Northern Maine Community College (NMCC) has secured a one million dollar grant that will allow them to renovate an existing 5000 sq. ft. lab space into a new simulation-based training lab for EMS students. The new simulation lab will provide students with simulated environments to experience real-life prehospital emergency events and practice life-saving procedures on simulated patients. Thus, students will acquire and hone essential clinical skills before they encounter actual patients, ensuring they can provide safe and effective care once they enter the workforce, ultimately improving the quality of rural healthcare in Maine.
The Rural Healthcare Crisis in Maine
Rural hospitals across the United States have struggled financially for several years, with over 130 rural hospital closures in the past decade. Since 2010, three of the over 20 hospitals in rural Maine have closed, forcing people to drive farther to get medical care or delay it altogether. Without easy access to healthcare, rural populations often experience lower health outcomes.
Furthermore, EMS often become the only access to health services for rural communities, putting additional pressure on these providers to deliver high-quality care. However, a nationwide shortage of paramedics, lack of reimbursements, and a shortage of Essential Emergency Medications (EEM) have negatively impacted EMS providers’ ability to deliver safe and effective care.
According to NMCC President Timothy Crowley, “healthcare in rural areas of Maine is at a precipice. Due to limited [financial and human] resources, many healthcare facilities find themselves having to make tough decisions regarding types of services and care to be provided. Emergency care has already reached that level of concern.”
Thus, one of the new EMS simulation lab goals is to help increase enrollment in the college’s EMS technician and paramedic programs and improve rural healthcare in Maine.
Improving Emergency Care Training with Simulation
The new EMS simulation lab will be equipped with various clinical tools, equipment, and high-fidelity patient simulators, including Gaumard’s Trauma HAL, which can simulate a wide range of health issues and injuries commonly treated by EMS professionals. Simulation sessions will also take place in a real ambulance. So, students can get used to working in this space and practice patient transport skills.
The point of this is to immerse students into the simulation and accurately reproduce various patient encounters so students can develop and practice cognitive, motor, and critical thinking skills. Since Trauma HAL can bleed, show physical symptoms, and produce vital signs that respond to the provider’s intervention, students can experience stressful and high-risk scenarios. Thus, simulation also allows them to develop coping skills and become used to the pace of providing care during emergency events.
Working hands-on in these high-stress environments allows students to engage in experiential learning. Students are encouraged to reflect on and learn from their actions, improving upon their past performance. Considering the increasing complexity of providing emergency care in rural areas of Maine, students will need training on various skills and producers.
Therefore, Trauma HAL’s advanced features will allow NMCC students to practice a broader range of medical procedures and experience more pathologies and patient populations. In the simulated events, students will practice actual medical techniques. An educator will supervise the students and provide feedback on their performance following the simulated event.
During these debriefing sessions, students can reflect on their performance and learn how to improve. Then, they can repeat the event or procedure as many times as needed until they master the skills required to provide safe and effective care.
Furthermore, the new simulation lab will allow EMS students to get repeated practice on low-frequency, high-risk procedures. Since knowledge and skills can deteriorate within a few months, training programs need to provide their students with as many training opportunities as possible. This allows EMS providers to maintain proficiency so they can respond accurately to any emergency event, no matter how rare.
Expanding Access to Training in Rural Maine
NMCC plans to use the new simulation lab as a regional training center for Aroostook County, where the college is located, as part of their continued support of the healthcare workforce in the county. NMCC has partnered with Houlton Regional Hospital and Northern Light AR Gould Hospital to provide training for their clinicians and staff at the simulation lab.
Dr. Peter Goth, critical care and transport medicine advisor for the new simulation lab, believes that NMCC can centralize training in the county and remove barriers to training. For example, many medical and nursing students struggle to complete clinical training hours due to a shortage of training sites. The simulation lab will provide invaluable hands-on clinical experiences, so these students gain the comfort and proficiency needed to provide effective patient care.
Additionally, clinicians, hospital staff, and EMS providers in the county will use the simulation lab to maintain procedural and clinical skills used throughout their professional careers. Thus, the new sim lab will ensure healthcare providers in the county have a space to maintain a high level of competency and confidence in these skills, especially for those infrequently used procedures. As such, patients will receive high-quality care starting in the prehospital environment and throughout their stay in the emergency department.
 Ross, Ally. “Maine’s rural hospitals in crisis, now asking lawmakers for more relief.” Portland Press Herald, https://www.wmtw.com/article/maines-rural-hospitals-in-crisis-now-asking-lawmakers-for-more-relief/35525782. Accessed 5 June 2021.
 EMS Services in Rural America: Challenges and Opportunities. National Rural Health Association, May 2018, https://www.ruralhealthweb.org/NRHA/media/Emerge_NRHA/Advocacy/Policy%20documents/2019-NRHA-Policy-Document-EMS-Services-in-Rural-America-Challenges-and-Opportunities.pdf. Accessed 8 June 2021.
 “Top 3 Challenges EMS Workers are Facing.” Medline, 11 Nov. 2019, https://newsroom.medline.com/caregiver-readiness/top-3-challenges-ems-workers-are-facing.