Medical Assisting Students Deserve Simulation-Based Learning Too !

Chattahoochee Valley Community College is a small institution, part of a system of 24 colleges across the state of Alabama. Known as something of a jewel in the local community, the college is nestled in the woods in Phenix City, just across the Chattahoochee River from Columbus, Georgia.

The college services a large area which includes a lot of rural communities, and students from Georgia enroll too. The demographic mix includes a lot of first-generation college students, mainly traditional students recently graduated from high school, but also non-traditional, with people wanting a career change after severance. The college also welcomes military service personnel and spouses from Fort Benning.

Shelly Holt is the Medical Assisting Program Director and also teaches the CNA program. She first came across SIMTICS Medical Assisting skill simulations at an ABHES conference in early 2016 and was excited to see a resource like this that is designed specifically for MA students, when many other products are targeted at nursing students.

Shelly explains that the challenge for MA students is that they don’t have a clinical preceptor with them, unlike student nurses. They are typically put straight in to a doctor’s office and expected to do whatever is asked of them.

“We have this mindset that nursing students have to be uber-super-prepared, but other types of students, like those studying Medical Assisting, need the ability to build that level of confidence too.”

From what she saw at the ABHES conference, Shelly knew that SIMTICS would be a valuable education resource for her students. “We were already doing a good job in our program, but I was convinced this would make it even better.”

When she presented it to her administration, her request was turned down, because of budget limitations. However, she was undeterred. As an interim step, she purchased a subscription and displayed SIMTICS modules on a big screen in her classroom so her students could see the videos, anatomy and simulations to support their learning.

“They really enjoyed it. They’d watch me controlling the mouse and come up to me, saying, ‘please let me do it’.”

When COVID came in the Spring of 2020, the faculty and students had to shift to a distance learning format with almost no notice – it was announced on a Thursday that the campus would be closed on Monday. It was a shock because the college was residential, campus-based, and did most of its instruction traditionally. Compounding the challenge further was that Shelly’s students were about to start the lab portion of their phlebotomy course.

The question was: how would the students graduate if they could not have the usual lab time?

Shelly knew the solution and seized the opportunity to propose SIMTICS to the college administration again. This time they were eager to do whatever they could to help the affected students get through the challenges posed by the pandemic, and federal funding became available.

“Adopting SIMTICS was crucial for those students,” she says. From her spring cohort of six students, four of them were immediately hired, despite the COVID situation.

And for the certification exam, she’s proud that 10 of 11 passed on their first attempt. “Many of the students specifically commented that SIMTICS helped them to achieve that result. I wasn’t expecting to hear that.”

In summer, the college approved on-campus labs with appropriate social distancing and other infection control measures in place. Despite the return to in-person labs, Shelly finds that SIMTICS is still very instrumental in her students’ success.

Where it had originally been adopted as a “replacement” when labs were not available, SIMTICS then became “preparation” for labs. Shelly says this is providing an unexpected benefit: “Rather than dreaming up scenarios in their heads and creating anxiety, the students can see in SIMTICS exactly what they’ll be doing when they get to the lab.”

Shelly has also noticed that her students are significantly more confident now that they have access to SIMTICS.

“In lab, some are quite nervous and unsure of themselves but they may not voice those feelings. Now they can go back to SIMTICS as many times as they want, which builds their confidence. And even after the lab is over, they still have access. My students absolutely love it. And although we have a calendar and a set syllabus, a lot of them learn ahead, because they want to.”

Another benefit Shelly has experienced is that SIMTICS has helped to cut down some of the teaching time.

“Our phlebotomy course is growing, and when you have 12 or 13 students with only one instructor, if they can’t practice first, it takes a lot more one-on-one time with the instructor. Often I had to stay back in lab longer or open the lab up again. SIMTICS has cut down on that. Students arrive with knowledge, because the simulations and other materials prepare them for what they’re going to be doing.”

Shelly can easily see that her students love SIMTICS, since it is evident in how they use the resource. “They don’t just do their study early, they really enjoy having something they can return to later. Especially when it’s time to go to preceptorship, they can go back to SIMTICS and refresh their skills.”

As a nurse by training, Shelly also appreciates that SIMTICS modules include the relevant anatomy and physiology as part of the whole experience of learning medical procedures. “It’s important that the students not only know how to do something, but the rationale behind it; what’s going on here. It helps them to connect the dots.”

We ended the interview by asking Shelly our normal closing question: What would you say to someone who is considering whether to adopt SIMTICS for their program?

Shelly laughed. “That’s easy! I’d say, ‘pull over a chair and I’ll show you how this can assist your students and enhance your life as an instructor.”

The SimTutor team would like to thank Shelly Holt for her time and assistance to tell her story here.

Check out Chattahoochee Valley Community College

Find out more about SIMTICS Medical Assisting

Read about the benefits of SIMTICS for educators and institutions

What is integrated cognitive simulation? How is it changing the face of teaching and learning in the healthcare sector?

For many of us, the best way to learn is to have a go: to take as many turns as we need to get it right. Practice makes perfect. But what if having a go has consequences? What if getting it wrong has higher stakes that can’t be resolved by simply pressing the restart button?

Continue reading “What is integrated cognitive simulation? How is it changing the face of teaching and learning in the healthcare sector?”

Making a Transition to Online/Hybrid Learning for Your Allied Health or Medical Program?

We can help

We know that the coronavirus has created unprecedented challenges and questions for everyone since early 2020. In the education sector, courses have been moved online, sometimes within days when campuses had to be suddenly closed. Many schools that did this, realized the benefits of a hybrid or completely online model, such as flexibility, positive feedback from students, and the knowledge they could cope much better with disruptions in the future.

Even now things are still different from life pre-COVID. Students may have more limited access to labs or sim centers – the infection control measures and social distancing requirements often reduce the number of people who can access them simultaneously or the time they have available onsite. We regularly hear that clinical externships are still being limited, postponed or even cancelled.

It can also be a struggle to adapt to the new format of teaching and learning.  How do you support students’ learning when you don’t see them in person every day? How do you help them to learn effectively when they may be under more stress than past student cohorts? How can you track what they are learning when they’re remote – and how much they are retaining?

We don’t have all the answers here, but we can help you work out whether simulation-based modules might help your students to learn, practice and test their competence in performing healthcare procedures and skills. SIMTICS is all online, no equipment needed, so it’s a great way to supplement your students’ lab and clinical time, giving them a stress-free way to learn and practice anytime, anywhere – while still enabling you to track their progress.

We’ve provided a few article links below that might be useful, and there are more on this blog site so please browse. And feel free to contact us to discuss your challenges and needs. Email us or use the webchat facility on our website. We look forward to hearing from you!

11 tips for using online simulations in your Allied Health program

Moving an MA program online – and expanding into two more states

Learning sonography by e-simulation – from skeptic to believer

How e-simulations support distance learning for sonography

What is integrated cognitive simulation?

P.S. Got questions about working remotely? We’ve done it for years – ask us any question

ICPR Junior College and SIMTICS: Improving students’ clinical skills through web-based simulations

By Dr. Mónica Cerejido Ruiz and Prof. Noris Colón Pagán

[This article is translated from the original Spanish]

ICPR Junior College is an educational institution on the Caribbean island of Puerto Rico with over 70 years’ history of preparing future professionals for the workforce. The institution has five (5) locations around the island with a range of academic offerings that include associate degrees, certificates and continued education in the fields of healthcare, business administration, gastronomy, education, information systems and criminal investigation among others. The healthcare department offers programs in nursing, clinical ultrasound, radiologic technology, and therapeutic massage.

The students of ICPR Junior College come from a wide variety of backgrounds. Youths and adults come from rural as well as urban areas looking for a short career program with good employment possibilities. Many of them are non-traditional students; they work while they study and often have families to look after.  They come from different social classes and many of them are first generation students with great aspirations for personal improvement despite social and economic difficulties.

Facing challenges in health care education

ICPR Junior College has encountered the typical challenges that most educational institutions that offer health courses are dealing with. Among these challenges is the emphasis that has emerged on the prevention of medical errors and the approach to patient safety, as well as other changes in the provision of health services. As a result, health centers, hospitals, clinics and medical offices have limited the opportunities for students to obtain an externship placement to practice the clinical skills that are necessary before they encounter real-life scenarios. For the college, this created the need to research and implement alternative strategies of learning, practice, and evaluation.

The other challenge that the college faced was the limited practice time available in our laboratories because of the number of students and the limited equipment available. This was a particularly acute problem in medical sonography where key objectives can only be met with repeated practice.  With the difficulty for students to practice with real patients, we determined that the required skills could potentially be obtained by simulation.

We therefore recognized that we needed changes in the traditional instructional methods that we were using in the medical area. The importance of competencies in clinical abilities has been emphasized which is considered part of an essential apprenticeship for students. New pedagogic support in health sciences is needed: before, teaching was centered on acquiring a wide volume of knowledge and now it’s centered on achieving the integration of clinical scenarios where learned skills can be put into practice and applied to different situations.

With our CIO advising us on advances in technology, we began looking for an affordable simulation-based education resource to enhance our allied health curriculum.

We knew, by experience and from the literature, that student satisfaction has a positive impact in their motivation and retention, giving positive attitudinal and cognitive results. Therefore we wanted to choose a clinical simulation product that would be both attractive and effective for the student.

We also knew that the ability to transfer knowledge or performance acquired with simulations into real scenarios, continues to be one of the biggest and most important challenges in education.

ICPR students working through a sonography simulation

Web simulations provide the solution

When we discovered SIMTICS we saw that the simulations would give us the capability to reproduce clinical scenarios, the opportunity of finding and responding to abnormal or critical findings in a standardized and secure environment, and the possibility of using individual performance metrics to track student progress and mentor them to success.

ICPR students in the computer lab

In ICPR Junior College the students take classes both on-site and in a blended format. We have successfully incorporated the use of SIMTICS simulations in our allied health courses in both formats. We have used SIMTICS as learning support in anatomy, protocols, processes and patient management, among others. For assessment, we have used it to measure performance and knowledge of important clinical skills through the simulations and quizzes incorporated in the modules, assignments, and investigation projects, individually and in group forms. These simulations have proven to be both attractive and effective for our students.

We have found that SIMTICS is a great tool. It was a wise decision for us to present it to the administrators of the institution not only as a solution to the challenges we were experiencing, but also to continue offering the highest quality in education.

Student views

In an action research study carried out in 2019, with 53 clinical sonography students of ICPR Junior College where simulations were used, including SIMTICS, some of the results obtained were:

  • 96% of students considered they achieved the course objectives;
  • 94% of students felt confident to apply their knowledge in other courses, in a job or in their everyday lives;
  • 83% perceived simulation as a useful method for learning;
  • 82% learned and improved scanning skills, machine operation and patient handling;

In addition, 86% of students agreed that the simulation scenarios presented were quite realistic and the same percentage also expressed that it was useful to observe errors, review them and fix them.

Also, the majority said they gained knowledge that went beyond the original objectives outlined in the course and they felt they improved their technical skills. In general, the students were really satisfied with the experience of the simulation.

We have been using SIMTICS in our medical imaging programs for about five years now. For us, as ultrasound professors, the structure of the SIMTICS modules with updated protocols and user-friendly interface have been of great value for both the professor and the student. Also, the opportunity that SIMTICS provides for students to use trial and error, and to repeat over and over until acquiring the required skill, are critical for successful learning. The new tests with selectable time limits make interesting challenges for the students and are closer to the license exam experience.  

We see in SIMTICS a valuable tool to reinforce clinical skills so the student can practice according to their own learning needs, at any time and any place. We are very satisfied and know that with the SIMTICS tools available to our students, ICPR Junior College finds itself to be a vanguard in health courses in Puerto Rico, which gives us a significant competitive advantage over other institutions. We recommend SIMTICS to other health and science education colleagues to improve professor performance and student learning.

The SimTutor team would like to thank Dr. Ruiz and Prof. Pagán at ICPR Junior College for contributing this article, and Nelson Mejias, the CIO, for facilitating it.

Right Now Nursing extends the reach and effectiveness of Limited Obstetric Nursing education with SIMTICS web-based simulations

Cindy Parke, owner of PEC

Cindy Parke, RNC, CNM, MSN leads a busy life. Certified nurse-midwife, educator and clinician, she took over management of Professional Education Center with her husband in 2010. Now called Right Now Nursing (RNNCEs), the company is devoted to continuing nursing and midwifery education specific to the field of Obstetrics, and since its inception has provided this type of education to over 1 million nurses.

Through RNNCEs, Cindy brings her years of clinical and lecturing experience in women’s health, pregnancy, fetal monitoring, and childbirth topics to nurses and other health professionals nationwide. An active member of the American College of Nurse-Midwives, Ohio Association of Advanced Practice Nurses, Sigma Theta Tau and the International Cesarean Awareness Network, her focus is on comprehensive maternal/fetal care throughout the labor and delivery process.

Cindy has a clear vision for her education business: the ultimate goal is to reduce maternal and infant mortality and morbidity.  She firmly believes that much rests on the skills of the nurse. 

RNNCE’s continuing education provides valuable knowledge that can be used daily in an OB practice. Their seminars have always been designed to be clinically focused, patient-centered, and result-oriented; from recognizing normal labor, ongoing assessment for risks, choosing appropriate interventions, and responding to both the normal and the critical clinical challenges.  And as you might expect, Continuing Education (CE) credits are available on completion of all their seminars and on-line educational products.

But, since they are working in a competitive market, Cindy wanted to offer more to meet the needs of their students.  In her team’s search to achieve that, early in 2014 one of Cindy’s OB ultrasound educators came across SIMTICS, an innovative education product that was just entering the US market at that time. Offering interactive web-based simulations for learning and practicing ultrasound scanning, including OB, SIMTICS seemed like it could be a perfect addition to their own seminar-based nurse education offerings.

After a thorough evaluation, Cindy decided to adopt the product into her programs and today SIMTICS is what she calls “an essential component” of their Limited Women’s and OB Ultrasound education. Now the company offers a variety of educational resources including Home Study Units, Webinars, Live Seminars, and on-line study utilizing SIMTICS web-based simulations, as part of RNNCEs “Ultimate Ultrasound Training Menu”.

Today SIMTICS is what Cindy calls “an essential component” of her Limited Women’s and OB Ultrasound education.

“From the beginning we used the SIMTICS modules as an adjunct for self-study. But then with assistance and permission, we began utilizing the graphics and ultrasound pictures within our lecture slides to further explain concepts. That has been very successful.”  Cindy and her instructors also utilize videos from the modules as a summary of sections of their lectures, and have added components of the modules, with acknowledgement, within their InPatient OB Review, Maternal Newborn Review, and EFM Review seminars as well.

“Finding excellent graphics for this type of education is difficult,” she explains.  “I go to SIMTICS first when looking for something to illustrate or explain a concept, and I’m amazed at the updates and additional details that I can utilize.”

RNNCE’s student audience for limited ultrasound is national and diverse, composed of nurses, midwives, and physicians.  Students typically attend live seminars, where they may have utilized a SIMTICS module as prep for the on-site seminar. During the seminar, an instructor utilizes relevant SIMTICS modules to demonstrate key concepts. RNNCE’s educators have also blended the use of SIMTICS modules with a webinar education series. This has been utilized without follow up, and also prior to check-offs of skills done by an instructor on site. 

“SIMTICS is modular which provides a great deal of flexibility and affordability,” says Cindy. “This is most important to the small hospital or midwifery group. They cannot manage for their staff to take time away for a conference, but they still need to refine the skills of limited OB ultrasound into practice.”

Trainees can study within their own time constraints, using relevant SIMTICS modules.  Ideally, then there is follow up by an educator including an onsite observation of a full exam to reinforce concepts. Cindy explains that this hybrid approach is very cost-effective for her customers, since a lot of pre-learning can be done by the students before any face-to-face instructional time.

Screenshot from SIMTICS showing scan of second trimester
Screenshot of a SIMTICS obstetric ultrasound simulation

Since adopting SIMTICS, Cindy has noticed significant positive change for her students, including the ability for them to demonstrate a level of competency through showing proficiency in the web-based simulations. “We had the request for hands on learning with our seminars for years, and SIMTICS provided the first opportunity to do this!”

We asked Cindy what made her feel comfortable to put such a reliance on SIMTICS in her business. “Obvious quality and the pricing were the first draw. Then the special attention in set-up that I received from the company was the crown on our initial decision to move to utilizing SIMTICS. That sense of personal attention has never changed as a customer, whoever at SimTutor is interacting with myself or my staff.  In addition, the continued quality improvements always make me proud to offer the product to my learners.”

Cindy was open about the initial learning curve required for some of her students utilizing this type of education technology. “Honestly, sometimes they are not patient with their computer and mouse, and have not read the instructions we provide! However, once they get that together, they just fly though the concepts.”

She points out that utilizing ultrasound in practice is a new skill and language for many of her students.  “SIMTICS, with the self-learning and anytime access, combined with the ease of repetition, is so very helpful to learners. They can take the time they need to become familiar with these new skills and terminology. I am confident to offer the use of SIMTICS to students for self-study, prior to my going to a clinical site to provide education.” 

“Do not hesitate! I consider my decision to utilize SIMTICS one of the best I have made as Director of RNNCEs!!” — Cindy Parke

We asked Cindy what advice she would give to anyone who is considering whether to adopt SIMTICS for their programs. Cindy was clear on the benefits. “For me, as an educator, SIMTICS makes my life so much easier and my teaching more effective. When students have used the SIMTICS simulations first, we move through concepts and the hand skills in the face-to-face sessions with much greater speed. This reduces the cost to the institution. And as a business owner, the quality of SIMTICS is a smart reflection on my company that we are able to offer this high quality learning resource.”

SimTutor would like to thank Cindy for her time in this interview, and most of all for being one of our long-term customers since 2014!

If you are interested in earning continuing education credits, up to 44 Board of Registered Nursing (BRN) Credits are available for SIMTICS obstetric & female ultrasound modules through RNNCEs. For further information, please visit the ultrasound training page on RNNCE’s website.  

How this Medical Assisting program expanded into two more states (with help from SIMTICS)

By Terri-Beth Williams

As Director* of the Clinical Medical Assistant (CMA) program at West Virginia Junior College (WVJC), Rayan Matthews is responsible for over 180 on-ground and online students across West Virginia, Ohio, and Pennsylvania. About two-thirds of the students are in the online program, which is growing rapidly, while the numbers in the residential program are dwindling. In late 2018 Rayan adopted the SIMTICS simulation-based product for her online CMA program, and she recently spoke with us about why she chose SIMTICS, her experience so far, and reactions from her students.

Why was there a need for online simulations?

In 2011, the College developed an online education delivery platform to support students who need to balance school with work and family. WVJC Online strives to maintain the same level of service that students experience at the residential campus.

Rayan Matthews joined WVJC five years ago, after working in multiple roles in the medical assisting field since 2004. This was to be her first teaching role.

“I originally applied for a position as a weekend instructor, teaching students on campus, but I was asked to consider the director position which was responsible for the online program. So not only was I new to teaching, but I was also wondering how on earth it was possible to teach medical assisting online!”

Rayan took responsibility for the Online CMA program, which at the time was operating in the state of West Virginia. For the online students, the approach involves assigning them to a campus for a regular clinical session. Staff members, who work as medical assistants during the week, go in to each campus to check off the students’ competencies.

Rayan was then asked to expand the program into two neighboring states. “Due to state guidelines we had to change the ratio of clinical component hours, so I started looking for simulations to enable us to achieve that without affecting the students’ learning opportunities. SIMTICS was one of the options we considered and it is the one we selected. Before SIMTICS I only ran the Online CMA program in the state of West Virginia – now I’m running the program in three states, including Ohio and Pennsylvania. We could not have achieved this without SIMTICS.”

Why choose SIMTICS?

When we asked Rayan what prompted her to choose SIMTICS over other medical training resources on the market today, her main criterion was clear: she wanted a product that would accurately represent the real-life situations students would face when working with patients in a clinic. She had seen other products which use animated characters in their simulations, but that wasn’t right for her program.

“None of the other products were as realistic. With SIMTICS it’s like you’re right there, doing the procedure on a patient, which is just what I wanted for my students.”

When it came to choosing the right educational resource for her program, Ms. Matthews wasn’t only looking for realism. She needed a technology platform that would work well for the many students who are located in remote areas with limited and unreliable internet access.

“I had to work closely with our IT Director to check out each product. It was important to know whether the students would be capable of running the product at home, particularly in the southern part of our state (West Virginia). When I was looking at other products the lag time was terrible for some internet providers. But when I found SIMTICS, I actually ran and got our IT Director since it not only looked so realistic but it worked so much better than other products I’d been evaluating.”

Stellar customer support is critical

There was one final factor in Ms. Matthews’ choice of product. Setting up and managing an online learning solution is not always easy, and when you’re putting education tools to work at a distance, you need responsive customer support to be there when you need them and to walk you through the questions and challenges that will inevitably arise.

For Ms. Matthews, the high level of customer care has been one of the most distinctive and valuable features of SIMTICS as a company: “With some other companies, you might have to wait for days for somebody to respond, but with SIMTICS, if I have a question, they answer me right back. It really makes a difference when you’ve got a student on the other line and you need an answer as soon as possible.”

Accelerating teaching and learning

When we asked Rayan how SIMTICS is integrated into her program curriculum and what effect that has had on teachers and students, she explained that the really important part for her students is the simulations. She requires them to go through the practice and test simulations, and they submit proof of their test simulation score which she uses to grade them. Rayan has also found that the ability for students to repeat each activity over and over is a big advantage, helping them to “lock in” all the steps for each procedure, right from gaining consent, to performing the procedure, including the post-procedure considerations.

Another significant benefit has been the effect on teaching. “Since we’ve been using SIMTICS, by the time the students come in to do the hands-on part on campus, my instructors can honestly move at a faster pace with them, rather than having to start at point A. The students have already done all the academic bookwork and completed all the simulations, so they have the knowledge they need to recognize the medical terminology, and the instruments and equipment they need for each procedure. Now, when the instructor gets to them, they are prepared and ready to jump right in.” Rayan says this gives her instructors extra time to help each student truly master the skills, which is better for the students and more rewarding for the faculty.

Rayan also notes that the interactive nature of the SIMTICS product appeals to the learning preferences of her allied health students, promoting interest, mastery, and memorization. “Interacting, doing; this is how my students learn best. SIMTICS is amazingly wonderful for this, it helps to lock in their knowledge. Anybody can look at a book, but when they actually do it in a simulation, they remember it… After studying with SIMTICS, it’s like the whole procedure is automatically embedded in their brains.”

Students “love it”!

Rayan laughed when we asked what kind of feedback she’d had from her students since integrating SIMTICS into the curriculum. “Oh my gosh, they love it.” She went on to explain that since using SIMTICS modules, she’s been able to significantly expand the number of student assignments each week and noted, “There has not been one complaint, because it’s fun and it’s interactive. They’re not just reading. It’s like real life for them. They love it and they don’t complain about the workload.”

And it’s not just the students’ interest that’s piqued by SIMTICS—so is their sense of pride and accomplishment in their learning. Rayan says: “One student told me, ‘I made my mom watch me do a procedure in SIMTICS because she couldn’t believe I could ever do something like that. She thought it was really cool to see exactly what I will do in real life.’ I was so pleased to hear that. For me, it’s all about the students, seeing them succeed.”

Advice for other instructors?

Rayan recalled her initial reluctance to use a web-based product. “I was very old school, so I was thinking, how can you teach medical assisting online? Will online simulations work? Of course, doing it on a computer is different than, say, performing a blood draw on an actual patient … But we have to face that times have changed. The generation of students we’re working with now are computer gurus compared to some of us. They like using computers and they expect technology to be part of their learning.”

We asked Rayan if she had any advice for those who are looking for web-based simulations or considering integrating SIMTICS into their program curriculum. “SIMTICS has changed my program for the better. As a long-time MA professional, I never believed that a simulation could be so realistic. So I would say, give SIMTICS a chance. You’d be surprised at how effective it is.”

*Rayan was program director at WVJC from 2014 to 2019, so has left the school since contributing to this article, but she remains a huge fan of SIMTICS. The SimTutor team would like to express their sincere thanks for her time and insights that inspired this article.

John Windsor: On a mission to democratize medical education.

Picture of

Imagine having a missionary as your father. Or moving to a foreign country as a small child and going to school in a remote rural area. Or learning about medicine from the age of 9, standing on a box by your father’s operating table. Any one of those life experiences would probably give you a very different perspective on the world, but for Professor John Windsor, one of the brains behind the SIMTICS product, they were all fundamental parts of his life until he was fifteen years old!

“I grew up in northern India and did all of my primary and secondary schooling there,“ says Professor Windsor. “My father went out in 1963 to set up a heart unit in a post-graduate institute, and thus helped establish that specialty in India.  He went on to work as a general surgeon in mission hospitals for twenty years.”

It’s no wonder John has such an interesting worldview, and such a passion for making education accessible and available to all, regardless of geographic location or economic circumstances.

As well as the wonderful climate and the spectacular Himalayas, he also remembers the principles he learned. “Under my dad’s influence I grew up understanding the importance of healthcare and community development, and that educational opportunities were precious. It was a wonderful upbringing, to be honest.”

When he finished secondary school John returned to New Zealand, completed a double major in physiology and biochemistry and then enrolled in preclinical medical school at the University of Otago. He later transferred to the University of Auckland and qualified as a medical doctor before training as a general surgeon. He then completed a two-year fellowship in hepato-biliary and pancreatic surgery in Edinburgh, working under Sir David Carter.

Back in New Zealand, he was encouraged to pursue an academic career. In 1992 he founded the Pancreas Research Group, which has been at the centre of his research endeavor, and in 1994 he was appointed as Senior Lecturer of Surgery at the University of Auckland and as a Consultant Surgeon at the Auckland Hospital.

Around this time, the advent of the laparoscopic revolution was putting significant pressure on traditional approaches to surgical training.  John set up the first Surgical Skills Centre in New Zealand to address this need.  Later, in 2007, he raised $2 million and, in partnership with Mercy Ascot Integrated Hospitals Ltd, he designed a purpose-built facility: the Advanced Clinical Skills Centre. This has become a world-class environment for skills research and training.

Windsor seems tireless; on top of all his surgical, academic and research work, over the last 5 years he has published 112 of 235 manuscripts, raised $6m in grants and given over 100 invited talks, including Visiting Professorships to Harvard, Oxford, Karolinska, Singapore, Capetown, Johannesburg and Delhi.

How did a surgeon come to develop an online simulation technology like SIMTICS?

The lessons learnt during his early life in rural India, the years of providing and managing skills training, and experience with using physical simulators and training centers have all played a significant role in John’s thinking. From this the approach to ‘integrated cognitive simulation’ – to be accessible anywhere – was developed, in partnership with two other doctors.

John’s interest in virtual learning began back in the early 2000’s when he met George Oosthuizen, a surgeon who had recently moved from South Africa to New Zealand. Before he could practice in his newly adopted country, Oosthuizen had to become a student again and retake his fellowship exam.

“George found studying inefficient and exasperating. Even as an experienced physician he had to find books and journals from libraries, videos on the internet, advice from colleagues, diagrams from elsewhere… He shared his frustrations and this led us to ask: could we use technology to bring together all of the necessary materials in one place to promote more efficient learning and knowledge retention?” John explains. “As we explored this idea further, we realized that there was an opportunity to incorporate modern educational theory and practice with appealing media like computer graphics and video to make the learning experience more interactive, effective, and enjoyable.

With the help of some programmers, they mocked up a basic product framework, then got to work on their first procedure prototype: a laparoscopic appendectomy. As the lead subject expert, John had a starring role, performing and narrating the steps for the video portion.

Laparoscopic appendectomy simulation
The first version of the SIMTICS simulator – to learn laparoscopic appendectomy

The company gained support from an Auckland based business incubator and gradually attracted investors. To ensure commercial viability, the growing team branched out from surgical procedures into the wider healthcare market with a range of medical procedure simulations. Later they developed three suites of simulations for ultrasonography and radiography, and eventually more clinical procedures for medical assistants and entry-level nursing students. Dental Assisting and updated Basic Life Support modules are the latest addition to the catalog.

Cognitive learning is valuable and needs greater emphasis.

In developing the content, the team focused on the cognitive learning required for procedures, since this is a layer of knowledge that can be easily addressed by technology, outside of the clinical setting. It is also thought that cognitive knowledge represents up to 75% of the skills required for the safe performance of procedures. Cognitive knowledge doesn’t replace hands-on, psychomotor skills learning, but it is a critical part of the required learning that can be addressed separately, even while the learner is working alone, and without equipment.

The idea that cognitive learning is highly valuable and needs to be given greater emphasis originally came from the world of sport. Not only do high-performing athletes practice to achieve excellent physical performance, they also mentally rehearse their event or activity, running every single aspect through their minds beforehand. The movie, Rush, about Formula One drivers, brings this to life with a scene where driver James Hunt lies down and ‘mentally’ drives his car around the course, steering and pressing pedals in his mind, before his next race.

The SIMTICS product also achieves Oosthuizen’s dream of having everything in one place for learning a medical procedure. It allows learners to read, watch, explore in 3D, practice, and test their skills, all from the same interface.

At the heart of SIMTICS is a web-based simulator. This is what allows the learner to do their mental rehearsal of each new skill or procedure. Each module covers one type of healthcare procedure, from lumbar puncture or administering an intradermal injection, to ultrasound assessment of the aorta or performing radiography of the chest. The simulations require the learner to cognitively learn and understand the steps of that procedure, then perform it online just as if they were doing it in real-life. For instance, in a SIMTICS simulation, the learner has to prepare, position the patient, select and move instruments and consumables, place them correctly, and in some cases operate virtual equipment. For people studying sonography or radiography, SIMTICS is a bit like having a real imaging machine at home or in the classroom – at a tiny fraction of the cost. No consumables are needed, either.

As well as interactive simulations, each SIMTICS module contains a step-by-step video demonstration, a text description of the procedure, explorable 3D anatomy, and a quiz to test theoretical knowledge. The product does not dictate a pre-set ‘one-size-fits-all’ sequence of learning, so these components can be accessed in any order. “We home-schooled our five children,” says Professor Windsor, “and through that I came to appreciate the value of individualized learning, and providing choices in order to match learning opportunities with learning styles. And regardless of that, everyone gains by being able to experience and absorb the same information in different formats.”

The built-in SIMTICS logbook continually tracks study hours, quiz and simulation completion times, and scores. It even records the errors made in the simulations, so students know what to work on in order to improve their score. When SIMTICS is used in education institutions and work-teams, the logbook data can also be accessed by instructors and supervisors.

Making education available anywhere, anytime.

The desire to find the most cost-effective and accessible education solutions has been a strong driver for someone who grew up in one of the poorest and most remote parts of the world. “Coming from a missionary background in rural India, I know how important it is to find a generalizable and sustainable approach to education, that can be accessed regardless of geographical location. The SIMTICS product is one of my contributions to achieving that mission.”

SimTutor currently has a catalog of over 170 SIMTICS modules, covering ultrasound scanning procedures and protocols, radiographic positioning, dental assisting, medical assisting, basic life support, and common medical procedures. For more information about SIMTICS, check out

And if you’re interested in creating your own simulations and interactive training activities using the same tool that powers SIMTICS simulations, you can find out more at

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