Jon Brouchoud: Welcome everyone to Simulation Pulse Live, episode 46. We’re doing this every Friday at noon central. Today, we have Bill Ballo from Madison College, Mitch Luker from NWTC. I’m Jon Brouchoud from Acadicus. And the reason I started doing that is because that introduces the AI to who we are so that the transcript will automatically have your names associated with it. If you guys are wondering why I started doing that, that’s why. Everybody knows who you are, so. But AI apparently doesn’t, so it’s always getting that wrong. Anyway, we have a great show today. We might keep it a little short, but there’s a first thing I wanted to talk about is Dr. Slamon at Nemours-Dupont Children’s Hospital, one of the first and earliest users of Acadicus and his team of researchers have published a paper. And I’m going to share a link to that paper. I thought I had it open, but apparently I don’t. So I’m going to grab that link and share it. Here it is in the chat so that we have it on the record. Everyone here. Yeah. So you can check out the research there on that page. I found that you can download the PDF and check out the research. So the abstract was essentially during the pandemic, Dr. Slamon and his team were unable to run traditional simulations, much like almost every other organization, you know, people weren’t able to gather around mannequins and sim labs. And so they were looking for other ways to continue doing simulation and helping their, their residents and fellows and other team members grow. So they started doing simulations with Acadicus, but sharing the screen over zoom, which allowed for people to participate from anywhere. So they were able to run, Dr. Slamon and his team were able to run mock codes and have people join in on Zoom. And basically they could run a mock code and delegate tasks to the people that were in the VR scene. And so I think all of us participated in one way or another in some of those simulations. And that work was then assembled into this research paper. And they’re going to be coming onto the Simulation Pulse live as guests sometime later this month. So I’m going to stop there and just save the rest for them to share and talk about their experience with that, what they learned, what worked well, what didn’t work, and what they would do next if they could. We’ll talk about that later this month. With that, I think today, we wanted to talk briefly about running your first simulation in fall. So last week, we talked about things you can be doing to prepare for fall semester during the slower summer months. And this week, we’d like to talk about what should that first simulation be. So you’ve got the VR systems, you’ve got an Acadicus license, what are you going to do first? And just wanted to turn that over to Mitch and Bill. I know that they have some great ideas about what that should be and we’ll go from there.

Bill Ballo: Sorry, I have to be right back.

Jon Brouchoud: It’s all you, Mitch. All right. What do you do first?

Mitch Luker: Well, so, you know, especially for those who are just starting off, don’t overcomplicate things. Keep it simple. You know, we have um, a great, uh, library in Acadicus from the open RN project. And, you know, when you’re getting started, start with something simple. I think the, one of the best ones to start with is hazard identification. And you can use it in a couple of different ways. So there’s one way to use it is you can do it as a clinical experience. I actually integrated into our fundamentals or foundations course where students come during class time and I rotate through all the students in class. So they’ll send two at a time, and I put two in headsets, and then I get the next two in headsets, and the next two, and then we just keep round robinning until all of our students have come through. And then they go back up into class, and they get to have a debate about what was the most unsafe thing they found in the room. So then, and their goal is to help argue using the principles that they learn in class about why something is more unsafe versus something else and see how many people they can get to come to their side of things. So it’s not just going through and being like, oh, look, here’s a bunch of unsafe stuff. OK, but now what’s the what do you do with that information and how do you take that information to the bedside and use it for your patients? And I think that’s a really nice way to kind of also help students figure out how to articulate themselves well and to explain to a patient in the future why you can’t have a bottle of vodka in your room or a pack of cigarettes or why we need to make sure that the trash is emptied and things like that. So it just kind of helps create a conversation. So when students have to have those, maybe more difficult conversations with a patient, they’re kind of used to having to present the argument in a way that helps persuade the patient to do what they need to do.

Jon Brouchoud: I like that a lot. So you’re, you’re combining the VR experience with that live dialogue, which is important because if it’s just, you know, you’re putting the students in the headset, it’s not just going to do it all by itself. It’s more about that. The, the, the creating the conditions for that dialogue, for that conversation to happen, the communication skills, and like you say, the ability to articulate and build an argument for something and communicate that with your, with your colleagues is a really important part of that. What about you, Bill? What’s the first simulations you run in fall?

Bill Ballo: Hey, by the way, my apologies. I have three kids at my house today. And so I am trying to manage that whilst also making sure they get fed and making sure that I’m here today. For me, you know, one of the things that I always want to stress to my faculty when they start using virtual reality is, because a lot of times what we’ll get is, well, does it do this? Does it do that? Does it do, and it’s like, well, wait a second, hold on. I’m not going to teach my student necessarily how to start an IV in virtual reality. that might not quite work out very well. Yes. Find it. That might not work. See, kids. That might not work out very well. So you know, like, I’m not going to teach someone the skill specifically. Okay. And what Dr. Slamon was sort of highlighting there in using Zoom is that virtual reality Maybe you can say, oh, well, they’re not going to feel what it’s like to put in an IV, or they’re not going to feel what it’s like to touch or do an abdominal assessment, those kind of things. But one of the things that we get out of that that can be so much more important is that sort of overall learning, right, of how to run a code. how to work with other people, how to communicate with other people. I think that’s what Mitch was saying when I walked back in, is really some of those skills that, you know, even when they start to go out to the jobs, you know, I know in EMS, We’d have people, you know, our students would go out there and they knew all the skills, man, no problem, knew all the skills. But then when it came to this sort of that interpersonal working with other people, understanding a good assessment, because the skills are great, but if you can’t really assess and figure out exactly what the what the issue is before you get to then what skill am I supposed to do, right? An example of this was when I was interviewing at Madison College, they had me do sort of a lecture portion and that was in my first interview. And then my second interview, I had to come and teach someone how to do a skill. I had to teach the interviewers how to do a skill. And I started off by saying, I’m gonna spend the last one minute teaching you how to do this skill. It was needle decompression for a chest. I had 15 minutes to teach it. I said, but the first 14 minutes, we’re going to go over what we’re doing, why we’re doing it, how we’re doing it, and what reasoning we have to have in order to get to this point where I’m going to stick a 10-gauge needle into someone’s chest. And so I did that, I did 14 minutes on explaining all about the skill, why we’re doing it, what are the signs and symptoms that I’m looking for? What are the things that are gonna trip me up? What are the things that I’m gonna make mistakes on? And then one of the interviewers said, okay, that’s great, but we’ve got like a minute left, you were gonna teach me the skill. I said, I was gonna do it in the last minute. And it took me about 20 seconds to really actually teach you the skill itself, you know, put the needle up straight goes in, this is what happened. That’s it. And in the end, I said, I think I’ve got about 30 seconds left. So Sometimes they get very focused on, but I have to teach this skill, that skill, this skill, that skill. But there’s so much behind the skill. There’s so much behind the IV. There’s so much behind the intubation, behind all of those skills, that that’s one of the things that we really need to be focused on. And I think that’s where VR actually shines.

Mitch Luker: I agree 100% because one of the things that whenever I have faculty who will say like, what can you do for a simulation for me? And there, and then I get the, like you said, the, well, but you know, dah, dah, dah, dah, dah, you know, it’s not this, it’s not, you’re not teaching them the skill. I’m like, that’s not the important thing. And I still remember one of my instructors, Ms. Sarah Ann Gates from nursing school, who during clinical, we were talking about passing meds and Uh, we were kind of being frustrated about the fact that she kept quizzing us so hard on our meds and she was, I mean, that woman went in, she was looking for blood when we were passing meds on that quizzing part. And finally, she just said, I can train a monkey to pass meds, to take pills out of a pouch, put them in a cup and hand them to someone. You need to understand. crucial piece of this, which is what happens when you give that minute? Is it safe to give? And she really kind of went and was like, oh. And ever since then, that has stuck with me about how important it is to understand. And that was why, like when we started to when I started teaching advanced skills. We made them as scenarios so that way the students have to come in and they would have to assess their patient first to determine that the skill was safe and verbalize why it was safe, why it’s okay to do this flush in the central line, why it’s okay to start this IV or give that med IV push or whatever that skill was. They had to understand why it’s safe. And that’s where VR shines is that we’re giving them that opportunity to learn that piece of information and then to articulate it and make it usable knowledge instead of here’s some steps that I follow blindly without thinking.

Bill Ballo: Yeah, I agree. Agreed. And in the early days of Acadicus, when we were dealing with some of the mannequins that weren’t Gen 2 like they are now, where you can do a whole lot of stuff, we had to do a lot of that. Like, why are you doing what you’re doing? Yeah, the skill is great. Tell me what you’re doing and why you’re doing it. And I think in some senses, it’s more important. My son learned at eight years old how to intubate a mannequin. I mean, I taught him how to intubate at eight years old, but is anybody thinking like, you know, he’s Doogie Howser and going to go, you know, there’s an old reference, going to go out and, you know, determine that a patient needs to be intubated? No. Um, you know, he didn’t know all the reasoning why we did what we did. He knew what I told him. Hey, there’s the courts. Hey, this is how you pass it through the courts, that kind of stuff. He got that. That was easy. That was very systematic. And, you know, and, and, and the thing is, is like when he did it, which was great when he did it in VR, cause I’m like, okay, now intubate this guy in virtual reality. And he’s like, oh, I remember this, you know, so it crossed over really well. And then he’s like, well, I can do it, I can put it in there, I can do this. And so the crossover was pretty simple. But yeah, and I think starting out when I’m just starting out with faculty in terms of teaching, we go to the easy stuff, we go to the beginning stuff. Like you said, Mitch, you mentioned the hazard ID for my EMS people. I actually go to the mass casualty. I do. I go, let’s go look at that mass casualty. Because they get it. Because they get it. We’ve been doing that for so long with the little gingerbread men laying everywhere. And you put a tag on them and stuff like that. That’s really easy to get. So all you really got to do is teach them how to teleport and then how to choose. And that’s it. And I find that one to be really good.

Jon Brouchoud: Yeah, in terms of using the simulation to capture the full spectrum in addition to just the skill. When we started building this, we wanted to learn and build on the lessons of existing simulation, but we didn’t want to just simulate simulation. And, you know, when, you know, I’ve had the unfortunate reality of spending an awful lot of time in the hospital with somebody that you love. And when you’re in there, you, you know, I’m doing, I’m obviously studying the environment, I’m taking pictures for reference, and I’m like, kind of geeking out on, you know, the space, the environment, the experience, and you realize that there’s a whole whole entire spectrum of things that happen when you’re in the hospital. And the actual skill is just a tiny sliver of what’s actually happening. And in the all of the other interstitial space is happening, you know, there’s communications, there’s different people coming in, there’s different specialists, and there’s different, you know, things that are happening. And all of that, together is what creates your overall sense of the care that you’re receiving. And, you know, right away when someone walks in the room if they do or don’t have that communication skill or the ability to articulate what’s going on right now, you know, because you’re scared you don’t know what’s happening and, you know, if somebody is really good at communicating and they’ve had that opportunity to practice that. it’s going to be an overall better experience. And so I think that’s really one of the powerful things about VR. And essentially exactly what you’re saying is that you can kind of tease that experience out. So it’s the skill, but it’s also all the other stuff that happens around that skill, which is arguably as important.

Mitch Luker: I think because in regular simulation lab, so when you’re in that physical sim lab with the plastic mannequin, the students are still mostly fixed on the physical skills and doing things instead of the thinking and the articulating. Where in virtual reality, They are focused more on the thinking because they don’t have things to physically grab and touch and they’re not overwhelmed by that. So they actually get to spend that time really focused on, okay, I need to explain what I’m doing. I need to talk to my patient. I need to assess them to understand what it is that’s going on. and making sure that what I’m doing is safe. And so, um, because like you said, in, when you are watching a nurse or a medical professional in action, their physical doing of stuff is pretty minimal.

Bill Ballo: Yeah, you know, and I think when I sort of first started in virtual reality, I almost, and wrongfully, I saw it as a limitation. I thought, oh, I can’t do this, and I can’t do that, and I can’t, and I was like, wait a minute. But the critical thinking portion of it, the stuff that we always complain about, how hard that is to teach. It’s so hard to teach people critical thinking. That’s what VR can do. That’s what we can do in VR where we can be together. The other thing I like, and I’ve had people disagree with me on this, and that’s okay. We can agree or disagree, but the other thing I like is that you can’t see facial expressions. I like that. Now, there are people that are like, I don’t know. Communication is so much about seeing someone’s face and all that, and I get it. If I’m scowling or if I’m worried or something like that, I certainly get that. But what I like about it is it makes you have to communicate. It makes you have to use closed loop communication more so than you do when you’re doing your mannequin simulation. Like in, you know, I use cardiac arrest as an example. You know, here I am doing ACLS and we’re supposed to be using closed loop communication. And so many times we don’t. And that’s one of the things that I used to critique on a lot of people’s you know, gratings is I would say, you know, more closed loop communication, making sure that that person heard what you said and repeating it back and those kinds of things. And I find that in VR, because you can’t see my face, you can’t see me go, well, you can see me nod my head, but sometimes, you know, it’s like, if you’re not looking directly at me, maybe you’re not catching it. So it forces you in some ways to use that closed loop communication And to use your verbal communication more so than just, you know, like, I can’t do a thumbs up. So I have to say, yes, okay, I got that. And that helps more with that closed loop communication.

Jon Brouchoud: So, well, yeah. And I think that’s actually one of the things that Dr. Slamon and his team like sort of accidentally discovered is they wanted to run mock codes. And then, you know, the code leader is on zoom. So they’re not able to grab onto things and help intubate or help set up EKG or help with anything. And that’s the temptation when you’re leading a code. Apparently, according to this team, you know, that’s the temptation is you want to get in there and do things because it’s urgent, but really as a code leader, you should be delegating. And if you’re delegating, it’s all about that closed loop communication. So running those simulations where the participants, you know, Mitch and Bill being in VR and, you know, Dr. Slayman was in there and, hey, this patient just came up from the ICU. What do we do? And the code leader has to just, you know, articulate you, you know, please do this, do this. And you’re using that closed loop communication and making sure you’re giving the right amount of medication, the right type of medication. and all of that. And that became the focus of those simulations. And, you know, I was able to sit in on some of the debrief and I think it was very, everybody learned something, you know, because you’re, you’re really going through the thought process and that communication, that critical thinking.

Mitch Luker: And also it’s more visual too. Like one of the things that I think come came out of that for me was, um, Cause I’ve done ACLS before and during ACLS and stuff, you, there’s a lot of like, oh, now you see this or, oh, now this, and you kind of have to imagine it happening. Whereas in VR, we actually get to see it happening. Like we get to see their pressure slowly coming down. Whereas when you’re doing it on, on a mannequin. you know, there’s kind of that gap time in between. You’re not seeing those things happen live in the moment. Um, and I think about like with pharmacology, that’s another one I like to run early on is, you know, okay, you give this med, here’s the result. You do this, here’s the result. And you can see it in that moment instead of being like, Oh, you give that med. So now you see this happening with your patient and you just have to say it. And the person has to imagine that that’s happening. versus actually seeing it happening, like live in that moment.

Bill Ballo: One of my big aha moments for VR and using it was I had a student that was doing a cardiac arrest scenario. So we were doing a, you know, a mega code. And the patient went from, I think he was an SVT and went into v-fib. And I immediately, I changed his skin color from our default, the sort of normal color, then to a really pale color. And she was looking down when it happened, like when he went from you know, normal color to pale color. And it happens progressively. It’s not like a switch, you know, like, and now he’s it happens progressively. And she was watching it happen. And I could tell she was because you can see you can see she was very focused. And she goes, Okay, that’s not good. Yeah, that’s not good. Something’s wrong. And she immediately looked up at the monitor. which is pretty much what I want you to do. You know, I want you to, obviously, you got to talk to your patient and say, hey, sir, can you hear me? But then I want you looking up at the monitor, because if he has, in fact, gone into v-fib, which he did, like we can do something about that. You know, that’s that’s a rhythm we can do something about. So That was sort of one of the big aha moments. I think it was November of 2020, if I remember correctly. And she just looked down and she went, oh, man, he’s pale. This is bad. And she looked up at the monitor. I was like, yes. And she immediately went into, all right, all right, I gotta do this, I gotta do this. And her tone and her movement was much quicker. It all of a sudden became much quicker. And that was the thing that, if I have a plastic mannequin and I go, okay, he’s pale now, it doesn’t have the same hit, really. And, you know, I mean, sometimes with the mannequins, you can make them cyanotic, and then you’ll see the little blue light turns on in their mouth, you know? And you go, oh, look at that, he’s cyanotic. But one of the ones that happened too with my students is I accidentally had cyanosis turned on on one of the patients in one of the EMT clinicals that we had just done recently. I accidentally had cyanosis turned on. I didn’t realize I did. I went back and, you know, saved it and everything, but they were like, man, sir, are you, do you have like purple, like, is that, are your nails painted? And I’m like, what are they talking about? So of course, I’m in ghost mode. I kind of sneak up there to see what they’re talking about. I’m like, oh, cyanosis is on. And it was that easy for them to tell. There wasn’t a blue light or anything like that. It was that easy. They went, he’s cyanotic. This is really bad. All right, let’s make sure that we get this going and we get this going. You can tell the tone changes immediately. That’s what I’m looking for. That’s it. So getting them used to that early on, letting them, what I’ll do too is, you know, obviously we’ll do the tutorial, but then after the tutorial, I just put them in a room with a patient and go, go for it, go for it, check things out. You know, sometimes it gets a little crazy and fun, but check things out, you know, check the patient over, listen to lung sounds, do all this stuff, get used to what’s in the room. And then I turn things on and off. I’ll have them vomit. That’s always a crowd pleaser. Um, you know, I’ll have him vomit and then, you know, I’ll have coughing and then he he’ll show you the green stuff on the, on the four by four and that kind of stuff, you know. Um, so I, I just, I, I let him sort of experience everything. Um, and then when they come back in, they’re well more prepared for it as well.

Jon Brouchoud: Yeah. I’m sorry, Mitch, go ahead. No, go ahead. I was going to take us in a different direction. I want you to finish.

Mitch Luker: One thing to early maybe start off with two is just have some open lab time. You know, during that like welcome week as you’re having your students come in and do their orientation. or doing whatever happens during that first week right before classes start, or even just send an email out and have some open lab hours that students can just drop in, even if your school doesn’t have a on-campus welcome week or something. Just have some time and let students come in and just make it low stakes, make it fun. Let them get to come in, like Bill said, come in and just play around with some stuff. and, you know, let them see the patient vomit, let them, you know, I like to sometimes will like throw in the seizure or whatever, just to kind of, and that way then when they see it the next time, it’s not as shocking and they don’t have that like, Oh my God, they’re having to like, Oh, okay. They’re having a seizure. Like I know it’s not, you don’t get that knee jerk panic that comes. So sometimes maybe even just considering having some open lab hours where people can drop in and you can spend some time with them and help them with getting comfortable in the space, especially for students who maybe are a little older and aren’t as comfortable with technology.

Jon Brouchoud: Absolutely. Open office hours. And also during summer, I think it’s a time that IT could also be involved with helping make sure that your systems are all up and running and ready to go. You know, if you wait until that second week of, you know, the semester, you’re trying to run a simulation and now you’re trying to get IT’s help. They’re going to be busy doing other things. They’re going to be frantic at that point because they’re going to have all kinds of other requests. But things are a little slower during the summer. Have them take a look at your systems. Make sure all the graphics cards are updated. Make sure you’re all your all the hardware is ready to go and use this opportunity. Or if you don’t have IT support, unfortunately, it’s going to be up to you to do it. But these aren’t very difficult things to do. It just takes a little time to go in and make sure all the computers are ready to go. And then I would also add, I love the idea of the open time and would also suggest that if your program is really early and just getting started, that’s as much for the other instructors as it is for the students. Because you need to build your evangelist, you need to build your tribe, your team of people that are going to be in there with you. And the more of these instructors you can get on board and the more they have their own aha moments and say, you know, I wanted to run a septic simulation and blah, blah, blah, and I don’t know how to do it. Now that they know what you have, they have the capabilities, you know, you can work. to build just about anything you can imagine. And you want them to know that that’s possible. Because a lot of times they just think it’s a standalone application that’s already pre-programmed. But once you get them in there and you show them the simulation manager and you show them you can change vital signs and you can make your own medications and you can have them go into shock and have all these different features, then their gears start turning and you never know what’s going to come out of that. And in my opinion, that’s the best stuff. Like you don’t want some pre-programmed stuff that a team of programmers went off in a corner and did. It’s what you, your team, your instructors are going to be able to create that I think is going to be the best. And that first couple of simulations of the year is an opportunity to bring them in, show them what’s possible.

Bill Ballo: In my first two weeks, I think, coming up here, I’m back to work on August 14th. So I think even that week, I only have two days that I’m working that week. But both of those days are people having meetings in the XR Center. One of them, I think, is interior design. And the other one, I believe, is I can’t remember, but then the week after that, nursing’s in there, EMS is in there. I invite them to have their meetings. Just have your meeting at the XR Center. I’ll take the last half hour, hour of your time, but have your meeting at the XR Center. Just get used to it, being there and knowing what you’re doing, that kind of stuff. When I didn’t have an XR Center, I used to come to their meetings. I’m like, give me an hour at the end of your meeting. Give me a half an hour at the end of your meeting. Because what I would do is I wouldn’t spend a whole lot of time talking about what VR can do for you and all that kind of stuff. I don’t sell it. I really don’t. I have them come in, put the headset on, and then they go, oh, well, we could do this, and we could do this, and we could do this. And I just sit and take notes. I really do. And then I tell them all, I’m like, I’ll put your name next to it. I’ll give you credit for all of this. But go on, you know, and I’ll just sit there and take notes because that’s what they’ll do. They’ll just start going, well, this would be and what if we did this? And what if we did that? And what if we did this? You know, and we’re always kind of thinking about, like, what is the next possibility? And and I’ll bring in the people that have been using it for a while, too, and say, hey, just come in and hang out with me for a little bit. You all have a half an hour. Like you already know how to get in there and use it and put the headset on all that. So once we, once we’re past all of that, like if you have a half an hour to come in and hang out with me and just go into these things, like I’m going to listen to anything that you have to say. And I’m going to try to, you know, figure out what we can do to build it or work it or whatever it may be.

Mitch Luker: That’s a great point, Bill. And also don’t forget about like your recruitment team. So like I just had our recruitment and admissions team come and spend a couple hours with me. And, you know, I let them put on the headset and try things out and showed them the different possibilities of things that we could be doing and showed them like the lecture that I’d made. And then, you know, we’ll start having those. And so like having that capability within and like letting them, because That’s how you’re going to increase your enrollment. Because one of the questions they asked were like, well, what other schools in our area have this? And I’m like, none. Like, the next closest one’s Madison. And then after that, it’s Western Technical College in La Crosse. Like, we’re it right now in this area. And we compete against four other colleges in our area. And they were like, really? None of them have this yet? And I’m like, yeah. So make sure you’re selling us with this stuff. Because we have the technology that’s going to help students learn better, learn faster, retain longer and do better. And so don’t forget your other ancillary services, you know, uh, your enrollment admissions, your student support services, your coaching and tutoring departments. I mean, all those areas, let them know and have them come and spend time in the lab to let them see what it can do and make sure that they’re utilizing it as much as they can as well.

Jon Brouchoud: Absolutely get featured in your your school newsletter, you know, get an article out, you know, they just love doing it’s a cool, you know, story about innovation and an opportunity to go in there and try something out. That’s a great, great story.

Bill Ballo: If your school has a school newspaper, we have the Clary on it at Madison. If your school has a school newspaper, find out who the editor or one of the reporters for the school newspaper are. The students love this kind of stuff and they love to write articles about it. We’ve had a couple articles written about the XR Center. And I have one student who just comes by all the time and he wrote an article, but he just comes by and just, you know, what’s new, what’s going on? He’s so excited about it that, you know, obviously you’re gonna, you know, you want your recruiters, we do the same. We bring our recruiting team in and that as well. But then like make sure as many students as possible know about it. I had EMS students come in and they’re like, why haven’t we been using this all year? And I’m like, We’ve got to talk more with your instructors. And then I heard from one of the EMT instructors, OK, what did you do? Because now I got students going, when do we go over to the XR Center again? When are we going over to the XR Center again? So they love this kind of stuff. I mean, who doesn’t? I’ve had a lot of people come in stone-faced. Like looking at me like, no, I’m not gonna like this. This is for gamers or this is for this. And then you put them in the headset and they go, okay, I get this. I totally get this. Now I understand why you like this so much. And that’s just it. Like first step, get them in. Second step, get them into the headset. Get them into the headset. Jon, you’ve said it over and over and over again. That’s the most important thing that you can do. Get them into the headset so that they can actually experience what we’re talking about.

Jon Brouchoud: Yeah, the headsets, they convert on contact. The minute you put that headset on, it’s like, oh, I see. And this doesn’t have to necessarily be a first part of the semester activity, but local news media loves this. And that’s something that Madison College and NWTC, you’ve both done masterfully, is bringing in local news media and, you know, putting them, you know, having them set up a camera crew. It’s a great, great story. A local, you know, college is using virtual reality to help train students. They love stories like that. So it’s another opportunity to raise awareness. And I think that’s one thing you’ve both done really well.

Mitch Luker: We’re actually getting ready to do a follow up from a year ago, because it was a year ago soon that we opened our actual health science XR lab. And so now we’re looking at doing a follow up and because we actually have some data now that we can actually present in it. now that we’re opening the one in Marinette, like that one is going to be finished next week. And so, like, we will, like, yeah, I mean, part of the things that we have to do is, you know, build the reputation of our institutions. And so part of that is, you know, doing those stories and working on getting, you know, that out there. So that way, then people in the community know and they’re gonna be like, oh, That’s cool. I want to go there to school because they have, you know, the cool technology that’s going to help me do better.

Bill Ballo: Yeah, what I always say, too, is it’s almost like in some senses, the leadership, they can’t say no. Right. At that point, too, like that’s important. You got to get leadership buy in. Now, you know, I’m extremely fortunate of Carly Brady. She’s my supervisor. And there’s probably no one who is more bought in as a supervisor, as a leader, than Carly is. I mean, just 100%. So that is extremely helpful. But then even our leadership above, right? So Shawna Carter used to be my dean over at Human Protective Services. But same thing. She gets it. She understands it. She’s been in the headset. right? They have been there, they get it. Even our provost, we got our provost in the headset. So it’s like, we want leadership to see it, we want leadership to understand it, and therefore leadership goes, yes, we do need to support this. And they want to see what the ROI is, right? They want to see, we’ve invested this amount of money, what’s the return? How do we get that return? So that’s where we have to make sure then we’re doing some of the, what I call some of the boring stuff, where we’re like, hey, this is how many students we’ve had. This is how many hours we’ve used. This is how many, Mitch, I know you do that a lot. This is how many simulations we’ve done so that we know what we’re getting back for the amount of money that we’ve spent. And I call it the boring stuff, but it is really important that we do that, that we make sure that we report back. And that gives our leadership a little better picture of what we do on a daily basis.

Jon Brouchoud: Absolutely. And in terms of ROI, we talk about that a lot. And obviously, we’ve articulated and demonstrated this idea that you can build a VR lab for less than the cost of one mannequin. And we’re building that argument on the ROI. But there’s also the idea of this earned media. And we don’t ever want anybody to buy VR or buy Acadicus just because they want to get a spotlight in the news. But if you look at the dollar value of earned media that’s not paid, I mean, for a school like that, for the administrators, that’s what they’re paying attention to. And, you know, when you’re looking to recruit and you’re willing, you know, looking to raise awareness and you’re getting two or three spotlights in your local news media because of your VR center, that’s ROI. That’s big time ROI. You’ve just paid for your whole VR lab and then some. You know, they’ll never tell you that, right? Like there’s no dollar and cents attached to those featured stories. But if they were to pay to have that 10 minute segment on the local news, it would be, you know, very, very expensive. So yeah, if you just look at the price of advertising, and you’re getting these featured stories, you know, it’s you’re getting your administrators interviewed and put them in the spotlight. It’s ROI big time.

Mitch Luker: So our marketing team does that. They actually do give us, so when we did our first media blitz, she sent me an email and she’s like, so doing this stuff that you did, and she’s like, this equaled to $175,000 worth of free advertising. I mean, she literally like had that in the email. And for Bill’s time out, you know, some of the boring stuff, the easy way to keep your boring stuff easy is I just sat, I literally take a QR code and I’ve slapped it on every on the side of every computer in my lab. And so when students are done. They take their phone, they scan their QR code and they complete a survey. And then I know how many students have come through. I know what scenarios they’ve done. I know what they’re, and then I take all that qualitative and quantitative data and I use that then. So like right now, our average, the average in our lab of student satisfaction with the XR lab is 8.8 out of 10. And that’s with over 250 students coming through. So, I mean, that tells me that if you can get 8.8% of people out of 10 to say that this is good stuff, I am extremely, that to me is like getting a five-star review on Amazon.

Bill Ballo: It’s hard to get 80% of people to agree on anything, Mitch. That’s, you know, like, yeah, that’s great. I mean, I’m actually going to look at, at our, at ours as well. We use a five scale. So, um, but I think, I think, I think it’s similar. I think it’s similar. I want to say we’re 4.3. Um, so 8.6, there you go. I mean, just comparing those two, you know, you can see the amount of satisfaction with these things is very high. Um, And it wasn’t necessarily as high with other things we tried, because this was pre-COVID. or during COVID we had one of our departments had tried something different and they didn’t have a really good result. And that was also like, we didn’t just kind of go, okay, we’re in for Acadicus and that’s it. We looked at other stuff too and we looked at the ratings on all these other things as well. We spent our time doing a good amount of research and yeah, I was right, 4.3. Acadicus was just what we needed and what worked best for us, because it gave us the ability to sort of translate what we were already doing into the VR environment. But yeah, you’re right, I did the same thing too. I have QR codes on all the desks, and they scan that QR code, they take my survey, and we’re good to go. We even have them now on our portable carts, too, because I have my portable carts for all of our Oculus equipment. And so when our students are done with their Spanish class, they do the same thing. They scan that and then They take a survey for us and they take a survey for their instructor in Spanish class. But yeah, then compiling all that together and just showing the satisfaction, the hours used, all of that kind of stuff. And that way you don’t feel like on a daily basis you have to justify what you do. You don’t feel that way. You feel like In the end, at the end of the month, whatever it may be, the end of the semester, you can kind of bring all that information together and go, this is what we did. And a lot of times you get that, wow, like what? How many programs? How many people? Yeah, wow.

Jon Brouchoud: Well, that’s quite a little checklist we put together there. This was an impromptu Pulse Live topic, but we got a lot of great stuff. I mean, this AI I’m running this through is going to give us a real nice bullet point of here’s all the things you have to think about if you’re starting up your semester for VR, which is going to be a great resource for anybody entering into the virtual frontier here. So it’s good stuff. Is there any other high-level topics in terms of beginning your semester, your first simulation? We talked about doing something simple, start simple, right? So the hazard ID, Mitch pointed out, that’s a great simulation. You can do that self-guided. It doesn’t have to be facilitated, but it’s a great opportunity for a lively debrief, I would say, like you said. inviting faculty, other faculty, and having an open lab time so anybody can come in and try things out. We didn’t really specifically mention this, but I think the orientation that we have is a great thing to do. It takes about 10-15 minutes the first time you go through it if you’re taking your time. So during that open lab time, you know, encouraging students to go through that orientation. So then when they come in for an actual live simulation, they’ve already got the controls down. It’s not really that complicated. But, you know, if your first time you want to be able to go through that orientation.

Bill Ballo: And we definitely found that students who did that tutorial had a much, much easier time. There was a much, much easier time. I stand up there and explain, if you do this, you do this. I explain all of that. But when they learn how to use it, and then their retention of it was near perfect. I mean, I probably, in all of the students that I’ve had, I probably had one that went, OK, wait a minute, I forgot. How do we do this? And I was like, OK, no problem, and went back over it. So we usually do it towards the beginning of the semester, and then the students will come in later in the semester, do VR. But the retention of it was near perfect. They came in, and they’re like, oh, yeah, that’s right. I’ve got to teleport. I’ve got to do this. I’ve got to do that. Easy.

Jon Brouchoud: Yeah, hats off to Rick Castille for that, our other host of The Pulse Live, who wasn’t able to make it today, but that was his brainchild. He came up with that idea, recognized that there was a need for it, and really kind of worked together with the team to build that orientation, and it’s been very popular. So, you know, that’s a, you know, and while I’m on Rick, the topic of Rick Castile, if you’re starting off your semester, reach out to Rick and let him know. Everybody who’s using Acadicus would benefit from just letting us know what your plan is for the semester so we can be there to support you. And I think that’s one of the advantages that we bring is you’re not just in a silo working by yourself, running your own simulations. This is a community. And the three of us, the four of us get together every week and talk, but there’s a lot of others out there and they’re all willing and excited to share. They want to work together with other people. So, you know, they’re all off for the summer but you know as we begin the fall semester let’s get the community together let’s get people sharing ideas and Rick is a great sort of catalyst or a hub for that like he knows how to connect you to other people that are maybe trying to attempt to do or have already attempted to do. what it is that you’re looking to accomplish. So really, you can lean on Rick as a resource. He’s great with that and able to help or even brush up on your training. It’s been a while since you’ve used it. You want a couple of refresher sessions to go through how to use the simulation manager. Rick is there to help you anytime.

Bill Ballo: Yeah, you’re definitely not alone. You’re definitely not alone. And I think another thing at the beginning of the semester is take a breath. Give yourself a little time here to just take a breath. The beginning of the semester can always be interesting and difficult. I have a few different projects that I work on besides the XR Center. At the beginning of the semester, those usually come up where I have to do trainings for and stuff like that. Make sure that you schedule lunchtimes. I really highly recommend that. Schedule yourself a half an hour, 45 minutes, an hour, whatever it may be for your lunchtime so that I put it on my schedule and block it off. That way I don’t get people just going, oh, he’s free at noon. I try to make sure that I block that off. Make sure you build in a little bit of time to just take a deep breath and prepare for whatever’s coming next. And then don’t be afraid. Don’t be afraid. One of the things that I get from a lot of people is they’re like, well, you know, if it doesn’t go well, then people are going to think of this of me or they’re going to look at me in this way, look at me in that way. You’re doing something that that very few people have have done before you. There are plenty of us that can help you out, but you’re doing things that are still new, new to you, new to your college, whatever it may be. Have some patience with yourself and help others to have patience with you as well. The spotlight is much less on you than you think it is.

Mitch Luker: That’s a good point. I always tell people, I’m like, nope, it’s not going to be perfect today. Like I’m probably going to make some mistake. I’m going to, and we’re all going to laugh together about it. Cause I’m going to laugh at myself and I’m not going to take it too seriously because you know what I’m human and this is new and I don’t ever do anything the first time perfectly or even well sometimes. So it’s okay. If it’s a little disjointed, just own it on the front, let your students, I tell my students, this may be messy today. because it’s our first time running the simulation. I’ve done it practicing, but it’s different always whenever you do it for real, because when you do practice, you can be like, oh wait, hang on, let me stop and think, or like you have that ability to kind of let things slide more than whenever you’re doing it for real the very first time and own it and just, you know, don’t take it too seriously. If you make a safe learning environment for your students, that means it should be safe for you to learn as a simulationist as well.

Jon Brouchoud: Yeah, if you’re going to be a leader in innovation, you’re going to have to go through that, that grit, that, that friction, you know, and that, but that’s friction is what gets you going forward. And if you’re not doing that, you’re not leading, you’re not an innovator. You know, if you’re waiting for someone else to do this for you and show you play by play, how to do it, that’s going to happen. We’ll eventually have that playbook for you, but right now we’re building it. And to be a part of that, to be a leader, to be an innovator, you have to go through that, that those difficult things where it, maybe it works, maybe it doesn’t work, but you live, you learn, you do the next thing, you read those surveys, you improve it. And you gradually get better and better at it. And that’s what gets you in the spotlight. That’s what gets the news media there. That’s what gets the students coming back and gets instructors excited. Cause it’s like, Hey, I get to be a part of this. I’m not being told what to do. I get to like come in here and decide what I want to do. And, uh, that’s, that’s the key.

Bill Ballo: Yeah, I mean, I had some frustrations, you know, when I was meeting with some of the faculty and, you know, I get the kind of, I don’t know, do I really want, you know, and I kind of felt like, like, even with some of my, I did, I did one demo for faculty. And I thought that was just the worst demo I’ve ever done in my entire life. Like that was terrible. What was I thinking? This was awful. Absolutely awful. I even said it to Carly. I even said, Carly, this is the worst demo I ever did. What, what, What in the world? And she goes, oh, don’t worry. She goes, you know, look, if there’s naysayers, they always come back. You know that. And actually, it turned out. So this is funny, because I thought I did a terrible, terrible job. And this department wound up going out and getting a $90,000 grant in order to use VR in their program. So apparently I did okay. Like, my bad demo was actually really exciting for them. And I just thought it was the worst thing I ever did. And they’re like, no, we loved it. We thought it was great, you know? Oh, you tripped over this or you tripped over that. We didn’t care about that. We loved the demo. And I’m like, you know, and Carly’s like, see, I know, but you know. You’re your own worst enemy. You really are. You’re your own worst enemy and your own worst critic. And it’s cool. Own it. Because honestly, it’s what makes us good at what we do. You know, you got three guys here that are probably their own worst critic. We have probably beaten ourselves up more than anybody else in the world or in our lives have. over things that we feel like we’ve done right, or things we feel like we’ve done wrong, or things that we feel like we didn’t do exactly right in the way that we wanted it to. And it makes us good at what we do. It really does. So own it, accept it, and just say, yeah, I criticize myself a lot, but boy, it makes me good at what I do.

Jon Brouchoud: Well, and what you just said is a perfect demonstration of why Carly Brady is a brilliant leader. And I’ve said that before on this podcast and I, you know, it seems like hyperbole, but if you’ve had an opportunity to talk to her, she’s been a guest in the past. We talked, I just had a meeting with her. She’d love to come back and be a guest and maybe even join us on a few more of these, but you, you, you have that difficult experience and you’re going like, Oh no, what did I, what have I done? Like, you know, and, A leader, a strong leader comes in and says, no, this is innovation. You’re fine. I’ve got your back, you know, and Carly does that repeatedly. And you can see how that program has been thriving under her leadership and the work that you’ve been doing. It’s just, um, she could have very easily just said, yeah, you know, boy, that’s not very good. Let’s maybe back away from this. There’s other ways, or, you know, there’s a million things she could have done, but instead she was like, no, you got this. I got your back. And then that gives you the confidence you need to go forward. Because it takes confidence, it takes that sort of persistence, and you’re going to need confidence to remain persistent.

Bill Ballo: So yeah, that’s excellent. Yeah, I’ve had a problem with confidence, you know, like, we all get that sort of imposter syndrome, right? Where like, you know, people are looking at me like I’m the expert. And I’m like, I I feel like I’m lying, you know, like I’m, I don’t feel like, come on, there’s no way. And then someone else comes along and goes, yeah, exactly. Someone else comes along and goes, yeah, no, you are the expert. You really are like, you know, way more. Cause then you start talking about it and they’re like, how do you even know that? And you’re like, I don’t know. I don’t know how I know this. I picked it up along the way somewhere and was able to do it, you know? So yeah, absolutely. If you have started implementing this, you are already the expert at your college or at your business. You are already the expert. Own it and forge ahead. And I agree completely. I told Carly this was three years ago. No, four years ago. I was leaving Madison College. I was looking at leaving Madison College. Jon knows. And Carly is what brought me back and what kept me at Madison College. Carly’s the person that kept me there. And I told her, I’m with you. I’ve got your back hopefully as much as you have mine. And man, it has been that way for the past four years without a doubt. Uh, you know, and in some of my moments where I’m just like, I am terrible at this. She’s like, yeah, no. You know, your bad day is someone else’s like, you know, aha moment. So like relax, you know? So, yeah.

Jon Brouchoud: Amazing. We’ll get her on another pulse live sometime soon. For sure. We got to get Jamie in here from Western too. I think Jamie would be, uh, a great guest to be able to join us. Just come and hang out with us. Paul Cusick. I’m just calling out all these people. Come on, come on in. It’ll be fun. Well, this was a great episode. Thank you both. Really appreciate you joining on a hot, humid summer day here. But yeah, better to be inside than outside. That’s right.

Bill Ballo: That’s right. Go see what the three children have done to the house, because I heard them thumping around up there. So this will be interesting.

Jon Brouchoud: All right, well, sounds great. One of the things that we have coming up in addition to Dr. Slayman and his team is going to be Rick wants to run a fall semester kickoff Pulse Live. So we’re probably going to do that either next Friday or the Friday after and really hopefully get more and more of our customers to show up and talk about like what are they going to be doing. It’s going to be a little tricky to get people. It’s still going to be the end of summer, but a few of them are coming back to campus. We’re going to have a fall semester kickoff, so we’ll look forward to that. So in the meantime, have a great weekend.