When Dr. Hannah Lawn returned home after completing a fellowship at Center for Medical Simulation, colleagues asked a simple question: How did the experience change you?
“It’s changed my career,” she said. “I honestly feel like a different doctor since returning from my fellowship.”
What she expected was advanced training in simulation and education. What she discovered instead was something broader and more transformative: a new framework for leadership, communication, systems thinking, and organizational change.
Today, those lessons are shaping not only how she teaches, but how she practices medicine every day.
Beyond Simulation Training
Before attending the fellowship, Dr. Lawn assumed the experience would focus primarily on technical simulation skills — how to design scenarios, facilitate sessions, and conduct debriefings.
Those skills were certainly part of the training. But the more lasting impact came from learning how to lead change within complex healthcare systems.
“The biggest takeaway was the leadership skills and change management,” she explained. “How do you actually navigate organizations and implement meaningful improvement?”
That shift in perspective fundamentally changed her approach to education and clinical leadership. Rather than designing simulations around what seemed interesting or dramatic, she began asking a more important question: What does our team actually need right now?
Designing Education Around Real Clinical Needs
As part of her fellowship project, Dr. Lawn developed a deteriorating patient study day tailored specifically for the realities of rural healthcare.
In smaller hospitals, clinicians often face critically ill patients without the support structures available in larger urban centers. There may be limited staffing, fewer specialist resources, and no ICU team available to call for backup. High-acuity events happen infrequently — but when they do occur, teams must respond effectively and immediately. The study day focused on those realities.
Rather than centering only on advanced technical interventions, the program emphasized practical skills such as recognizing patient deterioration early, communicating effectively under pressure, and functioning cohesively as an interprofessional team.
After returning to New Zealand, she worked closely with nursing leadership and department heads to ensure the program aligned with organizational priorities. That collaborative approach became a turning point.
“Before CMS, I might have decided we were going to run a cardiac arrest simulation because it seemed important,” she said. “Now I start by asking what challenges the team is actually facing.”
The result was a program grounded not in assumptions, but in operational need.
Reframing Debriefing and Psychological Safety
Another major shift came in how she approached debriefing. Previously, moments of underperformance during simulation were often viewed through a procedural lens: why wasn’t the algorithm followed correctly? Why didn’t someone act sooner? The fellowship introduced a different approach — understanding the “frame” behind people’s decisions.
Instead of assuming error or lack of knowledge, she learned to explore the reasoning, pressures, and perspectives influencing behavior in the moment.
“My debriefing style has really changed to understand people’s ‘why,’” Dr. Lawn explained. “That’s allowed me to debrief in a much more meaningful way.” Equally important was the emphasis on psychological safety. Simulation can feel intimidating, especially for clinicians who fear being judged or embarrassed in front of colleagues. By intentionally preparing learners beforehand, clarifying expectations, and removing the idea of “trick” scenarios, she saw participation and confidence improve significantly.
“Learners left feeling empowered instead of scared,” she said. “They felt ready to deal with emergencies after coming to the course.” That cultural shift proved especially important in rural environments, where small teams rely heavily on trust, communication, and collaboration.
Expanding Simulation Across Rural New Zealand
The impact of the fellowship quickly extended beyond her own hospital.
After returning home, she was invited to co-facilitate simulation programs through the rural simulation network associated with University of Otago. She also expanded her work with University of Auckland, developing simulation experiences for rural medical students and interdisciplinary teams.
The fellowship credential itself opened doors — but more importantly, it provided a shared educational language and framework that allowed her to collaborate confidently with established simulation faculty across the country.
“There’s probably not a week that goes by that we’re not doing some sort of simulation,” she said.
Some sessions are highly structured. Others are small, pragmatic, ad hoc simulations conducted during quieter moments in the hospital day. But all are grounded in the same core philosophy: helping clinicians perform at the top of their scope so patients receive excellent care regardless of geography.
“It doesn’t matter if you’re a rural patient,” she said. “You still deserve the best care.”
Bringing Simulation Into the Field
One of the most ambitious projects Dr. Lawn led after the fellowship was a large-scale mass casualty simulation involving medical students, ambulance services, firefighters, and live actors.
The scenario centered on a vehicle rollover in a rural field environment, complete with real emergency equipment and live operational hazards.
Before the fellowship, organizing an exercise of that scale would have felt out of reach. But the structured planning principles, safety frameworks, and educational design strategies she learned gave her the confidence to execute it successfully. The experience became a defining moment for many participants.
“Students said it was one of the most memorable experiences of their training,” she recalled.
The simulation demonstrated how immersive, psychologically safe learning experiences can prepare clinicians not just technically, but emotionally and operationally for high-stakes events.
Building Sustainable Change
Perhaps the clearest measure of impact is that the work continues to grow. Her deteriorating patient study day has now been formally embedded into organizational practice, and she has been selected to present the project at an upcoming world rural health conference in Wellington.
The presentation will focus on integrating interprofessional simulation into rural clinical pathways — work that began as a fellowship project and evolved into a scalable educational initiative. For her, the broader mission remains clear.
“It’s all about empowering people to be the best they can be,” she said. “Simulation is a key tool for that.”
What began as a professional development opportunity ultimately became something larger: a catalyst for leadership, systems improvement, and better care delivery across rural healthcare settings.
