Debrief is where simulation becomes learning

No one working in simulation needs to be told that the scenario itself is only part of the learning experience. The real educational value often takes shape afterward, when learners have the chance to examine what happened, reflect on why they responded the way they did, and consider what they need to carry into future practice. Debrief is where performance begins to turn into judgment, and where feedback becomes useful enough to change what happens the next time.

What determines the quality of that conversation, however, is not simply the skill of the facilitator. It is also whether faculty and learners have a clear, shared view of what actually took place. When debrief is built on memory alone, participants often walk in with different recollections of the same scenario. The learner remembers intent, the observer remembers selected details, and the facilitator remembers what stood out in the moment. A strong video platform reduces that gap and gives everyone the ability to return to the same event with the same visual evidence. This is what makes video such a critical component of effective simulation and debriefing.

Shared evidence makes debrief sharper and more useful

That point came through clearly in conversations with leaders in the space. Dr. Marie Lindley, Associate Dean for Strategic Initiatives and Innovation and Clinical Associate Professor at Dordt University, described video as a tool that helps students make sense of their performance while also strengthening the feedback faculty can provide. “Video in multiple ways allows us to help our students process information. But even more importantly for us, it helps our faculty and our simulation staff be able to both facilitate effectively and provide feedback to the students so that they can take those lessons learned into their future practice.”

Her point captures the value of VALT well. Its importance is not simply that it records a scenario. Its importance is that it gives faculty a stronger basis for debrief and gives learners a more accurate basis for reflection. Rather than spending the first part of the discussion reconstructing what happened, educators can move more directly into analysis: where communication broke down, what cues were missed, how priorities were set, and what clinical reasoning shaped the response.

Dr. Lindley connected that review process directly to patient care when she said, “By watching that video, by talking about the different things that we maybe did, we can then say, what’s the priority for our patient because the end is safe patient outcomes.” That line gets to the heart of why video belongs inside debrief rather than outside it. Playback is not useful because it allows a scenario to be watched again. It is useful because it helps learners connect what they did to what mattered.

Check out how to easily add timestamped feedback to highlight key moments of reflection in the VALT software.

Video deepens reflection in ways memory cannot

Recorded review also changes the quality of learner self-assessment. Simulation educators often ask students to reflect on their own performance, but that reflection is always limited by how much students can accurately recall and how well they can interpret their own behavior under pressure. Video gives them the chance to step outside the immediacy of the moment and see themselves from another perspective, which often leads to insights that would be difficult to reach through verbal feedback alone.

Danny Opperman, Director of Clinical Simulation Education at the Philadelphia College of Osteopathic Medicine, spoke to that value through the lens of competency-based education. “For competency-based education, it’s really important for our learners to see themselves over time… and see how they progressed,” he said. He extended that point in practical terms: “And they can watch themselves, they can take notes, and then they can better themselves for their very next task or simulation.”

That is an important distinction. Video review should not be understood as a one-time playback tool used only to revisit a single event. In a well-run program, it supports longitudinal growth. It helps learners recognize patterns, see progress across repeated experiences, and apply feedback in ways that carry forward from one scenario to the next. VALT supports that kind of work because it is built not only for capture, but for review and ongoing educational use.

Students learn from seeing both strengths and missed opportunities

Another advantage of video is that it gives students a fuller picture of their own performance. Strong debrief is never only about identifying what went wrong. It should also help learners recognize what they handled well, what they need to refine, and where they are already improving. That balance matters because confidence and correction are not competing goals in education. They are both necessary.

Dr. Lindley described that balance directly: “When they get to see their stellar moments, it boosts their confidence. And when they get to see areas where they may have been able to make better choices, they’re able to still use that as a positive learning experience.” What makes that quote especially useful is that it reflects what many faculty already observe in practice. Learners do not benefit from criticism alone, and they do not benefit from reassurance alone. They benefit from a clear view of performance that allows them to see both what should be repeated and what should be changed. Video makes that possible in a way that recollection rarely can.

Video reveals the parts of performance that are easiest to miss

Some of the most valuable learning in simulation has less to do with technical execution than with communication, tone, presence, and how care is experienced by the patient. Those aspects of performance are often difficult for learners to judge in the moment. A student may believe they were calm and reassuring, only to realize on review that they appeared rushed, overly task-focused, or less attentive than they intended.

That is one of the reasons video can have such a powerful effect on learner awareness. As Dr. Lindley explained, it is “a great way to just increase awareness of those things.” For educators working to improve communication, empathy, teamwork, and professional presence, that kind of visibility is not incidental. It is often where some of the most meaningful learning takes place, because it allows students to see the difference between what they meant to convey and what they actually conveyed.

Usability matters because faculty adoption matters

Of course, even a strong educational approach can lose momentum if the technology surrounding it becomes cumbersome. In simulation, a video system only strengthens debrief if faculty can use it easily and consistently. If it takes too many steps to access recordings, locate the right moment, or transition from scenario to review, the platform becomes one more source of friction in an already demanding teaching environment.

Dr. Lindley addressed that point with unusual clarity: “For every click, that a faculty member has to remember to do in a software or an extra button or an extra login, or every single step of that can become a barrier for faculty adoption.” That observation should resonate with anyone who has ever tried to build video more deeply into an educational workflow. Faculty do not need a system that looks impressive on paper but slows them down in practice. They need a platform that supports the flow of teaching and makes it easier to move from observation to reflection without losing time or momentum.

That is one of the clearest reasons VALT stands apart from generic recording systems and older tools that were never designed around simulation education. Because it is browser-based, supports multiple rooms and cameras, and is built specifically for observation, review, debriefing, and evidence capture in educational and clinical settings, it aligns more naturally with the reality of how simulation centers operate. The best debriefing technology is not the most complicated technology. It is the technology faculty will actually use because it helps them teach well.

A debriefing platform must fit operational reality

The practical fit of the platform matters even more when video is not an occasional enhancement but part of the daily infrastructure of a program. In many centers, video supports not only debrief, but observation, assessment, continuity across cohorts, and the broader consistency of simulation operations. When that is the case, the platform cannot be treated as secondary.

Opperman made that point directly in describing the role of video at PCOM: “...Video is critical, in our daily simulation centers.” He then made the operational case even more clearly: “Our system is critical. And if it’s down… we cannot move on without it.” Those comments matter because they remind us that video is not merely an enhancement layered onto simulation after the fact. In many programs, it is part of the educational and operational foundation.

Dr. Lindley offered a related perspective when discussing what mattered in selecting a platform over time. She emphasized the need for a system that is user friendly, allows quick access to recordings, supports sharing when needed, and can grow with changing learner and program needs. She contrasted those priorities with earlier systems that felt “more of a security system” than a tool built for education.

Trust and psychological safety still matter

Technology alone cannot create psychological safety, but the wrong technology can easily disrupt it. Simulation leaders already know that video only supports learning when learners understand how recordings are used, who can access them, how long they are retained, and what role review plays in the overall educational process. Trust depends on that clarity.

Dr. Lindley expressed that expectation simply: “What happens in SIM stays in SIM.” She also described the role of prebrief in creating a space where students can take risks honestly and use the review process constructively, saying, “We all deserve a day for an edit, and this is where it can happen safely.”[3] Opperman echoed the same principle from the learner perspective when he described simulation as “a safe space. Learn to make mistakes here and not… on a real patient.”

That is the environment a debriefing platform should support. VALT helps programs do that by fitting secure educational workflows rather than forcing faculty to rely on improvised tools that were built for other purposes.

Why VALT belongs at the center of debrief

Simulation programs are not looking for more technology for its own sake. They are looking for infrastructure that makes strong teaching easier to deliver and easier to sustain. They need a system that helps faculty move from observation to analysis without unnecessary friction, helps students reflect with more accuracy and less defensiveness, and supports the secure workflows that serious simulation programs require.

That is the case for VALT. It gives facilitators a clearer way to anchor debrief in real performance, gives learners a stronger view of their own decision-making and communication, and supports the daily realities of simulation operations across rooms, programs, and cohorts. The message from these conversations is consistent: when debrief matters, the video platform matters too. VALT does not replace good facilitation or sound educational design. It gives both a stronger foundation.

Get a personalized demo of VALT to see how you can deliver better outcomes in your sim space.

Gathered from select episodes of our podcast, On Record. Hosted by Mike Anzalone and Carmen Haak, On Record highlights how audio and video tools are used in education, healthcare, simulation, communication sciences, and research. The podcast offers a platform for professionals to share insights, experiences, and practical applications.
Episode 3 - Building Confidence Through Simulation with Danny Opperman
Episode 9 – Live from IMSH: How Video Strengthens Debrief, Confidence, and Outcomes with Dr. Marie Lindley

Introduction

Why Understanding AV Systems as a Whole is Crucial

The Importance of Identifying Fail Points

Every AV system has multiple fail points—places where a signal can degrade, get interrupted, or be routed incorrectly. Without a clear understanding of these, troubleshooting often turns into trial and error, leading to wasted time, frustration, and even unnecessary component replacements.

The good news? Fail points aren’t random. With a little practice, you can anticipate where they are and check them in a logical order. Each AV setup is unique, but the principles remain the same. Key areas to map out include:

• Where signals originate (e.g., microphones, vitals monitors, cameras)
• Where signals are amplified or modified (e.g., amplifiers, mixers, DSPs)
• Where signals split (e.g., distribution amplifiers, routing matrices)
• Where signals end (e.g., speakers, recording devices, messaging systems)

When you know your system’s starting points, processing points, and endpoints, troubleshooting becomes much faster. Instead of hunting blindly, you can isolate the problem logically and restore functionality with minimal downtime.

A Step-by-Step Framework for Troubleshooting AV Issues

When things go wrong in an AV system, it’s easy to feel overwhelmed by the number of components involved. Instead of jumping straight into random fixes, use a structured, step-by-step approach. Think of it as creating a checklist for your brain—simple, repeatable, and adaptable to almost any AV setup.

1. Start at the Source
Ask: Is the signal being generated in the first place?
• For microphones: Is it powered on? Is the battery fresh or charged?
• For cameras: Is it connected to power and sending a feed?
• For monitors or medical devices: Are they actually outputting data?
If the source isn’t working, the rest of the chain doesn’t matter.

2. Follow the Signal Path
Once you know the source is working, trace the signal step by step.
• Follow the physical cables—are they connected securely?
• Look for obvious wear or damage on wires.
• Check if inputs/outputs are plugged into the right ports.
A mislabeled or unplugged cable is one of the most common culprits.

3. Check Processing & Amplification Points
Ask: Is the signal being boosted, converted, or processed correctly?
• Verify mixer or DSP (Digital Signal Processor) settings.
• Check if mute buttons, volume knobs, or gain levels are set appropriately.
• Look for indicators—many devices have LEDs or small screens that show if a signal is passing through.

4. Confirm Distribution & Routing
If the signal passes through a router, switcher, or distribution amplifier:
• Double-check the routing configuration. Is the input mapped to the correct output?
• Ensure the device is powered on (yes, people forget this under pressure).
• If possible, test with a known-good source to confirm the distribution path is working.

5. Test at the Endpoint
Finally, confirm whether the destination is receiving and outputting the signal.
• For speakers: Is the volume turned up? Are they powered?
• For recorders: Is the recording input correctly selected?
• For displays: Is the right input selected on the monitor or projector?
Sometimes the issue is as simple as the wrong source being selected.

6. Isolate & Swap Components
If all else fails, swap in a known-good cable, microphone, or other component. This isolates whether the issue is with the equipment or the system itself. Keep a few backup parts handy (spare HDMI cable, microphone, power supply) to save time during troubleshooting.

We don’t need to tell you that background noises and sound effects are a simple and cost effective way to increase the realism of simulation scenarios. You already know this and you asked us for it! The survey results are in and links to the most requested sound effects are below for you to download and use in your simulations.

There are several websites offering free sound effects. Our favorite of all the websites was freesound.org They had the largest range of sounds, but also some of the worst quality sounds (poor audio quality or unrealistic sound effects). Others that you might like to search are:

https://commons.wikimedia.org

https://Soundeffectsplus.com

https://Soundbible.com

https://sound-effects.bbcrewind.co.uk/

Wondering how to use sound effects in your simulations?

For manikin sounds, navigate to the folder with the manikin speech sounds on the computer you use to control the manikin. Add the sounds to the folder and you should be able to access them just as you would with the other manikin speech sounds. If you have any issues reach out to the SimTribe in our member portal letting them know which manikin you are using or contact the manikin manufacturer for help.

Here are our best picks:

Hallway/room noise 1 - no signficant sounds

Hallway/room noise 2 - background conversations, curtain gets pulled

Hallway/room noise 3 - soft - some typing, people movement, distant conversations

Baby cry

Baby cry 2

Baby restless (not crying)

Baby babble content

Toddler cry

Toddler babble content

Cough - with slight wheeze, female 

Female cough 1

Female cough 2

Male cough

Child cough

Snoring - gentle

Snoring - louder

Male burp

Male gag/vomit

Sneeze male 

Sneeze female

Neutral sneeze

Baby sneeze

Disclaimer: SimGHOSTS, like any other organization, has used or is using these cables for their events and offices.  There is no financial interest in promoting them. The information expressed in this blog belongs to the writer, who is a user of the products. 

What are video connectors?

BNC

BNC “Bayonet-style Neill-Concelman Connector” are round plugs with a locking system which uses the coaxial cable. It is mostly used in professional AV systems. Due to some limitations, VGA is slowly fading away from new products, however, some legacy systems are still using them. BNC was patented in the 1950s and was very successful in TV and broadcasting for an extended period. Today the BNC connector is used only for very specific tasks and isn’t often seen outside broadcast facilities.

Male:

Female:

RCA

RCA is an older method of transmitting video signals using the composite and component video cables. They are both analog signals and are not used in the latest devices. 

A composite video cable is also known as an RCA. It comes with 3 colors:  yellow for video and red and white for audio. It doesn’t support High Definition (HD) video. The video is heavily compressed due to using one cable and it is loses much of its resolution and picture clarity. Some legacy equipment still may require this connection.

Component video splits the video signals into three cables (green, red, blue) and it transmits each color independently, and therefore, the resolution is higher than composite video. This allows the signal to support HD resolution as high as 1080P. Although it supports HD, the cable is fading away and being replaced by HDMI.

VGA

VGA (Video Graphics Array) is a very common connector used to connect computers and monitors. Until recently It could be found on almost every display and computer. VGA signal is analog. Its resolution is not as good as DVI and HDMI cables, which we are going to discuss later. The VGA port was standard on every desktop and display from the 1990s through 2010. VGA cables are capable of displaying RGB (Red, Green, Blue). VGA connectors have 19 pins.

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DVI-D

DVI (Digital Visual Interface) is an upgrade from VGA.  It is analog and connects computers to monitors with higher resolution. DVI connectors contain 24 pins, arranged in three horizontal rows of eight pins. DVI connections cannot transmit audio but supports high definition video signals. They can be found in the newer model of computers, ultrasound machines and recording systems.

DisplayPort

DisplayPort is an interface technology that is designed to connect high-end graphics capable PCs and displays as well as home theater equipment and displays. DisplayPort is commonly used for computer monitors but it does support other data transfers such as audio, even USB and Internet.  The latest version of DisplayPort is 1.3, 32.4 Gigabits per second of bandwidth which is huge.  It can also drive a 5K display.

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Female:

HDMI

HDMI stands for High Definition Multimedia Interface. HDMI technology uses the same video information as DVI but it also supports digital audio and control signals. This is pretty much the standard for many devices. There are several different generations with different capabilities.  The most recent version is HDMI 2.1. 

Male:

Female:

HDMI Mini

While HDMI cables are used on TVs, DVD players, Projectors and computers, HDMI Mini cables are used for DSLR cameras, and some smaller electronics. The quality of the signal would be the same as the regular HDMI, however the size of the connector measures 10.42 mm x 2.42 mm. 

HDMI Micro

The HDMI Micro connector is used for cellphones, cameras and some e-readers to display the content in bigger displays, the HDMI micro connector measuring 6.4 mm x 2.8 mm. Using this connector will still provide the same quality as the regular HDMI connection.

Stay tuned for next month’s blog about audio connectors and cables.

Disclaimer: SimGHOSTS uses Zoom for its internal meetings and webinars and does not sell Zoom products, the opinions expressed in this blog belong to the writer who is a Zoom user.

With the impact of the COVID-19 pandemic, the majority of workforces around the world started to use some sort of online collaboration tool, such as WebEx, Zoom, Skype, Google Hangouts, UberConference and more.

Zoom has become one of the most popular methods for conducting day-to-day business for schools, universities and businesses.  Below is some basic information about the platform and information on security and privacy issues that have arisen.

What is Zoom?

Zoom is a cloud-based platform that provides remote conferencing services that combines video conferencing, online meetings, chat, and mobile collaboration.  It is a platform that allows individuals, institutions, and businesses to meet with their friends, employees, co-workers, and clients.  It gives the participants the ability to share content and interact with each other using computers and mobile devices.  Although the technology has existed since 2013, it has become more popular after the outbreak of the COVID-19 Coronavirus. 

Signing up for Zoom is FREE with additional paid plans that can found on their website:  www.zoom.us/pricing

Core Features of Zoom:

• One-on-One Meetings (ability to meet with your coworker and share content)
• Group video conferencing (ability to have a group video conference, up to 500 participants)
• Content Sharing  (ability to share your desktop or application with your audience and Whiteboard, e.g. PowerPoint, PDF, .jpg)  
• Chat

Zoom’s Security/Privacy Issues:

One of the biggest security issues facing Zoom is the surge in "Zoombombing," when uninvited attendees break into and disrupt your meeting.  There are reports that students or hackers have exploited the content sharing features of Zoom and have shared pornographic and racist content. 

The following are 10 Security and Privacy Tips and Steps that you could use in order to prevent or stop such issues:

1. When scheduling your meeting DO NOT use your Personal Meeting ID (PMI). If you have a public meeting, make sure to Password Protect your meeting which creates another layer of security.

This screenshot shows how to create a unique ID for your meeting, which enables a password for your meeting.

2. Waiting Room: Enabling this feature allows the host to monitor who is able to attend/enter a meeting. Some hackers still may bypass this feature, especially in meetings with larger participant numbers. 

3. Join Before Host: It is recommended to disable this feature. 

4. Make sure that ‘Only Hosts’ are allowed to share their screens.
Limiting the ability for attendees to share their screen prevents hackers/hijackers from taking over and sharing unrelated materials. 

This feature could be configured at the Zoom Online Portal before that meeting (above left) or could also be enabled during the meeting by clicking on the Share Screen>>Advanced Sharing Options (above right).

5. Invite-Only Meeting

Enabling this feature during the scheduling of your meeting will restrict anonymous logins, which will allow only invited attendees to participate. This feature can be enabled on the Zoom Online Portal. 

6.  Disabling Private Chat

Disabling this feature will stop someone from sending inappropriate messages. This feature can be disabled on the Zoom Online Portal shown below.

7.  Locking Meetings

Once everyone who was invited has joined, Lock  the meeting.  This stops any unwanted attendees.  Click on Participants button>>At the bottom, choose More>Lock Meeting

8. Prevent File Sharing

Zoom allows participants and hosts to share files during meetings.  While this is a great feature, it could be dangerous.  If your meeting is compromised, someone could share inappropriate files in the Chat that would be visible to all attendees. I would recommend only enabling this feature if your meeting or session requires it. This option could be accessed from the Zoom Online Portal.  On the left side, go to Personal > Settings. Click In Meeting (Basic). Scroll down until you see File Transfer.

9.  Remove or Put Someone on Hold

As a host of a meeting, you are able to remove someone or put someone ‘on hold’ if they misbehave or do not belong in the meeting. Go to the Participants pane on the right. Move your mouse over the name of the person you want to remove and when options appear, choose REMOVE (pictured below left).

To put someone on HOLD: Move your mouse over the name of the person you want to remove and when options appear, choose PUT on HOLD (pictured above right).

10.  Mute all of the Participants

When you are the host of a meeting, you have the ability to Mute  participants.  This is especially helpful in preventing unwelcome participants. To do this you need to follow the steps below.

There are many other features on Zoom Online Portal that you could explore to 'enable or disable' to prevent any "Zoombombing."  Zoom also has a great online support library that explains its features in more detail.

Disclosure - Ferooz Sekandarpoor and SimGHOSTS have no affiliation with Ohmnilabs, this is an unsolicited review. 

Image courtesy of Bernard Goldbach (CC BY 2.0)

I recently learned about a new technology that I anticipate is going to be very useful in many settings including medical simulation. The technology is telepresence robots and there is one company that has a different approach that makes this technology attractive to simulation centers.

I am talking about Ohmnilabs, they are a Silicon Valley company, and they are making telepresence robots that you could place it in a remote location and control it from your smartphone or a computer. They are NOT the only company that offers such a tool but this company offers a development platform and kit that allows users to add new features that fit their setup. As an example, users could create or add arms to pick up objects or maybe perform CPR. I think having an open platform to build further is unique here. 

The telepresence robots can be utilized in many environments such as: 
Families:  You could place one of these robots in your parents' home and have the ability to remotely control the Ohmni robot, and video chat with them and follow them around the house. The Ohmni robot needs WiFi access and could dock itself to charge.

Healthcare facilities: Healthcare providers can use Ohmni robot to allow their medical specialists, doctors, nurses to attend their clinics remotely. This will save lots of time and resources to providers while it expands their service accessibilities

Education/School Settings: Ohmni robot could be utilized in a school setting. A medical condition, illness, or alternative event can prevent a student from learning.  With the Ohmni robot, the instructor will be able to have an interactive session with the student.

Businesses: Ohmni robot has an excellent application for the business world as well. People working can remote into the robot attend their meetings and communicate with their colleagues. They can talk to their colleagues, move around the office and chat with coworkers.

While the above usages are what the company intended for this technology but I think it will be a useful tool in the simulation settings as well. For example, we may not have always a trained debriefer available for each simulation sessions, using this kind of technology would be great to allow a remote debriefer to follow the learners during scenarios and then follow them into the debriefing room and interact with them.  The other scenarios that I would think of is that an instructor could be in a different hospital and still be able to participate with her/his simulation session remotely. Although, this could be also accomplished by Skype or other video conferencing services but this one adds a layer of interactivity for the instructor to be in each simulation setup while being physically away.

The major requirement for operation is connectivity. It can operate on 802.11 2.4 Ghz or 5 Ghz WiFi (5 Ghz highly recommended) and needs internet access with 3Mb speeds (robot and remote user) for best performance.  
 

For more information see the Ohmnilabs website 

Whether you are starting a new center, dissatisfied with your current system, or just need to consider your path for an update; choosing an A/V system can be quite a process.  The process can be long and arduous.  Typically these systems have a lot of cost associated with them, you’ll likely interact with the system every day, and there is the potential for this system to affect downstream data, grades, quality assurance, and a myriad of other points within your system.  Moreover, you’re likely to be the first line of support for this system.  Whether directly or in conjunction with your IT department, which can add an entirely other level of complexity to anything you want and need to do.

As a simulation specialist or tech, you may not make the decision in a vacuum, but you need a voice in this conversation.  Your perspective is key in helping make the right decision.  For your day to day work and for your center as a whole.

As you get ready to head down this path, these are the things I would be thinking about:

1.  Don’t get emotional
A/V systems, interestingly enough, can often elicit an emotional response.  People love their systems, hate their systems, dream about their systems, and fantasize about their destruction.  Before you start lining up demos, think about how you’re feeling about the process.  Are you dreading sitting through demos?  Does the idea of spending potentially hundreds of thousands of dollars make you ill?  Are you so desperate to get rid of your system that you’ll take the first system you meet?  Be aware of your biases before you get started and you’ll save yourself a lot of heartache in the long run.

2.  Consider your needs first
What do you actually need from your A/V system?  What kind of support can you provide in house?  Do you need to record your encounters?  Save them for 10 years?  What elements of your accreditation system may be met by your A/V system?  When you make a list of very specific needs for your program, you can determine where you might be willing to make sacrifices if need be.  This also gives you a chance to truly compare apples to oranges between different systems.  Knowing what features are crucial for you will help you separate out bells and whistles and really get your needs covered.

3.  Separate yourself from “what we’ve always done”
It’s easy to fall in to the trap of comparing any system you have to the way your system has taught you to behave.  A lot of computer systems only seem easy to use because we’ve grown so accustomed to using them.  Make a conscious effort to separate your thoughts about the process you work through and consider more the end product that you are looking for.  There will be a point to compare processes, but first consider your needs first (see above).

4.  Consider your wants and needs for the next 5 years
A/V systems aren’t cheap.  And you definitely don’t want to be saddled with a system that only meets your most modest needs or, worse, a system that you are unhappy with for the foreseeable future.  Do your best to consider a 5 year plan on things that you may want to do or produce.  In doing so, you may find that there are other essential items you need your next system to have.  Add these to your list and consider how much importance you want to place on each of them.

5.  Look at everything
Seriously, everything.  There is no room for company allegiance in this process, at least not early in this process.  Cast the net wide, look at every system out there.  Even systems that you may have looked at in the past.  Then, ask around.  Find people that use them and get their thoughts and feelings.  Gather as much data as you can.  And, don’t hold back!  If your questions aren’t being answered, ask them again.  You’re trying to make a big decision here, you need answers to every question you have.

6.  Make your five-minute pitch
The last thing that I would recommend is, once you’ve arrived at a system or two that you’re interested in.  Make a five-minute quick talk that you can give if you’re given an impromptu opportunity to speak to what you recommend.  Write it down, practice it, and be ready and armed with it whenever you may have the chance to pitch your recommendation.

What else do you consider when you look at a whole center system?

We’re all familiar with Skype, FaceTime, Zoom and other point to point video conferencing apps.  Yet they all have one common issue, if you don't use them with the right hardware you get poor picture and sound quality, which detracts from the meeting experience. To have the best video conference experience you need to have a good camera that is wide angle and a great microphone to capture everyone in the classroom or meeting room.

Here, we are going to talk about an affordable, all in one video conferencing system, that you could easily deploy in your teaching and workplace.

Logitech Group:

Logitech Group is an all-in-one package that contains all the hardware that you need to use during the video conference at a reasonable cost. It is a USB plug and play system that connects to your computer and will work with your preferred video conferencing software. 

It comes with a 1080P 30 frame performance camera, with motorized pan and tilt and 10x optical zoom, it also comes with a base station which embeds a large speakerphone and Omni-directional mic.

The system could be used for any room settings with the capacity of 8 to 14 people. The base or the hub of the system comes with a 2 meter long USB cable and additional microphone options.

Logitech partnered with Microsoft, Zoom, Cisco and other video conferencing solution providers, to allow their hardware to integrate with their software.

Logitech Group supports a seamless integration to the following videoconferencing system software such as Skype for Business, Microsoft Cortana, Cisco Jabber and offers enhanced integration with BlueJeans, Broadsoft, LifeSize Cloud, Vidyo, and Zoom.

The price for this product is different between regions, please visit their website to get the right price, but it is will cost between $999 to $1349 US.

https://www.logitech.com/en-ca/product/conferencecam-group

This is a genuine unsolicited product review. Ferooz Sekandarpoor and SimGHOSTS have not received any benefit from Logitech in return for publishing this review.

I Have the Power... Supply!" - How PSUs Work Inside Our Simulation Computers

Power supply units (PSUs) inside of a computer case have little influence on our daily lives. If they work for the computer when it was built, they rarely have problems. This article will discuss what can go wrong and what you need to know about them.

Power supply units are rated in watts, and most function on both 110V or 220V AC power supplies, thus making them universal across countries and power grids. Most standard desktop computers will require nothing more than a 300-400 watt power supply, and calculators such as this can help you determine your need. They will likely function for decades without problems. Other than replacing a cooling fan on occasion, they are unlikely to need repair. If the cooling fan does not begin rotating when the PSU is powered on, it will need to be replaced. Some fans will emit a sound as the bearings begin to fail, giving you time to plan this repair before the entire PSU overheats and needs replacing.

The power connector from current PSUs has been essentially standard since the mid-1990s, and is called an ATX power supply connector. It has 3.3V, 5V, and 12V outputs. These specific voltages and common (or ground) wires are arranged in a 2-row connector with 24 total pins (originally 20). This, much like the USB port, is almost taken for granted as one of the few truly universal connections available in the world of computers. As with all standards, however, there are exceptions.

ATX power supplies all allow for a unique trick that can be used to test the PSUs, or use them without needing an attached motherboard or computer. Having a reliable and high power regulated PSU can be useful for low-voltage light fixtures, USB charging equipment or in place of other power adapters. The ATX power supply does not turn on when plugged in, but instead will output power only when “switched on” by connecting pin 16 (usually the green wire) to a common wire (usually a black wire) terminal on the connector. Some PSUs even come with an adapter in the box to allow this connection for external operation. While this jumper wire is connected across the pins, the power supply will turn on and connected devices will operate (see diagram below by Collab, update by Sbmeirow (Own work) [CC BY-SA 3.0], via Wikimedia Commons)).

Dell has been producing proprietary motherboard and power supply units for a number of years that, although functional, will not allow the interchange of parts outside of the manufacturer or device for which they were produced. This problem is most common when upgrading to a “high-end” graphics card. These cards, whether from AMD or NVidia, will require additional dedicated power connections to support the massive processing demands on these devices. They may have either a 6-pin or 8-pin connecto,r depending on the power usage requirements.

With the explosion of virtual reality viewing devices, like Oculus Rift, Microsoft HoloLens, and HTC Vive, the need for high-end cards is increasing as well. Our center required a new graphics card to operate the Oculus Rift headset, but the new video card required more power than the included 365 watt PSU in the Dell Precision Tower 3620. The PSU looked standard in nearly every way until examining the connection to the motherboard. Instead of the customary 24 or even 20 pins, only 8 were present.The same green wire was there and could be used to turn on the device as described above, but the remaining pins only offered 12V (or very close to 12V) outputs. The most dangerous part of this motherboard connector is that the traditional ATX PSU plug would fit onto the eight pin motherboard header, but with incorrect power outputs on the connected pins.

Beyond just getting a system with a fast enough processor, enough RAM, the correct graphics chipset, and power supply with 8 pin power connectors for the graphics card, an additional adapter was required to install a standard PSU into the case.

Whether you are and audio/video guy or and facilitator or a moderator, we always experienced the time that takes for that microphone to be passed to the person who asks a question or says something in any event, sometimes the audience don’t wait and ask their questions which he/she needs to repeat it again when the microphone arrives. Well, that is no longer the case, here is the world’s first throwable microphone for the audience which called “The Catchbox.”

Catchbox is made of soft foam and covered in different fabric colors which you could throw from one person to another during your event. It is a great ice breaker for any workshop and event, and you can use as many as you want at your event. Most use this mic during an audience Q&A session or small group discussions.

How does it work? Every time the box in motion it is automatically muting itself and eliminating the unwanted noises and sounds and the quality is clear and crisp during the speech. Catchbox comes with a separate receiver that can be plugged into the various sound systems including stereos, computers, and professional devices.

How much does it cost? It is listed on their website for $499.

Cate 5e and now Cat 6 terminal ports (RJ45) are ubiquitous within the healthcare simulation environment, as well as in every other building or industry that uses a computer. Most people view these 8 conductor ports and jacks as a convenient, secure, and fast connection to an internal network or the World Wide Web. These simple cables and terminals are useful for ever so much more than this, but it requires users to think outside of the box.

The eight conductors that are required for Gigabit connection speeds (1000 kbits/second) can be divided. Using only four of these eight wires will still give you a viable network connection at 100 kbits/second, fast enough for all but the most data heavy transmissions. Both of these connections still require a network interface card; and usually a switch, gateway or server to be useful for connection between devices. But what if these cables were thought of as just wires, how else could they be put to use?

A patch panel was used in the past in the telephone industry to physically transfer an incoming call from one line to another at a telephone switch board. This same concept can allow a signal to be easily directed from one port to another in a simulation center. We ran an XLR audio input and output from each control station to a central patch panel in our server room. This system allows easy expansion of analog audio connections for communication from every simulation room to every control station in our center even if we are viewing over a network IP video stream with a small delay. A Cat 6 wire can be terminated into the back of a rack and made into an easily accessible patch panel in the same manner.

If two Cat 6 ports are paired together in location and termination 16 total conductors are available. As it so happens this type of paired cable run allows for some unique signals to be transmitted. HDMI cables known for transmitting high definition video and audio signals together on the same wire have a significant length limitation of 50ft. Any signal that needs to be transmitted further than this must be amplified or send over a specialty cable. Some specific cables using RedMere technology can send a signal a further distance, but the source and output must be pre-defined. Special adapter cables can be used to send an HDMI signal using a paired Cat 6 cable up to 100ft. These cables are still subject to a input and output source distinction, but as the primary cable distance is in the wall, the adapter box can be more easily moved should the source and display move. This type of adapter can expand the possibilities of video transmission using existing infrastructure.

Audio signals can also been designed to use a similar cable structure. Although often lacking the ideal shielding in a long cable run, companies like TOA planned on using this type of paired Cat 6 cabling for transmission of audio for a paging system. Our center has used a TOA multi-zone paging system to provide overhead announcements to individual simulation rooms, hallways, or lecture rooms. Because the selection of zone and audio are transmitted using a paired Cat-6 cable, we were able to use a paired Cat-6 patch system to allow the microphone to move between control rooms if necessary for these global announcements.

One more use of Cat 6 cables is for USB transmission. USB cables are also subject to length limitations of ~15 ft, but if you need to connect a pulse oximeter from the control computer to a plug under the bed, to avoid tripping learners, a USB extender is available from many vendors such as Monoprice that will send the signal using a RJ45 8-conductor terminal up to 150 ft.

Have you seen how small these devices are getting? Check out this recent post featured on TechCrunch about a tiny Arduino computer that is the size of an AA battery!

"Based on the Tiny328, AAduino takes the platform to its sexiest form factor yet: Turning a three-AA battery holder with two batteries in it — the third battery compartment holds the AAduino — into a powerful, yet diminutive computing platform that fits in the palm of even the smallest hands."

AAduino pretends to be a battery?

"The truly ingenious thing about using the form factor of an AA battery is that by wiring it in “backwards” (i.e. with the + and – poles reversed), the AAduino can pretend to be a battery itself, and be powered by the batteries that are resting by its side."

Read the full article on the TechCrunch webpage

Live simulation as a demonstration and educational tool is a powerful application for group learning and interaction. This concept has been demonstrated as a competitive art form in the style of SimWARS. This is a specialized form of in-situ simulation and audio visual needs take on a special importance. I have run a series of toxicology simulations in this form and want to share some of the important features for improved performance if others choose to add this to their repertoire of simulation education opportunities.

This type of simulation activity fully crosses the line from educational activity to theatrical experience. But Marshall McLuhan, Canadian English professor and communications thought leader of the 20th century, purported the following: "Anyone who tries to make a distinction between education and entertainment doesn't know the first thing about either." It is the engagement of learners that will enhance the retention of knowledge.

As with any simulation activity, identifying the objectives and reason for performing the activity must be carefully considered and planned so that the activity matches that need. These toxicology sessions were used to provide an engaging case-based teaching activity for an interprofessional audience. Clinical care providers, pharmacists, and poison center toxicology specialists each have a different viewpoint for these types of cases. Cases included cardio-toxic medications, pesticide exposures, environmental exposures to heavy metals, radioactive materials, and envenomation. Each scenario required coordination of care, and this type of simulation exposure allowed all members to join in the simulated care of these patients. This type of simulation may seem backwards to many, because your primary target is the audience rather than the direct participant. Think of creating an engaging lecture with simulation as the backbone.

Who needs to be heard? 

The first AV need for this type of simulation activity is audio and mic’ing. Often this type of live simulation is conducted on a stage or in a conference room setting. The usual choir mics or boundary microphones available in a high-fidelity simulation room may not be available. Fewer participants or multiple wireless microphones may be required to meet your needs. Having too many people talking or interacting is likely to be a distraction to the audience and will detract from the overall educational aspects being demonstrated. If you are trying to cover a larger area, consider adding choir microphones using an overhead ceiling attachment or tall microphone stand that will have a larger pickup area. The next problem, is where do you place your speakers? Place them as far in front of the performers and microphones as possible and angle them away from the stage to avoid audio feedback. If you have limited audio capabilities, focus on the visual aspect of your simulation by requiring physical tasks and movement of people or equipment to improve the audience experience.

What needs to be seen, and by whom?

Consider designing the simulation so that communication and patient interaction are the focus if you have a large setting or minimal video options and can clearly transmit the audio. If you are trying to use a projector for vital signs or video reproduction, keep in mind that increased lighting on your subjects may wash out any video screen in use. The vital signs monitor as a projection object is an easier subject than video of people because high resolution is not needed and most simulators already have a high-contrast scheme for the numbers and tracings. The constant movement of an EKG strip also serves as an engaging focus for the audience. If you want to record video of the personal interactions or stream this to a display, IV poles, microphone stands and body-mounted cameras such as a GoPro can enhance the point of view of the audience members. If you are using a standard video camera on a tripod run to a projector, consider over-exposing the scene to keep people and faces visible, especially if there is a video screen projected behind them. This will help the view of the subject because cameras will by default focus on the brightest object in the field of view.

A/V enhancements:

Radiology images, EKGs or pictures of physical exam findings will help to keep the audience engaged with the case. Consider broadcasting heart and lung sounds if that is a component of the expected physical exam.

While having a full team of staged performers as confederates is an option, it is still possible to use naïve learners as the stars of the show. Pre-briefing becomes even more important because they may feel vulnerable being on display. Scenarios in which they are expected to excel would be best. Be sure to give them the resources to succeed; this will be more enjoyable for the participants and the audience. We don’t go to the circus to watch people fall; in general, we want to watch people perform well.

When scripting this type of scenario, keep it light-hearted and entertaining. Confederates and distractors should be capable to keep it fun to watch, but also help the learners stay on track.

Plan to do a run through

If you are planning to perform his type of scenario, a run-through is even more important than at your simulation center. Plan to bring all of your own equipment. It is much harder to trust the audio or network infrastructure when you are on the road, even if it is just across the hall from your usual simulation equipment. Many networks at conference centers, for your protection, block the usual network sharing and connection ports used by simulators and for computer-to-computer file sharing. A portable router can make all the difference to a functional setup.

The term Li-Fi was first coined by Prof Harald Haas from Edinburgh University, who demonstrated the technology at a Ted (Technology, Entertainment and Design) conference in 2011.  Prof Haas described a future when billions of light bulbs could become wireless hotspots.

One of the big advantages of Li-Fi is the fact that, unlike Wi-Fi, it does not interfere with other radio signals, so could be utilized on aircraft and in other places where interference is an issue.  While the spectrum for radio waves is in short supply, the visible light spectrum is 10,000 times larger, meaning it is unlikely to run out any time soon.

But the technology also has its drawbacks - most notably the fact that it cannot be deployed outdoors in direct sunlight, because that would interfere with its signal.  Neither can the technology travel through walls so initial use is likely to be limited to places where it can be used to supplement Wi-Fi networks, such as in congested urban areas or places where Wi-Fi is limited, such as hospitals.

In the recent news Apple is planning to include a Li-Fi capability in their future iPhone, meaning it can access high speed internet using the LED lights around us.

The iPhone’s operating system now openly reference Li-Fi capability in its programming code.  The technology will reach consumers within three to four years.

See a YouTube video of this technology here.

Step 1: What type of microphone and speakers are to be used with the instructor PC?

A. Headphone and Microphone Combo

1) Input = one 3.5mm plug
2) Input = two 3.5mm plug

The goal is to determine the correct port on the computer.  Many have multiple inputs that accept only mic or only speaker and one input that accepts both.

Step 2: Configure PC microphone

A. Right-Click Volume and select “Recording Devices”

B. Choose “Microphone” and then “Configure”

C. Select “Setup Microphone” and choose if you’re using a headset, desktop mic etc….

D. Follow steps  -  Read/Record/and Set

Step 3:  Adjust SimMan Voice Conference Application

This Laerdal app allows the user to further adjust the computers and manikin’s mics and speakers.

A. Go to “Options” and select “Configure”
B. Adjust volumes up or down to meet requirements (Instructor Audio vs Manikin Audio)

* If a 3rd party AV system is being used in conjunction with SM then settings will vary i.e. mute manikin mic and instructor speaker.

BYOD “Bring Your Own Device” the new trend to allow people to use their own devices such as (iPad, iPhone, Google phone, laptop, and tablet) to present in any room and connect to the Internet all without any physical cable or dongle that we are used to.

There are many solutions out there but I personally recommend the following systems

• Crestron AirMedia and WePresent.

 Here are the top Reasons that you need to switch to a wireless presentation system:

• Get Rid Of The Cables - There is nothing worse than having a beautiful room, only to have the audio-visual system stick out like a sore thumb. A wireless system design makes your room look more elegant, makes your company appear more presentable, and makes the conference room users more comfortable in your rooms.
• Make Your System Easy To Use – By having a wireless system you can easily connect to the network and have your presentation displayed using your own device. 
• Multi-User Collaborative Meetings – Some of these systems allows up to 64 users to connect simultaneously making it a collaborative environment for presentation and learning. 
• Present from any Device – Nowadays everyone own a mobile device and most institution moving towards BYOD. A wireless presentation system solve all that.
• Mobile Tool - The wireless presentation system is small enough to be installed permanently into your AV system or could be carried and get connected to any LCD display or projector and still be able present wirelessly using their own devices.

Network configuration:

• Capture of audio in the scenario
• SimMan 3G or other manikin voice
• Playback / relay of audio for live viewing or debrief

Capture of audio in the scenario

Initially we relied solely on ceiling based microphones integrated into our camera feedback system, but it soon transpired that the wide variety of possible scenarios and soundscapes didn’t benefit from a ‘one size fits all’ audio capture setup. We found certain areas were covered well at good quality, whilst others were dead spots, whilst ‘noise contamination’ meant that key conversations were sometimes missed. We then trialled using a mobile clip mic addition, which brought excellent quality audio in from the main candidate- following the trial, we invested in 3 clip mics, and the system has remained the same since then.

SimMan 3G or other manikin voice

We use the default provided voice methods for our high fidelity manikins –usually some sort of Voice over IP connection which runs in parallel with the controls from the control computer. We find there is a steep learning curve for voice actors – mic positioning, volume and attention to delegate actions all can disrupt the effectiveness of the manikin voice fidelity.  Before we retired our SimMan 2G, we had improvised our own wireless mic & amp setup to provide the voice, and whilst it took a while to setup every time, it did provide an as yet unrivaled quality of audio.

We find ( in scenario) delegate comprehension of manikin voice is good about 80% of the time, with it dropping below expectation the other 20% of the time due to usually due to the reasons mentioned above. However, we find playback / live viewing room comprehension of manikin voice frequently is poor, which takes us into our final category…

Playback / relay of audio for live viewing or debrief

Each video source is paired with accompanying sound source, so we can allow several concurrent streams to be played. For example, the main 2 cameras in our 4 bedded ward will be paired with 2 ceiling based microphone located above their default viewpoint. This results in the users in a live viewing/playback situation having to select on screen which source they’d like to listen to. We are now in a situation where we possibly have too much choice, and the method of selecting an option on screen isn’t as dynamic as users expect, resulting in incorrect channels being selected with key conversations being missed. This requires an experienced technician the majority of the time to be present to live ‘mix’ the sounds for optimal use during debriefing.

The next step

Whilst the above gradual improvements gave us a much better system than we started with, the weak link in the chain was still at the viewing end - what's the point of having an amazing ‘in scenario’ system if it’s not user friendly at the other end?
It was with this in mind that we started to consult with our suppliers about making the system even better, which lead us to a demo of Q-SYS with a company called Shure. The Q-SYS system is used across the world in places where audio and media management is critical - such as airports, performance venues and even in Disneyland.  In essence, the Q-SYS system can take multiple audio inputs and outputs, and virtualize their transit from point to point. This enables a much broader range of flexible options for routing sounds than over an analogue system.

 In HILS we have 20 different sound channels, with multiple varying endpoints- imagine if we were less constrained by their physical location? The second thing that appeals to us about this system is the scalable management of the system - rather than being 100% dependent on the supplier we will be trained in the 'back end' programming of the system, meaning we can adjust the system as our needs change. This also links into our third benefit- the system interface can be presented in various levels of complexity- so we can programme a novice user interface, empowering our more tech phobic faculty to choose the sounds they want to hear, whilst techs can have a more complicated interface. The system also has a range of clever tricks such as noise cancellation, rules about not duplicating sounds and editable profiles and pre-sets, all of which we have yet to play with.

In summary, our quest for audio improvement is leading us on an exciting new journey, and we'll be keen to share the journey over the upcoming months

Speaker systems in general work well to allow many people to listen at the same time while still being able to talk behind the scenes about elements of a scenario or specific learner actions. If the control room is adjacent to the simulation room, however, audio may be heard through the wall or out into the hallway, allowing for feedback or eavesdropping by other learners. This design does not work well in a room with a shared control room space (one control room to view and operate multiple learner scenarios) due to cross talk from the adjacent scenario. Depending on the center’s design and scenario type, speakers may still be the easiest and most cost effective option.

Headphones have made some major improvements since the Walkman of the mid-80s. Now earbuds, on-ear, over-ear, open back, closed back and noise canceling options can confuse this technology. If your control room is a shared space, has remote or direct viewing, headphones can provide private listening for one or many observers.  Headphone splitters and headphone amplifiers can expand this option with little additional cost.