New pedagogical methods delivered through mobile mixed reality (via a user-supplied mobile phone incorporating 3d printing and augmented reality) are becoming possible in distance education, shifting pedagogy from 2D images, words and videos to interactive simulations and immersive mobile skill training environments. This paper presents insights from the implementation and testing of a mobile mixed reality intervention in an Australian distance paramedic science classroom. The context of this mobile simulation study is skills acquisition in airways management focusing on direct laryngoscopy with foreign body removal. The intervention aims to assist distance education learners in practicing skills prior to attending mandatory residential schools and helps build a baseline equality between those students that study face to face and those at a distance. Outcomes from the pilot study showed improvements in several key performance indicators in the distance learners, but also demonstrated problems to overcome in the pedagogical method.