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June 18, 2025

LGBTQIA+ Pride in Practice: How VR Simulation Can Help Make Nursing Education Inclusive

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User IconChristine Heid headshot
Christine Heid
PhD, MSN/Ed, RN, CNE, CHSE
Nursing Simulation Specialist, UbiSim
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As Pride Month invites reflection, celebration, and continued advocacy, it’s also a powerful time to ask: How are we preparing future nurses to care for all patients with empathy, equity, and cultural humility?

We sat down with Dr. Christine Heid, a nursing simulation specialist and passionate educator at UbiSim, to explore how virtual simulation is uniquely positioned to foster inclusive practices in nursing education. 

What does Pride Month mean to you in the context of nursing education?

Pride Month means an opportunity to celebrate the progress and ongoing efforts of inclusiveness in nursing education and practice. Recognizing the unique needs of the individuals and communities we serve requires creating safe spaces for nurses and patients to be alongside one another in the pursuit of equitable and just healthcare for all. Pride Month gives us the opportunity to open the door to have these conversations and celebrate how far we have come while acknowledging how much work still needs to be done.

How do you define inclusion in nursing education, particularly when it comes to LGBTQIA+ patients?

To me, inclusion is about celebrating differences openly and honestly, making the needs of LGBTQIA+ patients part of the narrative in everyday conversations and simulations, and highlighting the unique needs of a patient within the context of health, recognizing that illness doesn’t define them but is something they are experiencing. We need to change the way we teach and talk about LGBTQIA+ patients and their needs to normalize gender identity and sexual orientation conversations in healthcare.

Why is it important for students to encounter diverse patient identities, including LGBTQIA+ patients, in simulation?

Diversity across healthcare encounters provides enhanced perspectives and visibility for communities we serve locally and globally. Simulation-based learning experiences offer greater access to this diversity and opportunities to enhance awareness among learners. Education should provide opportunities for students to encounter not just the communities they intend to serve, but create an awareness of those that are different from or similar to themselves. 

Simulation provides a safe space for this discovery and allows students to recognize their own biases and stereotypes that may influence the care they provide, allowing them to gain perspective, improve patient care experiences, and ultimately enhance health outcomes for all.

How can virtual simulation help create safe spaces for students to explore inclusive practices without fear of making mistakes?

Virtual reality offers a unique opportunity to place the learner in the room with the client, free of the stage many feel they are on in a traditional manikin or SP-based simulation setting. Inclusive practices are not limited to the communities we serve, but also the learners we are engaging in the simulation experience. Everyone wants to feel that they have a place in the healthcare ecosystem - from the hospital bed to the board room. When creating scenarios featuring patients that reflect identities that are similar to learners as well as the community, we take one more step toward acknowledging the gift of diversity and generate real inclusivity in education and healthcare, which can lead to greater access to care and improved outcomes. 

Have you seen virtual simulation help students build empathy or reduce bias when interacting with diverse patient profiles?

One of the greatest gifts as a simulationist is to witness the impact of the educational experience on learners. Building empathy takes time and creating a realistic simulation that offers a sense of presence, as immersive learning so often does, can support affective domain learning, where empathy resides. For example, in an end-of-life scenario, I have witnessed learners express concern for a patient’s well-being following the simulation during the debriefing session or in reflective journals as they shared the impact of learning the patient’s life story while providing basic care. Humanizing patients, rather than solely focusing on their illness, cultivates empathy and lessens prejudice by shifting the perception from a diagnosis on a chart to the individual receiving care. 

Can virtual scenarios be used to normalize gender-affirming care or culturally sensitive communication in a way traditional learning might miss?

Absolutely! Virtual scenarios offer the ability to incorporate gender-affirming care in any and all simulation scenarios. Normalizing LGBTQ+ families by threading scenarios throughout the curriculum, as opposed to the use of a single LGBTQ+ patient scenario, is one way to move the needle (Díaz, Everett-Thomas, and Foronda, 2022). Virtual scenarios are infinitely repeatable and may be duplicated and edited to offer multiple opportunities for learning in diverse settings and situations. This allows learners to practice refining their communication skills to pick up on microaggressions or phrases they may use that negatively impact the nurse-patient relationship, allowing them to learn more inclusive language and culturally sensitive dialogue.

How can educators use simulation not just to teach inclusion but also to model it in their classroom culture?

 Simulation holds the power to create an inclusive, immersive environment that enhances the learner’s sense of presence and perspective that can be shared in any classroom setting. By casting to a screen using the Metaquest feature, learner observers can view the virtual environment and suggest actions to take in the moment. Prebriefing the experience can target inclusive techniques and debriefing may highlight opportunities to improve performance for better cultural humility (Foronda, McDermott, & Crenshaw, 2022).

What are some ways you’ve used (or would like to use) UbiSim to introduce LGBTQIA+-inclusive scenarios or communication training? What are some ways you’re proud of UbiSim’s integration of diversity?

UbiSim provides standardized, peer-reviewed LGBTQIA+-inclusive scenarios incorporating communication skills, gender-affirming care, and cultural humility exercises throughout the catalog and is infinitely editable using UbiSim’s Intuitive Editor. For example, the catalog includes a host of patient avatars, including transgender, female and male gender identities as well as infants, children, and adults across the lifespan in both rural and urban hospital and outpatient settings. Scenarios are thoughtfully designed to incorporate a host of demographic details and Social Determinants of Health to normalize the consideration of these influential factors in every patient care encounter. 

Final Thoughts

Inclusion in nursing education isn’t a checkbox—it’s a commitment. Through virtual simulation, educators can go beyond representation to create truly immersive, repeatable, and reflective learning experiences. As Dr. Heid reminds us, these tools offer students a safe space to grow, reflect, and ultimately become more compassionate, culturally competent healthcare providers—making Pride not just a celebration, but a call to action for year-round progress.

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UbiSim is used by all 1100 undergraduate nursing students and now accounts for 33% of simulation time in the BSN program

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Interested in trying UbiSim in your healthcare institution?
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User IconChristine Heid headshot
Christine Heid
PhD, MSN/Ed, RN, CNE, CHSE
Nursing Simulation Specialist, UbiSim

Dr. Christine "Christy" Heid is a seasoned nursing educator, simulationist, and healthcare advocate with over 20 years of experience. Currently pursuing a post-master's Nurse Practitioner certificate in Psychiatric-Mental Health Nursing at Maryville University, she is also committed to raising awareness and research funding for Ovarian Cancer. Holding a PhD in Nursing and an MSN focused on Healthcare Education from the University of Phoenix, along with a BSN from Mount Carmel College of Nursing, Christy blends academic rigor with clinical expertise. Her professional journey includes roles as a Nursing Education Consultant, Principal Investigator on a multi-site research project, and various faculty positions at Ashland University and Marion Technical College. Her clinical practice has taken her from large hospital systems and community care centers as a specialist in medical-surgical, oncology, palliative care, and vascular nursing. An advocate for innovative teaching, Dr. Heid has contributed to curriculum development and active learning strategies in nursing education. She serves as the chair of the International Nursing Association for Clinical Simulation Learning Education Committee and is involved with the Organization for Associate Degree Nursing Simulation Committee.

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