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Introducing the Fully Stocked Code Cart: A Game Changer for Virtual Simulations

Episode 40: June 14th, 2024
Hosted by Bill Ballo, Rick Casteel, Mitch Luker, and Jon Brouchoud with special guest Dr. Nick Slamon.

Jon Brouchoud: Welcome, everyone, to Simulation Pulse Live. This is episode number 40, believe it or not, in our 10th year in business with Arch Virtual. We made it to 40 episodes, so glad to have you. I also was just looking at the analytics, and the total combined views on the Pulse Live is up to 9,000 views, which is pretty incredible. That’s impressive. Yeah, pretty excited about that. These things have a pretty long tail. You know, people are looking around and interested in virtual simulation. This is an event that we do every Friday at noon central time. We post videos on our website. I will share a link to that as well in case anybody is interested. The other little bit of housekeeping news that I have is that I figured out a way which should have been figured out a long time ago, but I figured out a way to share or to create a transcript for each of these. So we can post a transcript of these events on these. So that’s going to be coming soon as well as a summary of each of the events and a chatbot that is trained on the event. So you’ll be able to ask it questions about what we discussed during Simulation Pulse Live. So that’ll be kind of fun. All kinds of cool stuff you can do with AI now.

Rick Casteel: Well, I was going to ask, John, what are you thinking to replace Bill and I with AI?

Jon Brouchoud: I’ve already been replaced. I’m not real. It’s only a matter of time.

Rick Casteel: Bill, we better watch it.

Bill Ballo: Just make sure my AI has sort of healthier knees and a little better back, OK?

Jon Brouchoud: I just added, Dr. Slaven is here. We have a very special guest in the house. And I actually told Dr. Slaven that we were going to be talking about the code cart because it was Nick’s idea from way back to build this code cart. He’s been asking feverishly, I would say, on a pretty regular basis for a stocked code cart to be able to run the simulations that he and his team run and to be able to do things that we haven’t been able to do. We’ve been able to sort of fake it with a code card. I think Dr. Sleeman and his team essentially took a surface of a cabinet and put all the stuff that would be in the code card on top of that card. So now we actually have a stocked code card. However, I have just realized, and I think we’re together kind of collectively realizing that this asset is still in the QA server. So it’s not on the public server, I don’t think. If you saw it, you would have had to go into one of our beta testing servers. So that said, we could either, we can try to go into the, yep, go.

Rick Casteel: Let me interrupt because I just saw there was a new download in assets that I downloaded called CodeCarp. That’s the one. And it may have it. So let me share my screen. I’m trying to do this in the headset, so it’s a little more tricky.

Jon Brouchoud: Let me see. I’ll figure out this. I’ll come and join you in non-VR so that we can.

Dr. Nick Slamon: It’s definitely live, John. I used it yesterday. OK, cool.

Jon Brouchoud: Cool, cool, cool. Let’s check that out.

Rick Casteel: All right. Now I can share screen.

Dr. Nick Slamon: I can’t remember if it’s CodeCart or fully stocked CodeCart. It’s one or the other.

Rick Casteel: Well, tell me what you’re seeing here.

Dr. Nick Slamon: Yeah, one with the it’s the one with the less drawers bigger drawers that open and close.

Rick Casteel: That’s Yeah, this one I can like open doors with now.

Dr. Nick Slamon: And then Rick next to that asset should be three individual drawers. And what you do is import an individual drawer. I think it’s drawer one, two, and three. and you toggle on the socket yes, and then toggle it socket no a second time, and you’ll be able to slide those drawers in and they’ll be part of the body of the of the code car. But you have to toggle in once and then off a second time.

Rick Casteel: Okay, I think that went in. Let me shut this one. And Let’s see, do I got any? Oh, yeah, look at that.

Dr. Nick Slamon: And then you should be able to grab stuff out of there, but not make the drawer come out.

Rick Casteel: Oh, wait a minute. Oh, you know what? I’m still in edit mode. Let me go into learner mode.

Dr. Nick Slamon: Yes.

Jon Brouchoud: And if you don’t mind, Rick, I’ll share my screen, so. Oh, yeah. Then it’s here.

Rick Casteel: Well, you may have trouble looking down in. I don’t know if my view is showing you better.

Jon Brouchoud: Yeah, I don’t know about anybody else. But I get super dizzy when I look at non somebody on VR mode. I can’t I won’t be able to. We could try that. I just won’t be able to watch because I can’t watch what other people are.

Rick Casteel: I’m going to or you know what, let me bring it in a kind of calm.

Jon Brouchoud: Yeah, there you go. It’s a good idea.

Rick Casteel: One second.

Mitch Luker: I’m super excited about this cart because that is something that we have been, I’ve been piecemealing together, kind of like Dr. Slayman. And, um, I’ll be adding it now for our, um, new emergency situation that I’m starting this summer with, um, our dental program.

Rick Casteel: Okay. How do we look now?

Jon Brouchoud: Oh, I’m sorry, Rick. I took over the share. I took over it, so you’d have to take it back. My apologies.

Rick Casteel: No worries. No worries.

Dr. Nick Slamon: Bill, I’m headed to the swamp on Sunday night. Yeah? Are you really? Giving a talk at Chan. So I’m going to be talking Monday or Tuesday. So I’m coming in Sunday night.

Bill Ballo: Oh, man. It’s like home for me. I haven’t been there, and it’s been too long since I’ve been there. Obviously, I did my undergrad there, and it’s just been too long since I’ve been there. I’m going to try to get the kids down maybe later this year. I miss Gainesville a lot.

Dr. Nick Slamon: Yeah, it’s a good place. We were there for almost five years.

Bill Ballo: Yeah, love Gainesville.

Rick Casteel: Okay, so now we should be good. Are you able to grab anything out of the drawer, Rick? Let me get over here. I don’t think I can grab for whatever reason.

Dr. Nick Slamon: So when you sock when you brought that in first, and you want to socket this you hit yes. And then you have to highlight the drawer, a second time before you put it in the cart and say no. Oh, and then put it in the cart, and then you should be able to grab everything and still open and shut the drawers.

Jon Brouchoud: Well, and the reason that’s happening is because, you know, we have, so the ability, once you build a scene, nothing that you create is interactable by a learner or by anybody that’s a guest in the scene. It’s only interactive by administrators and that’s by design. There are certain things you don’t want participants to be able to just grab onto. So when you grab onto that cart, you only want the cart to behave, you know, like a, like a drawer, right? You don’t want. to be able to grab the entire card and have it like where you can like move it and the entire card around you want to be able to just grab the stuff in there so what you’re doing is essentially selecting the drawer and saying I want all these things to be learner interactable but I don’t want the drawer itself to be learner interactable so that’s kind

of the that’s the toggle that you’re doing like it’s it takes a little getting used to to figure that out but like once you get how it’s working it makes sense.

Mitch Luker: It’s kind of like the IV pole with the IV bags. You don’t want the IV pole to be interactable. But you want to be able to pull the bags on and off yourself. So you have to fix that toggle in there. Otherwise, your students will drag the IV pole all over the room.

Bill Ballo: And then it ends up in the patient’s head. We had a monitor that was laser grabbable at one point, and the students accidentally figured it out. And they went to like, oh, that monitor up there, and someone clicked on it. And it was like, boom. And they’re like, um, wait. So I went, oh, I never even realized I made that laser grabbable. So it’s really easy to change it. You put it back where it was, and then you just hit, you know, Non-laser you take toggle that off. It’s just a toggle on off. And so yeah, it was it was kind of funny though because this laser grabbable like whoa now you can really see it so And Dr. Slayman it looked like in assets.

Dr. Nick Slamon: There were two more of these drawers at least correct There’s three drawers and then the bottom two drawers are empty You could theoretically put some other stuff in there like a bag of mask or some other, you know hand grabbable stuff.

Rick Casteel: Yeah, you can see as I shut these drawers, I can pop open the other ones. So you can have fully populated drawers or drawers that you’re going to put your own other contents on.

Jon Brouchoud: And just to rewind a little bit, I’m going to share a link here. This is a YouTube video of a mock code that Dr. Slayman ran with his team. So this is kind of the use case. And a lot of this started during the pandemic when you know, simulation labs were closing down and you couldn’t just walk into a school or a sim lab. But, but Nick and his team wanted to continue running simulations. So basically, they would take a scene in Acadicus and build out what the scenario was. And, you know, basically share their screen over zoom. And that way, residents and fellows, anybody that wanted to participate could just join real easily on their mobile device or on their computer, they could jump in on zoom. and essentially lead the code or collaborate with the person who’s leading the code. So it was a really cool use case and it enabled them to continue running simulations. And those are some of the most popular videos that we have, the ones that we shared. People really enjoy watching those and learning from them. So it was in the process of doing those types of simulations where Dr. Slaman and his team were like, you know, we need a code card. like in the real world, that’s what we’d be doing. So we started working on this. But as anybody knows, the content that we create is usually sponsored by someone who’s going to be using the content. And this was something that everybody needed, but there wasn’t one organization that raised their hand and said, yeah, we’ll pay for it. So this one was one that we built on our dime. one of the few assets that we built on our dime. Everything else was guided, you know, and paid for by subject matter experts. But Dr. Slayman was generous enough to kind of guide us on what’s all needed in a code cart. And even back before that, Bill Balow had me come into Madison College, and we went through all the code cart supplies and stocks. And I took hundreds of pictures and brought that to our 3D team. So this has been a collaborative ongoing effort to get this going for, I don’t know, we’ve been working on this a couple of years.

Dr. Nick Slamon: And the other use case, John, for this particularly that I think is going to be really great and you guys should advertise or maybe we do a video and put it out there, but for both pharmacists and nursing staff. So our pharmacists have almost become a mandatory attendant at code situations, both mock and real. And they’ve kind of taken over the job of drawing up the epi, the calcium, the atropine, the ketamine, the, you know, whatever’s in there and kind of handing it to a nurse to administer. So in the old days, it was the nurse had to do all that themselves and give the drug. Now the nurses are kind of the intermediary doing documentation and giving the drug and the pharmacist is drawing it up. So for student pharmacists and student nurses that are unfamiliar with like, what’s the code cart look like? What’s in the code cart? Where are things located in the code cart? So I can, you know, get fast and fast out grabbing all of it. This is going to be just invaluable.

Jon Brouchoud: Yeah, that’s fantastic. I think there’s gonna be a lot of different use cases. I don’t know how many times people ask us if we have a mock or a code cart. Such a very common request for this asset for sure.

Dr. Nick Slamon: And the other thing that Sean and I were talking about yesterday when we were playing with it is the next level of this is incorporating your syringe that already kind of plunges in the opposite direction. So, you know, grab one of those bottles, pop the top off of it, take a needle that’s already existing in a syringe that already exists in Acadicus, but have some function where using the thumb stick you can draw back and say, well, I’ve got three CCs or five CCs or 10 CCs, the correct dose where nurses and pharmacists can really practice. Not only I know what’s in the code cart, I know how to get the stuff out of the code cart, but I’ll draw up the correct dose for you as well. And, you know, maybe you link that in the future to one of our, um, check boards where it’s like, draw up three milligrams of atropine that equals two cc’s in this concentration, green check mark, and just go down the list of draw up this, draw up that for having pharmacists and nurses practice.

Bill Ballo: And this is a good example too of how, you know, the sort of sharing of assets in Acadicus is so valuable because my nursing faculty, they were asking, for a code card, and they had been asking for a code card. They were, you know, they were asking for it, especially the beginning of this past semester and a little bit in the past fall. And I said, well, no, we don’t have one yet, but I know that one is being developed. So let’s focus our attention you know, if we’re going to do any custom content, let’s focus on other things. And we did. We focused on doing an opiate reaction and we focused on doing a transfusion reaction. So I said, let’s focus on other things because someone else is building that code cart. And when that code cart is in, it’s going to be available to us. So let’s not do that. Let’s focus on stuff that we want to build out, and then we’ll use the code cart once it comes in. And they were asking questions about, OK, well, what’s it going to have? I said, well, I told them I know there’s going to be different stocking ability and stuff like that. So let’s hold on, and let’s focus on other things while we know that there’s a code cart on the way. So that’s just sort of that example of how we can kind of work together, even within Acadicus. And we talk about it a little bit in our community practice, our community of practices, like, what are you doing? What are you doing? What are you doing? So that we kind of know what’s happening and going to be happening to sort of help direct some of the other things that we want to do.

Dr. Nick Slamon: Now, Bill, that’s totally, totally right about Acadicus that somebody builds it and then everybody can use it. And people think of uses that you might not have thought of. And it’s just, it’s that, um, you know, shared concept. That’s really awesome.

Bill Ballo: Yep.

Dr. Nick Slamon: Absolutely. And Rick, I see in that second drawer that you put in another thing that I thought was just amazing about what Sean and Stefan and the guys did was in that far right-hand drawer, there’s multiple things layered on top of each other. just like in the code cart, you could pick up the top thing, which is like an IV setup, but there’s stuff underneath it. And with your virtual hand, you can reach through the thing on top and grab something else from underneath of it. And it all kind of sockets back into place when you’re done with it. And you’re like, all right, I don’t need that anymore. I’m going to put that back. Or I grabbed the wrong thing. It just kind of pops back into the drawer where it’s supposed to be. It’s really cool.

Rick Casteel: You know, I haven’t turned the grabbing function on yet, so you see a little bit of pluginess going on there. But

yep, you can see all these items in here.

Dr. Nick Slamon: And Rick, you won’t have to make all those things individually hand-grabbable. If you do that whole socketing process in the very beginning, the drawer itself, everything in it will be live, but the drawer itself won’t be able to be grabbed and pulled out by accident.

Rick Casteel: Very cool.

Jon Brouchoud: And this will be compatible with any of our Gen 2 patients as well. You’ll be able to bring a Gen 2 patient into a scene, create a simulation that you want to run. If it involves a code cart, you can add that into the scene and start using it with all of the other content that we have at this point. But really kind of exponentially multiplies the number of scenarios that you can write and something we’re always talking about on the Pulse Live. But, you know, it’s it’s not like, you know, oh, great. We have a code cart. We can we can run X, Y, you know, X scenario. It’s really now we have a code cart. We could run thousands of different scenarios. It doesn’t there’s no limit. You can just you can. mix and match these things to simulate just about anything you’d want to simulate in the real world. It’s not about like we created a scenario that you have to do it this way, and it’s only one way that you can do it. It’s a fully functional sandbox of content that you can work with all the other content in the platform as well. We’ll be looking forward to seeing how this gets put to use. That’ll be great. Looking forward to that.

Rick Casteel: I’m going to stop sharing at this point. OK. Awesome.

Jon Brouchoud: I appreciate you jumping out at last minute notice there, Dr. Slayman. I told him like three minutes before the event started, like, hey, we’re going to show them the code cart.

Dr. Nick Slamon: No, no worries, John. I appreciate you guys getting it done. And I’m hoping that. So I ended up designing, as we talked about on the phone, I use the empty commons area, the new commons. And then on those side rooms, I created one room. That’s kind of a heart room tutorial. The second room has three live mannequins. One’s an SVT, one’s and be tack and one’s a systolic. So, after we’re kind of done teaching in the room on the left, we’ll go in and run. some practice scenarios on the right. And since the audience is School of Veterinary Medicine and School of Pharmacy, in some of the blank common areas, I set up all the animals for demo for the veterinary folks. And then in the other wing of the common area, I set up what I thought would be some adjunctive pharmacy stuff. So the code card being one of them, all the modeling that you guys have done for different types of white, red blood cells, viruses, immunoglobulin 3D model that you made, and then Rick helped me bring in the medication creator. I’m hoping to run the teaching scenario with the heart stuff and the mock codes. And then on the way out of the lecture, just do a quick, and for you veterinary folks, here’s what already exists in Acadicus. And for you pharmacy folks, here’s what we’re doing and see if it piques anybody’s interest.

Jon Brouchoud: Excellent. That sounds great. Yeah, that’s a nice big space to work with. I feel like I want to use that for more, more things that was like originally, that environment, I think, was originally the dream big Madison College XR Center. Like we started off where, you know, Carly and the team were like, let’s just start thinking really, really big about what does the future of XR and education look like? And, you know, it was like a dream job for me. They were like, just gave me a real long leash to go out and explore and think about what does that look like? So we, it was the, the Truax campus is right next to the airport in Madison, Wisconsin. So we thought, well, maybe it’s like a huge hangar. And, you know, I imagined a world where eventually, you know, of course, you know, you can move around in a larger space. So maybe like more multi participants walking around in larger spaces. And you really want these spaces, any kind of XR lab, you want the flexibility to be able to move things around, you want things on wheels. You don’t want things built in. You don’t want to use drywall and studs and nails and boards. And not only does that add a lot of expense, but it also locks you into one way you can do it. You want things to be able to move around. So, um, we started off with a big warehouse that kind of looked like a hanger and then just imagined what that would be like. And if, if it was an XR center, so that was the, that’s the environment. So that’s now the commons and, and now a simulation area that Dr. Slayman and his team will be using. So that’s pretty cool.

Dr. Nick Slamon: And I’ll tell you one other thing that was really important in changing that kind of hanger into something that looked even more kind of customized was that image loader is just invaluable. And Rick was a huge help, A, in, you know, figuring out for me how to just, how do I get the empty room? and then start to bring things in it. But then how to, you know, decorate the room. I kind of said to him on that Sunday when we met, you guys are always better than I am about making the room look professional. I kind of like bring some stuff in the room, but it looks like a guy just brought some stuff in the room. So being able to put something up on the wall and, you know, bring in the logo of the school that you’re giving the lecture for and personalize it to them. I’m really excited. I think they’re going to be like, wow, this is amazing. Like, how did you, create the University of Georgia School of Veterinary Medicine. Where’d you get our logo? How’d you bring that in that room? And it was all, you know, Rick’s help with about two seconds of just push this button and go ahead and put it up on the wall, make it bigger, stretch it this way. And it was really easy.

Rick Casteel: And that’s just one of my favorite features. I mean, you’re exactly right. The customization and the learning content that you can bring into a scene is just, I mean, there’s no limit to it.

Jon Brouchoud: Yeah, absolutely. We’ve seen some scenes, you know, where, where you help them create, uh, just recently one scene where we had a ton of images imported for, um, one of our, one of our customers that we’re, we’re gonna, we’ll keep it secret for now. Cause we want to be able to share it at some point in the future. We’re going to have them as a guest, hopefully, and be able to talk about it. But a lot of imported images, it makes it look like a totally custom environment, like a totally custom simulation. You know, you can have all of your debriefing stuff like you’ve been doing forever, Dr. Slayman. You know, you’ve got the whole debriefing images are all set up so you can go over your H’s and T’s and everything else. And that really helps a lot. Helps to customize it for sure.

Rick Casteel: We did it. Well, you mentioned I got to get. Oh, go ahead, Bill.

Bill Ballo: Oh, no problem. We did it with our architecture students. I I had their their instructor secretly give me All of their designs that they had, you know, they were in an image format and I just said, you know, give me all their designs and even he didn’t know I was going to do it. And I put them in the amphitheater behind the Madison College scene. And I put them all in the amphitheater out back. And then I even put some on the walls like they were paintings and stuff like that. And the architecture students came in. And they were just like, you know, they’re kind of bopping around thinking, oh, this is neat. Yeah, it’s Madison College. Ha ha. Yeah, all right. And then one goes, wait a minute. That’s my design. And then it just devolved into everybody going, what? Wait, where’s mine? Hold on. Is it out there? Is it on the wall? And they’re walking around. They’re going upstairs trying to find it. And it just went into this whole thing of everybody going, oh, wait, my stuff’s in here. And it was really cool. It was a lot of fun.

Dr. Nick Slamon: That’s awesome. That’s really great.

Rick Casteel: Yeah, and I was getting ready to say Mitch and I met earlier this week. And we kind of had a brainstorm session And started to play around with some new tools that I’m going to tease everybody with that we’re going to have to do a whole session on about, you know,

different types of questions that you can ask learners while they’re in the headset and have them respond to.

Mitch Luker: I’ve already started building, Rick, and I will have it done this weekend. It’s supposed to rain on Sunday, so I’m going to finish all my 3D recording, but I’ve already built one entire learning plan for one of our competencies in nursing fundamentals. And so based off of what you and I discussed, and again, since we’re waiting to be able to share what this other person came up with, and that just made my brain start oozing out of my ears, Because I was like, Oh my gosh, the things I can do here. And so I’m very excited because now my leadership is super excited because Now, it doesn’t have to be always facilitated VR simulation. We’re actually going to be able to have non-facilitated VR simulation. And that has now spurred my leadership to say, okay, now we’re going to open a second lab on our Green Bay campus so that we can have one be the clinicals lab and the other one be the learning VR lab where students can just drop in and do individualized non-facilitated VR simulation to help them out. So because they see the potential of where this could go and what we could do with it and how impactful it will be to our students. So yeah. Yeah. Awesome stuff.

Rick Casteel: Yeah, we both had. This is totally unfair. I’m sorry, Dr. Slayman.

Dr. Nick Slamon: I said to Mitch, this is totally unfair. He just gave like this teaser trailer and he didn’t even say coming soon to a theater near you. Like when’s the release date? When are we going to see this movie?

Rick Casteel: Well, you know what? The stuff is actually already there. It was kind of this aha moment that wait a minute. If we take an image viewer and put this thing there next to this, wait a minute. Suddenly, you know, it kind of changes the game a little bit about interactivity and knowledge assessment. I’ll get with you anytime you want and we can go over.

Dr. Nick Slamon: That’d be awesome. And I’m definitely tuning in. When’s that simulation pulse going to be revealed? I need a, I need a link for that one, John.

Rick Casteel: Absolutely. We’ll let you know as soon as we get these folks lined up.

Jon Brouchoud: We do this every Friday at noon. So it could be any one of those Fridays. You’re just going to have to come to all of them. Yep. Good one, John. It’s great. Next week, we actually have Dr. Elizabeth Oviawe from NSU. It’s going to be, I don’t know that I’m going to be able to get her out as a live guest on The Pulse Live, but we’re going to do a Simulation Pulse interview because we have an awful lot of stuff to talk about. Dr. Oviawe has been one of the earliest and most significant, I would say, contributors to all of the things that we’ve been building. And the things that, you know, a lot of the procedures, you might remember Dr. Ovialle from such simulations as lumbar puncture, CVL, or no, the Yeah, the CVL, the new CVL procedure. We’ve done the wound treatment care, the EKG lead placement, endotracheal intubation scenario, and a lot more. There’s a lot of content. We actually built a simulation with one of the teams at NSU on caring for geriatric patients. We’ve done just a lot. There’s a rural healthcare simulation coming up. I don’t want to share any details about it because I don’t want to steal the thunder. There’s a lot of exciting announcements coming up, a lot of new content, a lot of new simulations that are really, really cool. And they’ve got some ambitious plans for implementing those in the in the months and years ahead. So we’re looking forward to that. But I’ve been trying to get Dr. Ovialle as a guest for for quite a while, and she’s generously agreed. And so we’re finally going to be able to talk about some of the work they’re doing down at NSU.

Rick Casteel: Well, I think, you know, what we’re getting at when we look at something like like the code carton, what was built there is and I do, you know, a lot of our demos for organizations that are exploring putting virtual reality in their programs. And a lot of times they start out with, you know, I want to understand what your pre-configured, pre-setup content is, right? Because they have this thought that they’re going to walk through a procedure and kind of check the boxes, and they want something to kind of lead them through that. But the real power of this stuff is doing what Dr. Slayman was talking about in terms of building this room, right? I can bring this content in, I can bring in my own images and documents, I can bring in, you know, I can set this content as I want and read somebody through an experience. It’s not so much about having this pre-configured content that, you know, is checking the boxes for you. Because nine times out of 10, I get in front of a subject matter expert with our pre-configured content, right? And they start telling me what they would do different. As soon as I get with that OB nurse and I start going through our childbirth scenario, they’re like, well, how come the monitor is over there? And why is the significant other standing here by the bed? And why is your sequential compression devices on the other side? And it’s like, wait a minute, you can change all of that, right? Any of that you want in, you want it out, you want it moved, we can do that. And it really is about the power building what it is to meet your needs.

Mitch Luker: I will second that because I reconfigured the birthing scenario because for our nursing students, birthing babies is kind of out of the scope a bit of what we do with them. And so now I take it in the classroom and we use it as a live case study. And so instead of having them go through and do the scenario in we focus more on what would the nurse do in those moments. And so like I took the fetal monitor and I moved it over across the room on that wall across from the bed and I made it humongous so that they could see it easily from on the screen in the classroom. Cause I hook into the AV system of the classroom and we run it through that way. So one student comes up at a time and they put on the headset to like, put on the fetal monitor and do things. And then we use it as, okay, now what would happen if this? And then we progress the scenario and they give answers as we go through. And we’ve actually seen an increase in exam scores on that content in our health promotions class. Because students are being able to take that information and use it more and make it more applicable knowledge instead of the trivia that it used to kind of be of memorize and dump. And because they memorize it, dump it out for an exam and forget it. And then, so we’re seeing better scores on our tests now because of doing it that way.

Bill Ballo: Yeah, we had to do sort of the same kind of thing. So with the birthing simulator, we did go through a birth with our nurses. But all of them commented on the fact that the clock was behind them and not right above the patient. And they were like, the clock should be above the patient. So they were looking at the patient. We’re looking at the clock. And I’m like, You’re absolutely right. And I just hopped in there real quick, grabbed the clock off the wall, put it over on the other wall and went, there you go. And it was like, that was the sort of that easy customization that I can stick the headset on real quick. I can just grab that clock off the wall and I can stick it on the other wall and we like it better over there. So, you know, that it was it was the same generally. And there were other things they were like, there’s like two of these. We don’t need two of these. There’s this. We don’t need this. And I’m like, OK, no problem. Delete, delete, delete, delete, delete, you know. So we customized it the way we wanted it hit save. And now it’s it’s there.

Jon Brouchoud: That’s fantastic. I mean, so there’s really like three really important parts of that, like, cause you’re, you’re editing a scene to create something that is aligned with your objectives. Like number one, like that’s really, really cool. That’s the whole objective with the platform. That’s amazing. But you’re integrating into the classroom too, which I think is another interesting thing, you know, and you and Bill both, I think are unique in that way that I’m sure there’s other schools that have done that, but I’ve seen you both personally just sort of using it in the classroom. So it’s not like, let’s all go to the simulation lab. and do a traditional simulation where we all gather around a mannequin. It’s like, you’re able to do this in the classroom. You get your students there, you’ve got a projection, you’ve got the ability to pull up Acadicus and use it

as an adjunct as part of a traditional learning style, which I think is really interesting. And then, so you’re integrated in the classroom, but then you’re measuring the outcomes, which is another thing that’s, I think, unique and I think more schools are doing it. But, you know, you guys are both like really you know, measuring and evaluating the efficacy of it so that you can build a better case over the longer period of time over like this is why we’re doing this because it works. It’s not just a shiny new thing. It’s not just VR is cool. It’s like we’re actually getting better results. And I think that’s that’s always going to be a really important part of this.

Bill Ballo: That was sort of my initial focus with the catechist early on, you know, was I want to teach cardiology and not use this stupid little plastic heart to teach it. You know, I want to I want something that’s more interactive and more interesting for my students, you know, and that was pre pandemic. And then when the pandemic came along, we did kind of look at like, OK, what are some better ways to implement this for simulation? since simulation is becoming a little harder and a little harder. I was in the EMS program at the time. For our paramedic students, they weren’t allowed to see respiratory patients at all, ever. The nurses and the staff at the hospitals would just say, no, you can’t go in that room. That room’s isolation, you can’t go in there. They weren’t seeing any respiratory patients ever. um in that in that first year there and so that was kind of that was one of the one of the turns in that and and cardiac arrest because that was my you know that was my specialty in my area of highest interest was how could we you know potentially leverage that so that was really the first simulation we kind of thought about was like, let’s do an ACLS simulation. But initially I looked at it as more of a, I can do more with my lecture and my theory class than I can with my simulation class. But now it’s just, you know, it’s both. Now you have both. You know, you have that, use it as a sim lab, use it as a lecture hall. And, you know, I love it. We did it. Dr. Cy Sabella, our veterinarian, used it for his lecture. He came in and instead of doing his lecture in the regular lecture hall, he brought all the students into the XR Center. They sat, we put it on the big 85-inch screen, and then he just went through a lecture and we hit record on it and 3D recorded the whole thing. He has that as well. So it’s great in both of those worlds. And I think that it might be a little underutilized for the lecture atmosphere, so.

Jon Brouchoud: Like bringing simulation outside of the simulation lab, you know, is really the key. Dr. Slayman has been doing the same thing. It’s like there’s, they have simulation, but it’s like, can you bring a simulation lab to the floor of the hospital? Can you bring it to your office and have your residents and fellows go through it? You know, it’s like, it really massively expands access to it. It’s like, we know how powerful simulation is as a modality. That’s been proven, but it’s limited in access. You have to have access to very expensive facilities with very expensive equipment that’s being managed by a lot of staff that don’t want you to come in there and just start messing with things. So by being able to take that and bring that modality as effective as it is outside of that simulation lab, you’re just cracking open a whole new world of possibility there that we’re just starting to scratch the surface of.

Dr. Nick Slamon: And John, what I love about Acadicus is the ability to blend those two things, those two modalities. So have a high stakes simulation without the risk of the patient being hurt, but ramp up the ramp up the urgency and ramp up the realism and ramp up the immersion. There’s background noise, there’s phones ringing, there’s people talking, the monitors beeping, the patient’s rhythm is abnormal, somebody’s doing CPR. You can do all that. and then you can take them out of that high intensity space because the catechist offers you so many different places to be. You could go into a nature scene, you could go into a classroom scene, you could go into the commons, and you can do your debrief or your teaching or your lecture in that safe space where it kind of like ramps down the pressure. So the mock code is the pressure cooker, but then, all right, you want to really lock in this knowledge. Let’s take what we just learned there in that simulation. Let’s step out of here. And now we’re in a nature scene where we can put a 50-foot poster, a 100-foot beating heart, and let’s really take apart what we did in that simulation and what went well and what didn’t go well and try to lock that in with visual learners and auditory learners and you know, people that don’t do well under pressure and stress, they’ve undergone that part, but now they’re going to do their learning in a safe debrief area where they can kind of communicate in a closed loop way and ask questions without a, you know, a lot of high stakes. They’re not asking a question in the middle of the code, so it just offers so much in terms of what you can do with it.

Jon Brouchoud: And you can integrate that over time where you’re like, you know, you’ve got a 3D recording like Dr. Sy did, you know, where it’s like, not only are you taking that high stakes thing, like you say, you’re, you’re doing the, you’re making use of the existing technology. You’re bringing it out, bring into the classroom, but then, you know, being able to record that. And then you’ve got that access anytime you want, right? Those students can come back if they like miss something or if they weren’t there that day or whatever. they can come to the XR Center, pull up that 3D recording, and now watch that over again. So it’s a matter of like, it’s like you’ve got the immediate urgency of learning, and then you’re reviewing that knowledge in some way that’s not in a headset, but then you’re integrating that over a longer period of time by revisiting that content whenever you need to, as many times as you need to.

Rick Casteel: And I just wanted to bring up what Mitch and I were originally meeting about earlier this week. And Mitch can talk about, again, this mixed mode that he’s able to bring to bear using Acadicus, where he did a 3D recording with a subject matter expert, but then he’s actually recording that off his computer screen in 2D so that students can consume that content in another modality. And Mitch, I’ll let you talk through the specifics if you could.

Mitch Luker: Yeah, so I had one of our faculty come in, and I built a scenario for her. And I used the image viewer to import her lecture. So that is up on the wall. And she’s actually doing the lecture in the space. And she’s interacting with objects as she’s doing the lecture. So it was on nephrology. So we’re doing acute kidney injury, chronic kidney disease, and several other disease processes. And so she’s going through and doing that lecture in there and I recorded it in 3D. And so now I’m going back and using a screen recorder to record those pieces. And then I’m going to cut them together as one long lecture. And then we’re going to drop that into Canvas, which is our LMS right now. So then students can watch something instead of the disembodied voice and a PowerPoint, which I’ve had to watch those now as part of my schooling. And it makes me want to slam my face against my desk every time because they are so boring and so hard to watch. And so trying to give them something where they’re actually seeing her put the stethoscope to the chest, they’re going to hear the heart sounds. They’re going to hear the lung sounds. They’re going to hear the bowel sounds. They’re going to, you know, get to see all the stuff that she’s doing. And like when we talk about oliguria versus in urea and normal urine output. And so I took the urinals and I have them with different amounts of urine in them and. using that as visual. So that way students can kind of see these concepts instead of, yep, Oliguria means you’re doing this and this means this. So they’re getting to see the PowerPoint still in the space so they can still follow along, take notes and they know what slide they’re on as we’re, as she’s presenting. But it’s going to make it a way more interesting way to watch lecture because we do all of our classes are, um, But, uh, oh my gosh, flip classrooms. So you always watch your lecture and then you come into the room for active learning. And so, um, this is just going to make a really nice way for students to be able to get the content in a way that will be hopefully more engaging. And, um, I’m excited to see how that translates to exam scores on that material. Cause again, we’re going to be able to compare. apples to apples, how did students do before this intervention and how did students do after this intervention? And we’ll have some really good data about, you know, does that increase that exam score overall?

Jon Brouchoud: Yeah, that’s fantastic. And even with with data or a video like that, you

could potentially even scaffold that with various AI components. You know, I mean, we’re just kind of getting started with that. It’s like the AI thing, like in VR, there’s obviously these use cases for it. But once you’ve got that video content, you can feed that into some of these AI platforms to get summaries and transcripts or even like, I want it to be like this, but I want to change where this person is standing, you know, and feed it into one of those generative AI video creators. And it just will make that change for you. You know, I mean, it’s just all the things that we’re going to be able to do. It’s like AI not replacing the instructors, but supporting and scaffolding and building tools that help the instructors leverage those resources that you can create with Acadicus. For what it’s worth, Dream Machine is the video one. If anybody hasn’t tried working with Dream Machine yet, it’s pretty incredible. Let’s see, is there anything left unsaid that we haven’t talked about? We’re getting ready to move on with our Friday afternoons.

Mitch Luker: I’ll just share that Jamie and I got invited to do the presentation we did at IMSH on Excellent. They reached out. So our little movie that we did at NWTC is going to now get shown to everyone who watches that video on So we’ll be spreading the message of Acadicus. and open our in, um, to a really large, um, set of people. So it’s exciting that we’re going to, we were working on getting scheduled with them to go in and do that as a CE and CME for, uh, their platform. So.

Jon Brouchoud: That’s fantastic. Let us know, and we can share and broadcast that, but everybody know. Yeah,, if anybody who’s watching hasn’t checked that out, definitely. I feel like everybody that’s in simulation probably already knows. But Lance Bailey, it seems like he’s like five people. It’s just tirelessly working on promoting simulation in all different ways. So really cool stuff. Feeling a little bit bad we missed Inaxle this year. I think it’s happening right now, I believe. Last year, I had a really good time in Providence going out to Anaxel, but this year we decided not to, but maybe next year we’ll be back. Yeah. We’re calibrating our budget carefully. We’re being an organic, an organic company. It requires sacrifices, unfortunately, sometimes. So we’re being very, very strategic and capital efficient so we can stay as focused on our customers as we can. But sometimes that means not being able to go to every single conference. Well, I also want to mention we have some pretty exciting or an exciting promotion that’s going to be coming up. Unfortunately, I can’t share details at this point, but it’s in the works. It’s coming. And I think we’re going to be able to offer some pretty exciting promotional opportunities through the summer. So if anybody is still paying attention during summer in these schools that wants to potentially explore new software, get in touch because you could get a great deal during the summer months here.

Rick Casteel: And we even have a new code cart we can throw into the deal, right, John?

Jon Brouchoud: There you go. It comes with a code cart. You’ve seen it here. Sign up now, get your free code cart. There you go. Saw it first on Simulation Pulse Live.

Dr. Nick Slamon: And coming this fall, an ECMO simulator, fully functional.

Jon Brouchoud: Oh, that sounds interesting.

Dr. Nick Slamon: You never know.

Jon Brouchoud: I may or may not be familiar with that project. is in the works.

Dr. Nick Slamon: Coming to an Akatekis studio near you.

Jon Brouchoud: That’s right. We’re going to have to dedicate an episode of this to that simulation for sure as soon as we get it done. A lot of exciting stuff.

Dr. Nick Slamon: I’ve already warned Dr. Callback to get his hair and makeup ready and star in that one.

Jon Brouchoud: Cool, cool. That’d be great. It’d be great to have him for sure. Cool. I guess unless there’s anything else, we could wrap it up early unless there’s anything anybody else wants to share any ideas or thoughts or news or anything at all. Well, let’s take the next 10 minutes and give it back to our Friday afternoons. Thanks for joining everyone. We’ll see you next Friday. Friday at noon central. We’ll see you then. Cheers. Have a great weekend. Bye, everyone.

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