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University of North Dakota Simulation Program Administrator Jessi Nicola and Simulation Education Specialist Andrew Lundstrom pose for a photo on Dec. 3 outside a medical bus in Fargo. Image: Andrew Weeks/Prairie Business

Around the Office and on the Road in North Dakota 

A simulation-in-motion program brings synergy to medical professionals across the state

This month’s Around the Office has a unique twist. We’re taking you on the road, so to speak, with a medical bus that is part of a statewide mobile education program. 

Called SIM-ND -- for Simulation in Motion-North Dakota -- the program has four buses that provide onsite training to critical access hospitals, EMS agencies, and other medical providers across the state. The bus can serve as both an ambulance and mobile hospital and is equipped with medical equipment, computers, and high-fidelity computerized manikins “that talk, breathe, have heartbeats, and can react to medications and other actions of the learners,” said Jessi Nicola, program administrator at the University of North Dakota. The university partners with hospitals to make the bus a unique experience in North Dakota. 

“Our mission is to improve patient care by the educational enrichment of rural and frontier healthcare providers,” she said. “Our vision is to enhance, support, promote, and facilitate healthcare education through the use of simulation.”

In early December, Nicola, Simulation Education Specialist Andrew Lundstrom, and Tom Tomaino, one of the program’s drivers, were at a safety and health conference in Fargo, where they gave Prairie Business a tour of one of the buses. 

Nicola, who is based in Fargo, answered additional questions for Prairie Business about the program: 

How long has this program been around and how did it start?

SIM-ND came into existence in August 2012, when the University of North Dakota’s School of Medicine and Health Sciences was awarded a grant from the Leona M. and Harry B. Helmsley Foundation for the purpose of creating a statewide resource that could be used to bring healthcare education to rural EMS agencies and emergency departments. Before we could begin offering education, our trucks had to be built and outfitted with all of the equipment that you can find in an ambulance or emergency department. We also needed to develop our educational offerings and train our educators. All of this took almost a year and we began offering training in June 2013.

How many medical buses are there in the program and where are they located?

We have four identical trucks located throughout the state that cover each of the regions. The truck in Grand Forks covers mainly the northeast and is operated by Altru Health System staff. The truck in Fargo covers the southeast region and is operated by both the Essentia and Sanford staff. The truck in Minot covers the northwest region and is operated by Trinity Health Staff. The truck in Bismarck covers the southwest region and is operated by CHI St. Alexius Staff. For larger events our trucks and staff will help out each of the regions. SIM leadership at UND oversees and manages the operations

Who are all the partners and players of the program?

This program is a partnership between Altru Health System, CHI St. Alexius Health, Essentia Health, Sanford-Fargo, Trinity Health, the ND Department of Health, and the leadership of the UND School of Medicine & Health Sciences Simulation Center. Each of the hospitals has a coordinator and staff who teach and facilitate the events. 

In what ways does the synergy between the partners help the program accomplish its mission? 

This program is unique in that the five hospitals throughout the state would be considered a competitor in the business world, yet they have come together to support and  provide education to our rural areas within the state. I believe and have heard that each of the hospitals share the same vision with this program to help educate staff in hopes to provide better outcomes for patients who need care.

How is the medical bus program funded?

This program was originally funded by the Leona M. and Harry B. Helmsley Charitable Trust, along with the University of North Dakota School of Medicine and Health Sciences, and the North Dakota Department of Health. This grant provided funding for the purchase of the four trucks, including supplies and manikins, the development of the educational curriculum, and operating expenses for the first three years. The program is currently funded through financial and in-kind contributions from each of the five partner hospitals, the University, and the Department of Health.

How long have you been with the program and what is your role? 

I’m the Program Administrator for the Simulation Center and the Program Director for SIM-ND. I oversee all of the operations, which includes financial, marketing, scheduling, human resources, and instructional delivery methods. I have only been with this program since the end of August. I have a background in healthcare, previously working as a Radiology Manager at Altru Health System.

The bus serves as an office, tech center, ambulance and hospital, is that right? What is the bus equipped with? Tell us about some of its unique features? 

The truck is 44 feet long by 8 feet wide and about 13 feet tall. It is equipped with slide outs that allow for the truck to expand and provide more space. The front of the truck is set up as an emergency room and the back of the truck is set up as an ambulance. This allows for training to occur simultaneously or to simulate care in different spaces. The set up of this truck will also allow for training to occur from the ambulance to the ER trauma room, by moving the manikin from one side of the truck to the other. Between the two spaces is a control room that allows for controlling audio and visual operations. A facilitator can control the patient within the control room. This includes things like voice control, the manikins blood pressure, and heart rate.

How many people staff the bus when on assignment or medical call? 

Staffing is dependent upon the number of learners and types of scenarios. Each of the five hospitals has a coordinator who coordinates the learning requests and staffs each event according to needs.

How often is the bus used? 

This is used mainly for rural outreach education. It is much harder for rural areas to send staff for training, and cost for training and continuing education can be expensive. This allows us to come and train onsite and sometimes within the environment of their work. The hope is to make the training feel as real as possible. One of the benefits that our partner hospitals receive is that they are able to use the equipment internally when it is not scheduled elsewhere. This saves them the costs of purchasing the simulation equipment, developing or purchasing the educational curriculum and training educators. … We have conducted over 300 training events for 4,200 learners in 2019.

What is the future of the program? 

Currently our four trucks have been able to manage the workload throughout the state. I see a future of growth with this program as we continue to expand our service requests and needs. I see opportunities to partner with other non-medical facilities. We have worked with military bases, nursing homes, and industrial businesses. I see lots of opportunity to grow.

What is your favorite thing about the program? 

My favorite thing about this program is that we are helping to improve patient care and outcomes. My teams are passionate about what they do and provide high quality education to the learners throughout the state.