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Beyond the Basics: Leveraging VR Assets to Create Problem-Focused Simulations

Episode 42: June 28th, 2024
Hosted by Bill Ballo, Rick Casteel, Mitch Luker, and Jon Brouchoud.

Key Highlights:

 

Virtual Simulation at NWTC

  • Mitch Luker shared exciting updates from NWTC in Green Bay, particularly about their first week of Blood Administration VR. Despite the long hours, the initiative has been well-received by students.
  • Student Engagement: Mitch discussed the flow of the VR lab sessions, which include pre-briefs, assessments, and debriefs. Students have shown a strong preference for VR simulations over traditional Sim Labs.
  • Curriculum Integration: The VR scenarios are integrated into the third-semester advanced skills course, focusing on blood administration—a high-risk skill that students cannot practice in clinical settings.

Customization and Flexibility

  • Scene Configurations: Mitch emphasized the flexibility of Acadicus, allowing for the creation of multiple scenarios within a single setup. This adaptability is crucial for tailoring simulations to specific curricular needs.
  • Student Feedback: Mitch collects feedback from students to continuously improve the VR scenarios, ensuring they meet educational needs effectively.

Quiz and Assessment Innovations

  • Rick Castille introduced innovative uses of Acadicus for creating interactive quizzes and assessments. These tools are designed to engage students actively, enhancing their learning experience.
  • Branching Scenarios: Mitch highlighted the potential for creating branching scenarios, which are particularly relevant for preparing students for the Next Generation NCLEX.

Community and Content Sharing

  • Content Exchange: The episode also touched on the importance of sharing content and scenarios within the Acadicus community. This collaborative approach can significantly reduce the time and effort required to develop new simulations.

Future Prospects

  • AI Integration: The discussion included the potential for integrating AI to enhance scenario development and create more dynamic learning experiences.
  • Upcoming Guests: We are excited to announce that on July 12th, we will have a guest from the U.S. Army to discuss their innovative use of Acadicus for training.

Practical Tips

  • Video Creation: Bill Balow shared tips on using Acadicus to create engaging video content for lectures and tutorials, emphasizing the ease of use and the ability to repurpose content across different platforms.

In summary, this episode of Simulation Pulse Live showcased the transformative potential of VR in medical education, the flexibility of Acadicus for creating customized learning experiences, and the importance of community collaboration and feedback. Stay tuned for more exciting developments and guest appearances in future episodes!

 

Full Transcript

 

Jon Brouchoud:  Welcome everyone, episode 42 of the Simulation Pulse Live, Fridays at noon central. We have Rick Castille, our customer experience specialist joining us today. We’ll have Bill Ballo coming from Madison College, potentially Mitch Luker, and of course, Mitch Luker from NWTC. It’s really dark in here. I was going to say, whoa, you are getting some weather up there in Green Bay. Yeah.

Mitch Luker: With it being hot, I pulled the blinds down and I never reopened them.

Jon Brouchoud: Well, thank you for coming. Thank you for being here. Thank you for everything that you’re doing to keep moving the ball forward with virtual simulation and pretty exciting, ambitious stuff that you have going on up there at NWTC in Green Bay. So it’s always great to hear about that.

Mitch Luker: But we just finished our first week of Blood Administration VR.

Jon Brouchoud: How did that go?

Mitch Luker: It went really well so far. I’ve got one more day on Monday. So I’m a little tired today because I’ve been doing 12 and 13 hour days of VR simulation with students. Oh, wow. For four days.

Jon Brouchoud: So I’m a little tired. I can imagine.

Rick Casteel: How many students are you cranking through, Mitch?

Mitch Luker: Um, this time it’ll be 43. Wow. So, and we’re doing, uh, two and a half hours at a pop.

Jon Brouchoud: So how does the flow of that go? The students show up and, you know, how did they, what was the precursor to getting into the VR lab to do the simulation? And then what’s the follow-up afterwards or kind of what’s, how does the, how does the, from a like a curricular perspective go, how does that work?

Mitch Luker: So in our curriculum, we have a course in our third semester called advanced skills. And one of the competencies is blood administration and blood administration is one of those things that students cannot touch at all in clinical. They’re not allowed legally to touch it because it is a very dangerous and high risk skill. So one of the we had a checkoff for it, but the checkoff was literally students just standing there reciting what they would do because we couldn’t afford to buy blood bags. They’re really expensive. Not with. blood in them or anything. It’s just an empty blood bag is like a hundred and something bucks a piece. And so when you talk about buying one for every student, that’s that’s only if you buy one and then they are not really easy to reuse. So so we kind of took that out and we made this quiz and actually I wrote the quiz when I taught the course and it’s a really hard quiz and students don’t score well on it. And I felt guilty about it ever since. So I I worked with our faculty that are now teaching the class and we developed the VR scenario. So we had a case study that we would have students do to help them prepare for the quiz. So I took the case study and I turned it into virtual reality. And then, so now the students come in, they sign up for their times. We use sign up genius for them to come in and get their time slots allotted. And I do anywhere from two to six students at a time because it’s a three phase scenario. So they come in, I get them in the tutorial. We go through that. Then we pre-brief on the patient a little bit. And then we work through the assessment of the patient to determine if blood is safe to give. And then we take, we have like miniature debriefs in between each phase. So then we chat for a little bit about how do we know what’s appropriate to give the blood? What would that look like? And then we go into hanging the blood. And then we have another debrief. And then we have management of a transfusion reaction. And then we debrief again. So it’s broken up into three phases. And So I spend two hours with the students and then that extra half hour is kind of last minute questions, whatever they need. And then me turning over the lab, meaning cleaning headsets and resetting the lab on my stations. And that way, then I can run it for the next group.

Jon Brouchoud: And how are their students’ reactions to it?

Mitch Luker: I’ve had a lot of really good stuff so far. One of them said, can we never go to Sim Lab again? I’ve had students being like, why don’t we learn like this for everything? And I’m like, I’m trying. I’m getting there. So, I mean, they’re loving it so far. They really enjoy it. So, their quiz is due on July 7th. So, I’m anxious to see how our scores change. Because normally our average is right around like a 75% on this quiz. And 80% is our cutoff for being successful on it. And so I’m really anxious to see how our students do.

Jon Brouchoud: Yeah, me too, me too. I mean, this is just basically, this is the whole thesis of what it is that you’re trying to do with VR simulation, where, you know, it’s not about identifying, we’ve talked about this extensively, but like, it’s not about identifying an existing product that you implement and it does it, you know, one thing, one way, the way, you know, the one curriculum, because chances are you probably can’t find an existing simulation. And even if you can, it’s probably not the way you do it. It’s not the way your school teaches it, the way you teach it. So you’re getting that, you know, so you can’t really do it with, you know, any other way. So you’re taking a product, you’re building a simulation to support a specific problem or an area of need in the school. And I think, Rick, when you’re meeting with prospect customers, that’s one thing you’re looking for is like, what is the pain point? Like, what’s the issue you’re trying to solve? We don’t want you to buy Acadicus because it’s a shiny new thing. We don’t want you to buy Acadicus so that you can put a picture on your website of somebody wearing a headset and say, look how innovative we are. We don’t want people to buy Acadicus for that reason. But if you’ve got a problem, if you have a pain point, that’s an area that’s difficult to teach for whatever reason, And you can create a virtual simulation, and you can make a difference in the outcomes using that virtual simulation. That’s the goal. That’s what we’re after. So that’s a perfect story. I just love the blood transfusion use case here. It’s something that we didn’t develop that, right? Acadicus didn’t say, let’s do a blood transfusion and build content to support. You’re using existing assets that are already in the library. and you’re recombining them in an interesting new way and doing something that’s solving a problem. So I’m really excited about what you’re doing there.

Mitch Luker: It’s been a lot of fun and no, yeah, I built everything. I built it as three different scenarios in Acadicus even so that I don’t have to go in and make a ton of changes and do this and the other. I have blood admin one, blood admin to blood admin three. And so then whenever we switch between phases, I just click and then the new assets are already in the room. The only thing I have to do is set the pump to the rate that they set the pump to. But I can do that in non-VR mode. So I don’t have to be in edit mode or whatever. I just go in and before I load them in, I go over, I move my little avatar over, I click on it, I drag over the pump setting to be where they had it at. And then I just scoot away and I do it all in ghost mode so they can’t see me in the space. Yeah, that’s literally, I changed that. And then the oxygen level that they had it set at, because we let them make the mistakes. Like when we were doing this over the past several days, I’d have students who would start the blood off at 150 mils per hour, which is a big no-no. You’re supposed to start really low and slow. And so, but I let them make the mistake. And then we talk about it afterwards in that debrief time about, okay, let’s talk about why you made that decision. They’re like, well, because we said we have to get it in in this amount of time. And so we made that decision. I’m like, okay, but let’s talk about the risk of transfusion. And if we put that much in that fast, how much more severe is that reaction going to be? And so they actually get to walk away. Like they get to have that mistake moment, but it’s in a safe environment. It’s not a big deal. And so, and if they had the pump really cranked up, then I make the reaction that much more severe. I just go in and make a few changes to vitals. And then we’re good to go. And so like all I really ever have to change is a couple things on slider bars. It takes me literally minutes. And that’s if I’m being sluggish to make those changes. And I can literally tweak and make it fit what my students did in the previous phase of the simulation. So I can customize not only the scenario, but then I can customize it to the student group that I’m working with in the moment. That’s invaluable.

Jon Brouchoud: Yeah, absolutely. I want to just take a little bit of a step back. First, I want to welcome Bill Ballo, Madison College. Bill is here. And we have Johnny Neist joining from Medical College of Wisconsin. Super glad to have you here. If you don’t mind being promoted to a panelist, and you are welcome to, I’m not going to just force that on you, though. I know you want to, a lot of people just come and they want to lurk. And I’m like, here, now you’re a panelist. But so I just wanted to kind of take a step back a little bit, you know, just because some people I think watch this asynchronously and they may not know what we’re talking about in terms of, you know, how are you doing this? What is this? What is this like? So you have a lab and Acadicus and in that lab, you can create scene configurations. So you’re going into a private lab. This is your, you know, NWTC has a lab and it’s not stuck to being one environment, right? You can change that lab. It’s like a holodeck. You can change the environment and say, we’re going to be in an ICU. We’re going to be in an operating room, whatever you want to do. You can change the environment, set up the scene. And we’ve done some examples of that in past episodes of The Pulse where we’ve actually gone into headsets and moved things around and edited scenes. But you save those configurations into your lab as a scene and And then you have the option of using 3D recordings if you want to, you know, have a demonstration or a lecture, or you can go into, like you said, ghost mode, which means your avatar disappears. We’ve also demonstrated that in past episodes. So your avatar is invisible to the learner, but they’re in there interacting with the patient and going through the scenario. And you’re sort of like using those various aspects to be able to achieve these outcomes. And it’s a bit of review for anybody that’s already been here before, but sometimes people are like, wait, what are you talking about? Like, how does that work? What do we do? How does this, how can we use this? So that’s kind of the basic idea there is you get a lab and then you get all the content that you can use in that lab to create those scenes.

Mitch Luker: Yeah, I’ve made about 60 so far.

Jon Brouchoud: Very cool. That’s a lot.

Rick Casteel: And one of the things that this opens up that that we want to see grow is this chain exchanging of of scenes and information across the community. Right. I mean, you know, obviously, Mitch is doing this. I’m sure there are other folks out there who would just be jumping at the bit who didn’t want to do it from scratch. Right. Mitch has already done it. And even if it’s 80 percent what somebody else might want to use, right, you’re 80 percent there. You know, other folks will always, you know, if Bill got it, he’d probably tweak a few things here and there for his organization and be off and up and running. And, you know, that’s that’s one of the great things that I think about Acadicus that that you’re able to do. You know, Stephen sent me a couple of scenes today. Right. And I just uploaded them and I’m ready to roll with them. I know. So this exchange, you know, of content is is not rocket science.

Mitch Luker: Yeah. All you gotta do is give someone your lab number and they can go in and drop in whatever you’ve made and then they can tweak and change. And, um, and like, I’ve been using the image viewer because that’s how I have the chart in the room. Image viewers up on, I have it on the wall and that has their marks. I made it as a slideshow. So it has their Mar, it has their, uh, report information, their labs, everything is in there. So that way then they can just click through the slides and they can see all their chart information. But then if Bill wanted to use it, then he would literally just go in and he could go in the image viewer, take out those images, put in his, and then he has his new chart to be his case study. And if he didn’t want to use Millie and he wanted to use Vincent, he could swap out Millie and Vincent and a whole new thing, or I mean, yeah, and you could even take that scenario and like, I just have my med surge room, which is just a generalized med surge room that just has like my patient and all the normal assessment tools, because then all I change is the vitals and the settings on the patient. And I can make, I do a scenario with students where there’s a potential of six different diagnosis they might see. They get no report on the patient. They have to come in and do an assessment and determine which one of the diagnosis they think it is. And I use the same patient, same room. I just reload it and I just go through and I change the vitals. I give them edema. I take it away. I change the lung sounds, heart sounds. And so one scenario is giving me or one room, one setup is giving me six different scenarios to run.

Rick Casteel: I like that. That’s awesome.

Jon Brouchoud: You know, I know you mentioned about having the, the sort of quiz has the, and you may be already kind of talked about this and I missed it, but like, so are students actually doing the quiz in VR or are they preparing for the quiz?

Mitch Luker: That’s preparing them for it. So it’s getting them ready to take a 20 question quiz. Got you. Got you. And so, um, and it’s what we do to measure their competency in blood administration.

Jon Brouchoud: Okay, okay, because I know Rick has been talking a lot about the possibility of or in actively developing these quiz kind of environments with Acadicus. And maybe you can talk a little more about the thinking behind that and kind of how that works. But basically using VR to to do a quiz. Now, we don’t have the ability to export out that data to an LMS or anything, you know, usually schools want to have control over that. But it gives you the ability to like, you know, maybe practice or just take some follow up questions. It’s not necessarily the exam, but it’s a way to be able to have like, OK, you’ve done this experience now. Check your ability. You know, how much of it did you retain and to be able to take that asynchronously?

Mitch Luker: After Rick showed me that, I started working on them and I’m calling them my learning adventures.

Rick Casteel: Yeah, yeah. And it’s it’s really exciting. I mean, it’s like one of these little pieces of asset that it’s kind of been hanging out there and you see it and you never pay attention to it. And then suddenly this light bulb goes off one day and you’re like, well, I can use this a hundred different ways. And I just started kind of playing around with how could I use this? And and so I made this little quiz room. Let me let me share the screen, I guess. Right. And this is just again, it’s very rough. But it was it’s my kind of mastermind work area about how can this be used. Right. And and Mitch had mentioned using the image viewers. And if you look at this, I mean, this slide is just it started out as a PowerPoint slide. And so this PowerPoint slide can be and contain any kind of information you want. Right. It can be a graphic. It could be text like we have here and and then these little true false assets are in our library and you’re able to use them again in in 100 different ways you can see in this case right it’s it’s just a true false right and you can see right we get this correct and incorrect feedback based on you know our understanding of of the data being presented really Simple and easy. And this is just another one. It’s kind of like a multiple choice. Right, John? I had to put our Acadicus, Al, in here, right? I love that. That’s great. So which one is it, right? Again, really simple. But it’s giving that, it works on a couple of levels. One, the student is having to interact, right? And then they’re getting that immediate feedback that they understood something or not. And again, this asset can be plugged in almost anywhere. You’re able to make these slides based on the data or the images you want to bring to bear. And then you’re just adding in this asset that it’s correct or incorrect. And then this was another one. Bill, this is for you. The mass casualty matrix. And this is one using our pen system. And again, it’s this interactive ability. And I think that helps get at what Mitch is looking to do, is raise these scores. I’m just not mindlessly reading or watching a PowerPoint or trying to absorb a ton of text data. I’m actually kind of interacting. And it’s just simple. Use the matching color pen to connect the tags to their description. They can come in here. They can grab the pen, and they connect the tag with the right description of the tag. And then using a little bit of hocus pocus, we’re using our recording feature here and our ability to hide things. And all we’re doing is unhiding stuff during a recording, and they’re able to pop the actual correct answer out. And so they have an automatic check, hey, did I get that right? And if I didn’t, well, what’s the correct answer? And so this is really simple to do. And then another method over here, right, is taking some of our 3D content, right? I took all of our digestive system organs here. And then I just made these little tags. And again, a very simple process. Grab the tile and place it on the arrow connecting to the named organ. And they go through this little process. Let’s connect it. And then again, very simply, let’s show them a diagram of what’s correct here. But again, it’s that interactive learning process where I’m just not trying to shove more data in my head. I’m actually problem solving. I’m working in a spatial environment. And I’m actually manipulating something. And that makes a difference when we talk about being able to retain data in this kind of manner. And then this one is just what I think you were describing earlier, Mitch, with Millie. And again, just using an image viewer, give them a really short, brief little description. Hey, Millie’s a 57-year-old patient who presents with shortness of breath, nagging cough, feeling tired, use the stethoscope to assess her lungs, and then select what you find. you know, very much like Mitch was saying. So they can come in here, you know, they can put that on there. But they can listen, you know, they have to do a full assessment, and then they can decide, you know, what are they hearing? Now, which is what Mitch was saying, right? We’ve already got Millie set up with a certain set of conditions, and we’re asking them to find it and to validate that they found the right thing. And to Mitch’s point, and this is what I love, Millie’s my favorite, I love Millie, you know, you can set Millie in a hundred different ways in regards to their assessment capabilities and what you want them to find. So, you know, this thing can just be repeated. Like Mitch said, you can have 10 rooms with 10 Millies and it’s, you know, cardiac sounds or respiratory sounds or neurological symptoms or edema or skin breakdown or you know, what do you want them to find? And it’s that process of just validating, yep, did I get that right or not? So this is just a, you know, a brief, brief view. You know, I put this together at, you know, a couple of hours one afternoon playing around because I wanted to experiment and give folks ideas about how with these few simple little assets that are included in their library, along with their own content, right? you can do so many different things that are going to engage learners as they’re learning.

Mitch Luker: And on top of that, do your lecture that way. So you can record, like you could have your PowerPoint slide from your lecture and you could pop that in there and you could have Millie in her bed and you could be talking about like, Oh, with CHF, you might be hearing crackles in the lungs and seeing edema on the legs. And the students can grab the stethoscope and listen as they’re listening to you talk about it. And they can check for edema. They can do those things in the moment. So instead of just listening, they’re actively engaging in the lecture part of it by using that 3D recording.

Rick Casteel: It’s just so many things. In fact, Mitch, you’ve given me an idea now for because I’ve started to work on quiz room two. Right. I just want to kind of keep continuing this. It’s just idea generation. Right. And hopefully that people can take this and run with new so many other different things than what I’m showing here. These are just kind of brainstorming examples. But then somebody might see this one slide and go, oh, well, that would be perfect for. You know, which one is the diseased organ and which was the normal organ or which one is, you know, This or that. And again, it’s just that level of engagement that you can get using a few of these simple tools in this 3d environment.

Jon Brouchoud: And it’s been fascinating to see how well received this is. I think I’ve heard from several customers that are saying, boy, have you seen the thing Rick is working on with the quiz lab? And I think it’s really exciting, too. And I think, you know, one of the things that I brought back to Rick was, you know, this is great. But, you know, when we do, you know, sales presentations, you know, we have all these like you know, pre-built scenarios that we created, like the lumbar puncture and the Foley catheter for the male and the female and the EKG scenario. And these are all sort of programmed that teach, you know, how to do the scenario. And then we have a 3D recording of an SME that teaches you how to do it. And we spent so much time and money building these scenarios. And I’m just thinking, like, that’s really the the great, you know, the thing we should be celebrating. And, you know, and they’re very, very valuable for what they do. But I think what we run into is like every school is like, yeah, just that’s pretty close, but I want to do it a little differently. I want to try it this way. I want to do it that way. And the amount of enthusiasm and excitement about the ability to create quizzes like this has just been a real eye opener for me. I think in the whole development team, we’re like, whoa, this is this is really a pretty key feature that people are looking for.

Mitch Luker: Well, and the other thing is you can make it branching scenarios, which is a big part of the next generation NCLEX, because your answers can be holocrons. And then you select the answer on the Holocron and that Holocron where it said, like, go to quiz room two, you could make that your answer. And then that could pull you to, like you’re saying, like, let’s say you have a patient who is having trouble breathing, dah, dah, dah, dah, dah. And you choose, I’m going to apply oxygen. You can make that pull to a room then that the patient has O2 on. And then there’s another question there for you. And as you answered that question, so let’s say that they, and if they choose maybe that they’re not going to apply O2, that they’re going to do cough and deep breathe. Well, they can select that room and go into there. And then there’s a patient now who’s desatting and having problems, you know, to try to urge them like, okay, put the oxygen on. And so you can actually make those type of branching scenario questions. which is very pertinent for Next Generation NCLEX as students are getting ready to take that exam. And so you can literally start mimicking with this different types of Next Generation NCLEX questions on your own. You don’t have to have other software to do it for you. You can do it right in Acadecus. And it doesn’t cost you any extra money.

Jon Brouchoud: Yeah, that’s fantastic.

Rick Casteel: Yeah.

Jon Brouchoud: Well, and it’s also potentially a way to integrate. Everybody’s, I’m sure, tired of hearing about AI at this point. It’s around every corner. But one of the things I’ve been doing with Bill, Bill, a while back, built a whole bunch of scenarios for paramedic training. And we still have all these scenarios. And we’ve been thinking about different ways to promote them and to share them and make sure people are aware that they exist. What I went in and I just started taking these scenarios and feeding it to chat GPT and saying, create an image of this patient, you know, and then here’s an image. And it basically like one of the scenarios was this patient just fell down the stairs and they hurt their head. And now they’re sitting on the bottom step and you arrive and there’s a little bit of blood on the floor, whatever the scenario is. And you just give it the scenario and say, create, you know, a series of images. And sure enough, there’s a guy sitting on the bottom step. There’s a little blood on the floor and he’s hurting his head. you know, and it just helps kind of walk you into the scenario a little bit. And I think, you know, even in terms of, you know, um, extending or augmenting the scenario with different things, or, Hey, here’s a scenario, create a quiz for me, you know, with, you know, 10 different questions. And of course you have to go in and you have to make sure that those are accurate and aligned with what you’re actually after. You can’t just trust the AI to do it. You have to go back in there, but it’s a great way to get a, a start on it. And then you go back in and edit, import those quiz questions into one of Rick’s quiz scenes. And, you know, you’re really, you know, harnessing AI to pull into a whole new dimension of possibilities that we just haven’t really seen before.

Rick Casteel: It’s really exciting. Yeah.

Bill Ballo: Yeah, I’ve been just, you know, every couple of weeks or something, just writing another scenario, just putting another scenario. And just because I know at some point, you know, right now, EMS is is is a little behind on it as far as I’m concerned, but that’s a personal opinion. But but I know that that’s going to change. I know that that’s going to change. I know that EMS is going to is going to kind of catch up and catch on. And they have like, you know, at Madison College, When I had left EMS back in 2020, I sort of took virtual reality with me, so to speak. And, you know, nursing has picked it up, and other programs have picked it up, and EMS didn’t quite pick it up as much, but that’s changed. That actually changed this past month. We did clinical scenarios with EMS, and on Monday, we’ll be doing more clinical scenarios with EMS. So we have four scenarios and and they the students go in pairs of two and I guess you can’t go in pairs of anything else, right? They go in groups of two. And they work through the scenario. They’re relatively short because with EMS, it’s a little bit more about we’re cutting to the next scenario, we’re cutting to the next scenario, which is why if you look at the scenarios that I’ve written out, they’re all relatively short. They’re pretty short and sweet. We’re looking for you to recognize something. We’re looking for you to do something. And then we’re looking for you to realize that, you know, there’s, there’s, there’s more that needs to be done and, or, or there isn’t more that needs to be done. And do I transport the patient? Do I not transport the patient? Those kinds of things. So, and, and, you know, I just, every once in a while, I’ll just write another scenario, write another scenario, write another scenario. And I’m just holding onto them because I know EMS is going to get there. I know EMS is going to get there. And, you know, It’s going to happen. It’ll happen when I least expect it, so to speak.

Jon Brouchoud: certainly a great need for it. I hear from, you know, various paramedic programs, you know, I’m still under, I’m still growing to understand kind of how those programs work, what the size of the programs, what are the pain points that they have that we can help address? And how do we articulate a message to help educate them about this, uh, about the potential. So still kind of learning about how to go to market for paramedic applications. We have so much content for paramedics in Acadicus. It’s just, it’s difficult to figure out how to, how to fight. Cause they tend to be, you know, we, we talk to a lot of programs that are, very, very tiny, you know, rural, you know, programs and they, you know, largely they need it the most, right? They don’t have access to high fidelity simulations for the most part, but this is a way that it could be more affordable for them. So we just really need to articulate that message better, I think.

Bill Ballo: Yeah, I’m, I’m doing some grassroots sort of on my end you know, speaking to everybody I know in in EMS and, and, you know, promoting it and even if they’re kind of like I don’t know that’s not really the thing we need right now. I’m still, I’m still putting it out there I’m still making sure that that. that they know that those kind of things are available, and that we are talking about high-fidelity simulation. We’re not talking about things that they’ve tried before that they didn’t like, because they do get a lot of that, where they’re like, well, we tried virtual reality, and we didn’t really like it. I’m like, what did you try? And then when they tell me, okay, yeah, yeah, yeah, yeah, there’s some issues there. So check this out, try this out. Just this past week, we had a bunch of nursing leadership come in and I had them all trying to birth a baby. Which was a lot of fun. We had nine of them. I had nine of them in at the same time and and All nine of them was great. They were like running around. I don’t do this. This is not my thing I don’t know what’s going on and you know, and then eventually they did birth the baby but then they forgot to cut the cord and so they had the baby over on the isolate and the poor cord was all the way back to the mom and I was like Somebody’s got to cut that cord, you know So and just to just have fun in there and then apparently they were just raving after that to the instructor about how great it was. So I think the key is, and it’s true with EMS, it’s true with anything, is to get people in the headset. You’ve said that multiple times, John. Get them in the headset, have them check it out. Once they do that, you get the, oh, moment. And that’s all I need.

Jon Brouchoud: Absolutely. Well, in a lot, some of the videos that you created that were, you know, tutorials, you know, you had created the skeletal anatomy and some of those, you know, just kind of recorded lectures. And I think Mitch had mentioned in the past using screen capture to just do a video of what those and put them, you know, or maybe you mentioned that. and you put them into your LMS as a flat screen, but you’re using Acadicus to generate that, those videos on the Acadicus channel are getting huge numbers of views. Like people are searching for that to find, you know, whatever COPD, whatever thing that you were talking about in that scenario. They’re very popular. So there’s this like spectrum of fidelity, right? The easiest way to get it is just watch a YouTube video asynchronously, but then obviously you can go all the way over to high fidelity, interactive, facilitated, multi-user simulation, but you can do all of the above. you know what like what Mitch was mentioning too about teaching in their class and actually having you know a screen up where you’ve got a patient in there and you’re in Acadicus you don’t need a whole VR lab to even do that you need one station essentially and okay here’s our patient what should we do and actually interactively doing things versus just looking at a powerpoint there’s that whole that whole spectrum available there so many possibilities.

Bill Ballo: Yeah, absolutely. And it’s more fun. And, you know, it’s more fun for the instructor, it’s more fun for the student. And then I have all of the videos from TikTok that at this point, are relatively ready to go on to on to YouTube. So you know, that’s the other thing is, I mean, I had I don’t know how many I’ve gone through over the past couple of months, just to make sure that they look the way I want them to, I had I don’t know, 30 or 40 of them, something like that. So, and yeah, that’s what I do. I mean, I go in, I create the lecture in Acadicus, you know, do a 3D recording. And then I actually, I use So I go in non-VR mode, in viewer mode, and I use that as the cameraman, because I like camera pans, and I like movement and stuff like that. And obviously, I can do it like a three-camera shot, where I set up a camera here and a camera here. And then I can record it from this position, record it from this position, record it from this position. But that also makes me do a bunch of editing in the end, because I like to edit anyway. that just makes me do a bunch of editing in the end. So if I just use my non VR as the camera, my non or my viewer mode as the camera and just move that camera and hit screen record, I use OBS studio. It’s one of the easiest ones to use. I just hit a screen recorder. I’ve been doing that now for a few years and it’s fun, it’s enjoyable and it’s a good way to do lectures. And then you have that lecture, created. I have stuff that I was doing before I got into virtual reality from 2017 that I just gave to a student the other day and said, hey, here, you need to go over these. Because I tutor students at Gateway Tech. And so I said, here, go over that. Watch these videos. This will be good for you. And it’s from stuff that’s 2017. So a lot of this stuff doesn’t make major changes. And that’s the same with your VR videos. So make the VR video, make the video, you know, go in there and do your recording, make the video. Don’t worry so much about your flubs and all of that kind of stuff that happens, you know. And then if in the end, if you want to edit some of that out, you can. But honestly, I just I I do it straight from the hip and and I just talk just the way I do now. And if I have some ramblings or something like that, hey, it is what it is.

Jon Brouchoud: And your TikTok account is VRparamedic? The virtual… The virtual medic. The virtual medic, that’s it.

Bill Ballo: Or the VRmedic, the VRmedic. The VRmedic, yep. Yeah, the problem is, is that I forgot because I had laid off of TikTok for a while. Although that’s going to change because as you mentioned, John. So one of the things that John and I talked about in the early days of doing TikTok videos was, you know, every time I would say to an instructor, oh, I have a TikTok, you know, channel, they’d go, oh, I was like, well, come on now, don’t think of it that way. And and John, John and I had talked about that. And he’s like, well, yeah, but that’s not really for the instructors. That’s for the students. That’s for students who are like, I have a question. And here’s this guy doing virtual reality. And wait a minute, why isn’t my teacher doing virtual reality? And that kind of opened my eyes to that. Because when you say TikTok to some of the teachers, they’re like, uh-huh. So what I wanted to do, though, was I wanted to try to mirror the TikTok channel that I’m coming back to because I had abandoned it for a little bit. But I’m trying to mirror that then on YouTube so that when I go to an instructor and say, I have a YouTube channel that they’re way more accepting of. But but then the the content also comes from the TikTok channel, because I had one student say, like, what happens in a heart attack? And I’m like, oh, Yeah. And we have a vessel environment. And so I took a bunch of garbage bags into a vessel and just kept copying garbage bags and putting them all against the walls and talking about how, oh, this is all that plaque that starts to build up. And it was just like, I don’t have plaque that’s in there. It’s not perfect and beautiful, but it’s exactly the way a student would want to hear it so that they’d remember it.

Mitch Luker: And that’s one thing I’ll add on for bills there. I think whenever you’re doing this, it’s important, whatever you build to get feedback from your students. And like, so I have a survey at the end of every scenario, students have to do my survey. I don’t let them leave the room until they have scanned my QR code that is stuck up on the wall. And they do that because I don’t get their perspective. I’m not a student. I’ve been nursing for over 20 years now. I, my perspective is vastly different than theirs. So it’s really important to be open-minded about making changes to whatever you build and make it more laid back and more relaxed. And, um, I tell my students the whole time we were doing blood this week, I was like, please be wrong. Take a guess. If you don’t know, cause you’re actually probably right. You just don’t think you’re right. And, but then getting their feedback on the backside. And, you know, I, I talked to him about what does constructive feedback look like? Because sometimes they would just be like, I don’t like it. And that’s all you get. And I’m like, well, that doesn’t help me any at all. But asking for that constructive feedback about, you know, what would help you as a student? What do you need from this that I can give you or build for you? And I mean, I’m constantly going in and tweaking things because of things students will tell me. And that helps me then to make sure that I’m giving them what they need. And so like Bill said, sometimes you have to get a little creative and trash bags or Jamie at Western, she didn’t have a burn patient at the time. So she took the red marker and she just colored the burns on the guy. Um, and so I was like, genius move. And there’s times you just have to, you know, but students don’t care about it being perfect or looking perfect. They care about, are they getting an understanding of the material? And so you do what you do and you just get creative and figure out how to make it work. And then it’s awesome because students love it and they love the flub because it lets them know you’re a human being as well. Because sometimes it’s that. your instructors are scary and they’ll eat your liver with some fava beans and a nice Chianti like they’re get very terrified of their instructors and letting them see you flub and have those errors. It’s wonderful.

Rick Casteel: You know, that’s amazing. It’s interesting. It’s like I call it the the Minecraft syndrome, right? You look at the game Minecraft. My grandkids love playing Minecraft. It is this blocky, low res, you know, kind of, you know, it’s not about like the best graphics and the most interact. They just get in there for hours and they’re they’re chopping away at the scenery and they’re running around and jumping off the top of trees. They don’t care that it looks like stuff we played back in the 80s, you know, when Nintendo first came out. It doesn’t matter to them, right? It’s this is creative. place, right, that really just kind of opens their brain pores or whatever, and allows them to kind of just experience things. And, you know, I find Acadicus can be like me, we have some high res stuff, certainly, right? I mean, IV poles and wheelchairs, and they look like IV poles and wheelchairs. But yeah, if you have to take a marker sometime and say, yeah, this left hand is going to be burned. That works, right? we don’t need to do something elaborate to have somebody understand that we’re representing something. I mean, think about the leaps that we make in mannequin labs sometimes, right? Yeah. This is Mrs. Jones. Why don’t you say hi to Mrs. Jones, right? And they’re talking to this hunk of rubber. You know, so it’s certainly far and away beyond that. It works. It just works.

Jon Brouchoud: Absolutely. It’s funny you mentioned, you know, that use of the markers, you know, because I think, you know, July 12th, we’re going to have a guest from the U.S. Army that is going to be in talking a little bit about some of the use cases they’re doing. And one of the things we saw them doing was using the red marker. to create a burn victim. So there’s a scenario that they’ve created and hopefully we’ll get to check that out and learn a little bit more about their process because they too kind of took Acadicus and ran with it in a direction that I don’t think any of us realized that they would do. And then one day they were like, hey, you know, you can, you know, check out the scene. And it was quite elaborate and quite interesting to see how they had innovated with the existing assets to create the experience that they did. So we’ll be hearing more about that on July 12th.

Rick Casteel: and I’ll put it right out there and I’ll say this again on the 12th, going into that lab triggered everything in my mind that’s in that quiz lab. It didn’t come from us. It was a customer going, huh, what if I did this? And what if I did that? And let me put this here. And then just seeing what they developed and going, you know, light bulbs are going off as we’re going through that lab going, oh my gosh, Why didn’t we think of this?

Jon Brouchoud: There’s a few moments where it’s like, how did how did they do that? Right. Did we spend some time thinking about like, wait a minute, how is this even working? How did they even do this? And we had to kind of like dissect it a little bit, like, oh, I see what they did. They put this thing under here and there’s one of these. And that was really cool.

Rick Casteel: Absolutely. Yeah. I mean, and there’s even some really engaging and numerous interactions with the recordings that that has made me start again, kind of doing some things with my recordings that I think, again, are just more engaging and capture the imagination and just kind of standing there lecturing. So, yeah.

Jon Brouchoud: You know, those 3D recordings are a key to a lot of really interesting ideas that we haven’t even scratched the surface of yet because they’re a whole, it’s like a whole new medium, right? Like there’s nothing else quite like it where you can go into an environment, you know, there’s professional motion capture studios that you can spend $10,000 an hour and go in and dress up with all the suits that have your body motion tracked. And, you know, then they have to clean it all up, but this is an easy off the shelf way to put on a consumer headset, go into the platform. and create a 3D recording, but people don’t realize I think sometimes that there’s layers to that tool, right? Because you can, excuse me, you can create 3D recordings from within 3D recordings. You can play 3D recordings while you’re in a 3D recording. You can nest 3D, you know, it’s really mind boggling what you can do with the tool, but because it’s so new, we have no idea. Like we just didn’t, you know, I always imagine like the first time they showed video, you know, like in a theater of a video, you know, I think there’s a famous story, it was like a train coming toward the camera, right, and everybody tried to get out of the theater because they thought it was coming right at them, you know, and it’s just like this whole new medium we just don’t know yet, we just, we don’t know, it’s totally unfamiliar, but as we experiment I think we’ll find, you know, deeper and deeper levels that we can take it.

Rick Casteel: All right, so I have to share, here’s a preview of Quiz Room 2 and just a little thing that Mm-hmm. I don’t know how they expect me to get all this done. Oh, hi. You snuck in through the door there. Well, welcome to the Akatekis Research and Development Department. Inside, you’ll find all kinds of new and interesting things that Acadicus is working on. I hope you’ll take a few minutes to explore, get some ideas for how you might use some of these tools in your particular environment and in your scenes and scenarios, and then reach out. Send us an email. I’ll get it right here. And we’ll contact you and see how we can best help you bring your learning objectives to life. Thanks, and we’ll talk to you soon. It’s just a silly little thing. But I think it draws people into feeling like, wow, I’m really in this space. He’s told me to go in here. And then I’ve got some other things planned that I hope, again, are going to be really fun in terms of playing with our anatomy and models and actually having the voice come out from within the anatomy model. So we’ll see how that goes over.

Jon Brouchoud: Yeah, that’s really cool. Thanks for sharing that. Well, we’re approaching the top of the hour. Is there anything else left on set or anything else we want to cover? I’m trying to mute because I’ve got my dehumidifier running. We had a lot of rain coming in the past few weeks here, so we’re trying to dry out. Apologize for the background noise.

Mitch Luker: We can’t hear when you’re unmuted.

Rick Casteel: Yeah, can’t not not hearing it at all. It’s fine.

Jon Brouchoud: Okay. Okay, good. Good. Good. It’s really loud in my ears. But Well, I guess then that said, we’ll be again, July 15th. I mean, I’m sorry, July 12th. Oh, we’re skipping next week, right? We’re skipping next week. Exactly. So I was just going to say July 5th. Next Friday, we’re going to be skipping due to the holiday. And then the following Friday, we will have the U.S. Army as our special guest here on the Simulation Pulse Live. And then soon thereafter, we’ll have an episode with Dr. Liz Oviyawe from NSU. I’m meeting with her tomorrow afternoon, and we’re going to capture a pretty comprehensive video recording of all the different projects that we’ve been working on. Dr. Liz is very, very special in the Akatekis family, I would say. One of the very first real true believers in what we were doing immediately recognize the potential and just started building and building and investing and building content in Acadicus and it’s been an amazing experience to work with her and I’m really looking forward to having her as a guest so we’re gonna we’re gonna do that asynchronously not as a part of the pulse live. She’s very modest and kind of introverted like I am. She doesn’t really want to be on camera live with people, but she is willing to do so if we’re capturing it in a way that we can edit out the ums and ahs. So that’s mainly for me. I tell her she’s very articulate and good at speaking about this. It’s better for me to be able to edit out my own ums and ahs. But that’ll be fun. We’ll be able to check that out, and maybe we’ll be sharing that video sometime in July. So I guess with that, we’ll just wrap up the episode. Thanks, everyone, and we’ll see you in a couple weeks. 

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