Mobile simulation lab trains first responders following closures of Missouri rural hospitals

FULTON, Mo. – In the past eight years, 15 hospitals have closed in Missouri, most of them in rural areas.

According to the Missouri Hospital Association, 10 rural hospitals have closed since 2014, most of them due to staff shortages or economic challenges. Now a 38-foot RV travels to Missouri with state-of-the-art equipment and simulations to train first responders.

You won’t find another like it in Missouri, a one-of-a-kind mobile training facility with life-like patient simulators.

“It’s a two-room facility, so it gives us the opportunity to have two different rooms and two different types of patients at the same time,” said Dena Higbee, director of simulation at the University of Missouri School of Medicine. “She [trainees] can experience anywhere between babies, pediatrics, adult care or even birth simulation.

Higbee said that the idea for the new $400,000 training lab on wheels started in 2010, when the school used a 2002 30-foot RV to help train first responders, health care providers, critical access hospitals, firefighters and EMTs. The training exercises include cardiac arrest, trauma and obstetric deliveries.

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“We’re at the point now where we’re able to expand to have more simulators available,” Higbee said. “We have a greater need in the rural community because of staff shortages. If they [trainees] comes and sees that her [simulators] actually blink, that it can respond, follow you and that their chest actually rises, and their vital signs respond, that’s where the aha moment happens.

The brand new customized RV travels across rural Missouri to provide hands-on simulations, training first responders and healthcare providers. During its inaugural stop south of Fulton in Callaway County, EMTs were tested on how to respond to an infant and a five-year-old in distress.

“I want to go home,” said the five-year-old simulator while crying. “Don’t touch me.”

“When you come to a rural facility like this, it might be the first time they’ve ever interacted with a simulator,” Higbee said. “Or they’ve seen what compressions really do to a patient, or that they actually have a really good seal and the patient gets the oxygen flow that he or she needs.”

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The scenarios are controlled by an operator behind the wall in the control room, who operates the vital signs, the conversation and the noise of the simulator and gives the first responders information about the call.

“There are two cameras in the ceiling and there is a microphone where we can record the scenarios and then we can play the video for the debrief afterwards,” Higbee said. “Being able to take this type of equipment that’s more high-tech and actually requires direct response to take care of the patient, it just enhances the type of training that they[the trainees]have had in the past.”

The patient’s vitals are displayed on a monitor in a room, allowing trainees to see how the simulator is responding to their care.

“They have a heart sound, lung sounds, vital signs and that can all be changed,” Higbee said. “You can do cardiac arrest with them, you can do compressions, ventilation and you can put them on an oxygen mask.”

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With the state of rural hospitals across the state, Higbee said this training is more important than ever.

“People are having to expand their scope of practice that they’ve had over the years because the smaller hospitals are closing,” Higbee said. “Your first responders, whether it’s a community hospital or whether it’s your EMTs, they’re really your first line of defense of better patient care.”

Over the next six months, with the help of a federal Health Resources and Services Administration (HRSA) grant, the Mobile Simulation Center will travel across the state to provide 20 free trainings. During these trainings, Higbee said the goal is to train 30 first responders or health care providers per day.

“I’ve been doing simulation for about 29 years, and I always get excited when I’m on the road doing these rural trainings because you get that moment to see people who aren’t used to simulators,” Higbee said. .

She said the university hopes to get more funding next summer to continue with the free trainings.


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