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Ryan Ribeira of SimX Tells Us About Virtual Reality Healthcare Simulation during COVID-19 Times

kokou adzo



Tyler Andre SimX

First of all, how are you and your family doing in these COVID-19 times? 

Ryan Ribeira: Fortunately, we have all stayed healthy during all of this. Our 4th child was born in February, just before the COVID pandemic picked up in the US. It was kind of a scary time to have a newborn in the house, especially given my frequent contact with COVID patients, but we’ve made it through. In some ways, it has been nice that the whole family has had so much time at home to bond with the new baby.  

Tell us about you, your career, how you founded SimX.

Ryan Ribeira: I went into medicine, knowing that I would be involved in changing things on a systems level. I was a business management major in undergrad and did a Master’s degree in healthcare management. Prior to SimX, I worked for CMS, AHRQ, and the AMA, working on quality improvement, patient safety, and technology innovation initiatives. I see this as an extension of that work. In addition to my work at SimX, I am an assistant professor at Stanford Medical School, and I still do a handful of shifts each month in the emergency department at Stanford Hospital.

As for SimX’s origins, I came up with the idea when I was in a simulation lab at UC Davis in 2013. I was a medical student working with sim mannequins to practice my skills. It was hugely beneficial, but there were some obvious limitations. The mannequins couldn’t have strokes, rashes, or missing limbs. They were all 24-year-old white dudes, not reflective of real patient demographics. And working with them didn’t allow for any of the psychosocial complexity that is a huge part of actual medical practice. I was pretty familiar with evolving VR and AR technology at the time and thought, if there is a way to replace these sim mannequins with virtual patients, they would be so much more flexible and so much more realistic. So we assembled the team and started working. We knew that it was too early to release a product since you couldn’t even buy a VR headset yet. But we knew the opportunity to make Sim better was too big to pass up, and we wanted to be ready.

How does SimX innovate? 

Ryan Ribeira: SimX is based entirely on innovation. We innovated from the start by taking an established way of training and making changes to the ideas and methods behind it to create an entirely new and more realistic way to simulate medicine. Each new customer brings with them new ideas about how to use VR in their training and, because we customize cases to their needs, new opportunities for us to innovate around how to teach these principles with VR. And as we grow, we are constantly adapting, whether it’s figuring out how to work with each of the new major headsets that come out or trying to scale our processes from making 1 case a week to 10.  

How the coronavirus pandemic affects your business, and how are you coping?

Ryan Ribeira: The coronavirus pandemic has been challenging in many ways, but we have found ways to innovate and create solutions in today’s market. In the first weeks of the pandemic, we put together two free COVID-19 training cases that we distributed for free. Over 150 institutions downloaded and used the cases to train Doctors, nurses, and other personal on triage, PPE, and diagnosis for COVID. Simulation has traditionally been done in person, and that has been challenging with social distancing. But fortunately, our product has built-in multiplayer capabilities that have allowed students to sim from home. But it’s still a huge challenge for us to find ways to support our customers during these challenging times.

Did you have to make difficult choices, and what are the lessons learned?

Ryan Ribeira: The pandemic hit shortly after we leased new office space and expanded our team of developers. Given the situation, we had to order a work-from-home mandate, and we continue to have our team work remotely. We miss the camaraderie of working together in a close-knit community, but we have found ways to improve our processes and are actually working at a more efficient pace. We also had to make the difficult decision of shutting down all sales travel to conferences and personal demonstrations. Once again, however, our business development and sales team has found ways to adjust and adapt, and we are on pace for a record sales year in the company. 

How do you deal with stress and anxiety? How do you project yourself and SimX in the future?

Ryan Ribeira: As a practicing emergency medicine physician, I’ve had to learn some serious stress management techniques. In both emergency medicine and startups, it’s all about cutting through the noise to what is most important and making sure you aren’t expending mental energy on distractors or other things that aren’t core to what you are trying to accomplish.

On a more practical note, I also do practice meditation and have for some time. I’m not always perfect at it, but I do try to sit for at least a little time each day, and the skills I’ve built through that consistent practice have been tremendously helpful. 

As for where we’re going in the future, with virtual reality becoming more mainstream in the educational space, I see SimX growing rapidly in the next few years. Our customer base has been tripling each year, and we expect that to continue.  

Who are your competitors? And how do you plan to stay in the game?

Ryan Ribeira: There are a few other companies out there doing similar things. Companies like Acadicus, Oxford Medical Simulation, UbiSim, and others. We have good relationships with all of them, and I think the differences in approach that we each take to addressing this problem mean there are opportunities for our platforms to coexist. VR sim will not be a niche; it will be the primary way that simulation is performed in the healthcare industry within 5 years. That being the case, there is a lot of space for different products and approaches. And at this stage, where the primary limitation to adoption is lack of access to hardware and lack of familiarity with the tech when institutions adopt any VR sim, it is a tide that raises all boats. SimX was the first in this space, having patented our core technology in 2013, and we are always trying to push forward new features. Not necessarily in a way guided by the competition, but in a way guided by our customers. We’re looking forward to seeing what the industry becomes in the coming years.  

Your final thoughts?

Ryan Ribeira: Virtual Reality simulation is all about taking the important life-saving training methodology of simulation and making it cheaper, easier, and more realistic. And I think everyone in healthcare sim has known it is the future of simulation for decades. While COVID has brought with it many challenges, it has certainly expedited the adoption of important distance learning technologies that will likely persist for years to come. And as hospitals, medical schools, nursing schools, and others start looking more and more for solutions that will let them continue to provide simulation training experiences remotely, SimX will continue to find new ways to make VR simulation cheaper, easier, and more realistic.

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Kokou Adzo is the editor and author of He is passionate about business and tech, and brings you the latest Startup news and information. He graduated from university of Siena (Italy) and Rennes (France) in Communications and Political Science with a Master's Degree. He manages the editorial operations at

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