Just four years ago, the idea of middle school students spending a week of their precious summer vacation attending "nursing camp" seemed pretty far-fetched to some.

Those skeptics have subsided.

Nursing camps have spread across Virginia, enrolling more than 400 children this year. And this summer, a new, more advanced breed of camp is being offered.

The veteran Inova Health System campers will try their hands next month at Level II, where they will further develop the skills they gleaned last year.

Instead of just practicing CPR, they'll earn certification. Instead of just visiting the labor and delivery rooms, they'll watch the examination of a high-risk pregnancy.

The national nursing shortage is serious business to health care officials, who project that the demand for nurses will climb 40 percent by 2020, while the supply of registered nurses is expected to grow 6 percent.

All the more reason for hospital officials to push hard to create interest in the field.

Inova helped pioneer nursing camps in Northern Virginia, and other hospitals have joined the effort, attempting to woo would-be nurses and others potentially interested in the health care field before they choose other careers.

This year, Virginia Hospital Center-Arlington began a nursing camp, and Loudoun Hospital Center and Potomac Hospital in Prince William County expanded their camps to include a second level with more advanced curriculum.

Warren Memorial Hospital in Front Royal is so excited about its program that it is considering offering a Level III next summer.

"It's building the future nursing base and the base of other areas in the hospital," said Barbara Brown, vice president of the Virginia Hospital and Healthcare Association, which in the past two years has provided $60,000 in grants to fund nursing camps across the state.

She said an expanded curriculum was the logical progression given the interest. Many of the camps have waiting lists. "At the end of the week, students wanted to come back," Brown said. "They'd say, 'We'll even do the same things.' Not only did they think it was fun, but they learned a lot."

This summer, Inova ran five Level I camps and one session for Level II campers, most of whom are high school underclassmen.

The 10 youths enrolled in Level II will find the programming expanded considerably from their experience last year. Students can shadow a nurse in their choice of specialty; be exposed to "disaster situation" nursing; and learn the role of a sexual assault nurse examiner, who will explain collection of emergency room evidence in homicide and rape cases.

Last year, campers went to George Mason University, where they learned to take vital signs and practiced wound care. This summer, they'll go back to the university to explore critical thinking techniques and diagnosis.

They'll also visit Northern Virginia Community College's medical and dental clinics and practice their new skills using the simulator, a male manikin that lets would-be nurses know whether they're providing the right -- or the wrong -- care.

"He can die," said Hillary Bedko, a camp director and Fairfax County teacher who has helped write the camp curriculum.

"But we can plug him back in," quipped Ashley El-Zein, a nursing research analyst for Inova and one of the camp's directors.

So what's the result of this close-up view of the health care profession?

"We've seen kids change their minds from 'I want to be a doctor' to 'Hey, nursing is pretty cool,' " Bedko said. "We've seen changes in their perceptions."

In a profession struggling for recruits, that is precisely the point.