By Debbie Fillmore, ME, BSN, CST


One of the reasons I left the operating room behind for a teaching career was because everything became too technical. I was spending more time figuring out why the image on the monitor was unclear than I was caring for my patients. When I went back to school, I found myself smack dab in the middle of classes learning about distance learning and wondering about its application in surgical technology education.

Montana is a western state defined by its varied terrain from the Rocky Mountains to the West and the plains to the East. Nicknamed Big Sky Country, it is ranked fourth in size but 44 in population. In such a vast state, it can be challenging to deliver quality distance learning for surgical technology education. For a program to expand its educational offerings, the cities chosen for expansion would need to have a large enough health care facility to meet student needs and an educational institution to offer general education requirements.

St. James Healthcare in Butte, Montana — a city 120 miles from our campus in Missoula — contacted me asking for help in starting a program. They were having difficulty attracting qualified surgical technologists and were using travelers, which was costly to them. My idea was to extend the AAS degree program using web-based delivery in conjunction with face-to-face instruction.

I was about to delve into the world of online learning. As I began this quest, there were some basic principles that could not be compromised:

  1. The standards and recommended practices of ARC/STSA and AORN would always be followed.
  2. All students, regardless of campus, would have the same learning opportunities.
  3. Exams would be in a proctored setting, not online.
  4. Labs and clinicals at the site would be taught by a graduate of the program.
  5. Even though the program was at a distance, we would visit each semester.

I began the process by looking at the ARC/STSA Standards to see what was said about online learning and this type of collaboration. I ran across words and concepts like satellite, consortium, branch, outreach and extended degree — needless to say, I was really confused!  What was this idea of mine going to turn into?

The next order of business was to consult the state’s higher education governing body. Montana has the Montana University System (MUS), which is governed by a seven-member Board of Regents (BOR). In addition to notifying ARC/STSA, the BOR must receive a Notice of Intent with further documentation.

After taking care of these preliminary requirements, it was time to gather the players, beginning with the affiliate to determine its needs and what they will be able to offer. Do they have adequate space for a lab? How many students are they willing to serve? Will students be able to meet the required minimum number of scrubbed cases?

I learned it was important to visit with the educational facility, which must be an accredited university or community college. Just because the schools are in the same state does not mean they offer the same general education courses. If they do not, will their courses be transferrable to your facility?

I also learned very early on that it is imperative to have supportive administrators who can appreciate your vision and innovative program faculty. After all, in addition to the typical teaching load, online classes will add to their responsibilities. Those who think online courses consume less time than face-to-face classes have never taught them.

Once the players were determined, a memorandum of understanding was created to define responsibilities of each party in the collaboration. (This is not the same as an affiliate agreement.)

Advising and the assessment of student readiness also proved to be a crucial consideration. Even though we are living in a world of social media and technology, do not assume everyone is comfortable with online classes. It is very important to make the students feel as though they are a real part of your campus community even though they are miles away. To that end, we hired a graduate of the program to function as a site coordinator to provide the connectedness to the home campus.

We began our outreach program in 2002 with the Butte campus. In 2003 we added a second campus in Billings and are preparing to add a third site. Our accreditation site visitors refer to our outreach efforts as the Montana Model.

Students are required to come to the Missoula campus once at the end of the program. They take the certification exam together on one day and walk in commencement ceremonies the next. In May 2016, we graduated 20 students with 95 percent having job offers before graduation. We recently learned that we had a 100 percent pass rate on the exam.

If this type of collaboration is a dream of yours, it can be done and will thrive just as our Montana Model has for the last 14 years.

FillmoreDebbie Fillmore has been the program director at Missoula College of the University of Montana since 2001. She began her teaching career in the nursing program and a few years later moved to surgical technology. The Outreach Consortium began in 2002. She is happy to assist any program director with the details of starting such a collaboration. She can be contacted via email at