We know that the coronavirus is creating unprecedented challenges and questions for everyone. In the education sector, courses have been moved online, usually within days. Students can’t access labs or sim centers. Clinical externships are being postponed or cancelled.
It can be a struggle to adapt to the new format of teaching and learning. We don’t have all the answers but we’re here to 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. All online, no equipment needed.
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!
Cindy Parke, RNC, CNM, MSN leads a busy life. Certified nurse-midwife, educator and clinician, she and her husband took over management of Professional Education Center (PEC) in 2010. PEC is an entity 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 PEC 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.
PEC’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 PEC seminars and on-line educational products.
But as CEO of PEC, and working in a competitive market, Cindy wanted to offer more to meet the needs of PEC’s 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 PEC’s own seminar-based 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 PEC’s 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 PEC’s “Ultimate Ultrasound Training Menu”.
Today SIMTICS is what Cindy calls “an essential component” of PEC’s 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 pieces of the modules, with acknowledgement, within PEC’s 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.”
PEC’s student audience for limited ultrasound is national and diverse, composed of nurses, midwives, and physicians. Students typically reach PEC by attending live seminars, where they may have utilized a SIMTICS module as prep for the on-site seminar. During the seminar, a PEC instructor utilizes relevant SIMTICS modules to demonstrate key concepts. PEC’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 a PEC 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 a PEC 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.
adopting SIMTICS, Cindy has noticed significant positive change for PEC’s
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 COO, Cherry Vanderbeke, 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.”
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 PEC!!” — 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 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 Professional Education Center. For further information, please visit the ultrasound training page on PEC’s website
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.
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.
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 www.simtics.com.
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 www.simtutor.com
We wouldn’t be overstating the case to say that Shelly Zimbelman was initially skeptical about teaching the clinical skills of her profession using computer-based simulations. Her first reaction was unequivocal: “There is no way you can simulate an ultrasound scan of a patient by using just a computer and a mouse!”
Professor John Windsor is co-founder of SIMTICS, an interactive learning company that provides web based simulations for allied health and medical procedures, which is now called SimTutor. John holds a personal Chair in Surgery at the University of Auckland and is a Consultant Surgeon at Auckland City Hospital. ILH asked him about simulation-based cognitive learning and what inspired him to dream of the SIMTICS product.
I’ve never spoken to an educator who doesn’t want the best possible learning experience for their students. That ambition to deliver a comprehensive, engaging and enjoyable educational experience is certainly shared by the instructors at the Kettering College Sonography program.
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?