to be easy to use for virtually any healthcare educator regardless of whether they have specialized simulation knowledge or not. It has been adopted by numerous university programs – at both large and small schools – as well as by hospital groups for use by their clinical healthcare educators who provide ongoing education to nurses and physicians in practice.

The HESS contains everything needed to conduct affordable, portable, easy to use and effective Simulation and Active Learning based training anywhere by Healthcare Educators in any role. The HESS easily enables critical thinking Healthcare Education exercises involving Assessment, Cardiac, Respiratory, OB and many other issues - using a choice of standardized patients, manikins or skill/task trainers within in-person, in-situ, classroom-based, virtual or online environments. The HESS offers the potential to enable better healthcare education - and therefore better healthcare outcomes - through advanced technology-enabled Active Learning / Simulation healthcare education.

The HESS Team is proud that HESS Kits are currently utilized by Healthcare Educators in a wide variety of school and practice settings - each at a cost of just $1.61 per day.

HESS Project Key Contributors:


Dr. Stephanie Justice, DNP, RN, CHSE

Stephanie is a nursing professional with substantial expertise in simulation based education. Stephanie's understanding of the objectives and methods of simulation based education at their fundamental levels have enabled her to have the vision to introduce the innovative and disruptive concepts and ideas that have expanded into the HESS toolset that enables affordable and accessible simulation based education to be utilized by anyone. Stephanie is currently an Assistant Professor of Clinical Practice and Graduate Simulation Coordinator at The Ohio State University College of Nursing.



Dr. Christine Zamaripa, PhD, RN, C-EFM

Chris is a Nurse Educator with almost two decades of OB educational practice experience, both in academic and clinical settings. Her experiences in OB education were the driving force behind the addition of the powerful Electronic Fetal Monitor simulator to the HESS toolset, which she has integrated not only into simulation, but also into the classroom as a teaching-learning tool. Chris is currently an Assistant Professor at Capital University.



Karen S. Prenger, MS, RN, APRN-CNS, CV-BC, CPHQ, CCNS

Karen is a Clinical Nurse Specialist at the The Richard M Ross Heart Hospital in Columbus, Ohio with over three decades of Cardiac/Vascular practice experience. Karen's substantial professional knowledge supported the creation of the Pacemaker Adjustment Simulator within the HESS toolset. Karen and team utilize the Pacemaker Adjustment Simulator as a key instructional aide in their Temporary Pacemaker Management course.



Jeffrey Becker, MBA

An engineer with an MBA, Jeff has the ability to move data from sensors to the cloud and back. Cursed from an early age with the ability to understand math, science and technology, Jeff just wants to make cool things with technology that make the world a better place. Leading the development of the software, firmware and hardware to support the mission and objectives of HESS project is a perfect fit. Jeff is currently Chief Maker at edgeThingZ, LLC.



Erin Bender

Erin is the Executive Director of The Point at Otterbein University. Erin's guidance with regard to involving student talent in "experiential learning" opportunities greatly accelerated the technology development that has been crucial to the success of the HESS project. She also co-manages C.A.B.B. Farms, LLC, a 65-acre family farm in Lexington, Ohio, that specializes in natural grass-fed and finished Angus cattle and hay production.


The HESS Project Partners:


The Otterbein University Department of Nursing:

The Otterbein University Department of Nursing provided the HESS project with ideas, expertise and guidance within a strong, well respected Nursing Program. Virtually every HESS project initiative got it's first real trial with Otterbein Nursing Students within the Otterbein Department of Nursing facilities. The collaboration between the Otterbein University Department of Nursing and edgeThingZ remains fundamental to the success and acceptance of the HESS by Healthcare Educators globally. The results of this strong relationship are characterized within an academic paper about the HESS project collaboration: Transforming nursing education through interprofessional collaborative innovation: A project story. Haverkamp et al. CIN: Computers, Informatics, Nursing: April 2020 - Volume 38 - Issue 4 - p 176-182



The Point at Otterbein University:

This collaborative effort between Otterbein University and The City of Westerville was home to the edgeThingZ Product Realization Hub when The Point was founded and edgeThingZ participated as an inaugural tenant. It is also home to the Otterbein Department of Engineering - where students participate with businesses in "experiential learning" efforts designing, engineering and producing real world solutions. An example of the potential of this collaborative "experiential learning" approach is this VCC Case Study that features results achieved by Otterbein Engineering Students working together with edgeThingZ on aspects of the HESS.




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