Behind every successful simulation is a dedicated team of simulation technologists, who ensure that the training runs smoothly from start to end. So what does a simulation technologist do? And how do they create solutions to help enhance simulation-based learning? 

Meet Bi Xia, Xin Yi and Ying Hong (left to right), our simulation technologists at the SingHealth Duke-NUS Institute of Medical Simulation (SIMS), as we take a look at their work and their latest creation, a low-cost uterus model that is used to train junior clinicians in emergency caesearean procedures effectively.


Hi! Tell us about what you do at SIMS.

Xin Yi: We are simulation technologists at SIMS. Our role is to assist healthcare faculty in their simulation training for healthcare professionals, to achieve learning objectives for a particular skill or procedure. A typical simulation training is often split into three components: planning, execution and post-evaluation.

  • Prior to the workshop, we plan for a proposed scenario in discussion with the faculty, to make sure it is feasible and achieves the learning objectives.
  • On the day of the workshop, we provide technical support for the set-up of the labs and equipment. This includes moulaging (the creation and application of mock injuries) to create an as realistic as possible scenario for the participants.
  • At the end of the workshop, we consolidate and review the feedback to assess what the participants learned from the workshop, and how we can improve the next training.

In essence, a simulation technologist does everything behind the scenes for simulation-based training. We are the technical person, the workshop secretariat, the ‘make-up artist’… the list goes on!

How did you come to work in healthcare simulation?

Ying Hong: I had a Bioengineering degree from NTU and I joined SIMS three years ago. At that time, I had no idea what healthcare simulation entailed.

During my first week at work, I witnessed an in situ simulation (simulation training that takes place in a real-life clinical setting) at the SGH ICU. Even though it was a manikin, the doctors and nurses took the simulation training seriously and rescued the patient as they would in real life. That was a real eye-opener for me – that simulation could help healthcare professionals practise their clinical skills in a realistic way.

Bi Xia: I have a degree in Biomedical Engineering, and started working at SIMS five years ago. With my background, I was also involved in the maintenance and operation of the high-fidelity manikins, which can be specially programmed to show full body symptoms for various types of simulation training.

Xin Yi: I’ve been working in healthcare simulation for nine years. My background was in Mechanical Engineering, but I’ve always had an interest in working in healthcare. Back in 2010, I saw this job opportunity in simulation, and I jumped in, despite having no medical knowledge and experience in simulation. Thankfully, my background in engineering helped me to take on the more technical aspects of simulation, such as programming, troubleshooting and conducting preventive maintenance for the high-fidelity manikins.

We understand that the team recently developed a low-cost uterus model for O&G that has received good feedback from faculty and participants. Tell us more about the project.

Ying Hong: In 2019, the Obstetrics and Gynaecology (O&G) doctors wanted to simulate a caesarean scenario in their training that required the use of SimMom, our female birthing high-fidelity manikin. However, SimMom already comes with a manufactured ‘cut’ opening at the uterus. This means that participants do not have the opportunity to identify where to make the cut, which may limit their learning.

Bi Xia: Carrying out an emergency caesarean during the simulation also means that the pre-existing skin in the manikin will be damaged and an entirely new skin has to be purchased. This can be quite costly since we run such O&G simulations four times a year. Hence, our team decided to come up with a more sustainable solution for the long run, by developing our own uterus model at a lower cost, which can be used repeatedly in workshops.

Describe your experience creating this uterus model from planning to implementation stage – what challenges you faced, and how did you over them?

Bi Xia: We started by researching on how a caesearean was done, through reading, watching videos and speaking to the faculty members. This helped us to better identify the necessary requirements for the model e.g., the abdominal skin needs to be firm and yet not too difficult to cut through, there needs to be different layers of skin to cut through as per in real life, etc.

Xin Yi: Initially, we started off with a simple model, using materials like felt cloth, ziplock bags and foam sheets for the ‘uterus’, and water and food colouring for the ‘blood’. To simulate the tenderness of the stomach, we even put the baby manikin and the ‘blood’ in a ziplock bag, which was then inserted into the manikin.

We also had to consider other factors, like how to contain the blood that would ooze out after the cut and not let it damage the inside of the manikin. This required some creative problem-solving, and we decided to insert a plastic container into the manikin to catch the blood.

Slowly, after lots of trial and error, we managed to get the result we wanted and surprisingly at a low cost too. The whole model only cost $10 to make!

Ying Hong: After training with the uterus model, several faculty and participants came up to tell us that the simulation was very realistic and they learned a lot from it. They also praised the detail of the model, right down to the blood oozing out during the caesarean process. I definitely felt proud that all our hard work had paid off, and it’s an added bonus to know that no task trainer is able to replicate this effect at the moment!

​ ​Photos of the low-cost uterus model outside (left) and inside the manikin (right)


​Participants during an O&G simulation workshop, using the uterus model to practice emergency caeserean procedures

What do you enjoy most about your work?

Ying Hong: Every part of a simulation training is rewarding – from setting up for the scenario to getting feedback from the clinicians on their experience! I like that simulation allows me to think out of the box by creating realistic models for procedures that are required by the doctors.

Bi Xia: Occasionally, faculty may have new ideas and suggestions to enhance their simulation training, and our team will brainstorm on the best way to deliver what they envision. When I see participants immersed in the simulation exercise, it makes me happy that we are able to contribute positively to their learning.

Xin Yi: During training, we can be tasked to mimic rare clinical scenarios that are not often seen in real life. Simulation gives participants a chance to experience and practise responding to such scenarios, which will be a big help to their clinical work. Knowing that I can be a part of their training is what makes my work worthwhile!

In your opinion, what’s an important quality for someone working in simulation to have?

Ying Hong: For someone working in simulation, it’s important to be responsible and detail-oriented. For example, if we carelessly leave behind simulation equipment after training in the clinical area, it could result in an accidental misuse of these equipment on real patients. That is why we always have an equipment checklist that we cross-check before and after the training. After the simulation training, we also have to identify and point out unsafe or unethical behaviour. Although these may seem like small things, they can actually go a long way in helping our healthcare professionals care for our patients safely.

Bi Xia: Creativity is also a key quality for simulation technologists like us. Simulating medical scenarios may require us to create different models or situations with day-to-day items, which can be found at home or in homeware shops. This creativity doesn’t always come about easy, but it’s rewarding to be given that space at work to innovate!

Xin Yi: Most importantly, you need to be able to work well in a team. No matter who you are, the simulation technologists or the faculty, we have to step in to help one another when technical support is needed during unforeseen circumstances in a simulation training. Learning to work as a team and problem-solve unexpected situations together is always crucial to the success of a simulation training!


Read the latest simulation stories from SIMS here, and learn more about how simulation has helped healthcare professionals develop their competencies and confidence for better patient care!