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What happens when a movement-first profession steps into a simulation lab built for physiology and decision-making under pressure? We sit down with Denise Romano, an assistant professor leading physical therapy simulation at Binghamton University, to unpack how PT learners can safely practice high-stakes mobility long before they enter acute care. From AFib in the ICU to COPD patients whose vitals shift during transfers, Denise maps out realistic scenarios that force students to balance safety, lines and tubes, and evolving clinical data while communicating clearly as a team.

We walk through a full landscape of PT-focused simulations: early infection control adapted from nursing with Glow Germ, mobility checkoffs in hospital-like spaces, ventilator cases requiring careful progression, and standardized patient interviews for differential diagnosis. Denise explains why PT relies heavily on SPs for authentic movement, where mannequins still shine for physiologic fidelity, and how thoughtful debriefs convert messy moments into durable clinical judgment. Her use of entrustability scales tied to EPAs gives faculty a shared framework to chart each learner’s path from novice to entry-ready clinician, with formative feedback that guides safer practice.

The conversation also tackles the big barrier: unlike nursing, PT lacks the large-scale evidence to replace a portion of clinical hours with simulation. Denise makes a compelling case for a multi-site study to unlock that recognition, particularly as acute care placements tighten and risk tolerance narrows. She also shares a favorite classroom memory that turned a tangled SCD mistake into a lifelong safety cue, highlighting why simulated missteps are often the most memorable teachers. If you care about physical therapy education, clinical placements, competency assessment, or the future of healthcare simulation, you’ll leave with concrete ideas and renewed urgency to give PT a stronger seat at the table.

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