Research and Development to improve Recruitment and Retention in Rural Emergency Medicine Using Mobile Simulation

Nationwide, Emergency Medical Services (EMS) plays a crucial health care role in the well-being of rural populations. There are substantial challenges within the rural EMS system including: high costs for providing EMS care to sparsely populated regions; fewer tax dollars to fund health programs and trouble with providing public services. In addition, rural regions have difficulties with increasing health care demands from aging residents, poor access to training and medical supervision, volunteer shortages, high response times and lower levels of training. There are many barriers to providing high quality training in rural areas. Rural EMS providers often have to travel long distances to receive training. Conferences, workshops, and specialty trainings tend to happen in urban centers, forcing rural personnel to take time away from their primary jobs and family, not to mention leaving their home community vulnerable in their absence. Widely used in aviation and the military simulation has shown promising results in healthcare. Medical simulation is an emerging training and feedback method in which learners practice tasks and processes in lifelike circumstances, at their own locations, using models or virtual reality, with feedback from observers, peers,and video cameras to assist improvement in skills. But for all its demonstrated potential in improving performance a number of barriers exist to the more widespread dissemination of simulation technology in health care including: 1. cost of simulators and related equipment 2. staff training in simulation technology and methodologies 3. resistance to change in training methods among faculty. It is recognized that the quality of simulation facilitators is one of the most valuable factors for successful simulation training. The primary objective of our Phase 1 project was to research and develop a feasible training approach and tools to make it possible to deliver, manage and measure the effectiveness of advanced medical simulation training for EMS in rural areas. Our results suggest that mobile simulation can be an effective means of improving EMS team and technical skills training in rural agencies. Our goals for our Phase II effort will be to demonstrate a medical simulation training capability that has a positive impact on recruitment and retention of Rural EMS providers and that can be deployed in various operational environments on a commercial scale. Our testbed region for the study will be a 9 county region in Upstate NY. The emphasis during Phase II will be on longer-term impacts. The following additional benefits are anticipated from the Phase II effort:1. Achieve turnover cost savings in rural EMS, 2.Improve patient quality and safety measures in Rural New York, 3.Improve teamwork and communication skills of trainees, 4.Advance the state-of-the-art in health care simulation technology. Mobile simulation training has the potential to decrease the overall cost of providing medical services in remote areas by decreasing the high costs associated with turnover and make scarce health care dollars go further.