Learning sonography through e-simulation: A non-believer turned believer

By Angelique Praat

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.”

While working at Career Education Corporation (CEC), Shelly was co-opted to work on a project with SIMTICS, which at that time no-one in the USA had heard of. A senior executive at CEC had stumbled on SIMTICS during an internet search while looking for a simulation platform to add value to the clinical skills courses in their medical imaging programs.

Shelly is a seasoned radiographer and sonographer, with experience in senior leadership, instructional design, and post-secondary and continuing education. Her mission on the SIMTICS project was to help design sonography and radiography simulations.

Cherry Vanderbeke, CEO of SIMTICS, remembers meeting Shelly at the initial design workshop in St Louis. “Shelly was leaning back from the table with her arms firmly crossed. Not only was the body language clear, but she was also very open in saying that it was crazy to try to simulate using ultrasound and x-ray equipment on a computer! Thankfully, after hearing our design ideas, she had warmed a little by the end of that first workshop. Even so, I knew she would need to see the new ultrasound simulations in action before she would be convinced of the feasibiilty.”

Stowing her skepticism, Shelly began working with the SIMTICS simulation developers. They picked her brains about what sonography and radiography students needed to learn, what concepts they particularly struggled with, and what types of scans were often hard or impossible for students to experience during their education program. As she started visualizing how the software might work. Shelly realized there just might be some merit in using online simulation to learn allied health skills.

However, seeing is believing and what really convinced Shelly in the end was hard evidence. That came early on with a student who used the first SIMTICS ultrasound simulation prototype while studying remotely. When Shelly brought her class together for a competency check in the lab, she was amazed that this remote student surpassed all the campus-based students in both procedural knowledge and confidence. The student could switch on the ultrasound machine, select the correct transducer and settings, position the patient and start scanning. She knew what images to obtain for the scan protocol and what to look for on the sonogram. With that foundational knowledge firmly anchored in her mind, she was able to concentrate in the lab session on the finer details of obtaining the best images, and how to communicate with the patient. The other students watched her with a twinge of envy.

To Shelly, this clearly demonstrated something she had wanted reassurance about: virtual learning did produce real-life results.

Shelly tells us she wishes she’d had the benefit of SIMTICS when she was a newly minted sonographer. ‘I was working in a hospital in my first job and an ultrasound exam came up that I hadn’t done before, but I didn’t want to confess that I didn’t know how to do it. The hospital didn’t have any textbooks. So I phoned my supervisor at college who gave me step-by-step instructions on how to place the patient and the towels, what the anatomy should look like, and so on. And there I was, hurriedly scribbling notes on a piece of paper! Thankfully I pulled the exam off and the radiologist was happy with the images. But imagine if I’d had SIMTICS available. It would have been so different. I’d have had the chance to review and practice the ultrasound scan before the patient arrived, right there from my computer.’

Shelly became one of the biggest champions of SIMTICS in that sonography project. So much so that, a few years later, she joined the SIMTICS team as a consultant, and now she’s working with them full-time.

Shelly is a strong proponent for the value of web-based simulation as a great way to learn practical skills. She says SIMTICS also opens up opportunities for people all over the globe to expand their learning and get guidance on skills and procedures that they may otherwise never experience as a student. The SIMTICS product’s potential to reach beyond campus walls, to break down geographic and distance barriers, and to be available where students are when they need it, seals its value in the learning toolkit.