quick update - august 30, 2018

A fellow QEII Simulation Program staff member shared this with me (thanks Donna W).
Check out 7-SIGMA's airway trainer.
I love these new products with increased realism!

Job Posting!

Jason Irving ( reached out to see if I could help spread the word about some interesting roles they have:

"We are looking for BLS AND ACLS Instructors who can travel for overseas assignments. These would be 1 - 2 week assignments in new Simulation Centers so candidates must be familiar with the use of High Fidelity manikins.
Link to job is here:"

Recently trucorp launched the TruMonitor app, an adjustable patient monitoring device for practicing realistic scenarios. You can download a free 21 day iOs trial if it’s something you’re interested in, simply download by clicking this link:
They will be launching an Android version soon.

MedicFX looks like they are making some really cool products... I really like the SimMan 3G face covers you can easily slide on to your simulator...

medicfx.JPG newsletter - august 14, 2018

Job Posting!
Ernesto at Cedars Sinai let me know that they are looking for a Simulation Specialist - if you're interested, check it out and apply below:

Chris from Fundamental Surgery reached out to let me know they are releasing low cost VR simulations on a subscription model, trying to democratise the kind of simulation that normally costs 100’s of thousands of dollars.  

Seems like a great approach... and I'm hoping to test it out in the next few months. Check out their intro below.

The great Jackie Langford reached out to let me know I was hosting an old version of her 'Art of Moulage' recipes book.
I have updated my version in the moulage section - or you can just grab it here now.

Thanks Jackie!

Great news for simulation  - CAE poised to revolutionize pilot, aircrew and healthcare professional training by investing C$1 billion over five years in innovation

CAE today announced that it will be investing C$1 billion over the next five years in innovation to stay at the forefront of the training industry. One of the main objectives of the investment is to fund Project Digital Intelligence, a digital transformation project to develop the next generation training solutions for aviation, defence & security and healthcare. In partnership with the Government of Canada and the Government of Québec, the project will allow CAE to continue to play a key role in making air travel safer, defence forces mission ready, and helping medical personnel save lives. Other benefits include reducing aviation’s environmental footprint and addressing the worldwide demand for aircrews. The Government of Canada and the Government of Québec will provide a combined investment of close to C$200 million over the next five years (C$150 million for Canada and C$47.5 million for Québec).    
Executives and employees of CAE were joined by Canadian Prime Minister Justin Trudeau and Premier of Québec Philippe Couillard for the announcement which signals one of the most significant investments in innovation in the aviation training industry globally.
“As a powerhouse of innovation, CAE has been at the forefront of the training industry, including digital technology, for years. This strategic investment will take our company to the next level,” said Marc Parent, President and Chief Executive Officer of CAE. “By seizing new technologies such as artificial intelligence, big data, or augmented reality, as well as many others, and applying them to the science of learning, we will revolutionize the training experience of pilots, aircrews and healthcare professionals, as well as improve safety. We are committed to investing C$1 billion over the next five years to help position CAE, Québec and Canada as leaders in digital technology.”
Project Digital Intelligence will transform CAE’s products and services to leverage digital technologies, ranging from big data to artificial intelligence, cloud-computing, cybersecurity and augmented/virtual reality. CAE will develop its next-generation training technologies for aviation, defence & security, and healthcare, while making use of its extensive training network and data ecosystem. The project includes three major activity areas: advanced digital technology development, digital transformation of the training and user experience, as well as CAE innovation and collaboration facilities.
CAE will carry out Project Digital Intelligence in Canada, utilizing its R&D laboratories, as well as its test and integration facilities. As part of the project, CAE will develop an innovation campus in its Montréal site by transforming its workspaces, laboratories and processes to allow for greater innovation and collaboration. Throughout Project Digital Intelligence, CAE will collaborate and codevelop technology solutions with small and medium companies from across Canada and will qualify more than 150 new innovative suppliers across the country. CAE will also work with over 50 post-secondary institutions and research centres. The project is expected to create and maintain thousands of highly skilled jobs at CAE in Canada and in CAE’s Canadian-based supply chain. CAE employs approximately 4,000 people in 18 locations across Canada and more than 5,000 in the rest of the world.

Saw this great introduction to simulation video posted on LinkedIn... check it out.

Operative Experience birthing simulator just got an upgrade. Check out RealMom 2.0 here:

realmom2 newsletter - june 18, 2018

Cleaned up the site a bit - removed some dead links, added some new links, added the audio files to a google drive folder... let me know if you come across any issues.

A quick plug for my local internal medicine team that has put together this great site of scenarios -

Dalhousie Internal Medicine Simulation was created with the intent of making high and low fidelity simulation cases easily accessible to internal medicine trainees within our program. Wherever possible, the cases have been mapped to existing Royal College objectives. Cases can be searched by topic, or by Royal College objective. We have included cases from other open-access sources, and encourage new contributions.

I recently started to listen to DJ Simulationistas… Sup?
It's the flagship podcast of the Center for Medical Simulation in Boston, Massachusetts.
Janice Palaganas and Dan Raemer (below), CMS faculty and thought leaders in the field of healthcare simulation, discuss the pressing issues in the field, interview expert guests, tell jokes, and dissemble on a variety of topics. Check them out here:


Gary Taylor, Business Development Director at TWME8 Limited, reached out and shared this information and video with me:

iRIS is a unique, collaborative, web-based platform to help you design high quality scenarios / cases that offer the best learning experience possible, as well as helping you get the best value from the investments you have made in simulation resources.

Over 1,000 simulation professionals globally author using the iRIS Health Simulation Authoring Platform. Whether you are building simulation using task trainers, high fidelity manikins, or standardized patients, iRIS will support you in developing the highest quality scenario / case.
iRIS will support you in:
• ensuring your scenarios are developed in a standardized, high quality manner
• creating significant efficiencies in terms of the time required for designing scenarios and collating simulation resources
• reducing the time and effort required to train colleagues in the design and authoring of scenarios
• building engagement with a wider range of clinicians to harness their expertise in developing new scenarios
• driving interprofessional collaboration and sharing of content with other simulation professionals

If this interests you, check out more here:

I'm not well versed on screen based training, but SimSTAT from CAE and ASA looks pretty neat. I'm excited to see what the future holds for this modality - and VR/AR...
More here:

Matthew let me know his company Amoveo was recently featured on with a Canadian focus on customized task trainers - you can check it out here:

equipment we use - vol 3 - control and debrief rooms setup and tech

For my third installment of 'equipment we use' I thought I would review how we setup our control, simulation and debrief rooms tech.

By no means do I say these setups or product seen here are the best or that they are the right solution for you - they are just things that have worked for us, and might assist in your search to find solutions for yourself.
Please note that I have no affiliation and no financial gain with any company.

Lets start with our Control Room. As you can see below we have (left to right):
1. Dedicated telephone line. When simulation participants want to call for assistance (from a phone we have in the sim room) they call this line and an educator can answer and reply appropriately.
2. All-in-one vital sign computer. We keep this in the control room and just splice the feed to the simulation room. We like not having this mounted in the sim room as this way gives the technician more control, and the ability to quickly unplug it and take it to insitu simulations.
3. AV Recording laptop. This lets us control the starting and stopping of recording a simulation so it can be used for debriefing / reviewed at a later date.
4. Desktop speakers. These let us hear what is happening in the simulation room, and the volume control is within arms length of the technician.
5. Patient Simulator laptop. This controls the simulator. Also easy for us to unplug to take to an insitu simulation when required.
6. Desk light. We have a dimmer switch on the rooms light switch, but if the tech needs some more light this can be used.
7. Camera joystick. This enables us to move any of the 3 ceiling mounted cameras easily and quickly if a view is obstructed. I highly suggest joysticks over touchscreen camera controls.
8. Overhead TV's (x3). These give us a view of what each camera is live streaming/recording, and can be watched if the two-way mirror gets obstructed.
9. Overhead / implanted actors microphone. We can switch the mic to be used for the simulation rooms overhead speakers, or to talk privately with actors (confederates) in-ear headphones.
10. Patient Simulators voice microphone. We run this mic separately from the overhead / implanted actors mic, as since its totally wireless, we can easily take it to insitu simulations.
11. A/V laptop. We use this to load images (ECG's / Xrays / etc.) that the educator supplies to show participants in the sim room.

We have seating for the technician and two educators in front of the two-way mirror.
We opted for cushion covered file cabinets for storage / extra seating along the back wall. These are used by extra educators, or small groups of participants instead of watching a live-stream in the debrief room. They can sit and watch the three ceiling mounted TVs.
We probably would have designed the room to be located behind the head-wall, but this room was built long ago and the gases/suction head-wall was placed on the outside wall - limiting our option to a side view.

In the Simulation Room (below), we have:
1. Overhead cameras (x3) and microphones (x2). These are for our live-streaming/debriefing system and the three TVs in the control room (split feed).
2. Dedicated telephone line. Used for participants to call for assistance (they call into the control room).
3. Vital signs TV (x2). We have the option to display either on the TV above the gas/suction wall (most users) or to change it to the monitor on top of the Anesthesia machine. Anything to keep anesthesia happy ; )
4. A/V TV. We use this to show images (ECG's / Xrays / etc.) that the participants might need/ask for.

Lastly, our sweet and simple Debrief Room (below). 
Just a big conference table to seat 14, a laptop and TV for presentations, live-streaming and/or debriefing.

If you've liked this edition of equipment we use, please feel free to check out my first two:

Vol 1 - communication with confederates / patient simulator voice

Vol 2 - online booking calendar newsletter - february 15, 2018

I received an email from Jason Irving - a sim recruiter you should keep tabs on if you're looking for a new opportunity! Check out / bookmark for safe keeping his website here:

...he also made the very first donation to thesimtech - thanks for the support Jason!

The amazing west coast sim tech Mark Searra threw a rough guide together for making a fluid exchanging drainage setup for manikins - basically a solution set with the filter inverted so you can swap out full and empty bags using the IV spikes. Easy and useful! Download the .pdf here.

I've added MedEdPORTAL to the link section.
MedEdPORTAL is a peer-reviewed online publication of instructional materials for medical education. Currently, a quick search of their database using the keyword "simulation" brings up 777 published modules. Check it out...

Angina from VirtaMed sent me this update:

VirtaMed has signed a preferred and exclusive partnership with the Arthroscopy Association of North America (AANA). As a first step, the Orthopaedic Learning Center in Rosemont will be equipped with VirtaMed simulators, giving residents across the country better access to the tools. Even more importantly, together we will develop a standardized national curriculum for arthroscopy simulation training. The curriculum will obviously be based on education expert experiences but also heavily on the data pulled from the simulators.
Read the news here:

Matthew Jubelius from Amoveo Training has started a simulation blog - you can check it out here:

The new 2018 Gaumard catalog is out - read or request one here:
And on the topic of Gaumard, check out this video of the new Pediatric Hal S2225. Great to see some new innovation!

Laerdal has released their top 10 articles of 2017:

In 2017, we published a variety of research-based articles about medical simulation. We want to give you a chance to read any that you may have missed. So, we've created a list of our top ten articles for you as selected by your peers. You can find them here:

Fellow Canadians... never too early to save the date:

Ferooz Sekanderpoor, President at SimGHOSTS mentioned this on LinkedIn. I thought I would share it here:

SimGHOSTS launches an award for the healthcare simulation technology community in recognition of exemplary performance as a healthcare simulation technology specialist or significant contribution to the field of healthcare simulation technology. If you like to nominate anyone from your team please kindly do so by clicking on the link below.

I received an email introducing me to Debriefly video capture. I've never used it, but looks like it might be a useful budget friendly tool. Any one out there try it? (I've also added it to the AV links found here)

Debriefly is designed to be the easiest to use, most portable, and most cost-effective capture and debrief solution that works with the iOS devices you use every day. Debriefly can be set up in less than five minutes to start capturing HD video, audio, and vitals signs. Our turn-key package of hardware and software makes it incredibly easy.
Anyone can download Debriefly for Mac, along with one of our sample scenarios (EMS-style with iSimulate vitals, or Hospital-style with Laerdal vitals), to see our video debriefing features. To check out our capture capabilities, you can download the free Debriefly Cam app for your iOS device from the App Store, and contact us to activate a free 30 day trial.
More info can also be found on our website. newsletter - december 01, 2017

Happy December Sim Techs!

I recently received an email from Dan Vuksanovich (a partner at Gravity & Momentum). He claimed they make the only stage blood in the world that is both safe enough to get in your mouth and will wash out of / off of anything with just warm water.


I'm not sure about all the other fake blood products out there - but this sounded great.
He offered to send me some samples - an offer I couldn't pass up.
Sure enough, they arrived a few days later.

From their website:

Blood Jam - Blood Jam is an “all-in-one” stage blood product which can be manipulated in a number of different ways. Out of the jar Blood Jam is a very thick stage blood which can be used as-is for makeup and gore effects that do not run or drip. It’s great for skin, costume, set dressing, or even for zombie crawls where you don’t want to worry about blood getting everywhere. Blood Jam can also be thinned with water, heated and/or frozen to create a variety of useful effects.

Blood Juice - If you’ve ever tried diluting a thicker blood product for maximum splatter you know that there’s a point past which the color simply disappears. Blood Juice stage blood is incredibly thin… so thin you can spray it with a spray bottle, and it still maintains its realistic coloring. Blood Juice is splatter-rific, perfect for exploding, gushing, fast running, or dripping blood effects.

Blood Syrup - Blood Syrup stage blood sits in the middle of our blood product line from a consistency standpoint. While Blood Jam won’t run at all and Blood Juice runs all over the place, Blood Syrup oozes and is perfect for slow to moderately bleeding wounds.

Here is a pic of the samples

Gravity and Momentum samples.jpg

I decided to test on a piece of spare task trainer latex and on a microfiber cloth.
The Blood Juice was a little more 'greenish' then I had hoped, but I loved the Syrup and the Jam.

 From left to right we have: Blood Juice, Blood Syrup and Blood Jam. I poured some on each material and let them sit/soak in overnight.

From left to right we have: Blood Juice, Blood Syrup and Blood Jam. I poured some on each material and let them sit/soak in overnight.

The next day I hand washed with warm water, and some hand soap. It all came out - fairly easily. To be honest, I was a little surprised. There was zero staining.

I haven't tested any other fake blood products in regards to staining, but I have used Ben Nye in the past and remember liking it. I know it can be used in humans mouths as well.

 24 hours later, a quick wash - totally clean / no stains!

24 hours later, a quick wash - totally clean / no stains!

All in all this stuff was really impressive (except for the slightly greenish Blood Juice), and I can fully recommend it. I have added their link to the moulage page for future reference.

UPDATE - Dan tells me the Blood Juice isn't supposed to look that that - and that they will do a better job at making sure that samples don't go out like that again. Any customers that received off color product would get an immediate free replacement at no charge. Good to know!

Please remember I get no financial or other type of compensation for any review or comments I make. These are just my thoughts and feelings - take em or leave em. : )


I just heard about this company - OSSimTech. I've added them to the Links page.

OSSimTech designs, manufactures and sells VR open surgery simulators. We are a high technology firm with strong intellectual property and unique knowledge of VR. Our core business is training simulators for open surgeries.

Looks like Gaumard has a cool new portable video capture system - Care In Motion

CARE IN MOTION™ is an innovative video recording and playback platform designed to maximize learning through video-assisted debriefing. Developed with a focus on usability, functionality, and reliability, Care In Motion finally makes recording and debriefing simple so you can focus on what's important—achieving better outcomes.

equipment we use - vol 2 - online booking calendar

For vol 2 of 'equipment we use' I thought I would post what we have developed to handle a few problems we encountered over scheduling, booking, evaluation and statistics.

Our current simulation program has three locations - two simulation centres and a skills centre. Each of the three locations used to have paper calendars, no online presence, and users would have to call or email each respective location requesting a date and time.
Often requesting dates that are already booked, you can imagine the excessive correspondence back and forth. This process was inefficient and led to a poor user experience.

We decided to hire a developer to build our simulation program a website including an integrated online booking solution.

We started with an overview calendar (img1) on our websites front page. This gave users an opportunity to have a quick glance at location schedules (less detailed).

Overview Calendar (img1)

We color coded our locations to help differentiate them from one another.
Once users identified the location they want to book, they click on that locations button, bringing them to the site specific calendar (img2).

Site Specific Calendar (img2)

On the site specific calendar you get a more detailed view of the daily schedule. Once you identify an available date and time you start the booking process by clicking the 'Book Now' text on the upper left corner of the date you want. That launches our request form (img3).

Request Form (img3)

The request form is too long to show here, but we capture all the information we need to run the course, invoice (if applicable) and collect statistics.
Once the form is completed and submitted by the requester, three things happen:
1. the requester gets a confirmation email that their request has been made
2. the sim staff get an email notifying them that someone has submitted a request
3. The time requested goes into 'pending mode' on the online calendar - so other users see that a request for that time has already been submitted. We follow a 'first-come-first-serve' policy.

The next step is for the sim staff to login to the back-end booking request list (img4) and review the request. Any requests that are 'pending' will be highlighted in red.

Back-end - Booking Requests List (img4)

Once they open the booking request (img5), they can edit the form if needed and most importantly - they can add the setup and cleanup time.

Booking request (img5)

Setup and Cleanup times (img6) show users that the location is busy from 11:00 AM to 5:00 PM, even though the course is from 12:00 PM to 4:00 PM.

Setup and Cleanup times (img6)

Once everything is reviewed, staff will approve the request. The approval automatically sends a confirmation email to the requester and the calendar goes from pending to booked.

We also have a 'reminder' emails automatically sent... 31 days and 8 days prior to their booking.

The final automated process is an online evaluation form (img7) that is emailed to the user a few hours after their session end time. This is an opportunity to receive feedback on our strengths and weaknesses, assisting us with continued development of the program staff, facilities, equipment and processes. 

Online Evaluation Form (img7)

This new system also collects all the information submitted into a database, which we can manipulate for various statistics - from number of learners, hours booked, cadaver use, department statistics, etc... 

Hopefully you found some interest and use in this edition of 'equipment we use'.
It is a tool that we are continuing to develop based on need and user feedback, but overall it has been extremely successful.

Please feel free to leave a comment below on your thoughts or your own solutions.
Thanks for reading.

FYI, you can check out equipment we use - vol 1 - communication with confederates / patient simulator voice here. newsletter - september 11, 2017 - Healthcare Simulation Week!

Happy Healthcare Simulation Week!
SSH info and events here.


I've been contacted by two new places to purchase moulage makeup/equipment:

Amoveo, founded by Matthew Jubelius (based in Canada), offers various simulated wounds (click here for their brochure and check out their video below)

The Makeup Armoury (based in the UK). Check out their brochure here, and send Alice an email asking for a discount if you see anything you fancy

SynDaver Labs, an advanced biotechnology company specializing in the creation of sophisticated synthetic humans and animals, announced the formation of a new international strategic partnership with medical manikin manufacturer Lifecast Body Simulation.

The new partnership will allow SynDaver and Lifecast Body Simulation to utilize each company’s unique proprietary technology to expand their capabilities to create ultra-realistic, next-generation synthetic bodies. Future human and animal models engineered by the two companies will combine the fully-functioning anatomy and life-like tissues of SynDaver surgical humans with the movie-ready realistic visual appearance pioneered by Lifecast Body Simulation.

Full press release here

This looks neat - a web-based scenario builder... IRIS -

iRIS is a unique web-based platform to help you design high quality scenarios and offer the best learning experience possible, as well as helping you get the best value from the investments you have made in manikins and other resources. iRIS will support you in:
• ensuring your scenarios are developed in a standardised, high quality manner
• creating significant efficiencies in terms of the time required for designing scenarios and collating simulation resources
• reducing the time and effort required to train colleagues in the design and authoring of scenarios
• building engagement with a wider range of clinicians to harness their expertise in developing new scenarios
• driving interprofessional collaboration and sharing of content with other simulation professionals
Authors can collaborate on scenarios together internally, or in partnership with other organisations, without the need to send scenarios and their related resources to each other via email. iRIS supports the entire simulation team offering benefits for authors, facilitators, simulation technicians and learners that drives operational performance, cost reduction, increased efficiency and continuous improvement. relaunches medical simulation resource website & newsletter with new features.


Guest article from David Halliwell - Manikin Mentality: Please don't abuse your manikins...

David Halliwell gave me permission to re-post an article he wrote on LinkedIn. Check it out below - and follow him on LinkedIn to keep up with all his great articles.

Whilst showcasing our new manikin products at conferences around the world this year our team at Lifecast have become obsessed by trying to understand the mindset of the user - trying to get to grips with why they behave differently with x manikin vs manikin y.

Is it realism of the features? Is it weight or warmth or touch? What exactly is making the difference? What can we do to increase Realism?

Smell, colour and fine detail...

I understand the manikin is only one small part of the training event - and the skills of the educator, the environment, the props, the learning contract, the debrief are all key components.

I have always been a fan of the "magician and the wand" discussion - please see below... BECAUSE if your manikin is an expensive Wand - then your magician needs to look after it!

I understand that there are different simulation tools for different jobs... and that with the right tools and people we can get the student to 'suspend their disbelief '.

Emotional Attachment / Buy in - are all concepts we have explored as we continue our journey to build tools that will transform simulation. Working with great brains to re-think the traditional simulation concepts.

As Educators / Trainers we need to try and explore the way tools are used - how and why they work - and long term to explore - how do they benefit student outcomes?

Recently I've noticed that there are a great deal of manikin abusers out there! 

Medical Manikin's are usually expensive tools - increasingly engineered to look and feel real - with new features being designed by companies around the world each week - yet as I watch people use them I sometimes feel concerned by the lack of care or attention they are given by participants.

In my previous NHS roles I would often spend £100,000+ a year (Every year) to replace broken manikins.

There are some common observations....

Rough intubation - a "I will get this tube down if it kills me!” mentality. Not every person is easy to intubate - not every manikin should be easy - maybe the educators are actually looking at how you cope when you can’t quite see the perfect view with ease.

If you continue to DIG around in the Away - rather than fall back, regroup and use plan B techniques - you are maybe not the right person to be playing with Airways.. 

Maybe its a positioning issue? Maybe its the tool you are using? Standard blade vs difficult airway blade - size of blade etc... Maybe the manikin is designed to be somewhat awkward.

Shoving OP airways in (without care…) Sufficient Attention is not given to OP Airway insertion - If you insert an airway with the little attention to detail that we see in manikins you really could be causing significant damage - to teeth and to soft tissues.

You may not know but the OP Airway causes more damage to teeth in Anaesthetised patients than the Metal Blade of the Laryngoscope -

Shoving fingers in places where fingers shouldn’t go! - Recently I’ve seen many people "Shoving their fingers down the Lady manikins throat"... Why? I don’t get it.. Is it sexual? because ... it sure as hell isn’t clinical!

When I ask them what they are doing they say - "I was having a feel of the anatomy" - (Really? - Do you do that with your patients?) "

"I was seeing if I could digitally intubate" -  When did you last do that to a patient in your theatres? I understand that these skills exist - and maybe for 0.005% of patients and clinicians these may be skills you need, but maybe we could save hundreds of thousands of pounds to the NHS by just thinking differently...

Please try and 'Treat your manikins with the same care and respect with which you would like to be treated...'

Its a simple message - Please look after your manikin like you would expect to be looked after... Manual handling, Clinical skills, Skin care, the list goes on...

I feel we need a shift in mentality - TREAT YOUR MANIKIN LIKE YOU WOULD A PATIENT!